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The data hinted at racism among white doctors. Then scholars looked again

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BLACK BABIES in America are more than twice as likely to die before their first birthday than white babies. This shocking statistic has barely changed for many decades, and even after controlling for socioeconomic differences a wide mortality gap persists. Yet in 2020 researchers discovered a factor that appeared to reduce substantially a black baby’s risks. In their study, published in Proceedings of the National Academy of Sciences (PNAS), they wrote that “when Black newborns are cared for by Black physicians, the mortality penalty they suffer, as compared with White infants, is halved.”

This striking finding quickly captured national and international headlines, and generated nearly 700 Google Scholar citations. The study was widely interpreted–incorrectly, say the authors–as evidence that newborns should be matched to doctors of the same race, or that white doctors harboured racial animus against black babies. It even made it into the Supreme Court’s records as an argument in favour of affirmative action, with Justice Ketanji Brown Jackson (mis)citing the findings. A supporting brief by the Association of American Medical Colleges and 45 other organisations mentioned the study as evidence that “For high-risk black newborns, having a black physician is tantamount to a miracle drug.”

Now a new study seems to have debunked the finding, to much less fanfare. A paper by George Borjas and Robert VerBruggen, published last month in PNAS, looked at the same data set from 1.8m births in Florida between 1992 and 2015 and concluded that it was not the doctor’s skin colour that best explained the mortality gap between races, but rather the baby’s birth weight. Although the authors of the original 2020 study had controlled for various factors, they had not included very low birth weight (ie, babies born weighing less than 1,500 grams, who account for about half of infant mortality). Once this was also taken into consideration, there was no measurable difference in outcomes.

The new study is striking for three reasons. First, and most important, it suggests that the primary focus to save young (black) lives should be on preventing premature deliveries and underweight babies. Second, it raises questions about why this issue of controlling for birth weight was not picked up during the peer-review process. And third, the failure of its findings to attract much notice, at least so far, suggests that scholars, medical institutions and members of the media are applying double standards to such studies. Both studies show correlation rather than causation, meaning the implications of the findings should be treated with caution. Yet, whereas the first study was quickly accepted as “fact”, the new evidence has been largely ignored.

The reason why white doctors at first looked like such a “lethal” combination with black babies, say the authors of the recent paper, was that a disproportionately high share of underweight black babies were treated by white doctors, while a disproportionately high share of healthy-weight black babies were treated by black doctors. Being born severely underweight is one of the greatest predictors of infant death. Just over 1% of babies in America are born weighing less than 1,500 grams, but among black babies the rate is nearly 3%.

The fact that the original authors shared their data and workings with their challengers should be commended, as should PNAS’s decision to publish this second paper and a guest commentary. In it Theodore Joyce, from City University of New York, offers several reasons why the authors and their reviewers might have missed this critical factor, including that it was technically hard to tease out of the data. Yet as a final possible reason, he notes that the original article was published two months after the murder of George Floyd. “Reviewers are only human, and these events may have affected how the results were interpreted,” he concludes.

That a flawed social-science finding which fitted neatly within the zeitgeist was widely accepted is understandable. Less understandable is that few people now seem eager to correct the record. The new study has had just one Google Scholar citation and no mainstream news coverage. This suggests that opinion-makers have, at best, not noticed the new article (it was published a month ago; The Economist only spotted it when the Manhattan Institute, a conservative think-tank, last week put out an explanatory note). At worst, they have deliberately ignored it.

None of this means that a physician’s race–or their sex–is never relevant. Several studies have shown that shared identity between doctor and patient can improve communication, trust, patient experience and compliance with doctors’ orders. A study in 2018 of black men in Oakland found that those treated by a black doctor were more likely to bring up specific health concerns and undergo invasive screening than those treated by a white doctor. It would be particularly valuable to look at whether the race of a woman’s obstetrician has any impact on her baby’s outcomes.

Mr Borjas and Mr VerBruggen end on an optimistic note, observing that science has “the capacity for self-correction, and scientists can facilitate this by being open with their methods and data”. Science journalists can help, too.

Economics

U.S.- Canada Trade Talks Collapse; Carney Says Retaliatory Tariffs Begin September 8

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U.S.- Canada Trade Talks Collapse; Carney Says Retaliatory Tariffs Begin September 8

Trade negotiations between the United States and Canada collapsed this week, with Canadian Prime Minister Mark Carney announcing that retaliatory tariffs on U.S. goods will take effect September 8, 2026. The breakdown follows the Trump administration’s imposition of 50% tariffs on certain Canadian goods, according to reporting from CNBC and the Washington Post.

What Happened

CNBC reported the collapse of talks as part of its ongoing business news coverage on August 22, 2026, noting the story as one of the week’s most significant developments for cross-border trade. The Washington Post’s business desk, in coverage also published August 22-23, quoted Carney characterizing President Trump’s 50% tariffs as “a miscalculation,” and confirmed the September 8 date for Canada’s retaliatory measures.

As of this writing, specific details on which categories of U.S. goods will be subject to Canadian retaliatory tariffs have not been fully reported. This article will be updated with additional specifics as they become available from primary government sources.

Why This Matters for Markets and Consumers

Trade disputes between the U.S. and its largest trading partners tend to have ripple effects across supply chains, consumer prices, and specific industry sectors with cross-border exposure. A Washington Post analysis accompanying the coverage noted that other countries unhappy with existing U.S. trade arrangements are likely watching the U.S.-Canada breakdown closely, suggesting the dispute could have implications beyond the immediate bilateral relationship.

Broader Context: A Volatile Week for Cross-Border and Fiscal News

The trade breakdown arrived during an already turbulent week for U.S. economic news. The same week saw the national debt cross $40 trillion for the first time, a sharp rise in Treasury bond market volatility, and the Treasury Department doubling the size of its debt buyback program. Whether the trade dispute has any direct connection to these fiscal and monetary developments has not been established in current reporting, but the concentration of major economic stories in the same week has drawn attention from market commentators tracking overall macroeconomic risk.

How This Fits the Broader Trade Policy Pattern

The U.S.-Canada breakdown is not occurring in isolation. Trade policy has been an active area of U.S. economic policymaking throughout 2026, with tariff actions and negotiations affecting multiple trading partners over the course of the year. Canada has historically been among the United States’ largest trading partners by total trade volume, meaning a prolonged dispute carries more direct economic exposure for both economies than a similar breakdown with a smaller trading partner would.

Industries with integrated North American supply chains — including automotive manufacturing, agriculture, and energy — have historically been among the most exposed to U.S.-Canada trade friction, given the degree to which components and raw materials cross the border multiple times during production. Businesses in these sectors should treat the September 8 deadline as a planning point regardless of whether it ultimately takes effect as announced.

What We Don’t Yet Know

Several material details remain unconfirmed or unreported as of this writing:

– The specific list of U.S. product categories subject to Canadian retaliatory tariffs
– Whether any further negotiations are scheduled between the September 8 deadline and the present
– Potential exemptions for critical supply chains, such as energy or auto parts, which have historically received special treatment in prior U.S.-Canada trade disputes

What to Watch Next

Businesses with cross-border exposure to Canadian suppliers or customers should monitor official statements from the U.S. Trade Representative’s office and Canada’s Department of Global Affairs for detailed tariff schedules ahead of the September 8 implementation date. Given the fluid nature of trade negotiations, a resumption of talks or a modified agreement before that date remains possible and would supersede current retaliatory tariff plans.

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Economics

U.S. National Debt Surpasses $40 Trillion for the First Time: What It Means for the Economy

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US Debt is now 40 trillions

The U.S. gross national debt crossed $40 trillion for the first time this week, according to Treasury Department data reported by NPR on August 20, 2026. The milestone caps a period of rapid fiscal expansion: the debt has doubled since 2017, and the federal government now spends more than $1 trillion a year just servicing interest on what it owes.

Why the Debt Load Is Accelerating

The debt has not grown at a steady pace. Instead, a combination of pandemic-era spending, tax policy changes, and elevated interest rates has compounded the federal government’s borrowing costs. As older Treasury bonds issued at lower rates mature, they are being refinanced at today’s higher prevailing rates, which pushes up the government’s annual interest bill even without any new borrowing.

That interest bill is no longer a minor line item. At more than $1 trillion annually, debt servicing now competes directly with discretionary spending on defense, infrastructure, and social programs. Economists watching the trend note that this dynamic can become self-reinforcing: higher interest costs widen the deficit, which requires more borrowing, which in turn raises future interest costs.

Bond Market Reaction

The debt milestone arrived during a volatile week for Treasury bonds. Bond prices fell even as equity markets touched record highs, a divergence that market analysts describe as bond investors signaling concern about the sustainability of federal borrowing, even as stock investors remain focused on corporate earnings and AI-driven growth.

U.S. Treasury Secretary Scott Bessent responded to the bond market pressure by expanding the Treasury’s debt buyback program, telling CNBC the size of buyback operations had been doubled to at least $4 billion per operation, with room to increase further. Buybacks are intended to support demand for existing Treasury securities and help stabilize yields during periods of market stress.

What Rising Debt Means for Ordinary Households

For everyday consumers, the national debt level itself is abstract, but its downstream effects are not. Elevated Treasury yields tend to push up borrowing costs across the economy, including mortgage rates, auto loans, and business credit. The same week the $40 trillion milestone was confirmed, average 30-year mortgage rates moved sharply, illustrating how bond market volatility connects directly to household borrowing costs.

Rising federal interest costs also narrow the government’s fiscal flexibility. As a larger share of the federal budget goes toward servicing debt rather than funding programs, policymakers face growing pressure to either cut spending, raise revenue, or both — choices that carry direct economic consequences for households and businesses alike.

What to Watch Next

The debt trajectory is expected to remain a central topic at the Federal Reserve’s Jackson Hole Economic Symposium, scheduled for August 27–29, 2026 — the first such gathering under new Fed Chair Kevin Warsh, who was confirmed by the Senate in a 54-45 vote in May 2026. While the symposium’s stated theme is financial innovation and payments policy, fiscal sustainability and its interaction with monetary policy are likely to feature in sideline discussions given the scale of the debt milestone.

Investors and households should watch upcoming Treasury auction results and any further changes to the buyback program as early indicators of how markets are digesting the government’s borrowing needs. A weak auction — one that requires higher yields to attract sufficient buyers — would be a signal that investor appetite for U.S. debt is softening further.

The $40 trillion figure is a threshold, not a crisis in itself. But combined with a bond market already showing signs of strain, it adds urgency to a fiscal conversation that has largely been deferred by successive Congresses and administrations.

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Economic Profile of the United States of America (2026–2030 Horizon)

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Economic Profile of the United States of America (2026–2030 Horizon)

Executive Summary & Core Macro Outlook

The United States enters the 2026–2030 macroeconomic window as the unquestioned heavyweight of nominal economic output, retaining its status as the primary engine of global financial liquidity, private enterprise innovation, and high-margin technological deployment. According to multi-year projections from the International Monetary Fund (IMF) World Economic Outlook and complementary datasets from the World Bank, the US nominal Gross Domestic Product (GDP) is projected to reach $32.38 trillion by 2026, accounting for approximately 25% of global nominal output and roughly 14.5% of world GDP measured at Purchasing Power Parity (PPP).

Unlike many of its advanced-economy peers across Western Europe and East Asia—which are grappling with acute demographic contraction and structural energy shocks—the United States demonstrates remarkable macroeconomic resilience. The IMF projects a real GDP Compound Annual Growth Rate (CAGR) of 2.1% to 2.3% through 2030. This expansion is sustained by three structural anchors: unmatched capital depth driving massive private-sector investment in Artificial Intelligence (AI) infrastructure, complete energy independence as a net exporter of hydrocarbons and liquefied natural gas (LNG), and high labor productivity gains that cushion the economy against rising debt-servicing costs.

Macroeconomic Data Matrix (2026–2030 Projections)

Economic MetricIMF / World Bank Baseline (2026–2030)Global Benchmark & Context
Nominal GDP (2026 Projection)~$32.38 TrillionRank #1 Globally
GDP at Purchasing Power Parity (PPP)~$32.40 TrillionRank #2 Globally (Behind China’s ~$38.5T PPP)
Projected Real GDP CAGR (2026–2030)2.1% – 2.3%Top decile among G7 advanced economies
Gross Public Debt (% of GDP)~122.5% – 128.0%Structural fiscal deficit trajectory
Core Inflation Rate (PCE Target)Stabilizing at 2.0% – 2.2%Federal Reserve inflation target alignment
Current Account Balance (% of GDP)-2.8% to -3.2%Persistent capital import & reserve currency demand

Deep Structural Growth Drivers

1. The AI Infrastructure Hyper-Cycle & TFP Expansion

The defining growth catalyst for the US economy over the 2026–2030 horizon is the unprecedented scale of private capital expenditure (Capex) poured into artificial intelligence infrastructure, enterprise software integration, and advanced computing hardware.

Major technology mega-caps and private equity funds are directing hundreds of billions of dollars annually into hyper-scale data centers, domestic semiconductor fabrication, high-voltage electrical grid upgrades, and AI-driven workflow platforms. According to World Bank economic research, technological adoption across American service and manufacturing sectors is driving a notable uptick in Total Factor Productivity (TFP). This productivity surge allows US companies to expand profit margins and output even in an environment characterized by higher structural real interest rates and tight skilled-labor markets.

2. Deep Capital Markets and Private Sector Liquidity

The structural backbone of US economic outperformance remains its financial system. US capital markets represent over 40% of global equity market capitalization and a vast majority of global venture capital and private credit assets.

This liquidity creates an efficient mechanism for capital allocation: high-potential emerging industries (such as quantum computing, synthetic biology, and advanced defense technology) receive early-stage funding at a scale that no other national market can match. When global monetary conditions tighten, global capital flees toward safety and yield, reinforcing US capital depth and lowering the relative cost of equity capital for American corporations.

3. Net Energy Independence & Industrial Cost Advantages

Unlike industrial hubs in Germany, Japan, or South Korea—which remain highly vulnerable to volatile sea-lane logistics and imported fuel price spikes—the United States operates as a major net exporter of petroleum, natural gas, and refined chemical products.

Access to abundant, cheap domestic natural gas provides US heavy industry, advanced manufacturing, and electricity-hungry data centers with a persistent structural cost advantage. Furthermore, federal policy frameworks (including the CHIPS and Science Act and clean energy tax provisions) continue to catalyze domestic private manufacturing investment, re-shoring high-value supply chains from East Asia back to the American Sunbelt and Midwest.

Macroeconomic Vulnerabilities & Downside Risks

1. Structural Sovereign Debt Trajectory

The most significant medium-term threat to US macroeconomic stability is the path of federal public debt. With gross national debt exceeding 120% of GDP and annual federal deficits running between 5% and 7% of GDP, the US fiscal baseline faces increasing structural pressure.

As older legacy low-yield Treasury bonds mature, they are refinanced at higher prevailing interest rates. According to IMF fiscal monitor assessments, federal net interest payments are absorbing an expanding share of total fiscal revenue, crowding out discretionary spending and narrowing the government’s capacity to deploy counter-cyclical fiscal stimulus during future downturns.

2. Commercial Real Estate (CRE) & Banking Sector Realignment

The structural transformation toward hybrid work models has permanently altered office space utilization across major US metropolitan areas. Regional and community banks, which hold a disproportionate share of commercial real estate debt, face ongoing balance-sheet pressure as legacy office loans mature and require refinancing at lower property valuations and higher interest rates. While systemic money-center banks remain well-capitalized, localized credit tightening from regional lenders presents a headwind for small-and-medium enterprise (SME) borrowing.

High-Outperformance Sector Matrix (2026–2030)

                     
  1. Enterprise AI, Cloud Compute, & Cybersecurity: Companies building enterprise-grade software, AI agents, cloud architectures, and specialized hardware protection layers.
  2. Next-Generation Energy & Grid Modernization: Power generation utilities, high-voltage electrical equipment makers, small modular nuclear reactor (SMR) developers, and energy storage systems catering to exponential data center energy demands.
  3. Advanced Defense Technology & Aerospace: Autonomous systems, satellite networks, hypersonic defense, and advanced materials supplying both domestic security needs and global allied demand.

Strategic Summary for Global Investors & Executives

The United States through 2030 remains the ultimate high-volume, high-yield destination for institutional capital. While fiscal debt risks require long-term monitoring, the immediate 5-year outlook is defined by strong technology-driven productivity, resilient private consumption, and unmatched market liquidity. For global corporations and institutional allocators, exposure to the US economy remains an indispensable pillar of long-term growth strategy.

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