In 2019, the AI researcher Rich Sutton published a short essay called “The Bitter Lesson.” Seventy years of AI research, he argued, kept demonstrating the same thing: The most effective ways to train AI rely on raw, brute-force computing power — simply scaling up — rather than clever approaches built on human insight. It didn’t matter how elegant the researchers’ work was. More compute would win every time. It’s a bitter lesson because, well, no one wants to accept that even the best efforts can go unrewarded.

This summer, climate change has been teaching its own kind of bitter lesson. Last week smoke from out-of-control Canadian wildfires reached more than 120 million Americans, sending out air quality alerts across 18-plus states from Minnesota to Virginia. Those wildfires, which were made more likely by the effects of climate change, followed record-breaking heat waves in Europe that contributed to the deaths of thousands of people.

Disasters like these inevitably renew calls for climate action, but no current US emissions policy, no amount of carbon cutting now, could clear the air, just as nothing Europe has done on climate — and it has done more than any other region, at no small cost — could protect it from those killer temperatures. Not this summer, not this decade, not the one after. The steps countries take now to reduce carbon emissions, to mitigate climate change, will not protect them from the present-day effects of climate change.

That’s the bitter lesson of climate change, and 2026 is the summer it has become unignorable. The dangerous effects we’ve been warned about are here, locked in on every timescale that matters to the people living through them. We can’t prevent the worst from happening right now, so we need to figure out how we’re going to adapt to it. 

The smoke we can’t stop

Canadian wildfire smoke is as close to an unstoppable disaster as exists today. The fires are Canada’s, the ignition is mostly lightning, the fuel is a subcontinent of boreal forest no fire agency can manage, and the whole system sits outside US jurisdiction. While strategies like prescribed burning and forest thinning can help reduce the wildfires that crop up in the western US, the sheer scale of Canadian forests makes such management far more difficult, maybe impossible. There is no timescale on which American mitigation clears American air of Canadian wildfire smoke. 

What this means is that for this wildfire smoke, at this moment, adaptation may be all there is.

American law has already conceded the point. Under the Clean Air Act’s Exceptional Events Rule, a state can petition the Environmental Protection Agency to strike wildfire-smoke days from the record used to judge whether its air is legally clean. In other words, the official response to one of the country’s fastest-growing air-quality threats is to delete it from the ledger. 

It’s true that climate attribution science ties heat waves to warming with the highest confidence of any extreme, while wildfire is messier — a compound event filtered through ignition, fuel, and fire weather. But fire seasons are lengthening, fuels are drying, and the most extreme wildfire events on Earth more than doubled between 2003 and 2023. The pattern is intensifying fire in particular regions — the boreal north among them — and the smoke goes where the wind says.

And that smoke is worse than it looks. Wildfire PM2.5 — the microscopic particles that are particularly dangerous —  is roughly three to four times more toxic to the lungs, per unit of mass, than ordinary urban particulate matter. During major smoke events, pediatric asthma visits can spike by more than 30 percent, and Harvard researchers have found the cardiorespiratory damage persists for months after the sky turns blue again. That’s especially dangerous for vulnerable populations like babies and pregnant women.

We can’t affect the winds, we struggle to stop the fires, and any current attempt to reduce warming enough to make those infernos less likely won’t be felt for years. But that doesn’t mean we’re helpless to protect ourselves from wildfire smoke, any more than we are from extreme heat.

We can purify indoor air, and it costs less than you probably think. Strap four furnace filters to a box fan — creating a Corsi-Rosenthal box — and indoor PM2.5 drops by roughly half; in testing during actual wildfire smoke, a DIY unit cut fine particles by about 56 percent in a large room and close to 99 percent in a small sealed one.

For heat, the toolkit is even better known — and one of the best proofs it works is in, of all places, France. The historic 2003 heat wave killed some 15,000 people there, most of them elderly and alone. The national heat plan built in its aftermath — tiered alerts, registries of vulnerable residents, check-in calls, cool rooms — cut the death toll of comparable heat waves by roughly 90 percent: When France hit its all-time record of 114.8°F in 2019, fewer than 1,500 died, per the Christian Science Monitor. A recent European analysis estimates a rerun of 2003 would now kill 77 percent fewer people in France than in a world that never adapted.

So technologies exist to protect ourselves. What’s too often missing are the standards, money, and the drive to deploy protection before the disaster arrives instead of after.

Catching up to today

When it comes to wildfire smoke, some governments are ahead of the game — and some aren’t. Washington state, Oregon, and California now regulate outdoor workers’ smoke exposure by air-quality index, under rules like Cal/OSHA’s wildfire-smoke standard; California funds “clean air centers” with upgraded filtration where people can shelter on bad-air days; Colorado’s Clean Air for Schools program ships free HEPA units to K-12 classrooms. A purifier humming in a classroom is essentially doing for smoke what a cooling center does for heat.

When it comes to heat, some parts of Europe are catching up. Barcelona now runs a network of nearly 400 “climate shelters” — libraries, museums, retrofitted schoolyards — with the goal of putting one within a 10-minute walk of every resident. For the first time, the city is keeping libraries open through August to do it, which, as anyone who has visited Europe in the late summer knows, is no small thing.

So adaptation exists, and it is saving lives. But this summer has also shown what happens when cities, states, and countries aren’t ready. 

In the US, the Midwestern and Northeastern states that spent last week under smoke alerts have almost none of the protections against wildfire smoke that have become more common in Western states, and no one is required to build them, because the country has no enforceable national indoor air-quality standard at all. In Europe, national heat plans are still reluctant to reach for the most powerful tool on the shelf. About one European household in five has air conditioning, compared to nearly nine in ten in the US, in large part because much of the continent still treats the machine as a moral defect. 

In both cases, rich regions that have largely taken climate mitigation more seriously than some of their neighbors aren’t pursuing adaptations they need. Which really means not taking climate change as seriously as they should. 

Accepting the bitter lesson

For a generation, adaptation was the word climate advocates were often reluctant to say out loud. In his 1992 book Earth in the Balance, Al Gore called adaptation “a kind of laziness, an arrogant faith in our ability to react in time to save our skins.” (He later changed his mind.) And in fairness, “we’ll just adapt” has often been a delaying tactic, an easy out for polluters. 

But the ground has shifted under that caution, because the projections did exactly what projections are supposed to do: they came true. 

Longer fire seasons, deadlier heat waves, smoke reaching places that never used to see it — this summer is the confirmation. And that changes what seriousness requires. If you’ve spent decades warning people that the effects of climate change are coming, you can’t treat readying for those effects as a distraction from the real work. None of this argues for easing up on emissions — each ton that isn’t emitted is adaptation nobody has to build. But preparing for what you predicted is what believing your own prediction looks like.

For AI researchers, Rich Sutton’s lesson was bitter for a specific reason. Those who resisted its conclusion weren’t foolish; they resisted it because it seemed to undercut all their hard work. They resisted it because it didn’t seem fair, just as it’s not fair that countries and states that have in many ways done much to mitigate climate change find themselves just as vulnerable, if not more so, than peers that have done comparatively little. 

But here’s the other half of Sutton’s lesson: The researchers who accepted it won. They stopped defending their cleverness and built what worked. That option is open to climate politics too. The atmosphere isn’t fair, but it is consistent, and it will deliver next summer’s version of this one on schedule. We can be ready. The bitter lesson is only bitter until you have the will to act on it. 

A version of this story originally appeared in the Future Perfect newsletter. Sign up here!

In January 2025, Linda-Gail Bekker stood inside a vaccine manufacturing plant and allowed herself to believe that the first HIV vaccine candidate conceived through African science and led by Africans might finally become a reality.

The vaccine would be built on mRNA technology, the same platform that had helped tame the Covid-19 pandemic. Bekker hoped it might finally crack the puzzle that had frustrated HIV researchers for more than four decades.

No virus has proved more evasive. Hundreds of HIV vaccines have entered testing; none has succeeded at providing durable protection against infection. And the need remains vast: In 2025, roughly 1.2 million new HIV infections were reported; anti-retroviral treatments have turned it into more of a survivable disease, but more than half a million people died from AIDS-related causes the same year. There is still no known cure.

So researchers like Bekker, an infectious disease specialist at the University of Cape Town, have more hope now, in part because there is finally a clearer idea of what an effective vaccine needs to do. It must coax the immune system into producing a particular type of protective antibody, a rare class of defender, capable of recognizing and disabling HIV despite the virus’s extraordinary diversity and rapid ability to mutate.

No one yet knows how to reliably do that. But mRNA is uniquely suited to the task of finding out, vaccinologists say. Thanks to the platform’s speed and flexibility, researchers can iterate rapidly through the otherwise laborious process of designing, testing, and refining the series of vaccine components needed to guide the body toward making those essential antibodies.

At the start of last year, Bekker and her colleagues were ready to put that strategy to the test. The clinical trial for their new mRNA-based HIV vaccine was just on the verge of enrolling its first participants. But the project depended on the same backing that had sustained HIV vaccine research for decades: US government funding. Washington had long supplied roughly 90 percent of the world’s investment in the field. Then President Donald Trump returned to office.

Within hours of his inauguration, Trump signed an executive order freezing foreign aid. The $45 million contract from the US Agency for International Development (USAID) that was supposed to fund clinical trials like Bekker’s disappeared, as did a web of other funds, many routed through the National Institutes of Health (NIH), that had helped fuel the field’s progress for years.

The timing could hardly be more cruel. After 40-odd years of chasing a shape-shifting foe, scientists believe they now know what kind of immune response an HIV vaccine must generate — and have in mRNA a powerful new tool for pursuing it. But just as many researchers have finally glimpsed a path to victory, the United States and much of the funding has pulled away from the fight. 

Pushing the envelope

From the outset, the target for preventing HIV was clear. Within a year of identifying the virus as the cause of AIDS in 1983, researchers had zeroed in on its envelope protein as the most promising point of attack for a vaccine.

Protruding from the virus’s surface in knobby clusters, the envelope protein acts like a molecular grappling hook, latching onto immune cells before pulling the virus itself inside. Without this feature, HIV cannot infect a cell.

Much as the coronavirus spike protein would later become the basis for Covid vaccines, this protein on the surface of HIV seemed an obvious bullseye. But identifying the target didn’t mean researchers could hit it. Most of what the immune system sees of the envelope protein is actually just a decoy. The parts that stick out and draw the strongest immune response are also its most changeable, differing from one strain to the next and mutating freely whenever antibodies close in, leaving the body to waste its firepower on a target that keeps slipping away.

Candidate vaccines kept making the same mistake. They would elicit plenty of antibodies, but not the kind that could keep up with the virus. Time and again, promising candidate vaccines generated excitement in the laboratory, only to come up empty when it mattered most in large-scale clinical testing.

The field’s fortunes started to change in the late 2000s when researchers began studying the small fraction of people living with HIV who developed antibodies capable of recognizing the virus’s concealed, conserved features. Though these hard-won antibodies came too late to protect their makers, they gave scientists a molecular blueprint for the defenses a vaccine would need to build.

As the field came to learn, these “broadly neutralizing antibodies” do not appear overnight but rather after years of battle with the virus. 

The challenge, then, was to design a vaccine that would not just trigger an immune response but guide a person’s immune system through the same evolutionary journey. This would require a succession of vaccine components to prompt a carefully choreographed process within the body, rather than the single, fixed target that suffices for shots against measles or hepatitis B.

It was a strategy rooted in rational design but dependent on trial and error. Progress would come through a steady stream of small proof-of-concept studies, each informing the next generation of vaccine candidates. Ordinarily, it would take at least a year — often longer — to manufacture and prepare each vaccine iteration before it could be tested in people. 

But then the Covid pandemic rocketed mRNA into the spotlight.

The mRNA advantage

mRNA technology upends the old recipe of vaccine development. Conventional shots work by showing the immune system a mugshot of the enemy: a killed or weakened germ, or one of its proteins, grown batch by batch in vats of cells or eggs. An mRNA vaccine takes a different route. Rather than supplying the mugshot, it supplies the instructions to draw one: a short, lab-printed strip of messenger RNA, the molecule cells normally use to ferry genetic directions from DNA to their protein-making machinery.

Inject the right sequence, and it will program the body’s own cells to become tiny factories, producing the target protein and presenting it to the immune system as if it were the real intruder. Because it is all just code, refining a design means editing text, not rebuilding a factory — the work of days, not months.

“We’ve been able to design vaccines in real time,” said University of Pennsylvania Perelman School of Medicine assistant professor Ted Kreider, who is a specialist in infectious diseases.

To HIV researchers, the appeal was obvious. HIV’s greatest weapon was its ability to shift and adapt. Now, at last, a vaccine could, too. 

The timing was ideal. Just as researchers were beginning to map the path to an effective vaccine, mRNA offered a way to move down that path at speed. With vaccine designs no longer bottlenecked by design and manufacturing, what once might have taken decades of stepwise vaccine development could, thanks to mRNA, be compressed into years.

Across a growing number of clinical trials, researchers are now testing different vaccine components, different sequences, and different delivery platforms, searching for the combination that most effectively nudges the immune system toward a truly HIV-thwarting response.

A paper published last month in Nature offered one such path forward, showing in monkeys that a painstaking sequence of eight shots could coax the immune system into producing potent antibodies capable of neutralizing a broad range of HIV strains. But even the study’s authors see a catch. “It’s still too many [shots] to be practical in humans,” said Dennis Burton, a professor of immunology and microbiology at Scripps Research who worked on the project.

Whether mRNA ultimately becomes the vaccine itself — or simply the tool that helps researchers discover it — remains an open question.

The fundamental challenge for now, after all, is vaccine design, notes Mark Feinberg, president and CEO of IAVI, a nonprofit research organization focused on developing vaccines against HIV. And for that task, he says, “the most obvious advantage of mRNA is simply the speed of getting an idea from the laboratory to the clinic.”

But if the technology reaches the finish line, researchers say it could offer other advantages as well. Because the protein is made inside the body’s own cells rather than in a lab, it folds and displays itself much as it would on the real virus, giving the immune system a more faithful target to train against. That way, when the real virus arrives, the body already knows its true face.

It also gives vaccine designers an unusual number of knobs to turn, notes Kristie Bloom, an mRNA vaccine researcher and molecular biologist at the University of Witwatersrand in South Africa. By altering the vaccine’s formulation, dose, or genetic design, researchers can shape not just the magnitude of the immune response but also its balance: favoring antibody-producing B cells, virus-killing T cells, or some mix of the two.

With mRNA, “there’s quite a bit of flexibility,” she said.

Not so fast

For all the putative upsides, however, mRNA does carry some baggage. There are concerns about public acceptance given the intense backlash and misinformation campaigns that followed the rollout of Covid-19 vaccines. And though those shots ultimately proved remarkably safe, with very low rates of serious side effects, a peculiar skin problem has emerged in early-stage trials of mRNA vaccine candidates for HIV specifically. 

In two separate trials reported last year, around one in 12 participants who received mRNA-based HIV vaccines manufactured by Moderna developed chronic urticaria, a form of persistent hives that in some cases endured for years. The vaccines encoded different portions of HIV’s envelope protein, yet both produced the same unexpected side effect.

The fact that the reactions appeared across distinct vaccine designs — but never before in Moderna’s other mRNA vaccine programs — has fueled suspicion that something about HIV’s envelope protein itself may be involved. Even so, no clear explanation has emerged. 

“We’ve ruled a bunch of things out,” said William Schief, a professor at Scripps Research’s department of immunology and microbiology who doubles as vice president for protein design at Moderna, “but there’s no smoking gun.”

Schief is continuing to investigate the source of the immune reactions. But not wanting an unresolved safety signal to bring the program to a halt, he and his collaborators have pressed ahead with lower-dose versions of the vaccine, betting that the hives will fade while the desired immune response remains intact. 

That strategy is now being evaluated in an IAVI-backed trial led by Bekker in South Africa. Known as IAVI G004, it has yielded encouraging early results. (Unlike the African-developed vaccine whose launch was derailed by the USAID funding freeze, this study is testing a different mRNA vaccine candidate, manufactured by Moderna.)

At the lowest dose tested, just one-tenth of the amount used in the original studies, the hives that had troubled earlier trials never materialized, Bekker said. Her team has since moved on to a somewhat higher dose, seeking the sweet spot between safety and immune potency. 

All of these discoveries and challenges along the way have helped map a path forward. “We know what we need to do,” said Barton Haynes, director of the Human Vaccine Institute at the Duke University School of Medicine. The task for them now is to move through the necessary iterations as quickly as the science — and the funding and political landscape — allow.

“A black hole”

When Bekker and her team learned about the sudden funding cut that would halt their African-designed, USAID-funded vaccine study in January 2025, they were already in Tanzania to prepare its launch. They immediately had to stop work on the project, which had been years in the making. “It was like falling into a black hole of depression,” she said. 

And the setbacks kept coming. With prominent vaccine critic Robert F. Kennedy Jr. overseeing US health policy, the federal government moved to undermine both vaccine science broadly and mRNA technology in particular.

The NIH, in addition to terminating dozens of smaller HIV-related grants, began winding down its flagship Consortia for HIV/AIDS Vaccine Development (CHAVD) program, which has long served as a cornerstone of global HIV vaccine research, while other federal agencies curtailed support for mRNA vaccine projects across multiple disease areas.

At the same time, South Africa, the continent’s leading center for biomedical research, found itself in the Trump administration’s crosshairs over allegations of anti-white discrimination. New federal research grants were no longer permitted to support collaborations with South African scientists, severing ties that had underpinned years of international HIV research.

“That’s a perfect storm to prevent us from building on the most exciting science HIV vaccines have had in 45 years,” said Mitchell Warren, executive director of AVAC, a nonprofit dedicated to HIV prevention access and policy. 

Yet for all the financial and political disruption, the scientific momentum hasn’t stopped. Philanthropic organizations and governments elsewhere have stepped up to help fill the funding gap, allowing key trials to move forward, although in scaled-down forms with more modest ambitions. 

The Africa-led effort that Bekker had dreamed of was salvaged, with emergency backing from the South African Medical Research Council, albeit in diminished form and built, in the end, on the same protein-based technology that mRNA was meant to leapfrog.

The only mRNA-based HIV vaccine study that is actually underway in Africa is IAVI G004: a program designed by US scientists, not by locals, and funded largely by the Gates Foundation.

A longtime backer of HIV research, that foundation is estimated to invest around $70 million annually — with $64 million being invested in 2022, and $70 million in 2026 — across a global portfolio of HIV vaccine programs. That’s a substantial sum, though only a fraction of the hundreds of millions of dollars once provided by the NIH, USAID, and other federal agencies. 

For now, some of that funding continues to flow. But even what remains is far from assured. The Trump administration’s proposed 2026 budget would slash the National Institute of Allergy and Infectious Diseases — the NIH institute that has long anchored HIV vaccine science — along with the Office of AIDS Research that coordinates HIV research across the entire NIH, leaving the field’s longer-term future in doubt.

“We’re not going to be able to fill the gap that’s been left by the US government,” said Nina Russell, director of TB & HIV research and development at the Gates Foundation. Still, she says, the foundation remains determined to keep the most promising vaccine programs moving forward: “We are super committed to it.”

All of these changes have left the research field daunted, but not hopeless. “It’s been a very disruptive time,” said Burton, who leads one of the CHAVD research hubs. But he remains convinced the field is on the right track. “The pieces of the puzzle are in place,” he said. “It’s obviously been a long, long journey, but you can begin to see the end.”

A higher bar

The funding crisis and political challenges are not the only forces reshaping HIV vaccine development.

For much of the HIV epidemic, which has killed over 40 million people worldwide, even a partially effective vaccine might have been enough to transform the course of HIV. Today, however, vaccine researchers are also competing against long-acting preventive drugs that can protect people for months at a time with just two injections. 

These drugs are an enormous step forward for HIV protection, but they also raise the standard the vaccine field must meet, Warren said. “The bar for a licensed vaccine that is going to have a public health impact has gotten much higher,” he said.

But these prophylactic drugs, which began as daily pills and have evolved into long-acting injectables, are only as good as the systems that deliver them. Cost, stigma, and the need for regular clinic visits have limited access in many countries with the highest HIV burdens. A vaccine, by contrast, that provided years of protection after a handful of doses could overcome many of those barriers.

That is precisely why many scientists view the current retreat of the US government with such alarm. After decades of disappointments and billions of dollars in investment, the field finally believes it has a coherent strategy for building an effective HIV vaccine. The fear is that momentum could stall just as researchers have begun to see a path across the finish line. As a result, what once seemed like a scientific problem increasingly looks like a political one.

For Bekker, the current moment feels all too familiar. In the early 2000s, South Africa’s government embraced AIDS denialism, delaying the rollout of lifesaving treatments and forcing researchers and clinicians to battle both the virus and the state. A quarter-century later, she says, the political opponent has merely changed address to Washington, DC, threatening once again to undermine the fight against HIV and cost countless lives.

“When politics interferes in science,” Bekker said, “that is the death of scientific progress.”

Bekker still does not know whether the vaccine she watched being manufactured last year will ever reach the people it was designed to protect. She and her colleagues still hope to carry out the made-in-Africa mRNA vaccine trial they spent years designing — if they can find a way to pay for it. But Bekker remains convinced that the scientific strategy behind it is the right one, and that mRNA may yet do for HIV what it did for Covid-19, rapidly transforming decades of scientific groundwork into an effective shot.

She only hopes politics does not succeed where HIV itself has failed in slowing the field’s progress. “We should only be fighting the virus,” Bekker said. “But we’re fighting the administration and its policies, and that is a waste of our energy.”

If the US wanted to be the world’s police officer, then why not try to be its doctor too? 

Just two months before the invasion of Iraq in 2003, George W. Bush announced an ambitious plan to pump $15 billion into the global fight against HIV, stunning his allies in Congress, health advocates, and heads of state of the program’s intended beneficiaries. 

The President’s Emergency Plan for AIDS Relief, or PEPFAR, was the largest commitment by any nation in history dedicated to addressing a single disease, a disease that killed about 3 million people in 2003, most of them living in sub-Saharan Africa, and infected 5 million more. “Ladies and gentlemen,” Bush proclaimed in his State of the Union address that year, “seldom has history offered a greater opportunity to do so much for so many.”

On that, he was right. In the two decades to follow, PEPFAR would save an astounding 25 million people’s lives through lifesaving HIV therapies, and prevent millions of babies from being born with HIV in the first place, all at a cost of about 0.08 percent of the federal budget. 

And yet, in the wake of the Trump administration’s foreign aid cuts, one of the greatest achievements in American history is now at risk. PEPFAR, mercifully, still exists, saved from the sledgehammer by an outpouring of bipartisan support last February. But experts say the program has been transformed beyond recognition by countless small cuts, and the abrupt gutting of global health architecture, reshaped not by decades of accumulated wisdom around HIV prevention, but by at times absurdly petty ideology.

Over the past year, more than 77 percent of PEPFAR grantees have lost funding or had their payments delayed, according to a survey released Tuesday by the HIV research group amfAR. 

Nearly two-thirds of grantees — especially those supporting vulnerable populations such as LGBTQ people, young women, and sex workers — said the cuts had disrupted their ability to offer HIV treatments and other services. The Trump administration released limited data showing a deep reduction in HIV prevention services, but a relative consistency in access to treatment earlier this year. However, this new survey paints one of the first pictures available of how PEPFAR cuts are actually being felt on the ground, and how the administration’s priorities are reshaping who and what gets funded.

According to the survey’s authors, at least 1,700 HIV-related sites or clinics have shut down as a result of cuts. Well over 16,000 health workers — including those going door to door to make sure pregnant parents get tested for HIV or children get on treatment — have lost their jobs. 

Many organizations surveyed reported receiving emails when their PEPFAR grants were terminated, noting that their work violated President Donald Trump’s executive order against “unlawful diversity, equity, and inclusion.” It appears, they say, that many of these groups were flagged not because they embraced the distinctly American concept of DEI in their work, but because their name or mission description included a phrase like “gender” or “LGBTQ.”  

A health clinic serving survivors of domestic violence in Mozambique, for example, might now be flagged just for using the phrase “gender-based violence” in their name. This may be part of the reason why even pregnant women — who even the Trump administration has emphasized as a critical demographic in its HIV goals — have lost access to services. 

Back in 2003, Bush defied conservative critics in his own party who attempted to redirect PEPFAR funding to abstinence-only programs. For decades, American presidents have been able to see past their ideology in service of saving lives. They largely understood that contraceptives like condoms and special interventions for those most at risk, including LGBTQ people, were necessary for stopping the spread of HIV. Under the Trump administration, this norm is unraveling. 

“This administration has zero interest in addressing clinical outcomes for vulnerable people with HIV,” said Asia Russell, executive director of the advocacy group Health GAP, who noted that “to be effective, HIV prevention and treatment services actually have to go where the disease is, and that risk is not evenly distributed,” surging in certain geographies like South Africa or within key populations like trans people or young women. Getting support to these groups is “morally right,” she said, but it is also “the only way to do effective HIV work, regardless of your stance on the morals or the merits.”

The fight against HIV is running on fumes

When HIV aid does get doled out these days, it is distributed with far less transparency than in the past, and in ways that often appear to be ideologically or politically driven, both in terms of the populations they serve and the countries they operate in, rather than guided by best practices. 

In theory, lifesaving HIV care was exempted from sweeping aid cuts last year. But in reality, access to even the most basic HIV services and treatments has also atrophied across the board, while falling disproportionately on at-risk populations. 

That’s come both in the form of direct cuts and as a byproduct of broader disruptions to the kind of outreach services, testing, and socioeconomic programs that get patients in the door to begin with. 

“You can’t cut pieces of the architecture of how PEPFAR functions and expect to maintain a really robust treatment program in the long term,” said Jennifer Sherwood, director of research and public policy at amfAR. “If you cut the testing program, the prevention programs, the kind of services that allow people to stay in care and return to care, you’re going to see that you can’t maintain a treatment program.”

The number of people getting on treatment for the first time has sharply declined over the past year, even according to the administration’s own limited data drop, while access to testing, contraceptives, and other preventative services — all critical to keeping infections down in the long run — face cuts that threaten their ability to function at all. 

To make matters worse, amfAR’s survey shows that services designed for the populations most at risk of HIV — such as sex workers, LGBTQ people, young women, and teenage girls — have been disproportionately affected by PEPFAR cuts. Among those who lost funding, a staggering 90 percent of organizations that serve gay and bisexual men were forced to slash access to PrEP — which strongly protects against HIV infection — and many stopped offering it entirely. The same was true for over half of organizations serving pregnant women, whose children now face a higher risk of contracting HIV in the womb.  

The majority of new HIV infections are concentrated in these “key populations,” as they’re known in public health parlance, many of whom face stigma or other obstacles to obtaining care. “One really powerful aspect” of how PEPFAR used to work, said Thomas McHale, public health director at Physicians for Human Rights, was that it consistently “followed the science and followed the epidemiology” to serve “groups that are at the margins of society.” That approach appears to have been thrown out under the new administration, and in at least some cases, actively discouraged.

McHale has been documenting the impact of PEPFAR cuts in South Africa in recent months, and “what we saw was a system under severe stress and strain,” he said. It is one in which a bisexual man stopped taking his HIV medications for weeks because the LGBTQ clinic he used to go to closed. “He just couldn’t bear the stigma of accessing services in a place that’s not meant for him,” according to McHale. Similarly, a young woman was forced to wait in line for 10 hours just to refill her PrEP prescription. 

“If we’re not focusing on preventing disease,” McHale said, “it’s just a more expensive and more devastating challenge to address in the future.”

Some countries may soon stop receiving PEPFAR funding altogether

As I’ve written previously, the Trump administration has attempted to remake foreign aid into a dealmaking enterprise, one in which money flows directly through national governments rather than through large, western-led non-governmental organizations or NGOs. 

In theory, there are benefits to this approach, because it prioritizes the expertise of local health groups and policymakers who are often best equipped to evaluate and address the needs of those in their care. In practice, however, amfAR’s survey shows that so far, under the Trump administration, local organizations have actually lost more funding and been forced to close more sites than international groups have. “These cuts fell heavily on locally-based organizations” while NGOs have fared somewhat better, said Sherwood, “and that really runs counter to all of our global health goals.”  

“I’m concerned because public health is no longer how we’re measuring success” when it comes to reaching PEPFAR’s goals, said Jirair Ratevosian, a senior fellow at the Duke Global Health Institute who served as chief of staff of PEPFAR under the Biden administration. He is especially alarmed by the decision last month to end PEPFAR support for South Africa, which has the largest HIV epidemic in the world. The administration appears to have done so in part because of Trump’s insistence that the nation is waging a nonexistent “genocide” against white Afrikaners. 

“If we’re not focused on preventing disease, it’s just a more expensive and more devastating challenge to address in the future.”

Thomas McHale, Physicians for Human Rights

“HIV control is not their chief concern,” said Ratevosian, who recently ran the numbers on a separate fissure with Zimbabwe, finding that cutting PEPFAR would lead to 75,000 new HIV infections in just one year. In South Africa, similar cuts could lead to over 2 million more infections over the next two decades, a toll that would invariably cross borders, and could threaten the world’s immense, hard-won progress against HIV. “You can’t have a global HIV strategy,” said Ratevosian, “if you’re not engaging these countries.”

Priorities shift under any new administration, and it’s not abnormal for an organization to tweak its language or services to adapt. But PEPFAR, the bipartisan program which began under Republican leadership, and thrived and expanded under three successive presidencies, including during Trump’s first term, has never faced such turmoil. 

“Even among organizations who didn’t lose US funding, we’re still picking up changes to the way they work, the populations they serve, the words they use,” said Sherwood of amfAR. Her group’s survey showed that nearly 80 percent of organizations that did not lose funding still altered the way their organization worked to comply with new policies. “This network of changes from the US,” she said, “are prompting a lot of changes on the ground.”

Hi readers! Shayla Love here, science journalist and longtime fan of Your Mileage May Vary. I’m honored to be subbing for Sigal Samuel while she’s out on parental leave. I’m diving into your questions as a way to help understand human nature and our choices through multiple lenses: philosophical, psychological, and beyond. Please send in any emotional, body/brain, sociological, perceptual, or other kind of life quandaries you might have.

My conundrum is common, I guess. I feel time accelerating as I grow older. I am expecting my second child, and as the days tick down until I meet her, I feel time catching up with me (I’m in my 40s). I want to savor every day, but they go by so fast. I know that novelty is a partial solution to this, so I do lots of new things. I take up hobbies, go to new places, etc. But I still feel an encroaching contraction of experience and memory, and I’m afraid my remaining decades will go by in a blur. I want to prepare to be as present as I possibly can to the new human I’ll work to raise. 

Do you have advice on slowing down time, or wisdom on how to dilate and cherish the moment I’m in? I’ve tried “mindfulness” and various meditation practices. These haven’t caught hold yet, though I’ll keep trying. Daily journaling and getting away from social media seem to help, but the days still fly by.

Dear Time Traveler,

Do you remember how long time felt when you were a child? I certainly do. I remember summer break stretching out endlessly; a whole eternity captured in one hot July afternoon. It’s no wonder that we respond with panic as we get older and weeks snap by so fast no matter what we’re doing — vacation, working, or as you are, growing a family.

There are two ways to think about time: the way it feels when you’re living it, which is called “prospective time.” And then how you remember time, known as “retrospective time.” It sounds like you’re struggling with both. You want moments to feel longer as they’re happening, and to look back and feel like time didn’t just slip through your fingers.

What’s interesting about our perception of time is that there’s no specific organ dedicated to sensing time. Our eyes see, and our noses smell, but feeling time is a vaguer sense, cobbled together by the combination of various inputs. It is also more easily manipulated. 

I took a close look at the work of David Eagleman, who is a neuroscientist at Stanford University and has studied what makes time feel slower or faster. On a basic level, you’re right, novelty does make time expand. When researchers show people a series of the same images over and over, a new picture thrown into the mix feels as though that new image is presented for longer — even if it’s not. He’s argued that this is one of the reasons why childhood feels so long. So much of what you experience is new when you’re younger. Then we create habits and routines, and time starts to accelerate. If you have the same commute each day, it’s easy for it to feel so familiar that parts of it may not even register in your memory on any given day.

Extreme emotions can elongate time too. In one of Eagleman’s more daring experiments, he asked people to free fall from 15 stories above the ground (they fell into a net). When the people were asked later to try to recreate how long the fall was by estimating it on a stopwatch, they overestimated the duration by about a third. He also had them wear a device on their wrists that rapidly flashed images and numbers while they fell. If their other senses had also slowed during their fall, like Neo in The Matrix, they should have been able to see some of the images flashing before them. They didn’t. The sensation that time slowed down didn’t mean much practically, it was simply a feeling.

When time appears to slow, it is perhaps more helpfully explained by how our memory works. Doing something scary or dangerous activates the amygdala, which tells the rest of the brain to pay attention to what’s going on, to remember more of the details later, which makes time seem to stretch out. Swiss geologist Albert Heim once interviewed people who fell while mountain-climbing. He found that while people were plummeting to what they thought was a certain death, time also expanded. When a race-car driver was launched 30 feet into the air after a crash, he told researchers at the University of Iowa that “It seemed like the whole thing took forever. Everything was in slow motion.” 

Some access this feature of our minds when they take up bungee jumping or skydiving. Or, like you, tamer new experiences that the brain takes its time registering more details of. Other people have turned to drugs like hashish or LSD, which can make minutes or hours feel like whole days. 

But the real issue comes down to a question of how you want to be spending that very time you feel passing you by. Is it obsessing over optimizing for activities that promise maximum time stretchage? I think that might degrade your experience of the life you have in front of you. 

As you note yourself, adding novelty for the sake of novelty doesn’t seem to be helping your life feel more time-rich. In fact, it sounds like you’re ending up with “time urgency,” or trying to achieve as much as possible in as short of a period of time as possible. Being anxious, burnt out, and multi-tasking can, in some cases, make time feel more sped up. This is because you don’t have the bandwidth to pay attention and build detailed memories around what you’re doing. 

Plus, constructing days where time always feels slow means never getting caught up with friends or children, or being engrossed in a well-loved hobby, where you look up at the clock and discover hours have passed in what felt like no time at all. There’s something bittersweet about that, but something to relish too. In fact, there is useful wisdom in acknowledging the difficult fact that as we get older, our time is running out. 

Many ancient philosophies advise to remind yourself of death in order to focus on the importance of life. In Stoicism, this is called memento mori, or remembering that you will die. I slightly prefer Buddhism’s Five Remembrances, which are mantras about accepting that change is inevitable and it’s our destiny to grow older. There’s nothing like having children to make you confront that reality. “I am of the nature to grow old, I cannot escape old age,” is the first remembrance. We might add onto it: “And I cannot escape the passage of time.” 

If you give up trying to slow down time to a halt, it doesn’t mean you can’t find some more spacious ways to live in the time you do have left. Meditation is often pulled off the shelf as a trick for paying more attention, but rather than sitting with your eyes closed and listening to your breathing, I suspect a more quotidian mindfulness would help you. 

Thích Nhất Hạnh, the Vietnamese Thiền Buddhist monk, wrote about taking back the time spent on everyday life through being mindful when doing the stuff that we tend to rush through. 

Nhất Hạnh reminds us that these things are also our life. When we wash dishes, for example, we might find ourselves thinking only about our list of what we’re going to do next. Then, “we are not alive during the time we are washing the dishes,” he wrote. Instead, “we are sucked away into the future — and we are incapable of actually living one minute of life.” Rather than adding another new class or going on another trip, try making parts of your routine life new again. When doing the dishes, Nhất Hạnh suggested putting the future out of mind, and focusing on the sensations of washing, of each cup and each plate. He also recommended reserving one day per week to do as little as possible, called a lazy day.  

These days are actually hard work because it can be difficult to do nothing, but within them something else opens up and expands time: boredom. (Remember those endless summer days as a kid? For me, at least, boredom certainly was a common tune in making that time — for better or worse — feel so long.) 

Several years ago I heard about a productivity expert named Chris Bailey who created a “month of boredom,” where he spent an hour each day doing the most boring thing he could think of: staring at the ceiling or watching his turtle swim back and forth in her tank. He found that creating gaps in the day with dull activities sometimes led to creative mind-wandering and the feeling that time was indeed ticking by more slowly than if his day was filled to the brim. 

I’m not always capable of carving out time to actually watch grass grow as Bailey did or of achieving the serene state while doing the dishes that Nhất Hạnh described. But I do try to force myself to be bored in micro-moments throughout my day and pay closer attention when I’m doing routine things, like walking to the train, or doing chores. This practice makes me more aware of how I’m spending my time, and occasionally even makes that time feel a little more expansive. 

Bonus: What I’m reading

Last week I read A Month In the Country, a lovely summer novel, which I realized is all about being in one place and letting time do what it will. 

What if we didn’t have a way to calculate the passage of time at all? I highly recommend reading the first section of the historian Daniel Boorstin’s masterful classic book, The Discoverers. It’s all about how time was measured from early human civilizations to now. “The first grand discovery was time, the landscape of experience,” Boorstin writes. 

Since I’ve become interested in the Luddites, as well as craving more time for tasks that require working with my hands (woodworking, gardening, lock picking, you name it), I have worried that I’m idealizing manual labor — hard activities that used to consume all of people’s time. This essay by the philosopher Joshua Habgood-Coote in Aeon explores this idea, which he calls “skill nostalgia.” We shouldn’t take the romanticizing too far, but Habgood-Coote writes that there’s reason to yearn for skills that we were never taught.

Physicists have longed for a theory of everything, a single framework that would explain every force in the universe. After the better part of a century, they’re still looking. But social science, improbably, may have beaten them to it.

In 2021, three British writers — John Myers, Sam Bowman, and Ben Southwood — published an essay in the progress-minded site Works in Progress arguing that a startling share of what ails the modern West comes down to one thing: too few homes built where people want to live. Slow growth. Widening inequality. Falling fertility. Obesity. Even climate change. They look like separate problems with separate causes, until you notice that each one gets worse when housing gets scarce. The authors called it “the housing theory of everything,” and five years on, the case has only gotten stronger.

The mechanism is simple: where you can afford to live determines your job, your commute, your family size, your neighbors, your politics. Make homes scarce where opportunity is, and every one of those suffers. 

As I wrote back in 2022, once you begin to understand the housing theory of everything, you start to see it everywhere. One estimate from the essay puts the cost of building restrictions in just three cities — New York, San Francisco, and San Jose — at 8.9 percent of US GDP, about $8,775 per American worker per year. And today a record 22.6 million renter households, or half of all renters, now spend more than 30 percent of their income on housing.

It’s not supposed to be this way. Since the 1970s, nearly everything material in American life has gotten cheaper measured in hours of work — a television fell from 60 hours of labor to 7 — while the house you put it in went the other way. If you’ve ever wondered why decades of genuine progress don’t feel like progress — a major obsession of this newsletter — housing is a big part of the answer. The gains are real, but our rents and mortgages are eating them. 

That’s the bad news. Here’s the good news.

A new law for our single biggest problem

What made all this feel so depressingly unfixable is that no one seemed positioned to fix it. Zoning is controlled by thousands of city councils and planning boards, each answerable to neighbors with a vested interest in scarcity, since for most American homeowners, the housing shortage bolsters their net worth. And Congress had simply left the field, going roughly 30 years without passing a major housing law. 

Then, over about three weeks this summer, lawmakers acted. On June 22, the Senate passed the 21st Century ROAD to Housing Act 85-5. The House followed a day later, 358-32, and after President Donald Trump chose not to veto it, the bill automatically became law on July 11. The ROAD Act is the most significant housing legislation in decades, and the first built squarely on a basic YIMBY premise that cuts to the heart of the housing theory of everything: Homes are expensive because America made them too hard to build.

The act stitches together more than 60 separate bills, 36 of them bipartisan, negotiated by Sen. Tim Scott (R-SC) and Sen. Elizabeth Warren (D-MA) along with Rep. French Hill (R-AR) and Rep. Maxine Waters (D-CA). Its centerpiece, the Build Now provision, ties federal block-grant money to results: cities that add homes get more, cities that block them get less, and a $200 million annual innovation fund rewards measurable increases in supply.

The rest of the bill takes scissors to the red tape strangling housing. The law streamlines federal environmental review for housing the federal government itself helps fund. It directs the Department of Housing and Urban Development to write guidelines for single-stair apartment buildings up to six stories — a small-sounding change that my colleague Rachel Cohen Booth has called “a deceptively simple reform that could unlock more housing.” And it ends a 1970s-era rule requiring factory-built homes to sit on a permanent wheeled chassis, a mandate that added thousands of dollars per unit and helped keep the cheapest form of American housing out of most neighborhoods.

What’s revolutionary here isn’t the elements of the bill — which are still largely small-bore compared to the scale of the problem — but the acceptance of the basic YIMBY idea that, as Republican Sen. John Kennedy of Louisiana said, “If we had more housing, the price would go down.” Ben Metcalf of UC Berkeley’s Terner Center told the New York Times the law was “catch-up on 30 years of policy,” while Laura Foote, executive director of YIMBY Action, put it more simply: the law is a triumph “simply because it exists.”

The states ran the experiment first

Congress may be late to these YIMBY ideas, but it has the benefit of knowing they have been tested. One of the best examples is in Auckland, New Zealand, which upzoned three-quarters of its single-family land in 2016, rewriting the rules so those lots could hold apartments, not just one house each. Construction roughly doubled within five years, and a study published last year estimates Auckland rents are now about 23 percent lower than they would have been without the reform.

The American version of Auckland — with better tacos — is Austin, which spent a decade legalizing apartments, killing parking minimums, and shrinking minimum lot sizes. The Texas city added 120,000 homes between 2015 and 2024, growing its housing stock by 30 percent. As my colleague Marina Bolotnikova reported this spring, Austin rents fell 6 percent in a single year, more than any other large US metro, with the fastest declines in older, cheaper buildings — exactly where relief matters most. 

Other states have noticed. California exempted most urban infill housing from its famously litigious environmental review law. Montana passed its “Montana Miracle” package, legalizing duplexes and backyard apartments on land that had allowed only single houses. Texas legalized homes in commercial zones statewide. 

Red states and blue states are coming to the same diagnosis about solving the housing problem: build more. The new federal law mostly just tells them to keep going.

Why your rent won’t drop tomorrow

It’s a sign of just how terrible federal housing policy has been for so long that what is ultimately a pretty modest law is being greeted so rapturously. 

The ROAD Act notably contains almost no new money — its final section is literally titled “No Additional Funds Authorized.” Zoning, which can make or break housing, remains a local power. The law mandates nothing; it nudges with grant formulas, which a determined city council can shrug off. The New York Times’ Conor Dougherty, one of the top reporters on housing, judged it “unlikely to do much to blunt the high cost of rent and ownership in America anytime soon.” Mortgage rates have been stuck above 6 percent since 2022 — as I could show you from my own mortgage statements. National homebuilding has barely moved, and forecasters expect little change this year.

Experience shows that a problem big enough to be a viable theory of everything is going to need more than one reform. Minneapolis famously ended single-family zoning in 2018, and only got a modest building response, because a dozen other rules still stood in the way. What worked in Auckland and Austin was the full stack — density plus permitting plus parking plus lot sizes. Housing, as advocates put it, is a door with many deadbolts; this law unlocks the federal ones and hands the states a better set of keys. The others are still bolted.

Usually with this newsletter I like to point at progress that has already arrived but gone unnoticed. Housing is the opposite case: The problem is exactly as bad as everyone feels it is, and what arrived this month is agreement about why. America spent 40 years treating expensive housing like the weather: unfortunate, unchangeable, nobody’s fault. It has taken five years for that diagnosis published on a magazine website to become a universally praised act of Congress.

The ROAD Act won’t pour a single foundation. What it did do was build the consensus upon which the next few million of them will be built. And consensus, in American politics, is the material that takes the longest to set.

A version of this story originally appeared in the Good News newsletter. Sign up here!

Much like its indifference toward soccer, America’s aversion to public transport has made it a global anomaly, an oddity encapsulated by the nation’s sacred pregame pastime: the tailgate. 

Here in the US, celebrating sports means driving your big car to a colossal suburban gridiron football stadium, where you’ll grill, baby, grill until the smoky scents of burgers and bratwurst float across vast plains of asphalt. So entrenched is the nation’s car culture that the average American spends about half a month sitting behind the wheel every year. In fact, while the US has tens of millions more cars than it has people to drive them, even its largest cities have far fewer trains or buses per capita than our global peers. 

As a result, Americans are more than twice as likely to die in a car accident as Europeans, and nearly five times as likely to die in a car crash as someone in train-happy Germany. While many transit projects carry similar price tags, the US still boasts many dozens more college football stadiums than it does rapid transit systems or subway networks.

So, it’s no wonder that critics doubted that US cities hosting this year’s World Cup, the largest single sporting event in human history, could effectively find ways to schlep visiting fans around. After abandoning its initial pledges to shepherd fans for free, New Jersey earned scorn for trying to sell $150 round-trip train tickets to MetLife Stadium, prompting journalists to test how difficult it would be to reach it by foot, bike, or canoe. Kansas City’s shiny new pop-up World Cup buses got caught in hours of ensnarled traffic on their way to their city’s very first game between Algeria and Argentina. 

And yet, on the precipice of the tournament’s final stage, the nation’s widely expected World Cup public transit meltdown has simply not materialized. To the surprise of pretty much everyone, US cities have managed to absorb the influx of fans with relative ease, even under the pressure of record ridership en route to stadiums, watch parties, and fan zones. 

Eli Lipmen, executive director of the advocacy group MoveLA, said that he had “actually been pleasantly surprised and quite impressed” with how the Los Angeles transit system performed amid the World Cup. As he explained, that notoriously gridlocked city is in the midst of a “major cultural shift” around public transit. As Angelenos spend less time in their cars, the city has gotten quieter, he said. “People are happier. There’s more of a sense of community,” Lipmen said.

A renewed commitment to public transit infrastructure has played a part in that shift — and not just in Southern California. In the lead-up to the World Cup and the 2028 Olympics, Los Angeles unveiled three new subway stations in May, its first new stations to open in over two decades. Meanwhile, Seattle’s Sound Transit shuttled a record-shattering 309,000 riders when Team USA faced Team Belgium, thanks in part to its completion of a light rail extension that had been in the works for nearly two decades. Atlanta overhauled its bus network, Miami made use of a new rapid transit line, and Kansas City spent millions to expand its tram service and rolled out pop-up shuttles. 

As it turns out, US cities can build new buses, trams, and trains much faster than they may think. The harder question now is whether they can keep up that momentum when it serves locals, and not just visitors. Just hours after Kansas City’s final World Cup match — Argentina 3, Switzerland 2 — its cash-strapped transit authority shut down its extended tram service with plans to slash a quarter of its regular bus routes by the end of this summer. 

Many host cities “are still not building [transit] as a serious modal shift” away from cars, said Eric Goldwyn, director of the NYU Marron Institute of Urban Management. “They’re building it as a cutesy-patootsie complement.”

Americans learned to love soccer. Can they learn to love transit too?

LA is among the exceptions, and not only because of its looming Olympics host gig. The city has made a concerted effort over the past couple of years to invest in and rebrand its transit system, which had long had a reputation for grime and danger. “If you’d spoken to me two and a half years ago, this conversation would be about safety and security on the metro system,” said Lipmen, referencing a bus that was taken hostage in 2024, one of several “really horrible, very high-profile incidents” that left many Angelenos feeling unsafe on the system. “Now, the conversation is about joy and celebration.”

What changed? 

LA began investing heavily in building more trains, buses, and subway stations, and overhauled its public safety approach, which led to a 6.7 percent drop in violent crime on transit and a 33 percent drop in incidents like drug use and weapons possession. For Lipmen, the real shift came when the metro system opened its three new stations along the D line in May, and released a raunchy “Ride the D” shirt to celebrate it. Almost immediately, the Metro’s cheeky merchandise sold out, and would continue to sell out every time it was restocked for months to follow. 

It might sound silly, but the hype genuinely helped dull some of the stigma associated with taking the train. “People who were quietly riding transit all of a sudden felt comfortable in their own skin as a transit-rider, and proud to be a transit-rider,” Lipmen said. 

Overall, LA’s big bet appears to be slowly working. “LA is a transit city,” Jennifer Vides, Metro Los Angeles’s chief customer experience officer, told the Associated Press last week. “People want to try to say that it’s not. Obviously, we have a lot more expansion to do and we’re working on it. But people really want transit.”

Beyond adding new train lines or bus fleets, normalizing public transit requires “a dramatic recast of how people get around and travel,” Goldwyn said. Cities need a vision that ensures that there is an actual “destination on the other end” of their new transit line, like offices or the kind of housing California’s new bill aims to get built near transit hubs. Most cities will need a mixture of “carrots and sticks” to help people who are used to driving everywhere see the value in hopping on a bus or tram as part of their everyday commute, not just to get to the airport or the stadium. “If your transit is not connecting you to places you want to go, you’re not going to use it,” Goldwyn said. 

A single tournament, like a single train line, will never be enough to change how Americans move. But if this nation of football fans can learn to love soccer, then surely they can learn to love the train a little bit more too. At the very least, with LA28 precisely two years away, Los Angeles just got closer to making its car-free summer Olympic dreams come true.

The modern soybean is one of the world’s miracle technologies, capable of cheaply, efficiently, and healthfully supplying protein and other nutrients to billions of people. But, unfortunately, we’ve mostly chosen to squander it on the most destructive purposes possible. 

Soy is America’s second most widely cultivated crop, occupying a land area equivalent to more than 4 percent of the continental US. That’s not (sadly) because we’ve become a nation of tofu obsessives. Rather, American soy production has expanded substantially in recent decades in part because the US government effectively mandates funneling it into fuel tanks. (The other major market for American soy, meanwhile, is feed for factory farmed animals.)

For the past 20 years, the US Renewable Fuel Standard (RFS) has required that biofuels — fuels made from crops and other biological materials like animal waste — be mixed into the national fuel supply. In practice, it’s dominated by corn ethanol that goes into passenger car tanks, and biomass-based diesel, comprised in large part of soybean oil, used to power trucks, tractors, and buses. And last month, the Environmental Protection Agency’s 2026-2027 rules for the Renewable Fuel Standard took effect, turbocharging that system with an unprecedented, nearly 70 percent increase in the biomass-based diesel mandate, relative to the 2025 baseline.

Ostensibly, part of the point of the Renewable Fuel Standard is to reduce greenhouse gas emissions by replacing some of our fossil fuels with renewable, less carbon-intensive ones. So it might come as a surprise that the Trump administration, which has been gleefully canceling anything having to do with green energy and climate policy, is expanding the program. But the RFS as currently designed does not benefit the climate — it actually probably harms it. 

Few experts outside the powerful agrarian lobby defend the Renewable Fuel Standard in its current, crop-heavy form as sound policy anymore. It survives now mostly to guarantee a market to corn and soy growers. These are industries that President Donald Trump is particularly keen to please after angering farmers with his trade war last year and the disruptions to global trade — including fertilizer supplies — from the war in Iran. 

The soy industry has hailed the program’s latest, massive increase in the biomass-based diesel quota. But it will likely come at the cost of more ecological damage than the fuels it’s meant to replace. 

Many biofuels are likely worse than fossil fuels

The first wave of interest in modern biofuels came during the 1970s energy crisis, as the US sought to reduce its dependence on foreign oil. But it wasn’t until the mid-2000s, when the RFS was devised, that they became a routine part of nearly every American’s trip to the gas pump. At the time, the thinking was that biofuels were less damaging to the climate than petroleum fuel, because at least growing corn and soybeans draws some carbon out of the air via photosynthesis, while extracting and burning oil only releases it. But that reasoning has been mostly discredited by a large body of research finding that biofuels made with food crops are just as bad, and perhaps even worse, for the climate than conventional fossil fuels. 

The main reason for this is land-use change, a concept that is more exciting than it sounds because it refers in this case to the destruction of our planet’s remaining wildlands. When the government suddenly mandates that billions of gallons of biofuel be added to gas pumps nationwide, the crops for that fuel must, to state the obvious, be grown somewhere. One widely cited study of the environmental impacts of the Renewable Fuel Standard found that between 2008 and 2016, the program caused the conversion of about 4.45 million acres of natural and seminatural areas into cropland in the US. And any time wild areas are cleared for agriculture, a substantial amount of greenhouse gases are emitted from the razing of existing vegetation and disturbance of carbon-rich soils. 

Whatever carbon sequestration results from growing crops does not make up for these impacts, nor for the lost carbon storing capacity of the preexisting ecosystem. As a result, the study found, for example, “the carbon intensity of corn ethanol produced under the RFS is no less than gasoline and likely at least 24 percent higher.”

Meanwhile, although the soy and corn used in US biofuels are overwhelmingly American-grown, the Renewable Fuel Standard’s impacts don’t stop at our borders. Crop-based diesel mandates in particular, driven by the RFS and similar policies in other countries, have created a huge new source of demand for vegetable oils on top of what’s already needed for food. As of 2023, about 17 percent of global vegetable oil is diverted to diesel production. That has had devastating impacts on wildlands abroad, especially the world’s remaining tropical forests.

It works like this: When US policy requires that massive amounts of crop-based diesel be added to our fuel supply, the market price of soybean oil rises around the world. The prices of other widely used vegetable oils — sunflower, canola, and palm — rise in tandem, because food manufacturers use them interchangeably with soybean oil in a massive range of packaged products, like salad dressings, Oreos, crackers, and others.

Higher prices signal to farmers around the globe to grow more vegetable oil crops. That can mean more soybean acreage in the South American Amazon, more canola or sunflower fields elsewhere, and more oil-palm plantations in Southeast Asia, where agricultural expansion into tropical forests and peatlands is especially destructive. The upshot is that using crops for fuel expands the world’s total cropland, pushing agriculture into forests, grasslands, and other wild areas — a mechanism known as indirect land-use change. The more American soybean oil goes into fuel tanks, the more food companies can and will simply replace it with palm oil.

A recent working paper by a group of University of California agricultural economists detailed how global demand for biomass-based diesel has accelerated deforestation in Southeast Asia. Between 2002 and 2018, they found, about 4.2 million acres of forestland in Indonesia and Malaysia were converted to palm oil plantations as a result of global vegetable-oil-based diesel demand — about 20 percent of all forest-to-oil-palm conversion in the region during that period. Accounting for these deforestation impacts, the authors found, makes vegetable-oil-based diesel about 22 to 52 percent higher in greenhouse gas emissions than petroleum diesel — and that does not include the impacts of land-use changes caused by biodiesel anywhere else in the world. 

Agricultural economist Richard Sexton, one of the authors of that study, told me in an interview last year: “We are deforesting Indonesia and Malaysia due to our biofuel policies.” And, of course, these forests are much more than carbon reservoirs. They are also the home of critically endangered orangutans and countless other species that live nowhere else on Earth. All of this will be made worse by the new RFS mandates, which are projected to drive by far the largest increase in soy-based diesel use in the program’s history.

There is another important consequence of biofuels mandates. By diverting valuable crops into the fuel supply, they have put upward pressure on global food prices, especially squeezing the world’s poor, who spend a very large share of their household incomes on food. 

There’s a bigger lesson here. Support for biofuels mandates in the US, like support for policies that favor farmers more generally, is a bipartisan affair, shielded by “a force field of agro-political influence,” as journalist Michael Grunwald phrased it in his book We Are Eating the Earth.  Surely part of the reason that it’s been possible for the Renewable Fuel Standard to skate by for so long is that, unlike fossil fuels, farming seems natural and virtuous. But all farms, as Grunwald puts it, are “a kind of environmental crime scene,” responsible for the devastation of the ecosystems that came before them.  

Biofuels mandates may now be too politically entrenched to disappear anytime soon. But it is possible, at a minimum, to limit further acceleration. The corn ethanol mandate has remained roughly flat for over a decade, and the EPA could certainly change its rules to prevent the continued proliferation of soy-based diesel. 

In the long term, the transition toward electric vehicles may finally render crop-based biofuels obsolete (for road transportation, at least — aviation is a different story). But in the meantime, the least we can do is to stop expanding them. 

Editor’s note, July 12, 8 am ET: We’re bringing you some of our best-loved Your Mileage May Vary columns while Sigal Samuel is on parental leave. The one below was originally published in January 2025.

This unconventional advice column offers you a unique framework for thinking through moral dilemmas. It’s based on value pluralism: the idea that each of us has multiple values that are equally valid but that often conflict with each other. Submit your own question here.

I live in an isolated part of a developed country, relatively far from anything else, and am struggling with my relationship to flying in the face of climate change. Most advice on minimizing flying seems tailored to more connected areas in the US or Europe; we have no trains or buses, and it’s a 12+ hour drive to the nearest city. I’ve considered moving to a more connected area where these would be options, but then I’d experience the same angst any time I wanted to visit my family where I currently live. 

I’ve tried to take the approach of flying less frequently and staying for longer periods of time, but I feel resentful toward the carefree way I see friends around me approaching this issue, like flying out every month to watch a game. I feel like I’m torturing myself with guilt over something that no one cares about, and that the good I do by avoiding the one roundtrip I would take on a vacation per year is erased by the behavior of my peers. 

On the other hand, the contribution my annual flight would make, in terms of global emissions and demand in the airline industry, is minuscule. I feel generally opposed to making climate change about individual actions, but flying is also something that is such a privileged action that it feels like a special case. I also feel conflicted because I don’t think I deserve to travel if I can’t do it ethically, but the strategies often proposed as alternatives are not available to me. 

Dear Resentfully Landbound, 

Your question has me thinking about Greta Thunberg. In 2019, the Swedish activist wanted to attend a climate conference in the US, but she refused to fly because of the high carbon emissions associated with air travel. So, instead, she traveled across the Atlantic by boat. On rough seas. For two weeks.

Should we all be doing what Thunberg did?

I think Thunberg is a heroic young activist, and there’s value in activists who take a purist approach, like refusing to ever fly. But the value lies less in their individual action and more in their ability to serve as a powerful jolt to our collective moral imagination — to shift the Overton window, the range of behaviors that seem possible. Thunberg’s well-publicized sailing voyage, for example, helped convince others to fly less. But to say her approach has been a potent rhetorical tool is different from saying it’s a model that every individual should follow to a tee.   

For one thing, not everyone can sail the seas for two weeks — whether because of the time required, a physical health condition, or some other factor. And it’s not clear that all people should forgo all flying. 

That’s because we each have multiple values. Yes, protecting our planet is a crucial value. So is, say, nurturing relationships with beloved family members and friends who live abroad. Or developing a career. Or learning about other cultures. Or making art. So, even though minimizing how much we fly is a virtuous thing to do, some thinkers would caution you against treating that as the only relevant value. 

Take contemporary philosopher Susan Wolf, who wrote an influential essay called “Moral Saints.” She argues that you shouldn’t actually strive to be “a person whose every action is as morally good as possible…who is as morally worthy as can be.” If you try to optimize your morality through extreme altruistic self-sacrifice, she says, you end up living a life bereft of the personal projects, relationships, and experiences that make up a life well lived. You can also end up being a crappy friend or family member.

We often think of “virtues” as being connected to morality, but Wolf’s point is that there are non-moral virtues, too — like artistic, musical, or athletic talent — and we want to cultivate those, too.

“If the moral saint is devoting all his time to feeding the hungry or healing the sick or raising money for Oxfam, then necessarily he is not reading Victorian novels, playing the oboe, or improving his backhand,” she wrote. “A life in which none of these possible aspects of character are developed may seem to be a life strangely barren.” 

In other words, it’s okay — even desirable — to devote yourself to a variety of personal priorities, rather than sacrificing everything in pursuit of moral perfection. The tricky bit is figuring out how to balance between all the priorities, which sometimes conflict with each other.

In fact, I think part of the appeal of the purist approach is that it actually makes life easier on this score. Even though it demands extreme self-sacrifice, the extreme altruist never has to ask herself how much of the luxury (in this case, flying) to allow herself. The right answer is clear: none. 

By contrast, if you’re trying to balance between different values, it’s nigh on impossible to arrive at an objectively “right” answer. That’s very uncomfortable; we like clear formulas! But I tend to agree with philosophers like Bernard Williams, who argue that it’s a fantasy to think we can import scientific objectivity into the realm of ethics. Our ethical life is just too messy and multifaceted to be captured by any single set of universally binding moral principles, any systematic moral theory. 

And, if that’s so, we have to look at how compelling we find the case for each competing value. It’s often obvious to us that we shouldn’t give equal weight to all of them. For example, I’m obsessed with snorkeling, and I’d love to be able to travel to all the top snorkeling destinations this year, from Hawaii, to the Maldives, to Indonesia. But I know I can’t justify taking infinite flights for infinite snorkeling trips during a climate emergency! 

At the same time, that doesn’t mean I won’t ever go on any trip whatsoever. I do sometimes let myself travel by air, especially if it’s for a purpose that is not only pleasurable but also essential to a life well lived, like nurturing relationships with friends and family members who live far away. And when I fly, I try to make those miles really count by staying for a longer time. 

This is basically what you’re already doing: “I’ve tried to take the approach of flying less frequently and staying for longer periods of time,” you wrote, describing “the one roundtrip I would take on a vacation per year.” I think that’s a reasonable approach, especially given the lack of trains and buses in your area.

So, even though you framed your dilemma as a question about whether or how much to fly, I don’t actually think the flying bit is your real problem. The real problem is this bit: “I feel resentful with the carefree way I see friends approaching this issue, like flying out every month to watch a game. I feel like I’m torturing myself with guilt over something that no one cares about.”

To be clear, it’s totally understandable to feel resentful; what your friends are doing does sound excessive. But the issue is that your resentment is making you miserable. And a virtuous but miserable life is not likely to be sustainable.

Some do-gooders can go to altruistic extremes without feeling resentful or judgmental. They may be able to forgo flying entirely and use that choice to create new forms of meaning and connection and to enrich other aspects of their lives so that they don’t become joyless, judgy, or one-dimensional moral optimizers of the sort Wolf described. But most of us are not in that category. And unless you are, I wouldn’t counsel you to go down the purist path, because resentment and judgmentalness can cause their own harm. They harm you. They harm the relationship between you and the targets of your judgment. And they can, ultimately, harm the cause itself because they’re off-putting to others and they make being climate-friendly seem impossibly hard. 

If you’re like most of us, a path of moderation will probably work better. You can decide on a balance that you think is reasonable — for example, one roundtrip flight per year — and stick with that. Once you’ve done that, ditch the guilt that’s torturing you. That’ll help diffuse the resentment, some of which I suspect is actually resentment toward yourself, because of how you’ve been torturing yourself. 

But that on its own might not be enough to get rid of all the resentment, because flying once annually still might feel like a big sacrifice relative to what your peers are doing. So one key intervention here is to expand your aperture, to look at what a broader group of people are doing, so that you don’t feel you’re sacrificing for the sake of “something that no one cares about.” More people care than you might think! 

A study published in Nature Communications found that 80 to 90 percent of Americans are living in a “false social reality.” They dramatically underestimate how much public support there is for climate policies. They think only 37 to 43 percent support these policies, when the real proportion of supporters is roughly double that. (And support is high across the world.) The study authors note that this misperception “poses a challenge to collective action on problems like climate change,” because it’s hard to stay motivated when you think you’re alone in caring.  

Concretely connecting with others who are choosing to fly less will help bring this home for you and make you feel that you’re part of a community that shares your values. Networks you can reach out to include Stay Grounded, We Stay on the Ground, and Flying Less. The sense of belonging and camaraderie you get from being part of such a group can help you form positive emotional associations with your reduced-flying lifestyle. You’ll feel like you’re gaining something, not just losing. 

I think that’s especially important given that resentment can actually feel good in the short term (even if it damages our well-being in the long term). Righteous indignation is a rush; it gives us an energy boost. So we can’t expect the brain to give it up just like that. We need to replace it with something else that feels good. The best candidate may be the pleasant emotion that philosophers and psychologists have identified as resentment’s exact opposite: gratitude. 

Next time you feel resentment bubbling up, go out in nature and do something you enjoy — birding, hiking, swimming — and really savor it. Pay close attention to each sound, each smell. Remind yourself that your reduced-flying lifestyle is helping to preserve this source of pleasure. In other words, it’s enabling you to get more of what you love. As you do that, I hope you’ll feel not only proud that you’re living in line with your values but also very grateful to yourself. 

Bonus: What I’m reading

• This dilemma reminded me not just of Greta Thunberg, but also of Simone Weil, a WWII-era philosopher who died early because she starved herself, refusing to eat more than people in occupied France. She was a “moral saint” if ever there was one. And as this excellent essay in The Point magazine notes, “Weil is a saint, but many couldn’t stand her.” She’s admirable for how much she cared about others’ suffering, but is her extreme self-sacrifice actually exemplary, in the sense that we should all follow her example? I don’t think so.    

• I also finally picked up a book that’s been on my to-read list for ages: Strangers Drowning by Larissa MacFarquhar. It does a beautiful job telling stories about extreme altruists and getting you thinking about the pros and cons of the purist path. 

• I’m enjoying Isaiah Berlin’s essay “The Pursuit of the Ideal” in which the moral pluralist philosopher argues that there’s no one right way to live, whether on the individual or state level. “Utopias have their value,” Berlin writes, since “nothing so wonderfully expands the imaginative horizons of human potentialities — but as guides to conduct they can prove literally fatal.”  

It’s been feeling very 1995 lately. 

Oasis, whose last good song came out back when Macs were still see-through, was the second-biggest tour on the planet last year. Gen Z is snapping up the flip phones and digital cameras their parents had traded in for smartphones, and Y2K-era fashion is flooding the mall, in case you were wondering where all the rhinestones came from. Pop star Olivia Rodrigo just released a hit album heavily influenced by alternative rock recorded a decade before she was born. 

Ask Americans directly and they’ll tell you: the 1990s are the decade we’re most nostalgic for, edging out even the boomer-beloved ’80s. 

Speaking as someone who lived through the 1990s as a teenager and mostly enjoyed it (at least in retrospect), it makes total sense to me. Of course, it would — as a Washington Post analysis found, when Americans name the country’s “best decade,” the answer inevitably boils down to whichever decade they turned 11. 

But personal experience also means that, with a little effort, I can remember what the 1990s were actually like to live through, and the reality was a different story than the myth — especially for teenagers of that era.

Take teen pregnancy. In 1991, the teen birth rate hit a record high of 61.8 births per 1,000 girls aged 15-19. In his 1995 State of the Union address, President Bill Clinton called “the epidemic of teen pregnancies and births where there is no marriage” America’s “most serious social problem.” A National Campaign to Prevent Teen Pregnancy formed the following year in direct response. 

And the fear ran well beyond pregnancy: juvenile arrests peaked in 1996 at nearly 2.7 million, at the height of the so-called “superpredator” panic over a coming wave of remorseless teenage criminals. In 1995, as the writer Adam Mastroianni points out in an excellent new essay that helped inspire this piece, half of high school students drank alcohol, 35 percent smoked cigarettes, 40 percent had at least tried marijuana, one in 10 had brought a weapon to school at some point, and about 6 percent of teenage girls were pregnant in any given year. The teen suicide rate for boys hit a record high in 1990. Americans were terrified for their teenagers, and terrified of them. 

So, no, the 1990s weren’t all teen boy bands, high school comedies, and endless economic growth. But what’s amazing, at a moment when everyone seems sure that kids today are not all right, is just how much those scary signs of teen dysfunctions from the 1990s have simply vanished.

This spring, the CDC reported that the US teen birth rate fell to 11.7 births per 1,000 girls ages 15 to 19 in 2025 — down 81 percent from its 1991 peak, and the lowest figure ever recorded. That has been the pattern for more than three decades now: the teen birth rate sets a record low, then breaks it, then breaks it again.

It’s not just teen pregnancy: nearly every risky teen behavior of the halcyon 1990s started collapsing almost at once, kept collapsing for 30 years, and is collapsing still. The teen birth rate dropped 7 percent in 2025 alone. And yet it’s hard to find anyone who planned this victory, and nearly impossible to find anyone who celebrated it.

The kids got careful

Let’s start with teen births, which largely comes down to two factors working in concert: fewer teens are having sex, and those who are use much better contraception. 

The share of high schoolers who have ever had sex fell from 54 percent in 1991 to 32 percent in 2023, and Guttmacher Institute researchers found that improved contraceptive use drove essentially all of the pregnancy decline in the late 2000s and early 2010s, including a sevenfold rise in teens using long-acting IUDs and implants. In the decade that followed, delaying sex became the biggest single contributor. 

But contraception can’t explain why violence fell too. The best unified theory comes from psychologists like Jean Twenge and more recently writers like Mastroianni, whose “Decline of Deviance” essays argue that kids stopped taking risks of all kinds in part because their futures became too valuable to gamble. As lives got longer, safer, and richer, the expected cost of any given joint, fight, or pregnancy went up. Twenge called this the “slow life strategy,” and it shows up as much in data about taking good risks as it does in taking bad ones: the share of high school seniors with a driver’s license, for instance, fell from 82 percent in 2005 to 63 percent in 2023.

If you’re waiting for smartphones to enter the picture, you’re going to keep waiting — most of these trends began in the 1990s, long before broadband, let alone Instagram. And policy didn’t seem to do much either. England spent hundreds of millions of dollars on a national teen pregnancy strategy, and a comparative analysis found rates fell about as fast as they did in similar countries that spent nothing. (Researchers have found that one of the few interventions with credible causal evidence behind it, at least in the US, was MTV’s iconic 16 and Pregnant — a reality show that worked by making teen parenthood look as exhausting as it was in reality.) 

Everything everywhere at once

The same collapse in dangerous behavior shows up everywhere you look. Half of high school students drank alcohol in 1991; 22 percent did in 2023. Seventy percent had tried a cigarette in 1991; under 18 percent had by 2021 — and no, they didn’t all just switch to vaping. E-cigarette use has also been falling since 2019. The share of high schoolers who’d been in a physical fight in the past year dropped from 42.5 percent in 1991 to 22 percent by 2019. And this year’s Monitoring the Future survey found that 66 percent of 12th graders — a record — used no alcohol, marijuana, or nicotine at all in the past month.

For me, no number stands out more than marijuana. When I was a teen in the 1990s… well, when I was a teen in the 1990s I was way too uncool to know anyone who had marijuana. (Honest, Mom.) But weed is now legal for adults in half the country, almost certainly easier for a teenager to obtain than at any point in American history, and generally regarded by young people as less dangerous than their parents ever believed. Yet even as marijuana use has spiked among adults, it has fallen among teens from its late-1990s peak. 

All that caution shows up in the most basic stat there is: teenagers stopped dying so frequently. In 1990, 88 of every 100,000 Americans ages 15 to 19 died each year; by 2013 it was 45. The single biggest reason was the car: since 1975, teen road deaths have fallen 67 percent thanks to safer vehicles, the graduated licensing laws every state adopted starting in the mid-1990s, and all those teens who never bothered getting a license in the first place. At the 2013 low, an American teenager was half as likely to die as one in 1990. 

That last stat is worth holding onto. Nostalgia isn’t just misleading; it also suffers from survivorship bias. Adults like myself may look back on their 1990s adolescence as a golden age, but there are tens of thousands of my peers who never lived to look back.

The price of caution

The problem with reducing risk-taking behavior across the board is that not all risks are bad. The same caution that might keep a 16-year-old from smoking or having sex might later keep her from founding a company, moving across the country, or writing a strange novel. In Mastroianni’s “Decline of Deviance” essays he documents falling cultural and scientific risk-taking right alongside fewer fistfights. “For the first time in history,” he writes, “weirdness is a choice. And it’s a hard one, because we have more to lose than ever.””

And if teens are so safe, why are they so sad? Forty percent of high schoolers reported persistent sadness or hopelessness in 2023, and the social psychologist Jonathan Haidt has argued that we’ve overprotected kids in the physical world while underprotecting them in online spaces that didn’t even exist in the dial-up 1990s. The timing backs him up: when the CDC first asked the sadness question in 1999, about 28 percent of students said yes, and the number barely moved for nearly two decades until surging after 2017. Physical safety and psychological well-being may turn out to be more separate than we ever realized.

But our valid worries about the mental state and uncertain future of today’s teens shouldn’t blind us to just how remarkable the shift from the 1990s is as a whole. As Mastroianni writes, “We would have spent billions to solve all of these problems back in the 1990s… and yet when we got the thing we wanted so badly, we didn’t even notice.” 

America wanted its teenagers to stop getting pregnant, stop smoking, and stop fighting — wanted it badly enough to put it at the center of a State of the Union address — and then got nearly all of it, mostly free of charge, from the kids themselves.

“Can we take a win?” Mastroianni asks. We can start by counting this one.

A version of this story originally appeared in the Good News newsletter. Sign up here!

“Gotta go,” a young woman murmured into her phone, slipping into a gaggle of gawking New Yorkers pointing and staring at a teetering office tower in the heart of midtown Manhattan on Tuesday. “This building’s like collapsing in New York.” 

If you squinted past the police barricades, you could see the sagging upper floors of the old Pfizer building at East 42nd Street between Second and Third Avenues, where steel beams had begun “bending like cigarettes” that morning, threatening dozens of luxury apartments being carved into the empty office spaces above. 

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Making housing out of high-rises was supposed to be common sense, a lemons-into-lemonade fix for a nation with a massive glut of underused office towers and a dire shortage of homes. In the six years since the pandemic instigated a major pivot to remote work, tens of thousands of such office-to-residential conversions have sprouted up across the country, including the 1,600-unit project planned for the former Pfizer headquarters, the largest project of its kind in New York City history, which involves retrofitting the existing structures and adding multiple new floors and expansions above them. 

It’s not yet known precisely why a chunk of it nearly came tumbling down this week, or why inspectors and project managers failed to note that the original 1960s columns would buckle under the weight of the added floors. One union worker blamed the developer’s reliance on mostly non-union labor. Others have pointed to the site’s history of safety violations. Still others, including many experts, say that it could well have been an engineering failure or a miscalculation baked into the renovation’s blueprints. (Neither the building’s developer nor the architectural firm behind the redevelopment responded to Vox’s request for comment.) Regardless, the near collapse is not an indictment of all such projects, but a reminder that they are often exceptionally hard to pull off. 

They are also worth it. Over the past few years, cities have gotten much better at turning empty offices into housing by offering generous incentives for wary developers and peeling off layers and layers of red tape. Meanwhile, architects have gotten much cleverer with the design hacks that can affordably and safely retrofit a vast, sterile office space into a place you could call home. As a result, over 90,000 apartments are now being built out of empty office buildings across the US, according to RentCafe, up from just over 23,000 in progress in 2022. 

If momentum continues to grow, these new apartments could help put a serious dent in America’s housing shortage — experts agree that we need a few million more homes to lower rent and mortgages — with the bonus of being located in some of the most desirable and well-connected neighborhoods in the nation. Converting empty office spaces into housing is also significantly faster, often cheaper, and much less carbon-intensive than building from scratch.

But teaching an old building new tricks is still difficult, delicate work. And as New York City learned the hard way this week, if something goes wrong, it can go very wrong very fast. “Every building is different,” said Anita Kramer, senior vice president at the Urban Land Institute. “You don’t know what you’re getting until you take it down to the bare bones,” until you “rip out the guts and get down to the cement slabs and the beams.”

What it actually takes to turn an office building into an apartment

You’d be forgiven for assuming that turning offices into apartments is more or less as simple as plucking out the water coolers, swapping cubicles for kitchenettes, and erecting a few extra walls here and there. 

Not so. In many cases, such conversions involve gutting the original building to comply with housing codes requiring dwellings to have amenities like operable windows or a running shower. When you build from the ground up, you can incorporate those requirements from the get-go, but it can be pricier and more complex to make them work after the fact. 

“If someone gets a piece of fabric and sews it [to the contours of]  your body,” explained Tracy Hadden Loh, a fellow at Brookings Metro, who studies office-to-residential conversions, “it’s going to fit way better than if you turn a bag inside out and cut a hole for your head.” Likewise, you can’t tweak a building made for corporate offices into one built for living without getting quite crafty.

Some buildings are naturally easier to change than others. New York City legitimized thousands of once illicit artist lofts — located inside abandoned warehouses, mills, and factories — by bringing them up to city housing codes in the 1980s. This was relatively straightforward because such factories were built over a century ago, when the sort of narrow floor plans, high ceilings, and wide windows well-suited for apartments were still the norm for most new construction. 

But most post-World War II office towers were built differently, with massive floor plans whose windowless interiors and central air conditioning might work for cubicles, but that work less well when broken up into individual units. As if poking a hole through a slice of bread and calling it a bagel, the developer behind the old Pfizer HQ carved out two deep atriums in a converted office tower in Manhattan’s financial district to let in enough natural light to build 1,320 apartments. Since most such buildings have central air conditioning and plumbing, making sure each new unit has its own individualized systems means punching small Swiss cheese-style holes throughout the structure and patching up the gaps with a concrete slab later. 

“There’s this whole subsegment of developers that are learning how nimble they have to be” to make such designs work well, said Kramer, finding themselves “redesigning and redesigning the configuration of all the units” as they unearth unanticipated challenges or materials in the original building that they didn’t know about until they took out the guts. 

Loh emphasized that adding new floors on top of old ones, as in the Pfizer project, is a common practice to make the most of a prime location. Under normal circumstances, she said, “steel-frame high-rise construction is incredibly stable.” But stitching new, widened top floors to the top of a building’s pre-existing 1900s structure is also a delicate, somewhat miraculous engineering feat. If something gets overlooked, either in the engineering or construction process — like a failure to properly reinforce a building’s original steel columns, as appears to be the case this time — it can have drastic consequences.

“The need for checks and balances to protect health and safety are real,” said Loh, but “the key takeaway here is not ‘Oh, we shouldn’t have done that’” at a time when momentum is rising rapidly, and developers are getting better and better at anticipating new challenges each year. Turning empty office buildings into housing is challenging, and sometimes even risky, but it can be done. Or as Loh puts it, “We should do that. We just need to make sure we have enough inspectors.” 

When you ask people when they knew Covid was going to be a huge deal, they give a range of answers. “When Tom Hanks got sick” is a popular one. So is “when the NBA suspended the season.” The most plugged-in people will sometimes cite early rumblings from Wuhan in December 2019/January 2020.

For me, the turning point came on March 17, 2020, when Republican Sen. Tom Cotton proposed sending every American checks from the government.

To be clear, at this point, my then-employer Vox had already sent everyone to work from home indefinitely, and it was clear something dramatic was happening. But I hadn’t yet internalized that the Overton Window in American politics had shifted dramatically. 

True, there were some Republican Senators who, by 2020, were expressing more openness to safety net programs, and rethinking Reagan-style laissez-faire economics. Tom Cotton, though, was not one of these senators. I didn’t think he really had strong economic policy opinions at all; he was a defense and culture war guy. He cared about defeating China and, secondarily, defeating Woke. Universal cash handouts were not his bag. And yet here was Cotton, not just calling for near-universal cash payments, but also for welfare work requirements to be suspended and for big block grants to states to expand unemployment insurance. 

This turned out to be an early indication of the actual policy the US would pursue. Within a couple of weeks, with the US unemployment rate fast headed for what would be a record high of 14.7 percent in April, a Republican Senate and president had signed off on the CARES Act, which included payments of up to $1,200 per eligible adult, $2,400 for eligible married couples, and $500 per qualifying child, along with a $600 per week unemployment insurance and a massive business bailout program. The Senate vote was unanimous, and the House approved the final Senate amendment by voice vote. 

If you had told me literally any of that would happen in February 2020, I would have laughed at you. But the normal rules had stopped applying. All that was solid had melted into air. Much, much bigger things were, suddenly, possible.

I’ve been thinking about that moment a lot as advanced AI models grow more and more capable, and more and more central to many businesses’ strategies. As of May, Anthropic is reporting an annualized revenue rate of $47 billion, equaling the likes of Coca-Cola and exceeding Netflix. That’s up from $30 billion a month earlier. If their revenue keeps growing at 56.7 percent a month, they will outpace Amazon, currently the highest-revenue company in the world at $717 billion a year, by late November or early December. The AI boom is already unfolding faster than the internet or mobile booms before it and may yet speed up even further. The debate over whether this tech is real and valuable is, essentially, over. The only question is what, and how large, its effects on our lives will be. 

This is happening unbelievably fast, and it seems likelier and likelier that we will face a moment, like that in March 2020, when the speed and disruption of AI progress begins to constitute an emergency that policymakers will be willing to take surprisingly large risks to confront. There will likely be a moment of unusual policy freedom and flexibility, a moment which is brief — but could enable large changes for the better.

The US is currently not ready for that moment. But we need to get ready, fast. And we need your help. My colleagues at the Center for Shared AI Prosperity, a new DC-based research group, are attempting to collect a menu of detailed policy ideas that can meet this moment. In fact, we have an open Request for Ideas with funding that can go to the best proposals people submit for how to set up the tax code and safety net in a way fit for the AI era. Now is the time to act.

These moments don’t last forever

I sometimes talk to friends in the tech world who assume that the power and economic impact of advanced AI will permanently shift our politics, and that the policies necessary to keep everyone afloat (like, say, a guaranteed income, or a sovereign wealth fund) will materialize without much effort. After some 17 years as a journalist covering US politics and policy, I think this is overly optimistic, so say the least. Congress is like jello: flick it and it will shake, but it eventually settles back to normal.

Take Covid. Within a couple of months, the apparent consensus had evaporated, and Republicans were back to resisting safety net expansion. By May, Cotton had pivoted to pushing the No Bailouts for Illegal Aliens Act, which “amends the CARES Act to prohibit sending future funds to states or municipalities until they certify they aren’t issuing stimulus checks or other payments to those in the United States illegally.” By August he had a bill to deny virus-related federal employment funds to people convicted of federal offenses because of “riots.” The pandemic was still raging but the policy emergency, and the bipartisan window for much larger-scale action, had mostly closed.

The 2008 financial crisis offers another example. There, the window was open somewhat longer. At the very beginning of the recession, in February 2008, the Bush administration went against its normal laissez-faire commitments and supported a stimulus package championed by then-Speaker Nancy Pelosi built around per-person checks to nearly all Americans, including many of those not owing income tax. In July, President George W. Bush signed a bailout of Fannie Mae and Freddie Mac in the face of strong opposition from fellow Republicans in the House, but having mostly won over his party in the Senate.

In September, when Lehman Brothers collapsed and the possibility of a cascade of massive bank failures seemed very real, Bush demanded a sweeping $700 billion bailout that proposed purchasing toxic assets from at-risk banks (the “Troubled Asset Relief Program,” or TARP). As the subsequent years would demonstrate, bailing out banks failing due to their own irresponsibility was not exactly a popular position in the general public. Members of Congress are not stupid, and they realized this at the time. On September 29, the House voted down the proposal, with huge numbers of both parties defecting from Bush and Pelosi’s position. That led to a large stock sell-off that terrified lawmakers. That experience, some last-minute tweaks, and truly herculean lobbying from the administration, the Fed, and others led the House to switch course and pass the bill on October 3, though within weeks of its passage, Treasury abandoned asset purchases in favor of buying equity stakes in the banks directly.

The full course of 2008 shows the value of, and power inherent in, being prepared. The February 2008 stimulus package was very roughly improvised. It worked a little bit, but proved nowhere near big enough. If Pelosi and Bush had had a more thought-through proposal on hand, perhaps one that automatically repeated and scaled the checks depending on where the unemployment rate went, then the recession would have been much less severe and the 2009 stimulus might not have proven necessary.

TARP was an example of a case where some key actors were prepared. The structure of the program came from the “Break the Glass Plan,” a proposal put together by Bush Treasury officials Neel Kashkari and Philip Swagel in April 2008 explicitly designed as a “just in case” plan for the extreme situation where the whole financial sector needed recapitalization. That case, of course, came to pass, and because Kashkari and Swagel had a plan, there was something for Congress to quickly pass. That was good — TARP played an important role in preventing the financial crisis from worsening.

But it also meant that the plan reflected Kashkari, Swagel, and their boss Hank Paulson’s overall conservative worldview. One could imagine a plan like that which saw the US government instead outright nationalizing major banks, or imposing strict capital requirements on them in perpetuity as a condition of the bailout money, or banning them from owning hedge funds or doing speculative trading. A different administration with different views might have designed a different emergency plan — and because it was genuinely an emergency, that plan would likely have passed, with very different consequences over the next few years. 

What stocking the shelves for AI means

One way to think of the project of AI economic policy in 2026 is as designing the equivalent of the Kashkari-Swagel plan: something detailed, opinionated, and actionable that can be deployed quickly when the situation gets dire. What that plan looks like will, of course, depend on one’s values and commitments; the America First Policy Institute’s emergency plan will not look like the AFL-CIO’s.

The Center for Shared AI Prosperity was founded with an aim to produce plans of this nature designed to make sure any economic windfall from AI is widely shared, and that workers and low-income Americans are not left behind in the transition. We were also founded out of a frustration at the inadequacy of the proposals we were seeing from two ends of the AI policy debate.

On the one side are ideas from the AI labs themselves. These tend to be ambitious — indeed ambitious enough to seem like plausible answers to a problem of the magnitude of AI completely reshaping the economy — but woefully unspecific. They more closely resemble dorm-room philosophizing rather than legislative drafting.

OpenAI’s “Industrial Policy for the Intelligence Age” from this past April, is one such example,  laying out a number of very broad ideas: taxing capital more, a sovereign wealth fund invested in the AI economy, portable job benefits. It’s light on the specifics: What kinds of capital taxes? How big a hike is too big? How do you make health benefits portable without disrupting people’s current plans? How does the sovereign wealth fund get its money? Anthropic’s Economic Policy Framework is somewhat more specific, offering paragraphs per idea where OpenAI has a sentence or two, but still nowhere near the level of detail necessary to actually write legislation.

On the other side are proposals from within the DC policymaking world, which are firmly rooted in what seems politically viable right now but would be woefully inadequate in the face of the likely economic disruption that’s coming. Former Commerce Secretary Gina Raimondo and her group RAISE US have centered employee retraining; Raimondo’s recent New York Times op-ed centered ideas like new credentials from community colleges and expanded apprenticeship programs as the answer to mass AI unemployment. These are sensible tools for ordinary labor-market churn, but they are mismatched to a transition that could displace whole categories of work on a compressed timeline. The dawn of machine intelligence will demand more from our leaders than certificate programs.

The best case for this kind of caution is that ideas on the scale of the labs — sovereign wealth funds, universal capital accounts for all Americans, permanent relief funds for the long-term unemployed — are dead in the water in DC. Which might be true — now, at least. 

But this is where Tom Cotton’s brief love of cash transfers becomes relevant. We should not overindex on the way the politics look right now. The world is about to become very strange, and we may be surprised by the scale of change in response that can earn even bipartisan support.

Indeed, it’s notable that both the 2008 relief measures and the 2020 CARES Act came under Republican presidents with Democrats controlling at least one chamber in Congress, which is also the likely situation after the midterms this year. Democrats are always willing to vote for big new safety net programs to protect unemployed and low-income people. But Republicans are often willing to compromise their usual anti-welfare stances when they’re the party in the White House, and their approval ratings depend on the country’s basic economic health.

What action they might take in a 2027 or 2028 featuring massive AI-based economic disruption is still unclear. But right now, we all have an opportunity to help shape it. The Center for Shared AI Prosperity is running a request for ideas, seeking proposals for shared AI ownership, new AI-related taxes and revenue raisers, and new safety net programs to share the gains widely. We want ideas from economists and think tanks, of course — but also from the labs, from independent researchers and academics, and from ordinary citizens with an interest in where this technology is going.

Stocking the shelves is hard work, and we don’t have all the answers. But you just might, and we’re going to need all the help we can get if the US is going to emerge from the AI transition as a prosperous, functional nation.

The climate case against beef is now almost boringly well-established: It is, by far, the most carbon-intensive food in the world, amounting to about 6 percent of all global greenhouse gas emissions. But cows don’t just become burgers and steaks. They also become shoes, bags, couches, and car interiors — products often marketed with a very different story about sustainability.

Leather has often been defended in the fashion industry as an essentially harmless by-product of meat production — a waste material that would otherwise be thrown in the trash. But if you think about it, that assumption is kind of weird: The global leather market is valued at hundreds of billions of dollars annually, and hides are an important revenue stream for cattle producers. We wouldn’t say that paper is a waste product of timber production just because the most valuable parts of the tree are used for lumber. Likewise, animal hides help support extra profits for cattle farming and also carry a share of that industry’s emissions and other planetary impacts. 

A recent meta-analysis published in ACS Sustainable Chemistry & Engineering reveals that cow leather’s carbon footprint is much larger than we thought: 70 percent larger than previous estimates. Using the study’s emissions estimate, Vox calculated that a men’s leather wallet would carry the emissions equivalent of roughly four American-made beef burgers; a leather tote bag, meanwhile, might be comparable to roughly 35 burgers. 

Pound for pound, the researchers estimate, bovine leather emits more than 12 times as much as vegan leathers made from materials ranging from synthetics like polyurethane — mass-market pleather — to next-generation fungi– and plant cellulose-based leathers. 

Mikaila Roncevich, the study’s lead author and a graduate student in the department of fiber science and apparel design at Cornell University, cautioned me that there’s still some uncertainty in the precise numbers due to gaps in the data on global cattle and leather supply chains. But the core insight of the paper for consumers remains the same. “If [leather’s] footprint is shocking or seems high to people, I think it should be a push to keep reflecting on the impact of raising animals for products,” Roncevich said. Leather may benefit (along with wool and other animal-derived materials) from a natural image, but on closer examination, it helps sustain one of the world’s most polluting, environmentally destructive industries.

Why leather’s carbon footprint has been so underestimated

The climate impact of beef and other foods has been relatively well documented — and covered exhaustively in outlets like this one — thanks in part to a landmark 2018 paper that consolidated and compared data for about 40 of the world’s most popular agricultural goods. But “much less attention has been paid to impacts of textiles and materials that originate from [these] farms,” Matt Hayek, an associate professor in NYU’s department of environmental studies and a co-author of the ACS study, told me. With the new paper, the first peer-reviewed meta-analysis of leather’s overall greenhouse gas emissions, the researchers hope to help bring leather the same kind of scrutiny that’s been applied to the food system.

When one industry produces several different saleable products — such as the meat, hides, and other materials derived from cattle — researchers must decide how much of that industry’s emissions should be assigned to each product. There are multiple methods for doing this, but one common one is to use each co-product’s relative economic value. The new paper’s estimate for leather’s carbon footprint comes in so much higher than earlier estimates partly because of the authors’ more accurate global accounting of emissions attributable to animal hides.

Many previous studies of leather’s carbon footprint have relied on the EU’s environmental footprint accounting guidelines for leather, which assume that animal hides are responsible for a tiny share of the environmental burden of cattle farming. That is because, in Europe, dairy and meat production are closely intertwined, with most cattle herds being used for both milk and beef. The European guidelines that have informed many estimates of leather’s emissions recommend allocating 88 percent of cattle’s environmental impact to dairy, and 12 percent to all products coming from the slaughtered animal carcass, which includes mostly beef, but also hides. The downstream result is that hides are treated as responsible for just 0.42 percent of the animal’s total farming footprint — essentially a rounding error.

But that assumption travels poorly to other parts of the world, including the US and other top producers of bovine hides destined to become leather, where most cattle herds are not used for dairy. In Brazil, the world’s cattle-farming capital, only a small share of cattle are dairy animals. Most cattle there are raised for their beef and hides, and demand for leather from the US and other rich countries has helped drive deforestation in the Amazon rainforest, which gets cut down to make room for cattle rearing.  

To correct for the “Eurocentric view” used in past research, as Roncevich called it, the team used data from the UN Food and Agriculture Organization to more accurately trace global cattle herds — accounting for differences between beef and dairy herds and calculating the emissions associated with them in different regions. To determine what share of those emissions should be assigned to leather, they then used estimates of the economic value of animal hides in different parts of the world. As a global weighted average, they found, bovine hides actually make up about 8.1 percent of the total value of the animal at slaughter. 

That might not sound very high, but, the authors argue, it’s significant enough to meaningfully shape the cattle industry. “Leather is a valuable co-product that impacts decisions during the cow’s lifetime,” Roncevich said. Farmers bring animals into the world according to demand for their products — and consumer demand for leather likely means that global cattle herds are larger than they would be otherwise. 

I consulted agricultural economist Richard Sexton, an emeritus professor at UC Davis, for his thoughts on that analysis. The 8.1 percent economic allocation to cattle hides “sounds roughly right,” he told me in an email, but he’s skeptical that even a collapse in demand for leather would have a major impact on global cattle populations. He predicts that such a scenario would result in “a new equilibrium with a somewhat smaller herd size and slaughter volume, but nothing drastic or extreme.” 

What comes after leather?

Beyond the wonky questions about carbon accounting, this research taps into a more visceral debate in the fashion world and our broader culture: the pervasive assumption that what comes from nature must be better for nature. But what seems natural is not necessarily good. 

That message is often especially anathema in fashion media and influencer circles, where natural fibers, including animal-based ones, are widely extolled. “There’s definitely such a gut reaction that people have when they hear the terms ‘natural’ versus ‘synthetic,’” said Roncevich, who is also a designer of accessories made with animal-free materials. (Of course, there is little that’s natural about cattle ranching or preserving animal skins so that they don’t readily biodegrade.)

Many shoppers believe animal leather is more durable than synthetic alternatives, which could partially offset its much higher carbon footprint if it means people need to replace shoes, bags, or jackets less frequently. That can be true, particularly when the synthetic leathers most readily available to consumers are the cheap, thin kind that can crack and peel after relatively little use. There is also concern about the damage of introducing more plastics-based products into the environment. But the reality is far more complicated than a clean quality binary between slaughter-based and synthetic leather (the former can fall apart, too, and is often made more durable with plastic-based finishes). Animal leather has plenty of toxic baggage of its own, from the chromium salts and other pollutants generated by tanneries to the manure runoff and water pollution associated with cattle ranching.

All of the non-animal leathers evaluated in the meta-analysis had a much lower carbon footprint than bovine leather — and the category is no longer limited to fossil fuel-derived pleathers. Startups are now developing leather-like materials from mycelium, cactus, pineapple leaves, apple pomace, and other bio-based materials. But for these materials to become more than niche alternatives and scale affordably, they’ll need continued innovation. 

I suspect people’s feelings about natural and synthetic materials have less to do with a rational weighing of impacts than with the cultural meanings and class signals attached to them. But those signifiers aren’t immutable. Some large companies like Apple have started to ditch animal-derived leather materials, and the study’s authors call for more brands to invest in bio-based leather alternatives. For that to succeed will demand a bit more of us as consumers, too: to be a little more open-minded about what vegan leathers can be, and more clear-eyed about the harms of the real thing.

Melissa Hirsch contributed additional research to this reporting.

This story was originally published in The Highlight. To get access to member-exclusive stories like this every month, become a Vox Member today.

America’s housing supply was built for a world we no longer live in. But what will replace it? 

As the nation turns 250, that is one of the most important questions we face in the coming decades. Building enough homes, of the right kind, and in the right places is a prerequisite for economic opportunity and growth. Our crippling housing shortage is upstream of many of the problems that ail the US, from our cost of living and increasingly zero-sum politics to our seemingly intractable national bad mood. 

The root of the problem is that the United States governs housing under a nearly century-old paradigm that’s been cracking under growing strain. Since the end of the Great Depression and World War II, when the baby boom massively increased the country’s population and millions of Americans sought relief from derelict urban housing, suburbia has been the country’s default blueprint for development. Big single-family homes, two-car garages, and giant strip malls were not merely consumer preferences. They were also written into law by rigid zoning codes — the rules that dictate what kinds of things can be built where — incentivized by midcentury lending standards, and absorbed into the professional common sense of planners and builders. 

The system shaped not just the suburbs, but also many cities, and has kept homes scarce, expensive, and sprawling, resulting in a housing affordability crisis that has come to dominate politics. And in the decades ahead, this pattern will become even more misaligned with the reality of American life. Households are getting smaller, and Americans are getting older. If today’s low immigration rates continue, the US Census Bureau projects the country in 2076 will have fewer families with children and working-age adults, and far more seniors — the inverse of the demographic transition that drove the great suburbanization. Climate change and new technology, such as driverless cars, will also force cities and suburbs and populations to adapt.

US history offers reasons for optimism, showing repeatedly that we can reorganize ourselves with extraordinary dynamism when the occasion calls for it. Our cities have already lived many lives, growing from tiny outposts into world-leading metropolises, before receding again in the wake of suburbanization and de-industrialization, and then more recently gaining new life with influxes of younger generations.

The transformations ahead may not be as physically dramatic as those of the American past, but they call for equally monumental cultural and political shifts in our approach to housing. We’re already making progress: The ascendant “yes in my backyard” (YIMBY) movement has persuaded states and localities to roll back restrictive policies that make it essentially impossible to build enough homes. The effects of those reforms are slowly making themselves felt in more affordable neighborhoods. 

But there is still far more to do. Housing reformers will need to turn their attention not just to removing bad regulations like single-family zoning and minimum lot sizes, but also toward reviving a role for government in shaping our communities through real, big-picture planning. Doing so would supply a missing piece in America’s housing agenda — making US cities and suburbs not just more affordable, but more vibrant and livable and helping us better use our existing infrastructure. That will matter even more as a shrinking working-age population makes endless outward sprawl harder to sustain.

A more abundant, more varied, and even more fun housing future is not inevitable, but it is decisively within reach. Here is what the future could look like by America’s 300th birthday, if we commit to making ourselves anew. 

Suburban retrofit abundance

Arthur Nelson, a professor emeritus of urban planning and real estate development at the University of Arizona, has a few words of warning for anyone trying to report on what cities might look like in a half-century: “You’re not going to be right.” 

Urban planners tend not to project many decades into the future because what that future will look like invariably hinges on factors we couldn’t possibly imagine today. The most important unknown for our future population and housing needs will be whether the US opens its doors to many more immigrants, as it has done at times in the past. Assuming immigration rates remain low, however, US population is projected to peak somewhere around the mid-21st century and fall thereafter; by 2076, it will have dropped back to today’s size, on the way to declining further. 

Despite that uncertainty, many of the housing abundance advocates, policy experts, and urban planners I spoke to for this piece expressed striking optimism that the future of housing will be better than the present, and enthused about how much can be transformed in 50 years. Start with the suburb, where the majority of Americans live today, and where the future of American housing will be decided. 

Imagine that, in 2076, you’re walking through a residential neighborhood in La Mirada, California, a midcentury, southeastern suburb of Los Angeles, one of the regions at the epicenter of today’s housing crisis. The bones look much like the suburbs we know today — gently curving streets, sun-baked yards, low-slung buildings set back from the sidewalk — but the old single-family monoculture in many neighborhoods has loosened: Houses built during the region’s mid-20th-century building boom now have small cottages, also known as accessory dwelling units (ADUs), tucked beside them. Some bigger houses have been subdivided into two homes. Other lots now hold triplexes, fourplexes, and small apartment buildings that sit comfortably among single-family homes. A few houses have become shared homes for seniors who want support and companionship without being cordoned off into a retirement community. (In 50 years, that will include people born in the 1980s, 1990s, and ’00s — me, and perhaps you, too.)

Even as the overall US population has plateaued, this late-21st century Greater Los Angeles might be home to millions more people than today, but it has not had to push all of them farther into the arid desert or the fire-prone hills. Because as many as two to three times more people are living on each acre of land, housing costs have eased. Many people rely on shared driverless cars, freeing up the space that would be needed for car storage, so land that had been parking can be put to better uses.

Perhaps most strikingly different from today’s suburbia, the hard wall between home and commerce — which is near-universally mandated by local zoning codes today — has softened. Near the neighborhood’s edge, where local streets meet a larger main road, a neighborhood grocery and clinic have opened on what used to be strictly residential lots. And, yes: That is a donut shop running out of a neighbor’s garage. A few doors down, an old three-bedroom has become a small co-working space, and a converted garage houses a bicycle repair shop. Housing has not only become more affordable, but with more of the rituals of daily life mixed in, the suburb has gained a richer, more connected public sphere. There are simply more people around — walking, talking, and lingering. 

Could we get there? Some experts I consulted predicted that simply easing regulations on what can be built in these neighborhoods will unlock a long-suppressed capacity for creative adaptation, allowing suburban areas to evolve in precisely this way. In the suburbs of superstar cities like LA, San Francisco, and Boston, land values are so high that property owners have strong incentives to redevelop single-family lots into more economically valuable uses, like multiple housing units. They just need to be legally allowed to do so. 

The YIMBY movement’s recent legislative successes have already put much of the country on that path. More than a dozen states, including California, have passed laws to allow building ADUs on residential home lots, and many others have new laws allowing denser housing, like townhomes and small apartment buildings in these areas too.

“I suspect it’s just a matter [of time] before the rest do the same,” M. Nolan Gray, senior director of legislation and research for the advocacy group California YIMBY, told me in an email. The upshot for the far future of housing is that “detached single-family zoning is dead,” predicts Gray, who is also an urban planner by trade. “I think the typical lot in a (non-HOA) suburb of a typical US city in 2076 will have at least a second unit; perhaps a manufactured ADU plopped in the back, perhaps a McMansion that has been converted into a duplex.” 

Such reforms also offer important tools for a graying population. As Nelson has argued, the number of senior households in the US is already growing faster than younger ones, and without zoning flexibility to redevelop single-family homes into smaller units or adapt them to the changing market in some other way, older homeowners would face the prospect of being stuck with large, hard-to-maintain houses. 

Even more dramatic suburban retrofits might come in commercial districts — think aging, abandoned malls, strip malls, and “power centers” built around big box stores and even bigger parking lots. As Vox’s Rachel Cohen Booth has written, there is a growing movement to turn those sites into housing. 

An increasing number of states have started allowing apartments in commercial districts, where building multifamily housing is an easier sell politically than allowing it in residential areas where neighbors might resist. 

Meanwhile, Gray added, communities across the country have been very rapidly repealing parking minimums — the fixed number of parking spots required at every residence and business. As minimums are phased out, parking lots can be redeveloped  into housing and other uses better than acres of underused, heat-trapping asphalt.

“I expect most of today’s strip malls and shopping malls will gradually be converted into mixed-use pocket neighborhoods,” Gray predicts — a distinctly American version of a much older human pattern of development, where homes, shops, services, and public life are allowed to coexist. 

Maybe we need an urban planning revival

Despite early signs these reforms are nudging American housing toward a better future, the national rate of new home construction has barely moved, and forecasters expect little change in 2026. That owes less to the reforms than to the broader economy: mortgage rates largely stuck above 6 percent since 2022, which raise borrowing costs for builders and freeze existing owners in place; rising material and labor costs; and a thinning construction workforce worsened by President Trump’s immigration policies. Where YIMBYs have passed new laws, many local governments prove adept at finding ways to flout them. Housing advocates will have to commit themselves to a long fight, until change exists not only on paper, but also in the real world.

Even then, unleashing the free market alone won’t solve every problem with how American cities and suburbs are built and organized, or how they feel to live in.

Those failures are visible everywhere: Have you ever wondered why so many residential streets wind around in aimless, circuitous patterns, disconnected from the town around them? Or why you are forced to endure a nightmare commute to drive just 10 miles? These are all failures not just of too much regulation in the form of rigid zoning, but also of an absence of coherent urban planning. 

Robert Goodspeed, an associate professor of urban planning at the University of Michigan, points to good planning as an essential missing element in today’s housing reform movement. “I think that the YIMBY movement has completely missed the importance of planning,” he told me. “Even if we repealed all zoning, it still doesn’t realize a well-designed, well-planned community that has high quality of life.”

The zoning approach works so poorly because it micromanages what can or cannot be built on any given parcel of land. It’s a set of prohibitions on what the private market is allowed to do (made without regard for how people actually want to live): No apartments can be built on this street, even if there’s an enormous amount of demand to live there; no coffee shop may be opened on that corner, even if it would fill up with neighbors delighted to make it part of their daily routine.

Urban planning, on the other hand, at its best is concerned with the public realm. It oversees the larger body of a city or area and provides the connective tissue of its infrastructure — roads, transit, parks, sewers, and other utilities — that links up the space, something the private sector can’t provide. It allows cities to function as a cohesive whole and has the potential to give the public access to what a community has to offer. 

In the late 19th and early 20th centuries, American planners were animated by real civic ambition, laying out future-minded street grids that could continue to grow and connect the residential and the commercial. One reason more recent development has been so poorly designed, Gray argues, is that planners have become so bogged down enforcing the tedious minutiae of zoning codes. “Zoning has utterly consumed planning, to the point that many city planning departments now do little that would resemble what a normal person might think of as planning,” he writes in his book Arbitrary Lines. Gray calls for abolishing zoning altogether, and freeing up municipal planning offices for more useful work that can accommodate the changes we know we need to make to our housing stock. 

Easier said than done, of course. The US comprises thousands of individual cities and suburbs, each with its own zoning code, and they will not surrender that authority willingly. 

But it’s not crazy to imagine that, in 50 years, planning in the US looks very different from today. Local governments derive their authority to zone from states, Gray points out. And just over the last few years, states from Montana to Maine to Oregon have been wresting certain zoning powers away from cities and suburbs. That shift could provide the seeds for a future where planning is run on a more unified, regional level, much like it is in peer countries like France and Japan. Local planners might then be empowered to focus on what matters — facilitating humane growth in places that people want to move to, and creatively solving the challenges that will arise from retrofitting a built environment that was not designed to accommodate that sort of evolution. 

Could we just…start over with all-new cities? 

One of the country’s most audacious attempts to revive American urban planning is unfolding in Solano County, California, roughly an hour north of San Francisco. There, a controversial, billionaire-backed company is advocating an iconoclastic solution to the Bay Area’s housing affordability crisis. 

Instead of fighting through red tape to get permission to add a few homes in Palo Alto or Marin County, the startup California Forever wants to build a new city from scratch. Forty years after construction begins, the company hopes, it would be more populous than the St. Louis, Orlando, or New Orleans of today, providing homes to around 400,000 people and jobs in advanced manufacturing, shipbuilding, and other industries. 

The project has not yet broken ground, and, ironically enough, likely won’t be able to for several more years, as it moves through environmental review and other required regulatory steps. But it eventually hopes to prove that it’s still possible to build physical things in the world’s tech capital, the place that has transformed everyday life at extraordinary speed but still struggles with the elemental task of making room for people to live. The project has won support from many prominent housing reform advocates, who welcome it as a bracing challenge to an untenable status quo that has meaningfully damaged the US economy. (According to one widely cited study, restrictive housing policies in superstar metro areas, including San Francisco and San Jose, lowered overall American GDP growth by around 36 percent between 1964 and 2009 because they prevented more people from moving to those highly productive cities.)

Despite its Silicon Valley provenance, California Forever’s most interesting ambition is less futuristic than throwback. It hopes not merely to add a mass of badly needed housing stock to the Bay Area, but to deliver it in the form of a pedestrian-centered city of the kind that hasn’t been built in the US in a hundred years. Its architectural renderings show handsome mid-rise townhomes, apartments, and single-family homes along shaded, walkable streets with a bus rapid transit system, all organized around a traditional grid network of streets. Gabriel Metcalf, the head of planning for California Forever, told me he predicts the city will eventually have the lowest per capita rate of car travel anywhere in the US other than New York City.

Of course, the project in its full form might not get past regulatory hurdles. Even if it does, it could end up being too expensive for the people who work in its schools, grocery stores, and coffee shops to live in, especially with California’s high labor costs, environmental review, and other expenses baked in. It’s also very difficult to build a successful city from the top-down. 

But whatever becomes of this movement to build entirely new cities, it is tapping into a real gap that already exists in the US housing market: Despite our reputation for being car-loving suburbanites, many Americans want something different. A 2026 Pew Research Center survey, for example, found that 44 percent of respondents say they prefer to live in a walkable area — even if the homes are smaller (other estimates actually put the number higher). The surest prospect for making that a reality might not be new cities, but repairing existing ones. 

Alicia Pederson, a Chicago-based writer, researcher, and founder of the organization Courtyard Urbanist, predicts that, with good urban planning, we could in 50 years see a “golden age of American city-building.” With a graying and eventually shrinking national population, many cities will have to work harder to attract and retain residents by offering a better quality of life, she told me in an email. That might mean providing better housing options that make vibrant, walkable life accessible to more Americans without sacrificing the benefits of suburban single-family homes: spacious, sunny housing units and abundant green space. The kind of courtyard blocks common in some European cities offer one elegant solution: They occupy an entire city block, with a perimeter of mid-rise buildings and an interior yard. And they can accommodate homes in a range of sizes, which are more flexible and easier for aging people to maintain than detached houses. 

The future is still up for grabs

It’s entirely possible that sheer inertia keeps the US on its current sprawling trajectory as it approaches its 300th birthday, with reforms producing only a scattering of ADUs and boxy apartment buildings often derided as “gentrification buildings,” rather than any deeper transformation of the American built environment. 

Arpit Gupta, an associate professor of finance at New York University who I consulted because of his talent for poking holes in urbanist orthodoxies, predicted that the US by 2076 will actually see “a dramatic increase in sprawl” thanks to the future adoption of autonomous vehicles. That’s because he and many other transportation researchers believe many people would be willing to tolerate longer commutes in self-driving cars than they do in cars they have to drive themselves, providing one more reason to push housing ever outward. Minus the self-driving cars, that’s what’s happening in the hyper-sprawling and still growing Sunbelt, where new housing continues to be built farther and farther from city centers. 

But there are many other paths we might take. Domestic migration may begin shifting northward in the coming decades, amid a warming climate and water scarcity in the Southwest. Many Midwestern cities are showing signs of renewed growth (may I recommend moving to Madison, Wisconsin?), offering a chance to build more and better housing on the region’s extensive pre-war urban bones. And it’s much too early to assume that AVs will massively increase the amount we drive, Michael Manville, a professor of urban planning at UCLA, cautioned me. Different policy choices could lead to shared self-driving systems that encourage less car ownership and more density.

The future won’t vindicate every utopian blueprint — nor should it. Our housing system ought to be open and capacious enough to accommodate the country’s diverse and evolving preferences. The way we’ve organized housing for much of the last century has given us not only pervasive unaffordability, but also too few choices, too few versions of the American dream. That very scarcity is part of why Americans today are so angry at one another: It feeds the sense that we’re fighting over scraps. 

But if we make room for more ways of living together and think big about how to get there, we may find ourselves less trapped by the failures of the present than we think. Cities often surprise us: Fifty years ago, who could have predicted that places like New York City and Boston, then battered by population loss and disorder, would recover so dramatically? 

The trajectory we take in another 50 years will surely confound our predictions, too. And that’s reason enough to build something less brittle than what we inherited — a housing approach with enough room, variety, and imagination to enable American life to change again.

This story was originally published in The Highlight. To get access to member-exclusive stories like this every month, become a Vox Member today.

Emily Hoffman was walking home from lunch in the Pittsburgh neighborhood of Squirrel Hill in February 2023, when a driver turning left struck her on the crosswalk.

Hoffman was 34. By the time paramedics arrived on the scene, she had gone into a traumatic cardiac arrest. They strapped her onto a machine that delivered automated chest compressions and rushed her to UPMC Presbyterian, a major trauma hospital in Pittsburgh.

Over the next several days, doctors performed multiple surgeries, kept Hoffman on a ventilator, and waited until she was stable enough for an MRI. The scans showed multiple strokes and severe traumatic brain injury. She was alive, but her family understood that she was not going to make a meaningful recovery to a life she would have wanted.

The next Thursday, a week after the crash, Emily’s parents and her sister Beth Hoffman met with the care team and decided to remove ventilator support to allow her to die naturally. Organ donation came up only afterward. Emily was already a registered donor, and Beth knew it was what her sister wanted.

For most of the short history of organ transplantation, Emily would not have been the usual kind of organ donor.

Almost all transplanted organs once came from patients who died in one specific and rare way called brain death, in which the brain has irreversibly stopped functioning, even as machines keep the heart beating and the organs supplied with oxygen. Brain death is extraordinarily rare,  but it happens often enough to create a workable — though far from sufficient — supply of life-saving organs.

But Emily was not one of the brain-death donors. Even after the strokes and brain injury, she still had some reflexes. She was dying, but not brain dead.

Her donation followed a different path, one that has transformed American transplantation in the last decade. It is called donation after circulatory death, or DCD. Instead of death being declared because the brain has stopped functioning, in DCD, death is declared after circulation ceases and the heart stops beating. Many more people die this way than by brain death.

Death by circulatory criteria has been legally recognized since the 1980s, but for decades, doctors rarely recovered organs this way, because, once blood stops moving through the body, organs begin to deteriorate within minutes. In recent years, however, new machines and surgical techniques have helped change that, giving doctors the ability to preserve organs outside the body, making DCD far more viable.

↗ Explore the interactive version of this chart.

Hoffman’s donation is hardly an outlier anymore. In the last decade, DCD has gone from a rare practice to something that now accounts for nearly half of all organ donors who have died in the United States. In 2000, DCD donors supplied just 219 organs (kidneys, livers, lungs, hearts, and pancreas combined) to the transplantation system in the US. In 2025, DCD brought in close to 17,000 organs. (Most transplanted organs, about 85 percent, come from dead donors, though some organs, most often kidneys, can also come from living donors.)

That growth has saved lives, but it has also pushed transplant medicine into an unusually sensitive moment: the time after a family has decided to let their loved one die but before death has actually occurred.

In brain-death donation, a patient has already been declared dead before the possibility of donation is raised with the family. Because most brain-dead donors are on ventilators, with machines supplying oxygenated blood to their organs, transplant teams can take their time with the donation process.

DCD doesn’t offer that same cushion. Because organs deteriorate so quickly after circulation ceases, the work of donation — the testing, matching, surgical teams flying in — has to be set in motion once the family has decided to withdraw life support but before the patient has died.

This is where the tension in DCD begins. The process pushes transplantation into the narrow interval between that decision to let someone die and the moment death occurs. It creates a situation with almost no parallel in medicine: one set of hands caring for the dying, even as another prepares to recover and transplant their organs.

The medical system tries to manage that complexity with a strict procedural sequence. First, hospital doctors and family conclude that no treatment will bring the patient back to a life they would have wanted. Only then, and only from a separate team, does the word donation come up. The firewall is in place so that the need for organs never shapes the decision to let someone die. 

“Ethically, you want to make sure that those two are uncoupled,” said Wade Smith, director of the Neurovascular Service at the University of California San Francisco.

But as DCD has scaled up, more weight is put on that narrow interval. What was once a rare event is now routine in hospitals across the country, carried out by teams with different levels of experience and overseen through rules that can vary from one place to another. At the same time, the organizations that handle organ donations are under new federal pressure to acquire and distribute more organs from eligible donors.

DCD has saved thousands of lives by making donations possible from patients who once wouldn’t have been donors. Hoffman’s donation improved several lives at once: Her kidneys went to two men, her liver to a third recipient, and her corneas helped give sight to a nine-month-old baby. 

But its growth has also made the fragile period before death more consequential: how families are told, which steps can be taken while the patient is still alive, how consistently hospitals and organ donation teams follow safeguards, and who has the authority to stop the process if something feels wrong.

When DCD was still rare, these questions stayed at the edges of transplantation. Now, they are moving towards its center, as a lifesaving practice becomes a routine part of how Americans die and donate.

The breakthrough

Modern transplantation is a relatively young field, only about 70 years old. And from the beginning, transplantation has depended on the novel medical achievement of keeping organs functional after a person had been declared dead.

The mechanical ventilator, developed in the 1950s, made that possible. It could keep a body breathing, and its heart beating, even after the brain had stopped for good. That created, for the first time, a situation where patients were deceased by every older measure, even as their organs were still functional.

Surgeons were initially wary of recovering organs, largely because the legal lines between life and death had never been clearly drawn. Then, in 1968, a Harvard committee proposed a definition of brain death. By 1981, a model law gave states the language to recognize two ways of legal death. Your heart and lungs could stop for good (circulatory death) or your entire brain could (brain death). Today, every state recognizes some version of that framework.

With those lines in place, transplant teams could work with more confidence, and brain death turned out to be close to ideal for them. Because a ventilator kept the heart beating and blood moving through the organs, even after death, there was no ticking clock to race against. The hospital staff had time to evaluate the organs, sometimes convince families to donate them, find the right recipients, and bring in surgical teams before recovery began.

The problem was always with the math. Brain death is rare — only about three in 1,000 deaths happen in a way that leaves organs usable for transplant. That puts a hard biological ceiling on how many ideal donors there could ever be.

But demand for the organs had no such ceiling. Nearly a million Americans are diagnosed with heart failure each year, while surgeons performed just 4,636 heart transplants in 2024, after DCD became a widely used part of transplantation, up 81.5 percent from 2013. There are “just not enough organs to go around,” said Ashish Shah, chief of cardiac surgery at Vanderbilt University. The kidney numbers are even bleaker. Over 500,000 people are on dialysis in the US, but only a fraction will ever reach the waiting list, and even among those who do, many will die before receiving a transplant offer, said Dorry Segev, a transplant surgeon and researcher at NYU Langone.

The modern DCD boom grew out of this desperation, presenting the possibility of donation in far more common cases of death that transplantation surgeons had rarely been able to draw on before: catastrophic strokes, car crashes, cardiac arrests, and other injuries that left patients with no meaningful chance of recovery but short of brain death. But with DCD, the clock suddenly became a factor. Once circulation stopped, the organs deteriorated fast, and, in many cases, they were ruined before surgeons could recover them. 

Because of those challenges, DCD stayed marginal for decades, at well under a tenth of all donations. Those numbers ultimately spiked because of several things that happened almost simultaneously.

The first was technological. New machines, like TransMedics’ Organ Care Systems — which were first used in 2015 in the UK — could keep a recovered organ alive outside the body, pumping it with warm, oxygenated blood instead of packing it in ice, allowing a heart to beat and function as normal inside a box. This meant that even if there was delay in recovering an organ, that damage could be limited, even reversed, once the organ was put in the machine. 

Other teams found ways to use machines originally developed to support failing hearts and lungs to restart circulation inside the bodies of donors after death had been declared. Transplant teams in Spain and the UK began adapting that technology before American programs picked it up for DCD hearts around 2019. Both approaches helped extend the time to successfully perform DCD.

“As soon as the results were good, the big American centers took it on,” said John Dimarakis, a cardiac transplant surgeon at the University of Washington.

Policy changes also helped push DCD further. In Hoffman’s case, the donation process was coordinated by CORE, the nonprofit responsible for organ donation in the Pittsburgh region. Organ procurement organizations, or OPOs, cover a particular region in the US, and they work with hospitals in that region to evaluate potential donors, speak with families, arrange testing, and offer organs to transplant centers. There are 54 such OPOs in the US, which are certified and regulated by the Centers for Medicare and Medicaid Services (CMS). 

For years, critics argued that OPOs were judged according to weakly defined standards based on numbers they reported themselves, and poor performers were rarely penalized. But in 2020, new federal rules began ranking them against one another, with a mechanism to strip the worst performers of their territory. Facing the threat of losing their monopolies, many OPOs began pursuing harder cases they would’ve earlier passed over, according to Greg Segal, who founded patient advocacy group Organize. A larger share of those more complicated donors were DCD.

Still, no single force explains the speed of DCD’s rise. “Technology plays a big role in it,” said Nader Moazami, a cardiac surgeon at NYU Langone who helped pioneer one of the new techniques. “But it doesn’t explain how suddenly 50 percent of our donors are DCD.” In 2000, there were only 118 DCD donors in the United States. By 2025, there were 8,137. Brain death donation grew over that same period but far more slowly — from 5,867 donors a year to 8,416.

↗ Explore the interactive version of this chart.

Whatever the mix, it’s clear that DCD has led to more organs, shorter waits, and saved thousands of lives that otherwise would have ended on a list. “People who have been waiting now wait less,” Dimarakis said.

On a chart, it looks like an unambiguous triumph — until you step into a hospital room.

The passage

Beth Hoffman remembers her sister Emily’s last morning. She read aloud an email from Bradley Whitford, Emily’s favorite actor from the TV drama The West Wing, who had written after hearing what had happened. Then, a playlist of Emily’s favorite songs played as the breathing tube came out. Within about 10 minutes, while “For Good” from Wicked filled the room, her sister was gone.

What Beth mostly didn’t see was the second sequence unfolding around her: the referrals, tests, calls, and scheduling that would turn Emily from a dying patient into an organ donor. 

Federal rules require every hospital to alert their organ procurement organization whenever a person may be nearing death. The OPO screens those referrals, and most go nowhere. Alexandra Glazier, who runs the OPO that covers most of New England, says hers get about 50,000 such referrals a year. Only 2 or 3 percent turn out to have any medical possibility of donation at all. 

Emily was one such possible case for her Pittsburgh hospital’s OPO. The organization had to reach out to her family; explain what DCD would involve; and, then, start the work that had to happen while she was still alive: reviewing her medical history, testing whether her organs could be used, matching them to recipients, and arranging the surgical teams who might fly in to recover them.

Most families never see much of that work, but some do. Smith, the UCSF neurologist, watched a family agree to withdraw life support and donate, set a time, and gather relatives for a final goodbye, only to learn that the withdrawal had to wait because the OPO still needed more tests. Some families, after being told their dying relative must stay on machines longer for donation’s sake, walk away.

For the Hoffmans, things proceeded more quietly. When the time came, Emily was wheeled into the operating room, and the breathing tube was removed there. The surgeons who would recover her organs were kept away from the withdrawal and death declaration. They often fly in from their own hospitals — sometimes several at once for different organs — but they’re walled off from everything that comes before. “We are not involved in that process,” said Dimarakis, the cardiac transplant surgeon at the University of Washington, “because it’s not ethical for us to be involved.”

That separation is the line DCD depends on. One team cares for the dying patient, withdraws support, and declares death. The other waits outside that decision and recovers the organs only after. The OPO stands between them, coordinating the donation without letting the firewall be breached.

Then comes the waiting. Once the ventilator is out, the clock starts ticking. If the heart doesn’t stop within a window — often about two hours — the organ recovery may be called off, and the patient is returned to end-of-life care. But when circulation does stop, as it did for Emily, the team counts exactly five more minutes to make sure it won’t restart on its own. Only then can a hospital physician declare death, and only then can the transplant surgeons begin.

DCD rests on a simple promise: The need for organs never causes the death. The death is already coming, and donation only changes what can come from it. 

But a new frontier in DCD complicates that promise.

The reversal

Normally, after death is declared, most DCD organs are removed and preserved outside the body, either on ice or on machines that circulate oxygenated fluid or blood. The goal is to slow the damage that begins the moment circulation stops.

Then, around the mid-2010s, transplant teams in Spain and the UK began using a newer technique that restores circulation inside the dead donor’s body, before the organs are removed. It’s called normothermic regional perfusion, or NRP.

In one version of NRP, called abdominal NRP, blood is meant to be restored only below the diaphragm to preserve organs such as the kidneys and liver. In a more controversial version called thoracoabdominal NRP, it runs through the chest, as well, and the heart starts beating again.

For the transplant team, especially heart surgeons, the appeal is clear. Kidneys and livers can survive a stretch without circulation, but a heart is harder to preserve. Once it has stopped, there’s no easy way to know whether it will beat reliably again. NRP helps answer that question by restarting it inside the donor’s body after death has been declared, where surgeons can watch it work before deciding whether to recover it.

Shah, the Vanderbilt cardiac surgeon, says the technique lets doctors take hearts from donors who otherwise would not be able to yield a workable one.

But this kind of NRP is unsettling for the very reason that it is useful. If a death is declared because the heart has stopped, what does it mean to start it again inside a donor’s body, often only minutes later? Is that still death? Or something else?

The controversy isn’t simply that the heart beats again. A beating heart is not, by itself, the same as a living person. The heart of a brain-dead patient can beat, too, can be kept going by machines, and that doesn’t mean the person is alive. The deeper concern is whether restored circulation in the body could reach the brain, which could potentially restore consciousness.

To prevent blood from reaching the brain, surgeons clamp or cut the vessels that carry blood to the head before circulation is restored. That distinction is central to the defense of NRP, and it lets surgeons say they are restoring circulation and restarting the heart, not the person. 

But those safeguards haven’t always worked. In a safety notice last November, the Organ Procurement & Transplantation Network (OPTN), the federal system that oversees transplant policy and data, said it had received “verified reports” that blood had unintentionally reached the brain and brainstem during NRP. Such events are extremely rare, the notice said, but can occur when a clamp fails or blood reaches the head through an unrecognized route. The notice asked transplant programs using either form of NRP to strengthen their safeguards and report any failures. But those recommendations were not national requirements and as of May 2026, the OPTN was still developing formal standards for NRP. For Claire Morgan, a transplant surgeon from North Carolina who has criticized NRP’s rollout, that is a central weakness. “It’s a bulletin. It’s not a policy,” she said. “There’s no punishment for not reporting.”

But even if blood never reaches the brain, NRP can still introduce deeper ambiguity into our understanding of circulatory death. In the first few minutes after a heart stops, it can often be brought back, an event that happens every day in a busy emergency department. In conventional DCD, however, doctors don’t try to restart the heart, because a patient or family has already decided against being revived. It is that decision, not just the stopped heart itself, that turns the moment into a death. The same goes for anyone who dies under a do-not-resuscitate order.

NRP puts pressure on that logic. The circulation declared permanently gone is deliberately brought back. “There’s a misalignment between NRP practices and the legal standard for how death is defined,” said Glazier. You cannot, critics argue, pronounce someone dead because the circulation will never return — and then return it.

Robert Truog, professor of Medical Ethics, Anaesthesia, & Pediatrics at Harvard Medical School, supports NRP but thinks the possibility of blood returning to the brain is the issue that matters most. “The only questions are, is there a risk of pain or suffering in the procurement of the organs?” he said. And there’s a possibility of that if the circulation is restarted in the brain.

None of this is settled, which is why some hospitals refuse to perform NRP at all. Moazami pioneered the NRP heart technique in the US and practices it at NYU Langone. “But you cannot do it at Columbia,” he said, “just five miles away.” Glazier’s OPO, one of the country’s largest, said her organization has done roughly 650 NRP cases since adopting the practice — but only the abdominal kind, holding off on the heart version until the national protocols are better standardized.

Claire Morgan, a transplant surgeon from North Carolina who has criticized the rollout of NRP, is more worried about what happens if something goes wrong. The donor cannot complain, families may never know if there was a concern, and clinicians who speak up may have limited protection if they challenge what happened in the operating room. 

All of that matters, because NRP is already far from marginal. The Organ Procurement & Transplantation Network (OPTN), the federal system that oversees transplant policy and data, only began collecting data on whether NRP was used in a DCD recovery in October 2025. In the first five months of that reporting, from October 1, 2025, through February 28, 2026, 3,463 DCD donors were recovered nationally, according to data shared by the OPTN with Vox. More than half of those involved NRP; though, OPTN doesn’t collect data on which kind.

Vox’s analysis also found that NRP cases were concentrated among some organ procurement organizations. The top 10 OPOs accounted for 47 percent of all DCD recoveries that used NRP.

The patchwork

The core safeguard in DCD — that the decision to withdraw life support must come before questions about donation — is widely accepted. But many of the details around that sequence that shape a family’s experience, or a patient’s protection, are still handled differently from hospital to hospital, OPO to OPO.

“The entire process of DCD or donor withdrawal is not very standardized across the United States or even within states, even within different hospitals in the same city,” Moazami said.

That can mean differences in what families are told about the donation process, what medications are considered appropriate before death, whether NRP is allowed and how it is performed, and who has the clear authority to pause or stop the process if someone believes something is wrong.

That unevenness matters more now, because the transplant system has been trying, with good reason, to recover more organs. For years, many in the field, and those who depended on it, argued that the organ procurement organizations were leaving transplantable organs on the table. Greg Segal, whose advocacy group Organize helped push for stronger OPO accountability, compared the old system to a canvassing campaign where you only knock on the easiest doors. “The problem with OPOs is they were only doing the much easier ones,” he said.

A 2020 rule from the Centers for Medicare & Medicaid Services, the federal agency that oversees OPOs, was meant to change that. It ranked OPOs against one another and created a path to penalize low performers by stripping them of their territories. That policy appears to have had some impact, but it is hard to separate from other forces driving DCD’s rise including new preservation technology, like NRP and broader clinical adoption. Jeffrey Trageser and Charles Strom from the Association of Organ Procurement Organizations, the trade group that represents OPOs, argued that the metrics are too broad, evaluating OPOs partly on whether transplant centers ultimately accept organs and not fully accounting for regional differences such as age of potential donors, local rates of cancer, or how far organs must travel to reach transplant centers.

This pressure to recover more organs has also made some OPOs seem more aggressive to the clinicians working besides them. “Some people view them as vultures, which is horrible,” said Smith, the UCSF neurologist who has experienced the tension from the hospital side. “They’re trying to do their job.” Still, he added, “when you impose that [pressure], then it changes how aggressive they are.”

Both things can be true. The old system needed pressure to perform better. And pressure can create risks, or perceived risks, in a process that depends on careful judgement around a dying patient.

And the safety question isn’t a theoretical concern either. A March 2025 investigation from the Health Resources and Services Administration (HRSA), the federal agency that oversees the national transplant system, documented what can happen when those safeguards fail. In a review of attempted DCD cases at Kentucky Organ Donor Affiliates, an OPO that covered Kentucky and parts of Ohio and West Virginia, HRSA found recurring problems about staff missing vital signs in patients that raised concerns, failed to work collaboratively with hospital medical teams, failed to respect family decision-making, and documented medical data poorly. HRSA said the pattern suggested “organizational dysfunction” and a weak safety culture.

One OPO’s failure does not prove that DCD is broadly unsafe or that OPOs across the country behave the same way. But the Kentucky review showed how badly things can go when the line between patient care and organ recovery is not honored.

Since then, federal officials have been trying to close some of the gaps. HRSA has pushed for clearer family education around DCD and more standardized reporting on ventilated patients referred to OPOs, as well as opened up a reporting channel that sends misconduct concerns directly to HRSA. In a separate case, the Department of Health and Human Services also moved to shut down an OPO in South Florida after finding unsafe practices, underperformance, and paperwork errors.

Organ donation is a touchy subject, because it relies so much on the goodwill and the trust of the people who agree to give their organs so they can live on in others. But the procedural issues also matter, because there are lives at stake on both sides of the process. 

Around 13 people die each day in the US waiting for organs. In that desperate landscape, the rise in DCD has led to many lives saved and helped several more live better, fuller lives. The dearth of organs even compelled my former Future Perfect colleague Dylan Matthews to sign up as a living donor and donate his kidney to a complete stranger. (You can read his story here).

And the value of the donation is not just measured in recipients saved. For the Hoffmans, the knowledge that Emily’s organs helped others offered a solace they had not expected. Emily “gave the gift of life in her death,” Beth told me.

That is the highest ideal organ donation — and DCD – can achieve: a death already coming that still changes the lives of others in need. The case for DCD is clear, but its future depends on its proponents’ ability to protect both patients and public trust.

Clarification, July 1, 6 pm ET: A previous version of this post described how the NRP process intends to stop blood from reaching the brain, but did not acknowledge cases where that does not go according to plan. The post has been updated to include a safety notice from the Organ Procurement & Transplantation Network, which said it had received “verified reports” that blood had unintentionally reached the brain and brainstem during NRP. The post has also been updated to clarify that Dorry Segev and Nader Moazami are doctors at NYU Langone. 

Hi readers! I’m Shayla Love, a science journalist and longtime fan of Your Mileage May Vary. I’m honored to be subbing for Sigal while she’s out on parental leave. I’ll be diving into your questions as a way to help understand human nature and our choices through multiple lenses: philosophical, psychological, and beyond. Please send me any emotional, body/brain, sociological, perceptual, or other kind of life quandaries you might have. 

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My mother is religious, and I can tell that it brings her peace of mind to think I share some of her religious views. For this reason, I currently attend church with her on Sundays. However, I hesitate to tell her directly that I do not necessarily share her beliefs, as this would likely upset her and would not substantially improve my own quality of life. 

At the same time, attending church while knowing I do not fully believe feels somewhat disingenuous. I am unsure whether continuing this practice is the more ethical choice or whether honesty, despite its potential emotional cost, would be the better path. On the other hand, would it not be selfish to prioritize my own sense of integrity over my mother’s peace of mind, especially when the “cost” to me is relatively small: attending church once a week in order to preserve this tacit understanding? 

Dear Pew-Warmer,

Your question raises two interesting issues: whether to tell your mom that you don’t share her religious beliefs and whether to still attend church with her, even if you don’t share the faith. They might seem to be part of the same quandary, but teasing them apart a little more, we’ll see that your church attendance doesn’t necessarily require as much dishonesty as you may think. 

First, no matter what you decide, it could be helpful for you to know that you’re far from alone in managing different beliefs within a family. The amount of mixed-faith families has been steadily increasing, often because — like you — children grow up to have different beliefs from their parents. And this includes people who decide to no longer follow any prescribed religion at all. A Pew Research Center survey done in 2007, for example, found that 44 percent of Americans had changed or left the religion they were raised in. Relationships between people of different religious leanings are common now, too. A different Pew survey from 2015 found that 39 percent of couples married after 2010 identified as mixed-faith (again, including people who identify as non-religious). 

How do all of these people deal with being married or related and believing such different big things? It’s not easy. In a more recent Pew survey from 2023, more than a third of parents said it was extremely or very important that their children have the same religious views as them, which is in line with your sense that your mom would like to share her faith with you. And this is where much of your tension seems to lie. But, perhaps, I can bring you some solace by sharing that the overall data on all of this is more nuanced. I reviewed some qualitative studies — which include interviews — on religion in families to hear from people on both sides of precisely what you’re grappling with. 

In general, parents do seem to wish for their kids to have the same faith as them. As a highly religious Christian father said in one study: “How to pass our belief to our next generation is a burden to me. … We want them and their next generations to have God’s blessings.” And that makes sense, especially for a parent who belongs to a faith tradition that comes with everlasting consequences for people depending on their beliefs and behaviors. 

But, of course, religion is more than a narrow set of rules and consequences. Each contains an elaborate offering of traditions, beliefs, and values. Many very religious parents responding to the same survey said they understood it was up to their children to choose whether to continue in the tradition or not and that what truly important to them was knowing that their children shared the same values. Religion served as a proxy for that. That same 2023 Pew survey referred to earlier found that the majority of religious parents thought it was more of a priority to pass on ethics and values, as well as traits like ambition and being hardworking, than religious belief alone. 

There can even be upsides for relationships when some core beliefs differ, as one 2022 study suggested. Interfaith families — by having to accommodate multiple beliefs — have the opportunity to actually become stronger. The authors concluded that such “families are not more turbulent or problematic than other family relationships” but actually had many additional strengths, like improved communication skills. 

I won’t try to predict your mom’s response based on others’ replies in a study. Nevertheless, I think these findings suggest, at the very least, that it’s not automatic that parents cannot handle it when their children don’t follow their own faith. From the experience of these families, I suggest, if you decide to be more honest with your mom about this, you should emphasize the moral qualities you have in common — and that you plan to maintain. It could be helpful to stress that your decision is a genuine one; taking any other position wouldn’t be true to what you really feel. 

No matter the outcome of this conversation, though, your quandary about whether you should go to church at all won’t be solved. You say that it might feel disingenuous or pose a problem for your integrity to attend church services if you don’t believe. That assumes that your presence at the church is endorsing a belief in God, or in the theology of that religion, or that the latter are required for the former. 

I wasn’t raised with religion, and, instead, grew up around several atheists who worked as scientists. A few had a pretty disparaging view of the belief in God, which they saw as empirically unsound. Yet, as I got older, I began to notice some streaks of religiosity in their positions, like a dedication to the idea that science is the only tool with which to understand the world, a view that’s sometimes called “scientism.” Science is an excellent way to figure out how the world works, but there are other aspects of life — like art, music, spirituality — where it can fall short. I bring this up to say that religious thinking can rear its head even in the non-religious. And within a religious framework, you may discover non-religious elements too. A sociologist from the late 19th and early 20th century, Emile Durkheim, would push back on the idea that going to church means you believe in God, which helps me understand what I saw in my family.  

Durkheim wanted to understand how religion functioned in society. He dismissed the idea that religion, at its core, was about supernatural events and God (or gods). In his 1912 book The Elementary Forms of Religious Life, he examined Australian Indigenous religions to come up with theories about what all religions had in common. He argued that religion emerges when a group of people get together and agree upon what is sacred and what is profane, and then they act in ways that support those categories.

I’ll add that Durkheim’s views on religion have been questioned over the years. For starters, he vastly oversimplified the Indigenous religions he focused on. Yet, I think one of his central ideas — that religion is primarily an expression of agreement within social groups — is useful in making the act of your going to church less about your individual endorsement and more about participating in a group with shared values. 

Durkheim didn’t think that the concepts of “sacred” and “profane” applied only to those within organized religions; it was a more general principle in how societies were organized. Secular groups like sports fans and political parties also gathered together to perform rituals about their shared definitions of what is sacred. Following Durkheim, you could see your choice as less a theological one and more a social one. There could be plenty of values at your mom’s church that mean something to you, like community, taking care of others, and acting morally. 

Durkheim’s theory does require you to be a participant, however, in upholding these values. If that doesn’t apply to you, there is still a way to engage with those with differing beliefs with curiosity, like the psychologist William James. 

His book, The Varieties of Religious Experience, was based on a series of lectures he did at the University of Edinburgh. He was assigned to do 20 talks, and he thought he would dedicate the first 10 to describing “man’s religious appetites” and the rest on various philosophical interpretations. Instead, he became so engrossed with recounting people’s religious experiences that the subject took up all of his lectures. 

James was not a very religious man himself, and so, his thirst for learning about religion is remarkable. In the introduction to The Selected Letters of William James, the novelist and literary critic Elizabeth Hardwick wrote how James’s tolerance for “nuts and cranks, his mediums and table-tappers, his faith healers and receivers of communications from the dead” sometimes confused his peers. How could a man of science be so interested in visions and conversions? 

Like Durkheim, James wasn’t focused on whether religion was true. He had very little interest in theology itself; he fixated on the psychological — the feelings that came with being religious. 

James thought that these feelings — which we all share — were the deeper source of religion. All organized religions came later; they were emotions transformed and organized. He recognized that there were true emotions at the heart of religious conventions, and that people turned to religion to solve human concerns: melancholy, uncertainty about the future, morality, the need for community, expressions of joy. Yet, he was an outsider. He didn’t require himself to be a convert in order to be curious.

James and Durkheim have different approaches, but they both offer clues as to how to turn toward shared social values and how to be curious about others’ emotional lives while not having to commit (or pretend to commit) yourself to beliefs that you don’t have. 

You say that the cost of going to church once a week would be relatively small for you, and, so, I’ll assume that your concerns don’t include participating in a religion that is openly hostile to you or your identity. It would be difficult to participate in shared sacred-making with a group of people that places you in the “profane” category. And being curious about others is a highly generous act that, if not reciprocated, feels dismissive. I hope that by opening yourself up to your mom’s emotional life that underpins her faith, she can do the same in return, even if your own interior landscape isn’t transmuting into religious belief. And it may well be that a genuine connection is what she wants — not a false one. 

A final thought related to Durkheim: He came up with a lovely concept called “collective effervescence”: when many people have the same big feelings together, and the emotions crash together into one big collective firework of expression. To see an easy example of this, watch videos of what happens at events like World Cup matches as teams and fans celebrate big wins. This experience comes about by shared feelings of any kind. If it still feels discomfiting to go to church with your mother, perhaps you can find another way to share ecstatic emotions together and come up with a new definition of the sacred.  

Bonus: What I’m reading

• Speaking of family, Jonathan Weiner writes in this ethereal piece in the American Scholar about how his robust memory skills compare with his brother’s patchier recollections as they both remember their father. 
• In Harper’s Magazine, Katie Thornton tries to learn the utopian, universal language of Esperanto. 
• And my favorite thing I read last week: an older piece of prose from the poet Elizabeth Bishop that I came across in a used bookshop in London, called “The U.S.A. School of Writing.” (It was originally published in The New Yorker.) Bishop takes a scammy job as a writing tutor over the mail and finds surprising connections with oddball students and co-workers.

This story was originally published in The Highlight, Vox’s member-exclusive magazine. To get early access to member-exclusive stories every month, join the Vox Membership program today.

This story was originally published on June 29 in The Highlight. To get access to member-exclusive stories like this every month, become a Vox Member today.

America in the summer of 1976 was not in a good place. 

The president who presided over the country’s bicentennial, President Gerald Ford, only had the job because the previous president and vice president had resigned in disgrace, making him the sole US president who was never actually elected. The Vietnam War had ended in defeat and disgrace when Saigon fell the year before, after the deaths of nearly 60,000 American servicemembers. Inflation hit double digits in 1974 and stayed ugly, unemployment sat near 8 percent, and economists had to invent a word — stagflation — for an economy that seemed to encompass the worst of both worlds.

Given all that, you might assume the national mood leading up to the 200th anniversary was grim. And, yet, on July 4, 1976, something strange happened: Americans threw themselves a hell of a party. 

In New York Harbor, more than 200 tall ships sailed up the Hudson for Operation Sail, drawing an estimated six million spectators — the largest crowd in the city’s history. Ford reviewed the fleet from the deck of the aircraft carrier USS Forrestal. It was the same scene up and down the country that day: parades in small towns, fireworks over the National Mall, church bells ringing in unison at 2 o’clock. It was one cathartic day of celebration after a decade that had offered little reason for it.

And when pollsters asked people how they felt about the country’s future that year, the mood was, improbably, sunny. A Roper survey found more Americans were optimistic than pessimistic about the future by a nearly three to one ratio. More than three-quarters told Gallup the nation had already achieved at least a fair amount of its founding ideals. Somehow, a nation that was in the middle of a genuinely miserable decade looked in the mirror and liked what it saw.

Jump forward 50 years, to this year’s 250th anniversary, and you’ll find the vibes flipped. Roughly 60 percent of Americans tell pollsters the nation is on the wrong track. A majority say its best years are behind it. About three-quarters think today’s children will end up worse off than their parents. Asked a version of that same founding-ideals question from 1976, 77 percent now say the founders would be disappointed in what we’ve become.

But just as they were in 1976, the vibes don’t match reality. Set the mood aside and look only at the numbers, and the country that felt so good in 1976 was, by the most important measures, a worse place to be alive than the country that now feels so terrible on its 250th birthday.

Start with whether you’re alive

Let’s start with the most basic test of how a society is doing: how long its people live.

Life expectancy at birth in the US was 72.6 years in 1976. In 2024, it reached a record high of 79 years — an extra six and a half years of life. At the start of life, a baby born now is far more likely to survive its first year than one born during the Bicentennial, while cancer, once nearly a synonym for a death sentence, now kills a much smaller share of the people it strikes. 

The US made those gains by stopping some of its worst habits, things that were commonplace in 1976 . You might have seen the Bicentennial celebrations through a cloud of smoke, as cigarettes were woven into ordinary life — on airplanes, in offices, in hospital wards — and roughly 37 percent of adults smoked. Today, it is closer to one in 10, and it keeps falling. 

The heart disease and lung cancer that were connected to all that tobacco have receded with it. Add seatbelts and airbags, better trauma care, and cheap drugs that lower cholesterol and blood pressure, and the result is a country where the things that were most likely to kill an American in 1976 are less deadly now.

The America of 1976 sat at the leading edge of a brutal crime wave; the murder rate would peak in 1980 and stay high for more than a decade. By the early 2020s, however, violent crime had fallen back to roughly a 50-year low, and homicide rates this year may end up at a record low. And the single most dangerous thing most Americans do — get behind the wheel of a car — is far less likely to kill them, with the death rate per mile driven now a fraction of what it was at the Bicentennial.

The country got cleaner, and richer, and fairer

In 1976, the air in American cities carried lead, an honest-to-God neurotoxin that was pumped out of every tailpipe of the more than 90 percent of American vehicles that used leaded gasoline. 

Rivers literally caught fire: The Cuyahoga in Cleveland had burned so many times it became a national joke, and Lake Erie was widely written off as dead. And things were bad outside Ohio, too. In Los Angeles, the smog got thick enough to keep kids inside at recess and erase the nearby mountains from view.

Since 1970, however, the combined emissions of the six main air pollutants the EPA tracks have fallen 78 percent — even as the economy nearly quadrupled in real terms, the population grew by tens of millions, and Americans drove far more miles. That split, with growth going one way and pollution the other, is one of the least celebrated but most consequential triumphs of the past half-century, the product of legislative efforts and technological response. And lead? It’s essentially disappeared from the air. 

And it’s not just economic or environmental statistics that have improved; society advanced, as well. Women now earn the majority of college degrees. The Black poverty rate sits near a record low. Support for same-sex marriage is now the norm — maybe the single biggest social change from 1976, when homosexuality was criminalized in most states. Pick a metric more or less at random, and the line usually runs the right way.

This is not a matter of cherry-picking a few flattering numbers. It is the overwhelming direction of the evidence, across health, wealth, safety, rights, even the basic cleanliness of the physical world an American walks through every day. Measured against its own recent past, the US is in some of the best shape it has ever been.

So what’s with the bad vibes?

A more perfect union doesn’t mean perfect

Well, some things genuinely got worse, and they are not insignificant. 

Americans’ faith in their government has collapsed; fewer than one in five now trust Washington to do the right thing, down from solid majorities in the 1960s — and the country is more polarized than it was in 1976. Democratic decline and even collapse is a live threat. Those economic gains I highlighted above have flowed disproportionately upward. The top 1 percent’s share of income, near a historic low in 1976, has since roughly doubled.

Climate change barely registered in 1976. The carbon dioxide in the atmosphere has since climbed from around 330 parts per million to about 427, and warming will only get worse in the future. And buying a home increasingly feels out of reach for many. By 2024, a record share of households spent more than a third of their income on housing. (Notably, though, the percentage of Americans who own a home is slightly higher than it was in 1976, and those homes are much larger on average.) 

These are real problems, but they remain exceptions to a broader half-century trend of improvement. And a country that scrubbed the lead from its air and put out smoking can overcome new challenges, as well. 

Which brings us back to a tale of two birthdays. In 1976, Americans had less of nearly everything you can count, and, yet, they reported feeling good about the future anyway. In 2026, we have more, and we don’t. 

Just as it can be for a person, a country’s mood is a poor instrument; it measures the story we are telling ourselves more than the lives we are actually living. For all our pessimism about the state of the nation, more than three-quarters of Americans say they are satisfied with their own lives.

The Americans crowding New York Harbor in 1976 were cheering a country that was sicker, dirtier, more dangerous, and less free than the one we live in now. But they were right to cheer; the line was already bending the right way, and it kept bending. It turns out a nation can travel a long way, even while it is convinced it is going nowhere.

A version of this story originally appeared in the Good News newsletter. Sign up here!