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For pregnant women, the future is herejust in time for an urgent healthcare crisis. In the U.S., maternity care deserts are growing, often leaving communities completely without options. And despite the numerous warnings, nationwide maternal mortality data still paints a dire picture for pregnant women (especially rural women and women of color) who face preventable risks. Its a hard reality, but one where technology can be up to the task, helping humans improve outcomes and increase access in innovative ways. That means more remote tools and apps that help women monitor their vital signs, get information, and advocate for themselves. Also data-rich systems that allow health data to be shared securely with doctors, allowing for easier monitoring in-between visits. And now, AI-powered doulas that offer 24/7 support at a time when doctors visits are rushed and sometimes even nonexistent. If youre skeptical of AI, youre definitely not alone. Across sectors, the rise of AI has come with plenty of promises, many of which have fallen short. But as someone who had her own pregnancy scare, which led me to develop a pregnancy app and AI doula with a human-centered approach, I’ve come to understand that maternal health is a challenge that AI may be uniquely suited to face. Not as a replacement for real doctors and doulas, but rather as a way to empower them and the people they servelowering costs, increasing their reach and effectiveness, and helping bridge a growing healthcare gap. But first, the companies building these AI assistants have to do more than move fast and break thingsthey must earn trust. A helping hand Obviously, AI doulas are not a cure-all when it comes to the complex issues pregnant women face as a result of our imperfect system. After all, AI still does not have the nuance to automatically navigate unwieldy situations where details matter. To see what I mean, try experimenting with AI image generation tools and enter in pregnant mother cradling her belly. The moment you specify an ethnicity, youll notice a difference in image qualityAfrican American and Native American images have the wrong number of fingers, mismatched eyes, or any number of other deficiencies in comparison to white and Asian ones. This suggests an error in the training data and an insufficiency across certain groups. If this is happening with basic image generation tools, imagine the impacts in clinical decision support tools. That said, Ive seen firsthand that AI is really good at culling through medical imaging, such as ultrasounds and MRIs, to make conclusions about the presence or absence of certain criteria or conditions. It is also really good at communicating confusing medical results in a way that everyone can understand. Thats what makes AI doulasaided by and leveraged alongside real doulas and medical professionalsa perfect application of the technology. They can remove many of the barriers of communication, information, and cost that currently plague the maternal health system. Curbing costs, in particular, cant be underestimated. Despite the very important historical and cultural role that they fill, especially in BIPOC and rural communities, real doulas are still a sizable investment on behalf of an expecting family and are not consistently covered by insurance. AI can stand in for doulas after hours without increasing costs or acting as a replacement for the real thing. Then there are the instances when women have questions that might be uncomfortable or make them feel too awkward to ask a friend, member of their care team, or their partner. Or, since pregnancy can be lonely, people might not have a trusted person in their network to ask questions. Other times, distrust between women and their doctorsespecially when it comes to disclosing mental health issuesresults in important warning signs falling through the cracks. In these circumstances, the comfort of an AI doula can calm anxieties, give women control, and provide useful answers to help them advocate for the care they need. Combating skepticism But if AI doulas are to have a positive impact on womens lives (not just on health tech companies bottom lines), we must learn to trust it. That means its crucial that theyre developed in ways that strengthen whats already working rather than promising to disrupt everything completely. Disruption may seem like an exciting blueprint for innovation, but its an ineffective philosophy for building trust. So instead, conceptualize the technology as a support tool, not a substitute for doctors or the human connection and cultural wisdom doulas bring. Do the important work of giving women a sense of ownership in every AI feature, embodying a deep understanding of how the tech impacts not just pregnant women but the communities around them. This is true for all women, but especially those from minority communities facing mistrust born from longstanding maternal mortality inequities. Its not an easy task. For our personal virtual doula, Aria, we talked to hundreds of doulas over the course of a long development, involving birth and community members directly in the design, testing, and rollout so we were confident it reflected lived realities and priorities. We are also transparent about how any data on our app is used, stored, and protected and this helps to allay concerns, especially in communities with a legacy of medical mistrust. Above all, AI must enhance the human qualities that make doulas and healthcare providers invaluable parts of the pregnancy journey. Care and comfort must not be sacrificed for efficiencyfor pregnant women and their doulas, too. After all, being a doula is more than an occupation to be disrupted. Its a calling that must be nurtured if they are to continue to play a crucial role in improving maternal health. With the right approach and eventual trust, families can leverage AI to navigate an evolving maternal health landscape with more confidence and continuity.
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On October 24, 2024, tens of thousands of fans lined the streets of lower Manhattan to celebrate their latest hometown championship team, the New York Liberty. They gathered to cheer current players, including Finals MVP Jonquel Jones, and former legends whod taken the team to the brink of a title in five previous seasons. But the parades biggest draw may have been the teams mascot, Ellie the Elephant. As the parade made its way along the Canyon of Heroes, Ellie moved from float to float, pounding her feet in sync with the music, doing her signature dance move, the Ellie Stomp. The parade terminated at City Hall for the official ceremony, and shortly after Mayor Eric Adams delivered a perfunctory speech, Ellie surprised the crowd by taking the stage and cajoling Liberty player Kennedy Burke to join her in an impromptu dance-off. Ellie famously never utters a word but communicates with a lingua franca of expressive body language and gestures. Before the dancing started, Ellie casually handed her couture purse to the mayor. Kennedy Burke I was a little nervous, but Ellie calmed my nerves because she is so unapologetically herself. I was like, you know what? Shes going to have a good time. Im going to have a good time. I just kind of fangirled because I love Ellie. Liberty fan Ava Brock It was hilarious having Mayor Adams hold her purse. It was the kind of crowd-pleasing moment that has made Ellie a viral sensation. Liberty Chief Brand Officer Shana Stephenson The performer is from Brooklyn. They sing, they dance, they understand what it means to connect with an audience. Brock She is who she is. Walking up to you, kissing you with her trunk and everything. Thats how New York is. Take us or leave us. You can be who you wanna be and no ones looking at you crazy. Stephenson Ive seen Ellies impact on fans who are 70 years old and fans who are 7 years old. The LGBTQ+ community identifies with Ellie. Black women identify with Ellie. Youth identify with Ellie. The way that she dresses, the way that she dances. Burke She can do any dance in this world. Salsa. Hip-hop. Im pretty sure she can do some ballet. Her versatility is just out of this world. Liberty CEO Keia Clarke One of the secret touches of Ellie is that she wears real shoes. Ellie wears sneakers, not big mascot feet. [She wears custom Nike Sabrina 2 By Big Ellie shoes.] While the team closely guards the identity of the performer inside the elephant costume, theres no hiding the impact Ellie has had since her debut when the team moved to Brooklyns Barclays Center in 2021: Her more than 350,000 followers on TikTok and Instagram helped drive the teams social engagement up 665% last year, and 24 of the Libertys 51 sponsors are new, including 19 that have never before partnered with a WNBA franchise. Ellie has played a key role in the partnerships with Fenty, Essie, Away, Shake Shack, and Pinterest. Stephenson Shes helped accelerate our growth and our visibility. Ellie is allowing us to be innovative in how we approach our partnership relationships. Shes opening up new doors. Clarke We have Ellie activations included in a lot of our partnership deals. Stephenson Brooklyn is our home, so [that evening] we had a celebration at Barclays Center that included a performance by Fat Joe and Remy Ma. Lil Mama came out and surprised everyone. Ellie came onstage and did the Ellie Stomp. Clarke Elephants are strong and resilient. Elephants are matriarchal. Elephants have remarkable memories, and we didnt want to forget where we came from.
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Transportation policy and infrastructure are determined by what the most influential lobbyists spend their resources on. If one of the old investigative journalism shows was publishing a story on this topic, theyd probably call the segment “Power Play: How Lobbyists Shape Transportation Infrastructure.” The grandfatherly voice would open up with, The corridors of power are often unseen, but their impact is felt by all. Dun dun dun. Its kind of their thing to sound over-the-top, but lobbying certainly deserves that sort of big-voiced, you-wont-believe-what-comes-next vibe. Lobbyists collect money from clients in order to buy legislation. In the olden days, they would stand in the Capitol lobby like it was some kind of high-stakes trading post. {"blockType":"creator-network-promo","data":{"mediaUrl":"","headline":"Urbanism Speakeasy","description":"Join Andy Boenau as he explores ideas that the infrastructure status quo would rather keep quiet. To learn more, visit urbanismspeakeasy.com.","substackDomain":"https:\/\/www.urbanismspeakeasy.com\/","colorTheme":"green","redirectUrl":""}} Transportation lobbyists have long been players in the political arena. Road building contractors, truckers, civil engineers, and labor unionsthey all funnel substantial sums of money into political campaigns because they want access to decision-makers and key influencers so they can shape legislation to their advantage. How to buy a bill From leveraging personal relationships and funding political campaigns to offering miraculous investment advice, a lobbyists objective is to sway decisions in favor of their clients. Their reach extends to drafting legislation, providing input on regulations, and shaping the allocation of funds for infrastructure projects. Details about this stuff are accessible all over the internet. Here are the best places to start: OpenSecrets.org Center for Responsive Politics Lobbying Disclosure Database Lobbyists spent $267 million on issues related to ground transportation in 2021, making it the sixth-most lobbied sector in the United States; that amount helped the ground transportation lobbyists win 72% of the bills they were trying to get authorized. Think about that win ratethey get what they want three out of four times. Heres a sample of the top spenders in a single year: American Trucking Associations ($18.5 million) United States Chamber of Commerce ($16.5 million) National Automobile Dealers Association ($15.5 million) American Public Transportation Association ($14.5 million) Railway Supply Institute ($14 million) American Road & Transportation Builders Association ($13.5 million) FedEx ($12.5 million) Uber Technologies ($12 million) Lyft ($10 million) National Highway Traffic Safety Administration (NHTSA) ($10 million) When you hit #10, I hope you heard the sound of a record scratch. NHTSA, a government agency, is paid by the government to lobby the government. Theyre the agency responsible for safety regulations, including life-or-death issues like truck underride crash prevention and automaker recalls. You know, the issues that those top lobbyists dont ever want to see brought before Congress. The feds are paying NHTSA to push for policies that improve safety. And NHTSAs recommendations are heavily influenced (sometimes even drafted by) trucking and automotive lobbyists. I know, they dont teach about widespread corruption in the kids cartoon about how a bill is made. NHTSA isnt alone. The Food and Drug Administration (FDA), Federal Trade Commission (FTC), Environmental Protection Agency (EPA), Securities and Exchange Commission (SEC), Federal Communications Commission (FCC) . . . name an industry, and theres a government agency that gets paid by the government to lobby the government. Is lobbying good or bad? Yes. Lobbying is the art of persuading and influencing policymakers to shape laws, regulations, and policies in favor of specific interests. Lobbyists act as intermediaries to policymakers. Their influence is measured in terms of financial contributions, personal relationships, and the nature of their expertise. But the thing that really matters is the legislation that gets passed or scrapped. The auto-oriented groups are by far the most funded, so they have the most influence. I have a bias for healthy neighborhoods. You know what it takes in modern America to abolish unhealthy policy that leads to junk infrastructure? Lobbying. I dont see how thats avoidable in the short term. Lobbying creates winners and losers. Winners are generally the large corporations and politicians. The percentage of congressional politicians who get into lobbying jumped from 3% to 50% just in my lifetime. When you include indirect policy-influencing jobs, the number is close to 60%. Its even more skewed in transportation, with close to 2,000 registered lobbyists, nearly 70% of whom previously worked in government. Losers are generally the people trying to reduce the number of Americans being injured or killed as a result of transportation policy. I dont know if money makes the entire world go round, but it definitely makes or breaks political careers. Campaign donations, super PACs (political action committees), and corporate-funded think tanks all play a role in greasing the wheels of influence. Its not a coincidence that public servants at the national level are able to live so lavishly. Theyre rewarded based on their votes. Lobbyists do provide valuable insights to policymakers, helping them make informed decisions. They write the tl;dr summaries for elected leaders. Its not all show me the money antics. Whether or not lobbying should exist at all is a worthwhile conversation. But for you and me, right now in todays environment, it helps to at least be aware of lobbyings purchasing power. {"blockType":"creator-network-promo","data":{"mediaUrl":"","headline":"Urbanism Speakeasy","description":"Join Andy Boenau as he explores ideas that the infrastructure status quo would rather keep quiet. To learn more, visit urbanismspeakeasy.com.","substackDomain":"https:/\/www.urbanismspeakeasy.com\/","colorTheme":"green","redirectUrl":""}}
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