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Every year in the United States, thousands of families face a devastating reality: Their child has a rare disease, but they wont know it until its too late for effective intervention. Thirty percent of children with rare diseases dont live to see their fifth birthday. For too long, weve relied on limited newborn screening panels that vary from state to state, waiting until symptoms are severe and irreversible before acting. This approach is not only medically irresponsible, its fiscally unsound.Experts estimate rare diseases cost the U.S. healthcare system $1 trillion annually. Beyond the cost to our healthcare system, families too often find themselves in the position of becoming medical experts just to care for their child, taking them away from work and other loved ones, creating an immeasurable burden on the entire family. As professionals who have spent their entire careers at the intersection of science, policy, and innovation, we believe we are standing at a pivotal moment where the status quo is no longer acceptable. We must approach diagnosing rare diseases at birth differently via genome sequencing. The science has never been more promising. The economics have never made more sense. And the human cost of inaction has never been higher. EARLY DIAGNOSIS, EARLY TREATMENT Earlier diagnosis of rare diseases is not a luxuryit is a moral and financial imperative for modernizing our health system. Take the case of KJ, a baby treated at the Childrens Hospital of Philadelphia. Born with a deadly genetic disease called CPS1 deficiency, KJ was diagnosed early and became one of the first children to receive gene therapy tailored to his specific mutation. That treatment didnt just save his life. It also likely saved millions in long-term healthcare, special education, and disability costs that the system would otherwise have shouldered for decades.This is the future we should be building toward: one where precision medicine is equitable, made possible by genomic newborn screening and next-generation gene therapies. One that prevents suffering and reduces the strain on public and private healthcare dollars alike. We already screen every baby born in the U.S. for certain conditions. But our current panel only scratches the surface. Thousands of serious, treatable genetic disorders go undetected every day because we havent modernized our approach. We can change that. We believe in a future where a single, affordable, and actionable genomic newborn screening at birth can identify hundreds of early-onset genetic conditions with established therapies and treatments. This allows for timely intervention that not only saves our healthcare system valuable resources but, most importantly, spares families unnecessary suffering. Lets be clear: Earlier diagnosis leads to better outcomes. Children with spinal muscular atrophy, for example, can now receive treatment in the first weeks of life that dramatically improves survival and quality of life. Thats only possible when they are diagnosed before symptoms begin. Delay by even a few months leads to expensive and tragic outcomes. POLICY CHANGES We need leadership to ensure genomic newborn screening is available to every child. I applaud Florida State Representative Adam Anderson for championing groundbreaking initiatives in newborn screening by sponsoring the Sunshine Genetics Act (HB 907), which is establishing free, opt-in whole genome sequencing for newborns in Florida. Public-private partnerships, federal investment in data infrastructure, and updates to newborn screening policy can all move the needle without increasing the deficit. Were already seeing progress with the recently announced BEACONS initiativethe countrys first multi-state genomic newborn screening initiative. Funded by a $14.4 million award from the National Institutes of HealthCommon Fund Venture Program, this program is laying the early groundwork for integration of whole genome sequencing into existing state newborn screening systems by examining the feasibility of incorporating genomic newborn screening into the public health system. BEACONS is just the beginning of a future where we envision a national standard for genomic sequencing at birth, grounded in early intervention, which can transform the lifetime health of the next generation of Americans. This transformation is about unleashing the power of American innovation in partnership with the families, clinicians, and researchers who are working tirelessly to transform care. Its about enabling the next generation of gene editing and cell therapy technologies to succeed by ensuring we catch the diseases they can treat early enough to make a difference. Importantly, we have the support of policymakers on both sides of the political aisle. Representatives Mike Simpson (R-ID), Kelly Morrison (D-MN), Nick Langworthy (R-NY) and Kim Schrier (D-WA) reintroduced the Newborn Screening Saves Lives Reauthorization Act. This legislation was moved forward in September to the full committee. Senators Roger Wicker (R-MS) and Maggie Hassan (D-NH) continue to champion the issue on the Senate side. The bipartisan bill will renew and strengthen existing newborn screening programs. This bill is the first step. The next step is ensuring all newborns have access to the latest genetic tests so we can screen for the full range of treatable rare diseases and genetic conditions. The Genomic Answers for Children’s Health Act, which is awaiting introduction in Congress, will be crucial to these efforts as this legislation would further increase access to critical genomic testing. CHILDHOOD HEALTH MUST BE ADDRESSED The current drumbeat of the U.S. government is driven by calls for efficiency and a childhood health crisis that must be addressed. Republican lawmakers have long championed policies that are fiscally responsible, pro-innovation, and pro-life. Supporting expanded early diagnosis of rare diseases is squarely aligned with these values. It reduces long-term entitlement spending, encourages market-bsed innovation, and gives every child a fighting chance at life. As policymakers debate the future of healthcare and innovation in America, we urge them to look closely at the rare disease community. What theyll find is not just a population in need, but a blueprint for smarter, more sustainable, and more compassionate healthcare. The tools are here. The evidence is clear. The time is now. Britt Johnson, PhD, FACMG is the SVP of medical affairs at GeneDx. Katherine Stueland is the CEO of GeneDx.
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The world of popular psychological ideas, which is largely the self-help industry, is not short of contradictions. For instance, it simultaneously promotes the benefits of emotional intelligence (the ability to empathize with others and engage in strategic impression management) and authenticity (the tendency to express what you really feel and think without much consideration for others opinions). It also frequently celebrates self-acceptance and constant self-improvement (love yourself as you are but also become the best version of yourself), mindfulness and relentless ambition (stay in the zone, present and serene while hustling aggressively toward big goals), and even self-awareness and self-belief, which pull in opposite psychological directions. Self-awareness requires confronting your flaws, limitations, and blind spots with brutal honesty; self-belief requires ignoring at least some of that evidence to maintain high-levels of confidence, optimism, and drive. One asks you to see yourself clearly; the other asks you to believe in yourself despite what you see. Yet this isnt a logical flaw so much as a reflection of our human tendency to categorize things as either fully good or fully bad, when in reality most psychological qualities operate in a yinyang balance. As Aristotle argued in his doctrine of the golden mean, virtue itself sits at the midpoint between two vices courage between cowardice and recklessness, generosity between stinginess and extravagance, confidence between timidity and hubris. In other words, even the qualities we most admire become dysfunctional when taken too far, and even the traits we distrust can be valuable in moderation. Human behavior functions the same way: most psychological strengths arent inherently good or bad, theyre dose-dependent. In line, emotional intelligence isnt inherently superior to authenticity; self-awareness isnt automatically better than self-belief. They each contain the seed of their opposite, and their value depends on the situation, dosage, and context. In fact, one of the most established findings in personality and organizational psychology is the too-much-of-a-good-thing effect: virtually any trait or competency becomes dysfunctional when taken to an extreme. Confidence turns into arrogance, humility into self-doubt, authenticity into impulsive oversharing, and EQ into manipulative charm. Every strength has a shadow side, every virtue has a saturation point, and every desirable trait comes bundled with its own trade-offs. The goal, then, is not to pick one pure ideal authenticity or impression management, self-awareness or self-belief but to learn to calibrate them, blending them in ways that make us more effective, rather than more extreme. {"blockType":"mv-promo-block","data":{"imageDesktopUrl":"https:\/\/images.fastcompany.com\/image\/upload\/f_webp,q_auto,c_fit\/wp-cms-2\/2025\/10\/tcp-photo-syndey-16X9.jpg","imageMobileUrl":"https:\/\/images.fastcompany.com\/image\/upload\/f_webp,q_auto,c_fit\/wp-cms-2\/2025\/10\/tcp-photo-syndey-1x1-2.jpg","eyebrow":"","headline":"Get more insights from Tomas Chamorro-Premuzic","dek":"Dr. Tomas Chamorro-Premuzic is a professor of organizational psychology at UCL and Columbia University, and the co-founder of DeeperSignals. He has authored 15 books and over 250 scientific articles on the psychology of talent, leadership, AI, and entrepreneurship. ","subhed":"","description":"","ctaText":"Learn More","ctaUrl":"https:\/\/drtomas.com\/intro\/","theme":{"bg":"#2b2d30","text":"#ffffff","eyebrow":"#9aa2aa","subhed":"#ffffff","buttonBg":"#3b3f46","buttonHoverBg":"#3b3f46","buttonText":"#ffffff"},"imageDesktopId":91424798,"imageMobileId":91424800,"shareable":false,"slug":""}} Hidden drawbacks At times, even traits that seem to have no downside, such as self-awareness, come with hidden drawbacks. Intuitively, one would assume that we are generally better off knowing ourselves, understanding how others perceive us, and being aware of our strengths, limitations, biases, and blind spots. After all, entire leadership models, coaching programs, and HR philosophies rest on the idea that insight precedes improvement. If you dont know whats broken, how can you fix it? If you dont know how others experience you, how can you expect to lead them? And if you dont understand your own motives, how can you trust your decisions? To be sure, this intuition is backed by a substantial body of research. For example, many scientific studies show that: 1) Self-awareness predicts better job performance. Employees with higher self-insight (as measured through multisource or 360-degree feedback assessments) tend to show greater effectiveness at work, including when they are managers and leaders.2) Self-awareness enhances leadership effectiveness. Leaders who are more attuned to their strengths and weaknesses receive higher performance ratings and foster better team climates (note, however, that underestimating your skills and leadership talents is also linked to higher leadership effectiveness compared to people who overestimate themselves).3) Self-awareness improves interpersonal relationships. Individuals who understand their emotional patterns and their impact on others display higher empathy and lower conflict. Its simple: if you know how you impact others, which equates to knowing how others see you, it will be easier for you to adjust your behavior to make a desired impact on others (this is what David Brent and Michael Scott fail to do, which makes The Office great comedy value but their characters an absolute nightmare archetype of a boss). The value of selective ignorance However, there are also well-documented benefits to poor self-awareness or, more precisely, benefits to selective ignorance, including being unaware of your limitations or unjustifiably pleased with yourself. Think of people with the arrogance or confidence of Kanye West, Cristiano Ronaldo, or Muhammad Ali but without the talents to back it up! Consider the following findings: First, people with inflated self-views tend to be more resilient and less affected by stress, being able to bounce back faster and stronger from setbacks. Along the same lines, decades of research on positive illusions shows that overly optimistic people cope better with adversity and maintain higher motivation. Second, self-deception can make individuals more persuasive: people who genuinely believe they are more competent than they are often appear more confident and convincing to others. If you can fool yourself, you are much more likely to fool others, since you dont even have to pretend or lie. Third, low self-awareness can fuel ambition. Many entrepreneurs, athletes, and leaders overestimate their odds of success and this unrealistic optimism propels them to attempt things that a more accurate self-assessment would quickly veto. The worlds innovations are not driven by people with perfectly calibrated self-views, but by those who believed they could fly even when the evidence suggested otherwise. All of which is to say: the self-help promise of clean, linear psychological virtues overlooks how messy human functioning actually is. A bit like nutrition advice that alternates between demonizing carbs, demonizing fat, and demonizing sugar (sometimes all three, and at times none), the self-help world tends to spotlight traits in isolation, ignoring the context in which they operate. Authenticity is wonderful until its not. Confidence is powerful until it becomes delusion. Empathy is admirable until it becomes people-pleasing. Even mindfulness has a dark side when it becomes an excuse for avoidance or emotional disengagement. A tool box A more realistic (and scientifically grounded) way of thinking about psychological qualities is to view them as tools in a repertoire. A hammer is useful, but not if you treat every situation as a nail. Emotional intelligence is helpful, but not if it turns into strategic manipulation. Authenticity is refreshing, but not if it comes at the expense of tact, professionalism, or prosocial self-regulation. And self-awareness is enlightening, but not if it becomes rumination, self-criticism, or paralysis by analysis. The true art of psychological competence, especially in leadership, is not picking the right trait but deploying the right trait at the right time. Its knowing when to believe in yourself fiercely, and when to question your assumptions. When to be transparent, and when to filter. When to push ruthlessly, and when to pause reflectively. When to take a risk, and when to seek feedback. Most importantly, its recognizing that every psychological asset becomes a liability when unbounded, and every liability contains the seed of an asset when calibrated properly. If the self-help industry were more honest, it would sound far less like a collection of tidy commandments and far more like a user manual for a complex operating system: one with settings, thresholds, sliders, and context-specific modes. But it depends will never be a bestseller, and everything in moderation is hardly a motivational tagline. So instead, we get a contradictory buffet of directives be yourself, but improve yourself; relax, but hustle; speak your truth, but avoid offending anyone; know your flaws, but never doubt your greatness. The irony, of course, is that mature psychological functioning lies precisely in reconciling these tensions. Not by choosing sides, but by developing the agility to move fluidly between them. In the end, the real contradiction is not in the advice we receive, but in our desire for simple answers to complex questions. Human nature is too nuanced for single-variable solutions, and the qualities that make us effective are rarely pure. They are contradictions held in balance (the yin and yang of psychological functioning) and the leaders who thrive are those who learn to navigate this paradox elegantly, not dogmatically. {"blockType":"mv-promo-block","data":{"imageDesktopUrl":"https:\/\/images.fastcompany.com\/image\/upload\/f_webp,q_auto,c_fit\/wp-cms-2\/2025\/10\/tcp-photo-syndey-16X9.jpg","imageMobileUrl":"https:\/\/images.fastcompany.com\/image\/upload\/f_webp,q_auto,c_fit\/wp-cms-2\/2025\/10\/tcp-photo-syndey-1x1-2.jpg","eyebrow":"","headline":"Get more insights from Tomas Chamorro-Premuzic","dek":"Dr. Tomas Chamorro-Premuzic is a professor of organizational psychology at UCL and Columbia University, and the co-founder of DeeperSignals. He has authored 15 books and over 250 scientific articles on the psychology of talent, leadership, AI, and entrepreneurship. 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The Bronx stands apart from New York Citys four other boroughs in stark ways. Home to 1.4 million residents and the nation’s poorest congressional district, it once flourished as fertile farmland. Today, were restoring this landnot to its agricultural roots, but as fertile ground for raising healthy, happy, and prosperous children. And in the process, were cultivating opportunity for a new generation of citizens. My wife Lizette and I founded and run Green Bronx Machine (GBM). Our nonprofit is dedicated to rewriting the narrative about the Bronx and its residents. Inside Community School 55, just across the tracks from rows of dilapidated public housing towers, sits an unexpected oasis: a thriving garden where fruits and vegetables grow alongside young dreams and possibilities. All year long, grandmothers find respite in the greenery while children eagerly plant seeds, harvest crops, raise chickens, and gather eggs. But this transformation didn’t begin outdoorsit started in a classroom. AN “UNEMPLOYED” TEACHER I playfully call myself an “unemployed teacher.” An educator/administrator since 1984, I left formal employment determined to launch a program that has now spread to more than 1,000 schools across the United States and a dozen countrieswith ambitious plans to scale that impact. Dubbed A Miracle in the Bronx, we combine urban agriculture, project-based learning, and community engagement that transforms educational outcomes in areas where success seems improbable, if not impossible. GBMs classroom model began almost by accident. When struggling to engage my students, I received a box of daffodil bulbs. Instead of discarding them, I tucked them behind a radiator. Weeks later, the bulbs sprouted and bloomed, and with them, a change in students’ engagement and attendance. These kids, who wouldn’t come to school to see me, were suddenly showing up to see plants. That was my a-ha moment. We planted 25,000 bulbs all across NYC that year. [Photo: Green Bronx Machine] Today, the program features indoor Tower Gardens and Babylon Micro-Farms, where students grow vegetables year-round in classroom settings, along the way learning math, English, biology, even phys. ed. The results extend far beyond agriculture. Participants show improved academic performance, higher attendance rates, better nutritional habits, and increased environmental awareness. Teachers are similarly inspired and engaged. Meanwhile, the produce students grow is sold to provide much-needed jobs and income, or taken home by students to feed their families. I learned that when a child plants a seed and nurtures that plant to harvest, they never go hungry againnot intellectually, emotionally, or physically. THE VISION DEFICIT IN AMERICAN SCHOOLS It is common to think that America’s educational challenges stem primarily from limited funding. But the more fundamental issue is a clear vision of whats possible in todays schoolssomething increasingly scarce in an environment dominated by misinformation, politics, and eroding social cohesion. For children growing up today, the harsh reality is that in America, despite our cherished narrative of meritocracy and individualism, ones ZIP code remains the primary determinant of social, educational, and health outcomes. Thats exemplified in marginalized areas like the South Bronx. This geographical determinism is driven by many things. That includes schools in low-income areas being starved for funding, experienced teachers, and enrichment opportunities. Students also face additional barriers such as food insecurity, housing instability, and exposure to environmental hazardsall impacting their ability to learn effectively. END ZIP CODE DESTINY By transforming schools into centers of community wellness, individual excellence, and environmental stewardship, weve demonstrated that innovative approaches can overcome systemic barriers. We’re growing high performing schools, engaged citizens, responsible neighbors, vibrant communities, jobs, and we’re growing healthy foodall together. The program has driven impact across a wide variety of communities, national and international, and that impact is captured in a documentary, Generation Growth, which highlights the program’s success and led to GBM being named a 2024 Most Innovative Company by Fast Company. SCALE A TRANSFERABLE MODEL What makes GBMs method so impactful is its transferability across states and international borders. Schools in diverse settings, from rural Alabama to suburban Colorado, have successfully adapted it to local needs while maintaining core principles. Were projected to impact 30,000 schools in the United States by 2030. This isn’t just about the Bronx. There is a Bronx in every American city and around the world; weve built a turn-key program that serves all of them. This is about transforming how we think about education, community, sustainability, poverty, and progress everywhere. [Photo: Green Bronx Machine] Many think I have a larger-than-life personality, but you dont need that to be effective. Its about community engagement. Ana Christina Garcia of Sloan Kettering and a GBM board member notes that “Green Bronx Machine capitalizes on community assets and unlocks the potential, desire, and passion that children, principals, and teachers already have. Community engagement is about making organizational resources more accessible to unlock people’s existing talents and power. It’s a two-way street where everyone benefits from sharing their wonderful talents as human beings and creating stronger community connections.” I call this social vitamin fortified with human capacity. We’re not just growing plants, we’re growing hope. And hope is the most powerful seed we can plant. In 2026 Id like to shake hands with other thought leaders to continue bringing this proven program across the country. It takes a village, of course, but it also takes an inspiring vision. Join me please. The author thanks Joel Makower and Jeff Senne for their contributions to this article. Stephen Ritz is founder of Green Bronx Machine.
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