Q&A with Elizabeth Howell

TEDMED: In your TEDMED 2018 talk, you mentioned that one way for hospitals to improve the quality of care around childbirth is to implement a bundle program as advised by the Alliance for Innovation on Mental Health. What infrastructural resources are needed to adopt such a program, and who at the hospital should be driving this change? 

Elizabeth Howell: Some of the Alliance for Innovation on Maternal Health patient safety bundles are easier to implement than others and some require little infrastructure or resources. All require sponsorship from individuals within the hospital or healthcare settings. Leadership can come from nursing, physicians, midwives, or hospital administration.

TM: While social determinants of health contribute to racial and ethnic disparities, there remains a component of racial bias in health care. What are some steps that we can take to dismantle providers’ racial bias? Does this happen during medical education or elsewhere?

EH: Addressing providers’ racial bias is important and some medical schools have begun implicit bias trainings for faculty and staff. However, a complex web of factors contributes to disparities. I suggest we tackle disparities brick by brick:

1.  Measure racial disparities in pregnancy outcomes and address them through quality improvement activities in hospitals.

2. Hold hospitals and healthcare organizations accountable for their performance on outcomes.

3. Teach medical students and trainees patient-centered communication strategies, shared decision-making skills, and actions to address implicit bias.

4. Address who institutions are admitting into medical schools and residency programs in an effort to diversify the workforce.

5. Ask how healthcare systems compensate and reward physicians within the system. Make compensation linked to performance on reducing and addressing disparities.

6. Challenge institutions to continually ask themselves whether they are doing everything they can to reduce disparities.

TM: How aware are pregnant women and new mothers of the risks and signs of maternal mortality or morbidity? What is the best way to educate these women on the risks that they face, so that they can take informed steps to protect their health?

EH: Women with obesity, hypertension, diabetes, and other chronic illnesses are at higher risk for complications during pregnancy.  It is important for all reproductive age women, especially for women with chronic illness and these risk factors, to seek healthcare before they become pregnant and receive education about the best steps to protect their health.

TM: If every hospital across the country adopted the highest quality of standard care around childbirth and maternal health, do you think we would still see racial disparities in maternal morbidity and mortality, or do you think that disparities would remain due to other uncontrolled factors?

EH: I believe a meaningful portion of the disparity gap can be closed by improving quality of care across the care continuum and improving standards across all hospitals.  While addressing the larger societal issues that drive racism is important work for scholars from every field, it is not an excuse for delayed action on these tangible steps.

TM: What was the TEDMED experience like for you?

EH: The experience crystallized for me the importance of storytelling in communicating important truths. As a scientist we frequently communicate through tables, data, and graphs but the emotional connection to the problem is often what motivates action.

TM: At TEDMED, we like to think about each talk as having a “gift” –  that thing that reveals new perspectives and profoundly influences our own, or our collective, health. What is the gift you’d like people to receive when watching your TEDMED Talk?

EH: We can save the lives of thousands of women who die or experience severe complications from childbirth every year if we raise standards in EVERY hospital and provide high quality healthcare for ALL women before, during, and after pregnancy.

TM: What was the highlight of your TEDMED experience?

EH: A highlight for me was being introduced by Michael Painter from the Robert Wood Johnson Foundation as a “nice radical… For Liz, there is no division between her passion and her compassion.”

How I Harnessed My Own Cancer Diagnosis to Help Kids with Cancer and Their Parents


By Hernâni Oliveira

This TEDMED Partner Blog Post comes to you from TEDMED 2020 Partner Astellas and Hernâni Oliveira. TEDMED is excited to partner with Astellas specifically around their Astellas Oncology C³ (Changing Cancer Care) Prize, which sparks new, innovative ways of caring for cancer patients and their caregivers. Hernâni Oliveira is the 2017 Grand Prize winner of the C³ Prize. His winning idea was a two-part virtual reality app to help solve common issues faced by children with cancer and their parents around education and physical engagement. Learn more about his award-winning idea here.

We know that the TEDMED Community is filled with patients, caregivers, and healthcare professionals, each with ideas that have the power to improve the lives of those impacted by cancer. We encourage you to submit your idea and apply to the C³ Prize by July 15. The winners will join us at TEDMED 2020, March 2-4 in Boston, MA.


My cancer journey started when I was diagnosed with lymphoma at the age of 27. Like most people, I was shocked to hear the infamous three words—“You have cancer”— but having studied cancer as a molecular oncologist, it struck me as ironic and terrifying that now, I would experience this disease as a patient, too.

I’ve never been the type to sulk about unfortunate events. I’ve always enjoyed taking on challenges, learning about subjects unfamiliar to me, and helping others understand it as well through effective communication. So, when I saw people who struggled to find accurate information about cancer, I decided to pursue a Ph.D. in health education to help people gain access to and understand healthcare information. It was during my second year of studies that I was diagnosed with cancer.

I was fierce, like all who are battling cancer and those who are caring for their loved ones with cancer. Every day brought a different challenge, but I focused all of my time and energy in between the treatments on developing an idea that I had been working on during my studies that I hadn’t yet had time to bring to life: an app to help children with cancer and their parents.

My idea was a two-part virtual reality app to help solve common issues faced by children with cancer and their parents around education and physical engagement. For the children, I wanted to create a video game for mobile devices that tells the story of a child who fights cancer as a superhero and educates the children about cancer, as well as promoting exercise and reducing anxiety during medical examinations. For the parents and caregivers, I wanted to create an educational tool so they could learn more about cancer and ways to support their children.

While working on my idea in 2017, I learned about the Astellas Oncology  Prize—an opportunity that came to change my life. The annual challenge was created in 2016 by Astellas to find and fund the best non-treatment ideas to improve cancer care for patients, caregivers, and their loved ones. I was so glad to find the  Prize because I felt like it empowered the public by widening the access to knowledge and tools to help those affected by cancer. It also helped solidify my belief that as a society, we need to look beyond treatments to truly care for people impacted by cancer.

I wholeheartedly believed—and still do—in my project, fittingly titled “HOPE,” and the impact it could have on so many lives touched by cancer. Still, I was surprised to find out I was the Grand Prize winner of the 2017  Prize. It was humbling and awe-inspiring all in one. What means the most to me is that winning the  Prize has fueled my idea and allowed me to have a real impact on people living with cancer.

Since winning the  Prize, I’ve developed a second prototype for the video game for children with cancer and validated the application for parents and caregivers in hospitals. Thanks to the  Prize and the countless hours of hard work, the final product will be available to the Portuguese public by the end of 2019. I’m also hoping to launch the application internationally and increase its impact on a global scale.

Beyond the funds I was awarded from the  Prize, I have had the opportunity to connect with a new network of people passionate about improving healthcare and am now in the process of working to bring educational programs into schools worldwide. With the support of the local community in Porto, Portugal, I’m developing an educational project to help improve cancer survivors’ reintegration process at schools. Thus far, more than 1,300 children and teachers have been trained, and we have won the best presentation award at the 4th European Health Literacy Conference.

Additionally, I was able to help establish a partnership between Astellas Portugal and University of Porto through the  Prize, which led to the creation of a national think tank focused on health literacy and innovation. The organization successfully hosted an event in May with 60 healthcare and communications professionals, patients, and caregivers, who worked together to find innovative solutions to create and foster health literate ecosystems.

Now in its fourth year, the Astellas Oncology  Prize is a truly amazing platform for anyone to showcase their idea to change cancer care and build meaningful relationships with innovators from all over the U.S. and the world. This year, the  Prize is looking for emerging and established ideas in the following categories: Cancer Care Journey, Cancer Health Disparities, and Cancer Survivorship. It will award up to $200,000 in total grants and resources, including a chance to connect with other healthcare innovators at TEDMED 2020.

I am so grateful to have been involved with the program as a winner in 2017 and now, as a judge, for the second year in a row. The beauty of the  Prize is that anyone with an idea to improve cancer care can apply—the idea can be big or small, emerging or established. What’s important is the ideas’ feasibility, originality, creativity, potential impact, and the applicant’s vision for how to reach people who might benefit from their idea—because innovative and informative healthcare tools are just as impactful for the cancer journey.

So, I encourage anyone—whether you’re a cancer patient, survivor or caregiver; a researcher, inventor or entrepreneur; a teacher, communicator, or even a musician—with an idea that could have an impact on cancer care to submit their ideas today at www.C3Prize.com. Applications are open until July 15.

Hernâni Oliveira is the founder and CEO of healthcare marketing agency BRIGHT. Previously, Hernâni was a molecular oncologist and researcher.

Considering the Moral Motivations for Whistle-Blowing

Psychologist Adam Waytz is dedicated to uncovering how opposing sides of moral conflicts understand and misunderstand each other’s motives. Adam studies the causes and consequences of perceiving mental states in other entities and investigates processes related to social influence, social connection, meaning-making, morality, and ethics. His ongoing work explores questions with direct application to politics, society, and current events; for example, studying how people establish trust with autonomous vehicles. At Kellogg School of Management at Northwestern University where Adam is an associate professor, his classes focus on how to resolve difficult ethical dilemmas and how to lead through values and ethical appeals rather than through traditional means. Adam was a Speaker at TEDMED 2018, and you can watch his Talk here.


Last week I attended the fifth annual conference of the Behavioral Science and Policy Association, which showcased how behavioral science can help create better public policies. Topics included how to improve financial decision-making, how to get people to increase vaccination uptake, and how to reduce single-occupancy vehicle commuting (to reduce carbon dioxide emissions). As I listened to the talks, it struck me that current governmental and organizational policies surrounding whistle-blowing are sorely lacking in incorporating insights from behavioral science.

The theme of my 2018 TEDMED Talk is that whistle-blowers, people who expose unethical conduct to outsiders, tend to be motivated by moral incentives. Whistle-blowers report wrongdoing out of a sense of justice and altruism as our research has shown, yet the dominant whistle-blower protection program in the United States centers on more self-serving incentives. The Dodd-Frank Whistleblower Program offers monetary rewards to people who report financial misconduct to the Security and Exchange Commissions (SEC) provided that the reporting results in successful prosecution and $1 million or more in sanctions.

Although reporting has increased under the program, its effectiveness in curbing financial misconduct is unclear (only 62 awards have been granted, amidst thousands of complaints since 2012). Furthermore, some research suggests that offering financial incentives can backfire. One set of studies shows that when whistleblower rewards are present but a potential whistle-blower is ineligible for the reward (because the fraud uncovered fell under the $1 million threshold), people assume the whistle-blower would be less willing to come forward compared to when no incentive is present at all. Other work suggests that although financial incentives for reporting organizational misconduct externally (i.e., to the SEC) can increase external reporting, it can simultaneously discourage people’s willingness to report misconduct internally to their companies.

So how do we build policies to encourage whistle-blowing that incorporate people’s moral motivations? Perhaps organizations could start by destigmatizing whistle-blowers as traitors or tattle-tales, communicating the message that what it means to be a good organizational citizen is calling out the company when it gets things wrong. One radical approach at the governmental level could be changing the nature of the financial incentive to be prosocial rather than self-serving, stating that if a whistle-blower uncovers misconduct, monetary rewards will be paid to the victims of that misconduct rather than to the whistle-blower. Reforming our whistle-blower policies will require bold action, and we can start by incorporating the lessons of social science to these efforts.   

Q&A with Kate Bowler

After being diagnosed with Stage IV cancer at age 35, Duke tenured professor and author Kate Bowler launched a national conversation about why it feels so difficult to speak frankly about suffering. She delves into how we live and cope with pain and suffering in Everything Happens for a Reason (and other lies I’ve loved), a NYT bestselling memoir, and in her popular podcast, Everything Happens. She is also the author of Blessed: A History of the American Prosperity Gospel, which received widespread media and academic attention as the first history of a movement based on divine promises of health, wealth, and happiness. She has appeared on NPR and The TODAY Show, Amanpour & CO, as well as in The New York Times, The Washington Post, and TIME Magazine. Her work has also been praised by a wide variety of religious and political publications, from liberal print media to conservative talk radio. You can watch her 2018 TEDMED Talk here.


TEDMED: In your TEDMED talk, you describe how people often try to find a reason for why you were diagnosed with Stage 4 colon cancer, assuring you and your husband that, “everything happens for a reason.” Given your experience, what would you encourage people to say or do when someone in their life experiences a difficult diagnosis?

Kate Bowler: It’s so tough because there usually isn’t much to say that will help–but the desire to say something is so strong! We have an intense desire to love the suffering person but usually it devolves into burdensome attempts to relate (“When my aunt had cancer…”) Luckily, the easiest approach is also the best one: trust that your loving presence is enough. Be useful and available, but ask for little. John Green recently told me something that his mentor in hospital chaplaincy taught him: “Don’t just do something! Stand there.” It’s wonderfully counter-intuitive and absolutely true.

TM: In the past, you’ve talked about how removing the need for a reason that bad things happen, and accepting your cancer has, in small ways, made you able to see and enjoy things more fully, and perhaps in a way you hadn’t before. Do any of these experiences stand out that you can share?

KB: Oh, wow, I immediately think of parenting. I had been on the superhighway of achievement, or at least I liked to think so. And now I am fiercely determined to keep my focus on my deepest loves, especially my five-year old human. There is usually a moment every day that I would have missed in my own rush to conquer the day. Today it was my son climbing up on my lap in his jammies while I was taking a call, solemnly looking into my eyes and whispering: “Can we talk about lizards now?” He was right. The sun was bright and the breeze was dreamy and it was exactly the right time to talk about lizards.

TM: Through your TEDMED talk, and the online community you have cultivated, you spark conversations about both the beauty and the difficulty of life – as you say: “Life is so beautiful and life is so hard.” How has your work been impacted by this online community and the conversations they engage in about the chaos and the clarity that comes with being human? Are there any stories that have been shared with you that you have found particularly inspiring?

KB: The biggest change in my life, after cancer, has been this incredible community I’ve found through my podcast, Everything Happens. As it turns out, I am not alone in feeling constrained by this American myth of self-mastery and endless progress. We are longing for what my friend Margaret Feinberg called “the fellowship of the afflicted.” Now when I speak to someone, I assume this person is carrying something he or she did not choose. One of the recent episodes was with Jayson Greene, whose toddler was killed in a terrible accident. His rich account of grief as the language of love was so powerful to me. In reassembling our worlds after loss, it feels honest to say that our pain is also an expression of our biggest loves.

TM: You are a self described “incurable optimist”. To what do you attribute this? Have you always been an incurable optimist, or did that come later in life?

KB: I have such a love-hate relationship with positivity as a category because I am an expert in the history of positive thinking. I found that so much of what passes as happiness or positivity is weaponized against suffering people. “Oh, are you not happy? You must be failing to live your best life now!” But I have found that a deep, hard-won joy is necessary when facing down hard realities. I may have insurmountable obstacles, but I am focused on finding beauty and truth regardless. That’s why I call myself an “incurable optimist.” It is pure stubbornness.

TM: What was the TEDMED experience like for you?

KB: It was the best public experience of my life. The community there was so absurdly loving and focused on helping me share my experience honestly. The organizers even had a stage manager there to HUG ME before I went on stage. Ok, that lovely person hugged everyone, but I felt so fortunate to be loved as I attempted to do a hard, public thing.

TM: At TEDMED, we like to think about each talk as having a “gift” – that thing that reveals new perspectives and profoundly influences our own – or our collective – health. What is the gift you’d like people to receive when watching your TEDMED Talk?

KB: Life doesn’t have to be better to be beautiful. Oh, if you are hurting right now, I want you to know you are so loved. You are not a mistake.

TEDMED 2020 Theme Announced & Early Bird Registration Now Open

We’re thrilled to share the theme for TEDMED 2020: Make Way For Wonder.

With this announcement we also officially open registration for TEDMED 2020 at a special Early Bird rate!  Join our passionate and diverse community this March 2-4 at an exciting new home in Boston – and for a limited time, we’re offering a special early registration rate of $1,000 off the registration fee.

TEDMED 2020: Make Way For Wonder


“Mystery creates wonder and wonder is the basis of man’s desire to understand.” — Neil Armstrong


The earliest philosophers regarded “wonder” as the foundational emotion that compels humans to explore, to learn, and to seek answers to life’s fundamental questions. Wonder – about our lives, our bodies, and our world – fuels an intense passion for learning. Indeed, “philosophia,” translated literally, means “love of wisdom.” As Plato described it: “Wonder is the feeling of a philosopher, and philosophy begins in wonder.”

But, what is Wonder?

It’s the feeling we get when experiencing the beauty of new life as it’s born into the world. It’s the euphoria we feel from unlocking secrets in the intricacies of our genetic makeup, or the curiosity that provokes us to expand the capabilities of the human brain. It’s the insatiable inquisitiveness that drives a researcher toward an astonishing discovery that saves millions of lives around the world. It’s the awe felt when standing at a precipice looking down at the Grand Canyon. Or the humbling acknowledgement of our place in an incomprehensibly vast universe. Perhaps the most awe-inspiring thing of all is that this feeling of wonder is firmly grounded in solid realities.

Today, we live in a world of sudden and surprising accomplishments, an era of astonishing possibilities, and an age of ongoing achievements happening in every single field. Let’s embrace the wonder in each step that humanity takes forward.

Now is the time for us to make way for wonder. It’s time we intentionally cultivate our sense of awe and our desire for new knowledge. It’s time to celebrate all we’re discovering and all that is yet to be discovered. It’s time to revel in our innocence, our capacity for delight, joy, and amazement.

When we allow ourselves time to muse and to marvel, to be energized with wonder, great advancements will follow. When we emerge from our silos, we have the opportunity to broaden our laser-like focus. When we step back and take time to look deeper, we can see with a wider perspective.

The results can be transformative. New doors are opened. New horizons reveal themselves. New possibilities suddenly leap from wild speculation, to well-grounded theory, to working reality.

At TEDMED 2020, we will connect with an invisible force that has been propelling humanity forward for millennia. Join us as we experience the power and possibilities that come to us when we make way for wonder.

Announcing the TEDMED 2020 Editorial Advisory Board

Planning for TEDMED 2020 is well underway, and we’re excited to share even more details about the Boston gathering over the coming months. Next week begins an important step in the process: the 2020 TEDMED Editorial Advisory Board (EAB) will meet to collaborate on the design and curation of the Stage Program.

The EAB—a group of leading experts in fields spanning the spectrum of health and medicine—plays a key role in helping us to identify important and timely nominations for the TEDMED Stage. The participation of this generous group is another example of how Community is at the heart of everything we do—we truly could not do the work we do without the people who support and believe in our mission to create a healthier world.

This year’s EAB represents organizations that intersect all areas of health and medicine, including technology, philanthropy, academia, medical journalism, clinical care, and much more. We are proud of the EAB’s depth and diversity of knowledge, as these are the qualities that help ensure the TEDMED Stage Program takes on its credible, multi-disciplinary, and unique perspective.

We welcome these passionate individuals to this year’s EAB, and we hope you’ll take the time get to know them below. We are both delighted and honored to announce them here:

Click here to read more about this year’s EAB and the role these individuals play in helping to shape the TEDMED 2020 Stage Program. And be sure to add your nominations for topics

TEDMED 2020 | BOSTON | March 2-4


TEDMED is excited to announce that the next convening of our diverse, multi-disciplinary community will take place March 2-4, 2020 in Boston, Massachusetts at The Westin Boston Waterfront Hotel. That’s right, TEDMED 2020 will be at a brand new location and a brand new time of year!

We feel that Boston is the ideal home for TEDMED 2020. Boston is a city and community with deep roots in pioneering new ideas and pushing innovation forward—much like TEDMED. Boston boasts renowned industry-leading companies,  world-class academic institutions and scientific R&D, some of the nation’s top-ranked hospitals, the country’s highest number of arts and cultural organizations per capita, and an impressive entrepreneurial ecosystem that supports a cutting-edge health tech start-up culture.

As a city with innovation at its core, we were interested to learn that Boston also lays claim to many technological and social “firsts,” including the world’s first telephone, and the United States’ first public park, first public library, and first public secondary school. Also, America’s very first inoculations happened in Boston, way back in 1721. To this day, the city remains a hotbed for health and medical innovation.

We have hosted TEDMED in Palm Springs, CA for the last 4 years, but TEDMED has regularly migrated to fresh venues every few years for most of the past decade, enabling people from many regions to join the community and participate in person at our annual gathering.

“TEDMED has a proud history of adopting a diverse range of venues, literally from coast to coast,” says TEDMED COO and Executive Producer Shirley Bergin, adding, “We are excited for everything that Boston has to offer and can’t wait to host TEDMED 2020 in this amazing city.”

So, what can you expect to experience at TEDMED 2020?

First and foremost, we are always striving to bridge the gap between science and the public by finding and sharing stories that inform, inspire, engage, and provoke action across a broad, passionate community both inside and outside of health and medicine. At TEDMED 2020, you’ll be moved by Talks from individuals working to improve humanity’s health. As one TEDMED Delegate said:

“When you come out of a session of Talks, and you’ve changed as a person—in outlook, in perspective, in opinion—that’s the mark of a conference worth attending. And that happened several times at TEDMED.”
– Giles N.

At TEDMED 2020, you will also become a part of a truly unique community of public health leaders, clinicians, researchers, scientists, influencers, and innovators from across the landscape of health, medicine, and scientific innovation. Over the 2.5 days of TEDMED 2020, you’re bound to make unexpected connections that will last well beyond the event. Again, our Delegates explain it best:

“It was such a humbling experience to be able to connect with such inspiring and passionate people who I would never have had the opportunity to meet otherwise.”
– Kittaya T.

By attending TEDMED 2020, you can expect to engage in interactive conversations hosted by TEDMED’s Partners—a dynamic group of global industry leaders, health systems, associations, research and academic institutions, foundations, and more. Our Partners not only help to make TEDMED possible, but they also enhance the program with their cutting-edge innovations, advancements in health policy, and large-scale global public health initiatives. Whether it’s a curated conversation with Partners and TEDMED Speakers about an unexpected theme that connects their work or a lively workshopping session over breakfast, there are plenty of ways to connect with other leading thinkers and doers at TEDMED.

In addition to the inspiring Talks, engaging community, and mind-expanding conversations, TEDMED 2020 offers you the chance to fully immerse yourself in various health experiences. For instance, you can choose to start your day with a mindfulness class or a heart-pumping workout. And from morning until night, we’ll provide you with nutritious meals and snacks to fuel your body and mind. Attending TEDMED 2020 offers you the space to unplug from your day-to-day routine and the opportunity to absorb new ways of thinking about the challenges we face in health and medicine today.

We hope you’ll join us in Boston for TEDMED 2020. Registration for TEDMED Alumni is open now, and early-bird registration opens soon. Stay up to date on the latest information about TEDMED 2020 by signing up for our newsletter and following us on Twitter, Instagram, LinkedIn, and Facebook.


For all media inquiries, please contact Rose Mary Romano at rromano@TEDMED.com.  If you are interested in partnering with TEDMED for the 2020 convening, please contact Lucy Crawford at Lucy@TEDMED.com. And, for all other inquiries, please email contact@TEDMED.com.


TEDMED is the independent health and medicine edition of the world-famous TED conference, dedicated to “ideas worth spreading.” TEDMED Talks have been viewed online over 150 million times around the world. TEDMED is a non-profit that is wholly owned by The TEDMED Foundation, a 501(c)(3) Public Charity.

 

How perfectionism became a hidden epidemic among young people

This article, authored by Thomas Curran and Andrew P. Hill, was first published by The Conversation UK.


In our roles as academics, young people knock on our doors almost every day. They are typically ambitious, bright and hard-working. They have a broad network of friends, and most come from supportive families. Yet no matter how well-adjusted they can appear, we are finding that our students are increasingly likely to seek our support for mental health issues, as well as academic ones.

We are not alone in observing this trend. Student mental illness on UK campuses is at record highs. And right across the globe, young people are reporting to clinicians at unprecedented levels with depression, anxiety and suicidal thoughts.

One possible reason for this is that across the US, Canada and the UK, today’s young people are the first generation to grow up in a society based on the principles of neoliberalism championed by the leaders of the late 20th century – Ronald Reagan, Brian Mulroney and Margaret Thatcher respectively. Over the last 50 years, communal interest and civic responsibility have been progressively eroded, replaced by a focus on self-interest and competition in a supposedly free and open market place.

In this new market-based society, young people are evaluated in a host of new ways. Social media, school and university testing and job performance assessments mean young people can be sifted, sorted and ranked by peers, teachers and employers. If young people rank poorly, the logic of our market-based society dictates that they are less deserving – that their inferiority reflects some personal weakness or flaw.

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There is, then, enormous pressure on young people to demonstrate their value and outperform their peers. And there is evidence that they are struggling to cope. In particular, emerging epidemics of serious mental illnesses speak to the negative effects of this market-based society, and a culture which is fundamentally changing the way young people think about themselves and others.

The rise of perfectionism

Leading psychologists, Paul Hewitt and Gordon Flett have suggested that one of the ways in which younger people are acting differently to their older peers is by showing a greater tendency toward perfectionism.

Broadly speaking, perfectionism is an irrational desire for flawlessness, combined with harsh self-criticism. But on a deeper level, what sets a perfectionist apart from someone who is simply diligent or hard-working is a single-minded need to correct their own imperfections.

Perfectionists need to be told that they have achieved the best possible outcomes, whether that’s through scores and metrics, or other peoples’ approval. When this need is not met, they experience psychological turmoil, because they equate mistakes and failure to inner weakness and unworthiness.

We recently published a study in the Psychological Bulletin, which shows that levels of perfectionism have risen significantly among young people since 1989. We think that this may, at least in part, be a symptom of the way that young people are attempting to feel safe, connect with others and find self-worth within market-based, neoliberal societies.

Irrational ideals of the perfect self have become desirable – even necessary – in a world where performance, status and image define a person’s usefulness and value. You don’t need to look far to find examples; corporations and their marketers offer all manner of cosmetic and material solutions for the flawed consumer. Meanwhile, Facebook, Instagram and Snapchat provide platforms to exchange curations of the perfect version of oneself and lifestyle with others.

This is a culture which preys on insecurities and amplifies imperfection, impelling young people to focus on their personal deficiencies. As a result, some young people brood chronically about how they should behave, how they should look, or what they should own. Essentially, agitating to perfect themselves and their lives.

It’s no wonder that there’s substantial evidence indicating that perfectionism is associated with (among other things) depressionanorexia nervosasuicide ideation and early death.

We feel a deep sense of sympathy with our students’ struggles. For the first time on record, young people are expected to be materially less well-off in adulthood than their parents. And it’s not just their material well-being that’s at stake – their mental and physical well-being is threatened by this hidden epidemic of perfectionism.

It’s time for organisations such as schools and universities, as well as the politicians and civil servants who help to shape the way these organisations operate, to take steps to safeguard the welfare of young people. They must resist marketised forms of competition, at the expense of young people’s mental health. They should teach the importance of compassion over competition. If they do not, the rise of perfectionism – and its association with serious mental illness – is likely to continue unabated.


 

Social and personality psychologist Thomas Curran studies the personality characteristic of perfectionism, how it develops, and it’s impact on mental health. He is a member of the Centre for Motivation and Health Behavior Change in Bath, UK, the Motivation, Personality, and Well-being research group in York, UK, and is currently an assistant professor in the Department for Health at the University of Bath. His research rose to prominence following a 2017 publication of the first systems-level cohort study to show that perfectionism is on the rise in American, Canadian, and British college students. Since then, he has written and spoken extensively on how we have created societies perfectly calibrated to promote perfectionism, which is contributing to almost epidemic levels of serious mental illness among young people. He is the author of over 30 published papers and has received numerous awards for his scholarship and research. Thomas spoke on the TEDMED Stage in 2018, and you can watch his Talk here.

Noise is Affecting our Health in More Ways Than We Think

Mathias Basner, MD, PhD, MSc is an Associate Professor in the Department of Psychiatry at the University of Pennsylvania Perelman School of Medicine. His primary research interests concern the effects of sleep loss on neurobehavioral and cognitive functions, population studies on sleep time and waking activities, the effects of traffic noise on sleep and health, and Astronaut behavioral health on long-duration space missions. These research areas overlap widely. Mathias has published 80+ journal articles and reviewed articles for 80+ scientific journals. He is currently on the editorial board of the journals Sleep Health and Frontiers in Physiology. Mathias spoke on the TEDMED Stage in 2018 and you can watch his Talk here.


Noise is a strange animal because it affects our health in many different ways, and we don’t even realize it. Short-term loud noise exposure damages our inner ear and is the reason for noise-induced hearing loss. As mentioned in my TEDMED talk: Whenever you have that ringing in your ear after you leave a concert or a bar, you can be certain that you have done some damage to your hearing, likely permanent. The problem is that we are only paying the price when we are older, in the form of tinnitus and hearing loss. Unfortunately, we are very bad at changing our current behavior based on something that we may experience in the future. Regardless, protecting yourself and your children from high noise levels should be a priority. Always ask yourself: “Is this (concert, fireworks, leaf blower) really worth destroying the hair cells of my inner ear?” As my colleague Daniel Fink recently pointed out, a safe exposure level that does not put our hearing at risk is likely 70 dBA, which is more than 30 times less the sound intensity than the 85 dB typically considered safe for the 8-hour workday.

However, noise affects our health in many different ways beyond hearing. The so-called non-auditory effects of noise include sleep disturbance, increased risk for cardiovascular disease, and disturbed communication. The latter has been shown to affect academic performance of school children, but it can also have catastrophic consequences, e.g. if something is misunderstood in a hospital setting. I believe there are several reasons why environmental noise doesn’t receive the attention it deserves in public health politics. First, humans habituate to their environment. If you are constantly exposed to noise, you may not realize it any more. It can nevertheless very much affect your physiology and psyche. For example, I only realized how loud my every day environment was after I spent some time in a very quiet environment. Second, many of the health effects require long-term exposure to relevant noise levels before they manifest. As mentioned above, humans often have problems making the connection between a present exposure or behavior and future effects. Third, many of the activities that generate noise also generate a societal benefit and/or revenue. For example, an outdoor concert venue can be greatly enjoyable for the patrons, but it can be a torture for those living next to the venue without a realistic opportunity to evade the nightly noise. Likewise, it is very convenient to live close to major transportation infrastructure like a highway or a rail station. However, if you are living too close to rail tracks or roads, this convenience can be offset by the noise and pollution associated with the traffic. Finally, we definitely have a noise equity issue, and those exposed to high noise levels often neither have the means to live somewhere less noisy nor are they influential enough to push the policy envelope.

We always should think of ourselves both as noise recipients and as noise generators. There are things we can do individually to reduce noise levels. For example, we can decide to buy and use products that produce less noise (think of a rake instead of a leaf blower). Or we can postpone activities that generate noise to times considered less sensitive: If you don’t have to, don’t start mowing your lawn a 7 AM on a Saturday morning, your neighbors will thank you. In more general terms: be considerate. However, this will only take us so far. We still need strong noise regulation that is properly enforced to prevent health consequences. And even though the increases in health risks induced by noise may be relatively minor compared to other environmental or behavioral factors, this still constitutes a major public health problem, as noise is so ubiquitous, and so many people are exposed to relevant noise levels. Our research tells regulatory bodies at what noise level certain health effect can be expected, and that helps inform better noise policy.

Further reading:

Basner, M., Babisch, W., Davis, A., Brink, M., Clark, C., Janssen, S., Stansfeld, S.: Auditory and non-auditory effects of noise on health. The Lancet, 383(9925): 1325-1332, 2014.

Basner M.: Much ado about noise: health risks of traffic noise. Dtsch Arztebl Int 2016; 113(24): 405-6; DOI: 10.3238/arztebl.2016.0405

WHO Environmental Noise Guidelines for the European Region, 2018

Q&A with Greg Asbed and Gerardo Reyes Chavez

Greg Asbed is a fierce advocate fighting against forced labor, sexual violence, and other gross human rights violations. He was awarded the 2015 Presidential Award for Extraordinary Efforts in Combating Human Trafficking at the White House on behalf of the Fair Food Program (FFP). As a co-founder, Greg leads the development of innovative market-based enforcement mechanisms, rights standards, and worker education processes. Through this program he coordinates relations among many agriculture stakeholders, including corporate buyers, industry suppliers, and farm workers. He has consulted both nationally and internationally on the adaption of the FFP to other contexts. He is the co-founder of the Worker-driven Social Responsibility (WSR) model, which has been recognized for its unique effectiveness in combating the above-mentioned human rights violations in agriculture. Greg has won numerous awards, including the 2014 Clinton Global Citizen Award and the 2016 James Beard Leadership Award. He was also named a 2017 MacArthur Fellow. He is an advisory board member of the EU’s Horizon 2020 project to end forced labor in supply chains.

Gerardo Reyes Chavez is a key leader of the Coalition of Immokalee Workers’ (CIW), mobilizing communities across the world to advocate for the rights of exploited workers. Through CIW’s Fair Food Program, Gerardo has facilitated unique partnerships among farmers, farmworkers, and retail food companies to ensure humane wages and working conditions for the workers on the participating farms. Gerardo leads workers’ rights education programs, as well as managing the complexities of complaints of abuses in the fields, wage theft claims, and investigating cases of modern-day slavery. He has spoken publicly about the Fair Food Program at events such as Harvard Law School’s Labor and Worklife Program Convening on Farm Labor Challenges and the Interfaith Council on Corporate Responsibility’s Multi-stakeholder Roundtable on Ethical Recruitment. Gerardo is a 2018 Aspen Institute Ricardo Salinas Scholar.


TEDMED: As you two mentioned in your TEDMED Talk, the Fair Food Program (FFP) model is being used in different industries and in different countries. Tell us more about how it’s being used outside of the American agricultural industry.

Greg & Gerardo: The Fair Food Program was the first, fully operational example of the new paradigm for protecting workers fundamental human rights in global supply chains known as Worker-driven Social Responsibility, or WSR. One of the other foundational examples of the new WSR model is the Bangladesh Accord on Fire and Building Safety in the Bangladesh apparel industry. The Accord came together following the horrific Rana Plaza building collapse that led to the deaths of more than 1,100 people in 2013, and it employs the same key mechanisms as the Fair Food Program — binding legal agreements between brands and worker and/or human rights organizations, worker voice throughout the monitoring and enforcement process, and the suspension of sales to participating brands when its standards are violated by suppliers— to ensure that no worker need fear that the building where he or she works will be their tomb due to easily preventable fire and structural hazards. The Accord has been a great success and has saved countless workers lives by preventing the tragic accidents that previously killed workers in the apparel industry by the hundreds every year.

Likewise, workers in many other industries — from the poultry plants of Arkansas to the movie sets of Hollywood — have taken note of the model’s unique power to prevent abuses and are working today to establish enforceable standards in their own workplaces.

TM: The FFP model has successfully interrupted deep-rooted patterns of violence and modern-day slavery in the agricultural industry. What do you think makes the program so effective?

G&G: The Program’s success is due to two key elements: 1) the participation of workers, from start to finish, in the standards-setting, monitoring, and enforcement process and, 2) its ability to harness the purchasing power of the billion dollar brands as both carrot and stick to encourage growers to participate and to enforce Program’s standards when they are violated. Workers not only know exactly how, when and where abuses take place in the fields, they also happen to be there when the vast majority of abuses take place. That makes them ideally suited to both set the standards for the Program and to be the front-line monitors of their own rights. But no matter how strong a set of standards may be, or even how well monitored, if the power to enforce those standards is missing, then it is all for naught. The purchasing power of the multi-billion dollar brands at the top of the food industry — companies like Whole Foods and McDonald’s — is the power that drives compliance in the Fair Food Program. And the incentive their purchases represent to the growers in the Program is so great that it not only fixes violations when they occur, it brings about the gold standard of enforcement — prevention — making a world without victims, the best possible outcome, possible.

TM: Tell us about the upcoming “4 for Fair Food Tour.” Who is involved and what are you hoping to achieve with the program?

G&G: The 4 for Fair Food Tour is a continuation of the CIW’s ongoing national boycott against the fast food giant, Wendy’s. Along with students, people of faith, and community leaders, farmworkers and their families will be traveling across the country to four of the nation’s top public institutions with Wendy’s restaurants on campus – Ohio State University, University of North Carolina Chapel Hill, University of Michigan and University of Florida – to call on the administration at each university to end business relations with Wendy’s.

As the sole major fast food company that has yet to join the Fair Food Program, Wendy’s has been offering stock public relations answers in response to what is a very real, very troubling human rights crisis in agriculture. This tour is about making it clear to Wendy’s that consumers are clear-eyed and deeply committed to real, tangible change for farmworkers, and that Wendy’s refusal to join the most successful supply chain monitoring program in the country has consequences for the company’s brand and business relationships. Because these universities have very clearly stated values and mission statements that support human rights in their suppliers’ operations — for example, in the apparel companies that produce their university logo sportswear — and because the students at these schools clearly support the idea of exploitation-free consumption when possible, we have already seen strong support for the campaign in both the student communities and the cities where the universities are located. We expect that we will see Wendy’s restaurants removed from campus, as were Taco Bell restaurants on 28 campuses around the country during the Taco Bell boycott fifteen years ago, as the students ramp up the pressure on their administrations to live up to the schools’ stated values. That pressure was ultimately successful in prompting Taco Bell to be the first fast-food giant to join the Fair Food Program, and we are confident that it will have the same impact in making Wendy’s the last major fast-food company to join.

TM:  What’s next for CIW?

G&G: As we grow and expand, we will continue to advance every level of our work: We will help convey the lessons and potential of the WSR model to new industries and regions across the globe. We will fortify the gains we’ve made in the current seven states of the Fair Food Program, and expand those protections to more states and crops. We will travel the country and the world to educate public figures, academics, leaders, and everyday consumers about the challenges faced by farmworkers, and the responsibility of consumers to get involved in transforming the food system so that it is more humane and more just. We will win new partnerships with corporate buyers to drive expansion of the Program – Wendy’s, for example, in the not so distant future. And, of course, we will continue to do everything we can to ensure that the people harvesting our food, sewing our clothes, assembling our phones, building our homes, and doing so many more of the crucial jobs at the bottom of global corporate supply chains are empowered to be the frontline monitors of their own human rights.