Pie Fight

This advice strikes me as so demanding as to be counter-productive

New health advice:

The new guidelines say:

· 30 minutes of moderate exercise a day is still the minimum, but vigorous as opposed to moderate activity should be "explicitly" recommended

· Combining days of moderate exercise with other days of vigorous exercise is better for you

· Moderate exercise should be in addition to daily activities such as casual walking, shopping or taking out the rubbish

· People should do two weight-training sessions a week

I would imagine that this would help dissuade many people from bothering to do even moderate exercise, since they'll reason that it's not enough.

Middle class myopia about the socio-economics of food

UPDATE: While my criticism of Blythman's article focused on the idiocy of her belief that public health policy can be based on middle class behaviour and assumptions, the article also deserved a right royal bollocking for its dodgy use of research. Adopting the faux objectivity characteristic of so much of the American press, it pretended to present two sides of the story by: A) offering accepted scientific evidence, then B) providing oppositional critiques of the mainstream science. See the trick here? It presents two sides of teh argument, but only lets one side critique the other. Thankfully, wiser men than me have called her on it. The best bit is the second letter, which points out that one of her key critics of putting folic acid in bread runs an online health food shop that sells - you guessed it - folic acid. Joanna, you got played.

This is one of the most egregious, up its own ass articles I've ever read. Joanna Blythman's normally pretty good, but in this piece she seems to be willfully myopic about the ways that socio-economic realities and the diets of the poor. Eg, she quotes, approvingly, this guy:

"It is noticeable that the FSA isn't proposing adding it to wholemeal bread because it already contains it. Why doesn't the FSA just tell people to eat more wholemeal bread?"

Um, because that wouldn't work, especially not with the mums who need this. (Hint: they don't have the same approach to food as you.)

Ok, that's one stupid question answered; how about another one?

The other main objection is that fortification is a sledgehammer to crack a nut. The estimate is that adding folic acid to bread will save 120 babies in the UK every year from spina bifida, but for every baby saved, half a million people, male and female, will have to take the added folic acid. "Why not target potential young mothers rather than mass-supplementing the population at large ?" asks Holford.

Hey, toughie! How about 'Because the young mothers who need this don't respond to government messages on health and diet?' You do; they don't - wishing ain't gonna change that. Or maybe the poor all quit smoking when I wasn't looking.

Pathetic.

Via Ezra Klein, here's an american example of the genre, in which well-off journalists who work from home bash those who don't make the time to cook proper meals after a 10-hour day.

Cancer wigs are funny

On the one hand, the US could have decent healthcare for all. Or it could mock cancer victims. Guess which one Sebastian Mallaby would choose?

Despite the excellence of Ezra Klein on the topic, I generally avoid articles on American healthcare, the debate in my erstwhile home being too damn primitive to be of any use to those of us in Europe, except in a cautionary sense. But this takedown by Ezra of Sebastian Mallaby is too good to pass up.

A good example of this came from Mallaby, who mocked Minnesota's insurance climate for mandating coverage of massage and wigs. (Minnesota, incidentally, has the lowest uninsured rate in the nation.) Ho, Ho, Ho. He had a good laugh over that one, I'm sure. Except the wigs are for chemotherapy survivors -- the sort of thing none of us expect to need, but may one day find necessary to continuing our lives. Good wigs, sadly, are very expensive, and few major businesses appreciate Cancer Chic among their employees. Without one, a breast cancer survivor can scarcely hope to continue her normal life. And massages, which sounds silly, are often more effective, less costly, and safer than over-the-counter medicines in treating back pain. Few folks know that. Like Mallaby, they've not read the studies. Unlike Mallaby, they're not professional domestic policy thinkers.

Health benefits of holidays

Via Ezra Klein, a small study indicating that holiday time brings short-term health benefits (they didn't test for the long-term).

I really should look for more of these studies.

I used to get jiggy till my jiggy got gone

Too old to fuck?

But let's talk about the sex. The average adult has sex about once a week, or 58 times a year, a number that's held steady since about 1988. The average, though, isn't adjusted for age. As you'd expect, 20 and 30 year olds have the most sex, with frequency dropping about 20 percent per decade through age 64 (when it begins plummeting). So Americans 18 to 39 have sex about 84 times a year, while those in their 40s get busy around 63 times annually. Extrapolating out, when you hit 50, your frequency will intersect your age, and you'll be making the beast with two backs (to use a Shakespeare-ism) about 50.4 times a year. Come 60, you're down to 40.32 encounters a year.

This ageing thing sounds even worse than it used to.

Kiddy crack

Sweet jesus christ: something like 2.5m American kids are now being prescribed anti-psychotic drugs. Ah well, I guess it's good for GDP.

Comedy gold: when I opened that link, the advert in the middle of the article read:

Attention ADHD sufferers! You can now FOCUS!

Healthcare and poverty

Ezra says that the relationship has to be made clearer:

Reading the John Edwards interview Sam linked to, I noticed an oversight far worse than his unfamiliarity with James Q. Wilson. Edwards ticks down the various factors contributing to poverty -- wage deterioration, the asset gap, the education gap, racism -- but doesn't say a word about health care.

When I was researching my poverty article, every expert I spoke to named the lack of health care as one of the leading perpetuators of poverty. Inadequate coverage inevitably ends in massive health bills, and is second only to deteriorating wages in contributing to poverty -- though, with rising health costs pushing down wage increases and hospital bills getting garnished from paychecks, it's contributing to wage depression too. And Medicaid, which people thinks covers the poor, largely doesn't. It, along with SCHIP, covers some poor families, but if you're a low-income male or a childless female, it's more than likely doing nothing for you.

Shaming Shalala

Down in Miami, Donna Shalala is being shamed for presiding over a university that denies healthcare and viable wages to its cleaning staff.

This article is absolutely brilliant, particularly when it juxtaposes the two women's lives.

While Shalala Lives in Luxury, Janitors Struggle
BY ANA MENENDEZ
Miami Herald, March 1, 2006

Zoila Garcia has the toughest job at the University of Miami.

From 10 p.m. to 6 a.m., five nights a week, she washes windows, cleans desks and picks up the potato chip bags and used condoms that students leave behind in the library.

''Ay mamita! And when they decide to draw on those tables, it's scrub scrub scrub,'' Garcia said.

When she returns to her mobile home off Southwest Eighth Street just after dawn, she takes the pills she gets through a Jackson clinic. Some are for high blood pressure. One is for the pain in her arms.

For now, there's nothing to be done about a blood clot that formed on her calf and blackened the leg from knee to ankle. She needs an operation. But when the doctor told her it would cost $4,000, she laughed. ``Where do you get that kind of money?''

Garcia, who makes $6.70 an hour, has no health insurance.

Sunday, janitors voted to strike for better pay and insurance from the company that hires them to clean at UM. They began walking out overnight.

''I have worked hard all my life, but the situation in this country has changed,'' Zoila said. ``The cost of living is so high and no one can live with these salaries. These millionaires just don't understand the struggles of working people.''

ALWAYS WORKING

Zoila, 51, arrived from Cuba in 1983. She has never stopped working, first picking peppers, then cleaning hotel rooms. She shares her 24- by 57-foot trailer with her dog Tribilin and her son. She helps a grown daughter with bills. But $6.70 an hour makes for a thin security blanket, and she now faces bankruptcy.

Any way you put it, Zoila Garcia is no Donna Shalala.

Two weeks ago, The New York Times Magazine printed an interview with Shalala, who was photographed amid the splendor of her 9,000-square- foot presidential residence, where she lives with her dog, Sweetie.

In the interview, Shalala describes, among other things: ''Her perfect day'' (which begins with someone giving the university a $10 million donation and ends with her playing three sets of tennis), ''What she drives'' (a Lexus hybrid SUV), ''Favorite vacation spot'' (the kingdom of Bhutan) ''Her best recent purchase'' (a 1790 French country cabinet) and ''Possession that best defines her'' (a personal drawing by Susan Kapilow).

Here are Zoila's answers to some of the same questions.

Her perfect day: ``Friday, when I get my check and know that I'll be OK for a few days.''

What she drives: ``A 1995 Ford Aerostar. When it rains outside, it rains inside.''

Her best recent purchase: ``Oh, dear. I can't buy anything . . . Well, yes, some chicken breasts. I have them in the refrigerator.''
What she's reading: ``My English study books. I just can't retain anything!''

Favorite vacation spot: ``I'd like to take my grandchildren to Parrot Jungle, but we can't afford it.''

Possession that best defines her: ``My smile. I always have a smile for everyone.''

COMMITTEE FORMED

Shalala, who as UM president makes more than $500,000 a year, has the power to make Zoila's life and the lives of 400 other janitors better. Shalala declined to comment beyond an earlier statement noting the formation of a group to look into compensation for contract workers.

Forget study groups. Shalala can begin by promising, as other university presidents have done, to hire only contractors who provide a living wage and health insurance to their workers.

What an irony that this is even an issue for Shalala, the former Clinton cabinet secretary who told the Times that what she's reading now is ``about healthcare, because I am teaching a class in it.''

Ms. Shalala: No one is going to begrudge you your 29-foot motorboat or Sweetie's four beds. But for God's sake, get these people health insurance and a dignified wage. The bare minimum, that's all they're asking.

Healthcare debate: Gopnik good, Gladwell gormless

I really struggle to see how any reasonably sensible American can be against universal healthcare... but then I talk to my dad, who's a bright and caring man, but thinks that universal healthcare is somehow, nebulously, bad. My brother Frank's self-employed, he says, so he pays for his own healthcare - and he's doing alright. It's arguments like this, and indeed opinions like this, in otherwise intelligent human beings, that make me want to stay out of America. And who knew that until very recently, Malcolm Ficking Afro Gladwell was pimpin' the same sort of illogical gin and juice?

GLADWELL BLINKS....Six years ago Adam Gopnik and Malcolm Gladwell debated healthcare in the pages of the Washington Monthly.  Gopnik was for universal healthcare and Gladwell was agin it.

But wait!  Via Rufus X, I learn that Gladwell has blinked!  He now says Gopnik was right:

Why have I changed my mind? Some of my reasons are in the piece on moral hazard I wrote for the New Yorker last summer. The bigger reason is simply that I woke up one day and realized what much smarter people than me (Adam Gopnik) realized a long time ago, which is that the idea of employer-based health care is just plain stupid — and only our familiarity with it and sheer inertia prevent us from rising up in rebellion.

I always try to think of a suitable analogy and fail. The closest I can come is to imagine if we had employer-based subways in New York. You could ride the subway if you had a job. But if you lost your job, you would either have to walk or pay a prohibitively expensive subway surcharge. Of course, if you lost your job you would need the subway more than ever, because you couldn't afford taxis and you would need to travel around looking for work. Right? In any case, what logical connection is there between employment and transporation? If you can answer that question, you can solve the riddle of the U.S. health care system. And maybe I'll change my mind back.

Gladwell wrote this because, for some reason, his old debate with Gopnik has suddenly gotten renewed attention in the blogosphere (20 cites in the past week) and, he says, "I shudder when I read what I said back then."

By the way, did you know that Malcolm Gladwell now has a blog?  Well he does.

British Social Attitudes Survey and NIMI-ism

taxationI may have posted on this at the time, but yesterday's posts and discussions have reminded me of it, so here goes (possibly) again: the purportedly liberal middle classes can be sneakily selfish, particularly in the vein of "now that I've made it, I conclude that society is quite good as it is and should no longer be tinkered with." Here's what the British Social Attitudes Survey showed. What would we call this? It's not nimbyism, but it's... maybe I could call it is NIMI-ism: Now I've Made It, we should keep things as they are, and not go getting crazy with this social engineering stuff.

People who have benefited from higher education are least likely to believe in more expansion of universities to help meet the educational aspirations of working-class young people. Graduates are less likely than the rest of the population to think NHS patients should get more choice about where they are treated.

The survey's chapter on education - written by the late Ted Wragg and Mark Johnson - found working-class people are more likely than the middle-class to stress the importance of academic qualifications. The proportion of young people going to university increased from 7% in 1964 to 43% in 2003/4 and the government wants to raise it to 50% by 2010.

It found that working-class people did not have more objections to tuition fees than the middle class people. About three quarters of both groups think students should pay fees. "There are no social class differences in this matter, suggesting it is not tuition fees that ... deter people from working-class backgrounds from going into higher education."

The survey - based on interviews with a random sample of more than 3,000 people across Britain - found 48% of working-class families favoured increasing opportunities for higher education, compared with 28% among the middle classes. About a quarter of the middle classes would like to see fewer opportunities for entry into higher education, compared with 9% of the working class. "This reflects an element of selfishness on the part of the middle classes in trying to deprive others of the opportunities they have enjoyed," the research centre said.