In last Thursday’s GOP debate, Marco Rubio, Ted Cruz, Jeb Bush and Chris Christie managed to avoid mentioning their common proposal to “reform entitlements” by raising the Social Security retirement age from 67 to 70. That was probably a good idea. Their proposal only demonstrates their lack of understanding about the demographics of older Americans, especially the dramatic disparities in their life expectancy associated with education and race. Recent research on life expectancy indicates that their proposed change would effectively nullify Social Security for millions of Americans and sharply limit benefits for many millions more.. While many people in their 30s and 40s today can look forward to living into their 80s, the average life expectancy for the majority of Americans who do not hold a college degree hovers closer to 70, or the average life expectancy for all Americans in 1950.

The Widening Inequalities in the Life Spans of Americans

This research, summarized recently in a study published in Health Affairs, found that life expectancy for various age cohorts of Americans is closely associated with both educational achievement and race. For example, the average life expectancy for college-educated American men who were age 25 in 2008, or age 33 today, is 81.7 years for whites and 78.2 years for blacks. (Table 1, below) By contrast, the projected, average life span of high-school educated males, also age 25 in 2008 or 33 today, is 73.2 years for whites and 69.3 years for blacks. Women on average live longer than men; but similar disparities based on education and race are evident. The average life expectancy of women age 25 in 2008, or 33 years old today, was 79 years for whites and 75.4 years for blacks for those with a high school diploma, and 84.7 years for whites and 81.6 years for blacks with college degrees. Most disturbing, the average life expectancy of Americans age 25 in 2008 without a high school diploma is just 68.6 years for white men, 68.2 years for black men, 74.2 years for white women, and 74.9 years for black women. Surprisingly, the researchers found that Hispanics in this age group have the longest life expectancies, even though they also have the lowest average levels of education. Since these data are anomalous and may reflect sampling problems, we will focus mainly on the life-expectancy gaps between African American and white Americans.

Tallying How Many People Are Adversely Affected

Census data on the distribution by education of people age 25 to 34 in 2010 (ages 30 to 39 in 2015) provide a good estimate of how many Americans are adversely affected by these growing differences. Overall, 56.3 percent of all Americans currently in their 30s fall are high school graduates or left school without a high school diploma, educational groups with much lower average life expectancies. (Table 2, below) More precisely, 10.1 percent or almost 4.8 million Americans in their 30s today lack a high school diploma, and 46.2 percent or 18.9 million thirty-somethings have high school diplomas and no further degrees. All told, they account for 23,702,000 Americans in their 30s; and among older Americans, the numbers and percentages are even higher.

Since race as well as education are major factors associated with differences in life expectancy, we turn next to education by race (Table 3, below). The totals differ modestly from Table 2, because Census data on education by race cover ages 30-39 in 2014, while Table 2 covers age 30-39 in 2015 (ages 25-34 in 2010).

• Among people in their 30s today, 45.4 percent of whites or 10,613,000 Americans have a high school degree or less – and their average life expectancy is 9.4 years less than whites in their 30s with a college or associate degree.
• Among people in their 30s todays, 64.4 percent of blacks or 3,436,000 Americans have a high school degree or less – and their life expectancy is 8.6 years less than blacks in their 30s with an B.A. or associate degree, and 11.6 years less than whites with a college or associate degree..
• Among people in their 30s today, 75.6 percent of Hispanics or 6,243,000 Americans have a high school degree or less – and their life expectancy is 5.0 years less than Hispanics in their 30s with a college or associate degree.

As a policy matter, these data tell us that across all communities—white, black, Hispanic—improvements in secondary education to prepare everyone for higher education, and lower-cost access to higher education, can add years to the lives of millions of Americans.

Preserving Meaningful Access to Social Security Benefits

The widening inequalities in average life expectancy associated with race and education have more direct policy implications for Social Security, because the number of years that people can claim its benefits depends on their life spans. The growing inequalities in life expectancy translate directly into growing disparities in the years people can claim Social Security benefits, based on their education and race. Assuming that Americans in their 30s today retire at age 67 (the age for full benefits for this age group), they can expect to claim retirement benefits, on average, ranging from 1.2 years to 19.3 years, based on their education and race. (Table 4, below)

The most pressing issues of life expectancy and Social Security involve white males, black males, and black females without college degrees: Among Americans age 33 today, white and black men without high school diplomas and black males with high school degrees, on average, can expect to live long enough to collect benefits for less than three years. Similarly, white and black women without high school diplomas and black women with high school degrees, on average, can expect to collect benefits for less than eight years. Together, they account for 25.2 percent of whites and 64.4 percent of blacks in their 30s today. By contrast, male and female white college graduates age 33 today, on average, can expect to collect Social Security for between 14.7 and 17.7 years, respectively; and 33-year old black men and women with college degrees, on average, will claim benefits for 11.2 to 14.6 years, respectively.

These findings dictate that proposals to raise the Social Security retirement age should be rejected as a matter of basic fairness. Among this year’s presidential hopefuls, as noted earlier, Ted Cruz, Marco Rubio, Jeb Bush and Chris Christie all have called for raising the retirement age to 70 years. Under this policy, black men in their 30s today without a college degree and white men now in their 30s without a high school diploma, on average, would not live long enough to collect any Social Security. The change would reduce the average number of years of Social Security for Americans in their 30s today,

• From 1.6 years to -1.4 years for white men with no high school diploma,
• From 1.2 years to -1.8 years for black men with no high school diploma, and
• From 2.3 years to – 0.7 years for black, male high-school graduates.

Furthermore, among Americans in their 30s today, white and black women without a high school diploma, white male high school graduates, and black female high school graduates, would live long enough, on average, to collect Social Security for just 3.2 to 5.4 years. The GOP change reduce the average number of years of Social Security for Americans in their 30s today,

• From 6.2 years to 3.2 years for white, male high school graduates,
• From 7.2 years to 4.2 years for white women with no high school diploma,
• From 7.9 years to 4.9 years for black women with no high school diploma, and
• From 8.4 years to 5.4 years for black, female high-school graduates.

All told, proposals to raise the retirement age to 70 years old would mean, based on the average life expectancy of Americans in their 30s today, that 25.2 percent of whites in their 30s and 64.4 percent of blacks of comparable age, after working for 35 years or more, would receive Social Security benefits for 5.4 years or less.

      

Much public focus is being given to a broader role for hospitals in improving the health of their communities. This focus parallels a growing interest in addressing the social determinants of health as well as health care policy reforms designed to increase the efficiency and quality of care while improving health outcomes.

This interest in the community role of hospitals has drawn attention to the federal legal standards and requirements for nonprofit hospitals seeking federal tax exemption. Tax-exempt hospitals are required to provide community benefits. And while financial assistance to patients unable to pay for care is a basic requirement of tax-exemption, IRS guidelines define the concept of community benefit to include a range of community health improvement efforts.

At the same time, the IRS draws a distinction between community health improvement spending–which it automatically considers a community benefit–and certain “community-building” activities where additional information is required in order to be compliant with IRS rules. In addition, community benefit obligations are included in the Affordable Care Act (ACA).

Specifically, the ACA requires nonprofit hospitals periodically to complete a community health needs assessment (CHNA), which means the hospital must conduct a review of health conditions in its community and develop a plan to address concerns. While these requirements are causing hospitals to look more closely at their role in the community, challenges remain. For instance, complex language in the rules can mean hospitals are unclear what activities and expenditures count as a “community benefit.” Hospitals must take additional steps in order to report community building as community health improvement.

These policies can discourage creative approaches. Moreover, transparency rules and competing hospital priorities can also weaken hospital-community partnerships. To encourage more effective partnerships in community investments by nonprofit hospitals:

• The IRS needs to clarify the relationship between community spending and the requirements of the CHNA. 
• There needs to be greater transparency in the implementation strategy phase of the CHNA. 
• The IRS needs to broaden the definition of community health improvement to encourage innovation and upstream investment by hospitals.

Download "Hospitals as Community Hubs: Integrating Community Benefit Spending, Community Health Needs Assessment, and Community Health Improvement" »

Downloads

• Download "Hospitals as Community Hubs: Integrating Community Benefit Spending, Community Health Needs Assessment, and Community Health Improvement"

      

       

       

In late October at the United Nations Economic and Social Commission for Asia and the Pacific (UN ESCAP) headquarters in Bangkok, a multi-stakeholder coalition was launched to promote the role of youth and civil society in advancing post-2015 United Nations Sustainable Development Goals (SDGs). The youth initiatives, fostering regional integration and youth service impact in the Association of Southeast Asian Nations (ASEAN) and counterpart regions of Northeast and South Asia, will be furthered through a new Asia-Pacific Peace Service Alliance. The alliance is comprised of youth leaders, foundations, civil society entities, multilateral partners and U.N. agencies. Together, their initiatives illustrate the potential of youth and multi-stakeholder coalitions to scale impacts to meet SDG development targets through youth service and social media campaigns, and partnerships with multilateral agencies, nongovernmental organizations, corporations and research institutes.

The “Asia-Pacific Forum on Youth Volunteerism to Promote Participation in Development and Peace” at UN ESCAP featured a new joint partnership of the U.S. Peace Corps and the Korea International Cooperation Agency (KOICA) as well as USAID support for the ASEAN Youth Volunteering Program. With key leadership from ASEAN youth entitles, sponsor FK Norway, Youth Corps Singapore and Peace Corps’ innovative program in Thailand, the forum also furthered President Obama’s goal of Americans serving “side by side” with other nations’ volunteers. The multi-stakeholder Asia-Pacific alliance will be powered by creative youth action and a broad array of private and public partners from Thailand, Malaysia, Myanmar, Indonesia, Singapore, the Philippines, Australia, Korea, China, Mongolia, Japan, India, Nepal, Pakistan, the U.S. and other nations.

During the event, Dr. Shamshad Akhtar, ESCAP executive secretary, pointed out that “tapping youth potential is critical to shape our shared destiny, as they are a source of new ideas, talent and inspiration. For ESCAP and the United Nations, a dynamic youth agenda is vital to ensure the success of post-2015 sustainable development.”

Dr. Surin Pitsuwan, former ASEAN secretary-general, called for a new Asia-wide multilateralism engaging youth and civil society.  In his remarks, he drew from his experience in mobilizing Asian relief and recovery efforts after Cyclone Nargis devastated the delta region of Myanmar in May 2008. Surin, honorary Alliance chairman and this year’s recipient of the Harris Wofford Global Citizenship Award, also noted the necessity of a “spiritual evolution” to a common sense of well-being to redress the “present course of possible extinction” caused by global conflicts and climate challenges. He summoned Asia-Pacific youth, representing 60 percent of the world’s young population, to “be the change you want to see” and to “commit our youth to a useful cause for humanity.”

The potential for similar upscaled service efforts in Africa, weaving regional integration and youth volunteering impact, has been assessed in Brookings research and policy recommendations being implemented in the Common Market of Eastern and Southern Africa (COMESA). Recommendations, many of which COMESA and ASEAN are undertaking, include enabling youth entrepreneurship and service contributions to livelihoods in regional economic integration schemes, and commissioning third-party support for impact evidence research.

A good example of successful voluntary service contributions from which regional economic communities like ASEAN can learn a lot is the current Omnimed pilot research intervention in Uganda. In eastern Ugandan villages, 1,200 village health workers supported by volunteer medical doctors, Uganda’s Health Ministry, Peace Corps volunteers and Global Peace Women are addressing lifesaving maternal and child health outcomes furthering UNICEF’s campaign on “integrated health” addressing malaria, diarrheal disease and indoor cooking pollution. The effort has included construction of 15 secure water sources and 1,200 clean cook stoves along with randomized controlled trials.

Last week, the young leaders from more than 40 nations produced a “Bangkok Statement” outlining their policy guidance and practical steps to guide volunteering work plans for the new Asia-Pacific alliance. Youth service initiatives undertaken in “collective impact” clusters will focus on the environment (including clean water and solar villages), health service, entrepreneurship, youth roles in disaster preparedness and positive peace. The forum was co-convened by ESCAP, UNESCO, the Global Peace Foundation and the Global Young Leaders Academy.

       

Volunteerism remains a powerful tool for good around the world. Young people, in particular, are motivated by the prospect of creating real and lasting change, as well as gaining valuable learning experiences that come with volunteering. This energy and optimism among youth can be harnessed and mobilized to help meet challenges facing our world today and accomplish such targets as the United Nations 2030 Sustainable Development Goals (SDGs).

On June 14, young leaders and development agents from leading non-governmental organizations (NGOs), faith-based organizations, corporations, universities, the Peace Corps, and United Nations Volunteers came together at the Brookings Institution to answer the question on how to achieve impacts on the SDGs through international service.

This was also the 10th anniversary gathering of the Building Bridges Coalition—a multi-stakeholder consortium of development volunteers— and included the announcement of a new Service Year Alliance partnership with the coalition to step up international volunteers and village-based volunteering capacity around the world.

Brookings Senior Fellow Homi Kharas, who served as the lead author supporting the high-level panel advising the U.N. secretary-general on the post-2015 development agenda, noted the imperative of engaging community volunteers to scale up effective initiatives, build political awareness, and generate “partnerships with citizens at every level” to achieve the 2030 goals.  

Kharas’ call was echoed in reports on effective grassroots initiatives, including Omnimed’s mobilization of 1,200 village health workers in Uganda’s Mukono district, a dramatic reduction of malaria through Peace Corps efforts with Senegal village volunteers, and Seed Global Health’s partnership to scale up medical doctors and nurses to address critical health professional shortages in the developing world. 

U.N. Youth Envoy Ahmad Alhendawi of Jordan energized young leaders from Atlas Corps, Global Citizen Year, America Solidaria, International Young Leaders Academy, and universities, citing U.N. Security Council Resolution 2250 on youth, peace, and security as “a turning point when it comes to the way we engage with young people globally… to recognize their role for who they are, as peacebuilders, not troublemakers… and equal partners on the ground.”

Service Year Alliance Chair General Stanley McChrystal, former Joint Special Operations commander, acclaimed, “The big idea… of a culture where the expectation [and] habit of service has provided young people an opportunity to do a year of funded, full-time service.” 

Civic Enterprises President John Bridgeland and Brookings Senior Fellow E.J. Dionne, Jr. led a panel with Seed Global Health’s Vanessa Kerry and Atlas Corps’ Scott Beale on policy ideas for the next administration, including offering Global Service Fellowships in United States Agency for International Development (USAID) programs to grow health service corps, student service year loan forgiveness, and technical support through State Department volunteer exchanges. Former Senator Harris Wofford, Building Bridge Coalition’s senior advisor and a founding Peace Corps architect, shared how the coalition’s new “service quantum leap” furthers the original idea announced by President John F. Kennedy, which called for the Peace Corps and the mobilization of one million global volunteers through NGOs, faith-based groups, and universities.

The multi-stakeholder volunteering model was showcased by Richard Dictus, executive coordinator of U.N. Volunteers; Peace Corps Director Carrie Hessler-Radelet; USAID Counselor Susan Reischle; and Diane Melley, IBM vice president for Global Citizenship. Melley highlighted IBM’s 280,000 skills-based employee volunteers who are building community capacity in 130 countries along with Impact 2030—a consortium of 60 companies collaborating with the U.N.—that is “integrating service into overall citizenship activities” while furthering the SDGs.

The faith and millennial leaders who contributed to the coalition’s action plan included Jim Lindsay of Catholic Volunteer Network; Service Year’s Yasmeen Shaheen-McConnell; C. Eduardo Vargas of USAID’s Center for Faith-Based and Community Initiatives; and moderator David Eisner of Repair the World, a former CEO of the Corporation for National and Community Service. Jesuit Volunteer Corps President Tim Shriver, grandson of the Peace Corps’ founding director, addressed working sessions on engaging faith-based volunteers, which, according to research, account for an estimated 44 percent of nearly one million U.S. global volunteers

The key role of colleges and universities in the coalition’s action plan—including  linking service year with student learning, impact research, and gap year service—was  outlined by Dean Alan Solomont of Tisch College at Tufts University; Marlboro College President Kevin Quigley; and U.N. Volunteers researcher Ben Lough of University of Illinois Urbana-Champaign.

These panel discussion directed us towards the final goal of the event, which was a multi-stakeholder action campaign calling for ongoing collaboration and policy support to enhance the collective impact of international service in achieving the 2030 goals.

This resolution, which remains a working document, highlighted five major priorities:

1. Engage service abroad programs to more effectively address the 2030 SDGs by mobilizing 10,000 additional service year and short-term volunteers annually and partnerships that leverage local capacity and volunteers in host communities.
2. Promote a new generation of global leaders through global service fellowships promoting service and study abroad.
3. Expand cross-sectorial participation and partnerships.
4. Engage more volunteers of all ages in service abroad.
5. Study and foster best practices across international service programs, measure community impact, and ensure the highest quality of volunteer safety, well-being, and confidence.

Participants agreed that it’s through these types of efforts that volunteer service could become a common strategy throughout the world for meeting pressing challenges. Moreover, the cooperation of individuals and organizations will be vital in laying a foundation on which governments and civil society can build a more prosperous, healthy, and peaceful world.

       

Amy Liu’s recent paper, “Remaking Economic Development,” is disruptive in that it rightfully undercuts the shaky foundation of what draws many practitioners to the field: the idea that success is simply structuring transactions to attract new jobs and investment. These two metrics alone can’t diagnose the economic health or trajectory of a community. Instead, as the paper outlines, setting the right goals—measured by growth, prosperity, and inclusion—provides a much richer framework for a community’s trajectory, vibrancy, and opportunity.

Goal-setting clarifies how a community defines success and when it has been achieved, and promotes collaboration and increases buy-in from diverse stakeholders. If, as Liu argues, goals were designed to lead to growth, prosperity, and inclusion, metro areas would make dramatically different choices around policies, investments, and priorities, and people and communities would likely be in an overall stronger economic position.

However, these goals represent a longer-term proposition than conventional measures, and, perhaps naively, “Remaking Economic Development” fails to acknowledge the barriers that prevent most communities from setting the right goals:

1. Goals should focus on long-term interests, but election cycles prioritize clear near-term political wins. Meaty investments in infrastructure, workforce development, and fiscal policy reform needed to shift the competitive position of a community rarely yield easily defined and clearly increased short-term political capital.
2. Economies function as regions, but many municipal strategies are not aligned with regional goals. A metropolitan area is the logical unit to measure success, but civic leaders are elected from individual municipalities, or from a state that has a larger focus. Although it’s easier to market a region of 5 million people than a city of 650,000, in Detroit, intramural competition between cities and suburbs, suburbs and suburbs, and even neighborhoods within the city all undermine the cooperative effort to set goals regionally. The failure of mayors within a region to recognize their economic connectedness is a huge problem and fuels wasteful incentive battles over retail and other projects that are not economic drivers.
3. Goal-setting takes time, money, and requires data, but capacity is in short supply. Most economic developers and political leaders lack the framework, experience, and manpower to effectively lead a goal-setting process. And if the choice is between collectively setting goals or managing a flurry of “bird-in-hand” transactions, the transaction under consideration will always receive resources first. Leaders are primarily evaluated on near term jobs and investment figures; not having the time to lead a goal-setting process and, in many cases, lacking the approach and datasets to appropriately undertake this activity make goal-setting easy to eliminate.

Despite these obstacles, setting the right goals is critical to building healthy communities. To combat political challenges, strong collaboration between business and public sector leadership is crucial, as is the recognition of diverse sub-economies with different value propositions and opportunities. Leaders must ultimately acknowledge that near term wins mean little if they are leading down a path that will not fundamentally address the long-term investment climate and the region’s productive capacities, grow wages or address employment levels, and offer broad opportunities for diverse economic participation. The following steps can help:

1. Harness diverse, cross-sectoral perspectives. Fundamentally, businesses understand their industries better than anyone else; hence the public sector should identify ways to encourage growth, increased productivity, greater inclusion, and more competitiveness in targeted sectors by listening to businesses and jointly setting goals that marry private sector profit and public economic and social interests effectively. This approach may offset some of the other realities of short election cycles and limited capacity to participate in goal-setting or planning processes.
2. Identify unique roles for communities within a larger regional framework. Although competition between local cities may inhibit the most meaningful dialogue and alignment of interests, deeper analysis often produces greater clarity on the niche opportunities for different communities. For example, although Detroit has a strong manufacturing base, a major project requiring more than 40 acres will likely have better site options in the suburbs. In the same vein, companies seeking a vibrant urban campus with easy access to food, living, and other amenities are likely better suited to Detroit than one of the surrounding communities. That said, both companies are likely to draw employees from communities all over the region. Effective goal-setting includes analysis that should allow municipalities to uncover their niche opportunities within a larger regional framework.
3. Balance short-term and long-term priorities and successes. The truth is that near term investments are vital in creating momentum, providing stability, and creating jobs while long-term investments, policy decisions, and industry-focused asset development fundamentally position an economy to win over time. For example, incentives play an important role in offsetting competitive disadvantages in the short-term and should be used as a way to fill the gap while a community fixes the bigger economic challenges, ranging from exorbitant development costs to workforce development issues. The disconnect is that many communities are not focusing incentives on strategic, long-term priorities.

"Remaking Economic Development” elegantly exposes the shortsightedness toward aggressive deal-making that often prevents communities from thoughtfully building their long-term economic strength with an eye on growth, prosperity, and inclusion. Sadly, the economic development profession has historically focused on growth without much attention to prosperity and inclusion, which are arguably most important in building a sustainable economy. Goal-setting—painful as it may be—is the first step towards remaking the practice and establishing an honest foundation to build a better economy in the future.

      

Event Information

2015 marked the 40th anniversary of China-European Union (EU) diplomatic ties, highlighting the achievements and continued cooperation in the fields of investment and trade. One of the primary issues in today’s world is green and sustainable development, and the European region has established itself as a central player in the practice of green design. This has become a key factor in coordinating EU relations, and China has been making headway towards the green design movement with energy saving practices, in addition to positive emission reduction commitments made in Paris in 2015.

On March 30, the Brookings-Tsinghua Center for Public Policy (BTC) hosted a public discussion featuring Jo Leinen, chairman of the European Parliament Delegation for Relations with China, and Qi Ye, director of the BTC. The discussion focused on the topic of the new pattern of the European Union under the green development and sustainable development goals of the United Nations. Leinen has been an elected member of the European Parliament since 1999 and the president of the Union of European Federalists since 1997. Since 2004, he has been a member of the Advisory Council of the Committee for a Democratic U.N. Prior to his time in the European Parliament, he was the minister of the environment in the state of Saarland, Germany and vice president of the European Environment Bureau in Brussels.

Leinen stressed the importance of global governance and international cooperation, which has been emphasized in recent years in order to maintain the stability of the financial system, protect the environment, fight against terrorism, and promote peace throughout the world. He discussed the progress that the China-EU trade relationship has made in the last year, with total trade reaching 400 billion euros, and expressed hope that China-EU relations can achieve new breakthroughs in the future. On the environmental side, Leinen affirmed China’s efforts in the development of a green low-carbon economy and contribution to the world in working to reduce emissions. He highlighted China’s crucial role at the climate change conference in Paris in 2015 and the country’s commitment to allow greenhouse gas emissions to peak by 2030, although he believes that may be a conservative estimate.

      

The year 2015 was a big one for global development policy debates, marking the end of the Millennium Development Goals (MDGs) and the launch of the new Sustainable Development Goals (SDGs), also known as the “Global Goals.” But how much did major media pay attention?

Last September, Christine Zhang and I published a working paper that examined mentions of the MDGs across major English-language press and academic outlets from 2000 through 2014. We blogged highlights from the original paper here. 

More recently, we updated some of the results to account for last year’s major MDG-SDG debates and events. Figure 1 adds 2015 newspaper data on the MDGs and also includes SDG mentions over the entire time period.

Figure 1: MDG and SDG mentions across 12 major newspapers, 2000-2015

Note: The 12 newspapers included are the Los Angeles Times (USA), The New York Times (USA), USA Today, and The Washington Post (USA), the Financial Times (UK), The Guardian (UK), The Independent (UK), The Daily Telegraph (UK), The Economist (UK), The Globe and Mail (Canada), the South China Morning Post (Hong Kong SAR), and The Sydney Morning Herald (Australia). Source: LexisNexis, authors’ calculations.

Here are three key takeaways from the new graph:

• First, by measure of article counts, 2015 was the second most prominent year for media coverage of the interlinked MDG-SDG agendas. But it only saw 62 percent as much coverage as the MDGs received in 2005, the year of the U.N. Millennium Project’s final report (January), the Gleneagles G-8 summit (July), and the U.N. World Summit (September). 

• Second, global summits have consistently helped to ramp up media attention and debate. The years 2005, 2008, 2010, and 2015 all stand out as the top years for references—the same years in which the U.N. convened major summits linked to the MDGs and, in 2015, the SDGs. But U.N. summits do not guarantee attention. Notably, the 2012 Rio+20 summit that initially called for the SDGs did not cause a big splash in the media outlets examined.

• Third, recent years saw a discernible transition from MDG references to SDG references. By 2015, fully 41 percent of the relevant articles referenced only the SDGs, 30 percent mentioned both the SDGs and the MDGs, while only 29 percent mentioned the MDGs alone. 

To be clear, these results do not provide a complete assessment of MDG-SDG media references in recent years, especially because social media and other new digital technologies now account for such a large share of public debate. (Note that the graph also excludes developing country newspapers, some of which we examined in the original working paper and similarly updated with 2015 results, but those do not make much difference to the overall story.) Thus one should not consider Figure 1 a definitive analysis of whether SDG advocates were successful in their public outreach campaigns last year.  From a research perspective, the simple new-ness of “new media” renders long-term comparisons difficult. Restricting the data sample to print media offers one way to benchmark apples-to-apples coverage across the period of interest back to 2000.

That said, a seasoned media observer once suggested to me that traditional news outlets are inherently less connected to the bottom-up nature of emerging SDG conversations, and hence less likely to cover the SDGs accurately than new media channels in which user-generated content helps to drive the conversation. It’s an interesting hypothesis worth testing. 

At a minimum, 2015 was a significant year for public conversations about the MDGs and SDGs, even if it might not have matched the peak year of 2005. An interesting line of research could seek to explain why.  In any case, for analysts of the new SDGs, more sophisticated forms of global media benchmarking will undoubtedly be in order through to the new deadline of 2030. 

       

Volunteerism remains a powerful tool for good around the world. Young people, in particular, are motivated by the prospect of creating real and lasting change, as well as gaining valuable learning experiences that come with volunteering. This energy and optimism among youth can be harnessed and mobilized to help meet challenges facing our world today and accomplish such targets as the United Nations 2030 Sustainable Development Goals (SDGs).

On June 14, young leaders and development agents from leading non-governmental organizations (NGOs), faith-based organizations, corporations, universities, the Peace Corps, and United Nations Volunteers came together at the Brookings Institution to answer the question on how to achieve impacts on the SDGs through international service.

This was also the 10th anniversary gathering of the Building Bridges Coalition—a multi-stakeholder consortium of development volunteers— and included the announcement of a new Service Year Alliance partnership with the coalition to step up international volunteers and village-based volunteering capacity around the world.

Brookings Senior Fellow Homi Kharas, who served as the lead author supporting the high-level panel advising the U.N. secretary-general on the post-2015 development agenda, noted the imperative of engaging community volunteers to scale up effective initiatives, build political awareness, and generate “partnerships with citizens at every level” to achieve the 2030 goals.  

Kharas’ call was echoed in reports on effective grassroots initiatives, including Omnimed’s mobilization of 1,200 village health workers in Uganda’s Mukono district, a dramatic reduction of malaria through Peace Corps efforts with Senegal village volunteers, and Seed Global Health’s partnership to scale up medical doctors and nurses to address critical health professional shortages in the developing world. 

U.N. Youth Envoy Ahmad Alhendawi of Jordan energized young leaders from Atlas Corps, Global Citizen Year, America Solidaria, International Young Leaders Academy, and universities, citing U.N. Security Council Resolution 2250 on youth, peace, and security as “a turning point when it comes to the way we engage with young people globally… to recognize their role for who they are, as peacebuilders, not troublemakers… and equal partners on the ground.”

Service Year Alliance Chair General Stanley McChrystal, former Joint Special Operations commander, acclaimed, “The big idea… of a culture where the expectation [and] habit of service has provided young people an opportunity to do a year of funded, full-time service.” 

Civic Enterprises President John Bridgeland and Brookings Senior Fellow E.J. Dionne, Jr. led a panel with Seed Global Health’s Vanessa Kerry and Atlas Corps’ Scott Beale on policy ideas for the next administration, including offering Global Service Fellowships in United States Agency for International Development (USAID) programs to grow health service corps, student service year loan forgiveness, and technical support through State Department volunteer exchanges. Former Senator Harris Wofford, Building Bridge Coalition’s senior advisor and a founding Peace Corps architect, shared how the coalition’s new “service quantum leap” furthers the original idea announced by President John F. Kennedy, which called for the Peace Corps and the mobilization of one million global volunteers through NGOs, faith-based groups, and universities.

The multi-stakeholder volunteering model was showcased by Richard Dictus, executive coordinator of U.N. Volunteers; Peace Corps Director Carrie Hessler-Radelet; USAID Counselor Susan Reischle; and Diane Melley, IBM vice president for Global Citizenship. Melley highlighted IBM’s 280,000 skills-based employee volunteers who are building community capacity in 130 countries along with Impact 2030—a consortium of 60 companies collaborating with the U.N.—that is “integrating service into overall citizenship activities” while furthering the SDGs.

The faith and millennial leaders who contributed to the coalition’s action plan included Jim Lindsay of Catholic Volunteer Network; Service Year’s Yasmeen Shaheen-McConnell; C. Eduardo Vargas of USAID’s Center for Faith-Based and Community Initiatives; and moderator David Eisner of Repair the World, a former CEO of the Corporation for National and Community Service. Jesuit Volunteer Corps President Tim Shriver, grandson of the Peace Corps’ founding director, addressed working sessions on engaging faith-based volunteers, which, according to research, account for an estimated 44 percent of nearly one million U.S. global volunteers

The key role of colleges and universities in the coalition’s action plan—including  linking service year with student learning, impact research, and gap year service—was  outlined by Dean Alan Solomont of Tisch College at Tufts University; Marlboro College President Kevin Quigley; and U.N. Volunteers researcher Ben Lough of University of Illinois Urbana-Champaign.

These panel discussion directed us towards the final goal of the event, which was a multi-stakeholder action campaign calling for ongoing collaboration and policy support to enhance the collective impact of international service in achieving the 2030 goals.

This resolution, which remains a working document, highlighted five major priorities:

1. Engage service abroad programs to more effectively address the 2030 SDGs by mobilizing 10,000 additional service year and short-term volunteers annually and partnerships that leverage local capacity and volunteers in host communities.
2. Promote a new generation of global leaders through global service fellowships promoting service and study abroad.
3. Expand cross-sectorial participation and partnerships.
4. Engage more volunteers of all ages in service abroad.
5. Study and foster best practices across international service programs, measure community impact, and ensure the highest quality of volunteer safety, well-being, and confidence.

Participants agreed that it’s through these types of efforts that volunteer service could become a common strategy throughout the world for meeting pressing challenges. Moreover, the cooperation of individuals and organizations will be vital in laying a foundation on which governments and civil society can build a more prosperous, healthy, and peaceful world.

       

       

Editor’s note: Brookings Senior Fellow Vanda Felbab-Brown is currently on the ground in Afghanistan and sent over a dispatch on what she’s seeing.

President Barack Obama is about to make crucial decisions about the number of U.S. soldiers in Afghanistan in 2016 and possibly after. His decision will be a vital signal to other U.S. allies in Afghanistan and its neighbors. Recent events in Afghanistan, particularly the Taliban's capture of Kunduz, show how too large a reduction in US military and economic support can hollow out the state-building effort and strengthen the Taliban and many other terrorist groups operating in Afghanistan, including those labeling themselves daesh. In such a case, collapse of the government and indeed a collapse of the entire political order the United States has sought to build since 2001 are high. Maintaining support at something close to the current level of effort does not guarantee military or political success or that peace negotiations with the Taliban will eventually produce any satisfactory peace. But it buys us time. On the cusp of a dire situation, Afghan politicians equally need to put aside their self-interested hoarding, plotting, and back-stabbing, which are once again running high, and being put ahead of the national interest.

The Taliban’s recent victory in Kunduz is both highly impactful and different from the previous military efforts and victories of the Taliban over the past several years. For the first time since 2001, the Taliban managed to conquer an entire province and for several days hold its capital. The psychological effect in Afghanistan has been tremendous. For a few days, it looked like the entire provinces of Badakshan, Takhar, and Baghlan would also fall. Many Afghans in those provinces started getting ready to leave or began moving south. If all these northern provinces fell, the chances were high, with whispers and blatant loud talk of political coups intensifying for a number of days, that the Afghan government might fall, and perhaps the entire political system collapse., In short, the dangerous and deleterious political and psychological effects are far bigger than those from the Taliban's push in Musa Qala this year or last year. Particularly detrimental and disheartening was the fact that many Afghan National Army (ANA) and Afghan National Police (ANP) units, led by weak or corrupt commanders, did not fight, and threw down their arms and ran away. Conversely, the boost of morale to the Taliban and the strengthening of its new leader Mullah Akbar Mansour were great. However, the Taliban also discredited itself with its brutality in Kunduz City.

The Taliban operation to take Kuduz was very well-planned and put together over a period of months, perhaps years. Foreign fighters from Central Asia, China, and Pakistan featured prominently among the mix of some 1,000 fighters, adding much heft to local militias that the Taliban mobilized against the militias of the dominant powerbrokers and the United States, as well as the government-sponsored Afghan Local Police. The support of Pakistan's Inter-services Intelligence for the Taliban, which the country has not been able to sever despite a decade of pressure from the United States and more recent engagement from China, significantly augmented the Taliban's capacities.

Kunduz is vital strategic province, with major access roads to various other parts of Afghanistan's north. Those who control the roads—still now the Taliban—also get major revenue from taxing travelers, which is significant along these opium-smuggling routes. It will take time for the Afghan forces to reduce Taliban control and influence along the roads, and large rural areas will be left in the hands of the Taliban for a while. Both in the rural areas and in Kunduz City itself, the Taliban is anchored among local population groups alienated by years of pernicious exclusionary and rapacious politics, which has only intensified since March of this year. Equally, however, many of the local population groups hate the Taliban, have engaged in revenge killings and abuses this week, and are spoiling for more revenge.

Despite the intense drama of the past week, however, Afghanistan has not fallen off the cliff. Takhar and Baghlan have not fallen, nor has all of Badakhshan. The political atmosphere in Kabul is still poisonous, but the various anti-government plots and scheming are dissipating in their intensity and immediacy. On Wednesday, Afghan President Ashraf Ghani reached out to some of those dissatisfied powerbrokers, who have been salivating for a change in political dispensation. The crisis is not over, neither on the battlefield in Kunduz and many other parts of Afghanistan, nor in the Afghan political system. But it is much easier to exhale on Thursday, October 8th.

United States air support was essential in retaking Kunduz and avoiding more of Badakhshan falling into the hands of the Taliban, precipitating a military domino effect in the north and inflaming the political crisis. Despite the terrible and tragic mistake of the U.S. bombing of the Médecins Sans Frontières hospital, maintaining and expanding U.S. air support for the Afghan forces, and allowing for U.S. support beyond in extremis, such as in preventing a similar Taliban offensive, is vital. It is equally important to augment intelligence- assets support. Significant reductions in U.S. assistance, whether that be troops, intelligence, or air support, will greatly increase the chances that another major Taliban success—like that of Kunduz, and perhaps possibly again in Kunduz—will happen again. It would also be accompanied by intensely dangerous political instability.

Equally imperative is that Afghan politicians put aside their self-interested scheming and rally behind the country to enable the government to function, or they will push Afghanistan over the brink into paralysis, intensified insurgency, and outright civil war. In addition to restraining their political and monetary ambitions and their many powerplays in Kabul, they need to recognize that years of abusive, discriminatory, exclusionary governance; extensive corruption; and individual and ethnic patronage and nepotism were the crucial roots of the crisis in Kunduz and elsewhere. These have corroded the Afghan Army and permeate the Afghan Police and anti-Taliban militias. Beyond blaming Pakistan, Afghan politicians and powerbrokers need to take a hard look at their behavior over the recent days and over many years and realize they have much to do to clean their own house to avoid disastrous outcomes for Afghanistan. To satisfy these politicians, many from the north of the country and prominent long-term powerbrokers, President Ghani decided over the past few days to include them more in consultations and power-sharing. Many Afghan people welcome such more inclusive politics, arguing that while the very survival of the country might be at stake, grand governance and anti-corruption ambitions need to be shelved. That may be a necessary bargain, but it is a Faustian one. Not all corruption or nepotism can or will disappear. But unless outright rapacious, exclusionary, and deeply predatory governance is mitigated, the root causes of the insurgency will remain unaddressed and the state-building project will have disappeared into fiefdoms and lasting conflict. At that point, even negotiations with the Taliban will not bring peace.

      

      

       

       

In last summer’s congressional debate over the Iran nuclear deal—the Joint Comprehensive Plan of Action (JCPOA)—one of the more hotly debated issues was whether the deal would decrease or increase the likelihood that countries in the Middle East would pursue nuclear weapons.

Supporters of the JCPOA argued that, by removing the risk of a nuclear-armed Iran, it will reduce incentives for countries of the region to acquire nuclear arms. Opponents of the deal—not just in the United States but also abroad, especially Israel—claimed that the JCPOA would increase those incentives because it would legitimize enrichment in Iran, allow Iran to ramp up its nuclear capacity when key restrictions expire after 10 and 15 years, and boost the Iranian economy and the resources Iran could devote to a weapons program.

I strongly believe the JCPOA will significantly reduce prospects for proliferation in the Middle East (and as my colleague Richard Nephew explains in another post out today, there are things the United States and other powers can do to help reduce that prospect further). But uncertainties about the future of the JCPOA and the region will persist for quite some time—and these uncertainties could motivate regional countries to keep their nuclear options open. They may ask themselves a variety of questions in the years ahead: Will the JCPOA be sustainable over time? Will it unravel over concerns about compliance? Will it withstand challenges by opponents in Tehran and Washington? Will it survive leadership transitions in the United States and Iran? Will Iran ramp up its fissile material production capacities when key restrictions expire? Will it then break out of the JCPOA and seek to build nuclear weapons? Will Iran continue to threaten the security of its neighbors in the years ahead? And will the United States maintain a strong regional military presence and be seen by its partners as a reliable guarantor of their security?

I strongly believe the JCPOA will significantly reduce prospects for proliferation in the Middle East.

Richard and I studied how these and other questions might affect nuclear decision-making in the Middle East. In particular, we evaluated the likelihood that key states will pursue nuclear weapons, or at least enrichment or reprocessing programs that could give them a latent nuclear weapons capability. We focused on four states often regarded as potential candidates to join the nuclear club: Saudi Arabia, the United Arab Emirates, Egypt, and Turkey.

Saudi Arabia

Of the four, Saudi Arabia is the most highly motivated to pursue nuclear weapons. It sees Iran as an implacable foe that is intent on destabilizing its neighbors, achieving regional hegemony, and upending the Kingdom’s internal order. At the same time, the Saudis have lost much confidence in the U.S. commitment to the security of its regional partners. In part as a result, the new Saudi leadership has taken a more assertive, independent role in regional conflicts, especially in Yemen. But despite their reservations about the United States, the Saudis know they have no choice but to rely heavily on Washington for their security—and they know they would place that vital relationship in jeopardy if they pursued nuclear weapons.

The Saudis clearly have sufficient financial resources to make a run at nuclear weapons. But acquiring the necessary human and physical infrastructure to pursue an indigenous nuclear program would take many years.

Given the Kingdom’s difficulty in developing an indigenous nuclear weapons capability, speculation has turned to the possibility that it would receive support from a foreign power, usually Pakistan, which received generous financial support from Saudi Arabia in acquiring its own nuclear arsenal. But while rumors abound about a Pakistani commitment to help Saudi Arabia acquire nuclear weapons, the truth is hard to pin down. If such a Saudi-Pakistani agreement was ever reached, it was probably a vague, unwritten assurance long ago between a Pakistani leader and Saudi king, without operational details or the circumstances in which it would be activated. In any event, the Saudis would find it hard to rely on such an assurance today, when Pakistanis are trying to put the legacy of A.Q. Khan behind them and join the international nonproliferation mainstream. 

United Arab Emirates (UAE)

Like Saudi Arabia, the UAE believes Iran poses a severe threat to regional security and has become more aggressive since the completion of the JCPOA. And like the Saudis, the Emiratis have lost considerable confidence in the reliability of the United States as a security guarantor. But also like the Saudis, the Emiratis are reluctant to put their vital security ties to the United States in jeopardy.

[L]ike the Saudis, the Emiratis have lost considerable confidence in the reliability of the United States as a security guarantor.

Moreover, the Emiratis are heavily invested in their ambitious nuclear energy program—with efforts currently underway, with the help of a South Korean-led consortium, to construct four nuclear power reactors—and they know this project would be dead in the water if they opted for nuclear weapons.

The Emiratis have also been a leading regional supporter of nonproliferation. In their bilateral agreement for civil nuclear cooperation with the United States, they formally renounced the acquisition of enrichment or reprocessing capabilities (the so-called “gold standard”), effectively precluding the pursuit of nuclear weapons. After the JCPOA permitted Iran to retain its enrichment program, the UAE, faced with criticism domestically and from some Arab governments for having given up its nuclear “rights,” said it may reconsider its formal renunciation of enrichment. But subsequently, Emirati officials have made clear that their nuclear energy plans have not changed and that they have no intention to pursue enrichment or reprocessing.

Egypt

Egypt is on everyone’s short list of potential nuclear aspirants—in part because of its former role as leader of the Arab world and its flirtation with nuclear weapons in the Gamal Abdel Nasser years. But while Egypt and Iran have often been regional rivals, Egypt does not view Iran as a direct military threat. Instead, Egypt’s main concerns include extremist activities in the Sinai, the fragmentation of Iraq and Syria, disarray in Libya—and the adverse impact of these developments on Egypt’s internal security. The Egyptians recognize that none of these threats can be addressed by the possession of nuclear weapons.

Although Russia is committed to work with Egypt on its first nuclear power reactor, Cairo’s nuclear energy plans have experienced many false starts before, and there is little reason to believe the outcome will be different this time around, especially given the severe economic challenges the Egyptian government currently faces. Moreover, although Egypt trained a substantial number of nuclear scientists in the 1950s and 1960s, its human nuclear infrastructure atrophied when ambitious nuclear energy plans never materialized.

Turkey

Because of its emergence in the last decade as a rising power, its large and growing scientific and industrial basis, and its ambition to be an influential regional player, Turkey is also on everyone’s short list of potential nuclear-armed states. But Turkey has maintained reasonably good relations with Tehran, even during the height of the sanctions campaign against Iran. Although the two countries have taken opposing sides in the Syria civil war, Turkey, like Egypt, does not regard Iran as a direct military threat. Indeed, Ankara sees instability and terrorism emanating from the Syrian conflict as its main security concerns—and nuclear weapons are not viewed as relevant to dealing with those concerns.

Current tensions with Russia over Turkey’s November 2015 shoot-down of a Russian fighter jet are another source of concern in Ankara. But the best means of addressing that concern is to rely on the security guarantee Turkey enjoys as a member of NATO. While Turkish confidence in NATO has waxed and waned in recent decades, most Turks, especially in the military, believe they can count on NATO in a crisis, and they would be reluctant to put their relationship with NATO at risk by pursuing nuclear weapons.

Former nuclear aspirants

For the sake of completeness, our study also looked at regional countries that once actively pursued nuclear weapons but were forced to abandon their programs: Iraq, Libya, and Syria. But we concluded that, given the civil strife tearing those countries apart, none of them was in a position to pursue a sustained, disciplined nuclear weapons effort.

Bottom line

Our study found that the Iran nuclear deal has significantly reduced incentives for countries of the Middle East to reconsider their nuclear options. At least for the foreseeable future, none of them is likely to pursue nuclear weapons or even latent nuclear weapons capabilities—or to succeed if they do. 

Editors’ Note: Bob Einhorn and Richard Nephew spoke about their new report at a recent Brookings event. You can see the video from the event here.

      

On June 23, Brookings hosted the release of the Immigrants, Immigration Reform, and 2016 Election Survey, a joint project with the Public Religion Research Institute (PRRI). The associated report entitled, How immigration and concern about cultural change are shaping the 2016 election finds an American public anxious and intensely divided on matters of immigration and cultural change at the forefront of the 2016 Election.

Dr. Robert Jones, CEO of PRRI, began the presentation by highlighting Americans’ feelings of anxiety and personal vulnerability. The poll found, no issue is more critical to Americans this election cycle than terrorism, with nearly seven in ten (66 percent) reporting that terrorism is a critical issue to them personally. And yet, Americans are sharply divided on questions of terrorism as it pertains to their personal safety. Six in ten (62 percent) Republicans report that they are at least somewhat worried about being personally affected by terrorism, while just 44 percent of Democrats say the same. 

On matters of cultural change, Jones painted a picture of a sharply divided America. Poll results indicate that a majority (55 percent) of Americans believe that the American way of life needs to be protected from foreign influence, while 44 percent disagree.  Responses illustrate a stark partisan divide:

74 percent of Republicans and 83 percent of Trump supporters believe that foreign influence over the American way of life needs to be curtailed.  Just 41 percent of Democrats agree, while a majority (56 percent) disagrees with this statement. Views among white Americans are sharply divided by social class, the report finds. While 68 percent of the white working class agrees that the American way of life needs to be protected, fewer than half (47 percent) of white college-educated Americans agree.

Jones identified Americans’ views on language and “reverse discrimination” as additional touchstones of cultural change. Americans are nearly evenly divided over how comfortable they feel when they encounter immigrants who do not speak English: 50 percent say this bothers them and 49 percent say it does not. 66 percent of Republicans and 77 percent of Trump supporters express discomfort when coming into contact with immigrants who do not speak English; just 35 percent of Democrats say the same.

 

Americans split evenly on the question of whether discrimination against whites, or “reverse discrimination,” is as big of a problem as discrimination against blacks and other minorities (49 percent agree, 49 percent disagree). Once again, the partisan differences are considerable: 72 percent of Republicans and 81 percent of Trump supporters agree that reverse discrimination is a problem, whereas more than two thirds (68 percent) of Democrats disagree.

On economic matters, survey results indicate that nearly seven in ten (69 percent) Americans support increasing the tax rate on wealthy Americans, defined as those earning over $250,000 a year. This represents a modest increase in the share of Americans who favor increasing the tax rate relative to 2012, but a dramatic increase in the number of Republicans who favor this position.

 

The share of  Republicans favoring increasing the tax rate on wealthy Americans jumped from 36 percent in 2012 to 54 percent in 2016—an 18 point increase. Democrats and Independents views on this position remained relatively constant, increasing from 80 to 84 percent and 61 to 68 percent approval respectively.

Finally, on matters of immigration, Americans are divided over whether immigrants are changing their communities for the better (50 percent) or for the worse (49 percent). Across party lines, however, Americans are more likely to think immigrants are changing American society as a whole than they are to think immigrants are changing the local community. This, Jones suggested, indicates that Americans’ views on immigration are motivated by partisan ideology more than by lived experience. 

At the conclusion of Dr. Jones’s presentation, Brookings senior fellow in Governance Studies, Dr. William Galston moderated a panel discussion of the poll’s findings. Karlyn Bowman, a senior fellow and research coordinator at the American Enterprise Institute, observed that cultural anxiety has long characterized Americans’ views on immigration. Never, Bowman remarked, has the share of Americans that favor immigrants outpaced the share of those who oppose immigrants. Turning to the results of the PRRI survey, Bowman highlighted the partisan divide influencing responses to the proposition that the United States place a temporary ban on Muslims. The strong level of Republican support for the proposal--64 percent support among Republicans--compared to just 23 percent support among Democrats has more to do with fear of terrorism than anxiety about immigration, she argued.

Henry Olsen, a senior fellow at the Ethics and Public Policy Center, remarked that many Americans feel that government should do more to ensure protection, prosperity, and security -- as evidenced by the large proportion of voters who feel that their way of life is under threat from terrorism (51%), crime (63%), or unemployment (65%).  In examining fractures within the Republican Party, Olsen considered the ways in which Trump voters differ from non-Trump voters, regardless of party affiliation. On questions of leadership, he suggested, the fact that 57% of all Republicans agree that we need a leader “willing to break some rules” is skewed by the high proportion of Trump supporters (72%) who agree with that statement. Indeed, just 49% of Republicans who did not vote for Trump agreed that the country needs a leader willing to break rules to set things right.

Joy Reid, National Correspondent at MSNBC, cited the survey’s findings that Americans are bitterly divided over whether American culture and way of life has changed for the better (49 percent) or the worse (50 percent) since the 1950s. More than two-thirds of Republicans (68 percent) and Donald Trump supporters (68 percent) believe the American way of life has changed for the worse since the 1950s. Connecting this nostalgia to survey results indicating anxiety about immigration and cultural change, Reid argued that culture—not economics—is the primary concern animating many Trump supporters.

       

       

       

       

      

      

       

       

On June 23, Brookings hosted the release of the Immigrants, Immigration Reform, and 2016 Election Survey, a joint project with the Public Religion Research Institute (PRRI). The associated report entitled, How immigration and concern about cultural change are shaping the 2016 election finds an American public anxious and intensely divided on matters of immigration and cultural change at the forefront of the 2016 Election.

Dr. Robert Jones, CEO of PRRI, began the presentation by highlighting Americans’ feelings of anxiety and personal vulnerability. The poll found, no issue is more critical to Americans this election cycle than terrorism, with nearly seven in ten (66 percent) reporting that terrorism is a critical issue to them personally. And yet, Americans are sharply divided on questions of terrorism as it pertains to their personal safety. Six in ten (62 percent) Republicans report that they are at least somewhat worried about being personally affected by terrorism, while just 44 percent of Democrats say the same. 

On matters of cultural change, Jones painted a picture of a sharply divided America. Poll results indicate that a majority (55 percent) of Americans believe that the American way of life needs to be protected from foreign influence, while 44 percent disagree.  Responses illustrate a stark partisan divide:

74 percent of Republicans and 83 percent of Trump supporters believe that foreign influence over the American way of life needs to be curtailed.  Just 41 percent of Democrats agree, while a majority (56 percent) disagrees with this statement. Views among white Americans are sharply divided by social class, the report finds. While 68 percent of the white working class agrees that the American way of life needs to be protected, fewer than half (47 percent) of white college-educated Americans agree.

Jones identified Americans’ views on language and “reverse discrimination” as additional touchstones of cultural change. Americans are nearly evenly divided over how comfortable they feel when they encounter immigrants who do not speak English: 50 percent say this bothers them and 49 percent say it does not. 66 percent of Republicans and 77 percent of Trump supporters express discomfort when coming into contact with immigrants who do not speak English; just 35 percent of Democrats say the same.

 

Americans split evenly on the question of whether discrimination against whites, or “reverse discrimination,” is as big of a problem as discrimination against blacks and other minorities (49 percent agree, 49 percent disagree). Once again, the partisan differences are considerable: 72 percent of Republicans and 81 percent of Trump supporters agree that reverse discrimination is a problem, whereas more than two thirds (68 percent) of Democrats disagree.

On economic matters, survey results indicate that nearly seven in ten (69 percent) Americans support increasing the tax rate on wealthy Americans, defined as those earning over $250,000 a year. This represents a modest increase in the share of Americans who favor increasing the tax rate relative to 2012, but a dramatic increase in the number of Republicans who favor this position.

 

The share of  Republicans favoring increasing the tax rate on wealthy Americans jumped from 36 percent in 2012 to 54 percent in 2016—an 18 point increase. Democrats and Independents views on this position remained relatively constant, increasing from 80 to 84 percent and 61 to 68 percent approval respectively.

Finally, on matters of immigration, Americans are divided over whether immigrants are changing their communities for the better (50 percent) or for the worse (49 percent). Across party lines, however, Americans are more likely to think immigrants are changing American society as a whole than they are to think immigrants are changing the local community. This, Jones suggested, indicates that Americans’ views on immigration are motivated by partisan ideology more than by lived experience. 

At the conclusion of Dr. Jones’s presentation, Brookings senior fellow in Governance Studies, Dr. William Galston moderated a panel discussion of the poll’s findings. Karlyn Bowman, a senior fellow and research coordinator at the American Enterprise Institute, observed that cultural anxiety has long characterized Americans’ views on immigration. Never, Bowman remarked, has the share of Americans that favor immigrants outpaced the share of those who oppose immigrants. Turning to the results of the PRRI survey, Bowman highlighted the partisan divide influencing responses to the proposition that the United States place a temporary ban on Muslims. The strong level of Republican support for the proposal--64 percent support among Republicans--compared to just 23 percent support among Democrats has more to do with fear of terrorism than anxiety about immigration, she argued.

Henry Olsen, a senior fellow at the Ethics and Public Policy Center, remarked that many Americans feel that government should do more to ensure protection, prosperity, and security -- as evidenced by the large proportion of voters who feel that their way of life is under threat from terrorism (51%), crime (63%), or unemployment (65%).  In examining fractures within the Republican Party, Olsen considered the ways in which Trump voters differ from non-Trump voters, regardless of party affiliation. On questions of leadership, he suggested, the fact that 57% of all Republicans agree that we need a leader “willing to break some rules” is skewed by the high proportion of Trump supporters (72%) who agree with that statement. Indeed, just 49% of Republicans who did not vote for Trump agreed that the country needs a leader willing to break rules to set things right.

Joy Reid, National Correspondent at MSNBC, cited the survey’s findings that Americans are bitterly divided over whether American culture and way of life has changed for the better (49 percent) or the worse (50 percent) since the 1950s. More than two-thirds of Republicans (68 percent) and Donald Trump supporters (68 percent) believe the American way of life has changed for the worse since the 1950s. Connecting this nostalgia to survey results indicating anxiety about immigration and cultural change, Reid argued that culture—not economics—is the primary concern animating many Trump supporters.

       

       

Ryan’s EITC is pro-mobility… but funding it may not be

Paul Ryan seems to be thinking seriously about the issues of poverty and social mobility. He is a reformer as well as an authentic conservative.

While his willingness to embrace EITC expansion is welcome, his proposed funding methods raise serious questions. Paying for anti-poverty programs by cutting anti-poverty programs runs the risk of being self-defeating. No doubt some of them are not working as intended. But reform is the answer, rather than abolition. Many of these programs help those in the deepest poverty - who in many cases are those least likely to benefit from welfare-to-work policies such as the EITC, according to recent research from the Center for Budget and Policy Priorities and from the National Poverty Center. 

Ryan's package is worthy of serious attention, not least from the perspective of social mobility. It is important, however, not to consider the impact of the EITC expansion alone, but also how - and by whom- it will be paid for. 

      

       

Policy Brief #181

The new normal for local, state and federal governments is fiscal austerity. Although President Obama supported education during his State of the Union address and in his budget proposal to Congress, cash-strapped localities and states—which foot most of the bill for educating America’s children—may have to balance their budgets with cuts to schools and teachers. The recession exposed a long-developing structural imbalance between public expenditure versus raising the revenue for public services. Especially on education, reality has set in, with a vengeance.

Cutting public expenditure is not necessarily a bad thing. There are, however, some activities that have become so fundamentally governmental and so critically important to the nation’s future that they require special care during a period of severe budget trimming. Education is one such example.

The Brown Center on Education Policy at Brookings has recently developed proposals to ensure that federal investments in education have impact. These proposals present the dual advantage of low costs of implementation at the federal level coupled with the promise of considerable leverage at the state and local level. Two of those proposals are presented in this brief: increasing digital and virtual education and expanding consumer information on higher education.

	RECOMMENDATIONS
	One important path to individual opportunity is higher levels of educational attainment. The U.S. economy is marked by an increasing economic divide between those who are educated and those who are not. In a time of fiscal austerity, every federal dollar invested in education must have a return. Congress should: Increase digital and virtual education. In reauthorizing the No Child Left Behind Act, provide that parents of economically disadvantaged students who are eligible for federal Title I funding should be able to direct that the funding associated with their child be spent to cover the costs of enrolling their child in virtual courses or in a virtual school.   Expand consumer information in higher education. Amend the Higher Education Act (HEA) to require that states that receive federal funds for statewide longitudinal data systems provide information on completion rates, employment levels, and annual earned income for each degree or certificate program and for each degree-granting institution that operates in the state. This information could be disseminated on the Internet.

Downloads

• Download full policy brief

       

       

Legislative proposals to accelerate and improve the development of innovative drugs and medical devices generally focus on reforming the clinical development and regulatory review processes that occur before a product gets to market. Many of these proposals – such as boosting federal funding for basic science, streamlining the clinical trials process, improving incentives for development in areas of unmet medical need, or creating expedited FDA review pathways for promising treatments – are worthy pursuits and justifiably part of ongoing efforts to strengthen biomedical innovation in the United States, such as the 21^st Century Cures initiative in the House and a parallel effort taking shape in the Senate.

What has largely been missing from these recent policy discussions, however, is an equal and concerted focus on the role that postmarket evidence can play in creating a more robust and efficient innovation process. Data on medical product safety, efficacy, and associated patient outcomes accrued through routine medical practice and through practical research involving a broad range of medical practices could not only bolster our understanding of how well novel treatments are achieving their intended effects, but reinforce many of the premarket reforms currently under consideration. Below and in a new paper, we highlight the importance of postmarket evidence development and present a number of immediately achievable proposals that could help lay the foundation for future cures.

Why is postmarket evidence development important?

There are a number of reasons why evidence developed after a medical product’s approval should be considered an integral part of legislative efforts to improve biomedical innovation. First and foremost, learning from clinical experiences with medical products in large patient populations can allow providers to better target and treat individuals, matching the right drug or device to the right patient based on real-world evidence. Such knowledge can in turn support changes in care that lead to better outcomes and thus higher value realized by any given medical product.

Similarly, data developed on outcomes, disease progression, and associated genetic and other characteristics that suggest differences in disease course or response to treatment can form the foundation of future breakthrough medical products. As we continue to move toward an era of increasingly-targeted treatments, this important of this type of real-world data cannot be discounted.

Finally, organized efforts to improve postmarket evidence development can further establish infrastructure and robust data sources for ensuring the safety and effectiveness of FDA-approved products, protecting patient lives. This is especially important as Congress, the Administration, and others continue to seek novel policies for further expediting the pre-market regulatory review process for high-priority treatments. Without a reliable postmarket evidence development infrastructure in place, attempts to further shorten the time it takes to move a product from clinical development to FDA approval may run up against the barrier of limited capabilities to gather the postmarket data needed to refine a product’s safety and effectiveness profile. While this is particularly important for medical devices – the “life cycle” of a medical device often involves many important revisions in the device itself and in how and by whom it is used after approval – it is also important for breakthrough drugs, which may increasingly be approved based on biomarkers that predict clinical response and in particular subpopulations of patients.

What can be done now?

The last decade has seen progress in the availability of postmarket data and the production of postmarket evidence. Biomedical researchers, product developers, health care plans, and providers are doing more to collect and analyze clinical and outcomes data. Multiple independent efforts – including the U.S. Food and Drug Administration’s Sentinel Initiative for active postmarket drug safety surveillance, the Patient-Centered Outcomes Research Institute’s PCORnet for clinical effectiveness studies, the Medical Device Epidemiology Network (MDEpiNet) for developing better methods and medical device registries for medical device surveillance and a number of dedicated, product-specific outcomes registries – have demonstrated the powerful effects that rigorous, systematic postmarket data collection can have on our understanding of how medical products perform in the real-world and of the course of underlying diseases that they are designed to treat.

These and other postmarket data systems now hold the potential to contribute to data analysis and improved population-based evidence development on a wider scale. Federal support for strengthening the processes and tools through which data on important health outcomes can be leveraged to improve evidence on the safety, effectiveness, and value of care; for creating transparent and timely access to such data; and for building on current evidence development activities will help to make the use of postmarket data more robust, routine, and reliable.

Toward that end, we put forward a number of targeted proposals that current legislative efforts should consider as the 2015 policy agenda continues to take shape:

Evaluate the potential use of postmarket evidence in regulatory decision-making. The initial Cures discussion draft mandated FDA to establish a process by which pharmaceutical manufacturers could submit real-world evidence to support Agency regulatory decisions. While this is an important part of further establishing methods and mechanisms for harnessing data developed in the postmarket space, the proposed timelines (roughly 12 months to first Guidance for Industry) and wide scope of the program do not allow for a thoughtfully-, collaboratively-considered approach to utilizing real-world evidence. Future proposals should allow FDA to take a longer, multi-stakeholder approach to identify the current sources of real-world data, gaps in such collection activities, standards and methodologies for collection, and priority areas where more work is needed to understand how real-world data could be used.

Expand the Sentinel System’s data collection activities to include data on effectiveness. Established by Congress in 2007, Sentinel is a robust surveillance system geared toward monitoring the safety of drugs and biologics. In parallel to the program for evaluating the use of RWE outlined above, FDA could work with stakeholders to identify and pursue targeted extensions of the Sentinel system that begin to pilot collection of such data. Demonstration projects could enable faster and more effective RWE development to characterize treatment utilization patterns, further refine a product’s efficacy profile, or address pressing public health concerns – all by testing strategic linkages to data elements outside of Sentinel’s safety focus.

Establish an active postmarket safety surveillance system for medical devices. Congress has already acted once to establish device surveillance, mandating in 2012 that Sentinel be expanded to include safety data on medical devices. To date, however, there has been no additional support for such surveillance or even the capability of individually tracking medical devices in-use. With the recently finalized Unique Device Identifier rule going effect and the ability to perform such tracking on the horizon, the time is now to adopt recent proposals from FDA’s National Medical Device Postmarket Surveillance System Planning Board. With Congressional authorization for FDA to establish an implementation plan and adequate appropriations, the true foundation for such a system could finally be put into place.

These next steps are practical, immediately achievable, and key to fully realizing the intended effect of other policy efforts aimed at both improving the biomedical innovation process and strengthening the move to value-based health care.