Map of life expectancy at birth from Global Education Project.

Friday, February 16, 2018

The T Word

Reporter James Risen has done some excellent work, and he has also gotten some things wrong. (Wen Ho Lee, for example.) But in this column in The Intercept, he is not doing original reporting but rather pulling together what we know and can fairly suspect about the relationship between the current white house Resident and Vladimir Putin. It's a bit surprising to see this in a publication overseen by Glenn Greenwald, who is consistently hostile to the suggestion that Russia had anything to do with our 2016 election or could conceivably be blackmailing its ostensible winner. But Greenwald is allowing this, so credit where it's due.

Risen, like a lot of us, has a pre-existing opinion about the state of the presidency:

 It is not that he is a complicated subject. Quite the opposite. It is that everything about him is so painfully obvious. He is a low-rent racist, a shameless misogynist, and an unbalanced narcissist. He is an unrelenting liar and a two-bit white identity demagogue. . . . Unfortunately, another word also describes him: president. The fact that such an unstable egomaniac occupies the White House is the greatest threat to the national security of the United States in modern history. Which brings me to the only question about Donald Trump that I find really interesting: Is he a traitor?
Risen proposes a four-part test. 1) Did Russia intervene in the 2016 election to help Trump? 2) Did Trump or his associates collaborate in this effort? 3) Did they obstruct justice by attempting to block or undermine the investigation into (1) and (2); 4) Are Republican leaders now engaged in a criminal conspiracy to further (3)?

Actually, the Trump is a traitor question stops at (2). The other items are additional. In the linked column, Risen addresses item (1) and, consistent with what is basically common knowledge, finds it true. He says his analysis of item (2) is coming shortly. We'll see if he knows more than the rest of us about this.

What I will say for now, however, is that it is astonishing how few people are taking this question seriously, or at least are willing to do so in public. It is certainly a fair one.

Wednesday, February 14, 2018

Ideology vs. Science

Joshua Sharfstein in JAMA discusses the opioid abuse epidemic and what to do about it. This is an opinion piece that doesn't have references, but I can assure you that he is right on the facts. People with opioid addiction seldom succeed in maintaining long term recovery without what we call Medication Assisted Treatment. That means either methadone or buprenorphine, both of which are themselves opioids. As Sharfstein tell us, "Many still believe that those who take methadone or buprenorphine are 'trading one addiction for another,' 'in bondage,' or 'taking a cop-out.'" People who are using these medications may face reprisals from judges or social service agencies.

Here is the reality. People on Medication Assisted treatment don't get high, and are not impaired. These particular opioids have a pharmacokinetic profile (as we say) that keeps them at a fairly steady concentration in the blood for a long time, meaning that they can eliminate craving without the side effects of intoxication. That means people can work, go to school, take care of their families, whatever they need to do. They are no longer committing crimes or at risk for overdose.

There are lots of chronic diseases for which people have to take medications every day, for a lifetime. These include diabetes, HIV, high blood pressure, high cholesterol . . . If you are over 45 or so, you probably take at least one medication every day yourself. If you didn't, you would be at higher risk for death and if you are, say, an insulin dependent diabetic or have HIV, you will certainly die. Do you consider yourself to be "in bondage," or that you have an addiction? No. You're just stayin' alive.

Now, these are true facts about medication assisted treatment for opioid addiction. There is no defensible reason to oppose it other than an ideological commitment to the principle that "Drugs" (meaning some drugs, when used by some people, in some contexts) are evil. This is also the reason why people who are caught with small amounts of opioids are put in jail, thereby ruining their lives and making recovery all the more difficult. That is pointless, but it happens because people morally condemn addicts. And why is that? Nobody sets out to become addicted, just as nobody tries to become diabetic. It's a disease.

As Lawrence Gostin tells us in the same issue, the present administration has abandoned truth:

Science and technology have not been salient in the Trump administration, including taking longer than any other modern president to name a science adviser, tasked with providing scientific guidance in “areas of national concern.”7 The administration has fired or reconfigured several science advisory boards, including at the Environmental Protection Agency (EPA), Interior Department, and National Oceanic and Atmospheric Administration. Scientific information regarding climate change was removed from official websites at the White House, EPA, and Department of Energy. Lesbian, gay, bisexual, and transgender (LGBT) content was removed from White House and State Department websites, and HHS removed LGBT questions from its survey of priority health needs for older US residents. . . .

The administration plans to eliminate the ACA’s Prevention and Public Health Fund. In addition, the president proposed deep budget cuts to research agencies, such as the National Institutes of Health, CDC, and the Energy Department.
The reason is, of course, that reality has a well-known liberal bias. The Republicans want to take us back to the 12th Century, before the Enlightenment, where truth was what the Pope said it was and the sun went around the earth.

Sunday, February 11, 2018

Sunday Sermonette: Wickedness

Perhaps you have heard of Ark Encounter, a tourist attraction in Kentucky featuring what purports to be a life-sized model of Noah's ark. The theme park was built with the help of a subsidy from the taxpayers of Kentucky by Answers in Genesis, an organization led by Australian-American Ken Ham, that insists the Bible is literally true. Funny thing: the ark was constructed by 1,000 Amish craftsmen using more than 3 million board feet of lumber and 95 tons of metal fasteners.

Anyway, here's the story:

This is the account of Noah and his family.
Noah was a righteous man, blameless among the people of his time, and he walked faithfully with God. 10 Noah had three sons: Shem, Ham and Japheth.
11 Now the earth was corrupt in God’s sight and was full of violence. 12 God saw how corrupt the earth had become, for all the people on earth had corrupted their ways. 13 So God said to Noah, “I am going to put an end to all people, for the earth is filled with violence because of them. I am surely going to destroy both them and the earth. 14 So make yourself an ark of cypress wood; make rooms in it and coat it with pitch inside and out. 15 This is how you are to build it: The ark is to be three hundred cubits long, fifty cubits wide and thirty cubits high. 16 Make a roof for it, leaving below the roof an opening one cubit high all around. Put a door in the side of the ark and make lower, middle and upper decks. 17 I am going to bring floodwaters on the earth to destroy all life under the heavens, every creature that has the breath of life in it. Everything on earth will perish. 18 But I will establish my covenant with you, and you will enter the ark—you and your sons and your wife and your sons’ wives with you. 19 You are to bring into the ark two of all living creatures, male and female, to keep them alive with you. 20 Two of every kind of bird, of every kind of animal and of every kind of creature that moves along the ground will come to you to be kept alive. 21 You are to take every kind of food that is to be eaten and store it away as food for you and for them.”
22 Noah did everything just as God commanded him.

So, because the earth is filled with violence, God decides to destroy nearly every living creature. That's quite psychopathic if you don't mind my saying so. Anyway, Noah, who lives in a desert and has presumably never seen a ship of any kind, does the work of 1,000 skilled craftsmen and builds a ship about 450 feet long. That's the size of the largest  wooden ships ever built -- which didn't come along until much later -- and they required metal straps to hold them together. This translation implies that there was an opening all around under the roof, but most translations have a single 18 inch window in the middle of the roof. In any case there is no ventilation on the lower or middle decks.

So, in order to get two of every kind of animal onto the ark, how many creatures would Noah need to round up? The answer, as best we can tell, is about 13 million. That is, the latest estimate is that there are about 6.5 million terrestrial metazoans. The vast majority of these live in tropical forests, and on continents far from Noah. Answers in Genesis also maintains that humans coexisted with the non-avian dinosaurs, who must also have been brought onto the ark but for some reason died out later. It would be awfully fun to have a T. Rex and a Brontosaur next to the marmosets!

While this story is obviously very silly, the sad news is that Ken Ham and a lot of Kentucky lawmakers and gullible tourists actually believe it. 

Friday, February 09, 2018

Not Staying Alive

I recently went into the deep history of human life expectancy. Now let's look at recent history in the U.S. vs. the rest of the wealthy countries.

The OECD is the Organization for Economic Cooperation and Development. It actually includes some countries you probably don't think of as wealthy, such as Mexico and Latvia, but also western Europe, Australia and Japan. As you can see, in the mid-90s the U.S. was average among OECD countries. As life expectancy increased throughout the OECD in the early part of this century,the U.S. lagged behind, and then life expectancy in the U.S. stopped increasing entirely.

I snatched this graphic from an editorial in BMJ (formerly British Medical Journal) by Stephen Woolf and Laudan Aron, both Americans.  (No link due to paywall.) They note that this can  in part be explained by the opioid epidemic, suicides and alcohol abuse, which they call "deaths of despair." As have many observers, they link this to economic dislocation, particularly in smaller cities and rural areas, that has affected the fortunes of lower educated white workers. I think this is a bit facile.

I don't think that is a big part of the explanation for the opioid epidemic, which has been pretty indiscriminate in its victims. However, we are clearly doing something wrong. We are not investing sufficiently in our people, to put it broadly. If families are struggling, they don't need to be lectured to about takers vs. makers and have their food stamps and Medicaid taken away. They need educational opportunity, economic development, and health care.

That means doing the exact opposite of what  Republicans are trying to do. We need to tax the rich and invest the money in public education, free or at least affordable access to all levels of post-secondary education, renewable energy development, health care infrastructure and services, child care for working parents, family and medical leave, transportation infrastructure including mass transit -- all the stuff those other countries do where the people live longer, healthier and happier lives. All of this creates jobs. People can get jobs in education, health care, child care, transportation, renewable energy -- much better jobs than mining coal or bolting cars together all day, and those jobs are never coming back anyway.

The only way to make this happen is to never, ever vote for a Republican.

Wednesday, February 07, 2018

Unboggle your mind

History has gone so batshit crazy that our minds have stopped encompassing what is really happening. This long form piece by Kurt Andersen is worth your while, in which he recounts how the Republican party went down the rabbit hole to nutville.

This is how we get a "president" who, among innumerable other insanities:

  • Started out in politics by promoting the lunatic conspiracy theory that Barack Obama was born in Kenya. (More than half of all Republicans still believe this.)
  • Claimed that Supreme Court Justice Antonin Scalia was murdered.
  • Claimed that Ted Cruz's father was involved in the assassination of John F. Kennedy.
  • Says that Clinton aide Vince Foster was murdered to cover up some guilty knowledge about Hillary Clinton. (Investigations by two special prosecutors and two congressional committees all concluded that he committed suicide because he was depressed.)
  • Insists that he won the popular vote and that three million votes were cast for Hillary Clinton by illegal immigrants.
Andersen concludes:

Since then, of course, Trump has fired the FBI director and pushed out the deputy director, provoked a special counsel’s investigation, and conjured an anti-Trump conspiracy at the bureau—which of course many on the right now believe, with help from members of Congress and the Sean Hannitys of the world. Republicans by almost 2 to 1 disapprove of Robert Mueller’s work, and nearly half of them say they now have “not very much” or no confidence at all in the FBI. In other words, our first conspiracy theorist in chief is harnessing his party’s old conspiracist tic, originally Kremlin-focused, to discredit the existence of an actual anti-American conspiracy hatched in the Kremlin. History is filled with tragic ironies, and this is a colossal one.
 What you must keep in mind at all times is that the Resident is batshit crazy. Really. That is kind of, you know, dangerous.

Sunday, February 04, 2018

Sunday Sermonette: Sci Fi

As I mentioned when we started this endeavor, the divisions into chapters were made by medieval monks. They do not mark the original fragments that were cobbled together to form the Torah, and often they are otherwise illogical. Genesis 6 has two obviously separate pieces. I'll take only the first part today. It's fairly short.

When human beings began to increase in number on the earth and daughters were born to them, the sons of God saw that the daughters of humans were beautiful, and they married any of them they chose. Then the Lord said, “My Spirit will not contend with humans forever, for they are mortal; their days will be a hundred and twenty years.”
The Nephilim were on the earth in those days—and also afterward—when the sons of God went to the daughters of humans and had children by them. They were the heroes of old, men of renown.
There are numerous disputes about the translation of this passage. "Nephilim" is often translated as "giants." I note now that we are about to see everything and everybody exterminated in the flood except for five humans and two of every kind of animal. (Next week!) However, the nephilim will survive, as they turn  up again in Numbers 13 -- no surprise given the interpolation "and also afterward."

Then there is the question of who are the Sons of God. According to Christian theology, of course, there is only one, and it ain't these guys. Although the Gospel of John uses the term loosely to refer to Christians, obviously that isn't any help here. In Job, Satan and his friends are the sons of God; and they were also present at the creation. "Whereupon are the foundations thereof fastened? or who laid the corner stone thereof; When the morning stars sang together, and all the sons of God shouted for joy?" It is unclear whether the nephilim are the beings who  had sex with the daughters of humans, or their offspring; and whether they are congruent with the sons of God or whether there were two kinds of alien beings banging our daughters.

It is also unclear why God is "contending" (in other translations "striving") with humans,  and why limiting their lifespan to 120 years relieves this. (Again, this seems to approximately double the reality, which suggests some sort of error in transliterating numerals.) This sentiment seems to be inspired by his sons having sex with human women, but it is entirely obscure why he should feel this way.

This passage has tied theologians in knots. I won't go into it at any length since it's obviously complete bullshit, but one example is the so-called pre-Adamite interpretation. Since there are two creation stories, the pre-Adamites figure, let's go with that and assume that after the first creation, God allowed some time for the humans to multiply and establish a population before making Adam and Eve. That explains where Caine got his wife and other problems, although it creates many problems they do their best to ignore. For example, why is the pre-Adamite population cursed for Adam's fall? Did they know good from evil? Were they already mortal? And why create Adam and Eve? There doesn't seem to be any further distinction between their descendants and the pre-Adamites. The whole thing seems gratuitous.

In any case, many pre-Adamites argued that the sons of God were white pre-Adamites who were having sex with non-white descendants of Caine, and this was the nature of the "wickedness" the heart of the upcoming story we will get to next week. Seriously. If you buy that, Europeans aren't descendants of Adam and Eve at all. But they must be, because Noah and his sons are descended from Adam and Eve through Seth, and the pre-Adamites must be extinct, no?

This is theology, folks. This is what you get for studying the Bible while trying to believe in it.

Friday, February 02, 2018

Stayin' Alive

Last Sunday I showed you all those characters in Genesis who lived 900 years, and I noted that is about 20 times what folks could actually expect back then. The story is a bit more complicated than that. Here's a useful resource from Oxford University about historic life expectancy. (You might enjoy exploring the site which has all sorts of other information about humans and the planet.) This only goes back to about 1850, when reasonably complete records are available, but in fact the story in 1750 was not markedly different than it was in 1750 BC.

Life expectancy at birth, historically, has been around 37 year or so. However, this is a bit misleading if you don't know how it's calculated. It's the mean expected age at death assuming that the current death rate by age cohort remains the same throughout your future. So if one person dies in infancy and the other lives to be 74, that gives you the 37 year life expectancy. Infant mortality was indeed much higher in the past than it is now; but that's not the whole story. Life expectancy for a one-year-old was indeed the approximately 45 years that I stated. People who died in infancy, obviously, would not have made it into the genealogy. On the other hand, some people did live into what we would today consider old age.

As it turns out, that mostly meant privileged men. Here we see that the kings of Judah, Greek philosophers, Christian church fathers and other elite men of ancient times who made it to age 15 could expect to get to Social Security age, though not much past it. Women, however, were not so lucky until about 1780. Probably a good deal of this had to do with maternal mortality. Today, women live longer than men.

The expectation we have today, that a full life is at least 70 years -- and really nowadays it's a bit more than that -- is extraordinarily different from what the human condition has been for most of our history.

This is from the Oxford site. As you can see we didn't really get there until the middle of the last century. (That big spike down around 1918 is WWI and particularly the global influenza pandemic. You can see a much smaller dip corresponding to WWII.) It's difficult to contemplate what life would be like if most people, even in young adulthood, didn't figure on getting much past 50. We take it for granted that the death of a 45 or 50 year old person is a tragedy, but for most of history it was pretty much the norm. Make of it what you will.