Sick Americans: cost and cause

Years ago a Canadian study found the treatment of common surgical and medical diseases was significantly better in Canada than in the US. So Canadians didn't only live longer, they also received better healthcare (on average).

Now middle-aged white English seem quite a bit healthier than similar Americans:

Health in America and Britain | Transatlantic rivals | Economist.com

... the comparison was between Americans and the English. Scots, with their notoriously high rates of heart disease, were conveniently excluded by the choice of the English Longitudinal Study of Ageing as the source of the British data, as were the Welsh and the Northern Irish. With this caveat, Dr Marmot's research revealed that people who are between 55 and 64 years of age are a lot sicker in America than they are in England (see chart). Diabetes is twice as common: 12.5% of Americans suffer from it, compared with 6.1% in England. Cancer is nearly twice as prevalent in America, while heart disease is half as high again.

The main environmental suspect is lack of activity and something dietary. Certainly genetics is a suspect too, maybe white Americans are too much like the Scots. A heck of a lot of English men died on the bloody fields of France 100 years ago -- were there recent severe selection pressures? A comparison with Canada might help.

The Economist makes the interesting point that US healthcare spending may, in part, be higher than the rest of the wealthy world because white Americans are a sickly bunch.

Update 5/9: Thinking about this further, I'm betting it's genetic and the key factor is resistance to diabetes. We already suspect that northern europeans are diabetes resistant compared to most human populations. My bet is the English are particularly resistant.

Update 5/10: My mother, who is English, ascribes any health improvements to drinking large volumes of black tea. She also claims that, irregardless of any helpful resistance to diabetes, the English are cursed with awful tooth and jaw development.

So is tea good for the islet cells? Who knows ...

Update 5/12: Or maybe walking is much more beneficial than we'd thought ... or lack of sleep is much more harmful than we'd realized ...

Mother's Day - who's the worst?

In the holiday spirit, the NYT reviews loving maternal behavior in birds and mammals. A cool antidote for Disney sappiness or penguin wish fulfillment.

My award for worst parent goes to the mother of the eaglet who starved it while its sibling pecked it 1,569 times, but really the competition is ... ummm ... fierce.

The weak die so that the strong may live. Be grateful for your abundance ...

An odd digression into mathematics: Physics and the Reimann-Zeta functions

I'm listening to my favorite pocast, In Our Times -- this one's on Prime Numbers. They start with Euclid, and work their way up to the Reimann-Zeta functions and beyond. Things get weird. The primes seem randomly distributed, with a probability of discovery that falls as the log of the number considered. Random and unpredictable, and yet the related Reimann-Zeta function has a very predictable component ... Where does the randomness come from? (It sounds like the imaginary component of the imaginary numbers in the RZ function hold the random component, but our lecturers didn't delve into that topic.)

This is the great dream for mathematicians then, that there is some method to transform the seemingly perfect randomness of the primes into something that's utterly predictable. True, this could devastate the world economy (encryption relies on the unpredictability of primes), but it would mean mathematical glory.

Randomness and utter predictability. It reminds me of Einstein's wistful declaration 'God does not play dice with the universe'. Surely he must have looked to the Reimann-Zeta function as a way to bring order from apparent chaos -- alas, to no avail.

In the age of Google, one can quickly ask if anything has come up recently. I did find this page. Physicists continue to play with these tempting toys ...

I do recommend listening to In Our Times ...

Humane execution

The electric chair sometimes required a few flips of a balky switch. Injection has its own imperfections:

Merciful (but messy) alternatives to lethal injection. By Hanny Hindi

... State executions today are strictly medical procedures, complete with lab coats and white sheets. Strapped to the gurney and carefully injected with an IV, the inmate looks as though he'll recover nicely. Though recent challenges have again revealed that the lab coats are worn by amateurs and the IVs are frequently botched, executioners can rest assured that their goal will ultimately be met. Prisoners may very well suffer needlessly excruciating deaths, but the witnesses won't feel a thing.

Painless witnessing and simple clean-up. That's what led to the current lethal cocktail. Too bad about that "cruel and inhumane" problem. This Slate article mentions vets are the true masters of the gentle putdown, so maybe we should turn this over to the vets. Alas, I've a hunch vets will be even less agreeable to assisting than physicians have been.

The Chinese are the true masters of the process. A soft nosed bullet to the back of the head. Personally, I'd be okay with strapping a significant explosive charge to my occiput. If administered in an armored incineration chamber it would even allow for convenient cleanup.

Or maybe we should think again about the idea of state murder of convicts who are both stupid (or mentally ill) and poor. (Smart sane killers are rarely caught, rich killers are rarely convicted.)

PS. If it's not obvious, I'm no fan of the death penalty. Were we to keep it, I would say we ought to require random assignment of attorneys for all death penalty cases. Even the playing field a bit ... And, at, the very least, learn from China.

Anonymity achieved - of a sort

This blog was once known by my true name. Problem was, periodically business contacts or interview subjects would google my name, and the first thing they came across were my blog postings. This occasionally led to some odd interactions. I figured I needed a bit more distance from the blog, so I renamed it. My true name is embedded in the url -- but of course from google's perspective that doesn't matter.

I also removed links pointing to my eponymous domain.

It worked. Now when I google on my name the blogs are all but invisible.

An interesting lesson in the effervescence of digital identity! A certain kind of anonymity is not hard to achieve.

Schizophrenia is "hot". Why now?

Schizophrenia is in the news. In the past week USA Today devoted much of their front section to this family of neurologic disorders, the Wall Street Journal featured an article on schizophrenia in the prison systems on their front page, and this morning NPR did a book interview with the parents of a schizophrenic adult.

Why now? This is not a new disorder. As measured by any reasonable combination of cumulative suffering, anguish, economic burden and prevalence schizophrenia is the worst affliction of the post-industrial world. And yet, it's been relatively ignored. Why should that change now?

The answer, my friend, is blowing in the wind. It's the boomers.

Schizophrenia is usually recognized around age 20. It's a disease that, unlike MS or breast cancer, silences its victims. Only parents can write about it and campaign against it.

The median boomer was born in 1955. She had her first child in 1983. That child was diagnosed with schizophrenia in 2003. By 2005 he was running into legal problems. Now she's writing about her son.

We can all wish that schizophrenia had been "public enemy number one" 10 years ago. No matter, now is the time. This is one issue on which a beleagured and widely despised president could win a few friends. Bush should declare war on schizophrenia. It's one of the few good things he can still do.

What are spleens good for?

In horses the spleen is an oxygenation turbocharger. In humans it's usually thought to be an almost disposeable part of our immune system (after splenectomy some usually manageable bacterial infections become much more serious however). Reading this, though, one must wonder if we've ever monitored spleen behavior during wind sprints.

At what gas price would Americans make changes?

From a comment on The Big Picture: More on Gas Prices:

At what price would gas affect consumer behavior?

I think gas in my birthplace, Quebec (Canada - still), goes for about $6/gallon US. You don't see a lot of SUVs there.

I suspect the price in BC is similar. It would be interesting to compare the per-foot costs of suburban vs. urban homes in Vancouver vs. Seattle. If $6/gallon gas changes behavior then the suburban/urban per foot costs ratio in Vancouver area should be smaller than in the Seattle area. (One might have to adjust for tax structure differences.)

I've long guessed that US middle-class behavior will change significantly (mass transit choices, preference for urban living) when gas hits $7/gallon. Can't say why, but I figure it's about the adjusted Canadian price. Mostly it would be a trend to smaller homes, smaller cars, urban condominiums, etc with shorter commutes or access to transit. Terrorism or social unrest could counteract a trend to urbanism though, so probably the most reliable marker of changed behavior would be the obvious and dull one -- smaller cars.

Origami: Microsoft lays another brick egg

Origami is now the "Ultra Mobile PC". You can buy one (Pogue, via Follow Me Here), but I recommend CARE.ORG as a better way to dispose of money.

I'd feel sorry for Microsoft, if Microsoft weren't an immensely powerful monopoly that escaped justice by "legal" bribery. Ironically, if Gore had won in 2000 Microsoft would have been split into two companies -- and the children would likely be far more effective today.

How can a corporation with so many brilliant and industrious employees be so dysfunctional? Theories abound. I've read that they have a lot of misdirected middle and upper managers. I suspect Balmer is a poor choice for a leader -- too ruthless and amoral for a monitored monopoly. I wonder about the hangover of their glory days, when so many became rich and either left -- or remain now as an odd aristocracy. Ultimately, thought, I think there's something fundamentally disheartening about earning billions irregardless of effort or result. It's the same disease that afflicts so many oil-rich nations.

The psychopathology of the CEO

This was news a few years back, but I only recently came across reasonable essay on the topic. A Canadian psych professor, known for this research on psychopaths, claimed that many CEOs met his diagnostic criteria.

It's an interesting thesis. The people he's describing are not sociopaths; they don't hurt people for pleasure, but rather it doesn't hurt them to hurt someone else. (The Brits define sociopath and pyschopath differently by the way.) ...

Hare began his work by studying men in prison. Granted, that's still an unusually good place to look for the conscience-impaired. The average Psychopathy Checklist score for incarcerated male offenders in North America is 23.3, out of a possible 40. A score of around 20 qualifies as "moderately psychopathic." Only 1% of the general population would score 30 or above, which is "highly psychopathic," the range for the most violent offenders. Hare has said that the typical citizen would score a 3 or 4, while anything below that is "sliding into sainthood."

On the broad continuum between the ethical everyman and the predatory killer, there's plenty of room for people who are ruthless but not violent. This is where you're likely to find such people as Ebbers, Fastow, ImClone CEO Sam Waksal, and hotelier Leona Helmsley. We put several big-name CEOs through the checklist, and they scored as "moderately psychopathic"; our quiz on page 48 lets you try a similar exercise with your favorite boss.

I have yet to try the quiz. If you don't see my score in an update you won't know whether I didn't have time to do the quiz ... or whether I'm psychopath.

The ideas are interesting, but they're subtle and complex. This article really doesn't explore them well enough, and I suspect Hare's model will be found to be quite incomplete. I don't see why thrill seeking is necessarily correlated with lack of a conscience. I knew, through my brother, a number of thrill seeking mountaineers with impeccable moral character, deep compassion, and powerful conscience. The more interesting feature is the variability of conscience. This fits with game theory influenced models of human evolution -- there's a genetic advantage to lacking a conscience if you're smart and able to hide from retribution. It's easy to see how too much conscience could also be disadvantageous, even in a small society.

That said, I've known a few bright and charming people who seemed not to be much bothered by conscience. They are a lot of fun, they're not CEOs, they are definitely positive contributors to society, and they really can't be trusted. I've had a historic weakness for this type, but I've learned they make poor friends. Now I prefer to enjoy them from a distance. I think their lack of conscience is somehow part of their appeal (again, these are not nasty people, they're just charmingly ruthless) -- they float free of the burdens that most of us bear.

PS. The average citizen scores a 3 or 4 out of 40 on this instrument? Hmm. I thought humanity was nastier than that. I think some people are cheating ...

Dept of Homeland Security doesn't do background checks

Talking Points underscores an amusing and disturbing aspect of the Cunningham/GOP/Bribery/Prostitution/DOD/CIA/Goss/Foggo/Wilkes mega-scandal -- the Department of Homeland Security doesn't run background checks on their transportation services. They also don't run checks against the terrorist watchlist (presumably they know the watchlist is complete garbage, so at least that makes sense).

That's how a large federal contract went to the brothel/limo service that's added new juice to a historic scandal.

Terrorists take note. You too can get a job driving DHS leadership around.

BTW, The Wall Street Journal's news page is the source much of this story. The wingnuts who write the editorial pages must be heaving hairballs. Has any newspaper ever had such a gulf between their news operations and their editorial functions? (Maybe the Christian Science Monitor?)

The new Iraq debate: how to retreat

This is a topic I don't have a strong opinion on. Do we cut and run (per Lt. Gen. Odom) or withdraw and engage? What's the least bad way to deal with the outcome of strategic incompetence and astoundingly poor leadership? What will cause the lesser ongoing pain to the Iraqi people? What will least help the many enemies of the US? What will best stabilize our alliances?

This is where the interesting debates are.

Porter Goss resigns: Hookers, spies and the GOP

When I metablogged on an Obsidian Wings post, I was too delicate to mention that the slander blogs were implicating Porter Goss, CIA director, in the Duke Cunningham/GOP Hookergate scandal.

I did not imagine he would resign a few days later.

Bush and the GOP have converted mad ravings into mundane speculation. There is now no rumor so outrageous and incredible that it can be immediately dismissed. What an astounding accomplishment.

What else will we find in this can of worms? I am fairly sure the NYT won't uncover any of it, I think the WSJ might, I'm sure the bloggers will not rest. Let loose the dogs ...

Update 5/4: Obsidian Wings has more.

Dell has jumped the shark: Spyware pre-installs

SONY jumped the shark when they covertly installed DRM software through their music CDs. The software could not be removed and caused technical problems to SONY's victims.

Now Dell has joined SONY in the inner circle of Heck. Whatever their financials may say, they must be desperate to have included funded spyware in their pre-install packages. This fits with Dell's deteriorating client services.

What went wrong with Dell? They invested in process innovation, but not in product innovation. As long as they could leach from IBM and Compaq they had a good strategy, but a parasite that kills its hosts is in trouble. They crushed IBM and Compaq on price, but they then had no-one to copy. Their organization discouraged innovators, so now they don't have them. Their primary hope now is that Apple's Intel transition will give them something to copy.

I don't buy SONY products. I don't buy Dell products. There are better choices out there.

Coming to terms with failure: Iraq and the US government

There's an old cliche, partly true, about how people react to learning that they will die much sooner than expected. Disbelief, Denial, Anger, Struggle, Resignation, Acceptance is one way to put it (I don't remember the supposed stages and they're pretty varied anyway). With acceptance comes planning on how to make the best of a bad thing.

I think the right wingnuts are in the anger stage, but it sounds like the rulers are moving towards Resignation ...

The New Yorker: The Talk of the Town

... The government is in a strange and prolonged state of paralysis. Many officials in the Administration now admit, privately, and after years of willful blindness, that the war, in which almost twenty-four hundred Americans have died, and whose cumulative cost will reach $320 billion this year, is going badly and shows no prospect of a quick turnaround. Asked why the President doesn’t take this or that step to try to salvage what will become his legacy—fire his Secretary of Defense, for example—they drop their heads, as if to say: We know, he should, but it’s not going to happen. At the same time, they can’t quite bring themselves to abandon hope for a miracle.

Why have the New Yorker, Salon, The Atlantic and even The (non-editorial page) Wall Street Journal risen, even as The New York Times and The Economist have fallen?