Archive for the ‘Health’ Category
A Louisiana Town Plagued by Pollution Shows Why Cuts to the EPA Will Be Measured in Illnesses and Deaths
Sharon Lerner reports in The Intercept:
When the Environmental Protection Agency informed people in St. John the Baptist Parish, Louisiana, last July that the local neoprene plant was emitting a chemical that gave them the highest risk of cancer from air pollution in the country, the information was received not just with horror and sadness but also with a certain sense of validation.
For years, many of the people living on this little square of land between the train tracks and the Mississippi River levee have felt they suffered more than their share of illnesses. Troyla Keller has a rash and asthma that abate every time she leaves the neighborhood and worsen when she returns. Augustine Nicholson Dorris had breast cancer and seizures. And David Sanders has trouble breathing, a tumor on his thyroid, and neurological problems. “It took a lot away from me,” said Sanders, whose speech is slurred, when I visited the area a half-hour west of New Orleans in February. Several people spoke of shuttling their children and grandchildren to the nearby ER for asthma treatments. And many residents also frequent the neighborhood’s two busy dialysis centers. A third is under construction.
“Everybody felt there was too much sickness,” said Robert Taylor, 76, whose wife had breast cancer and is now struggling with multiple sclerosis. Taylor’s daughter Raven suffers from gastroparesis, a relatively rare autoimmune disorder that has left the 48-year-old unable to digest food and bedridden, after an attempt to treat the condition surgically led to a staph infection. But there were plenty of other unusual conditions, too. Trollious Harris, who has spent most of her life a few blocks from the Taylors, suffers from myasthenia gravis, another autoimmune condition, which has caused her muscles to weaken. Kellie Tabb has a rapid heartbeat and recently met two other people in the area who have the same condition.
“Everybody has had someone that has died of cancer,” said Taylor’s daughter Tish as she stood in the doorway of the family’s home on East 26th Street. To an outsider like me, the neighborhood looked festive, with kids playing on neatly mown lawns and Mardi Gras beads adorning many of the doors. But when Tish, who is 53 and has lived on the block since she was 4, looked at the nearby houses, she saw the people who had fallen ill. “Mr. Henry died of cancer, and he had two sons who were diagnosed with it, too. And Miss Sissy, who lives down the block toward the river, she had pancreatic cancer and died this month. Ms. Diane died of cancer, too,” Tish said, ticking off the casualties on her fingers.
“Something is clearly not right with this area,” said Lydia Gerard, whose husband developed kidney cancer at age 64 that recently metastasized and spread to his chest. Gerard herself suffers from sudden bouts of diarrhea and anemia as well as vitiligo and other autoimmune problems. Her lips and eyes often swell inexplicably and she has itchy welts on her arms and legs that get better when she goes to work 30 miles away — and come back with a vengeance when she returns home. While I was interviewing Gerard and her husband in their two-story home, I also broke out in hives.
Besides being a likely human carcinogen, chloroprene, the gas the plant has been releasing into this community for 48 years, is known to weaken immune systems and cause headaches, heart palpitations, anemia, stomach problems, impaired kidney function, and rashes. So the EPA’s news, bad as it was, provided a form of relief. After all these years, a government agency was helping to explain the residents’ strange predicament. The people living next to the plant might be sick, but at least they weren’t crazy. . .
Stephen Covey in his book The 7 Habits of Highly Productive People used an image of the ladder of success, which he borrowed from Thomas Merton, who wrote, “People may spend their whole lives climbing the ladder of success only to find, once they reach the top, that the ladder is leaning against the wrong wall.” That seems to apply to many American men who were sold on the idea that the ladder of success referred to achieving career goals, only to find that once they achieved (or abandoned) their career goals, they had nothing of personal value.
Billy Baker writes in the Boston Globe:
LET’S START WITH THE MOMENT I realized I was already a loser, which was just after I was more or less told that I was destined to become one.
I’d been summoned to an editor’s office at the Globe Magazine with the old “We have a story we think you’d be perfect for.” This is how editors talk when they’re about to con you into doing something you don’t want to do.
Here was the pitch: We want you to write about how middle-aged men have no friends.
Excuse me? I have plenty of friends. Are you calling me a loser? You are.
The editor told me there was all sorts of evidence out there about how men, as they age, let their close friendships lapse, and that that fact can cause all sorts of problems and have a terrible impact on their health.
I told the editor I’d think about it. This is how reporters talk when they’re trying to get out of something they don’t want to do. As I walked back to my desk in the newsroom — a distance of maybe 100 yards — I quickly took stock of my life to try to prove to myself that I was not, in fact, perfect for this story.
First of all, there was my buddy Mark. We went to high school together, and I still talk to him all the time, and we hang out all the . . . Wait, how often do we actually hang out? Maybe four or five times a year?
And then there was my other best friend from high school, Rory, and . . . I genuinely could not remember the last time I’d seen him. Had it already been a year? Entirely possible.
There were all those other good friends who feel as if they’re still in my lives because we keep tabs on one another via social media, but as I ran down the list of those I’d consider real, true, lifelong friends, I realized that it had been years since I’d seen many of them, even decades for a few.
By the time I got back to my desk, I realized that I was indeed perfect for this story, not because I was unusual in any way, but because my story is very, very typical. And as I looked into what that means, I realized that in the long term, I was heading down a path that was very, very dangerous.
Vivek Murthy, the surgeon general of the United States, has said many times in recent years that the most prevalent health issue in the country is not cancer or heart disease or obesity. It is isolation.
I TURNED 40 IN MAY. I have a wife and two young boys. I moved to the suburbs a few years ago, where I own a fairly ugly home with white vinyl siding and two aging station wagons with crushed Goldfish crackers serving as floor mats. When I step on a Lego in the middle of the night on my way to the bathroom, I try to tell myself that it’s cute that I’ve turned into a sitcom dad.
During the week, much of my waking life revolves around work. Or getting ready for work. Or driving to work. Or driving home from work. Or texting my wife to tell her I’m going to be late getting home from work.
Much of everything else revolves around my kids. I spend a lot of time asking them where their shoes are, and they spend a lot of time asking me when they can have some “dada time.” It is the world’s cutest phrase, and it makes me feel guilty every time I hear it, because they are asking it in moments when they know I cannot give it to them — when I am distracted by an e-mail on my phone or I’m dealing with the constant, boring logistics of running a home.
We can usually squeeze in an hour of “dada time” before bed — mostly wrestling or reading books — and so the real “dada time” happens on weekends. That’s my promise. “I have to go to work, but this weekend,” I tell them, “we can have ‘dada time.’ ”
I love “dada time.” And I’m pretty good about squeezing in an hour of “me time” each day for exercise, which usually means getting up before dawn to go to the gym or for a run. But when everything adds up, there is no real “friend time” left. Yes, I have friends at work and at the gym, but those are accidents of proximity. I rarely see those people anywhere outside those environments, because when everything adds up, I have left almost no time for friends. I have structured myself into being a loser.
“YOU SHOULD USE THIS story suggestion as a call to do something about it.”
That’s Dr. Richard S. Schwartz, a Cambridge psychiatrist, and I had reached out to him because he and his wife, Dr. Jacqueline Olds, literally wrote the book on this topic, The Lonely American: Drifting Apart in the Twenty-First Century.
He agreed that my story was very typical. When people with children become overscheduled, they don’t shortchange their children, they shortchange their friendships. “And the public health dangers of that are incredibly clear,” he says.
Beginning in the 1980s, Schwartz says, study after study started showing that . . .
Fivebooks.com interviews Louise Gray:
You’ve just published a book called The Ethical Carnivore. What does it mean to be an ‘unethical carnivore?’
Well, to me, being an unethical carnivore means just stuffing your face with meat without caring where it comes from. Being an ethical carnivore means trying only to eat meat that you understand comes from a good source. I tried to define it in my book by saying that ethics is the effort to live a good life. My question was how can we ensure the meat we eat does not harm the environment and comes from animals that have lived a good life?
I know to some people that can sound a little wishy-washy, but I was aiming the book at the majority of people in this country. I accept that people eat meat; I myself was a carnivore. Those who are vegetarian have already made their choice, so I wanted to talk to the carnivores about how they could be more ethical. And I wanted to make it realistic, so you have to leave room for trying your best and not always being perfect—the occasional drunken kebab. I believe that is the way to make a difference, by giving people an opportunity to try their best.
In the book, you spend some time discussing the capacity of different animals, with molluscs at one end of the spectrum, to feel pain. Is this the main moral or ethical issue that we need to consider?
No, I think it’s a lot more complex. For a start, how do we judge the pain of other animals? You mentioned molluscs—there is still ongoing research into whether these particular animals can even feel pain. I think you have to always consider that, but also look at the wider impacts, such as upon the environment.
In the book, for example, I write about scallop dredging on the west coast of Scotland. This is not just affecting the molluscs but the wider marine ecosystem as all the coral and other life on the seabed is ploughed up just for the scallops. So, I would argue in this case the question of the environmental impact is worth considering as well as the ability of the animal to feel pain.
The other question to ask is how does the processing of that animal affect the humans around them. For example, you might choose free-range organic chickens because the animals are better cared for, but if they’re being processed in a factory where people are being treated appallingly, then isn’t there a moral question about the labour that was used to get that meat to your table? Between the animal being born, or hatching, and getting to your plate, there are so many questions to consider in terms of ethics.
It can halt you in your tracks and make you think ‘I won’t bother’. But I think asking questions and trying to understand is a good start. There are a lot of grey areas, I don’t see how you can have black and white answers when it comes to something so complex.
Would a simpler answer be instead of us tearing our hair out over the ethics of meat-eating, to not eat any meat at all?
Yep, that’s the easiest answer. I have enormous respect for people who choose to be vegan. They are undeniably having a lighter impact on the planet because it generally takes less energy, and therefore fewer greenhouse gas emissions, to produce plant-based foods than meat. There are also fewer concerns about welfare, the wider environment and labour. I would say that one of the big discoveries from the book is people often expect vegans to be very extreme and to lecture everyone else, but actually I’ve had some really nice responses to the book from people who choose to eat no animal products. They want to encourage more people to think about what they eat and welcome any effort in that direction. They understand that a clear message in the book is that if you are desperately worried about the environment, then one of the simplest things you can do is eat less meat.
You mentioned one non-environmental impact as being to do with labour and the first book that you’ve chosen, The Jungle by Upton Sinclair (1906)—a novel that portrays the working conditions of those in the meat-packing industry at the turn of the twentieth century—deals with this labour question. It touches on immigration, and class, and many issues beyond that of eating meat. Why have you chosen to start here?
One interesting thing with this book is that while there are lots of animals in it—and they’re being tortured horribly, literally being skinned alive in the background of many, many scenes in the novel—it’s what’s happening to the humans that is so terrible, and that’s what you’re left with, especially reading it now. When it first came out, people were really shocked by what went into their meat, and I think people would read it now and think things are a bit better, and they probably are… but when you think about it we had the horsemeat scandal a few years ago, a lot of what happens in meat factories is still unknown to us.
I think sometimes when we discuss meat-eating, we talk about the suffering of the animals, we even talk about the environment, but we often forget to talk about the people and I think that’s really important: the people who do it on your behalf are worth considering.
When you were writing The Ethical Carnivore, you went into slaughterhouses and onto fishing boats and spent a lot of time with people who are at the coalface of producing meat, often on industrial scales. How do you think that affects the people who do it, and do you think they have to become blind to some of these issues to be able to work in that industry?
I think they have to process those issues, but they shouldn’t be blind to them. All of the places I went to were in the UK which meant they were really highly regulated. Also, I would say they were probably quite good abattoirs because they were allowing a journalist in—I wasn’t undercover, I was being quite open about what I was doing. So those people weren’t blind to the issues because they had to be very good at what they did in order to keep their job.
In one abattoir, the slaughter-men who were doing the killing had trained for seven years on all the floors, and so I don’t think they’re blind to it. They have to be trained in all of the welfare stuff and they have to care for the animals because they’re being filmed. They have CCTV in most abattoirs in the UK and there’s a big campaign to get CCTV in all abattoirs—I don’t know why the government will not legislate on this as it protects the abattoirs as well. If they are doing a good job it should not be a threat to them.
“They had to control their emotions, otherwise they couldn’t do the job”
When I interviewed slaughtermen and -women they were aware of what they were doing, that they were killing a beautiful animal. They admitted that they had to control their emotions, otherwise they couldn’t do the job, but also said they were keenly aware of ensuring the animal had a quick death. They were proud of doing a job well. I think it also becomes part of your lifestyle, often there are whole families working in these industries. It is normalised in the sense it is part of your life and that’s just how things are.
One of the most interesting interviews I did was with Temple Grandin, an animal behaviourist. She’s audited a lot of abattoirs, and she said that the majority really care about their jobs and do it well but yes, like anything, there are a few bad apples. She admits it and is trying to redesign the industry, so that those kind of people are weeded out.
Publication of The Jungle caused public outrage, and as a result new legislation was brought in in the United States, the Meat Inspection Act. Do you think that the public want to know about what happens in their slaughterhouses?
I guess a few people don’t because I’ve had quite violent reactions to my book by people who often eat meat and really don’t want to know. It’s almost like they feel it’s a personal affront, that they’re being attacked when I start telling them where meat comes from. I try to be delicate because I can sort of understand that it is quite upsetting for people. But the majority of people absolutely do want to know because they want to know it is being done right.
I think [most] people do want to know, but you have to contextualise it. The first time I went to an abattoir to write about it, I was traumatised. It is a death factory, there is no way of getting around that. But you have to put it in context if you really want to understand, so I think people should know about the whole picture—another reason I wrote the book. You need quite a lot of education because you have to think about how the animals are bred and how they’re treated as well as how they are killed. I think that should probably be part of school education. We should know where our food comes from, otherwise we’re susceptible to the kinds of things that happened in The Jungle, or the horsemeat scandal, because people are getting away with stuff where no one’s wanting to loo
Your second book, Ruth Harrison’s Animal Machines (1964), revealed the indignities and the suffering of animals in industrialised agriculture. What impact did the book have?
It was like Upton Sinclair’s but in the UK. It led to the UK government changing the law—the 1968 Agriculture (Miscellaneous Provisions) Act and also the European Convention for the Protection of Animals Kept for Farming Purposes. Ultimately it led to the ‘five freedoms’, which vets had been working on, being brought into law. These summarised animal welfare as freedom from hunger and thirst, from discomfort, from pain, injury or disease, from fear and distress and, most controversially, the freedom to express most normal behaviours.
What I liked about Ruth Harrison was that . . .
Kevin Drum points out a particularly boneheaded decision by the Trump administration:
Reuters tells us what to expect from President Trump’s budget:
Under the proposal, which was sent to the EPA this week, grants to states for lead cleanup would be cut 30 percent to $9.8 million, according to the source, who read the document to Reuters.
What an idiot. This is hardly the biggest issue in his budget, and I’ll grant that the current allocation for lead cleanup is so pitiful that a 30 percent cut hardly matters. On principle, though, it’s obvious that Mick Mulvaney’s crew just saw a line item in their spreadsheet and slashed it without knowing anything about it. Nice work, folks. You get a gold star.
By coincidence, the Washington Post ran a piece yesterday that’s all about lead—though the reporter didn’t realize it:
In dozens of one-on-one meetings every week, a lawyer retained by the city of Philadelphia summons parents whose children have just been jailed, pulls out his calculator and hands them more bad news: a bill for their kids’ incarceration….[He] is one agent of a deeply entrenched social policy that took root across the country in the 1970s and ’80s. The guiding principle was simple: States, counties and cities believed that parents were shedding responsibility for their delinquent children and expecting the government to pick up the tab.
….“It was a very different time, when too many parents frequently wanted to essentially ‘dump’ their adolescent children on juvenile courts when they found them unruly, ungovernable, uncontrollable,” Linda O’Neal, executive director of the Tennessee Commission on Children and Youth, said of the era decades ago when the laws were implemented.
Regardless of what you think about this policy, there’s a reason it “took root” in the 70s and 80s: Kids of that era spent their early childhoods surrounded by lead fumes from automobiles, so they contracted lead poisoning in massive numbers. By the time they were teenagers they really were “unruly, ungovernable, uncontrollable,” and parents didn’t know what to do.
As it turns out, there was nothing they could do. The damage was done. But nobody knew that, so we put in place pointless laws based on the premise that if only they worked harder, parents could keep their kids under control. In reality, the only policy that ended up working came from Trump’s hated EPA, which banned leaded gasoline and put an end to our national epidemic of lead poisoning.
But the old laws are still around, even though they don’t work, while the EPA’s lead cleanup program is being slashed, even though it does work. Welcome to America.
Barbara King has an interesting report at NPR:
The average American eats more than 33 pounds of cheese a year.
This is according to Neal Barnard, physician and president of the Physicians Committee for Responsible Medicine. And that’s a problem, he says, because it’s helping to make us overweight and sick.
Barnard’s new book, The Cheese Trap: How Breaking a Surprising Addiction Will Help You Lose Weight, Gain Energy, and Get Healthy, is set to hit shelves Tuesday. In it, Barnard writes about cheese in strong terms:
“Loaded with calories, high in sodium, packing more cholesterol than steak, and sprinkled with hormones — if cheese were any worse, it would be Vaseline …
Some foods are fattening. Others are addictive. Cheese is both — fattening and addictive.”
I’d never before thought in terms of dairy products being addictive (with the personal exception of milk chocolate, I admit). Barnard explains that dairy protein — specifically a protein called casein — has opiate molecules built in. When babies nurse, he notes, they’re getting dosed with a mild drug: “Milk contains opiates that reward the baby for nursing.”
It’s no different with the cow’s milk — or other mammalian milk — from which cheese is made. In fact, Barnard says, the process of cheese-making concentrates the casein:
“A cup of milk contains about 7.7 grams of protein, 80 percent of which is casein, more or less. Turning it into Cheddar cheese multiplies the protein count seven-fold, to 56 grams. It is the most concentrated form of casein in any food in the grocery store.
Call it dairy crack.”
The U.S. produces more cheese than any other country in the world, according to Barnard.
The big issue, he says, is that cheese lovers aren’t just addicted to a delicious food, they’re addicted to one that may seriously contribute to health problems. He cites studies in the book that tie eating cheese to weight gain and risks of numerous diseases.
Barnard suggests that giving up cheese is associated, for example, with relief of asthma symptoms. In an email, Barnard summarized the case for this association this way: . ..
My own favorite cheese currently is Chimay.
David Epstein writes in ProPublica:
Years after research contradicts common practices, patients continue to demand them and doctors continue to deliver. The result is an epidemic of unnecessary and unhelpful treatment.
First, listen to the story with the happy ending: At 61, the executive was in excellent health. His blood pressure was a bit high, but everything else looked good, and he exercised regularly. Then he had a scare. He went for a brisk post-lunch walk on a cool winter day, and his chest began to hurt. Back inside his office, he sat down, and the pain disappeared as quickly as it had come.
That night, he thought more about it: middle-aged man, high blood pressure, stressful job, chest discomfort. The next day, he went to a local emergency department. Doctors determined that the man had not suffered a heart attack and that the electrical activity of his heart was completely normal. All signs suggested that the executive had stable angina — chest pain that occurs when the heart muscle is getting less blood-borne oxygen than it needs, often because an artery is partially blocked.
A cardiologist recommended that the man immediately have a coronary angiogram, in which a catheter is threaded into an artery to the heart and injects a dye that then shows up on special x-rays that look for blockages. If the test found a blockage, the cardiologist advised, the executive should get a stent, a metal tube that slips into the artery and forces it open.
While he was waiting in the emergency department, the executive took out his phone and searched “treatment of coronary artery disease.” He immediately found information from medical journals that said medications, like aspirin and blood-pressure-lowering drugs, should be the first line of treatment. The man was an unusually self-possessed patient, so he asked the cardiologist about what he had found. The cardiologist was dismissive and told the man to “do more research.” Unsatisfied, the man declined to have the angiogram and consulted his primary-care doctor.
The primary-care physician suggested a different kind of angiogram, one that did not require a catheter but instead used multiple x-rays to image arteries. That test revealed an artery that was partially blocked by plaque, and though the man’s heart was pumping blood normally, the test was incapable of determining whether the blockage was dangerous. Still, his primary-care doctor, like the cardiologist at the emergency room, suggested that the executive have an angiogram with a catheter, likely followed by a procedure to implant a stent. The man set up an appointment with the cardiologist he was referred to for the catheterization, but when he tried to contact that doctor directly ahead of time, he was told the doctor wouldn’t be available prior to the procedure. And so the executive sought yet another opinion. That’s when he found Dr. David L. Brown, a professor in the cardiovascular division of the Washington University School of Medicine in St. Louis. The executive told Brown that he’d felt pressured by the previous doctors and wanted more information. He was willing to try all manner of noninvasive treatments — from a strict diet to retiring from his stressful job — before having a stent implanted.
The executive had been very smart to seek more information, and now, by coming to Brown, he was very lucky, too. Brown is part of the RightCare Alliance, a collaboration between health-care professionals and community groups that seeks to counter a trend: increasing medical costs without increasing patient benefits. As Brown put it, RightCare is “bringing medicine back into balance, where everybody gets the treatment they need, and nobody gets the treatment they don’t need.” And the stent procedure was a classic example of the latter. In 2012, Brown had coauthored a paper that examined every randomized clinical trial that compared stent implantation with more conservative forms of treatment, and he found that stents for stable patients prevent zero heart attacks and extend the lives of patients a grand total of not at all. In general, Brown says, “nobody that’s not having a heart attack needs a stent.” (Brown added that stents may improve chest pain in some patients, albeit fleetingly.) Nonetheless, hundreds of thousands of stable patients receive stents annually, and one in 50 [2%! – LG] will suffer a serious complication or die as a result of the implantation procedure.
Brown explained to the executive that his blockage was one part of a broader, more diffuse condition that would be unaffected by opening a single pipe. The cardiovascular system, it turns out, is more complicated than a kitchen sink. The executive started medication and improved his diet. Three months later, his cholesterol had improved markedly, he had lost 15 pounds, and the chest pain never returned.
Now, listen to the story with the sad ending: Not long after helping the executive, Brown and his colleagues were asked to consult on the case of a 51-year-old man from a tiny Missouri town. This man had successfully recovered from Hodgkin’s lymphoma, but radiation and six cycles of chemotherapy had left him with progressive scarring creeping over his lungs. He was suffocating inside his own body. The man was transferred to Barnes Jewish Hospital, where Brown works, for a life-saving lung transplant. But when the man arrived in St. Louis, the lung-transplant team could not operate on him.
Four months earlier, the man had been admitted to another hospital because he was having trouble breathing. There, despite the man’s history of lymphoma treatment, which can cause scarring, a cardiologist wondered whether the shortness of breath might be due to a blocked artery. As with the executive, the cardiologist recommended a catheter. Unlike the executive, however, this man, like most patients, agreed to the procedure. It revealed a partial blockage of one coronary artery. So, doctors implanted a stent, even though there was no clear evidence that the blockage was responsible for the man’s shortness of breath — which was, in fact, caused by the lung scarring. . .
Kevin Drum has a very interesting post at Mother Jones:
I missed this when it was first written—probably because it was only a week after Donald Trump won the election—but Robert Waldmann decided to check out a few of his predictions:
In April 2008, I predicted that the UK violent crime rate would peak some time around 2008. I just googled and found that it peaked in around 2006 or 2007.
Here’s the chart, courtesy of the Institute for Economics and Peace:
Note two things here. First, Britain’s violent crime rate peaked about 15 years after it did in the US. Second, it dropped a lot faster than it did in the US. Why?
Because, first, Britain adopted unleaded gasoline about 13 years after the US (1988 vs. 1975). And second, because it phased out leaded gasoline a lot faster than the US. Within four years Britain had cut lead emissions by two-thirds, which means there was a very sharp break between infants born in high-lead and low-lead environments. Likewise, this means there was a sharp break between 18-year-olds with and without brain damage. In 2006, nearly all 18-year-olds had grown up with lead poisoned brains. By 2010, that had dropped substantially, which accounts for the stunning 40 percent drop in violent crime in such a short time.1
This is one of the reasons the lead-crime hypothesis is so persuasive. Not only does recorded crime fit the predictions of the theory—both in timing and slope—but it does so in . . .
Note this, later in his post:
Anyway, I might as well take this opportunity to repeat my prediction that terrorism in the Middle East will begin to decline between 2020-30. You heard it here first.