How will we govern super-powerful AI?
The AI constitution can mean the difference between war and peace—or total extinction.
- The question of conscious artificial intelligence dominating future humanity is not the most pressing issue we face today, says Allan Dafoe of the Center for the Governance of AI at Oxford's Future of Humanity Institute. Dafoe argues that AI's power to generate wealth should make good governance our primary concern.
- With thoughtful systems and policies in place, humanity can unlock the full potential of AI with minimal negative consequences. Drafting an AI constitution will also provide the opportunity to learn from the mistakes of past structures to avoid future conflicts.
- Building a framework for governance will require us to get past sectarian differences and interests so that society as a whole can benefit from AI in ways that do the most good and the least harm.
What is the purpose of universities?
For centuries, universities have advanced humanity toward truth. Professor Jonathan Haidt speaks to why college campuses are suddenly heading in the opposite direction.
- In a lecture at UCCS, NYU professor Jonathan Haidt considers the 'telos' or purpose of universities: To discover truth.
- Universities that prioritize the emotional comfort of students over the pursuit of truth fail to deliver on that purpose, at a great societal cost.
- To make that point, Haidt quotes CNN contributor Van Jones: "I don't want you to be safe ideologically. I don't want you to be safe emotionally. I want you to be strong—that's different."
CNN contributor Van Jones speaks onstage at the EMA IMPACT Summit in 2018.
Credit: Michael Kovac/Getty Images for Environmental Media Association
<p>There are many places and institutions whose purpose, or <em>telos</em>, is comfort. But a university is not one of those places. To make that point, Haidt quotes CNN contributor Van Jones:</p><p style="margin-left: 20px;">I don't want you to be safe ideologically. I don't want you to be safe emotionally. I want you to be strong—that's different. I'm not going to pave the jungle for you. Put on some boots and learn how to deal with adversity. I'm not going to take all the weights out of the gym. That's the whole point of the gym. <em>This</em> is the gym.</p><p>By prioritizing comfort over the pursuit of truth, universities are ignoring their purpose. Higher education should be an arena of open inquiry and free expression, where ideas are exchanged, tested, and scrutinized. A liberal education should be "an invitation to be concerned not with the employment of what is familiar but with understanding what is not yet understood," <a href="https://books.google.com/books?id=Jpu7BAAAQBAJ&pg=PT286&lpg=PT286&dq=%22an+invitation+to+be+concerned+not+with+the+employment+of+what+is+familiar+but+with+understanding+what+is+not+yet+understood.%E2%80%9D&source=bl&ots=bmqaS1BxSm&sig=ACfU3U0aOokPZOGJlLFUVO9-a8VBV50tCw&hl=en&sa=X&ved=2ahUKEwi_u-jd1_btAhWqzVkKHSdKBMsQ6AEwAnoECAEQAg#v=onepage&q=%22an%20invitation%20to%20be%20concerned%20not%20with%20the%20employment%20of%20what%20is%20familiar%20but%20with%20understanding%20what%20is%20not%20yet%20understood.%E2%80%9D&f=false" target="_blank">according</a> to philosopher Michael Oakeshott.</p>You might also like:
<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="d1a3bbdeaba1ed201e5892b6a2ccbfb5"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/IoXpNJLFngc?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span>The social determinants of health, explained
Want to tell someone's future in the US? You don't need a crystal ball, just their zip code.
- Social determinants of health, such as income and access to healthy food, affect well-being long before people may enter medical facilities.
- They're one reason neighborhoods in the same city can maintain life expectancy gaps larger than a decade.
- With growing awareness of how societal ills determine health, medical professionals and their partners are devising more holistic approaches to health.
Just 15 miles from Brownsville, Brooklyn, residents of the Upper East Side in Manhattan have an average life expectancy of 86.4 years.
Source: NYC DOHMH; Bureau of Vital Statistics, 2006-2015
<p>Such life-expectancy gaps are common across the United States.<a href="https://www.chicagotribune.com/business/ct-biz-chicago-has-largest-life-expectancy-gap-between-neighborhoods-20190605-story.html" target="_blank"> </a><a href="https://www.chicagotribune.com/business/ct-biz-chicago-has-largest-life-expectancy-gap-between-neighborhoods-20190605-story.html" target="_blank" rel="noopener noreferrer">Residents of Chicago's Streeterville</a> neighborhood can rest easy knowing they will live to be, on average, 90 years old. Chicago's Englewood neighborhood, however, maintains a life expectancy of around 60 years. That's ten years lower than<a href="https://data.worldbank.org/indicator/SP.DYN.LE00.IN?order=wbapi_data_value_2012+wbapi_data_value&sort=asc" target="_blank"> </a><a href="https://data.worldbank.org/indicator/SP.DYN.LE00.IN?order=wbapi_data_value_2012+wbapi_data_value&sort=asc" target="_blank" rel="noopener noreferrer">the world average</a>—in the world's most affluent country. The phenomenon is not just an urban affliction. On the whole, rural community members have lower life expectancies as<a href="https://www.cdc.gov/media/releases/2017/p0112-rural-death-risk.html" target="_blank"> </a>they become more likely to die from <a href="https://www.cdc.gov/media/releases/2017/p0112-rural-death-risk.html" target="_blank">these five leading causes</a> than their city-dwelling peers.</p><p>While it may be tempting to write off these life gaps as the result of lifestyle choices or bad luck, they aren't. They are the consequences of a complex intersection between social, environmental, and cultural conditions that fall under 'social determinants of health.'</p>The 80/20 rule of health
<p>Social determinants of health are those conditions in a person's life and environment that can either aid or degrade their health. They include employment, education, food availability, living conditions, communal support, neighborhood quality, socioeconomic status, and the wider systems that surround these conditions. When such determinants aren't wholesome, they erode health long before someone enters a hospital—at which point, health professionals may have only minutes to turn the tide of years of eroded health.</p><p>As Udai Tambar, vice president for community health at Northwell Health, said, "You can't medicate for social issues, and that's, in a way, the system we have developed. We're trying to medicate for social risks and social factors. <a target="_blank"></a>You can have the best treatments, the best physicians, the best facilities, but unless a patient's non-clinical needs are addressed, none of it will make a difference."<a href="#_msocom_1" target="_blank" rel="noopener noreferrer"></a></p><p>Today, experts generally agree that 20 percent of health outcomes are derived from the care received at medical facilities, 80 percent from the non-clinical care attributed to one's lifestyle, environment, and social circumstances.</p><p>The data bear this out.<a href="https://www.brookings.edu/research/a-dozen-facts-about-the-economics-of-the-u-s-health-care-system/#:~:text=The%20combination%20of%20long%2Dterm,7%20percent%20of%20total%20spending." target="_blank" rel="noopener noreferrer"> </a><a href="https://www.brookings.edu/research/a-dozen-facts-about-the-economics-of-the-u-s-health-care-system/#:~:text=The%20combination%20of%20long%2Dterm,7%20percent%20of%20total%20spending." target="_blank" rel="noopener noreferrer">U.S. health-care spending</a> has nearly quadrupled since 1980, and the country has invested that bankroll heavily in hospitals, nursing facilities, prescription drug development, and medical specialist training. Each is valuable in its own right, yet as a systematic whole, this massive, decades-long investment has not netted proportionate health dividends. In addition to country-wide life gaps, the U.S. has one of the lowest life expectancies, the highest suicide rate, the highest chronic disease burden, and the highest obesity rate when<a href="https://www.commonwealthfund.org/publications/issue-briefs/2020/jan/us-health-care-global-perspective-2019" target="_blank" rel="noopener noreferrer"> </a><a href="https://www.commonwealthfund.org/publications/issue-briefs/2020/jan/us-health-care-global-perspective-2019" target="_blank" rel="noopener noreferrer">compared to other major OECD nations</a>.</p><p>These other OECD countries don't spend more on health than the United States. In terms of absolute dollars, the<a href="https://data.oecd.org/healthres/health-spending.htm" target="_blank" rel="noopener noreferrer"> </a><a href="https://data.oecd.org/healthres/health-spending.htm" target="_blank" rel="noopener noreferrer">U.S. handily outspends these countries</a>. Instead, these countries spend<a href="https://www.commonwealthfund.org/sites/default/files/2018-12/Multinational%20Comparisons%20of%20Health%20Systems%20Data%202018_RTikkanen_final.pdf" target="_blank" rel="noopener noreferrer"> </a><a href="https://www.commonwealthfund.org/sites/default/files/2018-12/Multinational%20Comparisons%20of%20Health%20Systems%20Data%202018_RTikkanen_final.pdf" target="_blank" rel="noopener noreferrer">a larger portion of their GDP</a> on social services, helping to mitigate deleterious social determinants long before a hospital visit. By<a href="https://www.brookings.edu/opinions/social-spending-not-medical-spending-is-key-to-health/" target="_blank" rel="noopener noreferrer"> </a><a href="https://www.brookings.edu/opinions/social-spending-not-medical-spending-is-key-to-health/" target="_blank" rel="noopener noreferrer">one estimate</a>, other major OECD countries allot, on average, $1.70 for social spending for every dollar on health. The U.S. system is almost the inverse, spending .56 cents on social services for every dollar on health.</p><p>"You need social equity to get health equity," Tambar added.</p>There’s no pill to cure poverty
<p>This pattern of spending is one reason for the U.S. health-wealth divide, a pernicious and destructive social determinant of health. We've seen this divide's handiwork in the life expectancy differences between the Upper East Side and Brownsville, but those are samples of a whole.<a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30398-7/fulltext" target="_blank" rel="noopener noreferrer"> </a><a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30398-7/fulltext" target="_blank" rel="noopener noreferrer">According to a 2017 paper in </a><a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30398-7/fulltext" target="_blank" rel="noopener noreferrer"><em>The</em></a><a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30398-7/fulltext" target="_blank" rel="noopener noreferrer"> </a><a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30398-7/fulltext" target="_blank" rel="noopener noreferrer"><em>Lancet</em></a>, the "life expectancy of the wealthiest Americans now exceeds that of the poorest by 10-15 years." And these life-gap metrics signal the end consequences of a myriad of unmet social needs.</p><p><a target="_blank" rel="noopener noreferrer"></a><a target="_blank" rel="noopener noreferrer"></a><a target="_blank" rel="noopener noreferrer"></a>Consider the health barriers common in impoverished areas, where residents lack access to healthy, affordable food. Limited funds make it impossible to update or maintain safe housing without mold or lead-contaminated<a href="https://www.epa.gov/lead/protect-your-family-sources-lead" target="_blank" rel="noopener noreferrer"> </a><a href="https://www.epa.gov/lead/protect-your-family-sources-lead" target="_blank" rel="noopener noreferrer">paint</a> or<a href="https://www.cdc.gov/nceh/lead/prevention/sources/water.htm#:~:text=The%20most%20common%20sources%20of,1986%20may%20also%20contain%20lead." target="_blank" rel="noopener noreferrer"> </a><a href="https://www.cdc.gov/nceh/lead/prevention/sources/water.htm#:~:text=The%20most%20common%20sources%20of,1986%20may%20also%20contain%20lead." target="_blank" rel="noopener noreferrer">water pipes</a>. Narrow or nonexistent transportation options cut off residents from employment opportunities or health-care access. And being surrounded by street crime, unsafe public spaces or no greenways generates sustained high stress, which <a href="https://www.scientificamerican.com/index.cfm/_api/render/file/?method=inline&fileID=123ECD96-EF81-46F6-983D2AE9A45FA354" target="_blank" rel="noopener noreferrer">research shows</a> grinds away at our physical health as fiercely as it does our mental wellbeing.<a href="#_msocom_1" target="_blank" rel="noopener noreferrer"></a></p><p>Each of these conditions is bitter in and of itself, but these social determinants often come packaged as part of a social circuit that magnifies the effects of each.</p><p>Unfortunately, dietary fads and the U.S.'s rugged individualism have loudly espoused health to be the culmination of lifestyle choices (for some, even moral rectitude). While lifestyle and choice certainly have their role, an understanding of these social determinants shows how inextricably tied our choices are to our social conditions. As Tambar points out, a person can be well-versed in nutrition, but if their neighborhood is a food desert, their choices are constrained. Social circumstances can limit or adversely influence health in inimical ways.</p><p>As Dr. Mary Travis Bassett, Director of the FXB Center for Health and Human Rights at Harvard University,<a href="https://bigthink.com/videos/mary-bassett-on-new-york-city-health-disparities" target="_self"> </a><a href="https://bigthink.com/videos/mary-bassett-on-new-york-city-health-disparities" target="_self">told </a><a href="https://bigthink.com/videos/mary-bassett-on-new-york-city-health-disparities" target="_self"><em>Big Think</em></a>: "Nobody picks a substandard building to live in with terrible issues of rodent infestation and indoor allergens that trigger asthma. That's not a lifestyle choice. […] It's not about choice; it's about the fact that people don't have enough choice."</p>Going to the source
<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTIyNDM0Ni9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYzMTMwNTc3MH0.m2s2NNhfZz8Aca8H9IL3PK_B5ecVNurz82PuF8s88Js/img.jpg?width=980" id="87250" class="rm-shortcode" data-rm-shortcode-id="b2ca94d906942d55c11a83821ad79632" data-rm-shortcode-name="rebelmouse-image" data-width="6720" data-height="4480" />Credit: Getty Images
<p>Negative social determinants of health provide a massive challenge to the health-care community, but experts and medical professionals aren't powerless to meet it. As Michael Dowling, CEO of Northwell Health, writes in his book <a href="https://healthcare-reboot.com/" target="_blank">"Health Care Reboot"</a>:</p><p style="margin-left: 20px;">This trend toward greater awareness of the social determinants of health is one of the most encouraging developments in health care, for it creates greater awareness among providers of the whole patient, including all of the various elements—most of them outside what might be considered strictly medical issues—that affect an individual's overall health and wellbeing.</p><p>An outgrowth of this growing trend goes by the name "<a href="https://bigthink.com/Northwell-Health/health-care-2634148633" target="_self">upstreamism</a>." Upstreamist practitioners don't only focus on the patient's downstream symptoms; instead, they also turn their attention upstream to incorporate the patient's social determinants of health in their diagnosis. Dowling illustrates this paradigm with an example of a patient with chronic, life-interrupting headaches. Her upstreamist doctor provided her the usual medication but added the unusual prescription of a visit by a community health worker. The health worker found the patient's apartment walls to be infested with high levels of mold. The doctor and health worker told the patient to have her landlord fix the problem and provided the number for a public-interest attorney should the landlord fail to comply.</p><p>Dowling's story shows the holistic approach of upstreamism: to take into account all the determinants of health, not only those found within hospital walls. Sometimes, Dowling notes, that will require medical professionals to take the lead. But other times, when there are extra-symptomatic drivers of health, it will mean <a href="https://www.northwell.edu/news/insights/faith-based-leaders-are-the-key-to-improving-community-health" target="_blank">partnering with</a> or supporting social service workers, law enforcement, or legal minds to secure a combination of services to heal the whole person.</p><p>It's for these reasons that many health-care organizations are spearheading initiatives and outreach programs to directly target social determinants of health <em>before </em>they become medical issues. Examples include<a href="https://www.northwell.edu/center-for-gun-violence-prevention/news/the-latest/northwell-receives-1-4m-nih-grant-to-establish-gun-violence-prevention-screening" target="_blank" rel="noopener noreferrer"> </a><a href="https://www.northwell.edu/center-for-gun-violence-prevention/news/the-latest/northwell-receives-1-4m-nih-grant-to-establish-gun-violence-prevention-screening" target="_blank" rel="noopener noreferrer">Northwell's first-of-its-kind gun-violence screening program</a> and<a href="https://pediatrics.aappublications.org/content/early/2015/10/20/peds.2015-3301" target="_blank" rel="noopener noreferrer"> the American Academy of Pediatrics'</a> fight for food security for U.S. children.</p><p>As Tambar points out, this holistic outlook means changing our approach to more than just medicine. It will require many aspects of our society to adopt a multi-lens approach, one that adds an interdisciplinary depth to social problems beyond a solitary profession's expertise. He concluded, "What people are realizing is to holistically serve someone, it's not about you doing it all. It's about partnering with the best person who can do something you can't do."</p>I don’t believe in blind idealism: An interview with Katarzyna Boni
The author of "Auroville: The City Made of Dreams" talks about the difficulties of establishing (and writing about) utopian societies.
Want Americans to graduate college? Make it affordable.
Research from MIT's School Effectiveness & Inequality Initiative found making college more affordable cut dropout rates and boosted degree attainment.
The study groups
<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDk1OTU2OS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY1NzYyMjgyMH0.HoOUfA4eXLgFltk-M_Mu3E3qORUh2shzeYoVa3wk86E/img.jpg?width=1245&coordinates=0%2C237%2C0%2C237&height=700" id="861dd" class="rm-shortcode" data-rm-shortcode-id="cfef9e15abee21ae82c46b76199c4436" data-rm-shortcode-name="rebelmouse-image" data-width="1245" data-height="700" />An aerial view of MIT and Harvard Bridge. The university's School Effectiveness & Inequality Initiative partnered with the Susan Thompson Buffett Foundation for the study.
Credit: Adobe Stock
<p>The study comes from <a href="https://seii.mit.edu/" target="_blank">MIT's School Effectiveness & Inequality Initiative</a>. Its researchers wanted to determine the effect scholarships had on degree attainment. As they put it, </p><p style="margin-left: 20px;">"Financial aid is typically motivated by a desire to increase postsecondary attainment by making college more affordable. This raises the question of whether aid meets this test by boosting educational attainment. As with any sort of award or subsidy, it's worth considering the extent to which financial aid changes behavior. The fact that aid is motivated by the desire to increase schooling does not mean aid programs accomplish this."</p><p>To test this question, they partnered with <a href="https://buffettscholarships.org/" target="_blank">the Susan Thompson Buffett Foundation</a>, an organization that offers scholarships to first-time freshman attending public colleges in Nebraska. The researchers designed a partially randomized study around the Foundation's 2012–2016 scholarship applicants, a cohort of roughly 16,500 students seeking aid. </p><p>Because low-scoring applicants were unlikely to complete college, they were not provided a scholarship and were removed from the study. Similarly, while high-scoring applicants were awarded a scholarship, they too were removed from the study as their degree completion was likely with or without the financial abetment. This left a middle pool of applicants, each sporting a comparable level of need and college-readiness.</p><p>The Foundation awarded scholarships randomly to this middle group of applicants; those who did not receive scholarships served as the controls. Because the number of applicants far exceeded the available aid, no student was artificially denied a scholarship for the study's sake. All told, the study included 3,699 scholarship-awarded participants and 4,491 controls. Most sought degrees at four-year colleges though some matriculated into two-year schools.</p><p>As this group was comparable in areas such as GPA, colleges attended, and expected family contributions, any statistically significant difference between the recipients and the controls would provide some evidence of a causal connection between financial aid and degree attainment.</p>Easing the six-year itch
<p>The researchers followed the students' college careers, from freshman year to spring 2019, and found that the scholarships did change behavior. Enrollment was only slightly higher for the aid recipients than the controls—98.7 percent compared to 96.1—but as the two groups' college careers continued, a noticeable difference emerged in dropout rates. By the end of their fourth year, only 71.6 percent of the control group remained, a dropout rate of 24.5 percent; meanwhile, the scholarship group only declined by 18 percent.</p><p>The scholarships also bolstered degree completion. Though bachelor degree completion was roughly even by the end of the fourth year, the aid recipients began to pull ahead after that. By the end of their sixth year, 71 percent of the award recipients received their degree, 8.4 percentage points more than the control. This suggests that as degree completion began to drag on longer, the infusion of extra financial resources made the final push more manageable.</p><p>The researchers not only found that aid promotes full-time enrollment, but that it benefitted historically underrepresented groups most, including non-white and first-generation applicants. These findings support a <a href="https://vtechworks.lib.vt.edu/handle/10919/100548" target="_blank">growing</a> <a href="https://files.eric.ed.gov/fulltext/ED545465.pdf" target="_blank" rel="noopener noreferrer">body</a> of <a href="https://kuscholarworks.ku.edu/bitstream/handle/1808/12507/Shulenburger_University.pdf;sequence=1" target="_blank" rel="noopener noreferrer">research</a> that suggests college affordability directly impacts student decision-making and degree attainment.</p><p>The study, titled "<a href="https://seii.mit.edu/wp-content/uploads/2020/10/SEII-Discussion-Paper-2020.06-Angrist-Autor-Pallais.pdf" target="_blank" rel="noopener noreferrer">Marginal Effects of Merit Aid for Low-Income Students</a>," is part of an ongoing research study. Additional reports will be released as the study continues.</p>What does college affordability mean?
<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="2f032882b6038c7d6734ac69f95fbb69"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/qZTnmMxnU0A?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>Scholarships are one way of making college more affordable, but they are part of a much larger conversation as to what affordability means.</p><p>The <a href="https://www.cnbc.com/2019/10/24/why-college-tuition-keeps-rising.html" target="_blank">ballooning cost of tuition</a> in recent decades is another concern. Factors for this surge include a massive increase in demand, cuts in state funding, new student services, and <a href="https://www.chronicle.com/article/executive-compensation-at-public-and-private-colleges/#id=table_public_2019" target="_blank" rel="noopener noreferrer">bloated administrative compensation</a>. While colleges could certainly rein in some of their more extravagant expenses, and legislators agree to fund more, <a href="https://www.luminafoundation.org/files/publications/ideas_summit/College_Affordability-What_Is_It_and_How_Can_We_Measure_It.pdf" target="_blank" rel="noopener noreferrer">the question of affordability</a> goes further still. </p><p>It concerns the quality of education, whether students are dependent or independent, their resources before matriculating, what they can expect from the investment after graduation, and how much of their future income they are willing (or able) to pay. The calculus must also consider <a href="https://bigthink.com/kenzie-academy/software-engineering-school" target="_self">available alternatives</a>, their costs, and their potential outcomes. It's a multifaceted balancing act between what's available, what students can afford, and what schools can offer with the resources they have available—which, of course, ties directly to the funds that schools have available. </p><p>In <a href="https://www.higheredtoday.org/2017/05/16/think-college-affordability/" target="_blank" rel="noopener noreferrer">an op-ed for Higher Education Today</a><em>, </em>Susan Baum, a senior fellow in the Education Policy Program at the Urban Institute, correctly points out that a "low-cost program designed purely to train people for an occupation that is unlikely to exist in 10 years, while appearing 'affordable,' is not affordable at all."</p><p>So then, how should we think about college affordability?</p><p>Baum recommends we start the conversation with need-based considerations at the forefront. "The financial resources available to a student at the time of enrollment are critical. Students have very different starting points for measuring outcomes and value depending on their circumstances," Baum writes. But it also requires us to think beyond funding; we need to consider the resources colleges need to provide a valuable education as well as the types of experiences that students want. </p><p>If we want more students to graduate, we need to discover the right balance between moderate spending, need-based aid, and program quality, a balance that will make college accessible to all who desire to attend.</p>