(Roughly) Daily

Posts Tagged ‘health

“Infant mortality and life expectancy are reasonable indicators of general well-being in a society”*…

… and in the U.S., as Adam Tooze explains, we’re doing not so well of late…

In August America’s Center for Disease Control (CDC) published a set of data that ought to have brought political, economic and social debate to a standstill. If there is one question that should surely dominate public policy debate, it is the question of life and death. What did the Declaration of Independence promise, after all, if not “life, liberty and the pursuit of happiness”. But on that score the CDC in 2022 delivered alarming news. In the last three years, life expectancy in the United States has plunged in a way not seen at any point in recent history.

America is inured to bad news about its health. Life expectancy in the United States has stagnated since 2011, a trend which separates the United States not just from rich peer countries but from most other countries in the world, rich or poor.

Given economic growth and advances in medicine for life expectancy to stagnate requires serious headwinds. In the United States those headwinds include, homicides and suicides, the opioid epidemic (so-called deaths of despair) car accidents and obesity. As John Burn-Murdoch shows in the FT, without those factors the US would have tracked its peer societies much more closely…

But stagnation is one thing, the collapse since 2019 is a phenomenon of a different quality. It is a full measure of the disaster that was the COVID pandemic in the United States. Over a million Americans died of COVID, one of the worst outcomes on the planet.

…it is not only China that has overtaken the United States based on this metric. In 2021 Cuba has a higher life expectancy than the US. So does Albania.

In a society marked by inequality as deep as modern America’s, to speak in terms of national averages is not very meaningful. The circumstances of life and health outcomes are vastly different…

Source: BMJ

…One might think that faced with these stark facts all other subjects of political debate would pale into insignificance. Whatever else a society should do, whatever else a political system promises, it should ensure that its citizens have a healthy life expectancy commensurate with their nation’s overall level of economic development. An ambitious society should aim to do more, as Japan does for instance. Judged by this basic metric, the contemporary United States fails and for a substantial minority of its population, it fails spectacularly. And yet that extraordinary and shameful fact barely registers in political debate, a silence that is both symptom and cause.

Life, liberty and the pursuit of happiness? How China, Cuba and Albania came to have higher life expectancy than the USA,” from @adam_tooze. Eminently worth reading in full.

For an example of the ways in which these wounds are self-inflicted: “The Human Psyche Was Not Built for This.”

* P. J. O’Rourke

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As we ponder priorities, we might recall that it was on this date in 1892 that the first diagnostic public heath laboratory in the U.S. was founded by New York City (as its “Division of Pathology, Bacteriology and Disinfection”). Spurred by the cholera epidemic of the time, it soon took on the diagnosis and tracing of diphtheria and tuberculosis; in 1895, it began production of a smallpox vaccine.

The New York City public health laboratory became a model for other cities’ public health departments. Within a few years, similar labs had become essential components of an effective health departments across the nation.

“The Cholera Invasion,” from Frank Leslie’s Illustrated Weekly, by West B. Clinedinst, 1892. National Library of Medicine.

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Written by (Roughly) Daily

September 9, 2022 at 1:00 am

“The welfare and the future of our societies depend on our capacity to remain mobilized so as to improve the health of every mother and child”*…

Preparing for a world post Roe v Wade…

The red states poised to ban or severely limit abortion already tend to have limited access to health care, poor health outcomes and fewer safety net programs in place for mothers and children.

If the U.S. Supreme Court overturns Roe v. Wade, as it’s expected to, the ensuing increase in births will likely leave families in tough circumstances and strain systems that are already hanging by a thread.

“What we’re facing as a country is hundreds of thousands of births, probably disproportionately located in the states that have been most limited in what they do for pregnant women, infants and children. So this is the great paradox that we are dealing with,” said Sara Rosenbaum, a health law and policy professor at George Washington University. “We have not ever designed these programs for a world without Roe,” she added. “You need a child welfare system, the likes of which we’ve never seen.”…

A growing shortage of obstetricians, higher maternal mortality rates and worse health care outcomes generally, increased pressure on U.S. foster and adoption systems— it all bodes ill…

We know from focus on health outcomes that kids born into poverty, kids born into unstable social circumstances, tend to have higher incidence of early onset chronic diseases,” Shannon said. “We also know that when those children are raised in unstable circumstances and have to be cared for in foster care, the outcomes there are really sobering.

Richard Shannon, chief quality officer for Duke Health

Red states aren’t prepared for a post-Roe baby boom,” from Caitlin Owens (@caitlinnowens) in @axios.

* Jean Ping

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As we contemplate care, we might sending healing birthday greetings to Thomas Huckle Weller; he was born on this date in 1915. A virologist, he developed a technique for cultivating poliomyelitis viruses in a test tube, using a combination of human embryonic skin and muscle tissue– which enabled the study of the virus “in the test tube,” a procedure that led to the development of polio vaccines. He was awarded the Nobel Prize in Physiology or Medicine in 1954.

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“By temporarily disrupting the order of the brain, a new order forms. And that order may have incredible value at either the level of mental health and psychology or the level of creativity.”*…

But, Zoe Cormier warns, if the means of that constructive disruption are industrialized and turned into aggressively-marketed products, we could be in for trouble…

Welcome to the strange new world of “psychedelic capitalism,” where dozens of start-ups have already raised millions (and in some cases billions) of dollars to commercialize psilocybin (the psychedelic ingredient in magic mushrooms), DMT (found in the Amazonian brew ayahuasca), mescaline (peyote’s active component), and LSD—despite the fact that all of these “classic psychedelics” are still ranked as Schedule I drugs under the federal Controlled Substances Act. Manufacturing any of these drugs without a license can still land you a long prison sentence. But marketing one, even though they all remain illegal and none have passed all the clinical trials required for approval? That can make you a millionaire…

The days when mind-bending psychedelics were seen as appealing only to drug dealers, nut jobs, and hippies are over. Today, serious-minded people interested in randomized controlled trials and stock valuations are leading the charge.

The “psychedelic renaissance” we’ve awaited for half a century—the promised era when acid, shrooms, and peyote would be brought back into legitimate research and legal access—is finally here. But will it turn out to be worth the wait? Or the hype?

Because it’s not like we ever stopped enjoying them: In the West, hippies, scientists, “healers,” and others have used psychedelics continuously for seven decades. And before we got our hands on them, Indigenous cultures used psychedelics for thousands of years as ritual sacraments. Now dozens of start-ups want to standardize, commercialize, alter, patent, and market these ancient compounds—and they stand to make a fortune doing so.

Will old-school profit-centered tactics bring down decades of dogged work by activists, scientists, and reformers to have these drugs reassessed for their virtues? Will we experience another nasty, research-smothering backlash?…

The profiteers have arrived; get ready for Psychedelics Inc.: “The Brave New World of Legalized Psychedelics Is Already Here,” from @zoecormier @thenation.

* Michael Pollan, in conversation with Tim Ferriss on Ferriss’ blog

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As we tune in, we might spare a thought for Ellen Swallow Richards; she died on this date in 1911. The first female student admitted to MIT, she became its first female faculty member. A chemist, she did pioneering work in sanitary engineering, but is best remembered for her experimental research in domestic science, which laid the foundation for the new science of home economics, of which she is considered founder. She was one of the first ecofeminists, believing that women’s work within the home was not just vital to the economy, but also a critical aspect of our relationship to the earth.

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“Human history seems to me to be one long story of people sweeping down—or up, I suppose—replacing other people in the process”*…

Max Roser argues that, if we keep each other safe – and protect ourselves from the risks that nature and we ourselves pose – we are only at the beginning of human history…

… The development of powerful technology gives us the chance to survive for much longer than a typical mammalian species.

Our planet might remain habitable for roughly a billion years. If we survive as long as the Earth stays habitable, and based on the scenario above, this would be a future in which 125 quadrillion children will be born. A quadrillion is a 1 followed by 15 zeros: 1,000,000,000,000,000.

A billion years is a thousand times longer than the million years depicted in this chart. Even very slow moving changes will entirely transform our planet over such a long stretch of time: a billion years is a timespan in which the world will go through several supercontinent cycles – the world’s continents will collide and drift apart repeatedly; new mountain ranges will form and then erode, the oceans we are familiar with will disappear and new ones open up…

… the future is big. If we keep each other safe the huge majority of humans who will ever live will live in the future.

And this requires us to be more careful and considerate than we currently are. Just as we look back to the heroes who achieved what we enjoy today, those who come after us will remember what we did for them. We will be the ancestors of a very large number of people. Let’s make sure we are good ancestors…

If we manage to avoid a large catastrophe, we are living at the early beginnings of human history: “The Future is Vast,” from @MaxCRoser @OurWorldInData.

* Alexander McCall Smith

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As we take the long view, we might recall that it was on this date in 1915 that Mary Mallon, “Typhoid Mary,” was put in quarantine on North Brother Island, in New York City, where she was isolated until she died in 1938.  She was the first person in the United States identified as an asymptomatic carrier of the pathogen associated with typhoid fever… before which, she first inadvertently, then knowingly spread typhoid for years while working as a cook in the New York area.

Mallon had previously been identified as a carrier (in 1905) and quarantined for three years, after which she was set free on the condition she changed her occupation and embraced good hygiene habits. But after working a lower paying job as a laundress, Mary changed her last name to Brown and returned to cooking… and over the next five years the infectious cycle returned, until she was identified and put back into quarantine.

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“Who is to say plutonium is more powerful than, say, rice?”*…

A mysterious illness killed princesses and sailors alike. Wellcome Collection/CC BY 4.0

In the late 19th century, a mysterious illness plagued the upper reaches of Japanese society…

In 1877, Japan’s Meiji Emperor watched his aunt, the princess Kazu, die of a common malady: kakke. If her condition was typical, her legs would have swollen, and her speech slowed. Numbness and paralysis might have come next, along with twitching and vomiting. Death often resulted from heart failure.

The emperor had suffered from this same ailment, on-and-off, his whole life. In response, he poured money into research on the illness. It was a matter of survival: for the emperor, his family, and Japan’s ruling class. While most diseases ravage the poor and vulnerable, kakke afflicted the wealthy and powerful, especially city dwellers. This curious fact gave kakke its other name: Edo wazurai, the affliction of Edo (Edo being the old name for Tokyo). But for centuries, the culprit of kakke went unnoticed: fine, polished, white rice…

The fascinating tale of kakke, and of the determined doctor who found a cure: “How Killer Rice Crippled Tokyo and the Japanese Navy,” in @atlasobscura.

* N.K. Jemisin

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As we opt for brown rice, we might recall that it was on this date in 1937 that Marcel Boulestin became the first “television chef” when he hosted the first episode of the first TV cooking show, the BBC’s Cook’s Night Out. A successful chef, restaurateur, and cookbook author, Boulestin helped popularize French cuisine in the English-speaking world (and was an important influence on Elizabeth David, and in turn, on Julia Child).

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