Posts Tagged ‘health’
“The call is coming from inside the house”*…
As the old proverb goes, “we become what we hate.” In this post, two examples of groups adopting practices they had decried in their enemies.
First, from the fetid ocean of political finance: it’s been pretty obvious for some time that the Trump Administration and the Republican party at large have embraced the doctrine of “honest graft” (and here and here and…). What is perhaps less obvious is the extent to which that impulse has affected (infected?) their approach to campaign finance per se (and here).
But, as Stanford professor Adam Bonica demonstrates, greed is an equal opportunity vice…
The digital deluge is a familiar annoyance for anyone on a Democratic fundraising list. It’s a relentless cacophony of bizarre texts and emails, each one more urgent than the last, promising that your immediate $15 donation is the only thing standing between democracy and the abyss.
The main rationale offered for this fundraising frenzy is that it’s a necessary evil—that the tactics, while unpleasant, are brutally effective at raising the money needed to win. But an analysis of the official FEC filings tells a very different story. The fundraising model is not a brutally effective tool for the party; it is a financial vortex that consumes the vast majority of every dollar it raises.
We all have that one obscure skill we’ve inadvertently maxed out. Mine happens to be navigating the labyrinth of campaign finance data. So, after documenting the spam tactics in a previous article, I told myself I’d just take a quick look to see who was behind them and where the money was going.
That “quick look” immediately pulled me in. The illusion of a sprawling grassroots movement, with its dozens of different PAC names, quickly gave way to a much simpler and more alarming reality. It only required pulling on a single thread—tracing who a few of the most aggressive PACs were paying—to watch their entire manufactured world unravel. What emerged was not a diverse network of activists, but a concentrated ecosystem built to serve the firm at its center: Mothership Strategies.
To understand Mothership’s central role, one must understand its origins. The firm was founded in 2014 by senior alumni of the Democratic Congressional Campaign Committee (DCCC): its former digital director, Greg Berlin, and deputy digital director, Charles Starnes. During their tenure at the DCCC, they helped pioneer the fundraising model that now dominates Democratic inboxes—a high-volume strategy that relies on emotionally charged, often hyperbolic appeals to compel immediate donations. This model, sometimes called “churn and burn,” prioritizes short-term revenue over long-term donor relationships.
After leaving the DCCC, Berlin and Starnes effectively privatized this playbook, building a business around the party’s most aggressive tactics and turning an internal strategy into a fundraising powerhouse for the Democratic Party—or so it might seem on the surface.
They became the operational heart of a sprawling nexus of interconnected political action committees, many of which they helped create and which now serve as their primary clients. These are not a diverse collection of grassroots groups; they are a tightly integrated network that functions primarily to funnel funds to Mothership. Their names are likely familiar from the very texts and emails that flood inboxes: Progressive Turnout Project, Stop Republicans, and End Citizens United to name a few.
The relationship between the firm and this network is cemented by blatant self-dealing. The most glaring example is End Citizens United. In 2015, just one year after founding their consulting firm, Mothership principals Greg Berlin and Charles Starnes also co-founded this PAC. It quickly became one of their largest and most reliable clients, a perfect circle of revenue generation that blurs the line between vendor and client.
The core defense of these aggressive fundraising tactics rests on a single claim: they are brutally effective. The FEC data proves this is a fallacy. An examination of the money flowing through the Mothership network reveals a system designed not for political impact, but for enriching the consultants who operate it.
To understand the scale of this operation, consider the total amount raised. Since 2018, this core network of Mothership-linked PACs has raised approximately $678 million from individual donors. (This number excludes money raised by the firm’s other clients, like candidate campaigns, focusing specifically on the interconnected PACs at the heart of this system.) Of that total fundraising haul, $159 million was paid directly to Mothership Strategies for consulting fees, accounting for the majority of the $282 million Mothership has been paid by all its clients combined…
… After subtracting these massive operational costs—the payments to Mothership, the fees for texting services, the cost of digital ads and list rentals—the final sum delivered to candidates and committees is vanishingly small. My analysis of the network’s FEC disbursements reveals that, at most, $11 million of the $678 million raised from individuals has made its way to candidates, campaigns, or the national party committees.
But here’s the number that should end all debate:
This represents a fundraising efficiency rate of just 1.6 percent.
Here’s what that number means: for every dollar a grandmother in Iowa donates believing she’s saving democracy, 98 cents goes to consultants and operational costs. Just pennies reach actual campaigns…
For all of the details, and an explanation of why the Party looks the other way: “The Mothership Vortex: An Investigation Into the Firm at the Heart of the Democratic Spam Machine,” from @adambonica.bsky.social.
Second, consider the case of Texas, a state that used to hate lawsuits, the nanny state, and the film industry. As Christopher Hooks reports, it’s learned from the Golden State to embrace all three as a means of cultural influence. After unpacking the state government’s turnabout from tort reform to encouaging rise of private enforcement of laws through fines and lawsuits and it’s shift from it’s prior rejection of government nutritional and health guidelines, Hooks looks at Texas’ new push to become a seat of film and television production…
… Beneath the long-standing contempt for California and its tyranny was, apparently, a fair bit of envy. On no issue was this more obvious than the expensive package of film incentives the Lege passed this year—$300 million to refund movie and TV productions for money spent in the state.
Most lawmakers who supported the package doubtless did so because of a general positive feeling about the arts, or just because Matthew McConaughey came to the Capitol to lobby for it. But implicit in the way some lawmakers talk about the baleful influence of the California-centered movie industry—currently in a state of near collapse because of AI and the streaming revolution—is a belief that it represents a malign channel of cultural control and coercion by liberal Hollywood elites. In writing the incentives, Texas lawmakers seemed to be asking: What if we had that power instead?
Texas is likely to attract many additional TV and film shoots with this new money. Some productions will come specifically to take advantage of the bill’s Texas Heritage Project funding, a pot of money set aside and controlled by the governor’s appointees to fund projects that promote “family values” and portray “Texas and Texans in a positive fashion.” A cynic might blink twice and wonder if the governor just gave himself a propaganda fund.
The subtext of the bill is probably more important. The state has already in the recent past revoked film incentives from a movie, 2010’s Machete, because state officials disapproved of its message. Future films made here will likely aim to avoid the watchful eye of state lawmakers. The Legislature seems to be embodying the favorite idea of a profoundly influential Californian, Andrew Breitbart, who reminded conservatives at every possible opportunity that “politics is downstream from culture.” It’s perhaps true, but it’s also the kind of thing you think up when you’ve lived in Santa Monica for too long.
After ten years of a governor who has vowed to keep West Coast ways from our pleasant shores, the state is awash in tech exiles. Big money and a strong executive dominate the Legislature more than ever before. Republicans in the House have turned into granola-eating health food obsessives while trial lawyers are on the ascent. The lieutenant governor spends his days entertaining movie stars. Close your eyes, and you can almost imagine you’re U-Hauling down the 405…
Becoming your enemy: “Right-Wing Lawmakers Are Trying to California Your Texas,” from @hooks.bsky.social in @texasmonthly.bsky.social.
Yet another bizzaro flip: “Welcome to the age of Hard Tech” from @taylorlorenz.bsky.social.
* from When a Stranger Calls
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As we try to appreciate the ironies, we might recall that it was on this date in 2008, that a tour bus belonging to the Dave Matthews Band dumped an estimated 800 pounds (360 kg) of human waste from the bus’s blackwater tank through (grated surface of) the Kinzie Street Bridge in Chicago onto an open-top passenger sightseeing boat sailing in the Chicago River below. Roughly two-thirds of the 120 passengers aboard the tour boat were soaked.
More here.

“But man is a part of nature, and his war against nature is inevitably a war against himself.”*…
Nathan Gardels argues that health is not personal, but environmental…
If it weren’t for his dogmatic anti-science views on vaccines and pandemics, U.S. Health and Human Services Secretary Robert Kennedy Jr.’s Make America Healthy Again movement would mark a transformative shift in our understanding of health care. At its core, MAHA grasps that placing the onus for being healthy solely on the individual in a sickening environment and a food supply chain contaminated by industrial chemicals is a misplaced responsibility.
How can we be healthy in a sick environment? That is the right question. But answering it entails not a rejection of scientific authority in the name of libertarian politics, but an embrace of science as the path to deeper discovery of how to heal the environment and mend a planet in distress, which are the affective conditions of human health.
This is a perspective laid out in Noema by Nils Gilman, Paul Kortba, Alex Marashian and others. “What if the most salient factors shaping health today lie not within the atomized individual or even their immediate social milieu, but in the fractured, volatile relationship between our species and the Earth system itself?” they ask.
For the authors, the science of salutogenesis, which focuses on the origins of health instead of the origins of disease (pathogenesis), should in our day and age be expanded to the planetary scale.
“Adding the idea of the planetary to salutogenesis isn’t just an effort to insert an ‘environmental’ layer into existing health models,” they write. “It requires a radical revision of how we understand what constitutes collective human health.
“Today’s dominant medical paradigm treats individual personal health as the primary object of concern and relegates the environment to the status of an external variable to be managed or mitigated. Planetary salutogenesis proposes a reversal: that planetary health is the fundamental condition, the enabling context, out of which durable human health, both individual and collective, emerges.”
In this, they follow the thinking of the philosopher Ivan Illich. In his book, “Medical Nemesis,” Illich spoke of “iatrogenic illness” — illness that results from mistreatment by a bureaucracy of physicians who abandoned the ancient idea of health as “balance” within the environment in which a person lived.
As he colorfully related to me in one conversation some years ago at his rustic compound in central Mexico, such a healthy balance could not be achieved by treating the person as a “detached immune system,” apart from their environment and the wholeness of their being, to be managed “from sperm to worm” by the “Brave New Biocracy” of modern medicine.
“An approach to health that is confined to the individual while ignoring this broader context,” the authors write in Noema, “is like carefully tending a wilting flower while ignoring the poisoned soil, acid rain and encroaching desert around it.”
Planetary salutogenesis explicitly acknowledges “the planetary scale of our interconnectedness and predicament. It reframes our approach to health and well-being by contrasting it with the assumptions of individual pathogenesis.”
“Human health,” the authors point out, “is inseparable from the planetary systems we inhabit and constitute. We are not self-contained biological units interacting with a passive external ‘environment.’ Rather, as biologist Scott Gilbert has described, we are holobionts in a vast, interconnected, living web that encompasses microbial, atmospheric, oceanic and terrestrial ecosystems.
“Concepts like the ‘eco-holobiont’ capture this reality of the human organism itself as a complex ecosystem, intrinsically linked to and shaped by its surrounding ecological matrix. Our internal environments mirror our external ones. Soil influences the human gut; fresh air and sunshine impact our physiological functioning; biodiversity affects our immune system and mental health.”
What planetary salutogenesis means in practice is an emphasis on proactively supporting well-being instead of focusing entirely on eliminating disease. As such, it shifts our approach from treatment to prevention, emphasizing the need to confront upstream drivers of ill health — industrial agriculture, fossil fuel dependence, inequitable economic models and anthropocentric worldviews. It also understands that health is relational and emergent, arising from mutualistic, regenerative relationships between humans and the more-than-human world. In short, this perspective is eco-centric, recognizing we are embedded inhabitants in a biodiverse world.
Planetary salutogenesis shifts the focus from genome to exposome,highlighting the critical importance of the totality of environmental exposures (chemical, biological, social, physical) from conception onward — in shaping health trajectories. And finally, in practice this would mean abandoning an economic paradigm obsessed with perpetual growth in favor of an ecological economics that emphasizes the need for balance and recognizes biophysical limits.
These new understandings put personal lifestyle changes as the path to health in perspective. While they may retain ethical and symbolic importance, the authors note that “a planetary lens reveals that true leverage lies in transforming the macro-systems that drive the crisis: energy grids, industrial agriculture, transportation networks, financial markets and consumption patterns. It illuminates the actual scale at which resources — financial, technological, political, social, ecological — must be mobilized and demands met.”
The Make America Healthy Again movement has opened a path toward salutogenesis as a new direction for health care. But just as health care is more environmental than personal, so too is the health of nations a function of the health of the planetary system. Making the Planet Healthy Again is an objective that serves all living beings…
The future of health will be planetary or there will be no future health: “Make The Planet Healthy Again,” from @noemamag.com.
See also the article to which Gardels refers: “The Future Of Health On A Damaged Planet.”
And as a reminder (as if one was needed), what Gardels, Gilman, et al. are advocating is something very differerent from the program of RFK, Jr… whose fantastic (in the most literal of senses) enthusiasms are, as they are being pressed into policy, already having an impact…
* Rachel Carson, Silent Spring
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As we reframe for resiliance, we might recall that on this date in 1935 the Dust Bowl heat wave reached its peak, sending temperatures to 109 °F in Chicago and 104 °F in Milwaukee. While the period is mostly remembered for its dramatic dust storms and for the displacement of about 3.5 million people from the Plains states from 1930-40, it also had severe health consequences: increased hospitalization for respiratory disorders, increased infant and overall mortality, and increased incidence of measles. (Recent scientific studies have demonstrated that dust transmits measles virus, influenza virus, and coccidioides immitis, and that mortality in the United States increases following dust storms with 2-3-day lag periods.) There were also severe mental health consequences.

“The first wealth is health”*…
As Angela J. Wyse and Bruce D. Meyer explain, lack of health insurance explains five to twenty percent of the mortality disparity between high- and low-income Americans…
We examine the causal effect of health insurance on mortality using the universe of low-income adults, a dataset of 37 million individuals identified by linking the 2010 Census to administrative tax data. Our methodology leverages state-level variation in the timing and adoption of Medicaid expansions under the Affordable Care Act (ACA) and earlier waivers and adheres to a preregistered analysis plan, a rarely used approach in observational studies in economics. We find that expansions increased Medicaid enrollment by 12 percentage points and reduced the mortality of the low-income adult population by 2.5 percent, suggesting a 21 percent reduction in the mortality hazard of new enrollees. Mortality reductions accrued not only to older age cohorts, but also to younger adults, who accounted for nearly half of life-years saved due to their longer remaining lifespans and large share of the low-income adult population. These expansions appear to be cost-effective, with direct budgetary costs of $5.4 million per life saved and $179,000 per life-year saved falling well below valuations commonly found in the literature. Our findings suggest that lack of health insurance explains about five to twenty percent of the mortality disparity between high- and low-income Americans. We contribute to a growing body of evidence that health insurance improves health and demonstrate that Medicaid’s life-saving effects extend across a broader swath of the low-income population than previously understood…
“Saved by Medicaid: New Evidence on Health Insurance and Mortality from the Universe of Low-Income Adults,” from @nber.org.
Congress, of course, just moved to cut Medicaid; as the wording in the “Big, Beautiful BIll” stands, 8-10 million Americans stand to have the their covergae terminated orr severely reduced.
But even as we agree that extending coverage– fixing the “demand side” problem– could save lives, we should note that we have some serious supply side problems to address: 80% of the country, insured or not, lacks adequate access to healthcare service; and there’s a large and growing shortage of healthcare professionals and workers (a problem aggravated by the Trump administration’s draconian crackdown on immigration). Technology offers some hope, but humans remain at the center of the issue.
* Ralph Waldo Emerson
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As we contemplate care, we might send insightful birthday greetings to Susan Lindquist; he was born on this date in 1949. A molecular biologist, she was a pioneer in the study of protein folding. She showed that alternate structural shapes of protein molecules could result in substantially different effects and demonstrated instances in fields as diverse as human diseases, evolution, and synthetic biomaterials designed to interact with biological systems. Her work laid the foundation for the development of AI-driven systems like Alpha-Fold that accelerate the discovery and development of new drugs and therapies.
“Of all the forms of inequality, injustice in health is the most shocking and inhumane”*…

We tend to encounter data about public health in the form of averages over the population as a whole. But as a recent study published in The Lancet painfully demonstrates, the underlying reality is much more complicated– and alarming…
The differences in U.S. life expectancy are so large it’s as if the population lives in separate Americas instead of one.
Nearly two decades ago, a team of researchers published the landmark “Eight Americas” study, which examined drivers of U.S. health inequities between 1982 and 2001 by dividing the U.S. population into groups based on geography, race, income, and other factors.
A new research study, published this month by the University of Washington and the Council on Foreign Relations, revisits that landmark research project, adding two new “Americas” to account for Latino populations.
This new study finds that U.S. life expectancy disparities have grown over the last two decades between 2001 and 2021, with the differences between the best and worst of those “Americas” increasing from 12.6 years in 2000 to 20.4 years in 2021. COVID-19 exacerbated this divide, but gaps in longevity had already been growing before the pandemic hit…
“The 10 Americas: How Geography, Race, and Income Shape U.S. Life Expectancy,” from @thinkglobalhealth.org. Both this summary article and the underlying paper are eminently worth reading in full.
* Martin Luther King, Jr.
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As we unpack unfairness, we might send preventative birthday greetings to Ernst Wynder; he was born on this date in 1922. An epidemiologist and public health researcher, he is best remembered for his pioneering work in identifying the link (in 1950) between smoking and lung cancer.
Wynder devoted his career to the study and prevention of cancer and chronic disease, publishing hundreds of scientific papers. Through the 1950s and 1960s, he worked at Sloan-Kettering Institute for Cancer Research. In 1969, he founded the American Health Foundation. In 1972, he founded the academic journal Preventive Medicine and served as the founding editor.
“Every picture tells a story”*…
The world’s populations is unevenly spread across the globe. But, plotted by latitude (as per this visualization from Engaging Data), it’s a little more concentrated…
… which is interesting (perhaps better said, “bracing”) to consider aside this illustration from NOAA…
Global warming is coming for most of us: “World Population Distribution by Latitude and Longitude,” from @engagingdata.bsky.social and @climate.noaa.gov.
See also: “The world is heating up. How much can our bodies handle?” from @gristnews.bsky.social and “Understanding Climate Migration,” from RAND.
* traditional saying
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As we feel the heat, we might spare a thought for John Graunt; he died on this date in 1674. A haberdasher turned statistician, he is considered by many to be the father of demography (the statistical study of human populations).
A charter member of The Royal Society, Graunt distributed a 90-page book, Natural and Political Observations Mentioned in a Following Index, and Made upon the Bills of Mortality at the February, 1662 Society meeting. He described his work as having “reduced several great confused volumes” of parish records into a few easily to understood tables, and “abridged such Observations… into a few succinct Paragraphs.” He initiated “life tables” of life expectancy. His use of demographics was further pioneered by his friend Sir William Petty and Edmond Halley, the Astronomer Royal.
Graunt’s work also gives him some claim to having been the first epidemiologist.










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