For many years, the main figure informing the ethics of my shopping habits was a handsome celebrity. Paul Newman’s face—framed as it was by a variety of ethnic hats—signaled a quick opportunity to be a better person while just cruising down the condiment aisle. When I chose Newman’s Own over its competitors, I knew I was making the right split-second decision because Paul’s label declares, “All profits to charity!” Which charity? I’ll admit it: I never bothered to check.

When I accepted a job as lifestyle editor of this magazine last summer, I knew it was time to think a little harder about the ethics of my day-to-day choices. And soon, I heard from dozens of PR representatives who said they could help. They offered to send me $16 nail polish with sustainably harvested wood caps to support “organizations that help educate and sustain our beautiful planet.” Fine chocolates produced in Madagascar that promised the cocoa farmers make “4x more income than fair trade cocoa alone.” A wooden bristle hairbrush “handmade in Italy by native artisans,” presumably to combat the nonartisanal production of hairbrushes.
In July, a PR rep for a Brooklyn-based accessories company advanced the game. The Andean Collection, she explained, was a “chic, sustainable collection of accessories inspired by the rural Andes” founded by an American woman to “bring sustainable change to impoverished communities in Ecuador.” That fall, employees of the Collection would be traveling to the city of Otavalo to put the finishing touches on its line of jewelry, hats, and scarves. Would I be interested in tagging along to document the process?
Unlike Newman’s Own or, say, TOMS shoes, which are instantly recognizable as “ethical,” the Andean Collection is small. It relies on journalists and buyers to relay its feel-good story. Here’s how the company tells it: In 2008, Amanda Judge traveled to Otavalo to pen a master’s thesis on indigenous people’s experiences with rural poverty, and how nonprofit and government groups could help. But Judge soon realized that the best way to help these women was to get them jobs, not give them grants. Judge, who had been interested in jewelry design since she was a kid, drew from the artisans’ “long history of creating jewelry out of rainforest seeds,” and set about carving out a niche for it in the global market.
Today, the Andean Collection “continuously develops chic new designs inspired by the fusion of our urban surroundings in NYC and the natural beauty of Ecuador,” and commissions artisans to construct them. Seeds from rainforest palms are carefully carved, dyed, and polished into last season’s runway trends. At upscale pseudo-bohemian boutiques and their shopping-mall counterparts, like Chico’s and Anthropologie, the pieces retail for $29 to $138. Each tag features a quote from the people who fashioned the beads: “Our life has been difficult, but our children will have a better future, thanks to the people like you who buy our jewelry.”
I was skeptical that such a lopsided arrangement could truly be mutually beneficial. But I was impressed that the Andean Collection was willing to invite a reporter along to poke around its story’s edges, even in the form of a junket (months later, a GOOD editorial intern would tell me over beers on a Sunset Boulevard patio that I had acted unethically by going on the trip).
“We are really excited,” the PR representative told me when I accepted her offer. “Do you have a planned article in mind or would this trip be more exploratory?”
The latter, I replied. While I’ve never found myself in a Chico’s comparing a string of Andean Collection beads to a comparable but less-ethically produced necklace, maybe following these accessories to the source would help me make better decisions as a consumer. In a sense, I wanted to understand exactly what I’m getting when I reach for Paul Newman’s pasta sauce instead of Classico—to measure the gap between the status quo and the more ethical option.
* * *
The story of ethical consumerism in the United States begins in 1946 with Edna Ruth Byler, a Mennonite volunteer—the type of figure you might find staring out a window in a yellowing photo album, hands in lap, ankles crossed. On a church trip to Puerto Rico, the story goes, Byler dropped in on a sewing class, where she was struck by a new way to extend her charitable contributions. She began buying the island’s lace needlework crafts and selling them to her friends back home in central Pennsylvania, who found the doilies more appealing and exotic than the traditional charity ribbon. Byler’s work spawned Ten Thousand Villages, the first American craft supplier devoted to ethical global consumerism.
Ten Thousand Villages is still around, selling Nepalese heart pendants and Indonesian carved wooden geckos to consumers who are thoughtful enough to seek them out. But it’s been overshadowed by legions of big-namecompanies pushing their own ethical products. Today, socially conscious consumption is big business. Making choices about how to live well is tough. These companies tell us that we can do good by simply going about our days, buying what we already want to buy. Purchase Project (RED)-branded stuff— a Coca-Cola, Nikes, Belvedere vodka, a Gap shirt—and “the shopper has a cool, new T-shirt and has helped save a person’s life.” (Specifically, the life of an African woman or child with HIV.) Sip a Starbucks coffee and support fair wages for growers. Buy Warby Parker eyeglasses and automatically donate a pair to someone in need.
Many of these products are stamped in shorthand: Sustainable. Fair Trade. Sweatshop-Free. Buy One Give One. A constellation of certifications—Fairtrade International, the Fair Trade Federation, the FTO Mark, UTZ CERTIFIED, Counter Culture Direct Trade Certification, Whole Trade Guarantee, B Corporation, Green Seal—propose different standards for safe working conditions, livable wages, and environmental sustainability. We’re assured that these companies have done the ethical legwork. All we have to do is fasten the clasp.
No company has transcended such labels better than TOMS, the shoe seller that hawks distressed canvas slip-ons, silver-sequined ballet flats, vegan knee-high wrap boots, and, now, wedding footwear. Each time we purchase a $54 pair of petal grosgrain flats, a child in need receives a pair of black slip-ons. The contribution is so straightforward and wide reaching (TOMS has donated more than a million pairs of shoes since 2006) that the brand has become its own ethical shorthand. Consumers who want to buy better can pluck a pair of TOMS out of a sea of Urban Outfitters flats almost by muscle memory.
When you buy an Andean Collection bracelet, you can’t quantify your contribution in charitable funds or matching handouts. And to a certain extent, the company wants to keep it that way. On its website, some Andean Collection products carry Fair Trade stamps, but the company prefers to convince consumers its processes are ethical by relaying a narrative about specific artisans, workshops, and supply chains.
Indeed, the global economy is big and messy. As TOMS says on its website, ethical manufacturing is “a learning process,” and TOMS is committed to making it transparent. The company has published thumbnail photographs of some of the men and women who produce its shoes in Chinese, Argentine, and Ethiopian factories. “Regular visits by our production staff and third party audits ensure not only that the product meets standards, but that our factories provide a clean, safe place to work, fair wages and treatment, and never employ underage labor,” TOMS says. The faq doesn’t address potential follow-up questions like, “What constitutes a fair wage?” and, “Where are the results of the audits?”
Kelsey Timmerman, an American journalist who once traveled to China to interview the factory workers who make his Tevas, recently began raising questions about TOMS’ manufacturing practices. TOMS fans rushed to the company’s defense. Timmerman had not done his research, they said. “Get off your blog,” they told him. “Get inspired by something.”
Nobody’s perfect. Warby Parker’s “frames and their components are crafted in China.” Last year, Victoria’s Secret was criticized for claiming to sell fair trade bras and panties that were actually made from cotton harvested by child slaves. In the story of modern ethical consumption, we all tend to fast-forward to the good parts.
“What about the beginning of the story?” Timmerman asks. “Where the workers are?”
* * *
According to an Andean Collection tag tied delicately to a multicolored açai bead necklace, the story begins on the outskirts of the sprawling market in Otavalo. If you have anything to offer—grain, Colgate, a guinea pig, a poncho, a backpack with a glued-on patch of a Nintendo character—you carry it down to sell at one of the stalls in the labyrinthine market.
It’s here that Olga, the woman who beaded this necklace, once stood in a tiny stall selling grain. That is, until Amanda Judge crossed her path and plugged her into the global economy. Now, Olga and her husband, Cesar (for this piece, the company has requested that I refer to them by first name only “for their privacy”), lead an artisanal fair trade workshop. They make jewelry that will be sold in one of 2,000 locations around the world. Olga also has a brick-and-mortar shop in Otavalo where she sells her own jewelry designs; they are inspired by the Andean Collection, which is in turn inspired by her region’s traditional crafts.
Olga met Judge three years ago, when Judge dropped by Olga’s stall to interview her about her economic situation. Judge recalls that she invited Olga up to her hotel room, where Olga asked permission to sit on the bed. It was her first time on a mattress. “I don’t think I would want to sleep on a mattress,” Olga told Judge. Now that Olga has finally upgraded from a straw mat to a real bed, she says: “I can’t believe I was sleeping on a floor that whole time.”
Judge has a knack for delivering her company’s human-interest narrative in a wry tone that picks away at the sanctimony or sentimentality that might generally accompany such a story—imagine if Emma Stone spent her 20s learning the intricacies of the South American artisan economy. Judge’s thin frame is always draped with handwoven scarves and strings of dyed beads, her long, brown-red hair forever topped with an orange fedora or a sleek rabbit-fur hat. Because the Andean Collection designs are pegged to the fashion cycle, it has risen from the granola ranks of most fair-trade jewelry. But it is still an accessories line for American women who catch up on trends about one season late.
Twice a year, the Brooklyn- and Quito- based Andean Collection team descends on Otavalo to finalize its seasonal line, check up on the artisans’ welfare, and broadcast on-the-ground updates back to potential customers. It’s usually a whirlwind tour. On this trip, Judge and her employees have hired a van to help them traverse the city—in the span of a week, they must drop in on the handful of workshops where the Collection’s 70-plus artisans make hats, weave scarves, string beads, and carve rings.
Olga’s home, which doubles as her work- shop, is an open-air brick structure on a hill. When we arrive, Olga is wearing a T-shirt and sweatpants, directing the workers she’s hired to cook us lunch. Her kids run through the house clutching fistfuls of fake money. An enormous dog gnaws on a chicken foot in the yard. Olga changes into her traditional garb—gold beads, a white blouse, a black skirt with bright embroidery around the waist—and circles the workshop, answering questions about the requested tweaks she’s made to a half-dozen Chico’s prototypes.
Meanwhile, Judge leads us on a tour of the home’s recent improvements—an Andean Collection tag brought to life. This is Olga’s new refrigerator. Here are her new stove, new room, new driveway, new windowsills, new courtyard, new walls. A new brick outhouse surrounds her first toilet, which is also new. Her nails are newly manicured. Olga and Cesar join us, unlock their new car with two beeps, and drive us down the block. We wade into their new field, freshly planted with corn. Olga and Cesar recently bought the land with the help of an Andean Collection loan; it will enable the artisans to diversify their income.
Olga begins answering questions into several voice recorders and cameras. She doesn’t like talking about her past. “My life before was really very sad,” Olga says, adding, “Things are a lot better now.” Olga credits the turn of events to God—and Amanda Judge.
Judge, who is acting as translator, deliberately mistranslates Olga’s praise, directing it to “us,” or “we,” or “the Andean Collection.” But Judge and Olga’s relationship is a direct one. Judge is not giving away a million shoes to thousands of children; she is charting sustained progress in the lives of a few dozen artisans. Whenever Judge returns to Otavalo, Olga sits her at the head of the table, brings her flowers, and doesn’t let her help in the kitchen. Cesar calls her Amandita. “They bought me a live chicken once,” Judge tells me later.
Standing in the field, I ask Olga what she thinks of the American women who buy her jewelry. Olga has been told a story about us, too. “They’re good people who want to help us,” she tells me. “People who like to help people and have good hearts.”
Most people who buy the Andean Collection do like to help. Suzette Munson runs Love 41, an online specialty boutique dedicated to charitable consumerism. (Typical product description: “HIV positive Ethiopian women, left to die on a mountain, are rescued and taught to make jewelry from melted down bullet shells.”) She has stocked the shop with more than a dozen Andean Collection designs. “I especially love stories,” Munson explains. “Through the Andean Collection and these purchases, the artisans have transformed their children’s lives and their own lives. That’s very appealing to me.”
Munson found the Andean Collection after “a lot of searching online,” she says. She typed in “handmade” and “fair trade” and “jewelry” and began paging through the results. Munson learns the stories behind everything she sells to assure customers their money is well spent.
Earlier that week, the artisans sat for a PowerPoint presentation explaining why a piece they would sell to the Andean Collection for $2 could be marked up to $22 by the time it hits the neck of the consumer, pictured in the presentation as a smiling blonde woman on a city street. The presentation is meant to teach the artisans how to correctly price the items they sell to the Andean Collection and other international retailers, to ensure they can cover the cost of the materials, workshop overhead, and minimum-wage paychecks for themselves and the apprentice artisans who work beneath them. It sounds like the bare minimum, but the Andean Collection is actually going above and beyond. Minimum wage and other labor laws in Ecuador are pretty much optional.
American ethics don’t always mesh well with developing-world economies. We confront this firsthand after our visit with Olga, when we walk up the hill to Kevin’s house. The little stone structure looks the way Olga’s house looked before. Kevin’s father works construction, when there is construction work. His mother’s only source of income is a cow. When the Andean Collection arrived in Otavalo, Kevin found a job threading beads in Olga’s workshop. He was 11.
In order to ensure the country’s child labor laws don’t push the family deeper into poverty, the Andean Collection pays Kevin a stipend not to work. But Kevin’s mother is concerned: Spending all day at school instead of in the workshop, Kevin is losing his skills. “You can see why child labor does exist sometimes in some places,” Judge tells me. The Andean Collection is obligated under Ecuadorian law to refuse work to children under 15, though the regulations are lax. “Obviously, children working is not good, but an entire family starving, in my mind, is a lot worse,” Judge says.
The person who figures out how to deal with such quandaries is Chiara Gerlich, the Andean Collection’s nonprofit and environmental resource manager. When Judge goes home to Brooklyn, Gerlich stays behind in Quito and investigates where the Andean Collection’s economic development efforts are causing unforeseen problems. She makes sure workshops are paying their workers fairly, points out sagging roofs for repair, facilitates conflict resolution among the artisans, helps administer small-business education classes, and tries to help families like Kevin’s. She traces stories back to the beginning.
Right now, Gerlich is trying to get a handle on this tagua situation. “TAGUA (tahg-wah),” the Andean Collection tag reads. “This piece is handmade from tagua nut, commonly known as ‘vegetable ivory,’ which grows from a palm tree in the lowlands of South America. It is an eco-friendly material that requires little energy to process, and its commercialization promotes forest growth.”
Sometimes. The Andean Collection makes efforts to trace its products from the artisans to the suppliers to the tree, both to vouch for the quality of the materials (“If you buy a bracelet from the market, your wrist will turn purple,” Judge tells me) and to ensure that its products are truly sustainable. But it can be difficult to lock down the supply chain. “It’s assumed in Ecuador that all the seeds used are sustainably harvested, that because it’s palm they just grow back,” Gerlich says. “But that’s actually not the case.” Some suppliers will cut the trees more than once a year, making it more and more difficult for the trees to regenerate. The tagua harvesting business is competitive, and suppliers can hold their territories and techniques very close to the vest. It takes a lot of work to really know what you’re getting.
* * *
Amanda Judge is trying on an increasingly ridiculous series of hats—a floppy straw one; a version with loose frayed edges that dips down over the eyes; and one with a brim that explodes upward into a Chiquita Banana situation. “That one is crazy,” Judge decides. But she’s serious about the middle one. She’s seen a similar hat on the Anthropologie website priced in the hundreds. “I think this would sell really well,” she decides. She’ll need samples right away for a catalog shoot in the Dominican Republic.
We’re in one of the company’s more established workshops—in addition to the Andean Collection’s line, it produces Panama hats (each one with a “Made in Ecuador” label sewn inside) for other international companies. When Judge arrives, she kisses cheeks, takes a tour of the workroom, and is briefed on the production process—cutting, molding, ironing, and ribboning the felt for a fedora. Then Judge looks directly into another employee’s handheld video camera and expertly dictates the process back to it. The videos will later be uploaded onto the Andean Collection website, where a customer can get an inside look into how her Lola hat is made.

Down in the storeroom, Judge twists her fingers around rabbit fur hats she’s considering for a limited-edition high-end line that’s in the works. “I think the rich people would buy it in this style,” she says, placing one on her head. “It’s going to be a ridiculously expensive hat.”

Though Andean Collection customers are rich in Ecuadorian terms, the target consumer (rabbit fur line aside) is a middleclass woman who usually picks up on fashion trends after they’ve trickled down from the runway and into the mainstream. In the hat shop, Andean Collection employees circulate a dog-eared copy of Vogue to demonstrate the brims and colors that are in this season; the Andean Collection will catch up by the fall. “If you’re on trend, people are just going to buy more,” Judge says.
The more they buy, the more complicated the story gets. Last year, Anthropologie commissioned the Andean Collection to produce thousands of bright woven belts loosely inspired by Ecuador’s traditional waist-cinching fajas. The Andean Collection partnered with a small belt-maker. But when demand from buyers outpaced its looms, it brought in a more established outfit to pick up the slack. The company still works with small workshops, but increasingly, they aren’t enough.
The belts weren’t a hit with consumers. Anthropologie later slashed the price of one style from $48 to $4.95. But abandoning its belt-makers would run counter to the Andean Collection’s mission. So it transitioned them to producing “infinity scarves,” loops of fabric made from the indigenous weavers’ traditional materials (acrylics). The Collection’s designers mailed color swatches from Brooklyn to explain what “neon” meant. Now, weavers and designers are rushing to integrate “pops of neon” into a new crop of scarves before the catalog shoot. The Andean Collection likes working with this workshop because “they’re really collaborative,” Gerlich says. “Not everybody wants to do that. … Some people don’t want to change the designs, don’t want to change colors.”
Some might say that the production of neon infinity scarves is a perversion of traditional indigenous craftsmanship. But Otavalen artisans have been producing and transporting designs for tourist tastes for the better part of a century, long before fair trade practices hit the region. The artisans I speak to are proud that their designs are being sold in New York and Paris and Japan, if under the Andean Collection’s name.
But they aren’t sold in Otavalo. When the Collection drops a new design on its artisans, it has to make sure that it’s protected from the open market, where it could be cheaply copied and devalued before it even appears in the Anthropologie catalog. Once, Judge walked into an internet café and saw a group of artisans scoping out her designs to make and sell for cheap in Otavalo’s market. The competition there has grown fierce. “It’s much harder now,” says Rudi Colloredo-Mansfeld, a University of North Carolina anthropology professor and an expert on Andean artisan economies. “Every year there are more indigenous Otavaleños getting into this business.” Prices have been driven down to the floor. Artisans are forced to produce more and more pieces, then sell them at prices that don’t even cover their costs.
* * *
Soon, Judge may not be able to visit Olga every fashion cycle. Judge is busy scouting a new location, preparing to replicate this whole process in another needy economy. It’s not yet clear how the company’s story will adapt. In each artisan community, Judge will find different materials and styles, different traditional crafts, and different economic needs. Each location will require a new narrative.
The Andean Collection has reached a turning point, not just in Otavalo. If the Collection continues to partner primarily with the neediest artisans, its output will remain limited. Bigger retailers like Anthropologie demand it produce more, faster. Scaling up means fewer Olgas will
be elevated from grain pusher to jewelry designer. Instead, more established artisans will become a little bit more established.
But it also means shoppers will be more likely to stumble across Andean Collection designs in the mall, putting a more ethical option within reach of even people who aren’t reaching for it. Who knows? Maybe in five years, when an American woman sees an Andean Collection label, she’ll immediately know what it stands for, the way I instinctively react when I see Paul Newman’s smiling face on a bottle in the grocery store. But no matter how many opportunities the market offers to align our ethics with our shopping habits, the burden is still on us to resist the impulse to buy the cheapest, closest thing. Here at the top of the economic food chain, no one will hold us accountable but ourselves.
On our last day in Otavalo, Judge and I take a quick spin around the market for gifts to haul back home. As we speed through stalls of earrings and table runners and alpaca sweaters, artisans pitch lower and lower prices at our backs. Judge has volunteered to help me haggle for a trio of woven purses. I pay next to nothing for them. Judge begins driving down the price of a knit onesie, then decides not to push it.
“I think she can use the extra dollar more than I can,” she says.
  • Friendship is built over time, through ordinary moments – I teach lonely college students to notice them
    Nearly 6 in 10 college students said in 2026 that they felt lonely sometimes or always. Denis Novikov/iStock/Getty Images Plus
    ,

    Friendship is built over time, through ordinary moments – I teach lonely college students to notice them

    A college course explores how small, everyday interactions grow into lasting connections.

    Professor of Political Science and Director of the Center for Applied Civic Leadership, Coastal Carolina University

    The first skill I learned when I became a political science professor nearly 20 years ago was how to quiet a room full of chatty undergraduates.

    These days, I often walk into a silent room, with students staring at their phones and barely acknowledging the classmates beside them.

    As I read more about the United States’ loneliness crisis, I began noticing a version of it among my students.

    In a 2026 national survey of over 40,000 college students, nearly 6 in 10 said they felt lonely sometimes or always. At the same time, federal time-use data show that the share of Americans who socialized in person with family, friends or others on an average day fell from 38% in 2015 to 30% in 2025.

    Those and similar other studies capture a familiar contradiction seen on college campuses like my own: Many new students want close relationships, but feel anxious about initiating them and have had little practice sustaining them.

    I realized that my students rarely spoke to one another, and went entire semesters without learning their classmates’ names. Many students seemed unsure how to cross the few feet between them and their peers and make the social connection they craved.

    I designed a freshman honors seminar, “Friendship & Society,” around this uncertainty, combining the academic study of friendship with practical exercises in forming and sustaining it.

    Two women walk closely together down a stone path with red brick pillars on either side of them.
    College students in this class learn about how positive social interactions activate the brain’s reward system while isolation triggers a stress response. Klaus Vedfelt/Digital Vision via Getty Images

    Understanding friendship

    In this course, students examine how an initial exchange can develop into friendship through repeated contact and shared time, and why many potential connections never progress into a lasting friendship.

    They consider how friends help shape identity and memory, whether old friends are owed continued loyalty after their lives diverge and whether a friendship can remain meaningful after it ends.

    Students also look at how friendship can have strong effects on physical and mental health, making it what I believe is an overlooked public health issue. Friendships can also help shape people’s broader sense of belonging in a community, building the social trust that civic life depends on.

    Students test those questions through 10 “Friendship Practices,” a series of experiential activities I designed. Students are asked to share a meal with classmates or visit a public gathering place like a café or lounge to see how these settings can encourage conversation. During a “friendship safari,” small groups walk across campus, noting where conversations begin and where students pass one another without speaking.

    In private journal entries and submitted reflections, students record what they expected from each situation, and what happened when they tried to form connections. They make a short film telling a story of friendship on campus and end with a friendship memoir tracing how their own relationships and expectations changed during their first semester of college.

    Diving into friendship

    Students read “Stay True,” a memoir about a friendship between author Hua Hsu and his classmate Ken that shapes Hsu’s sense of himself long after his friend’s death.

    Neuroscientist Ben Rein’s book “Why Brains Need Friends” explains the biology of connection and isolation, and shows how positive interactions activate the brain’s reward system while isolation triggers a stress response.

    Students also read longform journalism, social science research, public health reports and political philosophy on aspects of loneliness. They also watch TED Talks and films that explore how a brief encounter with a stranger can, over time, become a friendship.

    Lessons learned

    Students learn that a friendship is built from countless moments that may feel meaningless while they are happening. An unremarkable meal, or a conversation that fills 10 spare minutes rarely feels consequential on its own.

    Over time, those moments build relational capital, meaning the shared trust and history friends can draw on when life becomes difficult or a disagreement needs repairing.

    That reserve reaches beyond a single relationship. Communities become more connected when people have accumulated enough ordinary experience together to trust one another and keep showing up.

    Four young women smile and pose as they lift one of the women, wearing a black graduation gown and carrying flowers, in the air.
    Individual, ordinary moments with peers over time can build and help form a friendship. Jeff Gritchen/MediaNews Group/Orange County Register via Getty Images

    By the end of the course, students can weigh different kinds of evidence about how friendships form, develop and sometimes fade. They also become better able to start a conversation, recognize which public spaces make it easier to meet and spend time with others, and identify habits that help relationships deepen over time.

    They finish with a clearer sense of how relationships take shape and how their own choices contribute to the communities forming around them.

    Uncommon Courses is an occasional series from The Conversation U.S. highlighting unconventional approaches to teaching.

    This article originally appeared on The Conversation. You can read it here.

  • Pope Leo XIV’s lung cancer highlights growing number of nonsmokers diagnosed with the disease – and younger people too
    A low-dose CT scan can help with early detection of lung cancer. In this image, the tumor is the white nodule in the upper right corner of the black space. Atlas of Pulmonary Pathology/Flickr, CC BY-SA
    ,

    Pope Leo XIV’s lung cancer highlights growing number of nonsmokers diagnosed with the disease – and younger people too

    Smoking isn’t the only risk factor, and screening can miss those who never smoked.

    When many people think of an average lung cancer patient, they often imagine an older man smoking. But the face of lung cancer has changed. Over the past 15 years, more women, never smokers and younger people are being diagnosed with lung cancer.

    In fact, lung cancer is the leading cause of cancer death among women, and more women die from lung cancer than breast, ovarian and colorectal cancer each year. The American Lung Association reports that while lung cancer rates have risen by 79% for women over the last 44 years, they decreased by 43% for men. And for the first time in history, there are more young women than men diagnosed with lung cancer.

    News about Pope Leo XIV’s lung cancer diagnosis on Oct. 13, 2026, sparked discussion about increasing rates of the disease among people who have never smoked. Leo reportedly is not a smoker. Potential causes for the disease include environmental exposures and genetics, and recognizing the diverse factors that can increase someone’s risk of lung cancer – regardless of their smoking history – is essential for timely and appropriate screening and treatment.

    Cancer that is found at the earliest stages, like that of the pope, can be treated with surgery and cured for both smokers and nonsmokers. The challenge is that people who have never smoked are not currently included in lung cancer screening guidelines, and tumors are often only found by chance.

    As a thoracic oncologist, I have seen many younger women and never smokers walk into my clinic with a new diagnosis of lung cancer. Particularly for never smokers, lung cancer is unexpected for both patients and their doctors, which can often lead to delays in diagnosis. Researchers have described this trend of increasing lung cancer rates among women in different parts of the world and are starting to understand why cases are on the rise.

    Lung cancer in women

    The first explanation of why rates of lung cancer in women have increased is that many started smoking later than men, pushing back their peak in smoking-related lung cancer diagnoses.

    Women also started smoking in the years when filtered cigarettes were most commonly used. This led to an increased risk of a type of cancer called adenocarcinoma due to the way cigarette filters distribute tobacco smoke to the outer parts of the lungs. Some studies suggest that women are more susceptible to the carcinogenic effects of exposure to tobacco and cigarette smoke, including second-hand smoke, and may develop lung cancer after fewer years of smoking compared to men.

    However, it is important to note that most people diagnosed today with lung cancer are not active smokers. About 20% of women with lung cancer have never smoked – higher than for men with lung cancer who’ve never smoked.

    Watch on  YouTube
    An increasing number of lung cancer diagnoses are among people who never smoked.

    Lung cancer risk factors

    Besides smoking and secondhand smoke, there are several other lung cancer risk factors. These include a family history of cancer and exposure to asbestos, radon and air pollution.

    Exposure to carcinogens in the workplace in the form of inhaled chemicals such as arsenic, beryllium, cadmium, silica and nickel is still a concern in some parts of the world. The potential lung cancer risk of e-cigarette and marijuana smoke is still under study but of potential concern.

    Recently, researchers have also found that genetics can play a role in lung cancer risk in some patients with a strong history of lung cancer. Studies of these families have helped identify potential susceptibility genes for lung cancer and environmental risk factors.

    Like BRCA1 and BRCA2 in breast cancer, alterations in genes that promote or protect against tumor development can contribute to lung cancer development. Researchers have yet to identify specific mutations that may predispose individuals to lung cancer. However, studying familial genetic predispositions can help elucidate how lung cancer develops and lead to new biomarkers for early cancer detection in high-risk groups.

    Lung cancer screening

    In 2021, the United States Preventive Services Task Force updated its lung cancer screening guidelines to include younger patients with less smoking history. Now, lung cancer screening is recommended for adults ages 50 to 80 who have smoked at least one pack per day for 20 years, current smokers and former smokers who quit smoking within the last 15 years. Women at risk for lung cancer can talk to their doctors about ordering a low-dose CT scan for lung cancer screening.

    Nationwide, more than 70% of eligible women undergo breast cancer screening but less than 6% of all eligible smokers pursue lung cancer screening. Researchers estimate that these new screening guidelines will increase the number of women eligible for lung cancer screening by 40% by including those at a younger age who have less smoking exposure.

    CT scan of lung adenocarcinoma
    A low-dose CT scan can help with early detection of lung cancer. In this image, the tumor is the white nodule in the upper right corner of the black space. Atlas of Pulmonary Pathology/Flickr, CC BY-SA

    Lung cancer diagnosis

    In recent years, increasing understanding of the genetic changes that can lead to cancer and how to harness the immune system to treat cancer has led to new targeted therapies and immunotherapies that have improved the prognosis of patients with lung cancer. Women tend to have a better lung cancer prognosis than men, especially if they never smoked and have tumors with molecular changes that can be treated with targeted therapies.

    However, lung cancer symptoms may go unrecognized in women. Symptoms of lung cancer can include coughing, shortness of breath, overwhelming fatigue and pain in the back, chest or shoulder, which could be confused for other ailments. Because women tend to be slightly younger when diagnosed than men, patients may be able to tolerate symptoms longer and delay seeking medical attention. Physicians also might not attribute these symptoms to lung cancer due to a patient’s younger age.

    Recognizing the early symptoms of lung cancer, expanding lung cancer screening eligibility and testing for genetic biomarkers to select the best therapy are some of the steps that could help address the global epidemic of lung cancer in women.

    This is an updated version of an article published on Feb. 1, 2023.

    Estelamari Rodriguez, Associate Director of Community Outreach in Thoracic Oncology, University of Miami

    This article originally appeared on The Conversation. You can read it here.

  • New world map makes Africa look bigger: what’s the fuss about? Cartographers explain
    A political wall map using the Equal Earth projection centred at the prime meridian. Wikimedia Commons

    The UN has passed a non-binding resolution to endorse the Equal Earth Projection, a map which more fairly represents the true size of the Earth’s landmasses. The current commonly used projection, called the Mercator Projection, greatly exaggerates land towards the north and south poles, which makes Africa look much smaller. In the Mercator projection, countries near the north and south pole can be anywhere from two to 14 times their true size. In the Equal Earth projection these distortions are minimised, making Africa look larger in comparison.

    We asked Jack Swab and Derek Alderman, cartographers and geographers who study the social and communicative power of maps, to explain what’s going on.


    What is a map projection?

    A map projection is a technique that cartographers (map-makers) use to transform the round, three-dimensional Earth into a flat, two-dimensional map that we see on the wall or on our computer screen. As cartographers flatten the globe, the map becomes distorted, changing shapes and areas. There is no map projection that does not distort the Earth, but some projections are better suited for some uses than others.

    A cartographer’s job is to choose from the hundreds of different map projections, and consider where the map is focused and how it is going to be used. No single projection is best for every use. This new Equal Earth projection is better suited than Mercator for producing global scale world maps for educational, public communication and policy purposes.

    The Equal Earth supports a more accurate geographic understanding of the relative sizes of countries and continents. It provides a fairer perspective for the public to compare regions in terms of population, environment, development, politics and other global patterns.

    Is the Mercator projection still useful?

    While the Mercator projection isn’t good for showing the size of the Earth’s landmasses, we won’t see it totally disappear. For example, it’s very useful for navigational purposes as it maintains the accuracy of a compass bearing between two points without having to recalculate it.

    This is why most online mapping platforms like Google Maps or Apple Maps rely on a variation of the Mercator projection to provide directions. Using the Equal Earth projection for navigation would not be as effective as the Mercator projection.

    How will the Equal Earth projection be used?

    Map-making is decentralised and there is no single authority regulating which map projection is used. What the UN did was endorse the broader message that Equal Earth is a fairer projection that more equitably displays the true size of the Earth’s land. And although this action is happening at a global level, there are movements underway in cartographic communities to make the Equal Earth projection the default world map projection.

    The UN resolution by itself will not make Equal Earth a globally adopted projection. That requires intentional revision of maps used in textbooks, databases, media productions and diplomatic discussions, which requires labour and financial investment.

    The Equal Earth projection was developed by cartographers and is a popular choice among map-makers since it was unveiled in 2018. It’s now possible to buy wall maps with the Equal Earth projection on them, and the projection has already been used in a wide variety of media. That said, individuals will need to opt in to using the Equal Earth projection over other types.

    Why has the Equal Earth projection sparked resistance?

    Resistance to the Equal Earth projection has been quite limited. There were several abstentions from the United Nations General Assembly vote, but most of this was for other reasons. Ukraine, for example, raised concerns over the depiction of the contested Crimean Peninsula on the map, which the Equal Earth Projection website depicts as contested territory.

    This spurred a Russian response, along with points from other nations about contested territory. Given the UN resolution was a vote on how the world is portrayed and not about any specific political boundaries (a point that both Russia and Ukraine agreed on), these discussions amounted to geopolitical posturing about non-map issues.

    The lone outlier, and only “no” vote against the Equal Earth projection, came from the United States. It claimed that the proposal was part of a “radical and ideological project” that was not appropriate for the United Nations to be debating. American delegates took issue with language linking Mercator’s distortions to colonial legacies and the marginalisation of Africa. This is not surprising since the current administration denies the existence of structural systems of inequality.

    It is hard to miss the hypocrisy at play. The US wants other countries not to discuss the political implications of cartography even as President Trump engages in his own nationalist branding of the map. He has unilaterally renamed the Gulf of Mexico to the Gulf of America and Lake Ontario to Lake America for clear ideological reasons and without international consultation.

    How does the new map matter when it comes to changing global views of the world?

    The argument that African nations put forward was that the Equal Earth projection is a form of “cognitive justice”. Cognitive justice recognises that people often equate power and value of places with their apparent size on maps. Traditional views of Africa as a smaller continent compared to Europe or North America typically reflect the perceived importance of these parts of the world.

    Equal Earth may make it easier to teach, broadcast and discuss a different view of Africa and its prominence in the world. Today, African countries are among the world’s fastest growing economies and fastest growing populations. Map projections alone cannot change people’s attitudes. Yet, as African nations seek to have more influence in international affairs, correcting the mental map of global leaders is an important step in amplifying the continent’s relevance and rights.

    Jack Swab, Assistant Professor Department of Geography & Sustainability, University of Tennessee and Derek H. Alderman, Chancellor’s Professor of Geography, University of Tennessee

    This article originally appeared on The Conversation. You can read it here.

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