Via the Healthcare Triage team, an explanation of survival v. mortality. Worth your five minutes and mandatory if you’re debating the merits of different healthcare system:
Almost every time someone wants to proclaim the US to be the “best in the world” in health care, they point to survival rates. Those refer to the percent of people who live a certain amount of time after they’ve been diagnosed with a disease. But there are real problems in using survival rates to compare the quality of care across systems. The metric people should be using is mortality rates. And when we compare mortality rates, we don’t look nearly as good.
It is easy to sanctify policies or identities by the deaths of victims. It is less appealing, but morally more urgent, to understand the actions of the perpetrators. The moral danger, after all, is never that one might become a victim but that one might be a perpetrator or a bystander.
It is tempting to say that a Nazi murderer is beyond the pale of understanding…Yet to deny a human being his human character is to render ethics impossible.
To yield to this temptation, to find other people to be inhuman, is to take a step toward, not away from, the Nazi position. To find other people incomprehensible is to abandon the search for understanding, and thus to abandon history.
“A full decade after the Supreme Court struck down anti-sodomy laws as unconstitutional violations of a right to privacy, the East Baton Rouge sheriff’s department was continuing to enforce the state’s version of the statute. Not only that, but it was going out of its way to do so, setting up stings to find and arrest gay men for the crime of having sex—even though the district attorney had pointedly refuse to prosecute those cases.”
Later in his post, Murphy writes, “Keeping anti-sodomy statutes on the books serves no real function, since the crimes are impossible to prosecute. Mostly, the laws’ supporters just don’t want their states to legally acknowledge that there’s something OK about homosexuality.”
The idea that invalid but still-on-the-books anti-sodomy laws serve no real function is exactly what’s belied by Murphy’s story and the reporting of the Baton Rouge Advocate, which first publicized the arrests.
Their function is to provide cover for local law enforcement to carry out a campaign of intimidation and harassment against the gay community. As the East Baton Rouge sheriff’s spox says, “This is a law that is currently on the Louisiana books, and the sheriff is charged with enforcing the laws passed by our Louisiana Legislature.” They’re well aware that courts have struck the statute down, but they’re intent on being assholes about it until the Legislature changes the law.
Being arrested has real consequences, even if charges from the local DA aren’t forthcoming. The handcuffs are real, the mugshots published on websites/local rags are real, and the feeling of intimidation is real.
It’s true that anti-sodomy laws don’t serve a legitimate function, but they carry very real consequences that go beyond a statement of disapproval from the state government.
Next year, the nation will mark the 50th anniversary of the War on Poverty, which President Johnson proclaimed in his State of the Union address of January 1964. Sadly, we should expect to hear a drumbeat of attacks claiming that, as President Reagan said long ago, we fought a war on poverty and “poverty won.” Indeed, House Budget Committee Chairman Paul Ryan said recently of the anti-poverty effort, “We don’t have much to show for it.”
The truth is very different. A number of anti-poverty programs — including some key efforts that have their origins in the War on Poverty and some that came later, often the product of bipartisan agreement — have an impressive record of achievement. Together, programs such as food stamps (now known as the Supplemental Nutrition Assistance Program, or SNAP), the Earned Income Tax Credit (EITC), Medicaid, college financial assistance and broader based programs such as Medicare, have reduced poverty and malnutrition, expanded access to health care, and opened doors of opportunity for millions of people. To be sure, poverty remains a serious problem in the United States and remains higher here than in many western industrialized countries. And, not every program begun in the 1960s or more recently has been effective. But, a bumper sticker analysis of the War on Poverty and today’s safety net that implies that “poverty won” misses the mark.
“This is supposing the present race of kings in the world to have had an honorable origin: whereas it is more than probable, that, could we take off the dark covering of antiquity and trace them to their first rise, we should find the first of them nothing better than the principal ruffian of some restless gang, whose savage manners of pre-eminence in subtilty obtained him the title of chief among plunderers; and who by increasing in power and extending his depredations, overawed the quiet and defenseless to purchase their safety by frequent contributions. Yet his electors could have no idea of giving hereditary right to his descendants, because such a perpetual exclusion of themselves was incompatible with the free and restrained principles they professed to live by…. Perhaps the disorders which threatened, or seemed to threaten, on the decease of a leader and the choice of a new one (for elections among ruffians could not be very orderly) induced many at first to favour hereditary pretensions; by which means it happened, as it hath happened since, that what at first was submitted to as a convenience was afterwards claimed as a right.”
In 1989, Hallam Hurt began what would become 25-year, federally-financed longitudinal study of babies exposed to cocaine in utero. Her subjects — babies born to low-income mothers in Philly’s Albert Einstein Medical Center — were divided between an experimental group of infants whose mothers had used cocaine during their pregnancy and a control group that had not been exposed.
The researchers consistently found no significant differences between the cocaine-exposed children and the controls. At age 4, for instance, the average IQ of the cocaine-exposed children was 79.0 and the average IQ for the nonexposed children was 81.9. Both numbers are well below the average of 90 to 109 for U.S. children in the same age group. When it came to school readiness at age 6, about 25 percent of children in each group scored in the abnormal range on tests for math and letter and word recognition.
Other researchers found similar results.
None of this suggests cocaine use is safe. The researchers only studied near- or full- term babies in order to separate the ill-effects of premature birth from the effects of cocaine exposure itself. Cocaine use during pregnancy increases the risk of premature birth.
But this does mean crack cocaine was not responsible for poor outcomes in full-term children:
While the cocaine-exposed children and a group of nonexposed controls performed about the same on tests, both groups lagged on developmental and intellectual measures compared to the norm. Hurt and her team began to think the “something else” was poverty.
As the children grew, the researchers did many evaluations to tease out environmental factors that could be affecting their development. On the upside, they found that children being raised in a nurturing home - measured by such factors as caregiver warmth and affection and language stimulation - were doing better than kids in a less nurturing home. On the downside, they found that 81 percent of the children had seen someone arrested; 74 percent had heard gunshots; 35 percent had seen someone get shot; and 19 percent had seen a dead body outside - and the kids were only 7 years old at the time. Those children who reported a high exposure to violence were likelier to show signs of depression and anxiety and to have lower self-esteem.
It’s easy to ascribe moral culpability to pregnant women who destroy their children’s chance at healthy development by using illicit drugs. It’s a lot more difficult to blame mothers for being poor and living in violence-ridden neighborhoods.
The supposed “Crack Baby Epidemic” made it easy for the media and conservative politicians to demonize poor, overwhelmingly Black, mothers. But turns out, we didn’t have a crack baby epidemic. We had — and still have — an epidemic of kids living in poverty.
TL;DR is that more and more of the total economic output in rich countries is being accumulated as wealth in a way that hasn’t happened in over a hundred years. This is probably due to slowing productivity and population growth, rather than everyone waking up and deciding they want to save more money. Obviously has massive implications in terms of investment taxation and regulation in the long run.
But holy eff I cannot get over this graph that shows the distribution of US wealth over time. In the early part of that graph, human slaves are one of the single largest sources of wealth. Like, the proportion of total wealth from the ownership of slaves was higher than the proportional of total wealth from the ownership of housing during the housing bubble. And things worked this way for decades.
So by and large, this is how American wealth was initially accumulated - by kidnapping and imprisoning Africans and forcing them to work and claiming ownership of the output of the labour. Not even an exaggeration there. It’s just really jarring to actually see data on it.
Yes: “So by and large, this is how American wealth was initially accumulated - by kidnapping and imprisoning Africans and forcing them to work [on land violently expropriated from Native Americans] and claiming ownership of the output of the labour.”
All doctors in NYC receive alerts from the NYC Department of Health about important health issues in the city. I just received this:
The outbreak of measles among Orthodox Jewish communities in Borough Park and Williamsburg, Brooklyn has ended. This was the largest outbreak of measles in the United States since measles elimination in 2000. A total of 58 cases were confirmed; the last case had rash onset on June 9. The outbreak began in a few extended families of vaccine refusers, and it was propagated by children whose vaccinations were delayed. No confirmed measles cases had documentation of vaccination at the time they were exposed to measles.
Seriously, vaccines have helped prevent a lot of really harsh and potentially deadly diseases.
Plus they save the lives of adults who are sick or immunocompromised.
Btw some anti vax people? Actually say it’s a good thing these diseases kill people, because it weeds out those too weak to survive. In case you weren’t aware that deadly ableism and anti vax sentiments often go hand in hand.
Insular religious communities are not the only places anti-vaxers are gaining strength.
Boulder, Colorado — wealthy, well-educated, liberal — has a vaccine exemption rate of 11%, which is a healthy reminder that conservatives don’t come close to owning a monopoly on irrationality and scientific illiteracy.
There’s probably a role for state law to place in fixing this. Colorado, along with 20 other states IIRC, permit parents to excuse their kids from vaccination with merely a “philosophical objection.” That needs to end. But most of the work is going to have to come from other parents applying pressure on their friends and acquaintance to not be idiots.
A fantastic report on inter-generational mobility, courtesy of researchers at UC Berkeley and Harvard and the NY Times. Some findings:
“Whatever the reasons, affluent children often remain so: one of every three 30-year-olds who grew up in the top 1 percent of the income distribution was already making at least $100,000 in family income, according to the new study. Among adults who grew up in the bottom half of the income distribution, only one out of 25 had family income of at least $100,000 by age 30.”
“The researchers concluded that larger tax credits for the poor and higher taxes on the affluent seemed to improve income mobility only slightly. The economists also found only modest or no correlation between mobility and the number of local colleges and their tuition rates or between mobility and the amount of extreme wealth in a region.”
The big news is about the geography of mobility: “Climbing the income ladder occurs less often in the Southeast and industrial Midwest, the data shows, with the odds notably low in Atlanta, Charlotte, Memphis, Raleigh, Indianapolis, Cincinnati and Columbus. By contrast, some of the highest rates occur in the Northeast, Great Plains and West, including in New York, Boston, Salt Lake City, Pittsburgh, Seattle and large swaths of California and Minnesota.”
My first reaction was to suggest that areas which attract a higher proportion of immigrants were going to have better inter-generational mobility, on the theory that there’ll be a lot of catch-up income growth between 1st and 2nd generations of Americans. But I’m not sure that’s right. A few of those southeastern MSAs with terrible mobility figures do attract a fair number of immigrants.
The Harvard/UC Berkeley research group released its data, in case the NY Time’s infographics don’t do it for you.
Pro-tip for these folks: When Elizabeth Warren says she wants to curb the power of Wall Street, she’s not advocating for expanding sidewalks that line the street in lower Manhattan.
When a newspaper lede reads, “The White House called on the Kremlin to respect the freedom of the press,” it is not the case that the building located at 1600 Pennsylvania avenue called up a fortress in Moscow to discuss printing presses.
Similarly, when President vowed to bail out Detroit, everybody understood him to mean the US-owned segment of the auto industry, which has offices and plants all over the country.
As Weigel writes, “If you’re still conflating the bankruptcy proceedings of “Detroit” (car industry) and “Detroit” (city) you’re probably just stupid.”