In 2021, the Drake Institute’s fellows highlighted a troubling reality: although women make up nearly half of the U.S. workforce and hold half of all undergraduate degrees, they continue to represent only a fraction of the nation’s science, technology, engineering, and math (STEM) professionals. At that time, women accounted for just 28 percent of science and engineering personnel, and fewer than one in five bachelor’s degrees in computer science and engineering were awarded to women. Researchers pointed not to ability but to confidence gaps as a key factor in this persistent segregation. This uneven representation was not only a matter of equity; it revealed a structural weakness in our economic infrastructure.

Clean air is not just an environmental issue. When asthma keeps mothers out of work, when respiratory illness drives up family medical bills, when rural women lack access to real-time air quality alerts—these are failures of economic infrastructure. Today’s updates reflect both the enduring accuracy of our original analysis and the urgency of new data, new standards, and worsening climate risks.

In 2021, the Drake Institute flagged a quiet but critical shift in maternal health policy: states were beginning to recognize doulas as Medicaid providers, opening new pathways for reimbursing services long delivered outside formal medical systems. At the time, four states—Oregon, Minnesota, Washington, and Oklahoma—had passed legislation to integrate doulas into Medicaid, while pilot programs were underway in New York, New Jersey, and the District of Columbia. Advocates, however, expressed concern: without inclusive certification structures and provider-led policymaking, landmark legislation could inadvertently exclude community-based doulas—the very practitioners most trusted by marginalized families.