Sunday, April 30, 2023

Ordinary people doing the right ordinary things make the most beneficial difference

Factfulness by Hans Rosling, Ola Rosling, and Anna Rosling Ronnlund.  Page 219.

In 2014, I went to Liberia to help fight Ebola because I was afraid that if it weren’t stopped, it could easily spread to the rest of the world and kill a billion people, causing more harm than any known pandemic in world history. The fight against the lethal Ebola virus was won not by an individual heroic leader, or even by one heroic organization like Médecins Sans Frontières or UNICEF. It was won prosaically and undramatically by government staff and local health workers, who created public health campaigns that changed ancient funeral practices in a matter of days; risked their lives to treat dying patients; and did the cumbersome, dangerous, and delicate work of finding and isolating all the people who had been in contact with them. Brave and patient servants of a functioning society, rarely ever mentioned—but the true saviors of the world.

History

 

An Insight

 

I see wonderful things

 

Destiny calls

Via Chartbook.  

If you project Germany’s growth rate between 1901 and 1913 down to the end of the twentieth century, you exactly predict where a reunified Germany - after WWI, Weimar crises, WWII, division after 1945 - actually ended up by the 1990s.















This is the extension of a famous graph first drawn by Knut Borchardt by Albrecht Ritschl.

An amazing example of the power of fundamentals.

Offbeat Humor

 

Data Talks

 

Watercolor by Teri Starkweather

Watercolor by Teri Starkweather



























Click to enlarge.

Saturday, April 29, 2023

The limits of leadership

Factfulness by Hans Rosling, Ola Rosling, and Anna Rosling Ronnlund.  Page 216.

Powerful leaders?

For example, Mao was undoubtedly an extraordinarily powerful figure whose actions had direct consequences for 1 billion people. But his infamous one-child policy had less influence on birth rates than is commonly thought.

Most often when I show the low birth numbers in Asia, someone says, “That must be because of Mao’s one-child policy.” But the huge, fast drop from six to three babies per woman had happened in the ten years preceding the one-child policy. And during the 36 years the policy was in place, the number never fell below 1.5, though it did in many other countries without enforcement, like Ukraine, Thailand, and South Korea. In Hong Kong, where again the one-child policy didn’t apply, the number dropped even below one baby per woman. All this suggests that there were other factors at play here—the reasons I have already outlined for why women decide to have babies—than the decisive command of a powerful man.

The pope is also credited with enormous influence over the sexual behavior of the 1 billion Catholics in the world. However, despite the clear condemnation of the use of contraception by several successive popes, the statistics show that contraceptive use is 60 percent in Catholic-majority countries, compared with 58 percent in the rest of the world. In other words, it is the same. The pope is one of the world’s most prominent moral leaders, but it seems that even leaders with great political power or moral authority do not have remote controls that can reach into the bedroom.

History

 

Social exclusion as a strategy

I am aware of the argument about the feminization of "X".  X might be academia, a legislature, a company, a department, etc.  The argument is that as X becomes feminized, it begins to manifest attributes of female competition strategies, female communication patterns, female social norms, etc.

While I suspect that there might be some kernel of truth in the argument, I am generally leery of it.  There are a lot of undefined predicate beliefs or contingent conditions for it to be reliably true.  It is not not dissimilar to the argument about Marxism.  Did Marx, as an economist, have some useful economic insights?  Well . . . yes.  A few.  Was his overarching argument an evil and disastrous failure?  Certainly yes.

The argument that an institution is verging into failure because it is becoming feminized feels the same to me.  There might be some nugget of truth in there but the entirety of the argument feels wrong.  

That said, this is an interesting piece from Women As Worriers Who Exclude by Robin Hanson.  

He is citing Warriors and Worriers by Joyce F. Benenson and Henry Markovitz.

This is an excellent 2014 book on how men differ from women:

In Warriors and Worriers, psychologist Joyce Benenson presents a new theory of sex differences, based on thirty years of research with young children and primates around the world. … boys and men deter their enemies, while girls and women find assistants to aid them in coping with vulnerable children and elders. … Human males form cooperative groups that compete against out-groups, while human females exclude other females in their quest to find mates, female family members to invest in their children, and keep their own hearts ticking. In the process, Benenson turns upside down the familiar wisdom that women are more sociable than men and that men are more competitive than women.

Especially interesting is her discussion of how central social exclusion is to female behavior: 

How does a woman compete while minimizing the risk of retaliation? I suggest that women use a few simple strategies. Strategy 1 is that a woman does not ever let anyone else know that she is competing with them. …  She preaches the mantra of equality for all, and sincerely believes it. …Unaware of her own competitive instincts, she tries to get as much as she can for herself, while insisting that everyone else share equally. If strategy 1 is not working out well enough, then a woman may switch to strategy 2, which requires employing social exclusion. She must ally with other females to run their target out of town. That way, they retain more resources, status, allies, babysitters, and high-quality mates for themselves. The virtue of social exclusion is that it allows overt competition but reduces the risk of retalitation because the target is outnumbered. Should strategy 2 fail, the final fallback is strategy 3, which is reserved for emergencies. It entails a direct hit on a competitor, a physical or verbal assault. If a woman must use strategy 3, she has failed. She is no longer nice; she is mean. … She will be abandoned by former allies. Not only that, but she risks retaliation from her target. …

Strategy 2 comes into play when one female stands out. She may stand out because she obviously tries to outdo everyone else. She may stand out because she is new, extremely talented, or simply has the resources or relationships that others want. She may even stand out simply because she is an easy target and has nothing going for her. She has no allies. It would cost little to be rid of her, leaving more for everyone else. In any of these circumstances, it might be worth using a more direct competitive strategy. However, any form of individual, direct competition leaves open the possibility of retaliation and potential harm. One way of minimizing this is for several girls or women to gang up on a single target. This way, there is little chance of any one of the group suffering harm. Social exclusion accomplishes just that. …

Barring imminent death of herself or her child, nothing strikes more fear into the heart of a girl or woman than the thought that she will be excluded. In one recent study, my students and I asked women and men simply to read about being socially excluded by a friend. Women’s heart rates increased much more than men’s heart rates did. In contrast, women’s and men’s heart rates increased equally when they imagined being physically assaulted by a friend. … 

Social exclusion is primarily a female strategy. … Girls practice it from early childhood. It has been used by females across diverse cultures in middle childhood and adolescence and adulthood … An experimenter brought two 6-year-olds, either girls or boys, to a room … One week later, the same two children returned to the room and …  a third child of the same sex was brought to the room after the pair had been playing for a while. … pairs of girls were more likely than pairs of boys to exclude the newcomer. … Girls took more than three times as long as boys to speak to the newcomer. … In 4 of the 15 girls’ groups, the girls never spoke a single word to the newcomer. …

[snip]

This all suggests to me that “cancel culture” can be seen as a straightforward extension of a common relatively-female strategy, upped in part by #MeToo. 

That is, many orgs are now willing to break association with anyone who enough others say they don’t like. Some sort of accusation is often required, but details or supporting concrete evidence are less often required. I guess this change is part of the overall feminization of culture, though it must also have other causes. (What?)

The above descriptions don’t give me much confidence that the excluded are typically guilty of justly-punishable offenses. Expect to see a lot more of this, unless we re-establish prior norms that discouraged it.

Hmmm.  I still am averse to the feminization argument but this gives me better reason to consider it than most of what I have seen.

One way or another, we certainly are seeing an awful lot of exercise of social exclusion as a strategy - deplatforming, cancelling, censoring . . . now much more obviously in play than in the past.  

An Insight

 

He legally owned weapons and kept them responsibly secured -The Horror!

I have been traveling internationally the past ten days and attending a family funeral.  I have been extremely unconnected.  Pleasantly so.  

Consequently, I am not up-to-speed on issues in the headlines.  As I departed the US, Teixeira had been identified as the leaker of US intelligence which seems equally damaging and embarrassing.  I have no other information about his guilt or innocence or the degree of damage actually wrought.  I am in the dark.

I see over at Althouse that Teixeira appears to have been arraigned while I was gone.  She quotes the New York Times account.  

"Investigators found a small arsenal in his bedroom at the house he shared with his mother and stepfather. Inside a gun locker two feet from his bed, law enforcement officials found multiple weapons, including handguns, bolt-action rifles, shotguns, an AK-style high-capacity weapon and a gas mask. F.B.I. special agents also found ammunition, tactical pouches and what appeared to be a silencer-style accessory in his desk drawer.... Prosecutors also made public a series of social media posts from 2022 and 2023 in which Airman Teixeira expressed his desire to kill a 'ton of people' and cull the 'weak minded,' and described what he called an 'assassination van' that would cruise around killing people in a 'crowded urban or suburban environment.'"

From "Airman Accused of Leak Has History of Racist and Violent Remarks, Filing Says/Prosecutors accused Jack Teixeira of trying to cover up his actions and described a possible propensity toward violence" (NYT). 

With no preconceptions or current context, I read this and think how weak the prosecutors case must be if their strongest points of condemnation are that

He keeps his legally acquired weapons under lock and key but accessible.  

He had made possibly racially insensitive remarks in the past.

He had made possibly violent remarks in the past.  

He only had a possible propensity towards violence.

I am not disputing whether he might be guilty, that he might have a history of violence and/or a dangerously real plan for violence, or that he might be a real racist.  

But the evidence just in those headlines and paragraphs are seemingly tellingly weak.  Empty accusations of racism are as grains of sand on the beach.  When speech is deemed violent in many establishment quarters, the accusation of violent remarks holds little water.  And the fact that he apparently legally owned weapons and responsibly kept them safely secured seems at best a non sequitur.  

Since this is the very first thing I have seen on the case in a week and a half, I assume I must be either missing something or am simply overly-jaundiced upon my reentry into the world of hysterical journalism.  I read the comments at Althouse to get a sense of which alternative might be true.

Nope.  People who have been following the case for the entire time I have been disconnected seem to have the same or even stronger response.  The shared view seems to that the New York Times reporting reads more as regime propaganda than as factual reporting.  

The Purifiers strengthen the Traditionalists

From "For all of his early promise, Nate Silver ended up swallowing, and even pushing what might be the single concept most destructive to the republic right now: bothsidesism." by Ann Althouse.  

"Silver long overstayed his usefulness, so if he does go? Good riddance."

Says the first commenter in a discussion at Metafilter, "The end of the road for FiveThirtyEight?" 

All in response to Disney/ABC terminating Nate Silver's contract.  Althouse's commenters make three points.  

First is that this is primarily left wing outrage that Silver was process and methodology driven rather than emotion driven.

Second is the observation that just a few months ago there was a similar dethronement where the founder icon is driven out of their own organization.  First James O'Keefe is defenestrated at Project Veritas and now Nate Silver is defenestrated at FiveThirtyEight.  A little odd, the similarities.

The third point made is that this is evidence of a continuing trend of the Woke and the mainstream media gradually deplatforming Classical Liberals for adhering to Age of Enlightenment ideological principles.  Enigma notes:

With Nate Silver's ejection, the pool of orphaned left-ideals-but-disgusted-with-the-establishment gains another member. When they find the will to toughen-up, watch for a decisive break from the corrupt-oligarchic-bully-or-bribe-you-for-votes left.

Jordan Peterson
Joe Rogan
Steven Pinker
Bret Weinstein
Bill Maher
Tulsi Gabbard
Krysten Sinema
Bari Weiss
Elon Musk
Howard Kunstler
Matt Tiabbi
Nate Silver

The authoritarian, totalitarian, freedom-rejecting Left becomes, the more pure.  The more Classical Liberals there are under the same tent with Libertarians, Conservatives, Free Marketers, Friedmanites, Traditionalists, and Heyekians, the better.  They don't agree on everything but they do agree on the important elements of Freedom and the Age of Enlightenment agenda.

I see wonderful things

 

G, P, C, and M

From The p Factor: One General Psychopathology Factor in the Structure of Psychiatric Disorders? by Avshalom Caspi et al.  Fro the Abstract:

Mental disorders traditionally have been viewed as distinct, episodic, and categorical conditions. This view has been challenged by evidence that many disorders are sequentially comorbid, recurrent/chronic, and exist on a continuum. Using the Dunedin Multidisciplinary Health and Development Study, we examined the structure of psychopathology, taking into account dimensionality, persistence, co-occurrence, and sequential comorbidity of mental disorders across 20 years, from adolescence to midlife. Psychiatric disorders were initially explained by three higher-order factors (Internalizing, Externalizing, and Thought Disorder) but explained even better with one General Psychopathology dimension. We have called this dimension the p factor because it conceptually parallels a familiar dimension in psychological science: the g factor of general intelligence. Higher p scores are associated with more life impairment, greater familiality, worse developmental histories, and more compromised early-life brain function. The p factor explains why it is challenging to find causes, consequences, biomarkers, and treatments with specificity to individual mental disorders. Transdiagnostic approaches may improve research.

From The p Factor by Arnold Kling.  The suheading is An under-studied hypothesis about mental disorders.  

In 2014, Avshalom Caspi and others published a paper arguing that the correlations among psychological disorders suggest the existence of a common factor. They proposed calling this the p factor. It is analogous to the g factor, known as general intelligence, popularly known as IQ.

I am surprised to find very little in the way of follow-up literature. When a striking and controversial theory appears in economics (take the Efficient Market Hypothesis, for example), the follow-on literature, pro and con, is voluminous.

I have not taken so much as one course in personality psychology. But the p-factor theory strikes me as interesting, in the same way that the EMH is interesting.

For one thing, the p-factor theory puts a focus on innate factors in determining mental health. But it suggests that parents with one disorder might have children with very different disorders.

Someone with a high p factor is likely to have parents with high p factors and/or experienced brain development that resulted in a high p factor. See Kevin Mitchell’s Innate.

For example, when I see an essay that refers to an old paper on mothers of boys with gender identity disorder showing that the mothers have dramatically higher incidence of borderline personality, I do not presume that the mothers’ behavior toward their sons caused their sexual identity issues. Instead, I think of the mothers as having a high p factor, which they pass along to their sons, and this happens to manifest itself in such issues.

When Jonathan Haidt wants to blame an increase in teen depression on an environmental factor (smart phones and social media), how does this relate to the p factor? One possibility is that the p factor predicts a propensity for mental disorders, but the environment heavily influences which mental disorders become manifest. Smart phones and social media do not affect the p factor, but they trigger an epidemic of teen depression, because that is how a high p factor manifests itself in the current environment. Before smart phones, the same people would have been susceptible to mental illness, but it might have manifested differently or not at all.

Later on he further speculates:

Another possibility that occurs to me is that instead of (or in addition to) thinking in terms of a p factor that causes mental illness we might think of a factor that protects against mental illness making someone dysfunctional. This might be termed a “coping factor,” which we could call c. That is, if you have two people with a propensity for a given disorder, the one with higher c will be able to overcome the disorder, and the one with lower c will be unable to do so. So we have the high-functioning autistic compared to the low-functioning autistic. We have the creative and original thinker compared to the schizophrenic.

To this hypothesized world of g, p, and c, one might add an additional measure of m for morbidity.  What is the individual's overall physical capacity in terms of strength and health?  

The ideal balance is something like High G (processing capability), Low P (not prone to mental illnesses), and High C (significant coping capability), all complemented by High M (overall healthiness).  

It all makes sense.  Perhaps further research might be forthcoming.  

Offbeat HUmor

 

Data Talks

 

Agglomeration Effects

From Wikipedia:

One of the major subfields of urban economics, economies of agglomeration (or agglomeration effects) describes, in broad terms, it explains how urban agglomeration occurs in locations where cost savings can naturally arise. This term is most often discussed in terms of economic firm productivity, however, agglomeration effects also explain some social phenomenon, such as large proportions of the population are clustered in cities and major urban centres.  Similar to economies of scale, the costs and benefits of agglomerating increase the larger the agglomerated urban cluster becomes. A prominent example of where agglomeration has brought together firms of a specific industry is Silicon Valley in California, USA.

Economies of agglomeration has some advantages. As more firms in related fields of business cluster together, their costs of production tend to decline significantly (firms have competing multiple suppliers; greater specialization and division of labor result). Even when competing firms in the same sector cluster, there may be advantages because the cluster attracts more suppliers and customers than a single firm could achieve alone. Cities form and grow to exploit economies of agglomeration.

Diseconomies of agglomeration are the opposite. For example, spatially concentrated growth in automobile-oriented fields may create problems of crowding and traffic congestion. It is the tension between economies and diseconomies that allows cities to grow but keeps them from becoming too large.

At the foundational level, proximity – especially to other facilities and suppliers – is a driving force behind economic growth, and is one explanation for why agglomeration effects are so evident in major urban centres. While the concentration of economic activity in cities has a positive effect on their development and growth, cities in turn help foster economic activity by accommodating for population growth, driving wage increases, and facilitating technological change.

Magnolia, 1886 by Louis Prang

Magnolia, 1886 by Louis Prang

























Click to enlarge.

Friday, April 28, 2023

Journalists' general knowledge, about equal to the public but worse than chimpanzees.

Factfulness by Hans Rosling, Ola Rosling, and Anna Rosling Ronnlund.  Page 210.

It is fashionable for intellectuals and politicians to point a finger at the media and blame them for not reporting the truth. Maybe it even seemed like I was doing that myself in earlier chapters.
Instead of pointing our fingers at journalists, we should be asking: Why does the media present such a distorted picture of the world? Do journalists really mean to give us a distorted picture? Or could there be another explanation?

(I am not getting into the debate about deliberately manufactured fake news. That is something else altogether and nothing to do with journalism. And by the way, I do not believe that fake news is the major culprit for our distorted worldview: we haven’t only just started to get the world wrong, I think we have always gotten it wrong.)

In 2013, we posted results from Gapminder’s Ignorance Project online. The findings quickly became top stories on both BBC and CNN. The two channels posted our questions on their websites so people could test themselves and they got thousands of comments trying to analyze why the heck people were getting such worse-than-random bad results.

One comment caught our attention: “I bet no member of the media passed the test.”

We got excited by this idea and decided to try to test it, but the polling companies said it was impossible to get access to groups of journalists. Their employers refused to let them be tested. Of course, I understood. No one likes their authority to be questioned and it would be very embarrassing for a serious news outlet to be shown to be employing journalists who knew no more than chimpanzees.

When people tell me things are impossible, that’s when I get really excited to try. In my calendar for that year were two media conferences, so I took our polling devices along. A 20-minute lecture is too short for all my questions, but I could ask some. Here are the results. I also include in the table the results from a conference of leading documentary film producers—people from the BBC, PBS, National Geographic, the Discovery Channel, and so on.












It seems that these journalists and filmmakers know no more than the general public, i.e., less than chimpanzees.

If this is the case for journalists and documentarians in general—and I have no reason to believe knowledge levels would be higher among other groups of reporters, or that they would have done better with other questions—then they are not guilty. Journalists and documentarians are not lying—i.e., not deliberately misleading us—when they produce dramatic reports of a divided world, or of “nature striking back,” or of a population crisis, discussed in serious tones with wistful piano music in the background. They do not necessarily have bad intentions, and blaming them is pointless. Because most of the journalists and filmmakers who inform us about the world are themselves misled. Do not demonize journalists: they have the same mega misconceptions as everyone else.

History

 

An Insight

 

I see wonderful things

 

Data Talks

 

Self Portrait 1940 by Rex Whistler (British) died in Normandy

Self Portrait 1940 by Rex Whistler (British) died in Normandy 
























Click to enlarge.  

Thursday, April 27, 2023

No single measure of a good society can drive every other aspect of its development.

Factfulness by Hans Rosling, Ola Rosling, and Anna Rosling Ronnlund.  Page 201.

Even Democracy Is Not the Single Solution

This is risky, but I am going to argue it anyway. I strongly believe that liberal democracy is the best way to run a country. People like me, who believe this, are often tempted to argue that democracy leads to, or is even a requirement for, other good things, like peace, social progress, health improvements, and economic growth. But here’s the thing, and it is hard to accept: the evidence does not support this stance.

Most countries that make great economic and social progress are not democracies. South Korea moved from Level 1 to Level 3 faster than any country had ever done (without finding oil), all the time as a military dictatorship. Of the ten countries with the fastest economic growth in 2016, nine of them score low on democracy.

Anyone who claims that democracy is a necessity for economic growth and health improvements will risk getting contradicted by reality. It’s better to argue for democracy as a goal in itself instead of as a superior means to other goals we like.

There is no single measure—not GDP per capita, not child mortality (as in Cuba), not individual freedom (as in the United States), not even democracy—whose improvement will guarantee improvements in all the others. There is no single indicator through which we can measure the progress of a nation. Reality is just more complicated than that.

The world cannot be understood without numbers, nor through numbers alone. A country cannot function without a government, but the government cannot solve every problem. Neither the public sector nor the private sector is always the answer. No single measure of a good society can drive every other aspect of its development. It’s not either/or. It’s both and it’s case-by-case.

History

 

An Insight

 

I see wonderful things

 

Data Talks

 

An Interior, s.d. by Hans Hilsøe (Danish, 1871-1942)

An Interior, s.d. by Hans Hilsøe (Danish, 1871-1942)


























Click to enlarge.

Wednesday, April 26, 2023

Almost every activist I have ever met exaggerates the problem to which they have dedicated themselves.

Factfulness by Hans Rosling, Ola Rosling, and Anna Rosling Ronnlund.  Page 187. 

I love subject experts, and as we all must do, I rely heavily on them to understand the world. When I know, for example, that all population experts agree that population will stop growing somewhere between 10 billion and 12 billion, then I trust that data. When I know, for example, that historians, paleodemographers, and archeologists have all concluded that until 1800, women had on average five or more children but only two survived, I trust that data. When I know that economists disagree about what causes economic growth, that is extremely useful too, because it tells me I must be careful: probably there is not enough useful data yet, or perhaps there is no simple explanation.

I love experts, but they have their limitations. First, and most obviously, experts are experts only within their own field. That can be difficult for experts (and we are all experts in something) to admit. We like to feel knowledgeable and we like to feel useful. We like to feel that our special skills make us generally better.

But …

Highly numerate people (like the super-brainy audience at the Amazing Meeting, an annual gathering of people who love scientific reasoning) score just as badly on our fact questions as everyone else.
Highly educated people (like the readers of Nature, one of the world’s finest scientific journals) score just as badly on our fact questions as everyone else, and often even worse.

People with extraordinary expertise in one field score just as badly on our fact questions as everyone else.
I had the honor of attending the 64th Lindau Nobel Laureate Meeting, and addressing a large group of talented young scientists and Nobel laureates in physiology and medicine. They were the acknowledged intellectual elite of their field, and yet on the question about child vaccination they scored worse than any public polls: 8 percent got the answer right. (After this I never take it for granted that brilliant experts will know anything about closely related fields outside their specializations.)

Being intelligent—being good with numbers, or being well educated, or even winning a Nobel Prize—is not a shortcut to global factual knowledge. Experts are experts only within their field.

And sometimes “experts” are not experts even in their own fields. Many activists present themselves as experts. I have presented at all kinds of activist conferences because I believe educated activists can be absolutely crucial for improving the world. Recently I presented at a conference on women’s rights. I strongly support their cause. Two hundred ninety-two brave young feminists had traveled to Stockholm from across the world to coordinate their struggle to improve women’s access to education. But only 8 percent knew that 30-year-old women have spent on average only one year less in school than 30-year-old men.

I am absolutely not saying that everything is OK with girls’ education. On Level 1, and especially in a small number of countries, many girls still do not go to primary school, and there are huge problems with girls’ and women’s access to secondary and higher education. But in fact, on Levels 2, 3, and 4, where 6 billion people live, girls are going to school as much as, or more than, boys. This is something amazing! It is something that activists for women’s education should know and celebrate.

I could have picked other examples. This is not about activists for women’s rights, in particular. Almost every activist I have ever met, whether deliberately or, more likely, unknowingly, exaggerates the problem to which they have dedicated themselves.

History

 

An Insight

 

I see wonderful things

 

Data Talks

 

The Study, Ardilea, North Berwick, Scotland, 1917 by Patrick William Adam

The Study, Ardilea, North Berwick, Scotland, 1917 by Patrick William Adam 




























Click to enlarge.

Tuesday, April 25, 2023

Beware of Generalizing from One Group to Another

Factfulness by Hans Rosling, Ola Rosling, and Anna Rosling Ronnlund.  Page 162.  

Beware of Generalizing from One Group to Another

I once used to believe and promote a fatally incorrect generalization that cost 60,000 lives. Some of those lives could have been saved if the public health community had been keener to question its misleading generalizations.

One evening in 1974, I was shopping for bread at a supermarket in a small Swedish town when I suddenly discovered a baby in a life-threatening situation. In a stroller in the bread aisle. The mother had turned her back and was busy deciding which loaf to buy. An untrained eye couldn’t see the danger, but fresh out of medical school, I heard my alarm bells go off. I restrained myself from running, to not scare the mother. Instead I walked over to the stroller as quickly as I could and I lifted up the baby, who was asleep on his back. I turned him over and put him down on his back. I turned him over and put him down on his tummy. The little fellow didn’t even wake up.

The mother turned toward me with a loaf in her hand, ready to attack. I quickly explained to her that I was a physician and I told her about the so-called sudden infant death syndrome and the new public health advice to parents: not to put sleeping babies on their backs due to the risk of suffocation from vomiting. Now her baby was safe. The mother was both scared and comforted. On trembling legs she continued her shopping. Proudly I completed my own purchases, unaware of my huge mistake.

During the Second World War and the Korean War, doctors and nurses discovered that unconscious soldiers stretchered off the battlefields survived more often if they were laid on their fronts rather than on their backs. On their backs, they often suffocated on their own vomit. On their fronts, the vomit could exit and their airways remained open. This observation saved many millions of lives, not just of soldiers. The “recovery position” has since become a global best practice, taught in every first-aid course on the planet. (The rescue workers “saving lives after the 2015 earthquake in Nepal had all learned it.)

But a new discovery can easily be generalized too far. In the 1960s, the success of the recovery position inspired new public health advice, against most traditional practices, to put babies to sleep on their tummies. As if any helpless person on their back needed just the same help.

The mental clumsiness of a generalization like this is often difficult to spot. The chain of logic seems correct. When seemingly impregnable logic is combined with good intentions, it becomes nearly impossible to spot the generalization error. Even though the data showed that sudden infant deaths went up, not down, it wasn’t until 1985 that a group of pediatricians in Hong Kong actually suggested that the prone position might be the cause. Even then, doctors in Europe didn’t pay much attention. It took Swedish authorities another seven years to accept their mistake and reverse the policy. Unconscious soldiers were dying on their backs when they vomited. Sleeping babies, unlike unconscious soldiers, have fully functioning reflexes and turn to the side if they vomit while on their backs. But on their tummies, maybe some babies are not yet strong enough to tilt their heavy heads to keep their airways open. (The reason the prone position is more dangerous is still not fully understood.)

It’s difficult to see how the mother in the bread aisle could have realized I was putting her baby at risk. She could have asked me for evidence. I would have told her about the unconscious soldiers. She could have asked, “But dear doctor, is that really a valid generalization? Isn’t a sleeping baby very different from an unconscious soldier?” Even if she had put this to me, I strongly doubt I would have been able to think it through.

With my own hands, over a decade or so, I turned many babies from back to tummy to prevent suffocation and save lives. So did many other doctors and parents throughout Europe and the United States, until the advice was finally reversed, 18 months after the Hong Kong study was published. Thousands of babies died because of a sweeping generalization, including some during the months when the evidence was already available. Sweeping generalizations can easily hide behind good intentions.

I can only hope that the baby in the bread aisle survived. And I can only hope that people are willing to learn from this huge public health mistake in modern times. We must all try hard not to generalize across incomparable groups. We must all try hard to discover the hidden sweeping generalizations in our logic. They are very difficult to discover. But when presented with new evidence, we must always be ready to question our previous assumptions and reevaluate and admit if we were wrong.

History

 

An Insight

 

I see wonderful things

 

Data Talks

 

Portrait of the Maselli family, c 1605 by Lavinia Fontana

Portrait of the Maselli family, c 1605 by Lavinia Fontana



















Click to enlarge.

Monday, April 24, 2023

Each swine flu death received 82,000 times more attention than each equally tragic death from TB.

Factfulness by Hans Rosling, Ola Rosling, and Anna Rosling Ronnlund.  Page 133.

Tuberculosis and Swine Flu

It is not only bears and axes that the news media gets out of proportion.

In 1918 the Spanish flu killed around 2.7 percent of the world population. The risk of an outbreak of a flu against which we have no vaccine remains a constant threat, which we should all take extremely seriously. In the first months of 2009, thousands of people died from the swine flu. For two weeks it was all over the news. Yet, unlike with Ebola in 2014, the number of cases did not double. It did not even go up in a straight line. I and others concluded this flu was not as aggressive as the first alarm had indicated. But journalists kept the fear boiling for several weeks.

Finally I got tired of the hysteria and calculated the rate of news reports versus fatalities. Over a period of two weeks, 31 people had died from swine flu, and a news search on Google brought up 253,442 articles about it. That was 8,176 articles per death. Over the same two-week period, I calculated that roughly 63,066 people had died of tuberculosis (TB). Almost all these people were on Levels 1 and 2, where TB remains a major killer even though it can now be treated. But TB is infectious and TB strains can become resistant and kill many people on Level 4. The news coverage for TB was at a rate of 0.1 article per death. Each swine flu death received 82,000 times more attention than each equally tragic death from TB.

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Morning by Melissa Scott Miller

Morning by Melissa Scott Miller
























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Sunday, April 23, 2023

It seems obvious when you compare the numbers.

Factfulness by Hans Rosling, Ola Rosling, and Anna Rosling Ronnlund.  Page 132.

Mari Larsson was 38 years old when she was killed by multiple blows to the head from an axe. It was the night of October 17, 2004. Mari’s former partner had broken into her house in the small town of Piteå in the north of Sweden and was waiting for her to come home. The tragic and brutal murder of a mother of three was barely reported in the national media and even the local newspaper gave it only modest coverage.

That same day a 40-year-old father of three, also living in the far north of Sweden, was killed by a bear while out hunting. His name was Johan Vesterlund and he was the first person killed by a bear in Sweden since 1902. This brutal, tragic, and, crucially, rare event received massive coverage throughout Sweden.

In Sweden, a fatal bear attack is a once-in-a-century event. Meanwhile, a woman is killed by her partner every 30 days. This is a 1,300-fold difference in magnitude. And yet one more domestic murder had barely registered, while the hunting death was big news.

Despite what the media coverage might make us think, each death was equally tragic and horrendous. Despite what the media might make us think, people who care about saving lives should be much more concerned about domestic violence than about bears.

It seems obvious when you compare the numbers.

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The dancer, 1917 by Gustav Klimt

The dancer, 1917 by Gustav Klimt




























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Saturday, April 22, 2023

The cruel reality of trade-off decision-making - focusing on 98.7% rather than 1.3%

Factfulness by Hans Rosling, Ola Rosling, and Anna Rosling Ronnlund.  Page 126

The child mortality rate of Mozambique was then 26 percent. There was nothing special about Nacala district, so we could use that figure. The child mortality rate is calculated by taking the number of child deaths in a year and dividing it by the number of births in that year.

So if we knew the number of births in the district that year, we could estimate the number of child deaths, using the child mortality rate of 26 percent. The latest census gave us a number for births in the city: roughly 3,000 each year. The population of the district was five times the population of the city, so we estimated there had probably been five times as many births: 15,000. So 26 percent of that number told us that I was responsible for trying to prevent 3,900 child deaths every year, of which 52 happened in the hospital. I was seeing only 1.3 percent of my job.

Now I had a number that supported my gut feeling. Organizing, supporting, and supervising basic community-based health care that could treat diarrhea, pneumonia, and malaria before they became life-threatening would save many more lives than putting drips on terminally ill children in the hospital. It would, I believed, be truly unethical to spend more resources in the hospital before the majority of the population—and the 98.7 percent of dying children who never reached the hospital—had some form of basic health care.

So we worked to train village health workers, to get as many children as possible vaccinated, and to treat the main child killers as early as possible in small health facilities that could be reached even by mothers who had to walk.

This is the cruel calculus of extreme poverty. It felt almost inhuman to look away from an individual dying child in front of me and toward hundreds of anonymous dying children I could not see.

I remember the words of Ingegerd Rooth, who had been working as a missionary nurse in Congo and Tanzania before she became my mentor. She always told me, “In the deepest poverty you should never do anything perfectly. If you do you are stealing resources from where they can be better used.”

Paying too much attention to the individual visible victim rather than to the numbers can lead us to spend all our resources on a fraction of the problem, and therefore save many fewer lives. This principle applies anywhere we are prioritizing scarce resources. It is hard for people to talk about resources when it comes to saving lives, or prolonging or improving them. Doing so is often taken for heartlessness. Yet so long as resources are not infinite—and they never are infinite—it is the most compassionate thing to do to use your brain and work out how to do the most good with what you have.

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Diogenes, 1882 by John William Waterhouse (English, 1849–1917)

Diogenes, 1882 by John William Waterhouse (English, 1849–1917)
































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Potato Patch, 1952 by Stanley Spencer

Potato Patch, 1952 by Stanley Spencer




















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Friday, April 21, 2023

These 1,600 people died because they escaped.

Factfulness by Hans Rosling, Ola Rosling, and Anna Rosling Ronnlund.  Page 115.

So the fear instinct can sure help to remove terrible things from the world. On other occasions, it runs out of control, distorts our risk assessment, and causes terrible harm.

Eight miles underwater, on the seafloor of the Pacific Ocean just off the coast of Japan, a “seismic slip-rupture event” took place on March 11, 2011. It moved the Japanese main island eight feet eastward and generated a tsunami that reached the coast one hour later, killing roughly 18,000 people. The tsunami also was higher than the wall that was built to protect the nuclear power plant in Fukushima. The province was flooded with water and the world’s news was flooded with fear of physical harm and radioactive contamination.

People escaped the province as fast as they could, but 1,600 more people died. It was not the leaking radioactivity that killed them. Not one person has yet been reported as having died from the very thing that people were fleeing from. These 1,600 people died because they escaped. They were mainly old people who died because of the mental and physical stresses of the evacuation itself or of life in evacuation shelters. It wasn’t radioactivity, but the fear of radioactivity, that killed them. (Even after the worst-ever nuclear accident, Chernobyl in 1986, when most people expected a huge increase in the death rate, the WHO investigators could not confirm this, even among those living in the area.)