The rise in youth despair and the costs of heat

On the importance of evergreen global health stories

Welcome to Under Development! This is a regular collection of recent writing (mine and others’) on global health and development.

I’ve been considering pulling something like this together for quite a while. News cycles shift rapidly, and the pressure to have a timely news peg means that evergreen stories about important problems can feel like they have have less of a place. This is particularly salient in global health and development, where challenges can recur for decades and, as a result, become buried by other headlines. With that said, here’s a bit about what I’ve written, what I’ve been reading, and what I’ve been thinking about over the past month. Reach out if any of it sparks thoughts for you!

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What I’ve written

The mid-life crisis has long had its grounding in pop-culture - and in the literature on measuring wellbeing. That pattern (known as the ‘u-shaped happiness curve’) has broken down: the young now are less happy and more unhappy than the middle-aged. I interviewed Danny Blanchflower, an originator of the u-shaped happiness curve, and wrote about the implications of the rise in youth despair for Scientific American.

“We have to focus on the people at the extremes,” Blanchflower says. “Think about those who are most susceptible to commit suicide, to have deaths of despair. These are the people who say, ‘Every day of my life is a bad mental health day.’” Between 2020 and 2022, more than half of respondents reported no bad mental health days. But 7 percent acknowledged exactly 30. The proportion of those with this response nearly doubled from 1993 to 2023. That rate has grown most quickly among the young, especially women 18 to 25 years old. “This fact alone is the most striking and scary: my estimates are that 11 percent of ... young women are in despair,” Blanchflower says.

Keep reading: Young Adulthood Is No Longer One of Life’s Happiest Times

Another major heat wave is building across the United States this week, and it’s not an anomaly. Last Sunday was the hottest day ever recorded — until Monday: the global average temperature reached 17.15°C (62.87°F), topping the prior day’s 17.09°C. This month, I wrote for Works in Progress about how heat is hostile human health, productivity, and social cohesion.

The harms of extreme heat are growing. By 2100, nearly three quarters of the population may be exposed to dangerous environmental heat for at least 20 days each year, up from 30 percent. Heat-related mortality for people over 65 increased by 85 percent between 2000–2004 and 2017–2021. Countries in the global south were hardest hit - leading to worsening global inequalities.

Keep reading: Heat Waves

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What I’ve been reading

This article about Gavi’s upcoming replenishment cycle, a determinant of the organization’s budget from 2026 through 2030:

At the same time, raising $9 billion is never easy, and Gavi has the misfortune of asking for funding during what experts are calling the “replenishment pileup.” A huge number of international humanitarian groups — the World Bank; the World Health Organization; the Global Fund to Fight AIDS, Tuberculosis, and Malaria; the Pandemic Fund; the climate-oriented Loss and Damage Fund — are all asking for donor funds at roughly the same time. That has fueled fears that donor fatigue and tight budgets will mean some, many, or all of these groups will fall short of their goals.

This piece covering the roll-out of the R21 malaria vaccine in Côte d’Ivoire:

The vaccine costs less than $4 a dose, making it “realistic to roll out in many tens of millions of doses from now on,” and it has high efficacy levels of around 75%-80% in young children, Professor Adrian Hill, director of the Jenner Institute at Oxford University, who led the development of the vaccine, said in an interview with BBC Radio on Monday.

This paper detailing results from a randomized trial that provided 1,000 low-income adults in the United States $1,000 per month for three years:

We find no effect of the transfer across several measures of physical health as captured by multiple well-validated survey measures and biomarkers derived from blood draws… We also find that the transfer did not improve mental health after the first year… We also find precise null effects on self-reported access to health care, physical activity, sleep, and several other measures related to preventive care and health behaviors. Our results imply that more targeted interventions may be more effective at reducing health inequality between high- and low-income individuals, at least for the population and time frame that we study.

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What I’ve been thinking about

How wonderful it is to have access to 24-7 public transportation. The New York City subway system has its issues - and can turn into what amounts to a $2.90 sauna in the summer months - but that it generally gets its average daily ridership of ~3.6 million where it needs to go is no small feat. The over 12,000 subway cars and buses that underpin daily commutes are likely a major reason New York is as large and dense - and desirable a place to live for many - as it is today.

The transit system is central to the basic functioning of most New Yorkers, but over time it has become more than purely practical; it’s become a quasi third place in and of itself. Walking through Grand Central and listening to the buskers, or spotting new details in the “Life Underground” art installation at 14th St is a unifying experience for New York’s commuters.

Until next time,
Deena