Sunday, March 31, 2013

Better condoms and bacon condoms

Photo credit:
The makers of vegetarian products that taste like bacon now sell bacon condoms (slogan: "make your meat look like meat").  Probably an April Fools joke, but perhaps this is what Bill Gates had in mind as the next-generation condom that would be more widely acceptable.  Could bacon condoms prevent HIV transmission in Africa? 

Friday, March 29, 2013

Red herrings in abortion

Florida is considering another abortion restriction bill.  During the hearing, they asked what happens if a live baby is born as the result of an abortion.  The answer has raised accusations of infanticide, which is a red herring.

Before 24 weeks, the fetus wouldn't be viable.  After 24 weeks, abortion is exceedingly rare:  only 1.3% of all abortions are after 21 weeks, and even fewer after 24 weeks. 

Abortion after 24 weeks is illegal in Florida unless two doctors approve and agree that the abortion is medically necessary, which is unconstitutional.  No woman is having an abortion after 24 weeks unless the fetus is unlikely to survive in any case.  This particular "born alive" red herring has been used for over a decade, most recently against President Obama in his elections in 2004 and 2008 because he opposed a similar bill in Illinois.  This medical care for accidental babies issue just hurts women facing already difficult and often traumatic circumstances.

Manufacturing dissent

Ezra Klein quotes from the American Sociological Association's statement on gay parents to contradict Scalia's statement that sociologists disagree about whether gays make good parents.  I think that he could go one further.  Scalia is probably taking Mark Regnerus's recent study as evidence of dissent within sociology.  Problems with Regnerus's study have been covered extensively, due to the e.g., defining gay parents as parents who have ever had a same-sex relationship, no matter how short-lived, as well as the conservative funding sources. The right comparison is obviously between children of stable same-sex and stable opposite-sex relationships, rather than between children of unstable same-sex and children of stable opposite-sex relationships. 

Scalia may hold a view common among conservatives that academic consensus derives more from liberal bias than from knowledge, so are only interested in findings contrary to liberal views.  Like many, I would call that cherry-picking, but conservatives seem to regard it as a necessary corrective.  It's a huge problem, and it's why there seems to be a red reality and a blue reality.

Two similar examples in my research areas:

Out of ~12 studies on virginity pledges, 2 find that pledges work, and those are the ones quoted by conservatives, especially because the first study found that pledges work (Bearman and Bruckner 2001 in American Journal of Sociology).  I reanalyzed B&B's data using better methods and found pledges didn't work. 

Out of hundreds or thousands of studies on condoms' effectiveness in preventing STIs, one prominent study (Zenilman 1995) found that people who reported condom use still got STIs.  Zenilman concluded that the subjects had over-reported their condom use; right-wingers said the study proved condoms don't work, which resulted in CDC being ordered to remove information about condoms from their website during the Bush administration. 

The biggest examples are global warming and Keynesian economics.  In red reality, the 0.3% of scientists who "don't believe" in global warming matter more than the 99.7% who do, and Scalia's discounting of the academic consensus on gay marriage is just the tip of the melting iceberg. 

Friday, March 22, 2013

Men's reproductive choices: children and rape

photo credit: bondidwhat via cc
A father discovers birth control, and wants to keep using it to limit his family size to five (five!).  His wife wants more children, but will please her husband by refraining from more children.  He goes to the rabbi, expressing anxiety about providing for more than five children, and the rabbi says that money comes from heaven.  When he lies, and says that his wife is stressed out with five children, the rabbi allows birth control.

I love how this story makes five children seem so natural, like a small number, when that's more children than most people would ever consider.

The idea that someone could not know about birth control is strange to me, and I wonder if he's exaggerated his story, or told it in a way that parallels the stories we've heard so often about women's constrained reproductive choices.  Chassidic men's lives are often more sheltered than chassidic women's, but are they really so sheltered not to know that most people in American society have fewer than 3 children?  He had access to the internet, so how could he have gone so long not knowing about birth control?  

Meanwhile, in evangelical 9th grade English teacher has an important piece on how she taught her students not to rape.  The classroom dynamic seemed to change from initial doubt that high school athletes close to their age could be rapists and that consent was always necessary, to a clear recognition of these facts among most in the class.   It's easy to speak about these issues in the abstract.  I'm so grateful that courageous teachers raise these issues again and again, when it's still possible to impact adolescents' thoughts.  I'm grateful that my teachers did. 

Thursday, March 21, 2013

Financial difficulties in obtaining community college certificates

Credit:  CarbonNYC
Community colleges are famous for offering second chances to people who have had disadvantages and set-backs.  Community colleges have been the institution most responsible for expanding college access to disadvantaged youth, and today about a third of college students under age 25 are enrolled in community college.

Certificates seem to be more attainable than degrees because they require fewer credits while offering real job skills; I'm currently doing research on that topic.  The NY Times just published a story about how financial aid is often unavailable to students seeking non-degree certificates.

The story is comprehensive, and I won't rehash it here, but parts of it surprised me.  I knew that employers required certificates in many new areas where there was no tradition of training employees on the job, such as information technology.   I had not realized how many traditional jobs --- police officers, fire fighters, and machinists --- had stopped training employees and required potential employees to obtain certificates in advance.  These employers are not social service agencies, and it may make financial sense for them to cut costs by outsourcing employee training to an outside entity.  Until funding for certificate programs becomes available, the most disadvantaged people are prevented from entering these fields. 

The reason that the government doesn't offer financial aid for certificate programs is because of the presumption that certificates don't prepare students for jobs.  Now that we know that some certificate programs prepare people for good jobs --- some of which are higher paying than BAs --- we ought to give financial aid for the programs.  But which programs?  All programs?  Carnevale in this article suggests that, given our limited funds, funding should go to job-relevant certificates instead of to 4 year English bachelors degrees.  While sensible, that rule may not be practical to implement.   How could a bank or the federal government determine which credentials might lead to good jobs, and which ones will not?

Federal educational loan default rates are extremely low, under 10%.  The government may even make a small profit on its educational loan program.  The federal government could easily cover the cost of expanding its loan program to cover certificates, and provide information about certificates similar to what it publishes about degree programs.  Expanding federal financial aid to community college certificates would be a worthwhile investment in our country's human capital, and also help disadvantaged adolescents and young adults transition into the labor force.  

Wednesday, March 20, 2013

Researchers surprised that whole milk might be healthier than skim

My favorite milk lately.
A recently published study analyzing the ECLS-B dataset found that children who drink whole milk are less likely to be overweight than children who drink skim.  The researchers said that they were surprised by their finding, as they had expected the opposite, and several researchers poo-pooed the findings, suggesting that probably fat kids were put on low-fat milk, rather than vice-versa. 

Which surprised me, given how surprised researchers in a 2005 study were at a similar finding for children.  

I don't see what's so surprising.  A hundred years ago, a livestock fattening manual said, "Skim milk is one of the most valuable adjuncts of the farm for fattening swine" and that the results were particularly good when fed with cornmeal.  There's a prevalent view that a non-sugar cereal such as cornflakes with skim or low-fat milk is a healthy breakfast, but what if it's not?  

I've looked at milk choice in other nationally representative datasets, and I found milk choice heavily confounded by socioeconomic status.  That's what surprised me the most about this study, that the socioeconomic effects didn't overwhelm the effects of the milk.  The highest socioeconomic status groups are most likely to follow prevalent nutrition advice, but they're also likely to be much healthier, making it hard to tell whether the prevalent nutrition advice is counterproductive. 

Friday, March 15, 2013

When politics turn personal

A Republican senator now favors gay marriage because his son is gay.

He framed his reaction in terms of equality of opportunity: ""It allowed me to think of this issue from a new perspective, and that's of a Dad who loves his son a lot and wants him to have the same opportunities that his brother and sister would have."

The story is similar to how one of the legislators who blocked a bill that would legalize abortion in Indiana later came to my grandfather (a pediatrician), asking for a referral to an illegal abortion for his 16 year old pregnant daughter.  Naturally this politician wanted to ensure that his daughter had the opportunities to succeed, in spite of any mistakes she may have made. 

Same-sex marriage is a wonderful example of where John Rawls' concept of the veil of ignorance applies:  we don't know whether our children will want to marry someone of the opposite sex or same sex, but we all want them to have the opportunity to marry.

About 3-5% of children of conservative politicians are likely to want to marry the same sex --- the same as in the general population --- so we may continue to see evolution like this on same-sex marriage.

It's too bad that conservative politicians are unlikely to have the same experiences for social policy.  Now that social mobility in the US is at a stand-still, the children born in the top quintile of income are likely to end up there themselves, and likewise for the bottom quintile.  Few policy makers make decisions informed by the personal experiences of people who are disadvantaged by the current system.  They are unlikely to know adults trying to support a household on minimum wage, and may truly believe that health and economic disparities are due to personal failings.

About 3-5% of the US population is gay, and aside from some predictors (e.g., having older brothers), gayness is more-or-less randomly assigned.  Not even 3% of children makers are randomly assigned to be socially disadvantaged.  If they were, we would have a situation paralleling Rawls's veil of ignorance, and we might have fewer social disparities.

Hooray for planning

Two years ago, in late March 2011, I gave a talk at the Society for Adolescent Medicine (SAM) in Seattle and flew immediately afterwards to the Society for Research on Child Development (SRCD) in Montreal.  The two conferences were always the same week, often across the country from each other.  SRCD is biannual, and alternates with a similar adolescent-specific conference (Society for Research on Adolescence, SRA.)  This year is no exception: the conferences are the same week in Seattle and Atlanta. 

Just noticed that next year the Society for Adolescent Medicine and Society for Research on Adolescence are still meeting during the same week, but finally holding their conferences in the same city.  It will be the 14th biannual SRA conference --- did it really take them 26 years to figure out this solution? 

Friday, March 8, 2013

Conservatives go soft on crime

photo credit: Chris Devers via photopin cc
For decades, liberals have said that the American criminal justice system is counter-productive.  Minorities and the poor are more likely to be arrested and convicted, and they are imprisoned for longer than comparable white-collar criminals.  The US's highly punitive criminal justice system stigmatizes already marginalized Americans, makes them unable to obtain legitimate employment, and further reduces their changes of social mobility.

My public health concern with prison --- beyond the obvious exposure to violence and disease in prison --- has been gender ratios: with 1/9 young black men incarcerated at any given time, and 1/3 of black men  in their life time, prison has reduced the number of marriageable black men, giving more leverage in the dating market among those remaining, and promoted the spread of HIV.  The increased practice of trying minors as adults has worsened the problem by sending adolescents to adult jails, where they are often victimized, traumatized, and permanently stigmatized. 

Conservatives have lead the charge towards these "tough on crime" policies.  Now some prominent conservatives including Grover Norquist seem to have just realized the enormous social and economic costs of this destructive and highly punitive approach.  The introduction of the article was promising because it noted all of the social and economic costs of prison, including the generations of unemployable men spit out by the prison system, but the authors seem more concerned with reducing the fiscal burden of imprisonment on states than the economic burden on society caused by the waste of human capital.  I was even more disappointed by the partisan slant of the article.  As if to make up for their almost liberal introduction, the authors claim that liberals are at fault, in opposite directions:  1960s liberals "ignored" crime and considered law-enforcement "pointless"; unions (prison guards) caused mass imprisonment; and Republican governors are leading innovation in reducing prison costs, although they did feature a policy by liberal state Hawaii.

The American Conservative has been refreshing in its relative lack of partisanship.  As happy as I was to see a conservative article noting the real problems with our punitive society --- and I am glad that we can all agree that this is a problem --- I was disappointed by its finger-pointing approach.  Many factors have led the US to imprison more of its citizens than any country in history, and it will take a great deal of effort --- including reducing partisan cheap-shots such as "soft on crime" labels --- to dig ourselves out of this hole. 

Tuesday, March 5, 2013

Seatbelts not only save lives --- they prevent tragedies

photo credit: AlamosaCountyPublicHealth via photopin cc
Everyone in the New York area has by now heard the tragic story of a young pregnant couple killed on their way to the hospital when their car was hit from the side by a hit-and-run driver (now identified as someone with an arrest record including recently driving under the influence of alcohol, but it's still unknown who was at fault.) The baby was delivered but sadly died because he was only 6 months gestation.  As tragic as this story is, the real tragedy is that the woman and possibly her husband and child might be alive today if they had been wearing seatbelts.

The couple was being driven in a 2008 Toyota Camry, a very safe car, but the woman was thrown from the car, meaning that she could not have been wearing a seatbelt.  The IIHS ratings for this car for a side impact give this car this highest rating for both passengers and drivers, and the driver walked away relatively unharmed.  Seatbelts reduce by half the risk of mortality from motor vehicle accidents, and certainly prevent passengers from being thrown from vehicles.

This couple was not alone in not wearing seatbelts in the backseat of a taxi, which is all-too-common behavior, although illegal in New York State.  Police are even allowed to stop cars for seatbelt non-use, but only drivers and front seat passengers can be ticketed.

A paper published last year in the journal Injury Prevention notes that the press often labels events as "freak accidents."  People mourn accidents, but journalists afraid of being seen as blaming the victims fail to communicate that many accidents could be prevented.   

Few accidents are truly freak accidents.  Many injuries, deaths, and tragedies can be prevented through sensible precautions, including wearing seatbelts.  There is no excuse not to wear a seatbelt, ever, even riding in a taxi.  New York State should expand its seatbelt laws to allow ticketing passengers.  If all passengers consistently wore seatbelts, we would have many fewer such tragedies. 

Friday, March 1, 2013

Lead in chicken broth?

After the lead and crime article in Mother Jones last month, I've been more aware of lead in the environment.  Perhaps that is why a paper finding lead in organic chicken stock in the journal Medical Hypotheses alarms me, at least slightly and hypothetically.  The researchers found concentrations of 9.5 mcg/L and 7 mcg/L, still below the EPA's "action level" of 15 mcg/L for drinking water, but the EPA in the same publication says that no concentration of lead is acceptable:  i.e., the goal level concentration is zero. 

As is the nature for a hypothesis-generating publication, the study used only one batch of chicken stock of each type:  one with bones, one with skin and cartilage, and one with meat.  Perhaps they picked a bad chicken, or perhaps it is only chicken from the UK.  It's impossible to know without more tests.  People always ask us statisticians what would have happened if the sample size would have been larger, and it's important to remember that we're statisticians, not fortune-tellers:  we can't know what results would have been without having the actual results.  It's strange and frustrating that with 3 authors on the paper, they couldn't be bothered to get a few more chickens to test.  At least they did a control of plain water boiled for the same period of time, which found near-zero concentrations, under 1 mcg/L.  (Chicken meat broth by contrast was just over 2 mcg/L.)

The authors neglected to mention that the technique of saving bones for stock from every piece of meat you eat is almost universally recommended by cookbook authors including Melissa Clark and Nigella Lawson, to ensure that you always have stock available when it's called for.  Cookbooks say that there is no substitute for stock, and if you don't have stock around, use water rather than canned.  It's disappointing that there might be dangers from what is considered a best practice for cooking, not to mention one that I've just started following myself!  The lentil soup made from homemade beef stock was amazing, and one guest told us that he'd never tasted anything like it. 

I will still use the chicken stock in my freezer, but I'd be reluctant to continue this habit if pregnant or if I had children, given how dangerous lead is during critical formative periods. I do wish that the authors had gotten their act together to get at least an n=10 from geographically dispersed chickens.  How hard would that have been, seriously?