I wish I was surprised

 The United Health Foundation recently released it's 2021 report on American Health Rankings. And, well, it's kind of what you'd expect. West Virginia ranks at or near the bottom on several indicators, including:

*49th in occupation fatalities (the legislature tried and failed to gut the state mine safety agency this year, which may knock us out of 50);

*47th in economic hardship (who could have guessed that years of anti-labor legislation, automation and corporate driven-globalization might not have brought prosperity?);

*48th in per capita income (see above);

*47th in poverty (see above); 

*49th in unemployment (the legislature also tried to cut unemployment insurance eligibility from 26 to 12 weeks this session);

*49th in food insecurity (in 2018, the legislature passed a bill that made it harder for low income adults without children to access SNAP benefits);

*49th in social support and engagement;

*50th in drinking water violations (lowering water standards to benefit extractive industries being an annual legislative ritual);

*49th in nutrition and physical activity;

*50th in depression;

*50th in drug deaths (not surprising given how WV was bombed with opioids by pharmaceutical companies in recent years);

*48th in frequent mental distress;

*50th in premature deaths; and

*50th in asthma, arthritis, cardiovascular disease, chronic kidney disease, COPD, diabetes, high blood pressure, and high cholesterol. I'm guessing that being a mineral extraction sacrifice zone didn't help here. Thank God and former governor Earl Ray Tomblin for expanding Medicaid--otherwise we'd be dropping like flies. No doubt the social determinants of health have a lot to do with this.

This is just a partial list. The rest is here. Meanwhile, instead of dealing with these issues, the legislature spent a lot of time this year going after what's left of public education; failing to pass caps on diabetes-related expenses; the bogey man of "critical race theory;" trying to make it harder for workers and their survivors injured or killed on the job to get compensation; trying to repeal the state income tax; and such.

It's nice to have good priorities. That's what I hear anyway

The boot or the face?

For some reason, “1984,” George Orwell’s book about a nightmarish society, has had a revival in the Trump era.

Maybe it’s the weather.

The New York Times reported it was top of Amazon’s list in early 2017. Around the same time, Penguin USA reported a 9,500 percent increase in sales over a few days. It’s a hot item nearly 70 years since its publication.

It’s probably a good thing that more people have been reading it. It’s probably a bad thing that people felt like they had to.

A haunting line from the book that has stuck in my mind: “If you want a vision of the future, imagine a boot stamping on a human face — forever.”

Some days I think that might not be too far off — unless we act to prevent it. There are dangerous trends that, if unaddressed, point towards a disastrous future.

The top two are economic inequality and climate change.

Let’s start with inequality, which is reaching record levels and is likely to worsen, since returns from wealth grow much faster than productivity or wages. This doesn’t just impact life chances; it affects the length and quality of life itself.

Research shows that one’s relative position within society has a huge impact on health and longevity. People in higher social positions tend to live longer and be healthier than those below them — even if you control for behavioral factors such as smoking, exercise, obesity and diet.

Studies by British epidemiologist Michael Marmot suggest that the key ingredients to longevity and health are a sense of control over one’s life and the ability to fully participate in society. These diminish as we move down the ladder.

According to Marmot, “It is inequality in these that plays a big part in producing the social gradient in health.” The wider the divide, the sharper are the effects.

In “The Spirit Level: Why More Equal Societies Almost Always Do Better,” epidemiologists Richard G. Wilkinson and Kate E. Pickett expand on these themes. Using international data, they found that high degrees of inequality have negative effects not just on mental and physical health, but also on things like substance abuse and addiction, education, incarceration, obesity, social mobility, violence, social trust, teen pregnancies and child well-being.

While social problems pile up at the bottom, “The effects of inequality are not confined to the poor. A growing body of research shows that inequality damages the social fabric of the whole society.”

Harvard researcher Ichiro Kawachi has described inequality as a “social pollutant.”

The concentration of wealth makes it easier for the very wealthy to buy political influence and further stack the deck, endangering democracy. One person/one vote is turning into one dollar/one vote. It’s a self-perpetuating cycle, with the state, including its means of repression, effectively being captured and controlled by economic elites.

Overheated economic systems are also prone to catastrophic recessions and depressions, which have devastating impacts on communities, as we saw during the most recent recession.

Widespread inequality increases social tensions around the world, and the frustration it causes is a fertile breeding ground for toxic political movements, hate groups, religious extremism, armed conflict, racism and scapegoating vulnerable people. Movements such as these feed on the pain but ultimately will fail to cure it.

In the worst case, authoritarian political movements can gain political power and use it to advance the interests of elites while repressing popular resistance. It’s happened before and the results weren’t pretty.

Unfortunately, the same inequality of economic and political power is also being used to block meaningful action on climate change, since those who profit from a fossil fuel economy prefer short-term profit to long-term sustainability.

The playbook is pretty obvious: use wealth and political clout to delay action on climate until it’s too late, then say it was going to happen anyway.

Meanwhile its effects include things like extreme weather events, heating oceans, melting glaciers, rising sea levels, extinctions, crop failures, health impacts, damaged habitats, invasive species, mass displacement and migration, conflict over scarce resources, water contamination, desertification, epidemics, collapsing fisheries, droughts and floods and a host of other unpleasantries that will affect everyone but hit poorer communities hardest.

And that fun is only beginning.

If this keeps up, things don’t look good for the human face. The smart money will be on the boot.

I’m not sure what it will take to keep that from happening, but it probably won’t be business as usual.

In 1933, the great German Christian theologian Dietrich Bonhoeffer pondered what a just response from people of faith would be required to deal with the evils of his time, particularly the persecution of the Jews.

He came up with three possibilities.

One was to “ask the state whether its actions are legitimate and in accordance with its character as state, i.e. it can throw the state back on its responsibilities.” That’s worth a shot, even though it hasn’t worked too well lately.

Another option was to “aid the victims of state action,” since “the church has an unconditional obligation to the victims of any ordering of society ...” That’s always in order, even if it doesn’t solve the problem.

The third option was a bit edgier: it was “not just to bandage the victims under the wheel, but to jam a spoke in the wheel itself.”

Just a thought.

(This appeared in today's Gazette-Mail.)

A tale of two counties

This New York Times story  has gone viral in these parts of West Virginia so you may have already seen it, Gentle Reader. It's about the gap in wealth and income--and longevity--between a rich county in Virginia and McDowell County, West Virginia. Sad but true. But I'll take folks from McDowell any day of the week.

Quote of the week (or century)

Here's one of the best quotes about literature I've ever found. It is attributed to Southern author Pat Conroy's mother:

“All Southern literature can be summed up in these words: ‘On the night the hogs ate Willie, Mama died when she heard what Daddy did to Sister.’” 

I tend to distinguish between Appalachian and Southern culture and literature, but I do recall a short story by my favorite WV author Breece Pancake which involved a bit of hoggish anthropophagy.

(And, by the way, how is anthropophagy for a cool word? It sounds way classier than man-eating.)

MUST READING. Here is yet more rationality from Coal Tattoo. Some of the links are really worth checking out.

WORK SHARING. Here's an op-ed by yours truly on a new way to deal with cyclical unemployment.

BABOONS AND PEOPLE. For both animals, those with higher social status are healthier.

GOAT ROPE ADVISORY LEVEL: ELEVATED

How absolute the knave is!

Goat Rope is still climbing Mount Hamlet, although we're nearing the summit. If you don't care for Shakespeare, you can scroll down to the links and comments section--although if you do, you'll be missing the graveyard scene.

As I mentioned yesterday, the gravedigger is the only person in the play who can hold his own against Hamlet. In their first exchange, Hamlet asks a simple question:

HAMLET: ...Whose
grave's this, sirrah?

First Clown: Mine, sir.

Sings
O, a pit of clay for to be made
For such a guest is meet.

HAMLET: I think it be thine, indeed; for thou liest in't.

First Clown: You lie out on't, sir, and therefore it is not
yours: for my part, I do not lie in't, and yet it is mine.

HAMLET: 'Thou dost lie in't, to be in't and say it is thine:
'tis for the dead, not for the quick; therefore thou liest.

First Clown:'Tis a quick lie, sir; 'twill away gain, from me to
you.

HAMLET: What man dost thou dig it for?

First Clown: For no man, sir.

HAMLET: What woman, then?

First Clown: For none, neither.

HAMLET: Who is to be buried in't?

First Clown: One that was a woman, sir; but, rest her soul, she's dead.

HAMLET: How absolute the knave is!

Hamlet, just back from his pirate adventure, has no idea that the grave will be Ophelia's. They banter some more before that becomes clear. It turns out that the gravedigger has had the same job since the day Old Hamlet slew the king of Norway and young Hamlet was born. He even knows about Hamlet's madness and trip to England, although he doesn't realize who he's talking to.

Playing along, Hamlet asks about reports of himself:

HAMLET: Ay, marry, why was he sent into England?

First Clown: Why, because he was mad: he shall recover his wits
there; or, if he do not, it's no great matter there.

HAMLET: Why?

First Clown: 'Twill, a not be seen in him there; there the men
are as mad as he.

HAMLET: How came he mad?

First Clown: Very strangely, they say.

HAMLET: How strangely?

First Clown: Faith, e'en with losing his wits.

HAMLET: Upon what ground?

First Clown: Why, here in Denmark: I have been sexton here, man
and boy, thirty years.

Hamlet is usually untouchable in verbal sparring, but he can't score a point on this guy.

HEALTHY AND HAPPY. Here's an interview with Richard Wilkinson, co-author of The Spirit Level: Why More Equal Societies Almost Always Do Better.

WHO'S POOR THESE DAYS? Lots of people.

DEFICITS aren't the main problem right now, according to economist James Galbraith.

DOES EVOLUTION HAVE A DIRECTION? Maybe.

GOAT ROPE ADVISORY LEVEL: ELEVATED

How all occasions do inform against me

The theme here lately is Hamlet, although you can scroll down to links and comments about current events if Shakespeare doesn't do it for you.

After Hamlet whacks Polonius, he is ordered to be sent to England under the company of Rosencrantz and Guildenstern, who unbeknownst to themselves carry with them an order for Hamlet's death at his uncle Claudius' command.

On their way to the ship, they pass the army led by young Fortinbras of Norway en route to fight with the Poles over a worthless piece of land. Fortinbras doesn't show up much in the play, but he serves as an anti-Hamlet, someone who is all action with little forethought.

Hamlet questions the soldiers about their mission and is shocked and shamed to find that they are about to sacrifice many lives for some worthless real estate while he can't even manage to avenge his own father's murder by Claudius.

Here's some of the dialogue:

HAMLET Goes it against the main of Poland, sir,
Or for some frontier?

CAPTAIN Truly to speak, and with no addition,
We go to gain a little patch of ground
That hath in it no profit but the name.
To pay five ducats, five, I would not farm it;
Nor will it yield to Norway or the Pole
A ranker rate, should it be sold in fee.

HAMLET Why, then the Polack never will defend it.

CAPTAIN Yes, it is already garrison'd.

HAMLET Two thousand souls and twenty thousand ducats
Will not debate the question of this straw:
This is the imposthume of much wealth and peace,
That inward breaks, and shows no cause without
Why the man dies. I humbly thank you, sir.

CAPTAIN God be wi' you, sir.

Hamlet is shamed by the contrast between their action and his own inaction:

How all occasions do inform against me,
And spur my dull revenge! ...
Witness this army of such mass and charge
Led by a delicate and tender prince,
Whose spirit with divine ambition puff'd
Makes mouths at the invisible event,
Exposing what is mortal and unsure
To all that fortune, death and danger dare,
Even for an egg-shell. Rightly to be great
Is not to stir without great argument,
But greatly to find quarrel in a straw
When honour's at the stake. How stand I then,
That have a father kill'd, a mother stain'd,
Excitements of my reason and my blood,
And let all sleep? while, to my shame, I see
The imminent death of twenty thousand men,
That, for a fantasy and trick of fame,
Go to their graves like beds, fight for a plot
Whereon the numbers cannot try the cause,
Which is not tomb enough and continent
To hide the slain? O, from this time forth,
My thoughts be bloody, or be nothing worth!

STRANGE BEDFELLOWS. The Economic Policy Institute and the Peter G. Peterson Foundation don't agree on much, but EPI's Lawrence Mishel and Peterson CEO David Walker have published a joint op-ed arguing that job creation needs to take precedence over concerns about the deficit until we get out of this recession.

INEQUALITY MATTERS. Here's another item on how inequality and social status affect health and longevity. The wonky term for this is the social determinants of health.

UNEMPLOYMENT. The unemployment insurance fund of El Cabrero's beloved state of West Virginia is heading south despite legislative action last year aimed at ensuring its solvency.

THE WAR ON SCIENCE is on.

CULTURE AND EVOLUTION. It looks like the former has affected the latter.

COOL FOSSIL. One has been found of a snake eating baby dinosaurs.

GOAT ROPE ADVISORY LEVEL: ELEVATED

What's it all about, Horatio?

Several years ago, I had a fun time plowing my way through Jacques Barzun's massive tome From Dawn to Decadence: 1500 to the Present. It was sort of a leisurely 800 page amble through the modern era.

I know it may seem strange to people today to think of the 1500s as "modern," but that's not an uncommon historical idea. That was the general period that saw printing, Protestantism, the Renaissance, early capitalism, the "discovery" aka plunder of the New World, and all kinds of other things take off for good or ill in the West.

One characteristic of early modernity that persisted through the centuries, according to Barzun was a heightened self-consciousness. One example of that can be seen in the above classic 1656 painting, Las Meninas by Diego Velasquez.

Velasquez is actually painted into the picture--he's the guy with the paintbrush on the left--something that would be unthinkable for a court painter in earlier times. He also plays around with a mirror that shows a reflection of the king and queen of Spain who aren't seen elsewhere.

It's pretty cool when you think about it: a picture of an artist painting a picture of a bunch of people (including himself) complete with images of people who aren't in the picture.

Velasquez is clearly having fun flouting traditions, but that kind of artistic self consciousness shows up in other works of the early modern period. Shakespeare's Hamlet is a case in point, about which more tomorrow.

INEQUALITY AND HEALTH, a frequent topic here, are inversely connected, according to the latest EPI snapshot.

SPEAKING OF HEALTH, most Americans prefer a tax on the wealthy rather than workers' insurance plans to help pay for the expansion of coverage according to a new poll.

HOWEVER, ALL BETS ARE OFF on the future of reform in the wake of the Massachusetts election.

JOBS, JOBS, JOBS. Here's Dean Baker on what we could do to save and create them.

ARE SOCIAL SKILLS INHERITED? Maybe.

GOAT ROPE ADVISORY LEVEL: ELEVATED

There is a tide...

El Cabrero spends a good bit of time working on public policy issues at the state and federal level. I find it fascinating that some issues seem to rise to the surface and get a lot of attention while others--often very important ones--don't.

Sometimes, when issues get "hot," the result can be the passage of significant legislation, but other times they fade from public view for years, decades or even for good.

Sometimes openings exist to get things done and other times they don't. When an opening occurs, one needs to be able to act swiftly and skillfully. And when there is no immediate opening to accomplish a particular goal, the best one can often do is lay the groundwork to take advantage of an opening when it eventually occurs.

It kind of reminds me of these lines spoken by Brutus in Shakespeare's Julius Caesar:

There is a tide in the affairs of men.
Which, taken at the flood, leads on to fortune;
Omitted, all the voyage of their life
Is bound in shallows and in miseries.
On such a full sea are we now afloat,
And we must take the current when it serves,
Or lose our ventures.

Over the next few days, I'm going to try to follow that thread through the labyrinth. I just hope I don't get eaten by the Minotaur...

THE STIGMA IS FADING FAST about food stamp usage, as the NY Times reports. Nowadays, one in eight Americans and one in four children are depending on them.

JOBS! In this op-ed, Paul Krugman calls for direct public sector job creation.

DEFICIT DISORDER, REVISITED. Here's economist Dean Baker talking sense on the federal deficit.

STATUS AND US. This op-ed by yours truly on the social determinants of health came out in the Gazette and Common Dreams yesterday.

LABOR. This Gazette article looks at the future of the labor movement in WV.

GOAT ROPE ADVISORY LEVEL: ELEVATED

Stars

Image courtesy of wikipedia.

(Editorial note: Apparently I got up so early yesterday morning that I thought I posted the following but didn't. My bad. On the bright side, this fact relieves me from having to think of something new for today. Just to be safe, I'm scheduling this in advance lest I sleepwalk again through the morning. If anything really bad happens between now and then please accept my condolences.)

A while back a friend visited Goat Rope Farm at night and commented on how bright the stars were. I guess one thing about living out is that you get kind of spoiled about certain things--like having bright starts. My friend, however, lived in a major city where light pollution makes the nightly light show dimmer if not invisible.

It reminds me of something Emerson said in his essay Nature:

If the stars should appear one night in a thousand years, how would men believe and adore; and preserve for many generations the remembrance of the city of God which had been shown!

I guess we take things for granted.

IT CAN BE DONE. Student activists have just won a major fight against sweatshops.

HUNGER hit a 14 year high in the US.

JOBS. Here's a call to action for serious action on un- and under-employment.

IT'S THE END OF THE WORLD AS WE KNOW IT. Here's a look at 2012 hysteria.

RACIAL DISPARITIES. A new report found some major ones between whites and African Americans in Kanawha County, WV.

THOSE DARWIN FINCHES are at it again on the Galapagos Islands.

GOAT ROPE ADVISORY LEVEL: ELEVATED

Another Dante moment

It's been a while since El Cabrero has discussed his old pal Dante Alighieri, but I've been thinking about a passage from his Inferno recently in the context of current political controversies.

In Canto III, at the outskirts of hell, Dante and his guide Virgil pass a large number of condemned souls driven eternally in circles and tormented by gadflies and hornets. They had it so bad that "They are envious of every other fate," which in Dante's version of hell is really saying something.

These unfortunate creatures are those who didn't take a stand for either good or evil during their days on earth and are equally unwanted in either heaven or hell.

What is interesting to me about this is that Dante also includes in this group those people who considered themselves too pure to get down and dirty in the real human world. He singles out Celestine, who was elected pope in 1294 but abdicated, leaving the spot to be taken by someone he considered to be much worse:

I looked, and I beheld the shade of him
Who made through cowardice the great refusal.

The Catholic Church didn't see things that way--Celestine was later canonized--but I see Dante's point. Holding out for perfection in an inherently flawed world can amount to choosing uselessness and allowing even worse things to prevail.


CAIRNS 'R US. This item from yesterday's Gazette is about cairns or rock structures found on a nearby farm and believed to be the work of American Indians. (We have some at Goat Rope Farm but they're not as big and could just be more recent rock piles.) When asked to estimate their age, Roger Wise, an archaeologist friend of mine gave a great reply. As the article reported,

"It's probably somewhere between 1750 A.D. and 10,000 B.C.," he said with a grin.

And you know what--I'll bet he's right!

INEQUALITY AND HEALTH. The social determinants of health, as in things like status and inequality, have been a frequent theme here lately. Here's an op-ed by a friend of mine on an issue we're working on in WV.

THEATER OF WAR. Greek tragedy has also been a favorite theme here. Now, the Department of Defense is taking a look at what some of the plays of Sophocles (Philoctetes and Ajax) can say about the problems of combat veterans.

(Has anyone noticed that it's been a long time since my last ancient Greek jag? I'm feeling another one coming on.)

GAME THEORY. This item looks at auctions and the psychology of commitment.

DEFICITS AND DEFICITS. In a post from his blog, Paul Krugman observes the following about politicians:

many, if not most, are perfectly happy to incur huge unfunded liabilities for the wars they want to fight, and/or to eliminate inheritance taxes for the heirs of multimillionaires. It’s only deficits incurred to help working Americans that get them all moralistic.

GOAT ROPE ADVISORY LEVEL: ELEVATED

Dying for a job

Seventeenth century painting by Philippe de Champaigne.

An article in Wednesday's Washington Post highlighted the Obama administration's efforts to grapple with rising unemployment in the midst of signs of an expanding economy. Both the administration and congress are going to have try to balance the need for action with concern over federal deficits.

Based on some pretty hard social science, there's one thing we know about recession-related unemployment: some people are going to die earlier than they would have because of it.

As British epidemiologist Michael Marmot summed up research on unemployment in Britain in his book The Status Syndrome: How Social Standing Affects our Health and Longevity, "people who became unemployed had 20 percent higher mortality than those who remained employed at the same social class level."

Obviously, lots of factors could be at work here, including greater stress and anxiety, which are known to have health consequences. Poverty could play a part, but Marmot argues that

it is useful to distinguish the two senses of poverty: a lack of basic material conditions for life; and insufficient resources, private or public, to participate in society. The first is unlikely to be the sole explanation, as unemployed professionals, who might be expected to have some saving,s have worse health than those still employed in the same occupational social class. This is not to say that financial problems are irrelevant. Far from it. Financial strain appears to be the complaint most associated with worse mental health in the unemployed. I would ague that this is consistent with poverty in the second sense--inability to participate fully in society. Whether initially well-off, or poorly off, deterioration in economic circumstances will cause real hardship.

Add to the mix another known factor related to health: being involuntarily unemployed also reduces one's sense of autonomy and control over one's life. Taken together, loss of control and inability to fully participate in society are a poisonous mix.

Economist John Maynard Keynes famously commented that "in the long run we are all dead." For some of the unemployed, the long run is getting shorter.

ON THAT SUBJECT, Congress approved an extension of unemployment benefits yesterday. And while we're at it, here's a call for public jobs creation along the lines of the New Deal.

RAMPAGE. It was a terrible day at Ft. Hood.

IS CLIMATE CHANGE happening in the Senate? Maybe, but we're not there yet. Here's Coal Tattoo on the subject.

EXERCISE AND WEIGHT LOSS. There is a connection, but it's not all that simple.

GOAT ROPE ADVISORY LEVEL: ELEVATED

Houses and sniffles

A Rhinovirus, courtesy of wikipedia. I think they magnified it a time or two.

There is a large and growing body of scientific research about how things like inequality, class and social status engrave themselves into our bodies. Generally speaking, people in higher social positions are less likely to develop conditions like heart disease or diabetes than those in lower positions. The same affect seems to apply to infectious diseases as well.

In a fascinating study, healthy adults first answered questions about their socio-economic status (SES) and that of their parents when they were growing up. They were then exposed to one of two forms of rhinovirus (aka common cold viruses) and kept in quarantine to monitor the symptoms.

Here's a surprising finding:

For both viruses, susceptibility to colds decreased with the number of childhood years during which their parents owned their home...This decreased risk was attributable to both lower risk of infection and lower risk of illness in infected subjects. Moreover, those whose parents did not own their home during their early life but did during adolescence were at the same increased risk as those whose parents never owned their home. These associations were independent of parent education level, adult education and home ownership, and personality characteristics.

The researchers concluded that "A marker of low income and wealth during early childhood is associated with decreased resistance to upper respiratory infections in adulthood. Higher risk is not ameliorated by higher SES during adolescence and is independent of adult SES."

In other words, poverty or relative deprivation during early childhood can have negative health affects throughout a lifetime. That's something to think about now, as the recession has driven more families on a downward economic spiral.

SIGN OF THE TIMES. Half of all US children and 90 percent of African American young people do or will receive food stamps, according to a new study.

THIS NEEDS FIXED. The House version of health care reform would phase out the Children's Health Insurance Program. Senator Rockefeller is not amused. Nor is El Cabrero. This needs to be fixed in conference.

A FAMOUS UNREADABLE (FOR ME ANYWAY) ANTHROPOLOGIST has died at the age of 100.

HOW SMART ARE DOGS anyway?

GOAT ROPE ADVISORY LEVEL: ELEVATED

All shook up

Engraving of the 1755 Lisbon earthquake.

Goat Rope has been running an occasional series lately about how things like inequality and social status affect health and mortality. Brief recap: they do; a lot; all across the board.

Some factors already examined include things like money and material conditions, while others have more to do with one's relative position within a given society. Another key factor is power, as in one's ability to have some control over what life throws at us.

Michael Marmot uses an interesting analogy in The Status Syndrome: How Social Standing Affects our Health and Longevity,

Imagine that if you were caught in an earthquake you could simply turn it off. Earthquakes might, then, be part of life's rich tapestry instead of being an uncontrollable stress. Imagine further that your ability to turn it off depended on your place in the social hierarchy. High-status people could turn it off at will; low-status people could not affect it at all; and there were gradations of power over earthquakes from top to bottom of the social ladder. If stress led to illness, such differences in power could have a profound affect on the health gradient. Stress does, and differences in power do.

We've recently been reminded of the terrible power that real earthquakes have over people in areas prone to them. But metaphorical earthquakes, in the form of shocks over which we have little control and which we can't predict, happen all the time and people at the lower end of the money/status/power spectrum are the hardest hit.

More on this to come.

JOBS, JOBS, JOBS. Here are two items highlighting the need for action to create employment and here is something on the Obama administration's likely response.

PUBLIC OPTION. The administration has been quietly trying to build support for it, according to this McClatchy report.

SCORE A POINT FOR ZEN. Sometimes nonsense or things that defy rational expectations can jog creative thinking. El Cabrero feels vindicated.

URGENT T REX COUSIN UPDATE here.

GOAT ROPE ADVISORY LEVEL: ELEVATED

It's relative

Would you rather be a big cat or a small dog?

Developments in behavioral economics have challenged the old idea of humans as belonging to the species "homo economicus," a fabled creature that purportedly rationally acts in accord with its material self interest. Real humans often have other priorities, including things like a need for social status and a sense of fairness (which admittedly aren't always compatible).

One experiment cited by Michael Marmot in The Status Syndrome: How Social Standing Affects our Health and Longevity is a case in point:

...people are asked to imagine two situations. First, you live in a society where the average income is $100,000 and your income is $125,000. Now consider a new situation. Average incomes are now $200,00 and your income is $175,000. In the two societies, a dollar has the same purchasing power. Which situation would you prefer?

If people were really out to go for the bottom line, they would pick scenario #2. In reality, most people pick #1. As Marmot puts it, "They would rather sacrifice material gains for better social standing."

There are several ways to interpret these results. One would be that people are obsessed not just with keeping up with the Joneses but with burying them in the dust. A more charitable interpretation--and one that makes sense in light of other research--is that a key factor in peoples' sense of well being, and even of health and mortality, is the ability to fully participate in society.

Being at a material disadvantage in comparison with others in the same society can limit our sense of being able to fully participate. For that matter, a lot of research on things from health to violence indicates that relative poverty, i.e. one's position in comparison with others, is a major factor in causing lots of problems--and not just for those who are relatively poor.

More on this to come.

PAYING MORE TO DIE SOONER. Here's another critique of the American health care system.

ONE THING NOT TO FEAR, Dean Baker argues, is the public option in health care reform.

By the way, I heard last week that the vote on the public option may take place today in the Senate. I don't know whether this has changed. Still, it wouldn't be a bad idea to make yet another call.

STATING THE OBVIOUS. The AFLCIO blog points out that millions of Americans already rely on government-provided health care. And they're not trying to get rid of it.

INCONSISTENCIES. This Gazette op-ed by a friend of mine looks at some of these on the right.

GOAT ROPE ADVISORY LEVEL: ELEVATED

Untangling a knot

He did it with a sword. "Alexander cuts the Gordian Knot," by Jean-Simon Berthélemy (1743–1811)

When it comes to health and well being, there are a lot of issues to untangle. Obviously one is the lack of health care at all, which is a serious problem in the US and one that is getting worse in the wake of the recession. In yesterday's post, I linked a recent news item about a report that found that 45,000 Americans die prematurely each year because they don't have it.

Obviously, moving towards universal health care is way overdue. But there are some things about health and longevity that go beyond mere health coverage. As I've mentioned in the last several posts, status matters. People in higher social positions enjoy better health and longer lives than people in lower positions.

Typically, people try to explain this in terms of bad habits of people down the status scale, particularly among poor people, but this is missing a major point. According to Michael Marmot, author of The Status Syndrome: How Social Standing Affects our Health and Longevity, two key factors are autonomy and social participation:

...social conditions affect the degree of autonomy and control individuals have and their opportunities for full social engagement. These needs, for control and participation are more adequately met the higher your social position. As a result, health is better.

Conversely,

Lack of social participation and inadequate control over your life, in the sense of not being able to lead the life you want to lead, will lead to chronic stress, which in turn increases risk of a number of diseases, heart disease among them.

Marmot argues that this lack of control and full participation may lead to behaviors that are bad for health in the long term, but those things seem like small potatoes when one is just trying to get by in the short term.

ON THAT NOTE, here's another take on the link between health and social conditions.

RECESSION NATION. The latest Census data shows that the recession has had a major impact on Americans.

MEANWHILE, BACK ON THE PARANOID RANCH. Here's an interview between Bill Moyers and Max Blumenthal about today's rabid right and here's former religious right leader Frank Schaeffer on far right versions of politicized religion.

HOW WE GONNA KEEP HIM DOWN ON THE FARM NOW? Gazette reporter and uberblogger Ken Ward of Coal Tattoo fame was featured on NPR's Living on Earth.

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The necessities

A large and growing body of research shows that things like health and mortality are affected by social standing. Once people have the basic resources needed to stay alive, health is influenced by how one stands in relationship to other people in the same society.

This isn't an entirely new idea. Adam Smith, writing in the 1700s, understood that what we consider to be necessities vary according to social customs:

By necessaries I understand not only the commodities which are indispensably necessary for the support of life, but what ever the customs of the country renders it indecent for creditable people in the lowest order to be without. A linen shirt, for example, is, strictly speaking, not a necessity of life. The Greeks and Romans lived, I suppose, very comfortably though they had no linen. But in the present times, through the greater part of Europe, a creditable day-labourer would be ashamed to appear in public without a linen shirt, the want of which would be supposed to denote that disgraceful degree of poverty which, it is presumed, nobody can well fall into without some extreme bad conduct. Custom, in the same manner, has rendered shoes a necessary of life in England. The poorest creditable person of either sex would be ashamed to appear in public without them.

In other words, it's not just about staying alive; it's about being able to participate decently in the life of the community.

SPEAKING OF NECESSITIES, a new study found that 45,000 Americans die prematurely each year due to lack of health care.

FEELING JUNGIAN? Click here.

SPEAKING IN (OR ABOUT) TONGUES. Here's the latest edition of the Rev. Jim Lewis' Notes from under the Fig Tree.

POLITICAL PARANOIA was the theme here a few weeks back. Here's another take on it.

FINANCIAL REFORM. Krugman says do it.

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I'd like to thank the Academy...

Earlier this week, there was a post about the connection between social status and health. Suffice it to say there is one and it's big.

In fact, there is what epidemiologist and author Michael Marmot calls "a social gradient" for health and mortality. It's not just that the very poor are sicker and more likely to die sooner, although that is true. It's also the case that there's a difference in health and mortality at every level, i.e. the very rich have better health outcomes than the rich, who have it better than the well off, who have it better than the middling sort and so on down the line.

Again, money is part of it but not all of it. A big part is status.

Here's a very interesting finding. Two researchers, Donald Redelmeier and Sheldon Singh looked at health and mortality data for actors nominated for Academy Awards over 72 years. They found that Oscar winners on average lived four years longer than those who were nominated but didn't win. The non-winners were highly respected actors with plenty of film credits and a healthy income, but there was some kind of magic boost in the recognition an award like that give.

The same kind of pattern shows up all over the place.

LINKS are on strike today. We're hoping they'll settle by tomorrow.

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Inequality and health

Image courtesy of wikipedia.

Topics like economic inequality and health outcomes show up frequently in this blog, but lately I've been nudged into looking at the overlap between the two. In the public health field, a growing amount of attention has been paid to what is called the "social determinants of health," which kind of is what it sounds like.

A large body of scientific research has shown that how long we live and how well we are is influenced in no small degree by our social standing. It has long been known that life can be nasty brutish and short for the very poor, but the latest research shows that this applies all across the board.

This also means that negative health outcomes increase as inequality grows.

It's not all about money or education level, although they are a major part of it. As Michael Marmot put it in The Status Syndrome: How Social Standing Affects our Health and Longevity,

...for people above a certain threshold of material well-being, another kind of well-being is central. Autonomy--how much control you have over your life--and the opportunities you have for full social engagement and participation are crucial for health, well-being, and longevity. It is inequality in these that plays a big part in producing the social gradient and health. Degrees of control and participation underlie the status syndrome.

In our society, autonomy and participation are closely correlated with income and education. And, as I've written about many times before, one of the nastiest things about poverty is that it robs you of both. The interesting thing about the latest research is that it shows the effect of status on health at all levels of education and income. In other words, it's everybody's business.

More on this to come.

HOW DID I MISS THIS? Here's a major NY Times article about water quality that highlights mining's effect on health in West Virginia. And here's way more on the subject from Ken Ward's Coal Tattoo.

HEALTH CARE. One positive feature of proposed health care reform is an expansion of eligibility for Medicaid benefits, but the politics are complicated. And here is an op-ed by a friend about the public option.

UNEMPLOYMENT is up in El Cabrero's beloved state of West Virginia, but is still below the national average.

HEALTH ADVICE. Your mama got it right sometimes. Other times, not so much.

GOAT ROPE ADVISORY LEVEL: ELEVATED