Joe Biden has come out fighting against perceptions that he is handling the US economy badly. During an address in Maryland, the president contrasted Bidenomics with Trumpian “MAGAnomics” that would involve tax-cutting and spending reductions. He decried trickle-down policies that had, “shipped jobs overseas, hollowed out communities and produced soaring deficits”.
Changing voters’ minds about the economy is one of Biden’s biggest challenges ahead of the 2024 election. Recent polling data suggested 63% of Americans are negative on the US economy, while 45% said their financial situation had deteriorated in the last two years.
Voters are also downbeat about Biden. In a recent CNN poll, almost 75% of respondents were “seriously” concerned about his mental and physical competence. Even 60% of Democratic and Democratic-leaning respondents were “seriously” concerned he would lose in 2024.
This appears a great opportunity for Donald Trump. He’s the clear favourite amongst Republican voters for their nomination, assuming recent indictments don’t thwart his ambitions.
Trump won in 2016 by capitalising on Americans’ economic discontent. Globalisation is estimated to have seen 5.5 million well paid, unionised US manufacturing jobs lost between 2000 and 2017. The “small-government” approach since the days of Ronald Reagan also exacerbated inequality, with only the top 20% of earners seeing their GDP share rise from 1980-2016.
Trump duly promised to retreat from globalisation and prioritise domestic growth and job creation. “Make America Great Again” resonated with many voters, especially in swing manufacturing states such as Pennsylvania, Michigan and Wisconsin. Winning these “rust-belt” states was crucial to Trump’s success.
These will again be key battlegrounds in 2024, but the economic situation is somewhat different now. There may be more cause for Democrat optimism than the latest polls suggest.
What is Bidenomics?
When Biden won in 2020, he too recognised that the neoliberal version of US capitalism was failing ordinary Americans. His answer, repeated in his Maryland speech, is to grow the economy “from the middle out and the bottom up”. To this end, Bidenomics is centred on three key pillars: smarter public investment, growing the middle class and promoting competition.
On investment, Biden’s approach fundamentally challenges the argument by the right that increasing public investment “crowds out” more efficient private investment. Bidenomics argues that targeted public investment will unlock private investment, delivering well paid jobs and growth.
Almost 80% of the US$485 billion (£390 billion) in IRA spending is on energy security and climate change investment, through tax credits, subsidies and incentives. Much of the investments announced into manufacturing electric cars, batteries and solar panels, and mining vital ingredients like cobalt and lithium, are in the rust belt.
Meanwhile, Biden’s 2022 Chips Act is a US$280 billion investment to bolster US independence in semiconductors. With both acts backing domestic investment, the strategy concedes Trump’s point that globalisation failed blue-collar America. This is underpinned by other protectionist measures such as Biden’s “buy American” policy.
A whole series of measures aim to boost the middle classes. These include increasing workers’ ability to collectively bargain, and widening the maximum earning threshold for workers entitled to overtime pay from US$35,000 to US$55,000 – taking in 3.6 million more workers. As for promoting competition, measures include banning employers from using non-compete clauses in employment contacts.
The results so far
It’s too early to judge these policies, but the US economy has been relatively impressive under Biden. Over 13 million new jobs have been created, though much of this can be perhaps attributed to workers resuming employment after COVID. Unemployment is below 4%, a 50-year low, though similar to what Trump achieved pre-COVID.
The federal deficit, the annual difference between income and outgoings, is heading in the wrong direction. It deteriorated under Trump, ballooned during COVID then partially bounced back, but is forecast to widen in 2023 to 5.9% of GDP or circa US$2 trillion.
Ratings agency Fitch recently downgraded the US credit rating from AAA to AA+. Fitch says the US public finances will worsen over the next three years because GDP will deteriorate and spending rise, and that the endless political battles over the US debt ceiling have eroded confidence.
Nonetheless, the other major ratings agencies have not made similar downgrades, and the widening deficit is mostly not because of Bidenomics. Tax receipts are substantially down because the markets have been less favourable to investors, while surging interest rates have increased US debt interest payments.
Overall, the economics signs are arguably moving in the right direction. An article co-written by business professor Jeffrey Sonnefeld from Yale University in the US, advisor to Democrat and Republican administrations, compares Bidenomics to President Franklin D. Roosevelt’s New Deal. It argues:
The US economy is now pulling off what all the experts said was impossible: strong growth and record employment amidst plummeting inflation … the fruits of economic prosperity are inclusive and broad-based, amidst a renaissance in American manufacturing, investment and productivity.
The Democrats know they must make this case to win in 2024. To compound Biden’s Maryland speech, there are plans for an advertising blitz in key states. Of course, the party may yet back another candidate, if they are thought more likely to win – currently Biden and Trump are neck and neck.
One consolation to the Democrats is that voters’ gloom is partly related to interest rates, which are probably close to peaking. Anyway, recent polling suggesting voters view the economy as the paramount issue is arguably good news: it means that Republican efforts to shift the narrative towards the culture wars are less likely to win an election.
These country-level investigations follow numerous examples of professional footballers being personally investigated for breaking betting rules. In 2022, Reading defender Kynan Isaac was handed a 12-year ban for placing illegal bets.
From the outside it might seem strange that well-paid athletes who seemingly have everything might risk it all in this way. Those who are eventually found guilty can be fined, suspended from playing the sport or even banned for life.
As yet not much is known about the benefits athletes get out of spot fixing, beyond payments from fixers, and researchers aren’t even sure if athletes always get payments direct from bookmakers. But it may not all be simply about money.
My previous research into why male professional athletes commit crime may help us understand why they would gamble their careers – the intense conditions of a professional athlete’s world can prime them for criminality.
Why do athletes do it?
Sport corruption cases have been on the on the increase around the world in recent years.
My study in sport and crime involved interviewing elite male athletes who have committed crimes, ranging from driving offences or drug possession, to importing drugs or grievous bodily harm.
I found the very characteristics that may have made them a good athlete may have also set them on the path to criminality. There are parallels between the core features of athletic excellence such as competitiveness, aggression, appetite for risk and assertion, and some of the traits that underpin criminal activities.
In some circumstances, an athlete may view crime as an intense and thrilling activity that fulfils their need for excitement and fuels their appetite for risk.
Some athletes viewed crime as a means to alleviate boredom, with players struggling to fill the void that was left when not competing or training. The thrill of the crime wasn’t necessarily an initial motivator but it was clearly a reason for repeated offences. As one athlete told me: “Some of those feelings, like feelings of elation and at times camaraderie as well, that I experienced on a football pitch, in a changing room… I got that from crime as well.”
Another athlete said: “There is a buzz of it … Anyone who tells you anything else is lying, it’s a buzz”.
Athletes in my study highlighted their susceptibility to temptation, their sense of invincibility and belief the rules did not apply to them and, in hindsight, their self-centredness. In psychology, these characteristics are linked with a type of behaviour called “terminal adolescence”, where they appear to not grow up because they don’t have to. Some athletes are so indulged they develop unrealistic views of themselves and a sense of invincibility commonly seen in adolescents.
A disregard for consequences was also clear. One participant said: “Of course there are consequences, of course there are people that go to jail, I know them, but I’m not going to get caught so I don’t have to think about that”.
Athletes may take part in crime because risky experiences can give people a sense of control in their largely constrained lives – it can help athletes escape from the restrictive nature of elite sport.
Negative sporting experiences influenced some atheletes’ criminal behaviour too. Rejection, failure and a belief that sporting bodies, coaches or fans are treating them unfairly can incite athletes to rebellion. For example, one professional boxer began a phase of going out with friends and taking drugs after he lost a match because he thought the outcome was unfair.
Substance misuse was also often a negative influence. The need for money to pay for drugs and increasing greed in general were given as reasons for these bouts of self-destructive behaviour.
What can be done?
Sport organisations need to ensure they know the backgrounds, and social pressures, that are inescapable for many athletes so they can protect them. Young athletes’ potential criminality is not always on the radar of coaches, but it needs to be. One of the athletes I interviewed did get pulled up by his coach who had realised what he was doing in his free time – and this was a changing point for him.
Participants in my study touched upon the pressure they felt to be successful and how they struggled with mental health. One athlete described how draining his sport could be, and how the intensity – combined with the pressure an athlete is constantly under to perform – was exhausting.
The destructive criminal behaviour may be self-inflicted but these athletes still need support. Failing to support an athlete who has committed a crime may well make things worse, as they struggle with the financial, social and emotional consequences of their actions.
The frequency of drug and alcohol misuse is also an influence on athletes committing crimes. Athletes were indifferent to the use of class B and C drugs, and the negative impact these drugs could have on their careers, or how these could result in a criminal record. Education should be extended to coaches about how to spot social drug use, as it was clear that athletes in this study were adept at hiding their substance misuse.
The experiences of athletes who have committed crimes can be used allow others to learn from their mistakes. Telling their stories will also enable those who have offended to give back to their sports, and give convicted athletes a focus for getting their careers in sport back on track.
England goalkeeper Mary Earps was named player of the match in England’s victory over Nigeria in the Fifa Women’s World Cup. She has played a key role in England’s recent successes, not just at the World Cup but in previous tournaments. Her performances have made her a hero to her fans.
But Earps’ fans are unable to emulate her by wearing a replica of her goalkeeper shirt: it is not being put up for sale by team kit manufacturer Nike. Earps has said that her goalkeeping shirt not being available to buy is “hurtful”, and a petition by fans calling for the shirt to be produced has reached over 35,000 signatures.
We are currently researching the availability of kits for women’s football fans, together with colleague Jess Richards. The merchandise and clothing available to female fans and male fans of women’s teams is often limited, undesirable or just not available.
Or women may feel obliged to buy a shirt that doesn’t fit them if women’s cuts (shirts made to fit the shape of a female torso) of men’s team shirts are unavailable.
Here, we’ve looked at the kits women can buy on the official online stores for six teams to explore some of these issues.
World Cup clothing
The official online store for England football kits currently highlights the women’s home kit on their home page. Fans can buy a men’s cut – a shirt fitted to the shape of a male torso – of the Lionesses’ shirt, including personalised versions with player names on.
But female fans have fewer items available specifically for them in the store. There are no women’s fit versions of the men’s national team jersey.
The same is true for France – men can buy a men’s fit of the women’s team kit, but there is no women’s fit of the men’s team jersey currently available.
In their official online shop the Republic of Ireland offer women the women’s national team jersey in two different fits. They do also have the women’s national team goalkeeper kit for sale. However, the men’s team shirts are available in both long and short sleeved versions, but the women’s team shirts only come with short sleeves.
The online store for Canada Soccer also features the women’s kit prominently, but the high-end “authentic jersey” is only available for the men’s team, and only in men’s sizes. A women’s fit of the men’s jersey is not available at all.
US soccer fans hoping to emulate women’s team goalkeeper Alyssa Naeher are currently only able to buy outfield shirts with her name on it on the official kit website. The only goalkeeper jersey on offer is for the men’s national team and it is only available in a men’s fit. The store has many more items for men than for women, even for products replicating the women’s national team kit.
In 2020 in Australia the away version of the Matildas’ kit, produced by Nike, was not initially available in a women’s cut. Football Australia now has equal availability in terms of the replica jerseys and there are more items for women than for men. But the replica shirts that are currently available for the men’s team are only offered in men’s sizes.
Subtle differences in how women’s sport is treated, such as those we have found here, show that women are still disadvantaged. It is important that fans continue to push for equal opportunities on and off the pitch.
The number of people using food banks in the UK has increased from 26,000 in 2008-09 to more than 100 times that in 2023. Nearly one in five British households experienced moderate to severe food insecurity in September 2022.
In the financial year to April 2023, Trussell Trust, the largest (but not the only) network of food banks in the UK, distributed emergency food parcels to nearly three million people.
Food banks provide free, pre-prepared parcels of food to those most in need. They have provided a great deal of support for low-income families, especially during the cost of living crisis.
However, they are not perfect. Food banks offer people little choice, are dependent on unreliable supply chains. Research has also shown that people who use food banks often experience shame and stigma when doing so.
My research, with colleague Heather Hartwell at Bournemouth University, has found a viable alternative. Community markets selling food and household items at subsidised rates to all could be a sustainable solution to the problems with existing food support programmes.
Food banks rely heavily on donations. But rising food prices means even would-be donors are struggling to buy that extra can of beans and other items. Beneficiaries of food banks also told us that parcels were mostly made up of dried, tinned and processed foods.
While it is important that parcels have a long shelf life, people experiencing food poverty want a choice of fresh and frozen food items, including meat. The constraints in the range and quality of food available are also associated with health problems such as diabetes, asthma and obesity.
Food banks also do not empower people who use them to become self-sufficient. Rather, they often result in long-term reliance on food aid. Hence, food banks offer temporary relief from hunger without addressing the bigger issues that lead to food insecurity.
Community markets operate differently to food banks. They are open to everyone in the local community, regardless of income level, and provide a range of food choices along with other items such as school uniforms and toiletries.
We interviewed 38 people who regularly used or were involved in the operation of these programmes in the UK. Through these discussions, we assessed how well community markets address the challenges of food security, and found that they are a possible solution to the limitations of food banks and parcel distribution.
Community markets do not solely rely on donations from the public or businesses. They pay a subscription to charity networks such as FareShare, which provide the market with items in bulk, which are sold to the community at a subsidised rate. All revenue from sales is reinvested to pay for future bulk purchases.
People with low incomes who shop at community markets told us they enjoyed having food at affordable food prices and felt a stronger sense of autonomy, and being part of the community. They did not feel their reliance on food support was a barrier to being part of society. As one person said:
I very much prefer being able to choose my food instead of being given parcels. … It just feels dignified to be able to pay for goods, even if it is at subsidised rates, and then being able to choose what I want based on what I would like to eat.
Food for all
These markets can be used by people from across the community, including those on a higher income. People who were more well-off told us they wanted to shop at the markets because they felt they were giving back, spending their money to be reinvested in the programme:
I thought that people who would come to the market … would be very needy, not only financially but mentally as well but it isn’t like that … I like shopping here because the money I pay is invested back into the community.
Additionally, community markets serve as a hub, offering organised group activities and services for people, such as cooking and gardening classes, yoga and sewing. Through these activities, the community markets are tackling loneliness and other health issues – not just hunger.
Community markets are economically self-sufficient. They use revenue generated from selling products at subsidised rates to subscribe to charitable food surplus redistribution organisations. This financial independence sets them apart from food banks, which often rely on grants. They can also be environmentally sustainable, actively reducing food waste and their carbon footprint by redistributing surplus food to local emergency services and farms.
As more people rely on food aid, it’s important that local councils and national governments support alternatives to food banks. For the family struggling to fill the fridge or the student coping with higher rent, our findings show community markets could be of significant help, while allowing people to maintain their dignity and be part of their community.
ChatGPT, the artificial intelligence (AI) platform launched by research company Open AI, can write an essay in response to a short prompt. It can perform mathematical equations – and show its working.
ChatGPT is a generative AI system: an algorithm that can generate new content from existing bodies of documents, images or audio when prompted with a description or question. It’s unsurprising concerns have emerged that young people are using ChatGPT and similar technology as a shortcut when doing their homework.
But banning students from using ChatGPT, or expecting teachers to scour homework for its use, would be shortsighted. Education has adapted to – and embraced – online technology for decades. The approach to generative AI should be no different.
The UK government has launched a consultation on the use of generative AI in education, following the publication of initial guidance on how schools might make best use of this technology.
In general, the advice is progressive and acknowledged the potential benefits of using these tools. It suggests that AI tools may have value in reducing teacher workload when producing teaching resources, marking, and in administrative tasks. But the guidance also states:
Schools and colleges may wish to review homework policies, to consider the approach to homework and other forms of unsupervised study as necessary to account for the availability of generative AI.
While little practical advice is offered on how to do this, the suggestion is that schools and colleges should consider the potential for cheating when students are using these tools.
But this research wasn’t investigating students’ use of Chat GPT or any kind of generative AI. It was conducted over 20 years ago, part of a body of literature that emerged at the turn of the century around the potential harm newly emerging internet search engines could do to student writing, homework and assessment.
We can look at past research to track the entry of new technologies into the classroom – and to infer the varying concerns about their use. In the 1990s, research explored the impact word processors might have on child literacy. It found that students writing on computers were more collaborative and focused on the task. In the 1970s, there were questions on the effect electronic calculators might have on children’s maths abilities.
In 2023, it would seem ludicrous to state that a child could not use a calculator, word processor or search engine in a homework task or piece of coursework. But the suspicion of new technology remains. It clouds the reality that emerging digital tools can be effective in supporting learning and developing crucial critical thinking and life skills.
Get on board
Punitive approaches and threats of detection make the use of such tools covert. A far more progressive position would be for teachers to embrace these technologies, learn how they work, and make this part of teaching on digital literacy, misinformation and critical thinking. This, in my experience, is what young people want from education on digital technology.
Children should learn the difference between acknowledging the use of these tools and claiming the work as their own. They should also learn whether – or not – to trust the information provided to them on the internet.
The educational charity SWGfL, of which I am a trustee, has recently launched an AI hub which provides further guidance on how to use these new tools in school settings. The charity also runs Project Evolve, a toolkit containing a large number of teaching resources around managing online information, which will help in these classroom discussions.
I expect to see generative AI tools being merged, eventually, into mainstream learning. Saying “do not use search engines” for an assignment is now ridiculous. The same might be said in the future about prohibitions on using generative AI.
Perhaps the homework that teachers set will be different. But as with search engines, word processors and calculators, schools are not going to be able to ignore their rapid advance. It is far better to embrace and adapt to change, rather than resisting (and failing to stop) it.
When Indonesian designer Vivi Zubedi made her debut on the international stage during the New York Fashion Week in 2018, critics gushed at the elevated abayas her models sported. Her high fashion takes on the traditional Muslim full-length garment married velvet and pearls with leather jackets, baseball caps and batik prints.
Modest fashion encompasses clothing that covers the body in a conservative manner, often in adherence to religious and cultural beliefs and identities. Though most often referred to in a Muslim context, it is not actually limited to one particular region or religion. Instead it is a concept that has been embraced by people of all kinds of backgrounds across the world.
The research my colleagues and I have conducted looks at female Muslim identities and how they are considered – or not – within the UK fashion industry. Despite the fact that the worldwide Muslim fashion market is projected to be worth $311 billion (£251 billion) by 2024, we have found that many women in the UK still have very little choice within their price bracket.
Not enough choice
Between 2017 and 2021, we conducted interviews with 23 Muslim women in the UK, from seven different ethnicities or cultural heritages: Bangladeshi, British, Indian, Iranian, Nigerian, Turkish and Tunisian. We wanted to understand how, as Muslims living in a non-Muslim majority country, their religious identity influenced their fashion consumption.
To our minds, the UK represented an ideal setting for this kind of study, because it has a strong retail sector and liberal values which encourage individual choice. It is also widely considered to be diverse and multicultural.
And yet, the women we spoke to still struggle to find clothing options they can afford, that they feel are appropriate and support them in adhering to their beliefs. As one interviewee, Izma, put it:
I want to wear something within my modest limits but it is so hard to find such clothes. I wish they start making fashionable clothes which are fully covered. Sometimes I see these modest lines, but these are out of my reach.
For these women, being fashionable is important and so is their Muslim identity. But they are still stuck with having to choose between the two.
You see, I don’t want to wear anything revealing because I am Muslim, but also because I come from a conservative family and certain background and ‘modern’ clothes don’t go well with my family image.
Many non-Muslim women embrace some degree of modesty in their clothing, in a bid to express personal style while maintaining a more conservative appearance. As the writer Sarah Al-Zaher has said:
Modest fashion is for people who just choose to show less. It is also for people who just prefer the ‘relaxed’ or the ‘oversized look’.
In the Muslim world, modest fashion plays a central role in projecting your religious identity. Al-Zaher puts it plainly:
It is not just a short-lived fad; it is a need because it is something that is embedded in our mindset and beliefs that will remain with us for life.
Back in 2018, when London followed New York in showcasing modest runway options, pundits assumed the buzz would push modest fashion into the mainstream and boost the market beyond high-end fashion. However, it still only receives temporary attention from designers and retailers alike.
By 2030, the Muslim population will represent over 25% of the global population. It is growing at twice the rate of the non-Muslim population.
This means that fashion brands have a great opportunity to bridge the gap between fashion and modesty, and properly cater to what is clearly a growing market demographic. However, the gap persists. In 2021, journalist Yasmin Khatun Dewan highlighted the example of Halima Aden, the “trailblazing hijab-wearing Muslim model” who had been hailed in 2017 as an “an icon of inclusivity” only to quit the fashion industry altogether four years later because, as she put it, she had compromised who she was in order to fit in.
Muslim women – and those for whom modesty is a guiding principle in how they choose to dress themselves – shouldn’t have to compromise. They deserve as broad a range of fashion choices as any other. As Ana, another woman I interviewed in 2021, said:
Just because you are Muslim doesn’t mean you can’t have fun wearing what you want to wear. You can still wear really pretty dresses if it’s long, or long tunics or whatever, it can still be fun. It doesn’t have to be just black and drape.
What to make of Adam Smith? You might have thought we would have straightened this out, given that he only ever wrote two books and it’s been 300 years since he was born. But no. Everyone wants to claim the Scottish philosopher and economist as one of their own. With the exception of Jesus, it’s hard to think of anyone who attracts such radically different interpretations.
Part of the problem is that we actually know very little about the man. Smith oversaw the burning of all his unpublished writings as he lay on his death bed – a common practice at the time, but not much help in settling endless arguments.
What we know is that he was born in the town of Kirkcaldy on the east coast of Scotland. His father was a judge who died just before he was born. Smith seems to have been a very scholarly child, rarely seen without a book about his person.
One early experience that seems to have affected him concerned the town market. Certain landowners were exempt from Kirkcaldy’s bridge tolls and market stall charges due to the town’s status as a royal burgh. This gave them a competitive advantage over their competitors, which did not sit well with the young Smith.
He left his mother at the age of 14 to study moral philosophy at the University of Glasgow, before completing his postgraduate studies in metaphysics at Balliol College Oxford. Thereafter he went on to spend his life studying, teaching and writing in the fields of philosophy, theology, astronomy, ethics, jurisprudence and political economy. Most of his career was spent as an academic in Edinburgh and Glasgow, though there were also stints as a private tutor in France and London.
The Wealth of Nations
The two books that Smith published in his lifetime are The Theory of Moral Sentiments (1759) and his more widely known, An Enquiry into the Nature and Causes of the Wealth of Nations (1776). The latter, a rambling 700-page text published over two volumes, was 17 years in the making.
The dominant economic ideology of the time was known as mercantilism. It viewed economic value simply in terms of the amount of gold that a country had to buy the goods it needs. It gave little consideration to how goods were produced – either the physical inputs or the human motivation.
But for Smith, motivation was at the heart of economic behaviour. He saw it as an all-purpose lubricant that delivers mutual benefit for all:
It is not from the benevolence of the butcher, the brewer or the baker, that we expect our dinner, but from their regard to their own interest.
Smith’s observations about how the division of labour can be organised to increase productivity remains one of his most enduring contributions to economics. Improving productivity is still seen as the holy grail for countries getting richer. Larry Fink, head of investment giant BlackRock, has only just been arguing that artificial intelligence could improve productivity, for instance.
The Wealth of Nations is an eclectic text – even an “impenetrable” one, according to the director of the Adam Smith Institute. Smith argues that slavery and feudalism are bad and that economic growth and getting people out of poverty are good.
He thinks high wages and low profits are good. He also warns against things like cronyism, corporate corruption of politics, imperialism, inequality and the exploitation of workers. In observations about the British East India Company, which was the Amazon of its day and then some, Smith even warned about companies becoming too big to fail.
Those on the right of the debate often cite Smith’s “invisible hand” phrase from the Wealth of Nations in support of their worldview. Borrowed from Shakespeare’s Macbeth, the phrase actually appears only once in the whole text. It is a metaphor for how a “free” market magically brings buyers and sellers together without any need for government involvement.
In more recent times, “invisible hand” has come to mean something slightly different. Chicago School free market advocates like Milton Friedman and George Stigler viewed it as a metaphor for prices, which they saw as signalling what producers wanted to produce and buyers wanted to buy. Any interference from government in terms of price controls or regulations would distort this mechanism and should therefore be avoided.
Ronald Reagan and Margaret Thatcher were disciples of this way of thinking. In a 1988 speech encouraging his people to be thankful for the prosperity that comes from free trade, President Reagan argued that the Wealth of Nations “exposed for all time the folly of protectionism”.
Yet those on the left also find plenty in Smith that resonates with them. They often cite his concern for the poor in the Theory of Moral Sentiments:
This disposition to admire, and almost to worship, the rich and the powerful, and to despise, or, at least, to neglect persons of poor and mean condition, though necessary both to establish and to maintain the distinction of ranks and the order of society, is, at the same time, the great and most universal cause of the corruption of our moral sentiments.
In 2013, President Barack Obama cited Smith in a speech to support raising the US minimum wage:
They who feed, clothe and lodge the whole body of the people should have such a share of the produce of their own labor as to be themselves tolerably well fed, clothed and lodged.
States and abuses
So how to square this circle? The truth is that Smith’s writing has enough ideas and inconsistencies to allow for all sides to cherry pick references as required. But one argument I find compelling, which has been put forward by the economist Mariana Mazzucato, is that many of those who champion laissez-faire policies misinterpret Smith’s notion of a free market.
This is linked to the fact that Smith was writing at a time when the British East India Company was responsible for a staggering 50% of world trade. It operated under a royal charter conferring a monopoly of English trade in the whole of Asia and the Pacific. It even had its own private army.
Smith was presenting an alternative vision for the UK economy in which such state-licensed monopolies were replaced by firms competing against one another in a “free” market. Innovation and competition would provide employment, keep prices down and help reduce the appalling levels of urban poverty of the time. This was capitalism. And ultimately Smith was proved correct.
But Mazzucato argues that when Smith talked about the free market, he didn’t mean free from the state, so much as free from rent and free from extraction of value from the system. In today’s world, the equivalent example of such feudal extraction is arguably global tech firms like Amazon, Apple and Meta playing nations off against one another to minimise their regulations and tax liabilities.
This doesn’t sound like the sort of “free” market that Smith envisaged. He would probably be cheering on the EU’s anti-trust case against Google, for instance. Those who believe that Smith saw no role for the state in managing the economy ought to reflect on how spent his final years – working as a tax collector.
Many people think of postnatal depression as a condition that only affects women. But in reality, postnatal depression affects almost as many men as women – with some research estimating it occurs in up to 10% of fathers.
Yet despite how common postnatal depression may be in men, there still isn’t very much information out there about it. This can make it hard to know if you may have postnatal depression – and how to get help if you do.
Here’s what you need to know.
This article is part of Quarter Life, a series about issues affecting those of us in our twenties and thirties. From the challenges of beginning a career and taking care of our mental health, to the excitement of starting a family, adopting a pet or just making friends as an adult. The articles in this series explore the questions and bring answers as we navigate this turbulent period of life.
There are many reasons why postnatal depression happens. And, contrary to popular belief, it isn’t just due to hormones. Even in women, hormones only play a small role in postnatal depression.
Instead, postnatal depression is typically due to a combination of risk factors – such as a previous history of depression, sleep problems after the baby is born, lack of social support or financial challenges. Postnatal depression can also happen at any age.
The symptoms of postnatal depression are quite similar to symptoms of depression. As such, symptoms of postnatal depression may include low mood, lack of motivation, poor sleep, feeling guilty or worthless, poor concentration, changes in appetite or weight, fatigue and thoughts of death or suicide.
The main difference between depression and postnatal depression is that these feelings tend to happen in the postnatal period (typically the first year or so after the baby is born).
It can be normal to struggle with your mental health somewhat after your baby is born. After all, it can be an overwhelming and emotional time, with nearly every aspect of your life changing – from your daily routine, your relationship with your partner, to the amount of sleep you get every night.
But if you’ve been experiencing low mood and lack of motivation for more than a few weeks, and are finding these feelings are making it difficult to engage with your infant, you may want to consider speaking with your GP or a mental health professional. It’s also worth noting that postnatal depression can happen at any time in the first year or two after the baby is born – not just in the early months.
Postnatal depression is not likely to go away on its own. If you suspect you may be struggling with postnatal depression, it’s important to seek support – not only for your wellbeing, but because postnatal depression can also affect your bond with your baby.
While it can be difficult to know how to take the first step in getting support, a good starting point is simply acknowledging that this is a difficult thing to talk about. As simple as this sounds, it may just help you feel less awkward about sharing your experiences when you do speak to someone. It’s also worth remembering that when you do speak to someone, it’s important to say how you really feel – not what you feel you should say.
It’s also normal if you feel angry about feeling the way you do. Many young men who struggle with their mental health feel angry that they feel this way, or worry that they’ve let their loved ones down or that the system will not listen to them. To deal with that anger, be patient. Try to let the anger go – it may help you feel more at ease opening up about your other emotions.
You may also find it easier to talk about your experiences in certain settings. For example, while some people may find it easier to speak with their GP or in online chat groups, you may find it more comfortable to speak up in a less formal setting – such as while watching sports with friends. You can begin this conversation with something as simple as asking how others are doing, before sharing your own feelings and experiences. Or, if your friends are also parents themselves, you might ask if any of them experienced similar feelings during the postnatal period.
If you’re finding it hard to speak to loved ones, you could also consider using a mental health app. Some people find it easier to use an app to ask questions, find solutions and discuss how they’re feeling. Apps such as DadPad have a number of resources that can help you navigate fatherhood.
Postnatal depression in fathers is real and it does matter. Fortunately, compared to just a few years ago, there’s more awareness and help available than ever before.
More than a quarter of people in the UK gamble online at least once every four weeks. And 1%–2% of UK adults demonstrate moderate-to-high risk levels of gambling-related harms.
The substantive and striking changes that the rise of online gambling have introduced are acknowledged by the UK government’s recently published plans to change the law in this area.
Through smartphones or other internet-enabled devices, people can gamble online anywhere, at any time. Gambling online also often allows those experiencing gambling-related harm to more easily hide this from those around them.
The reach of online gambling by operators, and gambling overall, is further enhanced by online promotion using social media. In an analysis of Twitter posts by several UK gambling operators, we found that over 80% of tweets related to sports, but less than 11% of tweets related to responsible gambling.
Greater use of social media for responsible gambling messages would increase the impact of responsible gambling strategies. It would also enable more personalised targeting of this messaging to groups who may be at higher risk of harms, such as members of the LGBTQ+ community, who report a higher number of life stressors.
There is also the increasing phenomenon of merging online gambling and other activities, notably loot boxes – which contain random game items that may or may not be desirable or valuable – in video games. These might allow the player to buy better weapons or armour for use in their game, or customise a player’s avatar. Players can purchase loot boxes in games, with either in-game or real-world currency.
From social psychology research, we know that how we behave and the attitudes we hold are strongly influenced by what we perceive to be the norm. Also, there are overlaps in the harms experienced with loot boxes, both in our research and media reports of issues that would be typically seen in gambling difficulties, such as overspending. Based on this, it seems likely that engaging with loot boxes will prime children and young adults towards becoming involved in gambling.
The technologies that create the risks and challenges of online gambling can also be used to prevent and reduce harms. Various techniques – known in the industry as responsible gambling tools – are already available from operators to help players take control of their gambling. These include deposit limits and self-exclusion, where users can ask to be denied access.
However, uptake of these tools is low, and impact relies upon people recognising that they are at risk and being motivated to engage with these tools. So we welcome the suggestion in the government’s new white paper around making deposit limits mandatory, which is consistent with the views of people who have experienced problem gambling.
This ability to receive immediate feedback regarding a harm prevention strategy from the target population is relatively new in psychology, and potentially very powerful. So including people with real experience of gambling problems in the co-creation of responsible gambling messages will result in more effective strategies.
The proposals included in the white paper would utilise some of the opportunities afforded by online technologies. For example, the use of affordability checks facilitated through credit reference agencies would likely reduce some of the harms associated with online gambling.
Similarly, online data-sharing on high-risk customers is a positive step, as many individuals engaging in problematic gambling report chasing losses until their money runs out.
Safer by design
We also welcome the proposed limit on online slots, which brings it in line with the 2019 reduction in stake in fixed-odds betting terminals, and the proposal to make online games safer by design. Our research has shown that individuals who are new to gambling are less aware of persuasive design techniques and thus potentially at greater risk from them.
Similarly, addressing gaps in legislation to ensure under-18s cannot gamble online may help prevent young people from developing problematic gambling behaviour later on. However, this impact may be limited by the UK government’s response in 2022 that no further legislation is planned to regulate loot boxes. Currently, little is known about the impact of gambling-related harms on children aged under 18.
It also cannot be underestimated how skilled gambling-addicted people are at finding a way around any restrictions. The white paper recognises the risks on unregulated gambling in online black markets, and calls for preventative action. But how this will be achieved remains to be seen.
The white paper’s new statutory levy is also a positive step that contributes to funding and the transparency of funding sources for quality gambling research, education and treatment.
While most people gamble online safely and responsibly, those who develop problems can experience severe effects. These negative consequences are not limited to the individual but can also affect those around them, including family, friends and work colleagues.
As technology continues evolving, it is vital that we continue to be mindful of the unique risks and opportunities that arise in online gambling to prevent people from being harmed.
The metaverse sounds like it could be a scary place. Recent headlines have highlighted the dangers to children of the metaverse – a generic term for the range of online virtual worlds, developed by different tech companies, in which users can interact. Children’s charities have raised concerns about its potential for harm.
Recently, Meta – Facebook’s parent company – announced that teenagers would be able to use its VR Horizon Worlds app in North America. In this online environment, users are represented by avatars and spend time in virtual worlds, making use of virtual reality (VR) headsets. Some politicians in the US have already voiced their unease. It is certainly possible that Meta could extend this access to teens elsewhere in the world.
It would be no surprise if parents were concerned about this technology and how it might affect their children. In fact, children are already online in the metaverse – and there are steps parents can take to understand this technology, the risks it may pose, and what they can do.
Avatars and online games
Perhaps the most famous current interactive world aimed at children is Roblox, an online platform that allows users to create avatars, play games, make their own games, and interact with others. Young people play games developed by other users – the most popular is currently Adopt Me!, in which players adopt animals and live with them in a virtual world.
This mix of gameplay, interaction with others, and opportunity for creativity are all reasons Roblox is so popular. While it can be played using VR headsets, the vast majority of interaction takes place using more traditional devices such as phones, tablets and laptops.
Another emerging platform, Zepeto, has a similar model of allowing users to create environments, access “worlds” developed by others, and chat with others within these environments. Some young people will interact solely with their own group of friends in a specific world; other worlds will allow interaction with people they don’t know.
However, there is a rich history of platforms that could be considered, in modern terminology, to be “metaverses”. One is Minecraft, perhaps the most popular platform before Roblox. Launched in 2011, Minecraft is a block-building game which also allows for interaction with other users.
Before Minecraft, there were other platforms such as multiplayer online games Club Penguin (launched 2005) and Moshi Monsters (launched 2008) which, while smaller in scope, still allowed young people to engage with others on online platforms with avatars they created. These games also attracted moral panics at the time.
While new terms such as the metaverse and unfamiliar technology like VR headsets might make us fear these things are new, as with most things in the digital world, they are simply progressions of what has come before.
And on the whole, the risks remain similar. Headsets in VR-based worlds do present new challenges in terms of how immersive the experience is, and how we might monitor what a young person is doing. But otherwise, there is little new in the risks associated with these platforms, which are still based around interactions with others. Children may be exposed to upsetting or harmful language, or they may find themselves interacting with someone who is not who they claim to be.
In my work with colleagues on online harms, we often talk about mitigating risk through knowledge. It is important for parents to have conversations with their children, understand the platforms they are using, and research the tools these platforms provide to help reduce the potential risks.
Most provide parental controls and tools to block and report abusive users. Roblox offers a wide range of tools for parents, ranging from being able to restrict who their children play with to monitoring a child’s interactions in a game. Zepeto has similar services.
As a parent, understanding these tools, how to set them up and how to use them is one of the best ways of reducing the risk of upset or harm to your child in these environments.
However, perhaps the most important thing is for parents to make sure their children are comfortable telling them about issues they may have online. If your child is worried or upset by what has happened on one of these platforms, they need to know they can tell you about it without fear of being told off, and that you can help.
It is also best to have regular conversations rather than confrontations. Ask your child’s opinion or thoughts on news stories about the metaverse. If they know you are approachable and understanding about their online lives, they are more likely to talk about them.
“I don’t listen to adults when it comes to this sort of thing”, a 17-year-old told me.
We were discussing how digital technology affects his life, as part of a long-term project in the west of England that I carried out with colleagues to explore young people’s mental health – including the impact of digital technology on their emotional wellbeing.
There is a widespread perception that being online is bad for young people’s mental health. But when we began the project, we quickly realised that there was very little evidence to back this up. The few in-depth studies around social media use and children’s mental health state that impacts are small and it is difficult to draw clear conclusions.
We wanted to find out if and how young people’s wellbeing was actually being affected in order to produce resources to help them. We talked to around 1,000 young people as part of our project. What we found was that there was a disconnect between what young people were worried about when it came to their online lives, and the worries their parents and other adults had.
One of the things young people told us was that adults tended to talk down to them about online harms, and had a tendency to “freak out” about these issues. Young people told us that adults’ views about online harms rarely reflected their own. They felt frustrated that they were being told what was harmful, rather than being asked what their experiences were.
The concerns the young people told us they had included bullying and other forms of online conflict. They were afraid of missing out on both online group interactions and real-life experiences others were showing in their social media posts. They worried that their posts were not getting as many likes as someone else’s.
But these concerns are rarely reflected in the media presentation of the harsher side of online harms. This has a tendency to explore the criminal side of online abuse, such as grooming, the prevalence of online pornography. It also tends to describe social media use in similar language to that used to talk about addiction.
It is no surprise, therefore, that parents might approach conversations with young people with excessive concern and an assumption their children are being approached by predators or are accessing harmful or illegal content.
We have run a survey with young people for several years on their online experiences. Our latest analysis was based on 8,223 responses. One of the questions we ask is: “Have you ever been upset by something that has happened online?”. While there are differences between age groups, we found the percentage of those young people who say “yes” is around 30%. Or, to put it another way, more than two-thirds of the young people surveyed had never had an upsetting experience online.
Meanwhile, the online experiences reported by the 30% who reported being upset often didn’t tally with the extreme cases reporting in the media. Our analysis of responses showed that this upset is far more likely to come from abusive comments by peers and news stories about current affairs.
This disconnect means that young people are reluctant to talk to adults about their concerns. They are afraid of being told off, that the adult will overreact, or that talking to an adult might make the issue worse. The adults they might turn to need to make it clear this won’t happen and that they can help.
How to help
There are three things that young people have consistently told us over the duration of the project, and in our previous work, that adults can do to help. They are: listen and understand – don’t judge.
Conversations are important, as is showing an interest in young people’s online lives. However, those conversations do not have to be confrontational. If a media story about young people and online harms causes parents concern or alarm, the conversation does not have to start with: “Do you do this?” This can result in a defensive response and the conversation being shut down. It would be far better to introduce the topic with: “Have you seen this story? What do you think of this?”
Working in partnership with others, such as schools, is also important. If a parent has concerns, having a conversation with tutors can be a useful way of supporting the young person. The tutor might also be aware that the young person is not acting like themselves, or might have noticed changes in group dynamics among their peer group.
But, even if they are not aware of anything, raising concerns with them – and discussing from where those concerns arise – will mean both parents and school are focused in the same direction. It is important that young people receive both consistent messages and support. And schools will also be able to link up with other support services if they are needed.
Ultimately, we want young people to feel confident that they can ask for help and receive it. This is particularly important, because if they do not feel they can ask for help, it is far less likely the issue they are facing will be resolved – and there is a chance things might become worse without support.
It’s sometimes difficult to imagine how the planet we call home, with its megalopolis cities and serene farmlands, was once dominated by dinosaurs as big as buses and five-storey buildings. But recent research has helped deepen our understanding of why dinosaurs prevailed: the answer may lie in their special bones, structured like Aero chocolate.
Brazilian palaeontologist Tito Aureliano found that hollow bones filled with little air sacs were so important to dinosaur survival, they evolved independently several times in different lineages.
According to the study, aerated bones evolved in three separate lineages: pterosaurs, technically flying reptiles, and two dinosaur lineages theropods (ranging from the crow-sized Microraptor to the huge Tyrannosaurus rex) and sauropodomorphs (long-necked herbivores including Brachiosaurus). The researchers focused on the late Triassic period, roughly 233 million years ago, in south Brazil.
Charles Darwin believed evolution created “endless forms most beautiful”. But some adaptations emerge spontaneously time and time again, a bit like getting the same hand of cards on multiple occasions. When the same hand keeps cropping up, it’s a sign that evolution has hit upon an important and effective solution.
The variant the Brazilian team studied was aerated vertebrae bones, which would have enhanced the dinosaurs’ strength and reduced their body weight.
Light but mighty
Your regular deliveries from Amazon or other online retailers come packed in corrugated cardboard, which has the same advantages as aerated bones. It is light, yet tough.
Corrugated cardboard or as it was first known, pleated paper, was a man-made design experiment that was hugely successful and is now part of our everyday lives. It was patented in England in 1856 and was initially designed to support top hats which were popular in Victorian England and the US at the time.
Three years later, Darwin published his On the Origin of Species which outlined how evolutionary traits that create advantages are more likely to be passed on to future generations than variants which don’t.
CT scan technology allowed Aureliano and his colleagues to peer inside the rock-hard fossils they studied. Without the modern technology, it would have been impossible to look inside the fossils and detect the air sacs in the spinal columns.
The study found no common ancestor had this trait. All three groups must have developed air sacs independently, and each time in slightly different ways.
The air sacs probably enhanced oxygen levels in the dinosaurs’ blood. The Triassic period had a scorching hot and dry climate. So more oxygen circulating in the blood would cool dinosaur bodies more efficiently. It would also allow them to mover faster.
The air sacs would have buttressed and reinforced the internal structure of the dinosaurs’ bones while creating a greater surface area of attachments for large, powerful muscles. This would have enabled the bones to grow to a far larger size without weighing the animal down.
In living birds aerated bones reduce overall mass and volume, while enhancing bone strength and stiffness – essential features for flight.
Palaeontology not only tells the story of what might have been for Earth, had it not been for that infamous asteroid, but also helps us learn about the evolution of still living creatures.
Echoes of this dinosaur legacy lie in many animals alive today. It is not only long-dead animals which found this type of adaptation useful. Many bird species living today rely on hollow bones to fly. Others animals use the air sacs to buttress and strengthen their large bones and skulls, without weighing them down.
An excellent example of this is the elephant skull. Inside elephant skulls are large air sacs which allow the animal to move its massive head and heavy tusks without straining the neck muscles.
The human brain is also protected by two layers of hard, compact, bone (inner and outer tables) which sandwich a layer of softer, spongey and aerated bone in between, known as the diploe. This allows our skulls to be light, but strong and able to absorb shocks to cranium.
These are examples of convergent evolution in which animals are faced repeatedly with the same problem, evolving similar – but not always identical – solutions each time. Animals today are playing by the same evolutionary playbook as the dinosaurs.
Rugby has a higher rate of injury than most other sports frequently played in schools in the UK. It is a collision sport where players purposefully tackle each other, which can result in serious injury, such as to the head and neck.
The risks of injury, and particularly brain injuries, from playing rugby are now widely recognised. And yet it remains a compulsory sport in many schools.
Tackle rugby should not be compulsory in any school, for any age of children. Where rugby is compulsory, it should be non-contact.
What’s more, schools should provide children and their parents with information on the dangers involved with playing sports like rugby at school.
Research with 825 teenage school rugby players over one season found that more than one in three of the children suffered an injury from playing full-contact rugby. Almost half of these injuries were serious enough that the child could not return to play rugby for 28 or more days.
These injury concerns are also recognised by teachers. Our research has found that 67% of teachers in charge of school PE believe rugby union is the sport that puts children at the greatest risk of harm.
Despite the high risks involved with playing rugby, our research also shows that it is one of the most common sports in schools. We surveyed 288 state-funded secondary schools in England and found that rugby union was played in 81% of these schools. It is more common for boys to play rugby, but over half of the schools offered rugby for girls.
What is more worrying is that rugby is compulsory in the majority of the secondary schools we surveyed. Where schools offered rugby for boys, in 91% of cases it was compulsory. And 54% of schools that taught rugby to girls made it compulsory.
The risks of playing
In elite sport, understanding of the risks of playing rugby is growing. Concussion is the most common injury suffered by elite-level rugby players according to the Rugby Football Union (RFU), the governing body of rugby in England. Professional rugby union players are more likely than not to have suffered a concussion after playing just 25 matches.
But research has found that lowering the tackle height might not reduce the number of concussions suffered by players.
Repetitive head impacts, such as those that happen in rugby, can also cause neurodegenerative diseases such as chronic traumatic encephalopathy and dementia.
Nearly 200 former players are suing the governing bodies of rugby. These players are suffering from neurological impairments and claim that World Rugby, the RFU and the Welsh Rugby Union did not protect players enough from permanent injuries.
Current England player Courtney Lawes has recently said that he would have reservations about his children playing professional rugby, because the financial benefits are not worth the injuries that come from playing the sport.
The risks remain at amateur levels. Amateur rugby players are also taking legal action against the same governing bodies who, they say, did not protect them from brain injuries during their playing careers.
Rugby, particularly at school level, does not need to include tackling. Safer versions of the sport, such as tag rugby, already exist.
Rugby can be played without tackling and still provide a wide range of physical and mental health benefits that help children stay physically active and maintain psychological wellbeing. School rugby must change to keep children safe.
It is notoriously difficult to work out how and why someone becomes a terrorism risk. While attacks cause immense pain and suffering, the actual number of terrorist incidents in the western world is small. That makes it difficult to arrive at reliable, quantified evidence.
But in our research, we’ve started to identify important patterns when it comes to different journeys into extremist offending. Most notably, we’ve found that in recent years, people who go on to be convicted of terrorist offences are far more likely to have been radicalised online – without any offline interactions at all – than was the case in the past.
While the seeming ease with which this can happen is worrying, we’ve also found that people recruited purely online are less likely to commit violent attacks and less committed to their extremist causes than those recruited via in-person meetings. While face-to-face radicalisation continues, the process is now found to take place primarily online.
Our work, which uses detailed risk assessment reports on people sentenced for terrorist offences in England and Wales, draws on 437 cases between October 2010 and December 2021. These reports, written by trained prison and probation professionals, focus on the pre-history of an offence and the current circumstances of the offender. As well as a detailed narrative, they also contain estimates of the levels of risk that the individual poses.
The shift online
We wanted to look into how people became radicalised in the outside world before they committed an extremist offence. We found that, over time, it is less and less the case that people are radicalised offline, such as at local meeting places or via direct contact with peers and relatives.
Mixed radicalisation, where extremist offenders are subject to both online and in-person influences, has also been declining. It is now much more common for people to be radicalised online. They might learn from online sources or engage with extreme views on social media. They might also use internet forums and chat groups that provide easy access to like-minded others.
While encrypted applications will always play their role, monitoring and regulating the more public online spaces is likely to make the most difference.
It was also interesting to note that those radicalised online consistently showed the lowest level of estimated risk. They were less engaged with extremist causes than those radicalised offline. They were also the most likely to have committed a non-violent offence, such as inciting and encouraging others to commit terrorism or possessing terrorist material, and to have committed their offences solely online.
They were also far less intent on committing further offences after leaving prison than those who were radicalised offline – and they appeared to have the lowest capacity to commit further crimes because of having less access to the knowledge, networks or materials they might need.
So it seems that while online radicalisation is the most pervasive form at the moment, it is not overly effective at permanently immersing people in an extremist mindset. Nor is the online approach particularly successful for conveying the skills and knowledge necessary to commit graver offences.
Disrupting online plots
In order to check for potentially more dangerous sub-groups, we also focused on those offenders classed as attackers. These were people who did not necessarily carry out full attacks but had, at the very least, cast themselves in such a role and had pursued attack plans.
The online group showed the lowest frequency of attack-related activities, and attackers in this group were least successful in progressing plots for attacks. Only 29% of these plots moved from planning to the execution stage and only 18% were successfully carried out.
All the plots we studied, which were not successful, had been disrupted by the police or other security services. The online world is, after all, not a perfect hiding place. Online activities often leave traces that can be detected by counter-terrorism practitioners.
While this could all mean that online radicalisation is comparatively harmless, there is a thin line between a relatively ineffective online-only radicalisation and a much more effective mixed radicalisation that includes both online and in-person influences. Online communication can slide into real-life interactions, and people radicalised via the latter technique were assessed as being highest in engagement and intent.
This article is part of the Insights Uncharted Brain series.
Jill* looked drained as we sat down to speak about her late husband. It had been a long day. It was February 2020, and we had been conducting interviews at the Concussion Legacy Foundation family huddle.
Despite being tired, Jill, 47, was keen to be interviewed. She wanted to share what she had gone through and hoped her story might help others. We sat down in a quiet corner of the foyer of the Rosen Centre hotel in Orlando, Florida, and I listened to her speak for over 90 minutes.
You can listen to more articles from The Conversation, narrated by Noa, here.
She told me all about her husband, Michael, a larger-than-life character who was the “life and soul of the party”. She spoke about how he had played many sports and had experienced multiple diagnosed concussions playing American Football and lacrosse – but this never dimmed his enthusiasm for sports.
Jill described how his behaviour gradually changed. How he forgot simple tasks. How he became aggressive. How his behaviour had become so erratic, she didn’t feel they were welcome at social events anymore. She said:
You’re just watching somebody you love disappear before your eyes and it’s hell.
Then one day she was on the phone to her husband while he was at work and the call went quiet. Jill rushed to his office, only to find that he had taken his own life.
Jill was one of the 23 interviews we conducted with family members over the three days our research team spent at the Concussion Legacy Foundation event. Our conversations provided an insight into what it was like living with a former athlete with chronic traumatic encephalopathy (CTE), a neurodegenerative disease similar to Alzheimer’s that has been caused by repetitive head impacts in contexts like sport and the military.
This story is part of Conversation Insights
The Insights team generates long-form journalism and is working with academics from different backgrounds who have been engaged in projects to tackle societal and scientific challenges.
The people we spoke to had been through so much. The confusion, hurt and despair of seeing the mind of someone they love gradually deteriorate seemed overwhelming. But we also saw some positive signs, such as how they wanted to share their stories to help others, and how there appeared to be a shared determination to change things for the better and to make sport safer so other families wouldn’t have to go through what they’d experienced.
Head injuries in sport
Chronic traumatic brain injury associated with boxing has been known about for around 100 years. In 1928, Harrison Martland first described chronic traumatic encephalopathy in retired boxers. It was first referred to as “punch-drunk syndrome” or “dementia pugilistica” and sometimes develops in boxers as a result of long-term sub-clinical concussions (not detectable by the usual clinical tests).
In 2002, neuropathologist Bennet Omalu examined the brain of Mike Webster, a former National Football League (NFL) player who died from a heart attack after his physical and mental health had rapidly deteriorated. Subsequently, former NFL players sued the league, claiming that they had received head trauma or injuries during their football careers, which caused them long-term neurological problems.
The VA-BU-CLF UNITE Brain Bank at Boston University is the largest tissue repository in the world focused on traumatic brain injury (TBI). In a 2017 study into the first 202 donated brains, high rates of CTE were found, with 177 diagnosed with CTE, including 110 of 111 from the NFL players (99%). The brain bank now has over 1,000 brains from donors as young as 14 who have been exposed to brain traumas, primarily from playing sport. Studying these brains is crucial, not only for preventing, diagnosing and treating CTE, but also understanding the long-term consequences of concussion and traumatic brain injury.
Subsequent research from Boston University’s CTE Center in 2019 found that every year of playing full tackle American football increases the risk of developing CTE by 30%. So for every 2.6 years of playing, the risk of developing CTE doubles.
But the problem is not isolated to American sports. Compared with most other sports, rugby union has a relatively high injury rate, including at school level in the UK where it is often a compulsory sport. In addition, it has been reported that there is about one brain injury per match in international rugby.
Demise of England’s ‘lions’
In football, concussion often results from accidental head impacts (like head-to-head collisions or collisions with the goalposts). But a growing number of studies have shown that detrimental sub-concussive impacts (a bump, blow or jolt to the head that does not cause symptoms) may result from repeatedly heading the ball. And there have been an increasing number of high-profile examples in recent years who have been raising awareness of this issue.
In late 2020, three incidents shifted attitudes on the dangers of football. First, Norbert “Nobby” Stiles, a member of England’s 1966 Fifa World Cup winning team, died. Stiles had been diagnosed with dementia and the cause of this disease was linked to repeated heading of the ball in his career.
Then, it was announced that Sir Bobby Charlton, another World Cup winning hero, had also been diagnosed with dementia. He was the second member of his family to suffer with this disease as his brother, Jack (who played in the same winning team) had died earlier in the year after his own battle with dementia.
Bobby Charlton was thus the fifth of the 11 starting players in the 1966 final to have been diagnosed with neurological diseases. Media reports have linked all of these cases to the repeated heading of footballs during their playing careers.
But the first case that drew attention to the link between football and traumatic brain injury was that of Jeff Astle. Following his death in 2002, the coroner’s verdict at the inquest into his death at the age of 59 recorded a verdict of “death by industrial disease”, linked to heading heavy, often rain-sodden, leather footballs. Astle’s health had deteriorated – he had struggled with an eating disorder and was unable to recognise his children.
Astle’s daughter, Dawn, has become a leading figure in the campaign to protect footballers. She presented evidence to the 2020 DCMS committee on concussion and brain injury in sport. Her submission to the committee included the following comment:
My dad choked to death in front of me, my mum and my sisters. Please think about that for one minute. He choked to death because his brain had been destroyed. Destroyed because he was a footballer. I don’t want any other family to go through what my family went through, and continue to go through every day. Please don’t let my dad’s death and all the other footballers deaths be in vain. My dad was my hero and my best friend. His death will haunt me forever.
Families speak out
In February 2020, our team of five researchers were invited by Chris Nowinski, the CEO of the Concussion Legacy Foundation, to Orlando. The CLF is an international non-profit organisation that aims to support athletes affected by head injury, and to assist patients and families by providing personalised help to those struggling with the outcomes of brain injury.
Our interviews were conducted at their “family huddle”, which was a support event for family members to allow them to share stories and connect with others who have had similar experiences.
We were given the opportunity to talk to family members, and build trust and rapport. This gave us a greater insight and understanding of their world. We conducted interviews with the partners, parents, siblings and the children of the deceased athletes.
Our research, published in The Qualitative Report, was presented as an ethnodrama (playscript) to best allow the stories of the family members to be heard. This also showed the distinct temporal phases that these family members went through, and by sharing these stories we hope this raises awareness of the powerful emotions they have experienced.
Many of the people we spoke to said the initial stage, when they started to see changes in the behaviour of their loved one, created very strong emotions because they couldn’t understand why this was happening. They had seen someone they loved decline in front of their eyes. Alice, 68, reflected on seeing this change in her husband: “He went from functioning perfectly, to struggling to remember or do anything he was so used to doing.”
People went on to recall specific instances when this behavioural decline became noticeable. For example, David told us this about his brother: “Once when he went to the airport to pick up my aunt. He proceeded to drive her around, and she finally said, ‘Where are we going?’” He replied that he didn’t know.
There was evidence of a mounting feeling of hopelessness that declines in neurological functioning were causing. Another striking, distressing example was this story Sophie told about her husband:
One weekend, I had 12 big black trash bags to go out to the garbage. And I told him when I got up and went to work on Monday morning, I said, ‘those are going out to the trash tomorrow’. I came home after work and he had unpacked every trash bag … I just sat there and cried … I’d worked a 12-hour day. I said, ‘why did you unpack all that trash?’ and he couldn’t tell me why. He just didn’t know.
Others reinforced other emotions at seeing this happening to their loved one. Emily explained how she felt: “I do think at the start you are in this sense of disbelief because the person you love is doing these things that are out of character.” And Evelyn reflected on the sadness of seeing such changes:
I was shocked, but also felt like the world had been turned upside down. We were so happy. I remember just sobbing.
Researchers have previously highlighted the emotional consequences that family members experience when they witness the decline of their loved one. For example, one 2019 study involving interviews with 20 wives of either current or retired professional American football players, revealed their serious concerns about the cognitive, emotional and behavioural decline of these players. Some wives identified behavioural changes that included rage, reduced positive social interactions and various erratic behaviour, like starting risky business ventures.
As we also found, deterioration in cognitive functioning meant that those affected by traumatic brain injury were no longer able to carry out simple household tasks and often struggled with language problems.
Anger, guilt and fear
Another study, which examined families who have experienced a severe traumatic brain injury outside of sport highlighted the difficulties caused by the uncertainty of the situation – both in terms of the progression of the illness and how to support and deal with the cognitive, physical and behavioural changes exhibited after the injury.
All of this presents huge challenges to families. Negotiating appropriate treatment is hard and the emotional and physical exhaustion of dealing with these difficulties just keeps mounting up for the people involved.
Our participants explained the toll it took on them as they saw first-hand the severe changes in behaviour as their loved one experienced further decline. For example, Katherine said she felt drained and responsible. “It’s hard because you don’t know what’s happening,” she said. “So you just blame yourself and think you are the reason. And that’s not good for your own wellbeing.”
Helen spoke about her intense feelings as her partner drank as a response to his condition:
I was so angry at him for making the same choices over and over with drinking though. Like, “you’ve drank so much that you fell down the stairs in front of me at home, are you kidding me?” And it hurt, you know, and left a lot on my plate, so I was really, really, angry. And that didn’t help things.
Changes in behaviour created further problems for family members, such as how their loved one was perceived in social situations. Elizabeth described one specific incident at a party:
We went to a catered event, and he would take the top of the [burger] bun off, take the meat out to eat, put the bun back, and then go to the next one. And someone caught him and was like, “what is he doing?” Of course, we never got invited back to any of those people’s homes. No one wanted to have anything to do with him because they couldn’t understand him.
Laura also spoke about the implications of a lack of understanding of this condition, highlighting how others would misinterpret her husband’s actions. This led to feelings of sadness as they became socially isolated from their friends. She said: “When we went to events, a lot of people thought he was an alcoholic, because he could have one cocktail and then he’d fall. They had no idea that the falling had nothing to do with that one drink that he had. And it became very sad because people didn’t want to have us around.”
Our participants also spoke of the burden as a result of effectively becoming their partner’s primary caregiver. Sophie spoke about the struggles she faced with supporting her husband with daily tasks. “I couldn’t physically handle him,” she said. “At that point he was unstable. He would shuffle, and fall, and he couldn’t get in and out of the shower. He was also incontinent, and I couldn’t handle him by myself. I felt so weak.”
Evelyn also spoke of these experiences, highlighting that the physical size of her partner caused significant strain. “The sheer problem with these guys was their physical size. As the disease progressed, he fell probably 10-15 times a day, and we’d have to figure out how to get him up. I was both physically and mentally exhausted,” Evelyn said.
Meanwhile, others spoke of the physical fear of danger they felt. Like Emily who told us:
I did become scared of him. I hate to say that, but I did. He made me sign some papers and I had no idea what they were. He was just escalating and escalating, and he was standing over me and I just knew if I didn’t sign that paper, I was in physical danger. Which was an awful thought to have about your own husband that you love.
Our interviews gave family members the chance to reflect on their time living with and caring for their loved one, and also, how they might approach the situation differently. Helen told us she wished she had taken more time for herself, and advised anybody going through a similar situation to “get into therapy, to help you process everything and to let you have an outlet”.
Katherine agreed, saying: “You’ve got to try and take some time for yourself. I remember I took a trip with a girlfriend once and I was scared to death the whole time I was gone, but I went, and we had a wonderful time, and I’m so glad I did it. You know, trying to keep some semblance of normalcy in your life for yourself, for your own good. Try to keep yourself healthy, eat healthily, work out. Keep yourself well because there really was nothing, I could do for him except be present. I couldn’t make him well.”
Other family members reflected on the dangers of certain sports. For example, Alice highlighted how her awareness had increased, giving her the knowledge and understanding to allow her to come to terms with her husband’s situation. She realised there were “significant pathologies” that he had no control over that affected his decision-making.
His brain was still functioning, and he was still able to make decisions, just the wrong parts of the brain were directing his decisions. That totally makes sense now, so that’s been a huge relief, that he wasn’t just an asshole in his own right, he really just couldn’t control it.
While our data contained accounts full of sadness, participants also reflected on different ways they were moving forwards in a positive way after experiencing the death of a loved one. Laura detailed the benefits of attending the huddle and being with people who had been through similar struggles: “Everyone here is in the same boat. It may not have looked exactly the same for us, but we don’t have to explain for once. And just the support I’ve got from the people here has been great.”
Others talked about how the support helped the grieving process and inspired them to get involved and help other families. For example, Evelyn spoke of the need to make changes at a junior sport level: “I’m just so concerned this horrible disease is hitting younger and younger people, yet no one knows about it … giving people the information to be able to make the correct decision is super important.”
The final word goes to Elizabeth, who had become involved in the support work of the CLF, and spoke of her new found purpose to help others. She said it helped make her loss “bearable” because “millions” might benefit and “hopefully not have to experience the kind of tragedy that affected our family”.
I feel like part of the reason this happened is for me to be part of raising more awareness and be a part of this movement towards new culture change. I can help families navigate … the difficult waters of dealing with this. And so, I feel like it speaks to sort of a calling … I have in life or part of my purpose.
What is clear to us after concluding this research project is that greater recognition of the challenges faced by both those living with diseases of the brain, such as CTE, and their carers is needed.
We heard about the devastating losses and tragedies. But we were also privileged to highlight more positive stories that showed how people were able to move forwards and help others to create a constructive change in sport so others won’t have to suffer.
It also illustrates how neurodegenerative disease resulting from head trauma as a consequence of impact sports has far reaching effects – not only the athletes, but also those around them. This represents a growing public health concern and societal problem.
It shows that greater recognition of the challenges faced by both those living with diseases of the brain, such as CTE, and their carers, is needed.
We hope their stories will stimulate discussion and be used to support people who might be going through similar experiences. Our findings might be used to help practitioners, sporting governing bodies and charities such as the CLF, to understand more fully these negative emotional responses and, in turn, consider strategies that might be developed to support people. In turn, these organisations must also act to address the causes of head injuries to make sports safer.
All names in this article have been changed to protect the anonymity of those involved.
Find out how engaging with the media can help lead to research impact and learn more about working with The Conversation in upcoming online training sessions:
Engaging with the media for impact – Wednesday 23rd November, 2pm – 3.30pm (online)
Explore how working with the media can raise the profile of your research and lead to impact. Take away practical tips on talking to journalists, tracking the impact of media coverage and finding the best ways to reach your target audiences.
Writing for The Conversation – Wednesday 7th December 2022, 2pm – 3pm (online)
BU is a partner of The Conversation, a news analysis and opinion website with content written by academics working with professional journalists. Find out more about writing for The Conversation and have the chance to pitch your article ideas to one of their editors.
Learn how to consider the news potential of your expertise, how to look for story hooks and angles from the news or your research, and how to write a quality pitch.