Jamie used to love his job. Working as a hospital porter, helping sick people in need, he probably never expected to become a patient himself: at 50, he was still fit and healthy. But then he strained his back at work, and so began a long, downhill slide. He was given physio exercises to follow online, but couldn’t access them, and before long he was in such pain he was signed off work for good. Unable to keep active, and putting on weight, Jamie was referred to a diabetes prevention programme; but by now his back hurt too much to drive to the clinic, and public transport was a struggle.

Overwhelmed and isolated, he ended up retreating inside his damp, mouldy council house. Five years on, Jamie still isn’t working, but his back is almost the least of his problems. He’s diabetic, asthmatic thanks to the mould, suffering from coronary heart disease, and if he isn’t depressed yet then he probably soon will be.

There are countless Jamies out there, many suffering from what some doctors privately call “shit life syndrome”: getting dealt a string of bad cards, lacking the money to bounce back from any of them, and sinking deeper with every passing day. They’re genuinely sick, often with multiple diagnoses, but sick in a particularly complex, tangled way that medicine alone can’t magically solve. And herein lies this autumn’s toughest political battleground, as a new Labour government attempts to kickstart economic growth by getting people who are long-term sick back to work.

These are worrying times for many people living on disability and sickness benefits. Keir Starmer’s warning in Liverpool that those who can work should has done little to quell anxious speculation about what this autumn’s budget means for welfare spending, especially as ministers have yet to spell out exactly what they’ll do about planned disability benefit reforms set in train by the outgoing Tory government. Starmer has stressed that he knows there will be “hard cases”, who physically can’t work no matter how much they try, and that Labour wants to help rather than force people back into jobs. But it’s difficult to relax when the roads to previous welfare crackdowns have been paved too often with reassuring words.

Enter Jamie, who isn’t a real person, but a representative example of countless very real patients devised by the NHS Confederation and the Boston Consulting Group’s Centre for Growth to illustrate their joint report on a more benign way to get half a million long-term sick Britons back to work. Their analysis skilfully separates tabloid myths about skivers and sicknotes from hard facts. Yes, Britain has 2.8 million adults economically inactive because of long-term illness, up by a startling 900,000 since 2020. No, this isn’t some unavoidable global hangover from the pandemic – economic inactivity has fallen elsewhere in Europe – but it’s also extremely unlikely to be because a life on welfare is just too cushy here. The introduction of universal credit, if anything, left many disabled people worse off than before.

The simple explanation is that Britons as a whole are sicker than we used to be, with a third of working-age adults admitting to at least one health condition; that economic inactivity is in some ways a canary down the mine, pointing to lives that are making too many people stressed and ill. Tellingly, the report concludes that the kind of social and environmental factors that so often underpin shit life syndrome explain more of the variation in health outcomes between different parts of the country than more obvious factors such as diet and exercise, with deteriorating living conditions and rising crime particularly closely linked to avoidable deaths.

But it also shows how little it would have taken to halt Jamie’s downward slide; how different things might have been if he’d been offered the chance to retrain for a desk job, or cheap transport to his various appointments, or a better roof over his head. The take-home message is that getting sick people fit for work again requires the whole of government uniting around a common purpose – or mission, to use the Starmer buzzword – to reach the parts doctors can’t, backed up by employers doing more to keep staff healthy.

There are reasons to be hopeful that ministers broadly get that. Wes Streeting’s announcement that “crack teams” to cut NHS waiting lists will be deployed first not in places with the longest waits, but in those with the highest rates of people off sick, is a promising sign of different bits of government pulling in the same direction. The promise by the housing secretary, Angela Rayner, to make private landlords tackle damp and mould swiftly wasn’t billed as a public health measure, but is potentially a life-saver for people with respiratory diseases. The promise by the work and pensions secretary, Liz Kendall, of “no more writing people off, then blaming them just to grab a cheap headline” reflects a genuine desire for less noisy tub-thumping, and more practical focus on results – including giving more freedom to local mayors and councils to run back-to-work initiatives on the ground.

But the NHS Confederation’s hopes of creating a virtuous circle – where upfront spending to improve the nation’s health ultimately leads to lower welfare and healthcare bills, freeing up billions for everything else – requires something bolder than a “Treasury says no” approach focused stubbornly on upfront savings. There must be money to match good intentions, or Labour risks making already tough lives still tougher.

It’s no secret that the political sentiments of Americans follow lines of race and ethnicity, education and age. But what makes presidential elections so competitive is how these demographic groups often balance each other out.

In 2024, this delicate equilibrium is key to understanding the seven battleground states where, according to the polls, the presidential race is closest. Last election, several of these states were decided by fewer than 40,000 votes. Since then, together they’ve added about 1.3 million potential voters, and the smallest shifts in sentiment or turnout among certain groups could be enough to alter the outcome of this election.

To better understand the demographic forces at play in the battlegrounds, The New York Times conducted a granular review of the 2020 contest and compared precinct-level results with census data to estimate who cast ballots and how they voted. We examined race and ethnicity, age, education and geography to identify trends and key groups in each state. (Gender is another growing factor in partisanship but was not part of this analysis.)

What to watch President Biden’s winning coalition relied heavily on Latino voters, who made up nearly a quarter of those who voted in 2020, a figure that will likely rise in this election. But while Latino voters in the state have typically favored Democrats, no group is a monolith.

Experts say Latinos have weaker party attachment than other nonwhite groups and could be persuaded to change their votes. Moreover, a significant share of this group is made up of U.S.-born, young Latinos who will vote for the first time, and their sentiment is less predictable. Recent surveys have shown former President Donald J. Trump making inroads with young people and voters of color.

Mr. Trump’s biggest support in 2020 came from white voters aged 35 and older. This group accounted for half of the ballots cast, due in part to the outsize number of white retirees in the state.

For Democrats, there are potentially more votes to gain. In 2020, there were more ballots cast for the Democratic Senate candidate than for Mr. Biden. “Those voters who voted for Mark Kelly but decided not to vote for Biden or Trump could have decided the outcome of the race,” said Samara Klara, a political science professor at the University of Arizona.

What to watch Democrats in Georgia have long been guided by the “30/30 rule,” a term made popular by the University of Georgia political scientist Charles S. Bullock III. It says that in order for Democrats to win, Black voters must make up 30 percent of all voters and at least 30 percent of white voters must vote Democratic.

Black voters, who cast nearly a third of the ballots in 2020, overwhelmingly favored Mr. Biden — by almost 90 percent. But that reliable base of support appeared to be slipping earlier this year, and it’s a group that experts say Vice President Kamala Harris must energize and excite. About 850,000 Black Georgia residents did not vote in 2020.

“If you have anemic turnout among Black voters, that will spell doom for the Democratic ticket,” said Andra Gillespie, a political science professor at Emory University.

Both parties will also be looking to appeal to a growing share of white voters with a bachelor’s degree, a group whose votes were split nearly evenly between Mr. Biden and Mr. Trump in 2020.

What to watch In 2020, Mr. Biden won Michigan handily — at least by the standards of a battleground state.

But Mr. Trump performed very well with white residents in suburban and rural communities, who made up nearly two-thirds of the voters in the 2020 election.

Democrats’ strong performance among nonwhite voters and in the suburbs of Detroit helped erase Republicans’ advantage in the suburbs around smaller cities in 2020. But even though Black voters overwhelmingly supported Mr. Biden, they were a relatively small group — just 14 percent of those who cast ballots. And experts say that Black support for Democrats could be waning in Michigan.

“There’s definitely an attitude that they aren’t represented, in comparison to their population and their outsize role in the Democratic party,” said Matt Grossmann, a political science professor at Michigan State University. He pointed to Detroit, a majority-Black city that does not have any Black representation in Congress. “The feeling is, how much attention are you paying to us? And how much are you taking us for granted?”

Disillusionment among the estimated 3 percent of Michigan voters who are Muslim and Arab American — a traditionally strong Democratic constituency — could also make a difference this year. Many of these voters have voiced their anger and frustration with the Biden administration’s support for Israel in the war in Gaza, and some have said they may choose to sit out this election or cast ballots in favor of a third-party candidate.

What to watch Nationally, education is a major political fault line, with college-educated voters far more likely to support the Democratic Party and less-educated voters favoring Republicans. But Nevada is the major exception to this rule: Democrats have won there in the past four elections, despite the state having a relatively low share of college-educated voters.

That’s because educational attainment divides mostly white voters, and many of Nevada’s less-educated voters are not white. Mr. Biden won half of the vote among voters without a four-year degree in Nevada, atypical for the nation as a whole.

Over the last several years, inflation has hurt working-class voters, and concerns about the economy could make it easier for the Trump campaign to eat into the Democratic advantage with blue-collar voters of color.

“Nevada is a little bit of a different animal,” said David Damore, a political science professor at the University of Nevada, Las Vegas, pointing to the state’s low voter turnout, high diversity and more transient population. “This all means that there are a lot of potential untapped voters that could be mobilized.”

What to watch In 2020, North Carolina gave Mr. Trump the narrowest lead of any state he won. Voters in rural areas, who accounted for nearly a fifth of the total, helped deliver Mr. Trump his victory.

But North Carolina also has many small cities with a strong partisan divide between city-dwellers, who favor Democrats, and suburbanites, who favor Republicans.

For Democrats to flip the state, they must lose fewer votes in rural areas and increase voter turnout in smaller cities, like Greensboro and Asheville, said Chris Cooper, a political science professor at Western Carolina University.

“If we see a marginal movement away from Trump in rural areas, that’s really important,” he said. “The map will still show these places as red, but those differences can be the difference between winning and losing.”

What to watch As it does in other states, education plays a big role in the partisan divide in Pennsylvania. White voters without a bachelor’s degree made up nearly half the total, and they favored Mr. Trump three to one in 2020. Even so, that wasn’t enough for him to overcome the coalition of white voters with a college degree and voters of color who delivered Mr. Biden a victory.

The other big factor is geography.

Mr. Trump dominated the state’s rural areas and small towns, as well as the Pittsburgh suburbs. But Mr. Biden had a strong showing in Pennsylvania’s cities and in the Philadelphia suburbs, areas that accounted for more than 40 percent of the votes in 2020.

Wisconsin saw a similar geographic divide among voters. The bulk of Mr. Trump’s support came from the state’s more than 1,000 small towns and the outer suburbs of Milwaukee.

But the fastest-growing part of the state is an area that increasingly favors Democrats: the suburbs of Madison, home to the main campus of the University of Wisconsin.

In 2020, turnout in Dane County, which includes Madison, was 89 percent.

“It is among the highest turnout counties in the country,” said Charles Franklin, the director of the Marquette Law School Poll. “The question for Democrats here is, is it even possible to squeeze more votes out of Dane County?”

“I’m not working class any more,” Keir Starmer told LBC’s Nick Ferrari this week. Of course that’s the case. As the Daily Mail rushed to point out, he has just paid off his mortgage on a £2m house, and earned a lot as a barrister and as the director of public prosecutions. The right loves to probe the hypocrisies and the “champagne socialism” of Labour people. The Bollinger Bullingdon Club members, meanwhile, are just fine as they don’t pretend to do good.

Tool-maker father, nurse mother, a childhood in which at times they struggled to pay bills – this we know about Starmer. Politicians do need to talk about their origins because it tells us where they’re coming from, in every sense. Why else were those infamous Bullingdon photos suppressed that displayed those young masters of the universe David Cameron, George Osborne and Boris Johnson, among other luminaries, at their arrogant worst? Class origins matter.

This cabinet is the most working-class in history, with some from backgrounds of grinding hardship. Wes Streeting’s remarkable autobiography tells of a family where neglect and crime were commonplace. He came up via good teachers pushing him to go to a summer school at Cambridge and there was no looking back from there. Angela Rayner’s story is harsher: a single mother at 16 in Stockport, no qualifications, she worked as a carer before rising up through the trade union movement. Bridget Phillipson’s single mother was poor in Sunderland. David Lammy and Steve Reed came up the hard way. And so on.

Roughly 46% of the cabinet had parents with working-class occupations – well above the average for the rest of the working population, according to sociologists Aaron Reeves and Sam Friedman’s new book, Born to Rule: the Making and Remaking of the British Elite. According to the Sutton Trust, only 4% were educated privately, which is significantly lower than previous Labour cabinets and in another world to Rishi Sunak’s cabinet, of which 63% were privately educated.

But no, of course they aren’t working-class now: MPs earn £91,346 and cabinet ministers an extra £67,505, while the national median wage is £35,000. But where they come from matters a lot. Looking at the latest Who’s Who – a catalogue of the most influential people in Britain – Reeves and Freidman examined 3,000 of its entrants and found “British elites from working-class backgrounds tend to tilt to the left politically and socially” and “are more likely to favour increasing taxes on the rich, to emphasise reducing poverty, and to think Britain is a racist country”.

These days, among the successful there is often a hankering to inflate your authentic working-class roots. I enjoyed a recent LSE survey of those in professional or senior managerial jobs that found an astonishing 47% of this well-paid cadre call themselves working class. Starmer is right to avoid that trap. A quarter of those in the survey actually had parents in middle-class occupations yet they still called themselves working class, referring back to grandparents or even great-grandparents’ occupations. The reason they feel they need that good working-class origin story is to prove they have earned their privilege. The right approach is to recognise that very large numbers of us in good jobs had a great boost, financially and educationally, because of our childhood backgrounds.

Admitting to being middle class can be embarrassing. That’s why I have tried in my memoir, An Uneasy Inheritance: My Family and Other Radicals, to be honest about how privilege is passed down the generations, benefiting from the self-confidence, the security, and the second and third chances if you mess up. My family of successful professionals have all been on the left, and were all confounded by the question of how to square their advantages with their beliefs; always painfully aware of falling short, and the remedies sought were sometimes comical. It’s painful to fess up to a background of every advantage: I searched for a working-class ancestor, but found not a twig of the family tree with which to claim I had earned my place. I watch with amusement others who have academics or doctors for parents who affect working-classness. Everyone wants to show they have the merit to deserve their status.

This cabinet takes over a country in which social mobility has gone backwards and the gap between rich and poor keeps widening. People are less likely to escape their roots than when I was born. Starmer and all of the new government talk earnestly of opportunity and fulfilment for every child, and they mean it. Every Labour government improves the lot of the poor, of children and pensioners: undoubtedly, this one will too. By how much, we don’t know.

Against an onslaught from the Tories and their pliant press, they have said they will take VAT relief from private schools, when no other Labour government dared touch them for fear of being accused of “the politics of envy”. The seriousness of their intent is beyond doubt and their backgrounds mean they know exactly what an extra £20 a week on benefits means to families on the edge, because they’ve seen it themselves. That is the £20 uplift that Sunak would later whip away after Covid, a man whose only disadvantage he could think of was that he went without Sky TV in his Winchester childhood. Best not to claim, as Kemi Badenoch foolishly did, that she of middle-class background “became working class” when she worked as a student at McDonald’s.

The Tories and their press will continue to slam Labour people over class. Rayner gets it non-stop: whether for going to the opera or for dancing in Ibiza, she can’t seem to win. Mostly, they seek out hypocrisy, which makes it essential that anyone on the left is absolutely honest about their background. Never pretend. The working-class background of this cabinet is likely to do more for the people and places of their past than they have dared propose so far.

Keir Starmer has told Russia he does not know how it can show its face at the United Nations after invading Ukraine and treating its own citizens as “bits of meat to fling into the grinder”.

Addressing the UN security council, of which Russia is one of five permanent members, Starmer delivered a direct message to Moscow that it should not be present at the meeting.

He accused Russia of violating the UN charter because its invasion of Ukraine was illegal, threatened global security and had caused “colossal human suffering”.

“We must ensure accountability for those violating the UN charter and this council must recommit to the values that it sets out,” he said. “This should go without saying. Yet, the greatest violation of the charter in a generation has been committed by one of this council’s permanent members.”

He drew attention to the 35,000 civilians who have been killed or injured, the 6 million forced to flee and almost 20,000 Ukrainian children kidnapped by Russia.

The British prime minister added: “I think of Yaroslav Bazylevych, whose wife and three daughters were killed earlier this month by a Russian strike on civilians in Lviv. And I wonder how Russia can show its face in this building.

“Six hundred thousand Russian soldiers have also been killed or wounded in this war. And for what? The UN charter, which they sit here to uphold, speaks of human dignity. Not treating your own citizens as bits of meat to fling into the grinder.”

As well as calling for accountability for Russia, Starmer also addressed the conflicts in the Middle East, saying the region was “on the brink”.

He called for diplomacy and an immediate ceasefire between Israel and Hezbollah, and an immediate, full and complete ceasefire in relation to Israel’s war in Gaza with the release of all the hostages.

“We need a political route to that agreement, which provides a bridge to a better future. A credible and irreversible path towards a viable Palestinian state,” he said. “Alongside a safe and secure state of Israel. This is the only way to provide security and justice for both Israelis and Palestinians.”

Starmer’s trip to the United Nations general assembly in New York is his third trip to the US in three months. The Ukrainian president, Volodymyr Zelenskyy, is also attending to present his “victory plan” to Joe Biden and the US presidential candidates, Donald Trump and Kamala Harris.

Zelenskyy has been seeking permission to use British-French made Storm Shadow missiles on Russian territory, with UK support, but negotiations with the US are still continuing as the weapons use some US technology.

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Pressed on when a decision would be made about the use of UK-supplied Storm Shadow missiles within Russia, Starmer said: “We will have discussions about a whole range of issues, and we will listen carefully to what President Zelenskyy’s got to say, and that’s what’s going to happen in the next few days.”

He added the discussions would not be about the “sole issue like long-range missiles” but a “strategic, overarching route for Ukraine to find a way through this and succeed against Russian aggression”.

Addressing the UN security council on Tuesday, Zelenskyy accused Moscow of committing “international crimes” by targeting Ukrainian civilians and energy infrastructure, and claimed he had proof that Putin was plotting to target three Ukrainian nuclear power plants to further degrade the country’s energy grid.