Where being a woman is a pre-existing condition

Originally published at Benfell Blog. Please leave any comments there.

For my class project in my Power of Partnership class this semester, I’ve been putting World Health Organization mortality statistics through a wringer. It hasn’t been easy. The sheer volume of data is tremendous. WHO warns:

The files available here do not constitute a user-friendly data collection which the average user can download and access. These are the basic underlying raw data files, together with the necessary instructions, file structures, code reference tables, etc. which can be used by institutions and organizations which need access at this level of detail mainly for research purposes AND have available the required information technology (IT) resources to use this information.

Okay, so I’m not an average user. I earned an A.A. degree in Business Data Processing in 1979 and worked for six years as a computer programmer before burning out. That doesn’t help me much with modern anything; the Python programming language, for example, implements concepts that are simply beyond my grasp. And frankly, there are times when I really wish I was back on a DEC PDP-11/70 running RSTS/E with a stack of documentation I actually understood, a CPU instruction set that irritates me for the failure of any processor since to implement anything nearly so elegant, and programming languages (including TECO, nominally a text editor) that I could pretty much make do anything.

My background also leaves me ill-prepared for modern databases. Here’s WHO again:

Due to the large size of these files, they are provided in ASCII (comma separated values) format to facilitate the download process. You should import these data files into a Database Management System rather than spreadsheets. . . . However users are strongly recommended not to try to import the data into spreadsheets because of the excessive number of records. There are over 1 million records in one data file.

So I had to deal with this monster file on a laptop which I had not purchased with serious number or data crunching in mind using, of course, a spreadsheet. I’ve limited my analysis to five countries, the Netherlands, the Philippines, Sweden, Thailand, and the United States, but the amount of work involved was still enormous.

I’ve just finished assembling the data. And as I began to look at what I have, I recalled U.S. Speaker of the House Nancy Pelosi’s remarks upon passage of the health care bill that “no longer will being a woman be considered a pre-existing condition.”

I’m wondering what Filipino physicians might say in response. Here are the top two causes of death, sorted by mortalities per one million population, for all five countries in my analysis:

cause total mortalities, per million total
of death year gender all ages population population
Philippines O99 2003 female 343,929 8,420.5 40,844,000
Philippines F33 2003 female 325,006 7,957.2 40,844,000

“O99” is the ICD-10 code for “Other maternal diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium” within the taxonomic hierarchy for “Ch. XV [O00-O99] Pregnancy, childbirth and the puerperium – [O94-O99] Other obstetric conditions, not elsewhere classified.” “F33” is the code for “Recurrent depressive disorder” within “Ch. V [F00-F99] Mental and behavioural disorders – [F30-F39] Mood [affective] disorders.”

Self-harm is in a separate category; I wasn’t aware that depression could, in and of itself, be lethal. And while I’ve noticed that a lot of cause of death codes include the words “unspecified,” “other,” “ill-defined,” and “unknown,” or the phrase “not elsewhere classified,” for such a diagnosis to be the leading cause of death for either gender raises questions about maternity care in the Philippines. And for depression to be listed as a second leading cause of death, whether or not these diagnoses are accurate, certainly raises questions about attitudes towards women amongst Filipino physicians.

There’s much more to come. I have to think about my next step in analyzing this data. And I have a paper to write which is due on the 11th.

To my Facebook Friends

Originally published at Benfell Blog. Please leave any comments there.

This is an invitation to remain friends. But Facebook is increasingly the wrong place to do this. I can’t say I fully understand why so many people are so complacent about privacy issues. But apparently not everyone is:

U.S. Senator Charles Schumer is adding fuel to the fire, asking the FCC to provide privacy guidelines for social networks. Schumer believes “The default policy should be one of privacy, and users should be in control of how they choose to share their information, not the other way around.” This “opt-out” to “opt-in” transition sounds smart to us, but check out the Senator’s Facebook page to find out what everyone else is saying and to put in your own two cents.

And that’s a politician who is part of the mainstream political establishment that has been complicit in a broad attack on privacy in the United States. Here, however, what he says is eminently sensible. Meanwhile,

Taking a more active approach, a group in Germany expressed their concern over “privacy invasions” by sabotaging a Google “Street View” car. The Google employee returned to find the tires let down and the camera cables slashed. However, the protestors were kind enough to leave behind the informative note, “Please do not drive away, you have a puncture”.

With Facebook, it’s been a relatively steep slippery slope, with one privacy outrage after another. The Electronic Frontier Foundation has a timeline, but what you really need to know is what Facebook founder Mark Zuckerberg has to say:

When I got started in my dorm room at Harvard, the question a lot of people asked was ‘why would I want to put any information on the Internet at all? Why would I want to have a website?’

And then in the last 5 or 6 years, blogging has taken off in a huge way and all these different services that have people sharing all this information. People have really gotten comfortable not only sharing more information and different kinds, but more openly and with more people. That social norm is just something that has evolved over time.

We view it as our role in the system to constantly be innovating and be updating what our system is to reflect what the current social norms are.

A lot of companies would be trapped by the conventions and their legacies of what they’ve built, doing a privacy change – doing a privacy change for 350 million users is not the kind of thing that a lot of companies would do. But we viewed that as a really important thing, to always keep a beginner’s mind and what would we do if we were starting the company now and we decided that these would be the social norms now and we just went for it.

Zuckerberg points to broader social trends, but in the end says, “We decided that these would be the social norms now.” Who is “we?” Facebook, of course. And they’re making that decision for all their users.

But those folks in Germany aren’t alone. A quick Google search (irony noted) reveals protests in Britain and in Japan. And I’ve been hearing about this pretty much since Google began expanding Street View outside U.S. borders.

I’m thinking Zuckerberg is taking a rather narrow view of public opinion which conveniently serves commercial interests. Maybe I’m wrong. But Zuckerberg stands to make a lot of money for as long as he can get away with what he’s doing.

And I’m increasingly troubled. I don’t think I should have to revisit Facebook’s privacy settings nearly so often as I have had to do. In a way, it’s “bait and switch.” I signed up under one privacy policy, and as EFF points out, now I have something quite different.

I’ve set up my own site. I’ve actually been moving the other way on privacy, towards stricter protections, at the same time I’ve been improving it. And I’m thinking that if I have to revisit Facebook’s privacy issues one more time, I just might close the account instead.

So this is an invitation to join me. But because I saw that the self-registration procedure was of more utility to would-be spammers than actual friends, you’ll need me or someone who is already an authenticated user on the site to issue an invitation through the site. Message me with your email address for that invitation.

Arizona and Utah and Tea Partiers and Republicans on my mind

Originally published at Benfell Blog. Please leave any comments there.

Seymour Friendly at Firedoglake points out that the vicious law recently passed in Arizona allowing police to ask anyone they suspect of being an “illegal” immigrant for identification isn’t the only one.

From the Huffington Post:

Arizona’s new immigration law is just about crime, its supporters say, but given that the state’s new education policy equates ethnic studies programs with high treason, they may not be using the commonly accepted definition of “crime.”

Under the ban, sent to Arizona Gov. Jan Brewer by the state legislature Thursday, schools will lose state funding if they offer any courses that “promote the overthrow of the U.S. government, promote resentment of a particular race or class of people, are designed primarily for students of a particular ethnic group or advocate ethnic solidarity instead of the treatment of pupils as individuals.”

But no one is teaching courses favoring hatred towards minority groups. The only existing courses that meet this criteria are ethnic studies courses. And the insistence on treating people as individuals rather than as members of groups serves only to deny racism and to promote a particular cultural perspective. Indeed, FoxNews quoted Arizona State Superintendent for Public Instruction Tom Horne saying,

This is consistent with the fundamental American value that we are all individuals, not exemplars of whatever ethnic groups we were born into. Ethnic studies programs teach the opposite, and are designed to promote ethnic chauvinism.

So whites determine what “fundamental American values” are and it isn’t “ethnic chauvinism” when whites do it. Then there’s this, from the Wall Street Journal:

The Arizona Department of Education recently began telling school districts that teachers whose spoken English it deems to be heavily accented or ungrammatical must be removed from classes for students still learning English.

Karla Campillo-Soto teaches a kindergarten class for students with limited English at Creighton School in Phoenix. The native of Mexico took a course to try to reduce her accent in English. Two other kindergarten teachers at the school were deemed not fluent enough for such students.

State education officials say the move is intended to ensure that students with limited English have teachers who speak the language flawlessly. But some school principals and administrators say the department is imposing arbitrary fluency standards that could undermine students by thinning the ranks of experienced educators.

There is a history to the fluency issue:

In the 1990s, Arizona hired hundreds of teachers whose first language was Spanish as part of a broad bilingual-education program. Many were recruited from Latin America.

Then in 2000, voters passed a ballot measure stipulating that instruction be offered only in English. Bilingual teachers who had been instructing in Spanish switched to English.

Ms. Dugan said some schools hadn’t been complying with the state law that made English the only language in the classroom. “Our job is to make sure the teachers are highly qualified in fluency of the English language. We know districts that have a fluency problem,” she said.

And apparently the federal “No Child Left Behind Law” also requires that “students learning English must be instructed by teachers fluent in the language.” As Seymour Friendly puts it,

Certainly, officially, the purge is limited to English classes, but obviously a school that removes an English teacher for not being acceptable to racist white “nativist” xenophobes under the new “policy” will try to purge teachers who don’t speak English as a first language or whom have an accent foreign to Arizonan ears from any class or program. One is left to wonder if a white male Christian fundamentalist teacher from New York City who happened to have a thick accent would be deemed “ungrammatical” or “heavily accented”.

A difficulty is that the standard of fluency is arbitrary. According to the Wall Street Journal, “Defining fluency is left to each state, a spokesman for the U.S. Department of Education said.” Further,

Ms. Santa Cruz, the state official, said evaluators weren’t looking at accents alone. “We look at the best models for English pronunciation,” she said. “It becomes an issue when pronunciation affects comprehensibility.”

But what are these “best models for English pronunciation?” It happens that, personally, I speak something very close to “standard American English,” which is already preferred on network news particularly for anchorpersons and reporters. It is an authoritative way of speaking, which means it isn’t really authoritative, but that as a culture, we often assume it to be authoritative. That’s a prejudice and Arizona is reinforcing it.

“Teachers should speak good grammar because kids pick up what they hear,” said Johanna Haver, a proponent of English-language immersion who serves as an adviser to Arizona educators. “Where you draw the line is debatable.”

So what this really amounts to is an exclusion of people who are different. And in combination with the law on ethnic studies courses, it is an exclusion of people who not only sound different but who think different. And in combination with the law that, according to the New York Times, “would make the failure to carry immigration documents a crime and give the police broad power to detain anyone suspected of being in the country illegally,” it legitimates a police state that distinguishes between “us” and “them” in a way that can be adjusted to exclude ever larger groups of people.

Fascism has arrived in Arizona. (UPDATE: At least ten other states may be considering similar legislation.) And it combines with something else rather frightening in Utah. Chip Ward began an article at TomDispatch this way:

What if the Tea Party ruled? Imagine a land, let’s call it Glennbeckistan, where white, patriarchal, religiously zealous, Tea Party-type patriots hold a super-majority in both houses of the legislature, sit in the governor’s mansion, and control most local governments. It’s a place so out of sync with the rest of the nation that states’ rights and even secession are always on the agenda. It’s a place where gun-ownership trumps all other rights, climate change is considered an insidious socialist conspiracy, and a miscarriage can be investigated as a potential crime. Welcome to Utah.

Our rightwing red-state legislature just finished its annual 2010 session. So-called message bills challenged the federal government’s right to govern federal lands, enforce gun controls, legalize abortion, and mandate health reform. In addition, Utah’s lawmakers cut the education budget, raised tuitions, and slashed services to the disabled. In fairness, state legislators across the nation, faced with disastrous drops in revenue, have likewise slashed social services and balanced budgets on the backs of the poor. In Utah, however, they also shelved pensions for public employees. That they could take such draconian action is instructive — organized labor is weak here, unions being another manifestation of creeping socialism. Utah’s history of labor organizing, or grass roots and civil rights organizing for that matter, is anemic compared to most of America. This is the place, after all, where IWW radical Joe Hill was arrested and executed.

But we on the left suffer from some of the same faults. We point at those people, those Arizonans, those Utahns, those Tea Partiers. We accuse them of being backwards and racist. We criticize them for seeking to impose their values on the rest of us.

Disparaging those people does not alter the reality that those people are acting from heartfelt convictions which cannot be reconciled with our convictions. But really it isn’t just Utah’s “Republican leaders here [who] want the rest of the nation to be more like [Utah].” The fact is that we want them to be more like us.

That isn’t happening. From either side. And it is foolish to think that there is some workable compromise in between. That’s why I think the country has to be broken up. Because the alternative is violence.

Oil and the path of moderation

Originally published at Benfell Blog. Please leave any comments there.

Oil, of course, is at the center of this whole stinking mess off shore of, but coming to a shoreline on the Gulf of Mexico near (enough to) you. And in the instant case, we have the usual suspects: Halliburton may have failed to properly cement the hole that the oil gushes out of but preferably into a riser pipe leading up to the drilling rig which British Petroleum leased and operated. BP apparently “suggested in a 2009 exploration plan and environmental impact analysis for the well that an accident leading to a giant crude oil spill — and serious damage to beaches, fish and mammals — was unlikely, or virtually impossible.” Now, according to the Los Angeles Times,

BP faces tough questions. Oil industry experts this week compared the accident to a plane crash or space shuttle disaster that may have been the result of a cascading chain of mishaps. There are supposed to be safeguards: sensors that detect changes in pressure, cross-checking protocols, emergency response systems, and people monitoring everything 24 hours a day aboard the rig and by satellite.

“We are all very curious,” said an industry source who asked not to be identified because he worked for a rival oil company. “What happened to all that equipment, all the computer power, all the automated systems and manpower in place, could not be invoked to stop this?”

The assumption is that an oil-rig perfect storm occurred, very quickly. “There would have been a dozen barriers that had to fail in order for this accident to happen,” said Tim Robertson, an oil-spill consultant with Nuka Research and Planning Group in Alaska.

Perhaps the biggest question, to experts, is why the blowout preventer valves didn’t shut. The huge device, which caps the well, is equipped with emergency systems, including a “dead man’s switch,” a device of last resort that is supposed to be fail-safe.

And as even the Washington Post notes way far down in their article about Obama trying to show he’s in charge without taking blame, the White House “must also deal with a parallel issue: Obama’s announcement just last month that he would allow vast new areas of the country’s coastline to eventually be opened to drilling.”

The possibility of further oil drilling in the Gulf of Mexico is now in question. Writing for Firedoglake, David Dayen explains that “you can basically say goodbye to oil drilling in the Gulf at this point because it’s about to all be gone, skimming to the surface and heading for shore.” He relies on the Los Angeles Times: “If the flow is not stopped, it will exhaust the natural reservoir of oil beneath the sea floor, experts say.”

And stopping that flow won’t be easy:

“Everything about it is unprecedented,” said geochemist Christopher Reddy, an oil-spill expert and head of the Coastal Ocean Institute at the Woods Hole Oceanographic Institution in Massachusetts. “All our knowledge is based on a one-shot event…. With this, we don’t know when it’s going to stop.”

Accidents have occurred before in which oil has gushed from damaged wells, he said. But he knew of none in water so deep.

And “everything is bigger and more difficult the deeper you go,” said Andy Bowen, a research specialist who works with undersea robotics at the Woods Hole center. “Fighting gravity is tough. It increases loads. You need bigger winches, bigger cables, bigger ships.”

There are so many paths to follow in a longer-term view that my head aches thinking about it. There is, of course, that plan to drill off shore, and Obama’s reluctance to abandon it. It didn’t impress capitalists or conservatives. Forbes called it “a classic case of all hat, no cattle.” And as the Los Angeles Times described it,

Conservatives complained it would “lock up” more swaths of ocean than it would open to drilling.

“If the president is trying to offer an olive branch in order to pass climate change, this hardly qualifies as any major step,” said Rep. Doc Hastings of Washington, the top Republican on the Natural Resources Committee.

Environmentalists were outraged by the plan, but their reaction to this disaster has been so tepid that Jane Hamsher took it as one more piece of evidence that “the progressive movement is officially dead.” And now, Obama has had to hold off.

In covering Obama’s initial announcement, the Los Angeles Times said,

Obama pitched the decision in national security terms and called it “part of a broader strategy that will move us from an economy that runs on fossil fuels and foreign oil to one that relies more on homegrown fuels and clean energy.”

“National security” would be a reference to the ever widening crusade against Muslims, particularly in and around the Middle East. But even with all the trouble Israel gets the U.S. into, which the New York Times quoted Obama describing as “costing us significantly in terms of both blood and treasure,” a plan to drill for oil offshore still didn’t make any sense because,

Analysts cautioned that under the most favorable circumstances, the plan would take years to begin producing new oil and suggested it would not reduce oil imports or gasoline prices substantially.

Chris Bowers figured that the rationales for the plan were a “compromise with ConservaDems” and something called “hippie-punching.” Bowers sees it as “home state pork for Conservadem Senators who are viewed as winnable votes on the energy bill.” And he quotes Obama saying,

Ultimately, we need to move beyond the tired debates between right and left, between business leaders and environmentalists, between those who would claim drilling is a cure all and those who would claim it has no place. Because this issue is just too important to allow our progress to languish while we fight the same old battles over and over again.

Some of us must be getting real tired of hearing about “tired debates between right and left” or between whomever and whomever. Particularly when,

All commercial and recreational fishing has been shut down in the Gulf for a second straight day, and remember we may not control this leak — or outright gusher — for several months. That area provides a third of the nation’s seafood. Basically, the livelihoods of tens if not hundreds of thousands of Americans are at stake.

Particularly when,

The Coast Guard conceded Saturday that it’s nearly impossible to know how much oil has gushed since the April 20 rig explosion, after saying earlier it was at least 1.6 million gallons — equivalent to about 2 1/2 Olympic-sized swimming pools. The blast killed 11 workers and threatened beaches, fragile marshes and marine mammals, along with fishing grounds that are among the world’s most productive.

Even at that rate, the spill should eclipse the 1989 Exxon Valdez incident as the worst U.S. oil disaster in history in a matter of weeks. But a growing number of experts warned that the situation may already be much worse.

And particularly when shorelines from Mexico to the eastern seaboard of Florida are threatened. From just this one well.