Friday, June 25, 2021

Overdoses are up political interest is down

Needlessly racialized but dealing with a topic which should be dominating our national politics but which only receives an occasional reference.  Deaths from drug overdoses, disproportionately from Chinese manufactured fentanyl.  From In pandemic, drug overdose deaths soar among Black Americans by Claire Galofaro.

We have a lot of vociferous and contentious debate about gun violence (some 19,000 deaths per year).  This is a popular partisan debate.  We have a little discussion about the rising suicide rate (45,000).

And we have virtually no discussion about the 92,000 overdose deaths in 2020.  Up from 52,000 in 2015.  The rise has been inexorable year-by-year and largely due to fentanyl.

Just as crack cocaine and heroin deaths were largely associated with the black community, fentanyl overdoses have so far been largely concentrated in the white population.  But that now seems to changing.

It was September, and as the COVID-19 pandemic intensified America’s opioid addiction crisis in nearly every corner of the country, many Black neighborhoods like this one suffered most acutely. The portrait of the opioid epidemic has long been painted as a rural white affliction, but the demographics have been shifting for years as deaths surged among Black Americans. The pandemic hastened the trend by further flooding the streets with fentanyl, a potent synthetic opioid, in communities with scant resources to deal with addiction.

In the city of St. Louis, deaths among Black people increased last year at three times the rate of white people, skyrocketing more than 33%. Black men in Missouri are now four times more likely than a white person to die of an overdose.

There is a lot of blather attempting to make this a race issue instead of the human tragedy it is.  There are no points for having the higher addiction rates or overdoses.  Galofaro outlines a timeline which seems plausible but which I have not seen laid out so cleanly before.  

Some researchers believe the nation is entering a fourth wave. The drug supply is so messy and unpredictable that people overdosing have multiple drugs in their system: dangerous cocktails of fentanyl, a depressant, and stimulants like cocaine and methamphetamine.

Maybe.  The unexpected disruption of drug supply chains owing to Covid restrictions leading to increased overdoses due to unfamiliarity with the product quality is an intriguing insight.  

A lot of illicit fentanyl is manufactured in Wuhan, China, where COVID-19 was first unleashed. Lockdowns initially disrupted the supply, said Vanda Felbab-Brown, a Brookings Institute fellow who studies trafficking.

In St. Louis, the drug trade became even more chaotic: People who used to know where their drugs were coming from no longer did. Fentanyl for a time was hard to find, and some turned to less-potent heroin.

But the Chinese laboratories rebounded and resumed shipping the chemicals to Mexico, where cartels process them, Felbab-Brown said. Pandemic border closures presented cartels with added incentive to traffic fentanyl: It is incredibly potent and profitable. The equivalent of a trunkful of heroin or cocaine can be carried across the border in a small suitcase.

And here is the rub.  Why are we not talking about the tragedy and impact of the loss of nearly 100,000 people a year and instead focus our political energies on controlling long guns which account for 750-1,000 of gun deaths.  All our time on 1,000 nearly no time on the 100,000 are dying from dug overdoses.  

My guess is that this is a partisan problem where both parties have backed themselves in untenable positions.  The Republicans are most associated with the get tough on crime strategies of the late nineties when violent crime peaked.  It has plummeted since then.  Did broken windows policing and three-strikes legislation cause the decline?  The correlation is clear and strong but the causation a little more unclear.

The two approaches drove down violent crime but never really "solved" drug addiction.  That is a third rail which no one wants to touch because there don't seem to be clearly effective solutions which are also politically expedient for either party.  

I don't think the Republicans want to be associated with the Just Say No days though they do campaign on tough on crime.  

For Democrats it is as nasty briar patch as for Republicans.  They are famously weak on crime which doesn't play well in an era of rising crime.  The racializing of the drug overdose catastrophe also complicates the management of their various factions.  They don't want to be seen to be over-solicitous of white victims when blacks were the clear victims of the three-strikes legislation which many Democrats supported.

And for both parties there is the China card.  As Afghanistan is a primary source of opium, it appears that China is the global leader in provision of fentanyl.  If true, and data is underreported, then it has been a markedly successful war on the US.  Six divisions of Americans are dying each year without China doing anything particularly overt.  The US lost less than a third of a division during the entirety of the Normandy Landings.  

And for either policy, while dealing with China's Pacific ambitions, trying to get cooperation on Covid-19 origins, cybersecurity attacks, patent theft, etc. why would you want to throw Fentanyl into the mix of issues to be dealt with?

For most people it is obvious - Because it is killing nearly 100,000 Americans a year.  For politicians it is less obvious.  The War on Drugs is tainted.  The probability of cooperation from China low.  The possibility of being besmirched from a race angle is increasing.  The 100,000 deaths are underrepresented among the Mandarin Class.  Why invest political capital? is, I suspect, a self-answering negative.

As an ordinary American I feel incredibly frustrated by the lack of seriousness and humanity among some of the key members of our two major parties.  Yes, it is a hard problem and could be politically ruinous to any individual politician.  But it is already ruinous to 100,000 Americans each year.  


When your priors determine what the answer must be

Not much new information in this piece but a useful recapitulation of what has long been known.  From The Complex 50-Year Collapse of U.S. Public Transit by Tony Frangie Mawad.

Back in 1970, 77 million Americans commuted to work every day, and 9% of them took a bus or a train. By 2019, the number of U.S. workers had nearly doubled, to more than 150 million. But the vast majority of these new workers chose to drive: The number of public transit riders increased by only around 1 million during those years, and their share of the country’s overall commuters collapsed to 5%. 

That historic shift reflects several broad trends in U.S. life, including suburbanization patterns and urban highway expansion, the growth of the car-friendly Sunbelt, and the depopulation of once-robust industrial cities. But fundamentally, the fading usefulness of public transit is a result of the fundamental lack of integration between federal transportation and land-use authorities, says Yonah Freemark, a senior research associate with the Urban Institute.

“In a number of other countries, the Department of Transportation and the Department of Housing and Urban Development are combined in one entity,” he says. “In the United States, we ended up with two different entities.” As a result, housing and mobility needs have been poorly aligned; the landscape is laden with housing that lacks access to public transportation, light rail lines that course through sparsely settled areas, and too many cities whose transit networks can’t connect riders with jobs.  

Missing from the entire article is that these outcomes may reflect 1) citizen choices, and 2) rising citizen prosperity so that they can make better trade-off decisions than before.

Also missing from the article is any history before 1970.  In the 1950s-1960s, most urban bus transport was provided by private companies.  There is no doubt that it was a competitive industry but it is also striking that public transportation ridership declines in the same period when the only choice was public transport.   

Also interesting Mawad buys into the idea that this is primarily a Federal institutional issue (Transportation and HUD) versus an issue of customer choices and preferences.  

Additionally striking is that Mawad does not discuss costs and, in particular, Federal, State, and Local subsidies which have a huge impact on ridership.  

This unequal pattern of transit commuting is even more acute when the share of commuters is taken into account. In New Orleans, for example, nearly a quarter of residents got to work via bus and streetcar in 1970. By 2019, only about 5% did. Similar drops are seen in smaller industrial cities like Buffalo, Richmond, Cleveland and Milwaukee. “In the 1970s, use of public transportation was really common in cities all across the country no matter their size,” says Freemark. Now, widespread transit commuting is a phenomenon limited largely to large coastal metropolitan areas. “Other regions don’t have realizable public transportation people can depend on.”

The lack of awareness of a market for ridership shows up again:

Cities where transit use has seen massive reductions tend to be those that have endured deindustrialization and suburbanization during the last 50 years, with a concurrent rise in investments in highways designed to shuttle car-driving commuters in and out of town. “These used to be places that had really successful downtowns, but now most of their workforce has suburbanized,” says Freemark.

The profoundly unequal geography of U.S. transit reflects — and contributes to — the economic gaps that have grown between cities; as struggling metros have shed jobs and wealth, their ability to maintain useful transit systems has likewise declined. “Most money that goes for transportation comes from state and local governments, and their ability to invest is based on their resources,” says Freemark. Poorer regions don’t have enough income to invest in transit, which in turn hampers economic growth even more. “It’s a negative spiral, a vicious cycle; there’s a trap situation going on.”  

Click to enlarge.

The closing paragraph is laden with unstated assumptions which drive the tone of his piece.

Not every region has the means to make the kind of transit investments that would be needed to bring riders back to their 1970 levels, and there’s no question that reversing the effects of a half-century of transit-unfriendly land-use decisions is a tall order. But it’s also increasingly urgent, given the role of car-centric planning in boosting greenhouse gas emissions. “The federal government could play an important job filling the gap” between wealthy and struggling cities, says Freemark. “But they haven’t done that yet.”

The questions unasked include

Why are people abandoning public transportation?

Why do they prefer car-centric transportation?

How do the different modes of transport compare to one another when all hidden subsidies are removed?

Mawad assumes that everyone agrees we need to control greenhouse emissions,  that use of public transportation in the 1970s represents some golden period of citizen need satisfaction, that the low use of public transportation is entirely due to land use decisions. 

Without answering the three questions above, Mawad will never unlock the supposed puzzle in his final paragraph.  


History

 

An Insight

 

It mattered not from whence it came; but all agreed it was come into Holland again.

A couple of years ago, I pulled down my copy of Daniel Defoe's A Journal of the Plague Year to read.  As frequently happens,  I read several pages and then it drifted downwards in the stacks by my bed.  

When Covid-19 descended on us, I surfaced it and read some more but then once again business and research pressures pushed it downwards.  Owing to a couple of foot surgeries over the past twelve months, I have not been upstairs at all; out of sight out of mind.  

Then, for no apparent reason, it crossed my mind.  I am sufficiently far along in my recuperation that I can, with time and exaggerated care, manage the stairs.  I retrieved the Journal to match it up to our 2020-2021 experience with Covid-19.

Daniel Defoe was only five years old at the time of plague which hit London and England in 1665 but the book was published fifty-seven years after the event.  From Wikipedia:

A Journal of the Plague Year is a book by Daniel Defoe, first published in March 1722. It is an account of one man's experiences of the year 1665, in which the bubonic plague struck the city of London in what became known as the Great Plague of London, the last epidemic of plague in that city. The book is told somewhat chronologically, though without sections or chapter headings, and with frequent digressions and repetitions.

Presented as an eyewitness account of the events at the time, it was written in the years just prior to the book's first publication in March 1722. Defoe was only five years old in 1665 when the Great Plague took place, and the book itself was published under the initials H. F. and is probably based on the journals of Defoe's uncle, Henry Foe, who, like 'H. F.', was a saddler who lived in the Whitechapel district of East London.

In the book, Defoe goes to great pains to achieve an effect of verisimilitude, identifying specific neighbourhoods, streets, and even houses in which events took place. Additionally, it provides tables of casualty figures and discusses the credibility of various accounts and anecdotes received by the narrator.

The book is often compared to the actual, contemporary accounts of the plague in the diary of Samuel Pepys. Defoe's account, which appears to include much research, is far more systematic and detailed than Pepys's first-person account.

Scholars have wrestled with whether A Journal of the Plague Year should be considered autobiography, non-fiction history, fiction or historical fiction.  Regardless of the debate, it is consistent with all the known facts established from contemporary accounts and from the recollections later of those who experienced it.  Probably best considered in Truman Capote's words about his own work, a nonfiction novel.

I have begun rereading from the start to see where the experiences of 1665 mirror those of 2021.  I had intended to read the whole thing before commenting but there are too many examples to let them all slide by.

Some of the terminology is different as is the context but you can see the same basic human interaction with an ill understood calamity.  1665 is just barely at the beginning of the Age of reason but you can see much Age of Reason thinking in the text.

For example, the opening paragraph is all about the origins of the plague.

It was about the beginning of September, 1664, that I, among the rest of my neighbours, heard in ordinary discourse that the plague was returned again in Holland; for it had been very violent there, and particularly at Amsterdam and Rotterdam, in the year 1663, whither, they say, it was brought, some said from Italy, others from the Levant, among some goods which were brought home by their Turkey fleet; others said it was brought from Candia; others from Cyprus. It mattered not from whence it came; but all agreed it was come into Holland again.

Where's it from?  

Check -  a major preoccupation today.  

Wet markets or Wuhan Institute of Virology?  Today, the question has somewhat greater pertinence because the origin both influences our view on how to tackle it but also helps us to interpret what happened and why.  If manmade, then that is suggestive of how we research it.  If from China, it allows us to interpret China's behaviors and actions as, or not, a good faith international actor.



I see wonderful things

 

Offbeat Humor

 

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Data Talks

 

Beach walk by Timothy Easton (b. 1943)

Beach walk by Timothy Easton (b. 1943)

Click to enlarge.

Thursday, June 24, 2021

Only 29% of Americans trust the news media. Which seems high, given the actual performance.

From Digital News Report 2021.  The headline is that the USA has the least trust of its media among 46 countries, including most those in the developed world.  Only 29% of Americans trust the news media.

If you were to strip out registered Democrats, I am guessing that that number might only be 10%.

W hich raises two questions - Do others have better and more reliable news and we are just too cynical? OR Do others have better and more reliable news and we are just underserved? OR Are all the the news sources around the world equally unreliable and only American consumers have cottoned on to just how bad it is?

Of the forty-six countries, in only fifteen do the majority of the population trust the news media.  In another fifteen countries, fewer than a third of the population trusts the news.  

In a connected world generating complex answers to difficult questions, it is a pity that there are ever fewer reservoirs of trusted information.  We could do with some trustworthy, reliable answers from trustworthy, reliable sources.