U.S. is getting sicker in all ways

I find my eyes turned southward more often these days, hardly surprising given that each day brings some new and usually revolting turn of events in the troubled U.S. (Today: Donald Trump picks Oklahoma Attorney General Scott Pruitt, whose state is currently suing the Environmental Protection Agency, to head the EPA).

But today's news brought unsettling news of another kind for Americans: Their life expectancy fell in 2015 for the first time in more than 20 years. And what marks this decline as different from the last one in 1993 is that it came after three years of flat-lined life expectancy - unusual in itself given that in the last 50 years, U.S. life expectancy has tended up until now to increase each year.

Overall life expectancy is now 78.8 in the U.S. Break that 0.1 per cent drop down and what it means in real terms is that Americans are now living one month less on average - and if they're men, two months less.

While the thought of living one month less may not seem like a troubling detail in the grand scheme of a life, it's the demographic trends and the  kinds of things that are killing Americans that ought to be sending up the red flags. Death rates have risen for eight of the 10 leading causes of death in the U.S.: Heart disease (0.9% rise), chronic lower respiratory diseases (2.7%), unintentional injuries (6.7%), stroke (3%), Alzheimer's disease (15.7%), diabetes (1.9%), kidney disease (1.5%) and suicide (2.3%).

A number of those eight causes are related to health conditions that have been on the rise year after year in the States. Diabetes rates are soaring; some 29 million Americans now have the chronic disease - more than nine per cent of the population - compared to 1.6 million in 1958. More than 95 per cent of those cases involve Type 2 diabetes, which is caused by lifestyle-related issues such as obesity and insufficient exercise.

Stroke rates have fallen among older Americans, but risen among younger ones. Americans born between 1965-74 - Generation X - have a 43 per cent higher chance of having a stroke than do Americans born 20 years earlier (1945-54) during what health researchers have dubbed "The Golden Generation."

And if all that isn't alarming enough, 2015 also brought a startling 11.4 per cent rise in accidental deaths of babies under the age of one. The majority died due to suffocation or accidental strangulation in their beds. In the BBC piece I linked to higher in this post, the medical director at Northwell Health's Huntington Hospital in New York said accidental deaths include car crashes, falls, suffocation and fires, but linked the rise in accidental infant deaths to "social stressors" such as financial pressures and addiction.

"The dramatic upswing in the use of opiates and narcotic use across our country is potentially a big factor in driving a phenomenon like accidental injury," he said. Like Canada, the U.S. has seen a staggering rise in opiate use and overdose deaths in the last few years, with a record 28,000 Americans dead from opiate overdoses in 2014 alone. (And check out the rising number of deaths from prescription drugs - frightening.)

The depth of the problems become even clearer when you look at how American health compares to health in other countries in the Organization for Economic Cooperation and Development (OECD) It now ranks 28th out of 45 countries - below the Czech Republic, Chile and Costa Rica.

Sadly, all the wealth in the world can't buy the U.S. out of this crisis. Its health-care costs per capita are among the highest in the world at $9,403, more than double the OECD average of $4,735. Next time someone tries to pitch you on the benefits of a privatized health-care system, remind them of that.

Is the lure of authoritarianism what got Trump elected?

I'm feeling rattled by Facebook, no longer sure if there's any point in sharing serious things there. It was the Trump election that did me in - things just got too weird. But then I see a story like this and I want to share it with people, because it's so damn interesting, so what can I do? When I want to be able to find something that I think is important enough that I'll probably want to track it down later when it's all coming true, I post it here.

The March 2016 piece in Vox  posits the theory that the U.S. is experiencing a rise in authoritarianism among its citizens, and that a guy like Donald Trump was pretty much the dream candidate for a period in time when this authoritarian tendency happens to be in full bloom.

"Authoritarians are thought to express much deeper fears than the rest of the electorate, to seek the imposition of order where they perceive dangerous change, and to desire a strong leader who will defeat those fears with force,"notes the article. 

"They would thus seek a candidate who promised these things. And the extreme nature of authoritarians' fears, and of their desire to challenge threats with force, would lead them toward a candidate whose temperament was totally unlike anything we usually see in American politics — and whose policies went far beyond the acceptable norms. A candidate like Donald Trump."

As you'll see in the piece, the people trying to figure out how to measure degrees of authoritarianism went with parenting questions. I've got no clue whether that's a valid comparison, but at the very least it does sort respondents into categories of people who think one way or the other. They're quite profound questions when you get to thinking about how you might answer them yourself as a parent.

Read the piece and weep, I guess. Personally, I'd hoped human rights, mutual respect and informed decision-making would get a longer run at being important issues, but things are not looking good for that line of thinking. I'm still struggling to know what to do about any of this, other than to talk about it with literally every person I've come in contact with since Trump got elected. I'm desperate to find pieces that help me understand at least a little more about how this can be happening, and this Vox piece was one of them. 

Information dumps as a tool to smother dissent

    This feels like an important piece. It's a New York Times commentary from Zeynep Tufekci, an associate professor at the University of North Carolina School of Information and Library Science who writes for the Times on occasion.

    Her point is that massive information dumps like the ones WikiLeaks is known for, one of which is currently making life miserable for U.S. presidential candidate Hillary Clinton, only look like strikes for freedom. In fact, they are tools for smothering dissent, says Tufekci. 

    "This method is so common in Russia and the former Soviet states that it has a name: kompromat, releasing compromising material against political opponents," she writes.

    "Emails of dissidents are hacked, their houses bugged, the activities in their bedrooms videotaped, and the material made public to embarrass and intimidate people whose politics displeases the powerful. Kompromat does not have to go after every single dissident to work: If you know that getting near politics means that your personal privacy may be destroyed, you will understandably stay away."

     Tufecki also notes the vast amount of collateral damage that a massive information dump causes. It's not just Hillary Clinton who is suffering. "Demanding transparency from the powerful is not a right to see every single private email anyone in a position of power ever sent or received. WikiLeaks, for example, gleefully tweeted to its millions of followers that a Clinton Foundation employee had attempted suicide; news outlets repeated the report."

     So yes, we live in an age where information is "free" in unprecedented ways. But what information? Made public by who, and for what purpose? Say what you will about mainstream media, but they did used to pay attention to such things. The wild and woolly world of wide-open public journalism has no such ethical base. 

The highs and lows of social media, as experienced through the issue I care most about

 
Social media is an interesting beast, most particularly for how each form appeals and responds to users in entirely different ways. This is fascinating stuff for us communications types.
     I’ve found kindred spirits on all three of the platforms I like best – Facebook, Twitter and Instagram. But they’re not the same kindred spirits. The people I want to know and connect with on one platform are not the same ones I want to connect with on others. The feel of each platform and the reasons for using them are so very different.
    Facebook, for instance, is the place where I’m most likely to connect with my real friends and family. It’s where I share photos of my grandkids, keep up-to-date on which of my acquaintances or cousins or whoever has gone travelling in Italy, had an injury, lost somebody close to them, taken their dog walking someplace cool, and so on – kind of like a virtual coffee shop for catching up with pals across time and distance on a personal level.
    What it’s significantly less good for, however, is for engaging people on the issue I care most about. I can draw 200 or more “likes” for a particularly charming photo of a dog we’re looking after or a new profile picture, but my posts about sex workers’ rights – the issue I feel most passionately about these days – routinely fare very poorly. I have a few Facebook friends who share my passion and can be counted on to like and share my sex-work-related posts, but essentially I’m preaching to the choir.
    A very small choir.
    I’m guessing my inability to connect around sex work on Facebook is because on that medium, I mostly interact with people I actually know, or we at least move in similar social circles. But while we may know each other in real life, that clearly doesn't mean that we share the same philosophies or passions. So do I give up trying to get the people I know on Facebook to care about sex workers' rights, or stubbornly keep posting in the hopes that eventually some will? The big question.
    I resisted Twitter for a long time, unconvinced that I needed a whole lot of 140-character thoughts from random people cluttering up my day. Oh, how wrong I was. Twitter is now a favourite of mine.
From a staying-current perspective, it’s much like having hundreds of people out scouring the planet on your behalf for interesting news and developments (presuming you’re following the right people and organizations). The hashtag system also means you can easily find the latest tweets pertinent to the issues you care about.
    Few of the people I’m friends with on Facebook appear to be active on Twitter, so I’ve found a whole other community there - one that stretches around the world, loves a good debate over tough issues, and interacts with other members of their “community” based on the issues they tweet about rather than any personal connection.
    Because the Twitter connection is around issues rather than friendship, I decided from the start that I would concentrate on tweeting about sex workers’ rights. I jump in on other issues every now and again, but I’d say that 90 per cent of my Twitter use is related to sex workers’ rights. Twitter has turned out to be totally amazing for connecting to like-minded souls on that issue.
    Yes, it does pose that preaching-to-the-choir problem. But on the upside, being among an entire world of people who think like me on this one keeps me hopeful and engaged on those dark days when you think, good grief, why can’t people get this? My fellow tweeters also keep me so clued-in on everything that’s happening around the world for sex workers’ rights that it makes me a much better informed activist and advocate for the rare times when I can actually catch the ear of the uninterested and possibly hostile majority.
    Would I post a grandchild photo on Twitter, or a pretty scene from my morning walk? Nope. I doubt that any of my Twitter followers give a hoot about how many grandchildren I have, and they definitely don’t want to see what I had for lunch yesterday. But I feel the same way about those I follow, too, so it all works out nicely. We don’t want to be friends, we want to be comrades in arms.
    Then there’s Instagram. I resisted this one for even longer, but this year decided I wanted to see how non-profit organizations were using it.  I quickly became an enthusiast of the form for personal use, though remain skeptical of its effectiveness for non-profits unless they’re skilled at telling their stories via powerful photos with very few words. (Humans of New York style.)
    But as a medium for sharing photos of the weird, wonderful and breathtaking scenes one might see in the course of an ordinary day, it’s really fun.
    Once again, I’ve found myself resistant to automatically following the same people I’m connected to on Facebook, as much as Instagram encourages me to do so. I don’t want to repeat my Facebook experience; I’m looking for something different from Instagram.  That said, I’ve sometimes seen a totally different side to some Facebook friends who I now follow on Instagram, and who also get that there are distinct reasons for choosing one or the other medium.
    Wearing my strategic-communications hat, this is what it all comes down to for me:

• Use Facebook to connect with real friends and allies in warm and fuzzy ways, but don’t count on it to drive issues forward or effectively challenge societal assumptions. Useful for calling out people to events, but I suspect you are still only calling out to the people who probably would have come anyway. As an aside, I also wouldn’t advise using Facebook as your main news platform, because people use the craziest sources and are very lax in checking whether the stories they share are real and recent, or six years old and virtually fiction
• Use Twitter to find great news from around the world that you care about by following people and organizations that know how to find legitimate and dependable sources. Pick an issue or theme that you want to specialize in so that people interested in the same things can follow you, and be equally stringent about your own sources. Find the hot hashtags for your issue and use them religiously to build followers
• Use Instagram to share interesting photos with other people who also like looking at and sharing interesting photos. Sure, you can use the medium to share personal photos with your family and friends, but for broader use remember that you’re going to be up against a world of staggeringly compelling photos if you hope to get noticed.
• If aiming to raise awareness for a cause or issue via Instagram, ditch the inspirational memes and follow the lead of the Humans of New York project, which in my mind leads the micro-story format with their brilliant photos and minimal writing.
• Write blogs when you really need to say something. Not only do blogs give you more room and create a permanent, searchable space for your thoughts, they provide those all-important links for sharing on all your other social-media platforms. 

Squeeze 'em until it hurts: The hostile takeover of the average air traveller experience

     I love almost everything about a life with lots of travel in it. But the modern-day airport and flying experience is one notable exception.

     I’m just back from flights in and out of Orlando, Florida, where I went for two weeks to visit family. I've been travelling quite a bit these past five years, and what becomes clearer with each passing flight is that the air industry service model is to slowly increase our suffering to the point that we'll pay them to make it stop.
    While I admire how the industry whips us around the world with impressive efficiency, its view of us as widgets to be profited from rather than flesh-and-blood customers is becoming increasingly transparent.

     I get that it’s a tough management challenge to safely move so many people to so many destinations every day. Some 3.5 billion travellers passed through the world’s airports in 2015. But that hardly justifies a business model built on the concept of deliberately eroding basic customer service so that your customers eventually feel miserable enough to pay for what they once got for free.

     Whether it’s about shivering in a sub-zero economy cabin or paying $25 each way just to check your only bag, I can’t shake this feeling that rather than being motivated by the desire to provide me with the optimal customer experience, what actually motivates the industry is discovering new ways to make me into a more efficient and profitable widget. Even the once largely democratic act of boarding the plane has been turned into a profit-making vehicle, with the industry constantly introducing new ways to lure travellers into paying to jump the line.

     A quick review of the typical airport experience based on my August 29 and September 12 flights, to make my case:

·        Uncomfortable seats. Your butt’s going to hurt, your legs are going to twitch, and your arms are going to cramp from trying to keep yourself from touching the passenger next to you. Unless you’re willing to pay for a better seat – what we long-time flyers used to know as “normal” leg room has now become a premium to be paid for – expect to feel cramped, jostled, and forced into unpleasant intimacies with strangers. If money’s no object, you might buy yourself one of those really great seats that the rest of us can only gaze upon longingly on the way to steerage, where everybody enjoys roomy lazy-boys and quaffs free booze and warm almonds. But most of us non-rich people tend to opt for the suffering. Yes, theatres and arenas also charge a price for premium seats, but for me it’s the physical discomfort of the cheap seats that really distinguishes the airline industry in this category.

·         Unfair baggage policies. Once, you could check two bags for free. Then one. Now, none. I just paid $50 so that my one bag could accompany me to Orlando and back. And then you sit in the cabin watching people stuffing increasingly enormous and ludicrous “carry-on” bags into those weary looking overhead bins, and a thinking person such as myself just might go, hey, WTF, does the industry truly not see how unpleasant they’re making it for us just to carry our stuff while we travel?

·         Food. Not even a decade ago, the airline industries fed you a meal at mealtime. It wasn’t a particularly terrific meal, but it was OK, and even came with a little bottle of wine if it was dinner. Oh, I laugh ruefully at the memory. Most of the airlines won’t even toss you a bag of bad pretzels anymore without charging, and those little bottles of wine are now $7. Not surprisingly, travellers responded by buying their own food in the airport to bring on the plane, but I now see that airport vendors have rather strangely countered this development by jacking up the price on anything that can be carried easily on a plane. I realized during this trip that at $12 and $14, airport sandwiches are now so costly that it makes more sense to buy a $7 sandwich on the plane. How clever – they've made me into a widget who will not only buy a $7 chicken wrap on the plane, but feel grateful for the chance. I wouldn’t want to suggest collusion between the airport and the airlines, but it sure looks that way from a customer perspective.

·         Security lineups. I know, we’ve all got a million anecdotes about this one, but it’s the big picture that gets me (that and the crazy lineups that screw up everything about the airport experience, including how much time you have to buy an exploitively priced sandwich). I mean, look at us: Taking off our shoes, belts and jackets; worrying whether we’ve got any trace of metal somewhere on our person; extracting our laptops to put them in bins; carrying only teeny-tiny bottles of creams and lotions in our carry-ons; shuffling through the naked x-ray machine without a word of complaint. Complaint, after all, just might get you sent into the back room with the scary looking dude wearing the latex gloves. It’s gotten so unpleasant that I’m now exploring the various pre-approved options for passing through security – which, of course, I will have to pay for. I can practically feel the industry using our largely baseless fears of security risks to reshape us as compliant widgets happy to pay for premium services if it means we get to skip at least some of the waits and humiliation.

·         In-flight entertainment. Let’s just say I was overjoyed to discover free movies and TV on both Air Canada flights to and from Toronto on my way south, but that’s not a common experience. I don’t want to romanticize the days when small, bad TVs dropped from the plane ceiling and you watched whatever the airline was showing that day, but there are fewer and fewer flights that provide any entertainment at all unless you pay for it. And maybe there’s nothing wrong with that, because bringing a good book is still free, but it still exemplifies the way airlines have found ways to package basic customer service as something you now have to pay for.

·         Cold. Freezing, freezing cold. The guy across the aisle from me was wearing one of those “slankets” yesterday to ward off the sub-zero chill and I was dead-envious. Sure, it’s minus-59 C. outside at 35,000 feet (Really. I saw it on the free TV screen.) but you can bet those high rollers in the comfy seats aren’t having to wrap themselves in fleece. Should you want one of those thin, small blankets of unpleasant material that the airlines used to provide for free, you now have to pay for it.

     I could go on. If there isn’t already a business-economics case study on the airline industry’s mastery at wringing profit out of what was once basic customer service, there ought to be. It’s not only a triumph of capitalism, it’s an example of how an industry can deliberately worsen the experience for their customers and not only get them to go along with it, but happily paying to stop the torment.

     Pack your slankets and homemade sandwiches, kids. They’re taking us for a ride.