Showing posts with label health. Show all posts
Showing posts with label health. Show all posts

Friday, February 4, 2022

Vaccines and Nazis

 In the wake of a Tennessee school board banning the graphic novel "Maus" a friend posted a meme 

"FUN FACT: Kids who read Maus don't grow into adults who constantly compare minor inconveniences to the Holocaust". 

One of their friends responded with:

"Those who have read Maus I & Maus II realize the steps to genocide and become aware much earlier than those who haven’t, that what appears to be minor inconveniences to someone who they are manipulated into “othering” is much more significant than that and is one of the first steps to much worse. I TA’d a class on the Shoah/Holocaust at UCLA in which we carefully analyzed the beginnings of the Holocaust, which most did not recognize. They looked at propaganda about Jewish people, political dissidents, gypsies and LGBTQ people as a minor inconvenience. They saw it, as is happening to some disabled and religious minorities today with the current drug mandates, to be a minor inconvenience that they couldn’t go to the movie theater or a play or dtudy or work anymore. They saw it as a minor inconvenience that they were forced to publically identify themselves as other. Often it was mistakenly justified as they can choose-a different political

ideology, sexual orientation, religion- and nowadays to take the offered drugs. It requires empathy to step into another’s shoes and realize that not being able to work, travel, or study is not a minor inconvenience. Not being able to go to cultural events, museums, the theater, restaurants or other public places like trains is not a minor inconvenience. At least not for those being othered. Did the author of this meme really study the Holocaust, including the couple of years before the camps? Did they sit and watch the propaganda videos and read Wiesel and Primo Levi? The Nazi propaganda is eerily similar to much of the big pharma propaganda played on corporate news nowadays. Very little facts, much obsession with a monolithic view of what science and facts are, which does not allow for critical thought or inquiry. Intensive censorship."

There is a lot to unpack here. Before I start, so it doesn't get lost in the rest of this little essay, I want to be clear. I view the facebook response to be a clear instance of "comparing minor inconveniences to the holocaust". But... the response is complex and makes some interesting points, so I think it's worth a discussion. References to support my statements are available upon request.

This as a slippery slope argument. I think the basic point that moving into the Holocaust was a step by step process of dehumanization is true and valid. It is also true that part of the process is a gradual separation of us and them, with "them" being restricted in activities. At first the restrictions seemed relatively innocuous, like explicit identification, but then moved rapidly to eliminating necessities like education, work, and property.

It is also true that these tactics are not novel and this can happen in any society, including our own. The target can be foreigners; look at the English treatment of the Irish before, during, and after the great famine. Sometimes they are used to oppress subcultures like the  Uyghurs in China. Sometimes it is appearance, like black people in the United States. As with the Nazis the playbook is often used in conjunction with other techniques to establish an oppressive dictatorship. Dictatorships are usually created with the support of a substantial portion of the population. Garnering support is easier in the face of an identified threat from within: communists, Jews, homosexuals, elitists... 

We know from past experience that there is a slippery slope. But not every government action that separates "us" from "them" leads down that slope. A counter example is the Americans with Disabilities Act, the ADA. It identifies a class, disabled people, that has historically been a group that is shunned and discriminated against. The ADA does exactly the opposite. It forces the rest of us, under force of law, to make accommodations for the disabled. Each of us must park farther from the door of the store, must make curb cuts when we put in sidewalks. When I built my coffee shop I had to install a section of counter that was low enough so that a person in a wheelchair could easily sign a credit card slip. In other words, for the protection of a particular class of people, my freedoms are restricted and I am forced to act in ways that are sometimes expensive and inconvenient. 

In fact, a defining characteristic of humans is our ability to band together and subsume our personal interests to the groups to which we belong. This is one of the characteristics that makes our species so powerful. It is also the double edged sword I have described. On the one hand it allows us to create cruel and dictatorial societies. On the other hand it allows us to band together and make the lives of everyone better.

We band together with different groups of different sizes. The most universal is the family, but we also create a societies with friends, work groups, and legal entities (city, county, state, nation...).

Because the subject of the facebook response is really the societal attempt to get everyone vaccinated for Covid, it is worth looking at vaccination in general. I think the most popular vaccination in the U.S. was for polio. Smallpox vaccination had shown people that vaccinations could be safe and effective. Polio was severe and widespread. Even today, there are people who do not have full use of their limbs because of polio. The polio vaccine was partially funded by voluntary public contributions. When the vaccine became available it was eagerly accepted and there was little protest.

When the Europeans came to the "new world" they brought disease, most notably smallpox, with them. Within a generation or two as much as 90% of the native population was dead from disease. This makes the Black Death in Europe look like a Sunday picnic.

Benjamin Franklin wrote: “In 1736, I lost one of my sons, a fine boy of four years old, by the small-pox, taken in the common way. I long regretted bitterly, and still regret that I had not given it to him by inoculation. This I mention for the sake of parents who omit that operation, on the supposition that they should never forgive themselves if the child died under it: my example showing that the regret may be the same either way, and that, therefore, the safer should be chosen.”

Franklin's son died in 1736, but he had been a supporter of smallpox vaccination since at least 1721. Why wasn't his son vaccinated? Franklin blamed himself, but there is a school of thought that it was his wife Deborah who resisted and Franklin resented her for it. It is known that he found excuses to be away from his wife for years at a time. If the speculation is true, it is a case where Franklin sacrificed his own desire to vaccinate to that of his family group (his wife), and it cost him his son.

There are groups that should generally be ignored regardless of their sincerity, their arguments, or the depths of their belief. An example is the "flat earthers". People who believe that the earth is flat. They are interesting psychologically and sociologically, but their beliefs are simply wrong. The current scientific theories of gravity are some of the best tested theories in existence. Over all space and time scales the theories have been confirmed. The structure of the earth and the solar system are well known and described. Our models are predictive and confirmed by those predictions. We can, for example, predict eclipses, the length of the days, the precession of the North Pole, the tides caused by the moon... In contrast, the flat earth theories are a mess. They don't explain much of anything and can be disproven by anyone who has a simple knowledge of geometry. Despite this, the beliefs are remarkably resistant to change. All objections are met with an answer, incorrect, but usually in a form that has a surface coherence, and apparently raise more doubts about the scientific explanation.

The flat earthers are a case where we (individuals, educational systems, the media, government...) do not have to discuss "both sides". There are not two sides. We have well established information and we have a few people spouting nonsense.

Gravity is relatively (pun intended) simple. Many of the things in our lives are much more complicated. We have created large systems to measure, analyze, theorize... In science the system includes peer review of results to enforce honesty and reduce sloppiness. It is not perfect but, on the whole, the system works and knowledge increases. 

In economics we require large scale data collection to feed our analysis and understanding. Over the past century the government has refined the collection of economic and demographic data and put firewalls in place to reduce political manipulation of the data and its analysis. Again, it doesn't always work, but in general the data we have is roughly correct.

Medicine is another case where large scale data is needed. Data collection is difficult, but we have made progress. The insurance system requires standard diagnosis and treatment codes. All deaths are classified, which is why we know how many people died from being tangled in bed sheets. Of course no one knows that you had a cold three years ago because you did the sensible thing and waited for it to go away without seeing a doctor.

In the case of vaccines, we keep records. Each suspected side effect is tracked. This includes reports from physicians and large scale studies of correlations between vaccine recipients and reported illness. The data are not perfect, but they are not bad. For Covid, hundreds of millions of doses have been administered. There is simply no doubt that the Covid vaccines are safe and side effects are incredibly rare.

For Covid as a medical condition, we have done a terrible job of keeping track. The best data we have are for hospitalizations and death. We also have the results from PCR tests. These come from a self selected sample, but act as a reasonable indicator of prevalence. 

Two things we know about Covid pretty certainly. First, in many people the disease is severe. Second, the vaccines used in the U.S. are safe and effective. The vaccines dramatically reduce the chance of severe illness and the rate of transmission. To dispute the severity of the illness or the effectiveness of the vaccines, you have to ignore the ICU at your local hospital and the testimony of the doctors and nurses who work there. This information is easy to get and widely disseminated. To deny it is ignorance at the level of the flat earthers. 

Smallpox and polio are diseases of humans, they have no animal reservoirs. That means if we eradicate the disease in humans, it goes extinct. Through world wide societal action, we have eradicated smallpox. It is simply gone. Some of this action was governmental and coercive. Children were not allowed in school unless they were vaccinated. Another way to say that is that unvaccinated children were identified as a group, singled out for special treatment, and refused access to education. This did not create a slippery slope leading to a dictatorship in the United States or anywhere else. In my view, it was a correct societal action that allowed a scourge of mankind to be eliminated.

Polio is nearly eradicated. It still exists in pockets around the globe. Those pockets exist because ignorant and militant ideologues in those places prevent vaccination. These repressive elements sometimes assassinate health care workers traveling from village to village trying to save children by vaccinating them.

An old saying is: Your right to extend your fist ends at my nose. In the case of disease it is sometimes hard to tell what your fist is and where my nose is. In 1907 a paper was published that traced a set of typhoid fever outbreaks occurring between 1900 and 1907 to a single person, later nicknamed Typhoid Mary. Mary was asymptomatic and never accepted that she was transmitting the illness. She was forcibly quarantined and her treatment by the state was appalling. Eventually she was released on condition that she take precautions to prevent spreading the disease and not work as a cook. She tried being a lower paid laundress but eventually returned to cooking. She again transmitted the disease and again was forcibly put into quarantine where she remained for over twenty years until her death. Conservatively, at least fifty three people were infected and at least three died because of Mary. There have been other asymptomatic carriers of typhoid fever, but none so famous or as appallingly treated as "Typhoid Mary". What should be done with someone who injures those around them and refuses to stop?

I have a grandson who is medically compromised. That is, he is more likely to get disease and, if he gets sick, is more likely to have severe symptoms. His life is easily put in danger. Because of Covid, this child has spent a third of his life basically confined to his home. His parents movements and actions are constrained because they do not wish to unwittingly infect him. Visitors to the home have to quarantine for a period of time and have a negative test before being allowed in. One of the reasons this has dragged on for so long is because there are a large number of people who have dug in their heels and refused vaccination. 

I am angry about this. I believe I am justified. Do I support restrictions on people who have not been vaccinated so the damage they inflict can be limited? You bet I do. If you want to go to a public place where you can infect other people, I want some assurance that you are not a danger to those people. Instead of my grandson, I want those who put him in danger to be restricted.


Monday, December 28, 2015

Creating Social Engagement

As the number of mass shootings continues to climb I, like everyone else, will put in my two cents about causes and possible solutions.

I do not believe the problem in the US is one of guns. It is a problem of culture and will not end until the culture changes. Luckily, culture is the sum of what each of us thinks, does, and says. That means we can change it by changing ourselves. This personally daunting task becomes easier as we see our friends and neighbors modeling the behavior. Each of us contains a multitude of selves and we just need to let the best of ourselves come out, repress the worst in ourselves, and reward the better actions of others.

In this post I won't be posting much in the way of references, but I believe that my argument is well supported by the evidence. I am looking at trends, not universals.

First, some words on "safe" and "comfortable". It is ingrained that these words belong together. In a recent survey on traffic in my city people were asked to prioritize the importance of a number of items. One of them was "Streets should be safe and comfortable". In fact, safety and comfort do not go together. If people feel too comfortable driving, they increase their speed which, off the highway, makes the street less safe. In the same way, we often feel most comfortable when we do not engage strangers, but we are social creatures and expanding our social circles makes us better people.

Violence against strangers tends to be perpetrated by people who are socially isolated. Social isolation is defined as a lack of contact with other people and it is deadly in a social animal like humans. The opposite of social isolation is social engagement. Increased social engagement makes us more capable in dealing with people in a variety of situations. It gives us greater control of our environment and makes us more aware of what is going on around us.

Here are some ways we can improve our culture and ourselves. Some are simpler than others. All require some effort, at least at the beginning.

You know that weird person you have noticed? The one that makes you a little uncomfortable? Next time you pass him/her, say hello. You need not converse, just acknowledge their existence as a fellow human being and move along. After a while you might make some small talk or even have a real discussion, but that is not a requirement. It is not likely, but eventually that person could turn into your best friend.

Join or start a group. Almost two hundred years ago Alexis de Tocqueville wrote: "Americans of all ages, all stations of life, and all types of disposition are forever forming associations." Prove him right. Join a book club, a bowling league, a soccer team, a bicycle club ... It doesn't have to require much time. Book clubs generally meet about once a month and you don't even have to read every book.

When you converse, listen to the other person. In general, allow them to have the last word. Listening does not signify assent. When it comes right down to it, you probably disagree with everyone around you on one topic or another. That doesn't mean you have to shun them. However... if someone's views are truly vile, feel free to call them on it. Tell the racist "I'm sorry, I could not disagree more. I think your beliefs are without support and if you act on them I will work against you." Again, this is hard, but with practice you will get better at it. If someone seems like they might be dangerous, report them.

If someone asks you for help, provide it. There are, of course, requests and circumstances that make this unwise or infeasible, but make "yes" your default answer. You can take this a step further. If someone looks like they need help, offer it. A little harder is a change of attitude. Be more concerned that everyone who needs help gets it and less concerned that someone who is "undeserving" may be abusing the system.

Our built environment is often badly constructed for social interaction. Do not support this. In choosing a home we often look at the inside amenities. This is important, but don't forget the outside. Is there somewhere outside, facing the street, where you and a couple friends can sit down and watch the world go by. If not, is there a way to easily construct a sitting spot? If a home fails this simple test, don't buy or rent it. Inside, is there a room where you are likely to spend time that has windows on the street? If not, you will have no opportunity to get to know the daily life of your street. It is harder to integrate into a neighborhood if you never see your neighbors. On a nice evening, think about walking around the block. As you go around, say hello to folks. Ask them about their day. If you cannot do this comfortably or if no one is ever around to say hello, you have a bad neighborhood. Try to fix it or move.

Vote to make your community better even if it means increased taxes. If there is a ballot measure to build/improve schools, support it. More parks and improved public spaces, support it. Support it especially if it goes to other folks who have less than you. Send your support to the lowest income schools and neighborhoods. Make sure poor kids have good parks and athletic fields. Even better, make sure your community works to integrate people of all incomes and backgrounds into the same neighborhoods. If, as is common, your school board sets the boundaries of schools to keep rich and poor separate, confront the candidates and ask them to change. A unit of neighborhoods is the boundary for the local elementary school. If a school does not have a mix of incomes, bus the rich kids in. Better is to build more lower income housing throughout the town. This seems scary, but all the evidence shows it makes everyone better and safer.

Underlying all of this is an acknowledgement that we are all people. We differ in backgrounds and in how we think society should work. Communication and engagement teaches us about each other, how to get along, and how much we are alike. We exist in a biological ecosystem, but also in a social ecosystem. Make your ecosystems stronger by encouraging diversity and strong connections.



Saturday, December 17, 2011

A Comparison of Sweden and the US

The other day someone pointed out that if Sweden were a U.S. state it would not rank very high on per capita GDP. This was a Facebook conversation and the tone of the post was "see you socialist left wing fanatics, even in the best case your socialist state is worse off than almost all of the U.S.". This, of course, created a small firestorm of posts, which I think was the object of the provocation. The comparison is interesting though.
There are cases where the differences in governance, national attitude and results are stark. For example, Haiti and the Dominican republic share an island, but the contrast between the two is stark. The same can be said of Costa Rica and Nicaragua. Sweden is not, of course, a socialist state. The U.S. and Sweden are both industrialized nations with relatively educated populations. The U.S. has a leg up because of its vast natural resources.
Given the general similarity of status of Sweden and the U.S. as industrialized nations, a comparison of social policy and the results for the average citizen is worthwhile. I think the differences between Sweden and the U.S. are largely a reflection of basic philosophical differences in national attitude. As a nation the U.S. attitude is: social darwinist, each man for himself, pull yourself up by your bootstraps, if you cannot make it here don't blame anyone but yourself, government always does a worse job than the private sector. I have never been to Sweden so I cannot report firsthand on conditions there. From the outside its social policy seems more: we are all in this together, each does better when all do better, we are all people and things happen so let us support each other, government programs work well at providing the basis for us to build strong lives.
The Swedish GDP for 2010 is about 458,000 (millions). With a 2011 estimated population of 9,415,300 the per capita GDP is about $48,640. This is roughly the same as North Dakota at 47,714 which ranks as the 20th highest state GDP per capita. There is some disagreement about these numbers. For example the wikipedia article on the Swedish economy gives a per capita GDP of about $37,775, which would make it closer to Michigan, the 42nd poorest state. Sweden cannot prop up its social welfare system with natural resources like North Sea oil (Norway, Britain). It must pay through basic productivity.
In the World Economic Forum (the Davos folks) Global Competitiveness Report, Sweden ranks above the US (because of the recession)
Sweden is not going bankrupt. Its overall national debt is 40% of GDP compared to 60% - 90% for the United States (depending on whose number you use). Sweden went through a real estate and financial crisis in the early 1990s and had to re-adjust its social spending to accomodate lower GDP. Sweden is now used as a model for how a nation should handle financial crises. Sweden can afford its social programs. Because it is somewhat poorer pre capita than United States, we could afford similar programs if our national philosophy allowed it. The difference is choice, not money.
Sweden ranks high in taxation about 48% of GDP (2007). In the developed world, Sweden is on the high end of taxation exceeded only by Denmark. In the U.S. taxes are about 27% of GDP (2006). The U.S. tax rate is one of the lowest in the developed world. Only Mexico, Turkey, Korea, and Japan have lower taxes as a percent of GDP.
So, which resident gets the better deal: someone living in Sweden with its not-outstanding per capita GDP and high taxes or a resident of Michigan/North Dakota.
Health care in Sweden requires patients to pay a fee per visit/prescription, but total costs to the patient is limited to about $360 per year. In comparison to the US Sweden has more doctors and nurses per capita. Life expectancy is higher, and infant mortality is lower. Over 80% of all medical costs are paid by the government (vs. 45% in the US) but the total cost spent on health care is so much lower that the US government pays more as a percentage of revenue than Sweden does. So, in Sweden everyone is guaranteed health care, the cost is lower both to the individual and the government than in the U.S.. The outcomes of health care are generally better, and citizens do not need to fear medical bankruptcy.
In education, Sweden works hard to make sure that opportunity is equalized for children. Grants from the national government take into account the economic conditions of the particular region. Poorer regions are subsidized and richer regions bear an extra cost. Rural regions are compensated for transportation costs and smaller class sizes. There are independent schools, roughly equivalent to charter schools in the U.S. Parents may have to pay a fee for preschool and childcare, but there is a ceiling to those costs which takes household income into account. Higher education is essentially free to the students. Students must pay for text books, and equipment needed for personal use. This means that students enter the workforce essentially debt free.
This contrasts with the United States which has limited pre-school support and where higher education is increasingly unaffordable. Two thirds of students leave higher education with an average debt of $23,000 dollars. We have created a generation of young adults who, instead of leaving college and becoming entrepreneurs, are forced by debt to ender the labor force as employees. In the United States, public dollars going to higher education have decreased and tuition costs have increased. The United States of America is the only OECD country where 25-34 year-olds are not better educated than 55-64 year-olds. This may be in part because other countries had more room to improve over the past 25 years.
In Sweden, taxpayers spend about 6.6% of GDP on education. In the U.S. about 5.5% of GDP is spent by the government on education.
We all know how skewed incomes are in the United States where the top 400 wealthiest people have more than the bottom 150 million.
About 80% of the Swedish workforce is unionized. As might be expected in a place where people tend to feel part of a single society and look after each other, the unions make the society more equal, but do not eliminate inequality or reward laziness. In hard times, looking after each other may mean unions accepting pay cuts to save jobs. The Swedish unemployment system looks much like the US unemployment system.
If we honestly compare industrialized societies, the US doesn't look so good. We have a national mythology that we are a nation of rugged individualists in a country that provides the opportunity for everyone with drive and determination to make whatever they want of their lives. While we do pretty well on the individualist side, shunning all non-business forms of collective action. We do less well on the opportunity side. American families are less socially mobile than families in other countries.
Much of the U.S. national catechism is simply incorrect.
People do not do best as rugged individuals working for their own benefit. We are social creatures who do best as collections of individuals working together and helping each other.
People are not naturally dishonest or working to game the system. There is a persistent, endemic problem of dishonesty, but this is the exception not the rule. Most people getting unemployment benefits, welfare, food stamps, WIC payments, social security, medicaid ... are ordinary hard-working folks just like you and me who have hit hard times. Most of them will be back on their feet in a little while, they just need some help to see them through.
Work and money are not the center of most people's lives. Most people work for money to earn enough to live, but are not particularly interested in accumulating large amounts of wealth. Everyone would love to be wealthy, but if you talk to people about what they would do once they got that big pile of cash, very few of them talk about accumulating more. Most people would simply do more of what they currently enjoy the most. We should not be educating our children to be effective workers, we should be educating them to understand themselves and the world around them.
Government can be effective. Government is comparable to other large organizations in efficiency and effectiveness. I have worked as a consultant to both government and private entities. The problems are somewhat different, but both government and private entities tend to have about the same level of bone headedness. If we look around the world, we can see examples of more effective governance. Sweden seems to be one of those places.
The United States has low taxation, both at the individual and the corporate level. The question in most of the developed world is not "how much am I taxed", but "what do I get for my tax dollars". As an example, the citizens of every country with universal health care are basically pleased with their system do not want a privatized system.

Friday, September 30, 2011

If We Aren't Careful, We May End Up Where We Are Heading.

It is easy to predict man made catastrophes. Sometimes they even happen. Here are some intractable problems/trends that are likely to make the next hundred years "difficult". If we do not find some way, pretty quickly (fifty to one hundred years), to change course I think we could be fairly described as a failed species. That is, things will look much more like "Blade Runner" or "The Mote in God's Eye" than "Ecotopia".
This post assumes an unstated desired future. If your view of a desirable world differs significantly from mine, you may not find any problems here.
The good news is that we can relatively easily make things much much better. The bad news is that, as a species, we seem incapable of making good long term choices. If change occurs it will likely occur on the back of poverty, war, famine, and plague. If change does not occur, we are condemning our descendants to an impoverished, less habitable planet.

Social Trends - Concentration of Wealth

It has always been true in settled societies that wealth is concentrated. As productivity increases in industrialized societies, it takes less and less labor to make the same amount of goods. Either we constantly increase the amount of goods we desire and require (endless growth) or more and more people become "redundant" as they say in England. That is, there is no need for their labor.
In the nineteenth and twentieth centuries there was a serious countervailing social movement to redistribute wealth to make societies more equitable. Tides seemed to have turned and, particularly in the United States, the scales have tilted toward unfettered wealth and, along with it, increasing manipulation of both media and elections to serve the plutocracy.
I am not suggesting a trilateral commission type conspiracy. Instead, individuals and groups with plenty of money are doing their best to publicize their point of view and make it the basis of discourse. There has been about a century of systematic work to improve marketing. In the political arena the admonition that government should be more like business has been taken to heart in the propaganda department. Political messages use the tools of marketing (focus groups, test markets ...) to find the most immediately effective messages.
There have been some genuine innovations in the exercise of power though. For example, it is no longer necessary to buy politicians. It is much easier to find someone who already holds your point of view and work for their election. An extreme example is Caperton v. A.T. Massey Coal Co..
Sometimes there are social policies that reinforce the concentration of wealth as an unintended consequence. For example, higher education is increasing in cost and is commonly funded with loans. Forbes reports that two thirds of all students graduating from four year colleges and universities carry loans with an average debt of $23,000. This is a doubling from 1996. Instead of leaving the University with knowledge and a clean slate to start new enterprises, this generation is pretty much forced by debt to become simple employees of existing operations.
We know the end of this story. In the U.S. there is relentless propaganda campaign that insists that we have a pure meritocracy and the wealthy are the ones who feed us all. As the gap between haves and have nots continues to widen and the number of have nots increases, eventually they will simply rebel. If that happens, expect decades of chaos and class warfare with guns.

Social Trends - Fewer, Larger Entities

As technology improves it becomes possible to create larger and larger organizations. Advances in information processing have accelerated this capability.
The current tendency is writ large in the video distribution industry. When VHS tapes became the technology winner, the low entry costs for starting a video store allowed thousands or even tens of thousands of independently owned video stores to blossom. Almost as quickly there was a wave of consolidation as smaller operations were either bought or driven out of business by a regional video chains. These, in turn, were consolidated into a few national chains (Blockbuster, Showtime) which dominated the market. There are still mom and pop video stores, but after the first boom they never had appreciable impact on the market as a whole.
In many industries there are very few real players. This includes media companies where nine companies control virtually all television and Clear Channel controls 1200 radio stations. Four cell phone providers own the lion's share of the mobile phone market (280 million subscribers). There are five major oil companies. Oil companies are among the largest companies that have ever existed. Over half of all farm seed is produced by fewer than ten companies.
As a side effect, increasing institution size also works to further concentrate wealth.
We know from network theory and from study of biological systems that diverse systems which have large numbers of highly interconnected parts are more resilient and less prone to catastrophic failure than systems with fewer nodes and interconnections. When diverse systems of many nodes have some of them fail, the remainder of the system tends to work around the problem. When their are fewer, strongly connected nodes, they tend to drag each other down in the face of disaster. Note how this sounds just like the start of the 2008 financial crisis and the current Greek debt crisis.
In agriculture, the number of farms has decreased, the acreage of each farm has increased, and the vast majority of farms are a monoculture. We have centralized meat and food processing. While the system may be immediately efficient, it is also incredibly fragile and shortsighted. We impoverish the ecosystem, including the soil ecosystem. We also make our food supply dependent on a smaller variety of foods where a single virulent disease can spell disaster. Centralized processing means that millions of people can be infected or poisoned from a single point.
Despite their inherent fragility when faced with the unexpected, in the normal course of events, centralization tends to win. The only way to redress the problems is by creating an environment that rewards smallness or penalizes bigness.

Social Trends - Race to the Bottom

Globalization has allowed the entire world to become a source of labor and products. One side of this is that wealth has flowed to some desperately poor places. The other side is that it has depressed pay in many developed countries and made jobs much less secure. While money does flow toward poor areas of the world, the net effect is to lower labor costs in general. It is interesting to note that globalization involves capital and goods, not people. A factory worker in Sheboygan is competing with workers in Bangalore, but it is unlikely the factory worker can emigrate to Bangalore and take advantage of its lower cost of living.
Globalization allows producers to reduce costs. Labor is part of this, but not the whole picture. It is also possible to reduce costs by operating in locales that allow costs to be ignored or externalized. For example, it will be cheaper to produce in a country that allows wholesale pollution or deforestation because you don't have to install that expensive emission control equipment or worry about forty years down the road when the trees are all gone.
Because every locality wants the jobs, the tendency is to offer the most attractive deal possible to producers who promise jobs. Producers use this to pit localities against each other. Internationally, this rewards countries with the worst labor practices and the most lax regulations. Within the U.S., communities generally bid by offering tax breaks. The hope is that the increased wage base will make up for the breaks, but often the end result is simply to starve local government.
When the cost of production goes down, a number of things can happen. The cost of goods to the end consumer can go down. High tech items show this most clearly but it also shows up in the price of clothes at Old Navy. Second, profits for producers can increase. This has happened as well. In the current "recession" profits for U.S. manufacturers have completely recovered. Finally wages for workers can increase. In the past few decades this has not happened. Wages in the U.S. have been stagnant for almost two generations. When producers (owners) increase profits but workers do not share in the wealth, this increases the concentration of wealth.
Remarkably, public discourse on workers benefits has joined this race to the bottom. Look at the discussion over public pensions. There is a problem with pension funding. Governments have sometimes promised more than was prudent (as did GM and other major corporations). The discussion never seems to be "how can we get private retirement better", it is always "public employees are getting benefits that private employees do not, let's reduce them".

Social Trends - Rise of the Ideologues

Never underestimate the power of a simple idea or worldview even if it is completely wrong or destructive.
People will take a few general principles and assume everything can be explained by them without much regard to complicating factors. If the ideas lead to bad results, it is a failure of application, not the principle.
Among the current Ideologies that are threatening social destruction I would include (non-exhaustive list): radical violent Islam, any religion based on literal inerrancy of the bible, libertarianism, and all forms of racism.

Social Trends - Algorithms and Hubris

There is a notion in computer science called the singularity. This is the creation of smarter than human intelligence. A basic question is, will we notice it?
We already have specialized machines that perform much better than humans. Computers have bested humans in games like chess. Robots create and assemble parts much faster and more accurately than humans. In the computer gaming world, our "enemies" are dumbed down to correspond to our terribly slow human reaction time and limited ability to handle large numbers of inputs. Our planes and cars are already run by computers. Humans enter basic parameters for flight, but the plane itself makes virtually all decisions.
To increase efficiency we constantly streamline and automate business processes. The end result is an expansion in the power of algorithmic systems. In a modern corporation there are fewer and fewer levers pulled by fewer and fewer people. Take shipping as an example. A company like Fed-Ex has completely automated the routing of packages. Once your package information is entered into the system, humans do nothing but follow a machine generated instruction to pick up a box in one place and drop it at another. Airline reservations are another example. Humans do not play any role in the process. The price is determined by complex algorithms that are probably beyond the understanding of any single person. Planes are automatically booked and overbooked. Even upgrades and seat re-assignments are pretty much controlled by the algorithm. The person at the gate has almost no choices and no authority.
The system we have to create these systems is not reassuring. When a business decides to automate a process, a team of people, often outside specialists, is assembled to analyze the problem and implement a solution. When successful, the results are put into production and handed off to a separate team that is in charge of operating, maintaining, and improving the system. In theory this is a repeatable process with each group playing its specialized role. The players usually do not understand each other's roles very well. At the business level, the indicators are productivity (how many flights are booked in how much time and at how much cost) and overall profit and loss. The systems are designed to report some set of indicators so this can be tracked. The people who look at the indicators do not usually understand the underlying algorithms. The people who design and implement the system are specialists in new product creation and generally leave the scene after the process is in place. The people who maintain and improve the system generally have documentation, but they may not be aware of why particular design choices were made and the trade-offs involved.
Another way to state this is that every day we create large algorithmic systems that no single person, or even group of people, understands. As long as he systems work reasonably well or can be discarded, there is no real problem. When the systems fail or are critical but so complex they cannot be discarded, we run into trouble.
On Wall Street, most trading does not involve humans. In 2009 almost three quarters of all stock trades were automated trades based on computer algorithms. Since then this number has almost certainly increased. When you listen to commentators discuss the stock market and why it moves one way or another, it is complete nonsense. It sounds good and it always supports the commentator's overall view of the world, but it is not based in any kind of fact. On May 6, 2010 the stock market briefly crashed. It took five months to issue a report that could attempt to explain what actually happened. The basic answer is that the machines did it.
The hubris part of this trend is that there are people who think we can model and control complex systems. As an example, one of the great failures of modern economics has been the attempt to quantify risk. Do a google search for "quantification of risk economics". You will get pages of google results that are complete nonsense written by people who actually believe they are close to the holy grail of putting a number on risk. Often they create models that work well in certain circumstances - but their predictions ALWAYS fail catastrophically in the long term.
What happens when you put a couple of people with Nobel Prizes in Economics in a room with the Vice Chairman and Head of Bond Trading at Solomon Brothers. You get a well funded scheme to make money based on the finest and most capable economic models of the day. You get "Long Term Capital Management" a firm which made profits until it completely failed in 2000. The failure of a single firm, even a big one, is not particularly important. Unfortunately the firm was so highly leveraged (highly leveraged means "playing with huge sums of other peoples money") it threatened to bring down large portions of the financial system. Fixing the problem required a massive bailout supervised by the Federal Reserve. It failed because of events that they simply could not predict. That is the point. There are always events that we simply cannot predict. We do pretty well with "normal distributions", hence the reliable existence of life insurance. Unfortunately, most real world economics are not "normal".
The run-up to the 2008 collapse was a tribute to the power of simple greed, but all good cons need a convincing story. In this case, investors were reassured that the risk involved in collections of mortgages was known and quantified, and besides, we can hedge (insure) to limit losses. There was outright lying at every level of the financial transactions, but a systemic problem was that the intertwined system intended to reduce risk by spreading it, simply increased risk for everyone. Of course there were some folks who knew about the lying and worked the system to their own advantage (notably, Goldman Sachs).

Social Trends - Missing the Big Picture

Evidence based action is important to understand what works and what doesn't. When we have the evidence it seems silly to ignore it. But, it is also silly to read more into our simple experiments than is actually there.
Experimentation is difficult and expensive. This is especially true with trying to understand humans. Too often we end up understanding and exploiting a tendency. The results may be immediately satisfying but ultimately destructive.
There are many situations where short term investigation gives us a "local optimum" where people are more satisfied at this instant, but the end result is ultimately destructive to our health and well being.
The prime example of this is industrial food production. To build a more popular food product you have to understand what people want so they will buy your product. An industry with a new product must be able to produce it consistently and on a large scale. If you create a focus group or simply ask people on the street to tell you which of several food products they prefer, the winner is likely to be the the cheapest product with the highest sugar/fat/salt. As organisms that evolved in circumstances of want, we crave these things. To produce the product consistently and in large quantities you have to industrialize the production of the raw ingredients. In the case of food this is living organisms. For crops, we standardize the breeds, the methods of production, and we process the results in chemical plants to homogenize, filter, and extract. For animals, we reduce them to eating machines on a cheap controlled diet and we engineer their genetics to change what was an animal into a muscle production machine.
We get consistent products that we biologically crave, we also get obesity, diabetes, heart disease, and an odd form of malnutrition. Don't worry about the malnutrition though, because we have processed supplements to fix that.
Since the introduction of the automobile we have done exactly the same sort of short term fixes. When faced with traffic problems, typically traffic congestion, the answer is always the same. Congestion will be alleviated if we add more lanes and reduce the number of entrances into the main streets (no houses on arterials). It also helps if people stay away from the congested areas. The end result is our typical suburban city form. That is, a built environment that is reasonable if you are a car, but not very suitable for supportive human culture.
On a business level the question is usually "How can we improve our profits this quarter or this year?" It is almost never "How can we stay in this business in a sustainable way?" or "How can we make the world a better place in ten or a hundred years?" If your time horizon for profit is one or even five years and an opportunity arises to make a profit based on destruction that will not become apparent for ten or twenty years, most businesses will take the profit and screw the future, which leads to the next section.

Environmental Trends - Destruction of the Natural World

It is clear that as a species we are quite willing to destroy everything around us for short term survival or short term gain. We are willing to completely destroy the natural environment. Take as examples mountaintop removal for coal, deforestation and overfishing.
On top of this, there are unintended results of our actions. The prime example is global warming. General habitat destruction as we exploit more and more of the world is a severe problem.

Environmental Trends - Unsustainable Human Population

We have already passed a tipping point in human population. We have more people than the planet can sustainably support. Like a profligate child with a large inheritance, we can live for some time by depleting our inheritance, but in the end we will be broke. In this case of humanity, our inheritance is the natural world and all its riches which we are rapidly despoiling.
It is not clear what the carrying capacity of our planet is, particularly since this is partially related to the technology at hand. It is clear that we have exceeded the current capacity. As the human population continues to increase we will see even more rapid environmental degradation as well as more frequent human disasters (crop collapse, famine, social unrest, war for resources...).
In industrial countries population has stabilized or even decreased. This gives some hope that we can control our own numbers. For the world as a whole I think it is likely that we will simply exhaust natural resources. This will cause a very painful decline in human population based on misery.
As a contrast, think what the world would be like with our current technology if we had a third of our current population. We could live in a world of human plenty with a massively improved environment. We have passed the point in human society where increasing human labor is the best way to improve the human condition.




Friday, July 4, 2008

Heart Rate Monitors and Training

This is something I wrote some time ago, originally to help my daughter who got a heart rate monitor. Periodically I change it slightly and send to someone. I post it here because it may be of more general interest.
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How you train depends on what you want to accomplish. Genetically people tend toward a predominance of one or the other of two muscle fibers: Fast twitch or slow twitch muscles. The ratio of these is not fixed. Slow twitch fibers can be recruited to be fast twitch, but there is a genetic diffference that tends people toward one or the other. Those who have lots of fast twitch fibers tend to be sprinters. Those with lots of slow twitch tend to be better at endurance. Related to the sprinter/endurance dichotomy are several metabolic pathways for producing energy. There are aerobic (with oxygen) and anaerobic pathways. The anaerobic pathways tend to be good for very short duration activities, a few minutes or less. I have never been tested, but I am the anti-sprinter, so I suspect I tend toward the slow twitch. At any rate, my goals tend to be fitness, endurance and speed (strength) over periods of about an hour. I choose an hour because that tends to be the amount of time I can manage for exercise on any given day. This puts me in the aerobic, endurance camp. I have no idea how sprinters (or their cousins, weight lifters) train.
Several things limit athletic performance. One of them is oxygen. A second is Lactate buildup. Another is muscle strength. In a sense, muscle strength is the simplest to train for. Muscles get stronger as they adapt to stress. To make your muscles stronger you stress them to the point of minor damage, then allow them to recover. Both stress and recovery are important. No stress, no need for adaptation. No rest, no chance for the damage to be repaired and the muscles to get stronger. In addition to simple strength there is also technique. Every activity can be done more or less efficiently. The more efficient you are, the less energy is required for a given result. This is good.
The oxygen/lactate systems are more complicated because there is so much going on. Every person has a maximum rate at which oxygen can be absorbed through the lungs into the bloodstream, pumped by the heart to the body and utilized by the muscles and other organs. This can be measured as your VO2 max. If you exceed your VO2 max value, by definition you can’t provide enough oxygen to support the work you are doing and something either has to stop or go anaerobic. The point at which you start going anaerobic is called your anaerobic threshold. The best thing you can do to improve your VO2 max is to choose your parents well. However, even the genetically ungifted can improve their VO2 max through training.
When you produce energy anaerobically, one of the by products is lactic acid. If the lactic acid accumulates in the muscle it changes the PH and the muscle loses the ability to contract. Of course none of this is black and white. Even when you are exercising mainly aerobically, some lactic acid is produced. You should be able to increase performance by improving your capacity to get oxygen to your muscles, improving your ability to remove lactic acid from your muscles when it occurs, and by making your muscles more tolerant of lactic acid when it is present. Lactic acid itself is burned oxidatively by mitochondria to produce energy. That is one of the ways that lactic acid is removed. See http://home.hia.no/~stephens/lacthres.htm.. Since this post was originally written I have spoken to some exercise physiologists. What happens when lose our ability to continue at a given level of exertion is not clear. It is NOT a simple matter of lactic acid and no particular metabolite has been identified. There may even be a mental control designed to protect the organism.
Two other factors in oxygen transport are your maximum heart rate and your resting heart rate. There is a speed past which your heart will not beat. The maximum differs from person to person and is also dependent on age. You lose roughly one beat per minute per year as you get older. Your resting heart rate serves as an indicator of heart efficiency. Take your resting heart rate while lying down, preferably in the morning before getting up or right before bed. At rest, your body still demands a certain amount of oxygen. The fewer heart beats needed to satisfy this requirement, the more efficient the heart is. As you get more fit, your heart simply delivers more blood per beat.
What does this have to do with training with a heart rate monitor? Your heart rate roughly corresponds with the amount of oxygen being demanded by your body. This, in turn correlates with the energy your body is putting out. The harder you work, the faster your heart beats. In an endurance sense your heart rate is limited on one end by your resting heart rate and on the other end by your anaerobic threshold. The range is expanded by making your heart pump more per beat (lowering the resting heart rate) and raising your anaerobic threshold (increasing oxygen delivery and lactate removal).
As long as you aren’t "overtraining", a heart rate monitor allows you to judge just how hard you are working. Surprisingly this can be more useful on easy days than on hard days. Using the monitor you can get a sense of your real anaerobic threshold (it hurts and you can’t sustain for long). You can gauge effort by finding how close you are to either your anaerobic threshold or to your maximum heart rate. This is usually expressed as a percentage (90% of maximum heart rate). Be aware that these measures are different because your anaerobic threshold is below your maximum heart rate. However, your anaerobic threshold is something you can figure out. Your maximum heart rate is difficult to determine. I knew my predicted one was wrong when I looked down at the monitor one day and saw a number above my "maximum".
Conventional wisdom is that training should be a mix of stress and recovery. Recovery does not mean inactivity. It means activity at a level below that which stresses you. Most of your time should be spent in recovery. Exercise at a recovery level can be performed for a longer duration than exercise at stress levels. This recovery not only allows you rebuild your stressed muscle, it increases endurance and gives you a chance to work on efficiency. Although technique is critically important, efficiency is not synonymous with technique. I believe some of it is a physiologic adaptation.
Stress levels for your heart lung system are right around the anaerobic threshold. To work on raising the anaerobic threshold, lactate recovery, and increasing VO2 max, intervals are the prescribed medicine. To stress the aerobic system rather than just using your sprint abilities, the intervals should be at least a couple of minutes long. These are very painful and it is recommended that you not do this more than about once a week.
A step below intervals is a hard workout. Ignoring my own advice about recovery, these are typically what I do on the bike. For a hard workout I basically work for an hour at just below my anaerobic threshold. For me on the bike this is around 90% of my predicted maximum heart rate. My excuse is that I am not an athlete and don’t have enough time to recover as an athlete would (easy days). I recover through inactivity. There are many days where I simply don’t get any exercise and it is uncommon for me to have the same exercise activity two days in a row.
For athletes and sensible people who actually schedule easy recovery workouts, the heart rate monitor is most useful. The trick is to set a level before you start. It is very easy to have a recovery workout turn into yet another hard workout. The heart rate monitor gives you a number. If that number goes too high, you ease off regardless of how you feel. I find this to be very difficult. Several sources give target recovery workout rates of about 70% of your max heart rate. I find it hard to give advice that I don’t follow, but conventional wisdom would probably have you do as many recovery workouts as you do hard workouts and intervals. Hard days should be followed by recovery days. I do not know much about recovery time. For example, I don’t know how long it takes muscles to heal from the micro-tears induced by a hard workout (but I think it is on the order of one to two days). This is probably what should govern your recovery schedule for any given muscle set.
My goal is general health and fitness, so I don’t tune my training toward any particular event or activity. I’m on maintenance and (I hope) gradual improvement regime. If you are tuning toward an event or season, there are longer cycles (weeks and months) of buildup and relaxation you should use. At that point you should find a coach.
All this assumes that your heart is a pretty good gauge of effort. For the most part it is. After using the heart rate monitor for some time on the bike and blades, I find that it correlates pretty well with perceived effort, that is, how hard it feels that I’m working. This isn’t always true though. It is not true when I’m boosting or dropping my heart rate. For example, increasing exertion to go from a heart rate of 150 to 155 can feel worse than a steady state of 165. Dropping from 170 to 165 can feel like heaven.
A second factor that can change heart rate is over-stressing. When I measure my resting heart rate after a hard workout day, it tends to be high. I think this is part of the normal recovery. If you over-stress for days or weeks, your resting heart rate will remain high and your total capacity to work will be reduced. Resting heart rate is both an indicator of general fitness (low is good) and of "overtraining" (goes up and stays up over a period of days). I think resting heart rate also goes up during illness.