Illustration by The Globe and Mail/iStock
The U.S. presidential election is just days away and the next person to occupy the White House will face a host of major challenges.
The pandemic disrupted a decade-long economic expansion, exposing serious weaknesses in the U.S. labour market. Many young Americans are weighed down by rising student debt. Health care costs have soared against a backdrop of public-health crises such as opioid addiction. Climate change could threaten hundreds of communities across the United States. Beyond its borders, the U.S. risks losing its influence over global affairs to China. Republicans and Democrats are growing farther apart on many of these issues, offering little hope for a political compromise.
Yet there are rays of optimism: A growing Hispanic population is replacing aging Baby Boomers in the labour market and bringing more diversity to the workplace. The future is bright for renewable energy. Americans are becoming more supportive of health care reform, while younger generations appear to be less polarized on issues such as climate change than their parents and grandparents. And maybe social media and smartphone addiction is not destroying our society as quickly as we think. It turns out most voters still spend a majority of their spare time doing what previous generations have always done: watching television.
Here are 10 challenges that the U.S. will be faced with in the coming years, regardless of who wins the election – and a few reasons for hope.
Table of contents • Health care • Labour • Geopolitics • Personal finance • Inequality • Partisanship • Drugs • Environment • Energy • Technology
1. Health care
Health care will be harder to access – and costlier
The U.S. spends far more on health care than most other countries. Medical costs now account for more than 17 per cent of the country’s GDP at roughly US$4.5-trillion, a figure that is set to rise to $6.2-trillion by 2028, according to the Centers for Medicare and Medicaid Services. Government spending on health care has been rising, but much of the growth has come from spending on private health insurance. Americans pay nearly five times what Canadians pay for health insurance premiums, at close to US$4,000 a year, according to a 2019 analysis by the Commonwealth Fund. They spend another $1,100 annually on average on out of pocket expenses such as co-payments for doctors visits and deductibles on insurance.
Yet despite spending so much on care, the U.S. has comparatively poor health outcomes. It has the highest rates of suicide and obesity among the 37-member Organization for Economic Co-operation and Development. Overall life expectancy actually declined between 2014 and 2017, driven in part by “deaths of despair” – overdoses and suicides – and by a widening racial gap. (Life expectancy was three years less for Black Americans than for white Americans, according to the Commonwealth Fund.)
high costs, few benefits
U.S. life expectancy has plateaued even though
the country now spends more per capita on
health care than any other nation in the OECD.
Per capita health spending. Amounts are adjusted
for inflation and price differences among countries.
Japan
Switzerland
Canada
Italy
82 years
Greece
LIFE EXPECTANCY
Germany
80 years
United States
Czech Republic
78 years
Mexico
76 years
Hungary
74 years
Asia
Europe
72 years
North America
Oceania
70 years
South America
68 years
2015
1970
$1,000
$3,000
$5,000
$7,000
HEALTH EXPENDITURE (2010 INT.-$)
john sopinski/the globe and mail, Source:
our world in data via World Bank, Health
Expenditure and Financing - OECDstat
(2017), Population(Gapminder, HYDE(2016)
& UN (2019))
high costs, few benefits
U.S. life expectancy has plateaued even though
the country now spends more per capita on
health care than any other nation in the OECD.
Per capita health spending. Amounts are adjusted for inflation
and price differences among countries.
Japan
Switzerland
Canada
Italy
82 years
Greece
Germany
80 years
LIFE EXPECTANCY
United States
Czech Republic
78 years
Mexico
76 years
Hungary
74 years
Asia
Europe
72 years
North America
Oceania
70 years
South America
68 years
2015
1970
$1,000
$3,000
$5,000
$7,000
HEALTH EXPENDITURE (2010 INT.-$)
john sopinski/the globe and mail, Source: our
world in data via World Bank, Health Expenditure
and Financing - OECDstat (2017), Population
(Gapminder, HYDE(2016) & UN (2019))
high costs, few benefits
U.S. life expectancy has plateaued even though the country now spends more per capita on
health care than any other nation in the OECD.
Per capita health spending. Amounts are adjusted for inflation and price differences among countries.
Japan
France
Switzerland
Canada
Italy
82 years
Portugal
Netherlands
Greece
Germany
80 years
United States
Czech Republic
78 years
Mexico
LIFE EXPECTANCY
76 years
Hungary
74 years
Asia
Europe
North America
72 years
Oceania
South America
70 years
68 years
2015
1970
$1,000
$2,000
$3,000
$4,000
$5,000
$6,000
$7,000
$8,000
HEALTH EXPENDITURE (2010 INT.-$)
john sopinski/the globe and mail, Source: our world in data via World Bank, Health
Expenditure and Financing - OECDstat (2017), Population (Gapminder, HYDE(2016)
& UN (2019))
The U.S. also has fewer physicians per capita than most OECD peer countries, including Canada. In some rural regions of the country, access to health care is so scarce that they are now considered “medical deserts” – places where residents need to drive more than an hour to reach the nearest hospital.
Health deserts contribute
to poor outcomes
Health Professional Shortage Area (HPSA) score
showing areas with a greater shortage of prima-
ry care physicians. Scores range from 0-25. A
higher score means a greater need. In many
rural areas of the Southeast and Southwest a
significant share of local residents lack easy
access to a primary care physician.
HPSA score
1 - 13
14 - 17
18+
Non-
HPSA
JOHN SOPINSKI/THE GLOBE AND MAIL, SOURCE:
u.s. Health Resources and Services
Administration
Health deserts contribute to poor outcomes
Health Professional Shortage Area (HPSA) score showing
areas with a greater shortage of primary care physicians.
Scores range from 0-25. A higher score means a greater
need. In many rural areas of the Southeast and South
west a significant share of local residents lack easy
access to a primary care physician.
HPSA score
1 - 13
14 - 17
18+
Non-
HPSA
JOHN SOPINSKI/THE GLOBE AND MAIL, SOURCE: u.s. Health
Resources and Services Administration
Health deserts contribute to poor outcomes
Health Professional Shortage Area (HPSA) score showing areas with a greater shortage of
primary care physicians. Scores range from 0-25. A higher score means a greater need. In
many rural areas of the Southeast and Southwest a significant share of local residents lack
easy access to a primary care physician.
HPSA score
1 - 13
14 - 17
18+
Non-HPSA
JOHN SOPINSKI/THE GLOBE AND MAIL, SOURCE: u.s. Health Resources
and Services Administration
Roughly 30 million Americans had no health insurance at all last year, and at least a million more lost insurance when they were laid off during the pandemic, according to preliminary estimates from the Congressional Budget Office. The large share of Americans without access to health insurance or paid sick leave is thought to be among the reasons why the U.S. has been particularly hard hit by COVID-19.
Another 20 million more Americans could find themselves without health insurance if the U.S. Supreme Court overturns the Affordable Care Act, an Obama-era law that made it easier for many people to qualify for low-cost insurance. The court is set to hear arguments in a case challenging the constitutionality of the law on Nov. 10.
The pandemic has shifted public attitudes toward government-funded health care, with more Americans saying they support the idea of a single-payer health care system this year compared with 2019. Most of those who have warmed to universal health care have been Democrats. Republicans are by-and-large still opposed to a government-run system.
A majority say government should be respon-
sible for ensuring health-care coverage for all
Is it the federal government’s responsibility to make sure all
Americans have health-care coverage?
Yes, govt. is responsible
No, govt. is not responsible
Single national
program
Mix govt./
private program
Continue Medi-
caid/Medicare
No govt.
involvement
Total
36
26
30
6
2020
30
28
35
6
2019
Republican leaning
2020
15
18
54
11
2019
13
16
59
11
Democrat leaning
54
33
10
2
2020
44
38
15
2
2019
Note: Survey of U.S. adults conducted July 27-Aug. 2, 20
JOHN SOPINSKI/THE GLOBE AND MAIL
SOURCE: pew research center
A majority say government should be respon-
sible for ensuring health-care coverage for all
Is it the federal government’s responsibility to make sure all
Americans have health-care coverage?
Yes, govt. is responsible
No, govt. is not responsible
Single national
program
Mix govt./
private program
Continue Medi-
caid/Medicare
No govt.
involvement
Total
36
26
30
6
2020
30
28
35
6
2019
Republican leaning
2020
15
18
54
11
2019
13
16
59
11
Democrat leaning
54
33
10
2
2020
44
38
15
2
2019
Note: Survey of U.S. adults conducted July 27-Aug. 2, 20
JOHN SOPINSKI/THE GLOBE AND MAIL
SOURCE: pew research center
A majority say government should be responsible
for ensuring health-care coverage for all
Is it the federal government’s responsibility to make sure all
Americans have health-care coverage?
Yes, govt. is responsible
No, govt. is not responsible
Single national
program
Mix govt. and
private program
Continue
Medicaid/Medicare
No govt.
involvement
Total
36
26
30
6
2020
30
28
35
6
2019
Republican leaning
2020
15
18
54
11
2019
13
16
59
11
Democrat leaning
54
33
10
2
2020
44
38
15
2
2019
Note: Survey of U.S. adults conducted July 27-Aug. 2, 2020
JOHN SOPINSKI/THE GLOBE AND MAIL, SOURCE: pew research center
2. Labour
Men leave the work force as wages stagnate
The U.S. experienced its longest economic expansion on record before the pandemic. Unemployment had fallen to its lowest level in nearly 50 years. But as the economic effects of COVID-19 made clear, the decade-long boom masked serious and longstanding problems with the U.S. economy.
The country has also seen a steady decline in labour force participation among men between the ages of 25 and 54, considered to be the prime earning years. While other advanced economies have also seen a drop in labour force participation, it has been particularly dramatic in the U.S. Participation rates among working-age men have fallen by more than four percentage points since 1990. What’s more, much of that decline has come from younger generations and is concentrated among Black men and those with only a high-school education.
Researchers point to a variety of factors for the decline. Wages for some workers have stagnated, with workers earning on average what they made in 1973, adjusted for inflation. Wages have actually fallen in inflation-adjusted terms for some lower-skilled jobs, discouraging less-educated workers from entering the labour market.
a long-term view on wages in the u.s.
Real hourly earnings for production and
non-supervisory employees*
$25
Recessions
Feb. 1973:
$23.24
March 2019:
$23.24
20
15
1964
1970
1980
1990
2000
2010
*Adjusted to March 2019 dollars using thre Consumer
Price Index for Urban Wage Earners and Clerical
Workers; seasonally adjusted
THE GLOBE AND MAIL, SOURCE: statista (via u.s.
bureau of labor statistics)
a long-term view on wages in the u.s.
Real hourly earnings for production and
non-supervisory employees*
$25
Recessions
Feb. 1973:
$23.24
March 2019:
$23.24
20
15
1964
1970
1980
1990
2000
2010
*Adjusted to March 2019 dollars using thre Consumer Price
Index for Urban Wage Earners and Clerical Workers;
seasonally adjusted
THE GLOBE AND MAIL, SOURCE: statista (via u.s. bureau
of labor statistics)
a long-term view on wages in the u.s.
Real hourly earnings for production and non-supervisory employees*
$25
Recessions
Feb. 1973:
$23.24
March 2019:
$23.24
20
15
1964
1970
1980
1990
2000
2010
*Adjusted to March 2019 dollars using thre Consumer Price Index for Urban Wage
Earners and Clerical Workers; seasonally adjusted
THE GLOBE AND MAIL, SOURCE: statista (via u.s. bureau of labor statistics)
A large part of that widening earnings gap has come from the decline of manufacturing jobs, which were once the pathway to the middle class for workers with only a high-school education. The U.S. has lost more than seven million manufacturing jobs since 1980. While the sector added roughly 500,000 jobs during Donald Trump’s presidency, the industry has taken a sharp downturn amid the pandemic. Manufacturing employment now stands 160,000 jobs lower than when Mr. Trump took office. And despite campaign pledges by both the Republican nominee and Democratic nominee Joe Biden to reinvest in manufacturing, the Bureau of Labor Statistics estimates that the sector will likely lose another 400,000 jobs by 2029.
While the U.S. unemployment rate has declined in recent years, the number of weeks that the average unemployed worker has been out of work has steadily increased after each successive recession. As workers spend longer periods of time out of work after losing a job, researchers believe some simply stop looking for work entirely.
There are bright spots in the U.S. job market. More workers are graduating from college, and those with advanced degrees have seen their earnings soar as the country shifts toward more highly skilled jobs. Immigration will also help boost the U.S. labour force, while also making it more diverse. A fast-growing young Hispanic population will help replace retiring Baby Boomers. The Bureau of Labor Statistics estimates that the proportion of U.S. workers who identify as Hispanic will rise from 16 per cent in 2016 to more than 30 per cent by 2060.
POPULATION CHANGE BY RACE, 2010-2030
Assumes average birth, average death,
and average migration.
Decline
Growth
-40
-30
-20
-10
0%
10
20
30
40
No population
HISPANIC
BLACK
WHITE
ALL RACES
THE GLOBE AND MAIL, SOURCE: URBAN INSTITUTE
POPULATION CHANGE BY RACE, 2010-2030
Assumes average birth, average death,
and average migration.
Decline
Growth
-40
-30
-20
-10
0%
10
20
30
40
No population
HISPANIC
BLACK
WHITE
ALL RACES
THE GLOBE AND MAIL, SOURCE: URBAN INSTITUTE
POPULATION CHANGE BY RACE, 2010-2030
Assumes average birth, average death,
and average migration.
Decline
Growth
-40
-30
-20
-10
0%
10
20
30
40
No population
HISPANIC
BLACK
WHITE
ALL RACES
THE GLOBE AND MAIL, SOURCE: URBAN INSTITUTE
POPULATION CHANGE BY RACE, 2010-2030
Assumes average birth, average death, and average migration.
Decline
Growth
-40
-30
-20
-10
0%
10
20
30
40
No population
HISPANIC
BLACK
WHITE
ALL RACES
THE GLOBE AND MAIL, SOURCE: URBAN INSTITUTE
POPULATION CHANGE BY RACE, 2010-2030
Assumes average birth, average death, and average migration.
Decline
Growth
-40
-30
-20
-10
0%
10
20
30
40
No population
HISPANIC
BLACK
WHITE
ALL RACES
THE GLOBE AND MAIL, SOURCE: URBAN INSTITUTE
3. Geopolitics
China is bringing a new world order
Over the past two decades, China has strengthened its influence on global affairs. China now files the most patents of any country, and homegrown tech players (from Alibaba to TikTok) compete beyond domestic borders. Despite various political tensions and tariff wars, more countries now count China as a bigger trade partner than the U.S. And increasingly, China is the financier of choice for many countries, from South Pacific islands to European countries.
China has barrelled forward as the U.S. took a backseat in foreign affairs.
In recent years, China has overtaken the U.S. in the amount of aid and other financial transfers it sends abroad, according to a research lab at Virginia’s College of William & Mary. The intent of those funds is decidedly different. While the U.S. often sends grants to developing countries, earmarked for things such as maternal health and disaster response, China is more likely to offer loans for infrastructure projects. A significant portion of Chinese lending is “hidden,” or not reported to the International Monetary Fund or World Bank, a National Bureau of Economic Research paper found. This makes it particularly difficult to assess the financial health of developing countries that have gorged on Chinese debt.
In turn, China’s creeping influence is raising alarms. Several countries have barred Chinese equipment (notably from tech firm Huawei) from being used in 5G networks over surveillance concerns. Public opinion is also shifting. Seventy-three per cent of Americans have an unfavourable opinion of China, compared with 35 per cent in 2005, according to survey results from the Pew Research Center. Many other countries, including Canada, have seen dramatic changes of opinion as well. For future U.S. governments, how it deals with China – on trade, security and other geopolitical matters – may become a pressing issue with voters.
4. Personal finance
An education or a house: Pick one
Since the financial crisis of 2007-08, when a whack of U.S. mortgages went sour, personal finances have become less alarming. U.S. household debt, as a percentage of gross domestic product, has ebbed to 77 per cent, from around 100 per cent in 2008.
There is, however, one area of explosive growth: student loans. Americans now have US$1.5-trillion in student debt, a 542-per-cent gain since 2003, and easily the largest percentage increase by loan product. Tuition fees have skyrocketed, leaving the average student-loan recipient with about US$36,500 owing. And it’s keeping graduates from achieving other life goals. A 2019 report from the Federal Reserve estimated that student loans prevented more than 400,000 young Americans from buying a home between 2005 and 2014.
5. Inequality
The rich double their money as poor fall behind
MEDIAN HOUSEHOLD DEBT-TO-INCOME RATIO BY COUNTY, 2019
1.01
1.37
1.82
2.63
0.78
1.19
1.58
2.16
>3.46
THE GLOBE AND MAIL, SOURCE:
FEDERAL RESERVE BANK
MEDIAN HOUSEHOLD DEBT-TO-INCOME RATIO BY COUNTY, 2019
1.01
1.37
1.82
2.63
0.78
1.19
1.58
2.16
>3.46
THE GLOBE AND MAIL, SOURCE: FEDERAL RESERVE BANK
MEDIAN HOUSEHOLD DEBT-TO-INCOME RATIO BY COUNTY, 2019
1.01
1.37
1.82
2.63
0.78
1.19
1.58
2.16
>3.46
THE GLOBE AND MAIL, SOURCE: FEDERAL RESERVE BANK
MEDIAN HOUSEHOLD DEBT-TO-INCOME RATIO BY COUNTY, 2019
1.01
1.37
1.82
2.63
0.78
1.19
1.58
2.16
>3.46
THE GLOBE AND MAIL, SOURCE: FEDERAL RESERVE BANK
MEDIAN HOUSEHOLD DEBT-TO-INCOME RATIO BY COUNTY, 2019
1.01
1.37
1.82
2.63
0.78
1.19
1.58
2.16
>3.46
THE GLOBE AND MAIL, SOURCE: FEDERAL RESERVE BANK
Income and wealth inequality has been a longstanding problem in the U.S., which has the highest income inequality among Group of Seven countries.
With earnings averaging close to US$250,000 a year, the top 5 per cent of U.S. households took home nearly a quarter of all income in 2018, up from 16 per cent in 1968. Part of the income divide is racial, with Black households earning roughly 61 per cent of white households. Growing income inequality has helped fuel an even wider wealth gap, which has doubled in the past 30 years as richer Americans have loaded up on real estate, stocks and other financial assets, while poorer families struggle to pay their bills.
In 1989, the richest 5 per cent of families had a median net worth of US$2.3-million compared with the poorest families, whose net worth averaged around $20,300, according to Pew Research Center. By 2016, the wealthiest families had more than doubled their net worth to $4.8-million while poorer families had seen their net worth fall to $19,500.
Rising inequality has burdened some lower-income households, particularly in high-cost parts of the West, with high debt loads compared with their incomes. While household balance sheets are better than they were heading into the 2008 financial crisis, the U.S. economy still faces a significant risk because household debt is still rising among the families who would be least likely to withstand a major financial crisis.
6. Partisanship
Young people could close partisan rifts
Dems and Repubs more ideolo-
gically divided than in the past
When surveyed on a range of issues—
from government regulation to racial
inequality—partisans are increasingly less
likely to have similar views.
1994
MEDIAN
MEDIAN
Democrats
Republicans
Consistently
liberal
Consistently
conservative
2004
MEDIAN
MEDIAN
Democrats
Republicans
Consistently
liberal
Consistently
conservative
2017
MEDIAN
MEDIAN
Democrats
Republicans
Consistently
liberal
Consistently
conservative
JOHN SOPINSKI/THE GLOBE AND MAIL
SOURCE: pew research center
Democrats and Republicans more
ideologically divided than in the past
When surveyed on a range of issues—from
overnment regulation to racial inequality—
partisans are increasingly less likely to have
similar views.
1994
MEDIAN
MEDIAN
Democrats
Republicans
Consistently
liberal
Consistently
conservative
2004
MEDIAN
MEDIAN
Democrats
Republicans
Consistently
liberal
Consistently
conservative
2017
MEDIAN
MEDIAN
Democrats
Republicans
Consistently
liberal
Consistently
conservative
JOHN SOPINSKI/THE GLOBE AND MAIL
SOURCE: pew research center
Democrats and Republicans more ideologically divided than in the past
When surveyed on a range of issues—from government regulation to racial inequality—
partisans are increasingly less likely to have similar views.
1994
2004
2017
MEDIAN
MEDIAN
MEDIAN
MEDIAN
MEDIAN
MEDIAN
Democrats
Republicans
Democrats
Republicans
Democrats
Republicans
Consistently
liberal
Consistently
conservative
Consistently
liberal
Consistently
conservative
Consistently
liberal
Consistently
conservative
JOHN SOPINSKI/THE GLOBE AND MAIL, SOURCE: pew research center
The U.S. has become increasingly divided. On a range of topics – immigration, sexual orientation and the size and scope of government – Democrat and Republican supporters are now further apart than in decades past. Indeed, the Pew Research Center found the typical Democrat has moved further to the left on political issues, while the typical Republican has moved further to the right. There are simply fewer people in the middle holding a mix of liberal and conservative viewpoints, seemingly a nightmare for any party looking to build consensus.
The situation is not entirely bleak, mind you. On some topics (eg. gay rights) Republicans have become more supportive – just not as quickly as Democrats, resulting in a wider gap between the parties. And among younger people, there’s greater consensus on some long-term challenges. For instance, a majority of millennial and Gen Z Americans (spanning the ages of 18 to 39) believe that climate change is owing to human activity, while more than half of Republican supporters under 40 think the government is doing too little to protect water and air quality. The results suggest an appetite for bold policy reforms, particularly as Gen Z becomes a bigger voting bloc.
Younger Republicans more likely to see effects
of climate change - and demand action
% of U.S. adults who say...
Among Rep./lean Rep. who are....
Dem./
lean
Dem.
Boomer and older
Gen X
Millennial and younger
0
20
40
60
80%
Climate change having at least some
effect on their local community
83%
Human activity contributes a
great deal to climate change
72
Government is doing too little to...
Protect water quality of lakes,
rivers and streams
85
Protect air quality
87
Reduce effects of climate change
89
Protect animals and their habitats
81
Protect open lands in national parks
75
JOHN SOPINSKI/THE GLOBE AND MAIL, SOURCE: pew research
Younger Republicans more likely to see effects
of climate change - and demand action
% of U.S. adults who say...
Among Rep./lean Rep. who are....
Dem./
lean
Dem.
Boomer and older
Gen X
Millennial and younger
0
20
40
60
80%
Climate change having at least some
effect on their local community
83%
Human activity contributes a
great deal to climate change
72
Government is doing too little to...
Protect water quality of lakes,
rivers and streams
85
Protect air quality
87
Reduce effects of climate change
89
Protect animals and their habitats
81
Protect open lands in national parks
75
JOHN SOPINSKI/THE GLOBE AND MAIL, SOURCE: pew research
Younger Republicans more likely to see effects
of climate change - and demand action
% of U.S. adults who say...
Among Rep./lean Rep. who are....
Dem./
lean
Dem.
Boomer and older
Gen X
Millennial and younger
0
20
40
60
80%
Climate change having at least some
effect on their local community
83%
Human activity contributes a
great deal to climate change
72
Government is doing too little to...
Protect water quality of lakes,
rivers and streams
85
Protect air quality
87
Reduce effects of climate change
89
Protect animals and their habitats
81
Protect open lands in national parks
75
JOHN SOPINSKI/THE GLOBE AND MAIL, SOURCE: pew research
7. Drugs
Drug abuse is the leading cause of death and disability
TOP 5 CAUSES OF DEATH AND DISABILITY IN THE U.S. COMPARED TO SELECT NATIONS, 2019
Higher rank
Lower rank
Ischemic
heart
disease
Other
musculo-
skeletal
Drug use
disorders
Lower
back pain
COPD*
U.S.
1
2
3
4
5
Austria
22
1
2
15
14
Belgium
26
2
1
16
7
Britain
9
1
2
16
5
Canada
4
1
2
3
12
*Chronic obstructive pulmonary disease
THE GLOBE AND MAIL, SOURCE: INSTITUTE FOR HEALTH METRICS AND EVALUATION
TOP 5 CAUSES OF DEATH AND DISABILITY IN THE U.S. COMPARED TO SELECT NATIONS, 2019
Higher rank
Lower rank
Ischemic
heart
disease
Other
musculo-
skeletal
Drug use
disorders
Lower
back pain
COPD*
1
2
3
4
5
U.S.
Austria
22
1
2
15
14
Belgium
26
2
1
16
7
Britain
9
1
2
16
5
4
1
2
3
12
Canada
*Chronic obstructive pulmonary disease
THE GLOBE AND MAIL, SOURCE: INSTITUTE FOR HEALTH METRICS AND EVALUATION
TOP 5 CAUSES OF DEATH AND DISABILITY IN THE U.S. COMPARED TO SELECT NATIONS, 2019
Higher rank
Lower rank
Ischemic
heart
disease
Other
musculo-
skeletal
Drug use
disorders
Lower
back pain
COPD*
U.S.
1
2
3
4
5
Austria
22
1
2
15
14
Belgium
26
2
1
16
7
Britain
9
1
2
16
5
Canada
4
1
2
3
12
*Chronic obstructive pulmonary disease
THE GLOBE AND MAIL, SOURCE: INSTITUTE FOR HEALTH METRICS AND EVALUATION
Overdoses from prescription opioids have been in steady decline since 2012, as several states and the U.S. Justice Department sued pharmaceutical companies for aggressive sales tactics and made it harder for doctors to prescribe opiates.
But that success has been overshadowed by a dramatic surge in fatal overdoses from synthetic opiates, with some estimates pointing to such deaths rising by an average of 70 per cent a year. Many of those deaths have been linked to illegally manufactured fentanyl, a synthetic painkiller that is 50 to 100 times more potent than morphine.
The rapid surge in fentanyl deaths has helped push fatal drug overdoses to a record of more than 70,000 last year, higher than the number of people killed by car accidents or by guns. Drug abuse is now the leading cause of death and disability in the U.S., in contrast to countries such as Canada and Britain, where heart disease is a greater health burden. Nearly 40,000 people have died from synthetic opioids in the 12 months that ended in March, accounting for three-quarters of all fatal drug overdoses in that time period.
The surge in opioid deaths has been particularly acute in states that had previously seen high rates of prescription opioid abuse, such as Ohio, Pennsylvania and West Virginia, although in more recent years states such as South Dakota, Mississippi and Maine have seen a jump in cases.
PERCENT CHANGE IN DRUG OVERDOSE DEATHS BETWEEN 12-MONTH ENDING PERIODS
March 2019 to March 2020
-20
-10
0
10
20
30
40%
South Dakota
50%
Iowa
35%
Maine
32.1%
Mississippi
34.3%
THE GLOBE AND MAIL, SOURCE: CDC
PERCENT CHANGE IN DRUG OVERDOSE DEATHS BETWEEN 12-MONTH ENDING PERIODS
March 2019 to March 2020
-20
-10
0
10
20
30
40%
South Dakota
50%
Iowa
35%
Maine
32.1%
Mississippi
34.3%
THE GLOBE AND MAIL, SOURCE: CDC
PERCENT CHANGE IN DRUG OVERDOSE DEATHS BETWEEN 12-MONTH ENDING PERIODS
March 2019 to March 2020
-20
-10
0
10
20
30
40%
South Dakota
50%
Iowa
35%
Maine
32.1%
Mississippi
34.3%
THE GLOBE AND MAIL, SOURCE: CDC
The opioid crisis is so acute that earlier this year the Council on Foreign Relations warned drug overdoses had become “a drag on the economy and a threat to national security” that has likely contributed to a drop in labour-force participation among working-age men and a decline in overall life expectancy in the U.S.
8. Environment
Mass movement owing to climate change
Climate change will cause both economic benefits and damages to different regions of the U.S. As temperatures rise, mortality costs - the economic damage caused by deaths due to extreme temperatures - are expected to fall in cooler northern regions and Rocky Mountain states, while costs are likely to soar in hot Southwestern states and across the Midwest.
AVERAGE TEMPERATURES
June, July, Aug. temperatures under high emissions with a median probability
16
17
18
19
20
21
23
26
28
29
32
35
38°C
NEXT 20 YEARS (2020-2039)
END OF CENTURY (2080-2099)
CHANGE IN MORTALITY COSTS FROM 1981-2010
Mortality costs as share of GDP, under high emissions with a median probability
-12
-10
-8
-6
-4
-2
0
2
4
6
8
10
12%
NEXT 20 YEARS (2020-2039)
END OF CENTURY (2080-2099)
THE GLOBE AND MAIL, SOURCE: CLIMATE IMPACT LAB
Climate change will cause both economic benefits and damages to different regions of the U.S. As temperatures rise, mortality costs - the economic damage caused by deaths due to extreme temperatures - are expected to fall in cooler northern regions and Rocky Mountain states, while costs are likely to soar in hot Southwestern states and across the Midwest.
AVERAGE TEMPERATURES
June, July, Aug. temperatures under high emissions with a median probability
16
17
18
19
20
21
23
26
28
29
32
35
38°C
NEXT 20 YEARS (2020-2039)
END OF CENTURY (2080-2099)
CHANGE IN MORTALITY COSTS FROM 1981-2010
Mortality costs as share of GDP, under high emissions with a median probability
-12
-10
-8
-6
-4
-2
0
2
4
6
8
10
12%
NEXT 20 YEARS (2020-2039)
END OF CENTURY (2080-2099)
THE GLOBE AND MAIL, SOURCE: CLIMATE IMPACT LAB
Climate change will cause both economic benefits and damages to different regions of the U.S. As temperatures rise, mortality costs - the economic damage caused by deaths due to extreme temperatures - are expected to fall in cooler northern regions and Rocky Mountain states, while costs are likely to soar in hot Southwestern states and across the Midwest.
AVERAGE TEMPERATURES
June, July, Aug. temperatures under high emissions with a median probability
16
17
18
19
20
21
23
26
28
29
32
35
38°C
NEXT 20 YEARS (2020-2039)
END OF CENTURY (2080-2099)
CHANGE IN MORTALITY COSTS FROM 1981-2010
Mortality costs as share of GDP, under high emissions with a median probability
-12
-10
-8
-6
-4
-2
0
2
4
6
8
10
12%
NEXT 20 YEARS (2020-2039)
END OF CENTURY (2080-2099)
THE GLOBE AND MAIL, SOURCE: CLIMATE IMPACT LAB
Climate change will cause both economic benefits and damages to different regions of the U.S. As temperatures rise, mortality costs - the economic damage caused by deaths due to extreme temperatures - are expected to fall in cooler northern regions and Rocky Mountain states, while costs are likely to soar in hot Southwestern states and across the Midwest.
AVERAGE TEMPERATURES
June, July, Aug. temperatures under high emissions with a median probability
16
17
18
19
20
21
23
26
28
29
32
35
38°C
NEXT 20 YEARS (2020-2039)
END OF CENTURY (2080-2099)
CHANGE IN MORTALITY COSTS FROM 1981-2010
Mortality costs as share of GDP, under high emissions with a median probability
-12
-10
-8
-6
-4
-2
0
2
4
6
8
10
12%
NEXT 20 YEARS (2020-2039)
END OF CENTURY (2080-2099)
THE GLOBE AND MAIL, SOURCE: CLIMATE IMPACT LAB
Climate change will cause both economic benefits and damages to different regions of the U.S. As temperatures rise, mortality costs - the economic damage caused by deaths due to extreme temperatures - are expected to fall in cooler northern regions and Rocky Mountain states, while costs are likely to soar in hot Southwestern states and across the Midwest.
AVERAGE TEMPERATURES
June, July, Aug. temperatures under high emissions with a median probability
16
17
18
19
20
21
23
26
28
29
32
35
38°C
NEXT 20 YEARS (2020-2039)
END OF CENTURY (2080-2099)
CHANGE IN MORTALITY COSTS FROM 1981-2010
Mortality costs as share of GDP, under high emissions with a median probability
-12
-10
-8
-6
-4
-2
0
2
4
6
8
10
12%
END OF CENTURY (2080-2099)
NEXT 20 YEARS (2020-2039)
THE GLOBE AND MAIL, SOURCE: CLIMATE IMPACT LAB
Scientists believe no part of the U.S. will be untouched by the effects of climate change.
Warming temperatures will cause storm surges across the Southeast, heatwaves in the Southwest, and longer and more intense wildfire seasons in the West, according to a National Climate Assessment put out by the U.S. government in 2018 examining the risks from climate change. In the Midwest, drought-driven dust storms could threaten the region’s agriculture industry.
Such climate disasters will wreak havoc with the economy. The Climate Impact Lab, a group of scientists and academics, estimates that the U.S. economy will lose 1.2 per cent of GDP for every 1 C rise in temperatures.
Weather-related disasters are also expected to force millions of Americans from their homes. By 2050, there could be more than 23 million homes and businesses at risk of flood damage from rising sea levels, according to First Street Foundation, a New York non-profit that models flood risks across the U.S.
Climate migration is expected to worsen economic inequality in the country, with poor counties in the South and Midwest hit the hardest by climate-related population loss, while wealthier counties in Northwest and Northeast will see an influx of new residents.
Some counties could see as much as a fifth of the economy wiped out by climate change as residents flee to more temperate parts of the country Climate Impact Lab found, while others will see their economies grow by as much as 10 per cent.
9. Energy
Renewable energy becomes the cheaper option
PROJECTED GLOBAL ENERGY DEMAND
GROWTH BY 2040, BY ENERGY SOURCE
Million tonnes of oil equivalent
Coal
Gas
Bioenergy
Other renewables
6,000
STEPS*
SDS**
5,000
4,000
3,000
2,000
1,000
0
1990
2000
2010
2020
2030
2040
*Stated Policies Scenario
**Sustainable Development Scenario
THE GLOBE AND MAIL, SOURCE: CARBON BRIEF
PROJECTED GLOBAL ENERGY DEMAND GROWTH
BY 2040, BY ENERGY SOURCE
Million tonnes of oil equivalent
Coal
Gas
Bioenergy
Other renewables
6,000
STEPS*
SDS**
5,000
4,000
3,000
2,000
1,000
0
1990
2000
2010
2020
2030
2040
*Stated Policies Scenario
**Sustainable Development Scenario
THE GLOBE AND MAIL, SOURCE: CARBON BRIEF
PROJECTED GLOBAL ENERGY DEMAND GROWTH BY 2040, BY ENERGY SOURCE
Million tonnes of oil equivalent
Coal
Gas
Bioenergy
Other renewables
6,000
Sustainable Development Scenario
Stated Policies Scenario
5,000
4,000
3,000
2,000
1,000
0
1990
1995
2000
2005
2010
2015
2020
2025
2030
2035
2040
THE GLOBE AND MAIL, SOURCE: CARBON BRIEF
Peak oil demand is nearing. Global demand for crude will begin to decline within the next decade, according to a recent projection from the International Energy Agency (IEA). In its own outlook, the Organization of Petroleum Exporting Countries said oil demand will plateau in the late 2030s, while energy giant BP Inc. recently said it may have happened last year.
Instead, the coming decades will be rife by opportunities in renewable energy. The IEA projects that non-hydro renewable sources (including wind and solar) will become the largest providers of electricity generation sometime in the 2030s. The Paris-based organization, which advises industrialized countries on energy issues, raised its 2040 forecast for non-hydro renewables output by 22 per cent from its 2018 report, while slashing its outlook for coal. “Solar projects now offer some of the lowest cost electricity ever seen,” the IEA said.
PROJECTED ELECTRICITY GENERATION
BY 2040, BY ENERGY SOURCE
Terawatt hours
Coal
Gas
Non-hydro renewables
15,000
2018 outlook
2020 outlook
12,500
10,000
7,500
5,000
2,500
0
1990
2000
2010
2020
2030
2040
THE GLOBE AND MAIL, SOURCE: CARBON BRIEF
PROJECTED ELECTRICITY GENERATION BY 2040,
BY ENERGY SOURCE
Terawatt hours
Coal
Gas
Non-hydro renewables
15,000
2018 outlook
2020 outlook
12,500
10,000
7,500
5,000
2,500
0
1990
2000
2010
2020
2030
2040
THE GLOBE AND MAIL, SOURCE: CARBON BRIEF
PROJECTED ELECTRICITY GENERATION BY 2040, BY ENERGY SOURCE
Terawatt hours
Coal
Gas
Non-hydro renewables
15,000
2018 outlook
2020
outlook
12,500
10,000
7,500
5,000
2,500
0
1990
1995
2000
2005
2010
2015
2020
2025
2030
2035
2040
THE GLOBE AND MAIL, SOURCE: CARBON BRIEF
Against this backdrop, there’s a great deal of bipartisan support for investments in renewables. Eighty-eight per cent of Republicans under 40 are in favour of more solar farms, with 80 per cent supporting more wind turbine farms, according to a recent Pew Research Center survey. Democratic Party supporters are even stronger backers of both energy sources.
10. Technology
Technology is changing daily life, but not quickly
On average, Americans have just over five hours of leisure time each day. Despite the quick pace of technological change and the current era of cord-cutting, how that time is spent isn’t remarkably different from 15 years ago: Televisions are the focal point. Just over half of daily leisure time is spent watching TV; for those 75 and up, with considerably more time on hand, a daily average of nearly five hours was spent watching TV in 2019, according to an annual report from the U.S. Bureau of Labor Statistics. That’s likely why tech giants (including Amazon and Apple) have moved into the content game, spending billions on their respective streaming services. If you want to get people’s attention, visual media is king. Conversely, these are tough times for the printed or pixelated word. Americans between the ages of 15 and 19 spent an average of eight minutes each day reading for pleasure last year.
Tamsin McMahon
Matt Lundy