How Self-Driving Cars Could Harm Marginalized Communities
By Hana Creger
Everyone's talking about self-driving, autonomous vehicles these days. Late last year General Motors announced that it will shut down production of several conventional car lines, partly to pour resources into its self-driving car unit, and GM is just one of many companies ramping up such efforts, alongside Google, Tesla, Uber and a slew of others. But what kind of transportation future will this autonomous vehicle revolution bring? And who will it benefit? In a country with an increasing divide between rich and poor, what will this whiz-bang technology mean for marginalized groups such as the poor, people of color, the elderly and those with disabilities?
Some observers have imagined a sort of transportation heaven—no more space wasted on parking, less smog, easier commutes and cleaner air as the autonomous fleet electrifies. More realistically, other writers have argued we face a heaven or hell choice, with many possible downsides. While the spotlight has been fixated on the shiny new technology itself, what has been largely hidden in the shadows is how self-driving vehicles will impact our most marginalized people. Depending on how self-driving cars are deployed, we could see a growing mobility divide between haves and have-nots—an alarming prospect in places where soaring housing prices are already pushing low- and moderate-income residents farther away from their jobs and into long, punishing commutes. But this mobility divide has enormous implications beyond just commute times.
Access to mobility is the key that unlocks economic opportunity, education, health care and a better quality of life for Americans, so we should all be concerned. A Harvard study found that a person's commute time is the single greatest factor in their ability to pull themselves out of poverty and up the economic ladder. And for low-income households, a chronic lack of affordable and reliable transportation options remains an insurmountable barrier to improving their lives.
Our car-centric culture and infrastructure contribute to economic inequality. While survey data have varied over the years, available figures consistently show that lower-income Americans spend a higher percentage of their income on transportation than the wealthy do. Those who can't afford their own vehicles struggle to get around on underfunded public transit or unsafe sidewalks and bike lanes. It's a strong possibility that the rise of driverless vehicles will only widen these disparities: Those with lots of money will lounge in the comfort of their personal self-driving cars while everyone else is stuck in increasing gridlock or on deteriorating public transit. If we make it too easy for people to own self-driving cars, this will only further entrench everyone in a transportation hell of bumper-to-bumper traffic. And while congestion is an irritating inconvenience to all of us, marginalized people will be hurt the most by deteriorating public transit, a loss of driving jobs and a transportation system that prioritizes cars over people. We need to get this right.
At The Greenlining Institute, we've just done the first analysis to look in detail at the social equity implications of the coming transportation revolution, especially for those who are too often ignored in transportation planning, like people of color, low-income folks and residents of rural communities. The best answer, we found, lies in what are sometimes called FAVES: fleets of autonomous vehicles that are electric and shared. FAVES lets us connect self-driving technology to the two other big changes now revolutionizing transportation: electrification and the proliferation of shared-mobility services, including Uber and Lyft, as well as many alternatives.
FAVES, deployed correctly and in tandem with increased walking, biking and public transit, can be the "magic bullet" that improves mobility for people at all income levels, cuts pollution and greenhouse gases, and helps make cities more livable. This isn't some futuristic fantasy; FAVES are already here. A multitude of companies are operational, such as Transdev, which has transported 3.5 million people in their electric self-driving shuttles.
But even FAVES won't have these positive social equity and environmental effects if we leave essential decisions to the marketplace. Left alone, companies will do just what you'd expect: cater to customers with disposable income and ignore the broader implications for communities and for marginalized folks. We've already seen glimpses of what a "hell" future might entail, with evidence suggesting that ride-hailing services like Uber and Lyft have cut into transit ridership and increased traffic congestion in some urban areas. Without oversight, what would prevent transportation companies from ditching their drivers for robots to double their profits? We can't allow the private sector to dictate the terms of this transportation revolution. We have to demand that self-driving vehicle technology fits into a vision of a fair transportation system that reduces pollution and contributions to climate change, and doesn't just leave those with driving jobs in the dust.
For the coming transportation revolution to truly benefit all, we'll need strong regulations to, among other things:
- Discourage personally owned autonomous vehicles and encourage FAVES fleets. We can do this with equitable "road pricing" that waives fees for low-income people. The "heaven" scenario of cleaner air, less space wasted on parking, and reduced traffic simply can't happen without FAVES.
- Ensure affordability for people at all income levels, and guarantee availability of autonomous ridesharing services in low-income communities and other places the market might neglect, like rural areas—with fleets that are right-sized to meet local needs.
- Guarantee equitable access to FAVES for those with disabilities, people who lack a smartphone or high-speed internet access, or who do not speak English.
- Ensure a just transition and retraining programs for the millions whose jobs will eventually be eliminated by automation, such as bus and truck drivers, and guarantee fair labor standards for the new jobs created in this emerging industry.
- Protect, enhance and prioritize the healthiest and most environmentally friendly transportation options, such as biking and walking.
We must demand that government at all levels increase investments in walking, biking and public transit infrastructure. Building more car-oriented infrastructure has never been the solution to our congested, polluted and unjust transportation system. Self-driving cars are only the latest distraction from what real innovation would look like in American transportation. A real transportation revolution would transform our cities into clean, vibrant places that are designed for people to live, work, and thrive—not de facto parking lots for their cars.
We have a unique opportunity to create a transportation system that prioritizes moving people over cars. If we get it right, the coming transportation revolution can be a vehicle to help fix transportation injustices while contributing to better mobility, more livable communities and greater economic prosperity for all.
Hana Creger is Environmental Equity Program Manager at the Greenlining Institute. She is lead author of the 2019 report "Autonomous Vehicle Heaven or Hell? Creating a Transportation Revolution that Benefits All."
This article was produced by Earth | Food | Life, a project of the Independent Media Institute.
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By Ana Maldonado-Contreras
- Your gut is home to trillions of bacteria that are vital for keeping you healthy.
- Some of these microbes help to regulate the immune system.
- New research, which has not yet been peer-reviewed, shows the presence of certain bacteria in the gut may reveal which people are more vulnerable to a more severe case of COVID-19.
You may not know it, but you have an army of microbes living inside of you that are essential for fighting off threats, including the virus that causes COVID-19.
How Do Resident Bacteria Keep You Healthy?<p>Our immune defense is part of a complex biological response against harmful pathogens, such as viruses or bacteria. However, because our bodies are inhabited by trillions of mostly beneficial bacteria, virus and fungi, activation of our immune response is tightly regulated to distinguish between harmful and helpful microbes.</p><p>Our bacteria are spectacular companions diligently helping prime our immune system defenses to combat infections. A seminal study found that mice treated with antibiotics that eliminate bacteria in the gut exhibited an impaired immune response. These animals had low counts of virus-fighting white blood cells, weak antibody responses and poor production of a protein that is vital for <a href="https://doi.org/10.1073/pnas.1019378108" target="_blank">combating viral infection and modulating the immune response</a>.</p><p><a href="https://doi.org/10.1371/journal.pone.0184976" target="_blank" rel="noopener noreferrer">In another study</a>, mice were fed <em>Lactobacillus</em> bacteria, commonly used as probiotic in fermented food. These microbes reduced the severity of influenza infection. The <em>Lactobacillus</em>-treated mice did not lose weight and had only mild lung damage compared with untreated mice. Similarly, others have found that treatment of mice with <em>Lactobacillus</em> protects against different <a href="https://doi.org/10.1038/srep04638" target="_blank" rel="noopener noreferrer">subtypes of</a> <a href="https://doi.org/10.1038/s41598-017-17487-8" target="_blank" rel="noopener noreferrer">influenza</a> <a href="https://doi.org/10.1371/journal.ppat.1008072" target="_blank" rel="noopener noreferrer">virus</a> and human respiratory syncytial virus – the <a href="https://doi.org/10.1038/s41598-019-39602-7" target="_blank" rel="noopener noreferrer">major cause of viral bronchiolitis and pneumonia in children</a>.</p>
Chronic Disease and Microbes<p>Patients with chronic illnesses including Type 2 diabetes, obesity and cardiovascular disease exhibit a hyperactive immune system that fails to recognize a harmless stimulus and is linked to an altered gut microbiome.</p><p>In these chronic diseases, the gut microbiome lacks bacteria that activate <a href="https://doi.org/10.1126/science.1198469" target="_blank" rel="noopener noreferrer">immune cells</a> that block the response against harmless bacteria in our guts. Such alteration of the gut microbiome is also observed in <a href="https://doi.org/10.1073/pnas.1002601107" target="_blank" rel="noopener noreferrer">babies delivered by cesarean section</a>, individuals consuming a poor <a href="https://doi.org/10.1038/nature12820" target="_blank" rel="noopener noreferrer">diet</a> and the <a href="https://doi.org/10.1038/nature11053" target="_blank" rel="noopener noreferrer">elderly</a>.</p><p>In the U.S., 117 million individuals – about half the adult population – <a href="https://health.gov/our-work/food-nutrition/2015-2020-dietary-guidelines/guidelines/" target="_blank" rel="noopener noreferrer">suffer from Type 2 diabetes, obesity, cardiovascular disease or a combination of them</a>. That suggests that half of American adults carry a faulty microbiome army.</p><p>Research in my laboratory focuses on identifying gut bacteria that are critical for creating a balanced immune system, which fights life-threatening bacterial and viral infections, while tolerating the beneficial bacteria in and on us.</p><p>Given that diet affects the diversity of bacteria in the gut, <a href="https://www.umassmed.edu/nutrition/melody-trial-info/" target="_blank" rel="noopener noreferrer">my lab studies show how diet can be used</a> as a therapy for chronic diseases. Using different foods, people can shift their gut microbiome to one that boosts a healthy immune response.</p><p>A fraction of patients infected with SARS-CoV-2, the virus that causes COVID-19 disease, develop severe complications that require hospitalization in intensive care units. What do many of those patients have in common? <a href="https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm" target="_blank" rel="noopener noreferrer">Old age</a> and chronic diet-related diseases like obesity, Type 2 diabetes and cardiovascular disease.</p><p><a href="http://doi.org/10.1016/j.jada.2008.12.019" target="_blank" rel="noopener noreferrer">Black and Latinx people are disproportionately affected by obesity, Type 2 diabetes and cardiovascular disease</a>, all of which are linked to poor nutrition. Thus, it is not a coincidence that <a href="https://www.cdc.gov/mmwr/volumes/69/wr/mm6933e1.htm" target="_blank" rel="noopener noreferrer">these groups have suffered more deaths from COVID-19</a> compared with whites. This is the case not only in the U.S. but also <a href="https://www.washingtonpost.com/world/europe/blacks-in-britain-are-four-times-as-likely-to-die-of-coronavirus-as-whites-data-show/2020/05/07/2dc76710-9067-11ea-9322-a29e75effc93_story.html" target="_blank" rel="noopener noreferrer">in Britain</a>.</p>
Discovering Microbes That Predict COVID-19 Severity<p>The COVID-19 pandemic has inspired me to shift my research and explore the role of the gut microbiome in the overly aggressive immune response against SARS-CoV-2 infection.</p><p>My colleagues and I have hypothesized that critically ill SARS-CoV-2 patients with conditions like obesity, Type 2 diabetes and cardiovascular disease exhibit an altered gut microbiome that aggravates <a href="https://theconversation.com/exercise-may-help-reduce-risk-of-deadly-covid-19-complication-ards-136922" target="_blank" rel="noopener noreferrer">acute respiratory distress syndrome</a>.</p><p>Acute respiratory distress syndrome, a life-threatening lung injury, in SARS-CoV-2 patients is thought to develop from a <a href="http://doi.org/10.1016/j.cytogfr.2020.05.003" target="_blank" rel="noopener noreferrer">fatal overreaction of the immune response</a> called a <a href="https://theconversation.com/blocking-the-deadly-cytokine-storm-is-a-vital-weapon-for-treating-covid-19-137690" target="_blank" rel="noopener noreferrer">cytokine storm</a> <a href="http://doi.org/10.1016/S2213-2600(20)30216-2" target="_blank" rel="noopener noreferrer">that causes an uncontrolled flood</a> <a href="http://doi.org/10.1016/S2213-2600(20)30216-2" target="_blank" rel="noopener noreferrer">of immune cells into the lungs</a>. In these patients, their own uncontrolled inflammatory immune response, rather than the virus itself, causes the <a href="http://doi.org/10.1007/s00134-020-05991-x" target="_blank" rel="noopener noreferrer">severe lung injury and multiorgan failures</a> that lead to death.</p><p>Several studies <a href="https://doi.org/10.1016/j.trsl.2020.08.004" target="_blank" rel="noopener noreferrer">described in one recent review</a> have identified an altered gut microbiome in patients with COVID-19. However, identification of specific bacteria within the microbiome that could predict COVID-19 severity is lacking.</p><p>To address this question, my colleagues and I recruited COVID-19 hospitalized patients with severe and moderate symptoms. We collected stool and saliva samples to determine whether bacteria within the gut and oral microbiome could predict COVID-19 severity. The identification of microbiome markers that can predict the clinical outcomes of COVID-19 disease is key to help prioritize patients needing urgent treatment.</p><p><a href="https://doi.org/10.1101/2021.01.05.20249061" target="_blank" rel="noopener noreferrer">We demonstrated</a>, in a paper which has not yet been peer reviewed, that the composition of the gut microbiome is the strongest predictor of COVID-19 severity compared to patient's clinical characteristics commonly used to do so. Specifically, we identified that the presence of a bacterium in the stool – called <em>Enterococcus faecalis</em>– was a robust predictor of COVID-19 severity. Not surprisingly, <em>Enterococcus faecalis</em> has been associated with <a href="https://doi.org/10.1053/j.gastro.2011.05.035" target="_blank" rel="noopener noreferrer">chronic</a> <a href="https://doi.org/10.1016/S0002-9440(10)61172-8" target="_blank" rel="noopener noreferrer">inflammation</a>.</p><p><em>Enterococcus faecalis</em> collected from feces can be grown outside of the body in clinical laboratories. Thus, an <em>E. faecalis</em> test might be a cost-effective, rapid and relatively easy way to identify patients who are likely to require more supportive care and therapeutic interventions to improve their chances of survival.</p><p>But it is not yet clear from our research what is the contribution of the altered microbiome in the immune response to SARS-CoV-2 infection. A recent study has shown that <a href="https://doi.org/10.1101/2020.12.11.416180" target="_blank" rel="noopener noreferrer">SARS-CoV-2 infection triggers an imbalance in immune cells</a> called <a href="https://doi.org/10.1111/imr.12170" target="_blank" rel="noopener noreferrer">T regulatory cells that are critical to immune balance</a>.</p><p>Bacteria from the gut microbiome are responsible for the <a href="https://doi.org/10.7554/eLife.30916.001" target="_blank" rel="noopener noreferrer">proper activation</a> <a href="https://doi.org/10.1126/science.1198469" target="_blank" rel="noopener noreferrer">of those T-regulatory</a> <a href="https://doi.org/10.1038/nri.2016.36" target="_blank" rel="noopener noreferrer">cells</a>. Thus, researchers like me need to take repeated patient stool, saliva and blood samples over a longer time frame to learn how the altered microbiome observed in COVID-19 patients can modulate COVID-19 disease severity, perhaps by altering the development of the T-regulatory cells.</p><p>As a Latina scientist investigating interactions between diet, microbiome and immunity, I must stress the importance of better policies to improve access to healthy foods, which lead to a healthier microbiome. It is also important to design culturally sensitive dietary interventions for Black and Latinx communities. While a good-quality diet might not prevent SARS-CoV-2 infection, it can treat the underlying conditions related to its severity.</p><p><em><a href="https://theconversation.com/profiles/ana-maldonado-contreras-1152969" target="_blank">Ana Maldonado-Contreras</a> is an assistant professor of Microbiology and Physiological Systems at the University of Massachusetts Medical School.</em></p><p><em>Disclosure statement: Ana Maldonado-Contreras receives funding from The Helmsley Charitable Trust and her work has been supported by the American Gastroenterological Association. She received The Charles A. King Trust Postdoctoral Research Fellowship. She is also member of the Diversity Committee of the American Gastroenterological Association.</em></p><p><em style="">Reposted with permission from <a href="https://theconversation.com/a-healthy-microbiome-builds-a-strong-immune-system-that-could-help-defeat-covid-19-145668" target="_blank" rel="noopener noreferrer" style="">The Conversation</a>. </em></p>
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