The Washington Post National Weekly - June 23, 2019

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oliticsPolitics Disconnect on health 4 care 4Nation Diabetics turn to Canada 8 food 23food 23 Disconnect on care health Nation Diabetics turn to Canada 85 Myths5Fast Myths Fast

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THE FIX

Biden’s badly timed bad week BY

A MBER P HILLIPS

J

oe Biden is having to defend his record on civil rights because of something he said, and he picked a heck of a week to step into the type of controversy that presidential candidates never want to court.

Supporting civil rights is as basic as it gets for a Democratic presidential candidate trying to unseat President Trump, a president they’ve all argued has allowed white supremacy to fester.

Biden has made Trump’s remarks on a deadly rally involving white nationalists in Charlottesville a central component of his campaign.

And yet, the former vice president opened himself up to criticism of his own record at a fundraiser Tuesday when he brought up his congeniality with two of the most notorious senators in the civil rights era to argue that he can work with anybody.

The point was inartfully made, even some of his supporters acknowledge. (And Biden does have powerful supporters in Congress, including the highest-ranking African American in Congress, Democratic Rep. James E. Clyburn of South Carolina.)

But the fact that Biden both worked with and befriended people like then-Sen. James O. Eastland of Mississippi — who has said the black race is inferior to the white one — quickly overshadowed what Biden was trying to say about his track record on bringing opposing sides together.

The next thing Biden knew, his 2020 rivals, most notably those with African American heritage, were launching punches at him.

To underscore his congeniality with Eastland, Biden had told potential donors: “He never called me ‘boy.’ He always called me ‘son.’ ” Sen. Cory Booker (D-N.J.), responded: “You don’t joke about calling black men ‘boys.’

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MELINA MARA/THE WASHINGTON POST

Former vice president Joe Biden is receiving backlash for his comments about previously working with racist senators.

Men like James O. Eastland used words like that, and the racist policies that accompanied them, to perpetuate white supremacy and strip black Americans of our very humanity.”

“If those men had their way, I wouldn’t be in the United States Senate and on this elevator right now,” Sen. Kamala D. Harris (D-Calif.) told reporters.

Letters between Biden and Eastland archived at the University of Mississippi then gained new prominence. It was the 1970s, and Biden opposed court-mandated busing of black students to whiter schools and vice versa.

“I want you to know that I very much appreciate your help during this week’s Committee meeting in attempting to bring my antibusing legislation to a vote,” Biden wrote on June 30, 1977, to Eastland, according to The Washington Post.

Biden’s opposition to busing in the 1970s isn’t a new revelation. The Post’s Matt Viser highlighted it before Biden officially got into the race, warning that it could become an issue.

This publication was prepared by editors at The Washington Post for printing and distribution by our partner publications across the country. All articles and columns have previously appeared in The Post or on washingtonpost.com and have been edited to fit this format. For questions or comments regarding content, please e-mail weekly@washpost.com. If you have a question about printing quality, wish to subscribe, or would like to place a hold on delivery, please contact your local newspaper’s circulation department. © 2019 The Washington Post / Year 5, No. 37

(“I’ll be damned if I feel responsible to pay for what happened 300 years ago,” Biden said at the time.)

But his 2020 opponents didn’t have to go to Mississippi and dig up the letters or find some sly way to bring them up into conversation.

Biden opened the door to all of this.

It’s a fact that worries Democratic strategists to whom I’ve talked. They say this is Biden’s race to lose and that his bumpy campaign skills aren’t helping him. On issues that are absolutely critical to today’s Democratic Party — federal funding for abortion, aspects of the #MeToo movement, criminal justice reform — Biden has underscored how his views are out of step with this generation.

The timing of the segregationist flap was perfectly wrong for Biden. It’s a week before the first Democratic primary debates, when many candidates will want to attack Biden to see if they can lower his standing at the top of the polls. That may have contributed to Booker and Harris directly confronting Biden on this. Up until now, they and other candidates have tried to diplomatically disagree with him rather than attack him.

Instead of highlighting his closeness with the first African American president and his work with African American leaders like Clyburn going into this critical week, Biden’s campaign is having to issue statements like this: “The insinuation that Joe Biden shared the same views as Eastland on segregation is a lie.

Plain and simple. Joe Biden has dedicated his career to fighting for civil rights.”

Biden is popular among black voters, writes The Fix’s Eugene Scott, and it’s too early to tell whether this will damage him. But defending his record on civil rights is certainly the last thing he wanted to be doing right now. And for that, he has no one to blame but himself. n

CONTENTS POLITICS THE NATION THE WORLD COVER STORY TECHNOLOGY BOOKS OPINION FIVE MYTHS

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ON THE COVER After decades of nonstarts, Bettye LaVette finally hit musical success in 2011. She is now 73. Photo by CELESTE SLOMAN for The Washington Post

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NATION

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Teen marijuana use triggers concerns J ENNIFER O LDHAM in Denver BY

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he first two states to legalize recreational marijuana are starting to grapple with teenagers’ growing use of highly potent pot, even as both boost the industry and reap huge tax windfalls from its sales.

Though the legal purchase age is 21 in Colorado and Washington, parents, educators and physicians say youths are easily getting hold of edibles infused with tetrahydrocannabinol, or THC, the psychoactive component that causes a high, and concentrates such as “shatter,” a brittle, honey-colored substance that is heated and then inhaled through a special device.

Each poses serious risks to adolescents’ physical and mental health.

“Underage kids have unbelievable access to nuclear-strength weed,” said Andrew Brandt, a Boulder, Colo., software executive whose son got hooked while in high school.

With some marijuana products averaging 68 percent THC — exponentially greater than the pot baby boomers once smoked — calls to poison control centers and visits to emergency rooms have risen. In the Denver area, visits to Children’s Hospital Colorado facilities for treatment of cyclic vomiting, paranoia, psychosis and other acute cannabisrelated symptoms jumped to 777 in 2015, from 161 in 2005.

The increase was most notable in the years following legalization of medical sales in 2009 and retail use in 2014, according to a study in the Journal of Adolescent Health published in 2018.

“Horrible things are happening to kids,” said psychiatrist Libby Stuyt, who treats teens in southwestern Colorado and has studied the health impacts of high-potency marijuana. “I see increased problems with psychosis, with addiction, with suicide, with depression and anxiety.”

BRENNAN LINSLEY/ASSOCIATED PRESS

In states where pot is legalized, youths are using highly-potent drugs, posing serious health risks It is unclear whether all of this means years of generally stagnant pot use among children are coming to an end. Surveys finding little change with pot since 2014 “may not reliably reflect the impact of legalization on adolescent health,” the authors of that 2018 study concluded.

Washington’s latest Healthy Youth Survey showed 20 percent of eighth-graders and nearly half of seniors “perceive little risk of regular marijuana use.” Many teens consider it less risky than alcohol or cigarettes.

As more than a dozen states from Hawaii to New Hampshire consider legalizing marijuana, doctors warn of an urgent need for better education — not just of teens but of parents and lawmakers — about how the products being marketed can significantly affect young people’s brain development.

The limited scientific research to date shows that earlier and more frequent use of high-THC cannabis puts adolescents at

greater jeopardy of substance use disorders, mental health issues and poor school performance.

“The brain is abnormally vulnerable during adolescence,” said Staci Gruber, an associate professor of psychiatry at Harvard Medical School who studies how marijuana affects the brain.

“Policy seems to have outpaced science, and in the best of all possible worlds, science would allow us to set policy.”

The critics also insist that more must be done to maintain tight regulation of the industry.

That’s not been the case so far, they argue, with dispensaries opening near high schools in Seattle and with retail and medical pot shops in Denver outnumbering Starbucks and McDonald’s locations combined.

The bills that passed this spring in each state’s legislature, with bipartisan support, aimed mostly for industry expansion or deregulation. Washington lawmakers lightened the conse-

Two teens share a joint at a rally in Denver in 2013, a year before recreational marijuana became legal in Colorado. In 2018, Colorado’s pot industry racked up a record $1.54 billion, which brought in $266 million in marijuana taxes, licenses and fees.

quences of administrative violations, allowing for written warnings in lieu of fines. Colorado lawmakers approved broader investment in marijuana businesses and home delivery for medicinal users — followed by delivery for recreational users in 2021.

Colorado also gave the go-ahead for consumers to use the drug in licensed dispensaries, restaurants and theaters.

Some physicians liken the states’ actions to a public health experiment, one that supports the cannabis industry’s interests while ignoring the implications for adolescents’ health.

“I hope we don’t lose a generation of people before we become clear we need to protect our kids’ brains,” said Leslie WalkerHarding, an adolescent medicine specialist who chairs the pediatrics department at Seattle Children’s Hospital. It also is seeing more teens with marijuanarelated symptoms.

The industry disagrees that potent products like crumble, budder and crystalline are a danger, saying additional studies are needed. Existing data are “inconclusive about whether the changes that have been linked to early cannabis use are damaging in the long term,” Morgan Fox, media relations director for the National Cannabis Industry Association, said in an email.

“There also needs to be more research on whether potency actually has an impact on consumers.”

What’s not disputed is how much is on the line financially.

Ten states and the District of Columbia — with Illinois poised to be next — allow recreational marijuana use for adults, and 34 permit medical marijuana.

Washington’s commercial market posted a record $978 million in retail sales in fiscal 2018, data show, which meant $358 million in excise tax for state coffers.

Colorado’s pot industry racked up even higher sales in calendar 2018: a record $1.54 billion, which brought in $266 million in marijuana taxes, licenses and fees. n

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POLITICS

Di≠ering priorities on health care B Y A MY G OLDSTEIN

M

edicare-for-all. Medicare-for-all who want it. Health care as a form of freedom. As they campaign, most of the 23 Democratic candidates for president are trumpeting bold ideas to achieve the party’s long-held dream of ushering in health coverage for every American.

The problem is that many voters are not focused on such lofty goals. They want something simpler — to pay less for their own health care.

Voters have plenty to sort out, with nearly two dozen Democrats running, each offering a raft of proposals on many issues. But in public opinion surveys and interviews, people rank health care as their top concern. And with insurance deductibles, prescription drug costs and other medical charges squeezing the middle class, they consistently say they want elected leaders to lower their out-of-pocket costs.

The disconnect between those views and candidates’ talking points has left voters such as Raleigh, N.C., Democrat Ron Jungling eager for a nominee who can defeat President Trump — but feeling his party is not speaking to him on a centrally important issue.

“I don’t think it’s probably the right time to push Medicare-forall,” said Jungling, 57, an electrical engineer whose wife, an insurance broker, has enrolled uninsured clients in Affordable Care Act health plans. His in-laws just went into an assisted living facility that costs $20,000 a month.

“Medicare-for-all would be great if we could do the other side of the coin — get the cost down,” Jungling said. “I don’t see that happening here.”

Such misalignment — in candidates’ focus and, in some cases, their level of attention — is striking because surveys show that health care is the issue on which the Democratic Party holds the greatest advantage over Republicans. In three polls this year that have asked which party voters

MANUEL BALCE CENETA/ASSOCIATED PRESS

Candidates focus on wider access, while Americans urge lower costs trust more to handle health care, Democrats have had an edge over the GOP that averages 19 percentage points.

According to pollsters, policy analysts and political strategists, the candidates’ emphasis on Medicare-expansion plans is partly a missed opportunity and partly a reflection of the slice of the electorate that participates in Democratic primaries.

Candidates are failing to recognize “the debate is not going to be 2008 or ‘16 over again. It’s going to be about the price of insulin, hospital charges and insurance premiums, with, ‘What are you going to do about them for me?’ ” said Robert J. Blendon, a Harvard professor of health policy and politi-

cal analysis, who studies public opinion on health care.

The candidates’ focus on universal coverage, including Vermont Sen. Bernie Sanders’ plan to eliminate private insurance in favor of a single-payer system “is a replay of earlier elections [when] it was about getting everybody covered,” Blendon said.

Celinda Lake, a veteran Democratic political strategist, said the candidates could capitalize, for instance, on the fact that public concern about prescription drug prices is a hot issue with both primary and general-election voters. “In my opinion, we’re not talking enough about it,” she said.

Lake said that candidates are playing to the values of Democrat-

Sen. Bernie Sanders (I-Vt.) contends that a single-payer system would be more efficient and would lower the nation’s health carespending. But reducing overall costs is not a priority with the public, recent polls show.

ic primary voters, who tend to lean further left than others in the party. Unlike the party as a whole, primary voters typically want political leaders to promote access to health care, as well as its affordability.

In a new poll that asked respondents which health-care topics they want candidates to discuss in the first primary debates this month, nearly one-quarter of liberal Democrats said they are most interested in hearing about a single-payer system, compared with just 9 percent of party moderates and Democratic-leaning independents.

Still, lowering the amount that individuals and families pay for health care was the topic of great-

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POLITICS est interest with every one of those groups, according to the poll by the Kaiser Family foundation, a nonpartisan health policy group.

Once a winner emerges from the primary field, the nominee will need to pivot to the theme of affordability, Lake said. The focus, she said, should be on the concerns of insured Americans, given that 98 percent of general-election voters have coverage, while people without coverage are unlikely to vote.

“It is going to be tricky to do,” Blendon predicted. “It’s going to have to be a shift.”

For now, with the exception of Sanders, who has updated a Medicare-for-all bill that was a centerpiece of his first run for president in 2016, the candidates have not produced detailed health care proposals.

“We’re at the stage in the campaign where candidates are mostly speaking in bumper stickers,” said Larry Levitt, Kaiser senior vice president.

That contrasts with the most recent Democratic presidential primary season when there was no incumbent and health care was a dominant issue. Running for the 2008 nomination, thenSens. Barack Obama, Hillary Clinton and John Edwards each issued a detailed health-care plan

by May, 2007 — before now in the current election cycle. Ideas from the Obama and Clinton plans became ingredients of the Affordable Care Act, which Obama pushed through a Democratic Congress in 2010.

In 2016, the next presidential election without an incumbent, the GOP wielded the ACA as a club, with now-President Trump vowing to repeal it and Clinton, the Democratic nominee, pledging to improve it.

This year, candidates perceive that at least for now, they have more to lose than to gain by laying out specifics, including the pricetags of their ideas, analysts said.

Former Vice President Joe Biden included in his April campaign kickoff speech a position that is regarded as moderate in this Democratic field. Even for the majority of Americans who get insurance through their jobs, Biden said, “you all should have a choice to be able to buy into a public option plan for Medicare,” before 65, the program’s tradi-

WIN MCNAMEE/GETTY IMAGES

SCOTT OLSON/GETTY IMAGES

tional eligibility age.

For the most part, however, Biden is focusing on preserving the coverage expansions and consumer protections created by the ACA. Talking of “total health care” recently, he broached the idea of letting younger people join Medicare with no insurance premiums, if they would qualify for Medicaid under the ACA but live in a state that has not expanded the program.

While polls, including by The Washington Post, show voters’ eagerness for political leaders to improve health care, some candidates are giving the issue little attention at all. On his campaign website, Gov. Steve Bullock (DMontana) includes the phrase “fulfill the promise of universal health care” in the middle of a

sentence that sets out eight other policy goals, from breaking the power of Wall Street to tackling climate change.

Sen. Elizabeth Warren (DMass) regales audiences with a thick stream of policy prescriptions that so far do not delve into health care, although she is a co-sponsor of Sanders’ Medicarefor-all legislation.

A few candidates already are mingling talk of expanding insurance with empathy about rising consumer costs.

“If you’re uninsured, you’re paying too much for health care,” South Bend, Ind., Mayor Pete Buttigieg says on his website. “If you’re insured, you’re still paying too much.” He heralds guaranteed health coverage as a form of freedom — unleashing people from

Some presidential candidates have mingled talk about insurance with empathy about rising consumer costs. Pete Buttigieg, top, says guaranteed health coverage unleashes people from jobs they only keep because of the benefits. Sen. Kamala D. Harris, below, often connects her discussion of Medicare-for-all with memories of her mother dying of cancer.

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jobs they keep only because they need the benefits.

In interviews and campaign speeches, Buttigieg says he favors what he terms “Medicare-for-all who want it,” in which consumers could buy public insurance that, if it proves popular and efficient, could serve as a glidepath to a government-run system.

Sen. Kamala D. Harris (D-Calif.) often laces her discussion of Medicare-for-all with memories of her mother dying of cancer a few years ago. During an MSNBC town hall in Spartanburg, S.C., she said she thought at the time about other families burdened with the logistics of care and grief — “and on top of that, [to] have to worry about how they’re going to pay a hospital bill, is immoral.”

When Sanders talks of Medicare-for-all, still near the core of his campaign’s rationale, he contends that a single-payer system would be more efficient and would lower the nation’s health care-spending. But reducing overall costs is not a priority with the public, recent polls show.

While about half of respondents in one poll said they support the basic idea of giving everyone Medicare with little or no role for private insurance, just over one in three bought Sanders’ argument that it would significantly reduce the nation’s health-care costs. Still other polling suggests people have little understanding of what Medicare-for-all would mean.

Some Democratic voters are drawn to Sanders’ goal.

“We have such wonderful modern medicine, and all these wonderful things are held away from people if they can’t afford it,” said Kisstrin Kaikkonen Cosier, 51, who lives in Marin County, Calif., where she has a small wine business and is a child care provider and programmer at a local television station. She buys insurance for herself and her 16-year-old daughter through Covered California, the state-run ACA insurance marketplace.

When she caught Sanders on TV the other day, she thought he sounded on the right track.

Jungling sees it differently. As he listens to the candidates, “I’m hearing more about getting more people covered,” he said. “I think they should do what they need to do to get elected, [but] . . . getting the costs down is the most important thing.” n

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TECHNOLOGY

Meet your new co-worker BY

D REW H ARWELL

T

o Walmart executives, the Auto-C self-driving floor scrubber is the future of retail automation — a multimillion-dollar bet that advanced robots will optimize operations, cut costs and revolutionize the American superstore.

But to the workers of Walmart Supercenter No. 937 in Marietta, Ga., the machine has a different label: “Freddy,” named for a janitor the store let go shortly before the Auto-C rolled to life.

Freddy’s career at the store has gotten off to a rocky start. Workers there said it has suffered nervous breakdowns, needed regular retraining sessions and taken weird detours from its programmed rounds.

Shoppers are not quite sure how to interact with Freddy, either. Evan Tanner, who works there, recalled the night he says a man fell asleep on top of the machine as it whirred obediently down a toy aisle.

Walmart executives said they are skeptical that happened, because the Auto-C is designed to stop if someone interferes with its work. But Tanner insists Freddy dutifully stuck to the job at hand. “Someone had to pull [the sleeping man] off,” he said. Freddy “was going to swing toward groceries, just cleaning away.”

Over the past 50 years, Walmart has recast the fabric of American life, jostling mom-andpop shops, reshaping small towns and transforming how millions work and shop.

But the superstore titan’s latest gamble is an entirely new kind of disruption — the biggest realworld experiment yet for how workers, customers and robots will interact.

The nation’s largest private employer has unleashed an army of robots into more than 1,500 of its jumbo stores, with thousands of automated shelf-scanners, box-unloaders, artificial-intelligence cameras and other machines doing the jobs once left to human employees.

The swarm is already remak-

RICK T. WILKING/GETTY IMAGES

As Walmart turns to robots, it’s the retailer’s human employees who feel like machines ing how the retailer’s more than 1 million U.S. “associates” go about their daily work. Given the chain’s ubiquity across the country, the local Walmart store also is likely to become the first place millions of Americans meet a real-life, working robot.

Walmart executives have promised the all-hours robot workhorses will let employees endure less drudgery and enjoy “more satisfying jobs,” while also ensuring shoppers see cleaner stores, fuller shelves and faster checkouts.

But the rise of the machines has had an unexpected side effect: Their jobs, some workers said, have never felt more robotic. By incentivizing hyper-efficiency, the machines have deprived the employees of tasks they used to find /njoyable. .Some also feel like their most important assignment now is to train and babysit their often inscrutable robot colleagues.

Customers, too, have found

coexisting with machines to be confusing, if not alarming. Some shoppers have been spooked, for example, by the Auto-S scanner, which stands six feet tall and quietly creeps down the aisles, searching for out-of-place items by sweeping shelves with a beam of light. Other shoppers, store workers said, have made a game of kicking the things.

Employees at a half-dozen newly automated Walmarts said the machines at times are helpful, even charming. Some talked about the robots’ personalities and said they had adorned them with employee name tags. But others also felt this new age of robotics had accelerated the pace of work and forced them to constantly respond to the machines’ nagging alerts. Some said it made them doubt the company valued their work.

This awkward interplay of man vs. machine could become one of the defining tensions of the modern workplace as more

A Bossa Nova Robotics scanning device at a Walmart Supercenter in Rogers, Ark., in May 2018. The automated shelf scanner is being tested in a pilot program at a limited number of Walmarts.

stores, hotels, restaurants and other businesses roll in robots that could boost company reliability and trim labor costs.

Many Walmart workers said they had long feared robots would one day take their jobs.

But they had not expected this strange transition era in which they are working alongside machines that can be as brittle, clumsy and easily baffled by the messy realities of big-box retail as a human worker can be.

Walmart executives say that the machines are helpful companions that will allow workers to focus on more-creative, customer-facing goals and that early responses from workers have been “overwhelmingly positive.”

In an announcement last month titled “#SquadGoals,” the company said it would be expanding its robot program and compared the machines to the Star Wars droid R2-D2 and the Transformer Optimus Prime. “Every hero needs a sidekick, and some of the best have been automated,” the company said.

The robots also don’t complain, ask for raises, or require vacations and bathroom breaks.

During a company earnings call in August, Walmart president and chief executive Doug McMillon said the machines were an important part of how the company, which has annual revenue of $500 billion, could trim waste and “operate with discipline.”

“We’re testing or scaling new automation efforts in several areas,” he said. “Our mind-set and specific plans and actions around cost management are vital.”

The scale of the effort is impressive. The Fast Unloader machines automatically scan and sort freight as it is tossed off shipping trucks. Auto-S camera robots roll past shelves to scan which products are mislabeled or out of stock. Giant orange obelisks, called automated pickup towers, spit out goods for online shoppers like 16-foot-tall vending machines. Scurrying little Alphabots bring items to workers for packing. Auto-C robot Zambonis come out at night

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SCIENCE

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Want to feel more happy? Go outside.

BY

CHRISTOPHER INGRAHAM

I MARK LENNIHAN/ASSOCIATED PRESS

Dozens of cameras, part of a large artificial-intelligence system, hang above aisles at a Walmart Neighborhood Market in Levittown, N.Y.

to buff the floors.

One Walmart Neighborhood Market in Levittown, N.Y., has 100 servers, 10 cooling towers, 400 graphics-processing cards and 150,000 feet of cables in service of a complicated artificial-intelligence system designed to assess the store in real time.

Cameras and weight sensors automatically detect when the shopping-cart pen is empty and the bananas are overripe.

But the technology can only do so much. When the AI senses a problem, it sends an alert to the handheld devices most Walmart workers are expected to carry, saying it is time to corral the carts or replenish the produce. The store’s roughly 100 human associates are the ones who do the physical work.

That has added a layer of discomfort to a job some workers said already could feel demeaning. Quitting or getting fired, some joked, is like getting “promoted to customer.” Now they find themselves in the uneasy position of not only training their possible replacements but also tending to them every time something goes wrong.

The self-driving floor scrubbers, for instance, must be manually driven until they learn the store’s layout — and when the aisles are shifted around, as is common during seasonal displays and remodels, the machines must be retrained.

Technical glitches, surprise breakdowns and human resentment are commonplace. Some workers said they have cursed the robots out using their employee-

given nicknames, such as “Emma,” “Bender” and “Fran.”

The human customers have to be trained, too. Walmart workers said they have seen people following the robots around, recording them, talking to them, slapping their emergency-stop buttons, jumping in their way suddenly — and, yes, assaulting them with kicks and shoves.

The inventory-scanning robot is well-traveled: Its kind has captured more than 3 billion images across 24,000 miles of Walmart shelving, all at speeds of less than a half-mile per hour. But to customers, it remains a stranger.

“Customers freak out when they see him,” said Dreama Lovett, who works at a supercenter in Jacksonville, Fla. “They’ve not seen anything like him before.”

Other customers find their time with the robots to be unsatisfying, including older shoppers for whom a trip to the store is as much about human interaction as anything else. “A lot of them will say, ‘I didn’t come here to talk to a machine,’ ” said a worker at a Walmart in Dunedin, Fla., who spoke on the condition of anonymity because he didn’t want it to affect his job. “ ‘I came here to shop and have someone help me with my groceries.’ ” Martin Hitch, the chief business officer of Bossa Nova Robotics, which makes Walmart’s inventory-scanning robots, said the company has spent years teaching its machines to be as humanfriendly as possible. But there’s no agreed-upon etiquette for how robots and people should communicate. n

t’s been established that people who spend more time in parks and other natural settings tend to report higher levels of health and happiness, but new research shows there’s actually a magic number for it.

According to a study published this past week in the journal Nature Scientific Reports, spending 120 minutes a week strolling a tree-lined street or sitting by a lake can greatly enhance a person’s overall sense of well-being. Less time didn’t yield any significant benefit, the research showed.

Those who got in two to three hours in nature were about 20 percent more likely to report high overall satisfaction with their lives than those who spent no time outdoors at all. The benefits to physical health were even greater, with those who met the outdoors benchmark being 60 percent more likely to report being in good health than their cooped-in counterparts.

The figures were adjusted for a number of characteristics known to influence health and happiness, including socioeconomic factors, neighborhood characteristics and general demographics.

People who already spend a lot of time outdoors aren’t likely to find these results surprising: There’s already a substantial body of work linking green spaces to lower risks of heart disease, diabetes, obesity, asthma, mental health problems and overall mortality; and to greater rates of health, happiness, and cognitive development in children.

But most of these studies simply measured the physical characteristics of neighborhood environments. They didn’t actually ask people how often they experience the natural world to create a gauge of nature exposure at the individual level.

That’s exactly what the cur-

rent research does, using a nationally representative sample of 20,000 people living in England. The authors note their approach is similar to what governments have used in the past to develop physical activity guidelines for adults and children. They envision the creation of similar guidelines around exposure to nature.

Overall, they found, two hours or more of nature exposure had a significant impact: Its positive effect on an individual’s health and well-being was comparable to getting recommended amounts of exercise or of living in a high socioeconomic status area versus a low-status one.

They stress, however, that the effect is not necessarily a causal one. Though researchers controlled for a wide range of variables known to affect health and happiness, the study’s design didn’t allow them to completely rule out other factors that could result in higher health and happiness for nature lovers.

It may be the case, for instance, that people who are more inclined to be physically active and have a positive outlook on life are more likely to seek recreation opportunities outdoors. It may also be the case that being outside in nature, which typically involves a lot of moving around, may serve as a proxy for physical activity overall.

However, the authors note that other studies have demonstrated the benefits of being outside even in the absence of physical activity. Research in Japan, for instance, found that simply sitting passively in a natural environment can confer benefits to physical and mental health. Other research has shown that exercising outdoors provides a boost to mental health above and beyond what you’d get from doing the same exercise inside. n

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‘Well, what do I want now?’

Decades after life took them down one path, these women are reinventing themselves

hen women turn 50, the world starts to tune them out. Employers see them as less valuable and are more likely to discriminate against them, according to research. Hollywood disproportionately portrays them as unattractive, unfriendly and stupid.

Many women describe a sense of invisibility.

But something else happens as women leave their 40s behind. “[For] everyone I know around my age, there’s this major energy shift in being able to ask the question: Well, what do I want now?” writer and cultural critic Heather Havrilesky, 49, told The Washington Post.

“Without feeling totally cowed by what you should want, what seems selfish.” The world may tend to forget older women, but they feel freer than ever.

For American women in middle age and later, that might mean returning to ambitions set aside years ago to raise a family or follow a spouse’s career. It might mean finding ambitions they never had before or reaping longoverdue success. “Our culture tells us a story that we’ll lose and lose and lose as we get older,” says Havrilesky. “And it’s not true.”

The Post asked seven women who achieved personal or professional milestones after the age of 50 to share their experiences, in their own words.

— Jenny Rogers

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Ernestine Shepherd, 82 BALTIMORE

Became a champion bodybuilder after avoiding exercise

A

t age 11, I got hit by a car and broke my ankle. The bones didn’t heal correctly, and the doctors said I would never be able to do any type of exercise or ride a bike, because one leg was slightly longer than the other. So I was always afraid to try. Then, in my 50s, my husband invited my sister, Velvet, and me to a church picnic. He said, “You girls can wear bathing suits.” Velvet looked at me in the swimsuit and started laughing, and I looked at her and started laughing, and she said, “We need to do exercise.”

Velvet started working out and was looking good, and I was looking like nothing. She said, “If you want what I have, you have to do what I’m doing.” So I started doing aerobics and working out. When I first started, I didn’t think I could keep up with everyone in the class, and I was afraid to do anything with my left leg. But when I started doing the exercise, I proved to myself that I could.

Velvet said to me, “If anything were to happen to me, do you think you can continue what we started through prayer, exercising, eating healthy, walking, running, lifting weights?” I said, “Yes, I could do it.”

Velvet died of a brain aneurysm in 1992. I suffered anxiety and depression and cried all the time, because Velvet and I were very close. I stopped exercising. Then one night about two years after she died, Velvet came to me in a dream and said, “You’re not doing what I asked you to do.” In church, I said, “Here I am, Lord. I have heard you.”

I began slowly with walks and aerobics.

Then I started working with a trainer at age 71, even though I thought I wasn’t up to it. He said, “You’re an athlete, and you will do it, and remember what your sister wanted.” In seven months, he had my body ready for my first bodybuilding show, for novice competitors of any age. I won first place.

Now I live by and teach a mantra: determined, dedicated, disciplined to be fit. I always tell those I work with that age is nothing but a number. Many of those I have trained say they never thought they could do what they did at their age.

— As told to Gary Gately, a freelance journalist based in Baltimore

PHOTOS OPPOSITE FROM TOP: TRAVIS DOVE, CHERYL SENTER AND MICHAEL A. SCHWARZ, ALL FOR THE WASHINGTON POST; THIS PAGE: MARVIN JOSEPH/THE WASHINGTON POST

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COVER STORY

Vi Lyles, 68 CHARLOTTE

Sandy Warshaw, 85 NEW YORK

TRAVIS DOVE FOR THE WASHINGTON POST

Suzanne Watson, 57 CINCINNATI

CELESTE SLOMAN FOR THE WASHINGTON POST

MADDIE MCGARVEY FOR THE WASHINGTON POST

Entered politics and now runs city

Chose to live as openly gay woman

Went to medical school

I

I

I

n 2011, when I was working as director of community outreach for the Democratic National Host Committee, my husband was diagnosed with pancreatic cancer. A surgeon told us it was nonoperable and that we should prepare for the worst.

He got so sick and dropped to 125 pounds. He said: “Vi, you’ve got to find something to do. I can’t stand the fact that you’re walking around and sweeping and dusting and taking care of me only.”

The city was having a debate then over the streetcar, and you could see that it was disintegrating into what I didn’t consider to be our values. So I called Anthony Foxx, who was mayor and believed strongly in the streetcar, and I said: “I need to help you. My skills are as a facilitator, as someone that believes in collaboration. I’m going to run at-large for city council.”

I was campaigning, but my husband was a cheerleader. That was our best time. As he got sicker, I cut back on the campaign. I’ve got deep relationships with people in this city. I said to them, “I need your help.” They went out and spoke. They recruited people for endorsements. They took care of me.

My husband and I had lots of long talks. We were very prepared. He died on the day of the primary.

Three years after I was elected to city council, a police officer shot and killed an African American man named Keith Lamont Scott. Everything led in that moment to what I would call the uprising. Protesters threw rocks and water bottles at our police officers, who were not expecting that kind of reaction, and they blocked Interstate 85.

The shooting was like the spark that ignited the fire.

But the logs were systemic issues that we had in our city — housing and jobs — and that’s when I decided I had to run for mayor. I knew that we could do all of that fixing of police, but if we didn’t fix neighborhoods and people’s lives, we weren’t going to be the city that we claimed to be.

— As told to Elizabeth Leland, an author and freelance writer in North Carolina, where she worked as a newspaper reporter for 40 years

was born in the 1930s, when a nice Jewish girl was told, “You get married, you have children, and you live happily ever after.” Growing up, my mother used to warn me to “stay away from those lesbians,” but I didn’t know a thing about it.

I was married for 22 years and had two children. A few years ago, it occurred to me that I owe my exhusband an apology because I no more loved him than I love that roof over there. It had nothing to do with being a lesbian — marriage and children were just not the first thing on my agenda. I was 21 years old and had all these ambitions.

It wasn’t until I was in my early 40s that I realized I was attracted to women. There was a friend of mine who was also married, and we would go to Fire Island for a week at a time. We were drinking heavily one day, and I told her. She said: “Not now. I’ve been there. I don’t want to upset my marriage.” So I tucked it away.

I got divorced in 1977, when I was 44, and I had my first relationship with a woman after that. We had an eight-year relationship, but I was not out. We both worked for the city of New York and didn’t think it was a very safe thing to do.

I dated women for 16 years before I came out to my family. My kids threw me a 60th birthday party, and the present they gave me was a trip to Japan. They asked if I was traveling with anyone because they could only pay for one person. I said: “Sit down. I have something I’ve wanted to tell you. I’m gay.”

They said, “Oh, we’ve been wanting to talk to you about it for 10 years.” They weren’t surprised at all. My grandson’s reaction was only that he was sad that I didn’t have a girlfriend at the time.

Eventually, I joined the Jewish me and the lesbian me. I ran for the board at my synagogue, and they needed a bio. I put down that I was an LGBT advocate, and the head of the election committee said, “Don’t you want to take that out?” I said, “No, because that’s who I am: I am a Jewish feminist lesbian activist.

Mother of two, grandmother of three.”

— As told to Laura Bassett, a freelance journalist and commentator on politics, gender and culture

applied to medical school at the age that people usually do and got accepted. By the time I enrolled, I had a 9-month-old baby and a commuter marriage, so when I got pregnant again, it was just too much. I withdrew maybe a week into medical school.

My husband and I settled down, and I stayed home with the kids for a while. Then I experienced a call to ministry and became an Episcopal priest. You can do part-time work in the church, and I thought that was what I would do. But right after I was ordained, my husband took his own life.

With suicide, oftentimes life insurance doesn’t pay, so I found myself with a huge mortgage and four little kids, trying to wonder how on earth I was going to do this. It was a hard time. We sold our big house, and I went to work full time in the church.

But I had never lost the dream to practice medicine.

When I was 50, I started to take stock of the years I had left, and my son said to me, “You know, I’ve heard you talk about this your entire life, and you either need to do it now and sign up tomorrow, or you need to just shut up about it.” And I just decided, you know what, I might as well give this one more shot.

For six months, at night and between services, I was doing flash cards and taking online science courses. On Christmas Eve, we had three services. My sermon was ready, so I sat in my office cramming physics because I was taking the MCAT in January.

On the first day of classes at Wake Forest, as soon as I walked in, the whole room quieted down because everybody thought I was the professor. Same thing with my medical school interviews: When I’d walk into the waiting room, everybody would go silent and sit up really straight, thinking I was the interviewer.

Right now, I’m finishing my second year of residency.

I’m doing two specialties, in family medicine and psychiatry. When I was in the ministry, I traveled around to little Arctic villages in Alaska. There is a high need for treatment of depression and addiction and a high suicide rate, and I would love to serve in a place like that.

— As told to Karen Weese, a freelance writer based in Cincinnati

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COVER STORY Iris Gomez, 63 MILTON, MASS.

Bettye LaVette, 73, WEST ORANGE, N.J.

CHERYL SENTER FOR THE WASHINGTON POST

Immigration lawyer turned novelist

T

here were a lot of barriers to dedicating the time to write a novel, because I was raising two kids and working full time as a lawyer. It took me at least five years to write “Try to Remember,” my first. I gave what I could, which was every Saturday and most Sundays.

I tried to write about these difficult childhood subjects when I was younger, but hitting the right notes came much later. My work has gotten richer as I’ve matured. Dialogue came more naturally than I expected — the sound of people’s voices and the way they express themselves comes back to you. It’s like a fountain of resources that you carry around in your head. Not speaking English when I came to the U.S. from Colombia taught me to really listen to language and to understand context beyond words, and that helped me become a writer.

I’ve always adored the coming-of-age genre, books like “Their Eyes Were Watching God” by Zora Neale Hurston, “Nada” by Carmen Laforet, and writers such as Sandra Cisneros and Luis Álvarez. I found inspiration in my daughter, who was becoming a young woman when I was writing the book; I wanted to leave a lasting legacy for young people like her.

If you have families in your books, you have to live in them, too — it takes a lot of emotional engagement, which is another reason being older helps. You have more endurance for the struggles in your own family and in your fictional families. I learn from my characters’ mistakes.

You can’t wait to have enough money to live your dream. I talk with a lot of people who think there will come a certain point that they’ll have the resources and then can start. But you have to start where you are. Even if you can’t dedicate as much time as you want, you can dedicate some. Take the time you can, and believe in yourself — those are the key ingredients.

— As told to Joelle Renstrom, who writes about robots, space and sci­fi (including for her blog, Could This Happen) and teaches at Boston University

KLMNO WEEKLY

Patricia Forehand, 57 PERRY, GA.

CELESTE SLOMAN FOR THE WASHINGTON POST

MICHAEL A. SCHWARZ FOR THE WASHINGTON POST

Took decades to hit it big

Retired educator turned comedian

I

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n 1962, I was 16, living in Detroit. I heard a band on the radio, and they were appearing at a place called the Graystone Ballroom.

Singer Timmy Shaw was there, and he said, “I know you can sing” and took me to his producer. And in two weeks, I was on the Atlantic Records label.

I recorded a single (“My Man — He’s a Lovin’ Man”), and the label took a demo to the radio stations.

The single came out. And then . . . nothing happened.

That was Career One. I left Detroit and went to New York. I recorded a song called “Let Me Down Easy.” And then what happened?

Nothing.

In 1972, it looked like I might finally have an album. I had a contract with Atlantic for the record. They sent me a stack of plane tickets for the promotion tour. Then they called and said, “We’ve decided not to go forward with the project.”

I was back to performing in Detroit. In the 1970s and 1980s, I had a band. I was doing other people’s songs, and I liked to dance, so that didn’t bother me.

But over the years, my fans got bigger, richer, older.

One in France came to New York and went through the Atlantic Records vaults, and found one of my albums and released it. A friend in Holland had me come over and perform. A friend here knew a producer and released another album. It was like they took my entire career and gave it all to me in a week. This was around 2001, and I was in my mid-50s by then.

In 2008, my husband, Kevin Kiley, found out that the Kennedy Center Honors would pay tribute to George Jones. I had sung one of his songs. Kevin called them.

From that, I performed for the Barack Obama inaugural, and then I did the album “Interpretations,” where I sang other people’s music. I just performed at Carnegie Hall for the 11th time and was nominated for two Grammys.

It’s much better to find success later in life. It takes a very long time to become good.

— As told to Caren Lissner, a writer in New Jersey and the author of the novel “Carrie Pilby”

taught for 32 years in the public school system and grew up in this town where you were supposed to do something practical. I love kids and kind of eased into education because it was what all the females in my generation were eased into — that or nursing or marriage. (I met my husband at Sonic when I was 16, but for me, marriage wasn’t the end-all.)

I grew up admiring Robin Williams, Eddie Murphy and Gilda Radner, and I always tried to get in front of an audience and do speeches. At a teacher’s retirement party three years ago, for instance, I said, “You know it’s time to retire when you’re peeing in your pants more than the kids.” They were just rolling on the floor. A few of my co-workers said I should really try comedy. There was an open mic in Atlanta.

At first, I thought I could never do it. I look like an older, proper lady, and I’m not worldly — I haven’t traveled very far. Even the idea of going alone to Atlanta scared me, just driving and finding a parking place. And all the comics were so young. But I decided I didn’t want to waste another minute.

The first time I went backstage, I thought, “What am I doing up here? I should be at home doing grandmother things, like knitting a damn bootie.” But the other comics were just so welcoming, my friends and family were so supportive, and the audience loved it.

After the open mic, I had trouble getting my feet into the door, as far as getting shows, but then I took Lace Larrabee’s class in 2017, and she really gave me and other women the courage, the strength and the skills to make a difference in this comedy thing. Now, I’m doing shows here and there, mostly women-only lineups, building newer material and trying to get booked more.

After I retired, I took the teacher mask off and really cut loose. I do dirty jokes and — I didn’t even do this around the house! — cuss. I feel like I can be myself again. I worried that I wouldn’t be able to connect to younger audiences, but I know what they’ve gone through, because I’ve gone through it, too. n

— As told to Sonam Vashi, a freelance journalist based in Atlanta

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NATION

For insulin, diabetics drive to Canada BY

E MILY R AUHALA

A

s their minivan rolled north, they felt their nerves kick in — but they kept on driving.

At the wheel: Lija Greenseid, a rule-abiding Minnesota mom steering her Mazda5 on a crossborder drug run.

Her daughter, who is 13, has Type 1 diabetes and needs insulin. In the United States, it can cost hundreds of dollars per vial.

In Canada, you can buy it without a prescription for a tenth of that price.

So, Greenseid led a small caravan last month to the town of Fort Frances, Ontario, where she and five other Americans paid about $1,200 for drugs that would have cost them $12,000 in the United States.

“It felt like we were robbing the pharmacy,” said Quinn Nystrom, a Type 1 diabetic who joined the caravan that day. “It had been years since I had 10 vials in my hands.”

They’re planning another run to Canada this month to stock up on insulin — and to call attention to their cause. This time, they’ll be taking the scenic route, driving from Minnesota through Wisconsin, Illinois and Michigan en route to London, Ontario, where Frederick Banting began the work that led to the discovery of insulin nearly a century ago.

Like millions of Americans, Greenseid and Nystrom are stressed and outraged by the rising costs of prescription drugs in the United States — a problem Republicans and Democrats alike have promised to fix.

Insulin is a big part of the challenge. More than 30 million Americans have diabetes, according to the American Diabetes Association. About 7.5 million, including 1.5 million with Type 1 diabetes, rely on insulin.

Between 2012 and 2016, the cost of insulin for treating Type 1 diabetes nearly doubled, according to the nonprofit Health Care Cost Institute.

Some pharmaceutical companies, under pressure from U.S. lawmakers, have tried to reduce

JENN ACKERMAN FOR THE WASHINGTON POST

Families plan to purchase the lifesaving drug across border, where it’s a tenth of the U.S. price the cost for some patients. But many who rely on insulin still struggle. Large numbers resort to rationing — a dangerous and sometimes deadly practice.

Some diabetics and their families are taking matters into their own hands. They meet in coffee shops and strip mall parking lots to exchange emergency supplies.

An unknown number travel outside the country to buy the lifesaving drug for less.

None of this is recommended

by U.S. officials, and some of it might be illegal under Food and Drug Administration guidelines.

But the organizers of the caravan — their word, a nod to the migrants traveling in groups through Mexico to the U.S. border — are speaking out about their trip because they want Americans to see how drug prices push ordinary people to extremes.

“When you have a bad healthcare system, it makes good people feel like outlaws,” Greenseid said.

“It’s demeaning. It’s demoralizing. It’s unjust.”

The caravaners aren’t the only ones looking north. Republicans and Democrats have produced federal and state proposals to import drugs from Canada.

Those ideas aren’t necessarily popular in Ottawa, where many worry that bulk buys from the United States could cause shortages or higher prices.

Barry Power, director of therapeutic content with the Canadian Pharmacists Association, said the group is tracking both U.S. drugbuying proposals and reports of cross-border trade closely but has yet to see a disruption to Canadian insulin supplies.

He said insulin prices in Canada are controlled through policy, including price caps and negotiations with manufacturers.

“This is something the U.S. could do,” he said.

In the nearly 100 years since insulin’s disovery, it has become a lifeline for millions. But the price in the United States has surged in

Lija Greenseid of St. Paul, Minn., helps her daughter check her blood sugar.

Greenseid organizes insulin-buying trips to Canada.

ways its discoverers could not have predicted.

When Nystrom was diagnosed with diabetes as a child in the late 1990s, she said, her family paid about $15 to $20 a vial. Now, at 33, she sometimes pays more than $300 for the same amount.

Nicole Smith-Holt, who drove north with Greenseid and Nystrom, said her son spent about $1,000 per month on the drug.

Alec Raeshawn Smith, an uninsured Type 1 diabetic, rationed his insulin supply due to cost, his mother said. He died in 2017.

Elizabeth Pfiester is founder and executive director of T1International, a British-based nonprofit that advocates for people with Type 1 diabetes around the world.

Pfiester grew up in the United States. One of the reasons her organization is based overseas, she said, is that the cost of treating her diabetes in the United States is so high.

A spokeswoman for the Pharmaceutical Research and Manufacturers of America noted that drug companies are increasingly offering rebates on insulin in the United States — but they aren’t always reaching consumers.

“Too often, these negotiated discounts and rebates are not shared with patients, resulting in the sickest patients paying higher out-of-pocket costs to subsidize the healthy,” PhRMA spokeswoman Holly Campbell said in an email. “This is the opposite of how health insurance is supposed to work.” ow much you are going to pay.”

In the United States, you can buy some types of insulin without a prescription. But to get the newer analog insulin on which Type 1 diabetics rely, you need to visit or call your doctor.

If Nystrom forgets to pack enough for an extended trip, she said, she needs to get her endocrinologist on the phone. In Canada, she can walk into a pharmacy and get the analog insulin she needs.

“The attitude up there is: ‘Why would someone buy insulin if they didn’t need it?’ ” Nystrom said. n

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KLMNO WEEKLY

FIVE MYTHS

Fast food BY

A DAM C HANDLER

There may be no American institution more polarizing than fast food. Whether it’s wages, health, the environment or those Colonel Sanders ads, the problems associated with the all­American meal inspire lots of detractors. But for many millions, places like McDonald’s, Taco Bell and Steak ’n Shake generate fierce loyalty for their convenience, value, ritual, shock­and­awe menu items and community; the Centers for Disease Control and Prevention reported in 2018 that more than one­third of Americans eat fast food on any given day. As the summer season of road trips and Frosties enters full swing, here are five myths about fast food.

MYTH NO. 1 The primary customers are low-income families.

For decades, the world of inexpensive, quick-service food has been associated with the American underclass.

But fast food’s appeal crosses all demographic lines, from income to age to ethnicity. Studies and surveys show that fast food is most popular among the upper-middle income brackets. “Wealthier Americans — those earning $75,000 a year or more — are more likely to eat it at least weekly (51 percent) than are lower-income groups,” a 2013 Gallup survey found. “Those earning the least actually are the least likely to eat fast food weekly — 39 percent of Americans earning less than $20,000 a year do so.” These findings were reinforced in a similar CDC study released in 2018, which showed that a higher percentage of diners who live above the poverty line eat fast food on a given day than those below it.

MYTH NO. 2 Fast-casual dining is healthier than fast food.

One trend to emerge from the backlash against fast food has been fast-casual restaurants, marketed as having healthier food with better-quality ingredients — still served quickly.

While fast-casual darlings cashed in, a few studies dumped sour cream on these misperceptions. In 2015, the New York Times revealed that “the typical order at Chipotle has about 1,070 calories,” more than half the daily calories recommended for most adults.

Then, researchers at the University of South Carolina compared entrees at more than 60 fast-food and fastcasual restaurants and found that the fast-casual offerings averaged 200 calories more than fast food.

MYTH NO. 3 The McDonald’s ‘hot coffee’ lawsuit was frivolous.

In 1992, a 79-year-old retiree named Stella Liebeck spilled a scalding cup of McDonald’s coffee on herself while sitting in the passenger seat of a parked car.

After a New Mexico jury awarded Liebeck $2.7 million in punitive damages, the episode became an international sensation. In news broadcasts, for example, it was reported that Liebeck had spilled while carelessly driving down the road. She was mocked as craven, greedy and an unpatriotic abuser of the legal system.

But Liebeck had truly suffered — 16 percent of her body was burned, including 6 percent with third-degree burns, and her injuries required multiple skin

CHRISTOPHER DILTS/BLOOMBERG

Fast food isn’t necessarily the least-healthy dining option, and it shouldn’t be blamed entirely for the increase in obesity. Factors such as exercise, genetics and access to health care also come into play.

grafts and an eight-day hospital stay. Liebeck filed a claim for $20,000 to cover her medical bills and took McDonald’s to court only after the company offered her just $800. The huge award was the jury’s decision and was later heavily reduced by a judge. Finally, the sides settled out of court, reportedly for less than half a million dollars.

MYTH NO. 4 Fast food causes obesity.

But the difference between correlation and causation makes the picture more complicated.

For example, two new major studies have linked ultraprocessed food — the factoryproduced, additive-heavy, industrialized items often found in boxes of nuggets and soda fountains — to premature death and cardiovascular disease. And yet the researchers could empirically connect obesity only to the human tendency to overeat. “The simple fact that fast food restaurants and obesity have both increased over time is insufficient proof of this link, as are studies that rely on differences in fast food consumption across individuals,

since people who eat more fast food may be prone to other behaviors that affect obesity,” the National Bureau of Economic Research notes. Factors such as exercise, smoking rates, air quality, genetics and access to health care also come into play.

MYTH NO. 5 Fast-food jobs are entry-level work for teenagers.

Yet according to recent data from the Bureau of Labor Statistics, the median age of a fast-food worker is just over 26 years old. Since 2000, more teenagers have opted out of work altogether, with the workforce participation rate among 16-to19-year-olds dropping from just over 50 percent to 34 percent.

This has created an opening for more seniors and foreign-born workers to step into the breach.

In fact, McDonald’s recently joined companies like Google and Macy’s in partnering with AARP to recruit retirees and older employees. n Chandler is a Brooklyn-based writer and the author of the forthcoming “Drive-Thru Dreams,” a book about the fast-food industry.

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POLITICS

Race is on to detect ‘deepfake’ videos

ASSOCIATED PRESS

Researchers fear seamless fabrications will become devastating political tools BY

D REW H ARWELL

T

op artificial-intelligence researchers across the country are racing to defuse an extraordinary political weapon: computer-generated fake videos that could undermine candidates and mislead voters during the 2020 presidential campaign.

And they have a message: We’re not ready.

The researchers have designed

automatic systems that can analyze videos for the telltale indicators of a fake, assessing light, shadows, blinking patterns — and, in one potentially groundbreaking method, even how a candidate’s real-world facial movements relate to each other, like the angle they tilt their head when they smile.

But for all that progress, the researchers say they remain vastly overwhelmed by a technology they fear could herald a damaging

new wave of disinformation campaigns, much in the same way fake news stories and deceptive Facebook groups were deployed to influence public opinion during the 2016 race.

Powerful new AI software has effectively democratized the creation of convincing “deepfake” videos, making it easier than ever to fabricate someone appearing to say or do something they didn’t really do, from harmless satires and film tweaks to targeted ha-

An image created from a fake video of former president Barack Obama displays elements of facial mapping used in new technology that allows users to create convincing fabricated footage of real people, known as “deepfakes.”

rassment and deepfake porn.

And researchers fear it’s only a matter of time before the videos are deployed for maximum damage — to sow confusion, fuel doubt or undermine an opponent, potentially on the eve of a White House vote.

“We are outgunned,” said Hany Farid, a computer-science professor and digital-forensics expert at the University of California at Berkeley. “The number of people working on the video-synthesis

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POLITICS side, as opposed to the detector side, is 100 to 1.”

These AI-generated videos have yet to drive their own political scandal in the United States. But even simple tweaks to existing videos can create turmoil, as happened with the recent viral spread of a video of House Speaker Nancy Pelosi, distorted to make her speech stunted and slurred. That video was viewed more than 3 million times.

Deepfakes have already made their appearance elsewhere: In central Africa last year, a video of Gabon’s long-unseen president Ali Bongo, who was believed in poor health or already dead, was decried as a deepfake by his political opponents and cited as the trigger, a week later, for an unsuccessful coup by the Gabonese military.

And in Malaysia, a viral clip of a man’s seeming confession to having sex with a local cabinet minister is being questioned as a potential deepfake.

The threat of deepfakes, named for the “deep learning” AI techniques used to create them, has become a personal one on Capitol Hill, where lawmakers believe the videos could threaten national security, the voting process — and, potentially, their reputations.

Rachel Thomas, the co-founder of Fast.ai, a machine-learning lab in San Francisco, says a disinformation campaign using deepfake videos would likely catch fire due to the reward structure of the modern Web, in which shocking material drives bigger audiences — and can spread further and faster than the truth.

No law regulates deepfakes, though some legal and technical experts have recommended adapting current laws covering libel, defamation, identity fraud, or impersonating a government official. But the dividing line between a First-Amendment-protected parody and deepfake political propaganda may not always be clear-cut.

In a Pew Research study released this month, about twothirds of Americans surveyed said altered videos and images had become a major problem for understanding the basic facts of current events. More than a third said “made-up news” had led them to reduce the amount of news they get overall.

There also are fears that deepfakes could lead to people denying

MAURY PHILLIPS/GETTY IMAGES/SAG-AFTRA

legitimate videos — a phenomenon the law professors Robert Chesney and Danielle Citron call “the liar’s dividend.” President Trump, for instance, has told people the “Access Hollywood” video, in which he boasted of assaulting women, was doctored. (After the real audio was first revealed by The Post in October 2016, Trump apologized for the remarks.)

Officials with the Democratic and Republican parties and the nation’s top presidential campaigns say they can do little in advance to prepare for the damage, and they are counting on social networks and video sites to find and remove the worst fakes.

But the tech companies have differing policies on takedowns, and most don’t require that uploaded videos must be true.

The technology is progressing rapidly. AI researchers at the Skolkovo Institute of Science and Technology in Moscow last month unveiled a “few-shot” AI system that could create a convincing fake of someone with only a few still photos of their face. The lead researcher, Egor Zakharov, said he could not discuss it due to ongoing peer review, but in a statement the

team said that the “net effect” of making video special-effects technologies more widely available “has been positive . . . (and) we believe that the case of neural avatar technology will be no different.”

Another group of AI researchers, including from Stanford and Princeton universities, just debuted a separate system that can edit what someone appears to be saying on video, just by changing some text, with the AI swapping around the person’s voiced syllables and mouth movement to leave only a seamlessly altered “talking head.”

The lead researcher, Ohad Fried, said the technology could be used to enhance low-budget filmmaking and help localize videos to international languages and audiences. But he also said it could be abused to falsify video or “slander prominent individuals.” Video made using the tool, he said, should be presented as synthetic.

But he said regulators, tech companies and journalists should play a more leading role in researching how to unmask.

“In general people do need to understand that video may not be

an accurate representation of what happened,” he said.

Deepfake video is just one part of how AI is revolutionizing disinformation. New natural-language AI systems like GPT-2, by the research lab OpenAI, can feed on written text and spit out many more paragraphs in a similar tone, theme and style — a boon, perhaps, to spam chatbots and “fake news” creators, even if the underlying ideas sometimes trend toward gibberish.

Convincing fake audio is also on the horizon, including from Facebook AI researchers, who have replicated a person’s voice using computer-generated speech that sounds deceivingly lifelike.

Much of the funding for researching ways of detecting deepfakes comes from the Defense Advanced Research Projects Agency, the Pentagon’s high-tech research arm, which in 2016 launched a “Media Forensics” program that sponsored more than a dozen academic and corporate groups pursuing high-level research. Matt Turek, a computer-vision expert who leads the DARPA program, called synthetic-media detection a “defensive technology” against not just foreign adversaries but domestic political antagonists and Internet trolls.

The trick for unraveling a deepfake, researchers said, is building a tool that works in what cryptography circles call a “trustless environment,” where authoritative details of the video’s creator, origin and distribution can be impossible to trace. And speed is critical: With every minute that an investigator spends debunking video, a clip can expand that much further across the Web. Forensic researchers have homed in on a range of subtle indicators that could serve as giveaways, such as the shape of light and shadows, the angles and blurring of facial features, or the softness and weight of clothing and hair.

With one new method, researchers at the universities of California at Berkeley, and Southern California, built a detective AI system that they fed hours of video of high-level leaders and trained it to look for hyper-precise “facial action units” — data points of their facial movements, tics and expressions, including when they raise their upper lip and how their heads rotate when they frown. n

KLMNO WEEKLY

“In general people do need to understand that video may not be an accurate representation of what happened.”

Ohad Fried, a researcher in artificial intelligence

Digital forensics expert Hany Farid said the ratio of those working on synthesizing deepfakes versus detecting them is “100 to 1.”

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