Category: Analysis

Source: The Conversation – USA (3) – By David B. Sarwer, Professor of Social and Behavioral Sciences, Temple University

The Trump administration is making a significant effort to reduce the cost of weight loss drugs. Its agreement with pharmaceutical giants, announced Nov. 6, 2025, will reduce the monthly prices of these medications by hundreds of dollars.

For the past 25 years, I have treated people with obesity and have developed and studied treatments for the condition in both adults and adolescents. One major frustration of my work is the fact that evidenced-based treatments for obesity are woefully underused

These drugs, originally approved to treat Type 2 diabetes, mimic a natural hormone called glucagon-like peptide-1 that regulates blood sugar and reduce appetite.

In my view, by making GLP-1 drugs more accessible to patients, this agreement represents one of the most significant advances the federal government has made to address obesity, one of the country’s most pressing public health issues. However, this reduced price tag alone may not make a meaningful dent in rates of obesity in American adults without additional policy changes.

Treating obesity

The Centers for Disease Control and Prevention estimates that about 40% of adults in the U.S. – more than 70 million people – have obesity. Researchers and clinicians generally define obesity based on a measure called body mass index, or BMI, which is the ratio of a person’s weight in kilograms to their height in meters, squared.

BMI is an imperfect measure, to be sure, but most medical organizations consider a person with a BMI greater than 30 to have obesity.

Between television commercials, advertisements on social media and suggestions from family and friends, Americans are bombarded by approaches to losing weight. For many of these approaches, there’s little to no evidence showing they successfully help people lose weight. However, extensive and rigorous research supports the use of GLP-1s for treating obesity. Studies show that these medications can reliably help people lose about 15% of their body weight in six to 12 months.

There are two other evidence based-approaches. Lifestyle changes, such as consuming fewer calories and increasing physical activity, can help people lose about 5% of their weight in the same period of time. With surgical treatment, now referred to as metabolic and bariatric surgery, patients can achieve a loss of about 30% of their body weight after about 18 months.

Which of these treatment approaches is appropriate for a given person depends on their circumstances and is best discussed with their health care provider. But in my experience, too few health care professionals refer their patients to any of these therapies.

Addressing the cost barrier

According to a November 2025 poll from the Kaiser Family Foundation, 1 in 8 adults in the U.S. have tried a GLP-1 medication. That may sound like a lot, but given that more than 40% of American adults have obesity, it may not be enough.

In clinical trials, people taking GLP-1 drugs to treat obesity generally maintained their weight loss for a year if they stayed on the medication. However, participants in the trials did not have to pay for the medications. Research suggests that more than half of people using the drugs stop taking them after six months, most often because they can’t afford them.

The federal government’s deal with Eli Lilly and Novo Nordisk aims to address this barrier.

GLP-1 drugs currently cost more than US$1,000 per month for people unable to get them covered by health insurance – and many insurance plans do not.

According to the Nov. 6 White House announcement, starting in early 2026, certain GLP-1 drugs covered by the agreement will be available for $350 per month or less through an online marketplace the government plans to launch.

Some drugs will be as cheap as $150, according to the announcement. Companies will also drop the amount that Medicare and Medicaid pay for them, and certain Medicare patients would be able to access them with a $50 co-pay.

These prices are still in flux, news reports suggest. However, for most Americans, paying even $150 a month for a single medication remains a budget buster. That’s especially true given that people from lower socioeconomic groups experience higher rates of obesity and often have other related health conditions that require costly medications.

These costs are not temporary. Most patients with obesity and related health problems will likely need to use these medications indefinitely. According to emerging research, people who stop taking them typically regain the weight they lost. Realistically, very few people who take GLP-1 drugs can maintain their weight loss with lifestyle changes alone.

Beyond cost

The reduced pricing for GLP-1 drugs is an important first step in increasing affordability and access to these treatments. Given that the food environments people live in make it difficult to make healthy choices, I believe that this move will only meaningfully benefit the health of all Americans if it is combined with other policy changes.

While several countries have a national plan to prevent and treat obesity, the U.S. does not. Instead, American public health policies are largely set state by state. They often include strategies such as free school meals for children or more robust insurance coverage for treating obesity and related health conditions. However, most such policies are often too narrow to have significant benefits at the population level.

Broader policy shifts and legislation targeting obesity prevention could move the needle.

For example, research is increasingly showing that ultraprocessed foods play a role in promoting weight gain and potentially other diseases, such as colorectal cancer. Legislators could draw on that research to better regulate these foods – for example, to limit the use of certain especially harmful ingredients, to restrict marketing of ultraprocessed products, or to limit their inclusion in school meals.

Another policy change that may help would be to build more extensive nutrition education into the training that medical students and other health care providers receive. This may better position the next generation of clinicians to help their patients make the healthiest choices to maintain their weight and health.

These and other policy changes will be critically important in efforts to reduce the rate of obesity among Americans in the future.

David B. Sarwer’s program of research has been funded by grants from the National Institutes of Health for over the past 20 years. He also serves as Editor-in-Chief of the journal Obesity Science and Practice.

– ref. Making GLP-1 weight loss drugs cheaper isn’t enough to address America’s obesity problem – here’s why – https://theconversation.com/making-glp-1-weight-loss-drugs-cheaper-isnt-enough-to-address-americas-obesity-problem-heres-why-269361

Source: The Conversation – USA (3) – By Shannon Fyfe, Assistant Professor of Law and Assistant Professor of Philosophy, Washington and Lee University

Following the federal government’s changes to COVID-19 vaccine eligibility and recommendations in 2025, many people are wondering whether they can get COVID-19 vaccines for themselves or their children.

In May 2025, the U.S. Food and Drug Administration limited eligibility for updated COVID-19 vaccines to people ages 65 years and up and to those under 65 with a “high-risk” condition. In September, the Centers for Disease Control and Prevention adopted an “individualized decision-making” approach to COVID-19 vaccination instead of broadly recommending the vaccines.

It’s not just the public that is confused. Many physicians and pharmacists also have questions about whether and how they can administer COVID-19 vaccines.

As philosophers with expertise in bioethics and legal philosophy, we have been following the ethical and regulatory landscape for COVID-19 vaccines since they first became available in late 2020.

In the fall of 2025 that landscape looks a bit different in light of the new guidelines. While it is causing understandable confusion, most people who want to get a COVID-19 vaccine can do so. Broad access is possible, in part, through what in health care is called “off-label use.”

“Off-label” refers to using an FDA-approved product for a different purpose, or with a different population, than that for which it received approval. Off-label prescriptions are common in health care, particularly in pediatrics.

COVID-19 vaccines from 2020-2025

People likely recall that COVID-19 vaccines were developed faster than any vaccine had been previously, thanks to efforts such as the U.S. government’s Operation Warp Speed. Initially limited in supply, the vaccines first became available through “emergency use authorization” in December 2020, with health care workers among the first prioritized by the government to receive them.

In August 2021, the FDA fully approved the first COVID-19 vaccine for people ages 16 and up. Following this, younger children started to become eligible for COVID-19 vaccines. From 2022 through summer 2025, COVID-19 vaccines were available to everyone 6 months and older in doctors’ offices or pharmacies, mostly free of charge, albeit with disparities in access due to an individual’s age, geographic location or vaccine costs.

But in May 2025, the new FDA and CDC leadership appointed by the Trump administration started to change their agencies’ positions on COVID-19 vaccines. Such regulatory changes affect who is considered eligible for the vaccines and whether public and private insurers must provide coverage. Meanwhile, state laws influence the ability of pharmacists, who frequently provide routine vaccinations, to administer COVID-19 vaccines.

Understanding the role of federal agencies such as the FDA and the CDC, as well as medical professional organizations and guidelines, can help untangle the complicated picture for access to COVID-19 vaccines.

2025 changes to FDA and CDC guidance

It’s helpful to understand the process through which vaccines become approved and endorsed by government agencies in the U.S.

First, the FDA approves drugs and other biologic products such as vaccines for specific uses, in specific age groups – in this case, to prevent people from getting COVID-19 or, if they do get it, to reduce the severity of their symptoms.

Next, the CDC recommends products that the FDA has approved or authorized. These recommendations have a different regulatory function than the initial FDA decisions. The CDC issues public health guidelines for which vaccines people should receive and which ones public and private insurance must cover. In some states, the CDC’s recommendations also affect whether pharmacies can administer vaccines.

Until September 2025, when the CDC shifted its stance, the agency broadly recommended COVID-19 vaccines for everyone 6 months of age and older, regardless of their underlying conditions. These recommendations supported public health and ensured that public and private insurance covered 100% of the cost of these vaccines as preventive health care.

Medical and CDC recommendations

Despite the FDA’s updated eligibility criteria and the CDC’s revised guidance, medical professional organizations have continued to broadly recommend COVID-19 vaccines.

In August, the American Academy of Pediatrics issued its own vaccine schedule. In addition to kids who meet FDA eligibility due to heightened risk, the organization recommends that all children between 6 months and 2 years old be vaccinated against COVID-19, as well as any child whose parent or guardian wants them to be vaccinated.

When the Advisory Committee on Immunization Practices, or ACIP – the committee that advises the CDC on vaccine policy – met in mid-September, it voted to recommend that anyone 6 months and older can get a COVID-19 vaccine according to “individual-based decision-making.” The committee also voted to require continued funding of COVID-19 vaccines through private and public health insurance and the Vaccines for Children program that provides free vaccines to children who are Medicaid eligible, uninsured or underinsured. In October, the interim CDC director adopted the ACIP recommendations as the formal guidance from the CDC for the 2025-2026 COVID-19 vaccines.

These recommendations from the CDC and medical professional organizations are difficult to square with the FDA labeling changes for COVID-19 vaccines. The CDC is recommending that people make individual decisions with their medical providers about COVID-19 vaccination, regardless of their eligibility through FDA approval.

This is possible because anyone who doesn’t meet FDA eligibility can get a COVID-19 vaccine through off-label use.

Off-label use of COVID-19 vaccines

Using COVID-19 vaccines off-label means administering them for the same purpose but to a wider population than those who are FDA-eligible. In 2021 the CDC prohibited the off-label use of COVID-19 vaccines purchased by the federal government. This was an unusual move and is no longer the case.

While uncommon, off-label vaccination is sometimes recommended. One example is off-label vaccination against measles, mumps and rubella, or MMR, for children under 12 months old who plan to travel to areas where measles is not eradicated, or are exposed to a disease outbreak.

Moreover, the CDC’s 2025-2026 COVID-19 vaccine recommendations remove certain barriers that typically accompany off-label use.

For example, products used off-label are not always covered by insurance. Many private insurers already committed to covering COVID-19 vaccines as preventive care for the 2025-2026 vaccine season. The recommendations from ACIP and the CDC subsequently guaranteed that private and public health insurance plans would continue to cover COVID-19 vaccines in full. This includes COVID-19 vaccines under the Vaccines for Children program that purchases vaccines for approximately half of U.S. children.

Off-label use of a product is ethically and legally permissible if a physician believes its benefits outweigh its risks for their patient. But the CDC’s recommendation for individual decision-making may also lessen clinicians’ worries about liability. So might the guidance from the American Academy of Pediatrics, as well as the American College of Obstetricians and Gynecologists’ vaccine recommendations that anyone who is pregnant should get an updated COVID-19 vaccine during pregnancy.

Off-label use is typically done via a doctor’s prescription. Yet many COVID-19 vaccines are administered in pharmacies. Getting vaccinated in a pharmacy is especially helpful for people without primary care doctors or the time or money for a clinic visit. Many states have taken steps to remove barriers to obtaining off-label COVID-19 vaccines at pharmacies. The CDC’s October 2025 recommendations for individual decision-making also enable COVID-19 vaccination by pharmacists.

For people who would like to be vaccinated against COVID-19, knowing how off-label use fits into current regulations may be helpful for understanding their access to vaccines this respiratory virus season, and medical treatment in general.

The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.

– ref. Off-label use of COVID-19 vaccines was once discouraged but has become common amid new guidelines – https://theconversation.com/off-label-use-of-covid-19-vaccines-was-once-discouraged-but-has-become-common-amid-new-guidelines-268345

Source: The Conversation – USA – By Stefani Langehennig, Assistant Professor of Practice, Daniels College of Business, University of Denver

When the Colorado Artificial Intelligence Act passed in May 2024, it made national headlines. The law was the first of its kind in the U.S. It was a comprehensive attempt to govern “high-risk” artificial intelligence systems across various industries before they could cause real-world harm.

Gov. Jared Polis signed it reluctantly – but now, less than a year later, the governor is supporting a federal pause on state-level AI laws. Colorado lawmakers have delayed the law’s enactment to June 2026 and are seeking to repeal and replace portions of it.

Lawmakers face pressure from the tech industry, lobbyists and the practicalities related to the cost of implementation.

What Colorado does next will shape whether its early move becomes a model for other states or a lesson in the challenges of regulating emerging technologies.

I study how AI and data science are reshaping policymaking and democratic accountability. I’m interested in what Colorado’s pioneering efforts to regulate AI can teach other state and federal legislators.

The first state to act

In 2024, Colorado legislators decided not to wait for the U.S. Congress to act on nationwide AI policy. As Congress passes fewer laws due to polarization stalling the legislative process, states have increasingly taken the lead on shaping AI governance.

The Colorado AI Act defined “high-risk” AI systems as those influencing consequential decisions in employment, housing, health care and other areas of daily life. The law’s goal was straightforward but ambitious: Create preventive protections for consumers from algorithmic discrimination while encouraging innovation.

Colorado’s leadership on this is not surprising. The state has a climate that embraces technological innovation and a rapidly growing AI sector. The state positioned itself at the frontier of AI governance, drawing from international models such as the EU AI Act and from privacy frameworks such as the 2018 California Consumer Privacy Act. With an initial effective date of Feb. 1, 2026, lawmakers gave themselves ample time to refine definitions, establish oversight mechanisms and build capacity for compliance.

When the law passed in May 2024, policy analysts and advocacy groups hailed it as a breakthrough. Other states, including Georgia and Illinois, introduced bills closely modeled after Colorado’s AI bill, though those proposals did not advance to final enactment. The law was described by the Future of Privacy Forum as the “first comprehensive and risk-based approach” to AI accountability. The forum is a nonprofit research and advocacy organization that develops guidance and policy analysis on data privacy and emerging technologies.

Legal commentators, including attorneys general across the nation, noted that Colorado created robust AI legislation that other states could emulate in the absence of federal legislation.

Politics meets process, stalling progress

Praise aside, passing a bill is one thing, but putting it into action is another.

Immediately after the bill was signed, tech companies and trade associations warned that the act could create heavy administrative burdens for startups and deter innovation. Polis, in his signing statement, cautioned that “a complex compliance regime” might slow economic growth. He urged legislators to revisit portions of the bill.

Polis convened a special legislative session to reconsider portions of the law. Multiple bills were introduced to amend or delay its implementation. Industry advocates pressed for narrower definitions and longer timelines. All the while, consumer groups fought to preserve the act’s protections.

Meanwhile, other states watched closely and changed course on sweeping AI policy. Gov. Gavin Newsom slowed California’s own ambitious AI bill after facing similar concerns. Meanwhile Connecticut failed to pass its AI legislation amid a veto threat from Gov. Ned Lamont.

Colorado’s early lead turned precarious. The same boldness that made it first also made the law vulnerable – particularly because, as seen in other states, governors can veto, delay or narrow AI legislation as political dynamics shift.

From big swing to small ball

In my opinion, Colorado can remain a leader in AI policy by pivoting toward “small ball,” or incremental, policymaking, characterized by gradual improvements, monitoring and iteration.

This means focusing not just on lofty goals but on the practical architecture of implementation. That would include defining what counts as high-risk applications and clarifying compliance duties. It could also include launching pilot programs to test regulatory mechanisms before full enforcement and building impact assessments to measure the effects on innovation and equity. And finally, it could engage developers and community stakeholders in shaping norms and standards.

This incrementalism is not a retreat from the initial goal but rather realism. Most durable policy emerges from gradual refinement, not sweeping reform. For example, the EU’s AI Act is actually being implemented in stages rather than all at once, according to legal scholar Nita Farahany.

Effective governance of complex technologies requires iteration and adjustment. The same was true for data privacy, environmental regulation and social media oversight.

In the early 2010s, social media platforms grew unchecked, generating public benefits but also new harms. Only after extensive research and public pressure did governments begin regulating content and data practices.

Colorado’s AI law may represent the start of a similar trajectory: an early, imperfect step that prompts learning, revision and eventual standardization across states.

The core challenge is striking a workable balance. Regulations need to protect people from unfair or unclear AI decisions without creating such heavy burdens that businesses hesitate to build or deploy new tools. With its thriving tech sector and pragmatic policy culture, Colorado is well positioned to model that balance by embracing incremental, accountable policymaking. In doing so, the state can turn a stalled start into a blueprint for how states nationwide might govern AI responsibly.

Stefani Langehennig receives funding from the American Political Science Association’s (APSA) Centennial Center Research Center.

– ref. Colorado is pumping the brakes on first-of-its-kind AI regulation to find a practical path forward – https://theconversation.com/colorado-is-pumping-the-brakes-on-first-of-its-kind-ai-regulation-to-find-a-practical-path-forward-269065

Source: The Conversation – USA – By Anya M. Galli Robertson, Assistant Professor of Sociology, University of Dayton

When the center of protests against immigration enforcement switched recently to Charlotte, North Carolina, so did the frogs.

Back in October 2025, an agent with Immigration and Customs Enforcement, the agency popularly known as ICE, deployed pepper spray into the air vent of a peaceful protester’s inflatable frog costume. Video of the incident in Portland, Oregon, quickly went viral. Frogs and other inflatable costumes became a fixture of protests against Trump administration actions everywhere.

As a sociologist who studies social movements and political discourse, I knew when I saw the video that we’d soon see frogs everywhere at protests.

And indeed, the costumes have visually distinguished recent events from earlier anti-Trump demonstrations, softening their public image at a time when Republican officials were calling protesters “violent” and “Antifa people.”

It’s hard to be violent in a frog suit.

Humor is subversive. When used strategically, it can help undermine the legitimacy of even the most powerful opponents.

Playful and potentially protective

Portland activist Seth Todd began protesting in an inflatable frog costume as a way of “looking ridiculous” when federal law enforcement ramped up repressive tactics against his fellow protesters at ICE facilities in October 2025.

“Nothing about this screams extremist and violent,” he told The Oregonian newspaper.

Such costumes are interactive, playful, physically unwieldy and potentially protective. They can help activists appear less threatening to police, evade facial recognition systems and even deflect the blows of police batons or rubber bullets.

Wearing inflatable costumes at demonstrations checks all the boxes for tactics that can be widely imitated: cultural relevance, symbolic power, accessibility and easy participation. My interviews with activists who used glitter bombing in past protests revealed that light-hearted tactics can expand participation by attracting newcomers who are wary of more confrontational forms of protest. This is especially true when the tactics are easy to adopt – notably, wearing inflatable costumes in the weeks leading up to Halloween.

“Protest costumes” are now a category on Amazon.

Unlike the seasoned activists who were early adopters, protesters who wore inflatable animal and character costumes – sometimes because frog costumes had sold out – at No Kings protests on Oct. 18 represented a range of experiences and affiliations, including many first-timers.

“We are middle of the road,” explained one protesting frog in Chicago, “we’re just regular folks who have had enough.”

Bears, unicorns, dinos and raccoons

Activists continue to don frog costumes in solidarity. One group calling itself the Portland Frog Brigade says its goal is “artfully exercising our First Amendment right to free speech.”

Others created Operation Inflation to collect and distribute inflatable costumes to Portland protesters.

Just days after the pepper spray incident, a video circulated showing people outside the Portland ICE facility wearing inflatable bear, unicorn, dinosaur and raccoon costumes, dancing to raucous music in front of a line of law enforcement officers clad in riot gear.

Despite the almost literal novelty value of frog costumes, there’s nothing new about any of this.

Inflatables have long played an important role in outlandish protest tactics. A large inflatable “Trump chicken” was installed outside the White House back in 2017, while a “Trump baby” blimp hovered over Parliament in London during a 2018 state visit by Trump.

During the 1960s, the Bread and Puppet Theater used towering puppets and satirical street performances to protest the Vietnam War and social inequality.

Carnivalesque tactics and clown costumes have been popular responses to police repression at anti-globalization protests.

The Raging Grannies were a mainstay at antiwar and antinuclear demonstrations in the early 2000s, easily recognizable with their colorful costumes and witty songs.

And LGBTQ+ rights advocates have thrown pies and glitter-bombed right-wing politicians, while also staging costumed flash mobs and dance parties outside the offices and homes of prominent public figures.

Absurdist performances and playful public displays are powerful tools of political dissent, especially when they stand in contrast to state violence, authoritarianism and human rights abuses.

Anya M. Galli Robertson does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. The plague of frog costumes demonstrates the subversive power of play in protests – https://theconversation.com/the-plague-of-frog-costumes-demonstrates-the-subversive-power-of-play-in-protests-268327

Source: The Conversation – USA – By Richardson Dilworth, Professor of Politics, Drexel University

Pennsylvania Sen. John Fetterman – among the eight Democrats who voted to end the federal government shutdown – has always been a unique character and a sly self-promoter.

His political brand is that of an anti-politician. It’s reflected in his ultracasual wardrobe, his willingness – and even eagerness – to vote and express opinions across party lines, and his stated inability to socialize or glad-hand.

Even his new book, “Unfettered,” is not your typical political memoir, and thus is entirely on-brand for Fetterman. Most political memoirs are written to advance the politician’s career. Fetterman’s, however, discusses his dissatisfaction with Congress and spends far more time on his battles with depression than his role as a senator.

As a politics professor who studies Philadelphia and Pennsylvania, I find that one of the most unique things about Fetterman is his political rise from mayor of Braddock, Pennsylvania – a small borough outside Pittsburgh with fewer than 2,000 residents – to the U.S. Senate.

And yet, while this sort of political leap is highly unusual, it also reflects a recent trend in American politics. Over the past five years, more mayors of small and midsized cities have developed national political profiles in a way they hadn’t before.

It’s a phenomenon that has roots in suburbanization and 1990s-era political trends, and it’s one we will likely see again in 2028, at least among Democrats.

From small town to Senate chambers

Boroughs are the smallest form of municipality in Pennsylvania, and there are more than 950 of them in the state. The office of borough mayor is so insignificant that in Braddock, it came with a small stipend instead of a salary.

Yet after holding that obscure position for a decade, Fetterman mounted a credible campaign to be the Democratic candidate for a U.S. Senate seat in 2016. He fell short but captured nearly 20% of the primary vote against three other candidates.

In 2018, Fetterman was elected Pennsylvania lieutenant governor, and then in 2022, he ran again for the Senate. He beat Conor Lamb by a landslide in the Democratic primary and then squeaked out a victory against Republican candidate Dr. Mehmet Oz.

It may seem incredible that someone could jump from being a borough mayor to lieutenant governor and then U.S. senator. But other politicians over the past decade have used their positions as mayors of small-to-midsized cities to run for national office, including the U.S. presidency.

Cory Booker, for instance, was elected mayor of Newark, New Jersey, in 2006; U.S. senator in 2013; and briefly ran for the Democratic presidential nomination in 2020.

Booker was joined in the early race to be the Democratic presidential nominee by Pete Buttigieg, who was elected mayor of South Bend, Indiana, in 2011; and Wayne Messam, who was elected mayor of Miramar, Florida, in 2015.

The 2020 presidential primaries also included some big-city mayors like then-New York Mayor Bill DeBlasio and his immediate predecessor, Mike Bloomberg. Eric Garcetti, mayor of Los Angeles at the time, was apparently also considering a presidential run in 2020.

By contrast, before 2020, a grand total of 13 people who had ever served as a mayor later ran for president. Only Grover Cleveland and Calvin Coolidge were successful.

Of course, Fetterman has never run for president, but then, few mayors ever run for U.S. Senate either. As Booker noted in his 2017 memoir, “United,” he was, in 2013, the 1,949th person to ever be sworn in as a U.S. senator, but “only the 21st person since 1789 to ascend directly from mayor to Senator.”

Free trade and fractured bonds

How did this trend start? I trace it back to the eight years of the Clinton presidency, from 1993 to 2001, and more specifically, the North American Free Trade Agreement that went into effect in 1994 and the Clinton administration’s focus on community and civil society.

NAFTA was a treaty signed by the U.S., Mexico and Canada agreeing to lift tariffs and other barriers to trade. It had bipartisan support, but it was also politically divisive, especially with labor unions, historically a key pillar of the Democratic Party, which did not want to see manufacturers move their operations to Mexico to take advantage of lower labor costs.

NAFTA is often blamed for, among other things, the “hollowing out” of U.S. communities in the Rust Belt that stretches from the Northeast to the Upper Midwest states that surround the Great Lakes. In this vast area, there are thousands of small and midsized towns and cities, many of which depended on single industries like paper milling or auto parts manufacturing. Once those businesses relocated, residents found themselves unemployed, underemployed and stranded in increasingly poorer towns.

At the same time, President Bill Clinton convened a series of seminars on American democracy and community at Camp David and the White House. He invited some of the country’s most prominent “communitarian” intellectuals to glean policy and speech ideas from them. He also established the AmeriCorps program, which expanded and provided support for various civic-oriented volunteer opportunities.

Of the mayors who developed national political profiles in the 2010s, arguably the most successful were Booker, Buttigieg and Fetterman. All three came from Rust Belt communities that had suffered severely from the deindustrialization that many residents and analysts of various stripes blamed on NAFTA, and all three spoke effectively about their personal experience with it in their communities.

Each mayor was also able to tell stories about personal interactions and interventions in their cities that spoke to the sense of a lost community that came to define the turn of the 21st century. The hardest evidence for this lost community came from the book “Bowling Alone” by American political scientist Robert Putnam, who participated in the White House seminars on community and American democracy.

It’s also notable that, prior to running for mayor of Braddock, Fetterman worked at an AmeriCorps program in a poor Pittsburgh neighborhood.

Suburbanization and polarization

Immediately after World War II, federal mortgage guarantees and massive investment in highways fueled suburban housing construction, for which the returning GIs and the baby boom created huge demand.

Along with suburbanization has come political polarization. Urban areas are increasingly composed of people with liberal ideologies, while rural areas are increasingly more conservative. Suburban areas fall somewhere in between – often serving as key battlegrounds in statewide elections.

Midsized cities like South Bend or Miramar are often suburban in nature and design. They typically don’t carry the Democratic ideological baggage of large cities, but they are often also dealing with so-called urban problems such as poverty and crime. This is especially true of Braddock, a suburb with uniquely high levels of poverty and unemployment.

A mayor like Fetterman can therefore show how he’s able to address fundamental and widespread problems while at the same time being relatively nonpartisan about it. Among his better-known accomplishments as Braddock mayor were building a new community center, rehabbing properties, establishing an urban farm and running a youth program.

No doubt, Fetterman is a unique politician. But he is also the product of a specific moment in American political development and culture when mayors became viable actors on the national stage. My guess is that this trend will continue in what will most likely be a crowded Democratic presidential primary race in 2028.

Read more of our stories about Philadelphia and Pennsylvania, or sign up for our Philadelphia newsletter on Substack.

Richardson Dilworth does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. John Fetterman is an unusual politician – but his rise from borough mayor to US senator reflects a recent trend – https://theconversation.com/john-fetterman-is-an-unusual-politician-but-his-rise-from-borough-mayor-to-us-senator-reflects-a-recent-trend-269993