health/medicine

In the late 1990s, I turned down my publisher’s offer to do a third edition of my criminology textbook.  It wasn’t just that editions one and two had failed to make me a man of wealth and fame.  But it was clear that crime had changed greatly.  Rates of murder and robbery had fallen by nearly 50%; property crimes like car theft and burglary were also much lower.  Anybody writing an honest and relevant book about crime would have a lot of explaining to do.  And that would be a lot of work.

I politely declined the publisher’s offer.  They didn’t seem too upset.

If I had undertaken the project, I probably would have relied heavily on the research articles in The Crime Drop in America, edited by Al Blumstein and Joel Wallman. They rounded up the usual suspects – the solid economy, new police strategies, the incarceration boom, the stabilization of drug markets, anti-gun policies.  But we all missed something important – lead.  Children exposed to high levels of lead in early childhood are more likely to have lower IQs, higher levels of aggression, and lower impulse-control.  All those factors point to crime when children reach their teens if not earlier.

Lead had long been suspected as a toxin, and even before World War I many countries acted to ban or reduce lead in paint and gasoline.  But the U.S., thanks to the anti-regulatory efforts of the industries and support from anti-regulation, pro-business politicians, did not undertake serious lead reduction until the 1970s.

Kevin Drum at Mother Jones has been writing about lead and crime. Because race differences on both variables are so great, it’s useful to look at Blacks and Whites separately.  In the late 1970s, 15% of Black children under age three had dangerously high rates of lead in their blood (30 mcg/dl or higher). Among Whites, that rate was only 2.5%.  By 1990, even with a lower criterion level of 25 mcg/dl, those rates had fallen to 1.4% and 0.4%, respectively.

The huge reduction in lead was matched – years later when those children were old enough to commit crimes – with a reduction in crime. (note that the graphs show rates of arrest, which may somewhat exaggerate Black rates of offending):

Much of the research pointing to lead as an important cause of crime looks at geographical areas rather than individuals.  A study might compare cities, measuring changes in lead emissions and changes in violent crime 20 years later.  But studies that follow individuals have found the same thing.  Kids with higher blood levels of lead have higher rates of crime.  The lead-crime hypothesis is fairly recent, and the evidence is not conclusive.  But my best guess is that further research will confirm the idea that getting the lead out was, and will remain, an important crime-reduction policy.

Kevin Drum also emphasizes race differences.  And here the evidence is less solid:

[A]rrest rates for violent crime have fallen much faster among black juveniles than among white juveniles…  black juvenile crime rates fell further than white juvenile crime rates because they had been artificially elevated by lead exposure at a much higher rate.

But that  depends on how you intepret the data. As the graphs of arrests show, the percentage reductions are roughly similar across races.  Among Black youths, the arrest rates for all violent crime fell from 1600 per 100,000 to less than 700 – a 57% reduction.  For Whites the reduction was from 307 to 140 or 54%. But in absolute numbers, because Black rates of criminality were so much higher, the reduction seems all the more impressive. In that sense, those rates “fell further.”

Arrest rates for Blacks are still double those of Whites for property crimes, five times higher for homicide, and nine times higher for robbery.  Lead may be a factor in those differences.  Remember the lag time between childhood lead exposure and later crime. Twenty years ago, high blood levels of lead among children 1-5 years were three times as high for Blacks as for Whites.

Cross-posted at Montclair SocioBlog.

Jay Livingston is the chair of the Sociology Department at Montclair State University. You can follow him at Montclair SocioBlog or on Twitter.

We all know — because we are being constantly reminded — that we are, collectively, getting fat.  Americans are at the forefront of the trend, but it is a transnational one. Apparently, it is also transspecies: pets, wild animals, and laboratory animals are also gaining weight.  Here’s some country-level data from the New York Times:

In an excellent review of the existing literature, David Berreby at Aeon skewers the idea that a simple, victim-blaming “calories in, calories out” model can explain this extraordinary transnational, transspecies rise in overweight and obese individuals.  I won’t summarize his argument here, except to simply list the casual contenders for which there is good evidence:

• Sleeplessness
• Stress
• Viruses
• Bacteria
• Industrial chemicals
• Heavy metals
• Electric lights
• Air conditioning
• Famine in previous generations

If you ever want to have an opinion on fat again, read Berreby now.

Lisa Wade, PhD is an Associate Professor at Tulane University. She is the author of American Hookup, a book about college sexual culture; a textbook about gender; and a forthcoming introductory text: Terrible Magnificent Sociology. You can follow her on Twitter and Instagram.

Black Americans are 3.7 times more likely than Whites to be arrested for marijuana possession, despite having equivalent use rates.  It’s a war on what again?

New York Times, via Gin and Tacos, one of my favorite blogs.

Cross-posted at Racialicious.

Lisa Wade, PhD is an Associate Professor at Tulane University. She is the author of American Hookup, a book about college sexual culture; a textbook about gender; and a forthcoming introductory text: Terrible Magnificent Sociology. You can follow her on Twitter and Instagram.

As our society becomes increasingly technological, I love stories that remind us of the value of simpler ways to solve problems, like a faux bus stop to catch escapee nursing home residents or dogs that are trained to sniff out cancer (both stories here).

This weekend we were treated to another such story, this time by Google. The company has announced a plan to bring internet to the whole world… with balloons.  The very first launch of a gas balloon was in 1783.  Two hundred and thirty years later, the company aims to deliver what is arguably the defining feature of our age — the internet — with helium-filled balloons.  That technology will then bring almost countless other technologies, such as medical advances and agricultural information, to people who are largely excluded from them now.  A fantastical plan.

Here’s how it’ll work:

Lisa Wade, PhD is an Associate Professor at Tulane University. She is the author of American Hookup, a book about college sexual culture; a textbook about gender; and a forthcoming introductory text: Terrible Magnificent Sociology. You can follow her on Twitter and Instagram.

Teen pregnancy, like obesity, is often framed as an “epidemic.”  As such, both the “epidemic” of teen pregnancy and the “epidemic” of obesity can be understood through the lens of what sociologist Stanley Cohen popularized as a “moral panic.” In Cohen’s words, moral panics are “condensed political struggles to control the means of cultural reproduction”; additionally “successful moral panics owe their appeal to their ability to find points of resonance with wider anxieties.”

“The Real Cost of Teen Pregnancy” — a public health information campaign launched by the Mayor and Human Resources Administration of New York City in March 2013 — features babies and toddlers, primarily children of color, chastising their teenage mothers. Launched at a time when teen pregnancies have actually declined, primarily due to the availability of safe and affordable reproductive health care, the accusatory “shame and blame” narrative of these images is not only out of proportion to the “problem” it seeks to address, but is weighed down by its obvious cultural narratives about teens of color, poverty, gender and sexuality.

Having a pensive toddler of color next to the slogan “Honestly Mom… chances are he won’t stay with you. What happens to me?” and a weeping boy of color next to the words “I’m twice as likely not to graduate high school because you had me as a teen,” serves to re-stigmatize single teen mothers, encouraging wider social senses of moral outrage, hostility and volatility toward young, predominantly impoverished girls of color. Not unlike cultural narratives about “welfare queens,” the campaign plays into racist and classist fears about sexually active girls of color and teenage mothers who use social services. The message just under the surface here is about the need for social control of “unruly bodies.”

These 4,000 posters, put up in buses and subways, cost a reported $10,000 per year for the city, and have already drawn harsh critique from many. Haydee Morales, vice president for education and training at Planned Parenthood of New York City, for instance, has reportedly suggested the campaign has got it backward. In her words, “It’s not teen pregnancies that cause poverty, but poverty that causes teen pregnancy.”

According to Samantha Levine, a spokesperson for New York’s Mayor Bloomberg, “it’s well past the time when anyone can afford to be value neutral when it comes to teen pregnancy.” Public health campaigns are never value neutral. They communicate social beliefs about normalcy, productivity, desirability, and cultural worth.

An additional cost of the unexamined acceptance of this new teen pregnancy campaign is accepting yet another narrative about individual choice over systemic change. Placing responsibility on the shoulders of the individual, such campaigns silence more complex conversations about accessible and affordable reproductive health care, anti-poverty campaigns, and gender and social justice work. Instead of buying into the “moral panic” of teen pregnancy, perhaps the mayor’s office might look into more long lasting and less stigmatizing possibilities of structural change to improve the lives of young women in New York City.

“Shame and blame” has rarely gotten public health anywhere. In the words of researcher and speaker Brené Brown, “Shame diminishes our capacity for empathy. Shame corrodes the very part of us that believes we are capable of change.”

Sayantani DasGupta is a faculty member in Narrative Medicine at Columbia University. She is the editor of Stories of Illness and Healing: Women Write their Bodies,  co-authored The Demon Slayers and Other Stories: Bengali Folktales, and authored Her Own Medicine: A Woman’s Journey from Student to Doctor.

Cross-posted at Montclair Socioblog.

We got another reminder last week that despite complaints about federal government programs that give money to the poor, when it comes to taxes, the government is much more generous to the wealthy.  The news came from a report from the Congressional Budget Office on tax expenditures.

These are the ways that the government uses the tax system to give money to people. Some expenditures are tax credits, which can take the form of cash payments.  Others are tax breaks — taxing people less than the going rate. For example, if I am in the 35% tax bracket, but the government charges me only 15% on the $100,000 I made playing the stock market, the government is giving me $20,000 it could otherwise have had me pay in taxes. That’s an expense. The preferential rate for my luck in the market costs the government $20,000.

The justification for these expenditures is that they are a way the government can encourage people to do something that it wants them to do.  With tax breaks, the government is basically paying people by not charging them full tax fare — encouraging them to buy a house or give to charity or get health insurance at their work.  Similarly with the tax credits that go mostly to the poor. We want people to hold a job and to care for their kids.  The child tax credit gives people more money to care for their children.  The Earned Income Tax Credit pays them for working, even at jobs that pay very little.  By the same logic, the government is paying me to invest my money in companies — or put another way, to play the stock market.

This government largesse, however, benefits some people more than others:

About half of all tax expenditures go to the top quintile (top 20% of income earners).  The bottom 80% of earners divide the other half.  And within that richest quintile, the top 1% receive 15% of all tax expenditures (this distribution of tax breaks roughly parallels the distribution of income). Were you really expecting Sherwood Forest?

Here is a breakdown of the costs of these different tax expenditures:

The Earned Income Tax Credit, which benefits mostly the poor, costs less than $40B.  The tab for the low tax on investment income (capital gains and dividends) is more than twice that, and nearly all of that goes to the top quintile.  More than two-thirds goes to the richest 1%.

Dylan Matthews at the Washington Post WonkBlog regraphed the numbers to show the total amounts overall plus the amounts in each category for each income group:

The point? People complain about government payments to the poor, but tax breaks are also payments, though less obviously so, to the rich.  And those tax breaks cost the government a lot more money.

Jay Livingston is the chair of the Sociology Department at Montclair State University. You can follow him at Montclair SocioBlog or on Twitter.

This post originally appeared in 2010.

Most of us familiar with Down‘s Syndrome know that it brings characteristic facial features and delayed or impaired cognitive development. People with Down, however, are also more vulnerable than the general population to diabetes, leukemia, and infectious and autoimmune disease, and about 40% are born with heart defects.

For most of history, then, the life expectancy of people with Down was very low.  But, with advances in knowledge and access to health care, life expectancy has risen dramatically… especially for white people:

The Centers for Disease Control explain that severity of Down does not vary by race, so most likely the cause of the gap in life expectancy is differences in the quantity and quality of health care.

Possibilities include differences in factors that may be associated with improved health in the general population such as socioeconomic status, education, community support, medical or surgical treatment of serious complications, or access to, use of, or quality of preventative health care.

This is just one striking example of the wide racial gap in health outcomes and access to care.  We see data with similar patterns most everywhere we look.  As examples, pre-term births, cancer diagnosis and treatment, and likelihood of living near a toxic release facility.

Morbidity and Mortality Weekly Report, via Family Inequality.

Lisa Wade, PhD is an Associate Professor at Tulane University. She is the author of American Hookup, a book about college sexual culture; a textbook about gender; and a forthcoming introductory text: Terrible Magnificent Sociology. You can follow her on Twitter and Instagram.

Cross-posted at Girl w/ Pen.

Having written about sexually transmitted HPV (human papillomavirus) for 13 years, I’ve been waiting for the day when a celebrity would lend his or her fame to spotlight the realities of HPV infection, especially of HPV-related oral cancers.  That day has come: this week Michael Douglas has announced that his cancer was caused by an HPV infection that was likely transmitted through oral sex.  The mucus membrane tissue of mouth and throat are similar to those of genital skin, so researchers have known for some time that, like herpes, HPV could be transmitted oral to genital, as well as genital to oral.

My hopes are that big news can be a long-needed catalyst for change.  Back in 2009, the research findings were already clear: oral transmission of cancer-causing HPV means that almost all of us are more likely at risk than we are safe from risk.  For my 2010 feature article in Ms. Magazine, I focused on the importance of not only educating the public about HPV-related cancers in men but also about the HPV-oral cancer link. In addition, I advocated for the need to destigmatize all STDs: my research and book have shown that STD stigma makes it more likely for at-risk/infected  individuals to put off getting tested and treated. STD stigma also makes it less likely for individuals to disclose their sexual health status to partners, placing those partners at greater risk for infection.  In addition, negative stereotypes about the “types” of women and men likely to be infected distort our ideas of who is at risk.

I’ll wrap up this post with a call: for us to come together, to learn the facts and not be swayed by incomplete media coverage and confusing pharmaceutical claims.  We must support significant funding increases to investigate exactly how we can prevent HPV-related oral/throat cancers, which research shows to be steadily on the rise and more fatal than cervical cancers in the U.S.

Adina Nack is the author of Damaged Goods? and a professor of Sociology at California Lutheran University.  She specializes in medical sociology, gender inequality, and sexual health and writes for Girl w/ Pen.