Posts Tagged ‘immigration’
“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.
“And miles to go before I sleep”*…
Anna and Kelly Pendergrast on the mechanics of a disorienting life event (that has spawned a mammoth industry)…
In 2022, about 12.6% of the US population (aged 1 year or over) lived in a different house or apartment than they did a year prior. The migration rate within the United States has been steadily declining over recent decades after sitting around 20% from the end of World War II to the 1980s. While people moving within the same county consistently make up the largest share of movers, the percentage of people moving between states has been rising, increasing from 18.8% [that the portion of the opularion that moved] in 2021 to 19.9% in 2022.
Moving house is profoundly disorienting, throwing into disarray the entirety of your material existence, your daily routines, and your relationship to the land and built environment. It’s also one of the most significant organizational challenges people willingly undertake — a moment of intersection with the global logistics infrastructures that move things from one place to another.
Moving house is a very specific, personal pain, but as with all stressful life events (marriage, divorce, death) there’s an entire industry around it. Professional moving companies — previously represented by the American Moving & Storage Association, now a part of the broader American Trucking Association — are dedicated to streamlining all aspects of moving house and extracting money from the weary and frazzled. Moving is a big industry: There were 17,936 companies in the moving services industry in 2024, with over 109,062 employees.
If you’re accustomed to scrappy DIY moves, watching a moving company at work is like glimpsing a more logistically sophisticated world. If the DIY mover is a stevedore, loading lamps and houseplants one by one into a truck or station wagon, professional movers are workers at the containerized port, a model of efficiency as they stack standardized boxes into a standardized truck. The professional move is faster and more streamlined than doing it yourself, but it requires more materials, more coordination, and more infrastructure.
Part of the mover’s arsenal is the specialized box and other assorted paper products. For instance, the Dish Barrel is a double-walled cardboard container designed specifically to move dishware, enabling multiple layers of delicate kitchen items to be stacked while minimizing the risk of crushing. There are different methods for packing a Dish Barrel, both with and without cardboard dividers (which U-Haul calls cell kits). But in all cases the best practice for the Dish Barrel is to use copious sheets of newsprint before packing into a box.
A review of moving YouTube videos like those linked above reveal a curious gender binary: While organizing YouTubers (who teach viewers how to sort, label, and display items in a house) tend to be women, moving YouTubers (who teach viewers how to wrap, pack, and box items to leave a house) are more likely to be men. While the tasks are very similar, the connotations of the work — homemaking and aesthetics on the one hand, lifting and logistics on the other — keep them squarely in gendered categories…
More redolent reportage on relocation: “Moving House,” from @annapendergrast.bsky.social and @kellypendergrast.bsky.social in Scope of Work.
(Image above: source)
* Robert Frost, “Stopping by Woods on a Snowy Evening“
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As we decamp, we might recall that it was in this date in 1962 that the Seattle World’s Fair (more officially known as “the Century 21 Exposition”) opened. Nearly 10 million people attended the fair during its six-month run; and as planned, the exposition left behind a fairground and numerous public buildings and public works (including the iconic Space Needle and the monorail). Unlike many Fairs of its era, Century 21 made a profit– and, relevantly to the topic above– is credited with revitalizing Seattle’s economic and cultural life and attracting an increased flow of movers to the area.
“By improving health, empowering women, population growth comes down”*…
… And increasingly across the globe, starting in the developed world, we’ve been doing a better job of that. Indeed, some are beginning to worry about a kind of problem that the modern world has never faced– depopulation.
History Today offers a fascinating snapshot…
During the 1930s and early 1940s, many Americans held off on starting families because of the economic insecurity of the Great Depression and uncertainty of World War II. But the prosperous postwar era led to an increase of births between 1946 and 1964 that gave the baby boomer generation its nickname. Over this 19-year period, the booming birth rate helped the U.S. population grow by more than 50%. The country’s demographic makeup shifted so rapidly that by 1960, there were 64.2 million Americans under age 18, out of 180 million overall — a whopping 36% of the population. For context, in 2022, an estimated 22.4% of the U.S. population was under 18.
General fertility rates in the baby boom era peaked in 1957 at 122.9 live births for every 1,000 women aged 15 to 44 — that’s 4.3 million babies that year alone. The general fertility rate took a nosedive throughout the 1960s as the birth control pill became more widely available and women entered the workforce at much higher rates. By 1970, the general fertility rate was 87.9, and the much smaller Generation X was well underway.
The baby boomer generation didn’t reproduce at the same rapid clip as their parents, but because there were so many of them, they still produced a lot of offspring. Indeed, 1990 — the year all those 1957 babies turned 33 — was another banner year for births, with 4.2 million millennials entering the world, despite a general fertility rate of just 70.9…
Consider these population pyramids from the U.S. Census Bureau:
This picture is of course in aggregate: some locales (e.g., Utah) continue to grow and are “younger”; others, like Alexander County, Illinois are much “older.” And globally, the picture is even more mixed:
The global population reached nearly 8.2 billion by mid-2024 and is expected to grow by another two billion over the next 60 years, peaking at around 10.3 billion in the mid-2080s. It will then fall to around 10.2 billion, which is 700 million lower than expected a decade ago. However, changes in global population are uneven and the demographic landscape is evolving, with rapid population growth in some places and rapid ageing in others…
… The world’s overall fertility rates are dropping, with women having one child fewer on average than they did around 1990.
In more than half of all countries and areas, the average number of live births per woman is below 2.1 – the level required for a population to maintain a constant size.
Meanwhile, nearly a fifth of all countries and areas, including China, Italy, the Republic of Korea and Spain, now have “ultra-low fertility,” with fewer than 1.4 live births per woman over a lifetime. As of 2024, population size has peaked in 63 countries and areas, including China, Germany, Japan and the Russian Federation, and the total population of this group is projected to decline by 14 per cent over the next thirty years…
While the slow growth or decline of populations is occurring mainly in high-income countries, rapid population growth will occur in low-income and lower-middle-income countries.
Specifically, Angola, the Central African Republic, the Democratic Republic of Congo, Niger, and Somalia, very rapid growth is projected, with their total population doubling between 2024 and 2054.
This population growth will increase demand for resources, especially in sub-Saharan Africa and South Asia and, combined with poorly managed urbanisation and rising living standards, it will worsen environmental impacts.
Climate change, a major challenge, affects these countries the most, where many rely on agriculture – and food insecurity is prevalent.
In countries including India, Indonesia, Nigeria, Pakistan and the United States [our inherent decline offset to some extent by immigration… at least until now], population is also expected to increase through 2054 and could potentially peak in the second half of the century or later…
Implicit assumptions of a growing population underlie many– if not most– of the decisions we’ve made about everything from social policies (e.g., social security) to business plans (e.g., growing markets).
Populations grow for some combination of three reasons: fertility is above replacement level, people live longer, and/or immigration swells the ranks. For quite a while, the U.S. was hitting on all three cylinders; more lately, on the latter two. But recently, life expectancy has stalled.
Immigration is currently strong (and, as noted above, keeping U.S. population growth positive), but it’s looking increasingly uncertain: political energy to restrict (indeed, to undo) immigration is high, even as the pressures of climate change and political upheaval are increasing numbers of people from around the world hoping to find a home in the U.S.
If, as Comte is said to have suggested, demography is destiny, then what is ours? “In 1960, more than a third of the U.S. population was under 18.”
Apposite: “Why people over the age of 55 are the new problem generation,” gift article from The Economist
* Bill Gates
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As we dig into demographics, we might send thoughtful birthday greetings to Robinson Jeffers; he was born on this date in 1887. A poet renowned both for his longer (narrative and epic) verse and his shorter work, he was an icon of the environmental movement. His philosophy of “inhumanism” argued that transcending conflict required human concerns to be de-emphasized in favor of the boundless whole.
“Without debatement further, more or less, / He should the bearers put to sudden death, / Not shriving time allow’d.”*…
“Cell suicide” is inherently self-destructive, and yet it’s an essential and productive process in complex organisms. How did cells evolve a process to end their own lives? As Veronique Greenwood reports, recent research suggests it first arose, first arose billions of years ago… but why?…
It can be hard to tell, at first, when a cell is on the verge of self-destruction.
It appears to be going about its usual business, transcribing genes and making proteins. The powerhouse organelles called mitochondria are dutifully churning out energy. But then a mitochondrion receives a signal, and its typically placid proteins join forces to form a death machine.
They slice through the cell with breathtaking thoroughness. In a matter of hours, all that the cell had built lies in ruins. A few bubbles of membrane are all that remains.
“It’s really amazing how fast, how organized it is,” said Aurora Nedelcu, an evolutionary biologist at the University of New Brunswick who has studied the process in algae.
Apoptosis, as this process is known, seems as unlikely as it is violent. And yet some cells undergo this devastating but predictable series of steps to kill themselves on purpose. When biologists first observed it, they were shocked to find self-induced death among living, striving organisms. And although it turned out that apoptosis is a vital creative force for many multicellular creatures, to a given cell it is utterly ruinous. How could a behavior that results in a cell’s sudden death evolve, let alone persist?…
The story in full: “Cellular Self-Destruction May Be Ancient. But Why?“, from @vero_greenwood in @QuantaMagazine.
* Shakespeare, Hamlet (Act 5, Scene 2)
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As we appreciate apoptosis, we might send healthy birthday greetings to Lillian Wald; she was born on this date in 1867. A nurse, humanitarian, political reformer, and author, she was instrumental in establishing a nationwide system of nurses in public schools. Known as “the Angel of Henry Street” (for her founding and running of the Henry Street Settlement in New York City), she directed the Henry Street Visiting Nurse Service, while at the same time tirelessly opposing political and social corruption. She helped initiate the revision of child labor laws, improved housing conditions in tenement districts, drove the enactment of pure food laws, championed and improved education for the mentally handicapped, and led the passage of enlightened immigration regulations.
“One bullion cube… one Concord grape… one Philly cheese-steak… and a jar of garlic pickles! No one will want to kiss me after these, eh, Smithers?”*…
Kunwar Khuldune Shahid explains how immigration patterns and global politics — plus a bit of serendipity — intertwined to make Philadelphia’s iconic sandwich a hit in a 13-million-resident Pakistani megalopolis…
… [Chef Mazhar] Hussain has worked at some of the most high-profile restaurants in Lahore — Monal, Tuscany Courtyard, Chaayé Khana and Café Aylanto, among others — covering a wide range of cuisines. His experience at Philly’s Steak Sandwich, though, has been unique. It’s a smaller restaurant than those, he says, and the guests come from all walks of life. The one thing that connects them: “The steak sandwich is extremely popular with everyone.”
Philly’s Steak Sandwich sits on a small highway apart from Johar Town’s main food centers, atop a hair salon. The shop fights for customers with a biryani restaurant across the street and buzzes all evening with motorbikes and cars jammed into the cramped parking spaces. The cheesesteak is especially popular among nearby students, who can enjoy it for PKR 579, or a little over two bucks.
…
Lahore, Pakistan’s second-largest city and the capital of the historic Punjab region, is considered the country’s food hub (although citizens of Karachi loudly dispute that claim). Its location at the crossroads of the many empires to have ruled over the Indian subcontinent, from the Mughals to the British, has added multicultural layers to Lahori heritage and culture. This is reflected in the city’s food, which blends Persian and Afghan flavors, a combination we now deem synonymous with the cuisine of North India — which Lahore was an integral part of before the 1947 partition created what is today called Pakistan, in the northwestern part of the Indian subcontinent.
That Indic syncretism, which Lahore has oozed with for centuries, is today introducing a new cuisine to the city’s taste buds: Philadelphian. But while Philly’s Steak Sandwich might be the first to put our city’s renowned sandwich on local billboards, Lahore’s love-in with the cheesesteak is, in fact, decades old…
More fission than fusion: “The Amazing Story of How Philly Cheesesteaks Became Huge in Lahore, Pakistan,” from @khuldune in @PhiladelphiaMag.
* “Montgomery Burns,” in The Simpsons
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As we muse on migration, we might recall that it was on this date in 1959 that the St. Lawrence Seaway opened. A system of locks, canals, and channels in Canada and the United States, it permits oceangoing vessels to travel from the Atlantic Ocean to the Great Lakes of North America– as far inland as Duluth, Minnesota, at the western end of Lake Superior. The Seaway handles 40–50 million tons of cargo annually, about 50% of of which travels to and from international ports in Europe, the Middle East, and Africa.
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