April 22nd, 2014

Today's Inactivities Include: Being sick, reading about public health

Alas, my son started throwing up at quarter to 4 this morning. Not sure what happened; presumably he ate something (or otherwise something got into his mouth) that was Not Good. He is disturbingly quiet, other than reluctantly getting up to throw up more. I'm giving it another hour or so before I start to panic.

I'm reading Tom Farley and Deborah Cohen's _Prescription for a Healthy Nation_, since Farley had a recent op-ed in the NYT (that was about sodium levels in food, specifically, a topic of interest to me because it drives me nuts how freaking hard it is to find food that isn't insanely high in sodium, and I know from travel in other countries that it doesn't have to be that way. Arguing that adopting policy limits by category/type of food would reduce freedom makes me want to exercise freedom all over the person making the argument. Probably by screaming Right Up In Their Face. You know, freedom of speech.). It is, unfortunately, a really problematic book in a variety of ways, so my love for it is limited, however it is a relatively good piece of advocacy.

Anyway. We know -- and Farley and Cohen lay out some of the numbers -- that if you raise the price of tobacco and alcohol products, they are consumed less. They argue in favor of reducing the price of fruits and vegetables (including prepared ones like salads) and increasing the price of high fat/high sugar ("junk") foods. There is a slight problem here. While it is straight forward to tax stuff, collect the money for the general fund (or even targeted programs of a related nature, say, tax "junk" food to subsidize purchase of fruits and vegetables through SNAP), it is not so obvious how we could reduce the price of fruits and vegetables. I suppose we could provide subsidies to growers? But if you did it by regulating price, you could perversely increase production of high sugar/high fat (if you mandated higher prices, rather than tax, which doesn't seem too likely, it would have the effect of raising still further the profit margin on these items) and decrease production of fruit and veg (by reducing the already slim margin -- even when the margin on fruit and veg looks fat, it rarely is because the volatility associated with harvest is higher than the inputs for high sugar/high fat, altho that, in turn, is partly a result of historic farm policies here in the US).

Pricing is tricky, as the authors learned during an effort to recoup some of the costs of a condom campaign -- usage even at .25 a piece plummeted, which was entirely at odds with what they were attempting to accomplish.

I hope they start talking about advertising at some point. I really do. Because advertising is a huge obstacle for any public health campaign. Altho it is very difficult to deal with, given the aforementioned freedom.

ETA: "In the early 1980s, after years of state "buckle up campaigns that people ignored, seat belt use nationally was an abysmal 14 percent. The idea of requiring people to wear belts seemed ridiculous at first, because people had always had the option to use their seat belts, and the laws would be virtually unenforceable."

Seriously? _Always_ _had_ _the_ _option_? For 20 years, _maybe_, at that point.

Okay, whatev. NY usage went from 20% to 47%. "It wasn't the fear of punishment that made people buckle up, because cops didn't (and in most states legally couldn't) pull people over for not wearing belts it was the statement that the law represented. Buckling up was something people were supposed to do. It was expected, normal, what any regular person did."

Bull shit. I remember the early 1980s. My parents were vocally in favor of mandating new cars having car seat belts, always required that we use them and never let us forget how hard they'd worked to get them into cars. But everyone _else_ I knew started using seat belts after they got an add-on to their ticket for failing to wear a seat belt, or knew someone who did. There was _intense_ "lawyering" around who was required to buckle up and who wasn't and loud arguments in cars on group outings about who was going to pay the ticket if someone did not buckle up who was being told to and who wasn't accustomed to obeying that law. And the extra on the ticket was always mentioned. I also heard a bunch of stories about people getting pulled over with that as the explanation for the pull-over.

I have no mortal clue how the law was written in NY at the time, but given the behavior of law enforcement in NY with respect to other written law, I just don't even see how that would be relevant.

"the seat belt laws didn't always get a smooth ride through state legislatures...Of course it is stupid to drive without seat belts, some protested, but we have no right to force people to be smarter if the only ones they put at risk are themselves"

One of the arguments that I heard a lot in the early 80s did not accept that wearing a seat belt was smart: I heard dozens of people argument, sincerely, at length and volume, that they'd rather be ejected from a vehicle than be hurt by a seat belt. One of the counter arguments, of course, became hey, I don't want you flying around in the car hurting my neck and head, when people were arguing about whether passengers in the back seat needed to wear a seat belt (the rationale being that people riding in the back without a seat belt tend to have lower risk than people in the front with a seat belt, at least according to some statistics being tossed around at the time).

ETAYA: The authors do go on to talk about primary enforcement laws vs. secondary, but even if you have secondary only, you can usually increase a fine for failure to wear seat belts. A deterrent factor unmentioned, but that I remember people using in arguments.

Complaining about _Prescription for a Healthy Nation_

I've seen references to a study mentioned here a million (<-- hyperbole) times: Carnegie Mellon, 276 healthy volunteers, asked about social ties, gave them a rhinovirus. "Within five days, the volunteers with the fewest social ties were about four times as likely to get colds than volunteers with the most social ties, even when the researchers took into account their age, sex, weight, race, and education."

They come to the usual conclusion (social connections make us healthy) but it occurs to me that the fewer people you are close to, the less up-to-date your immune system's firmware is. Of _course_ you're more likely to get sick -- because you haven't experienced that virus or any of its zillion close relatives yet.

Has anyone controlled for that? Do we even know how?

ETA: And on the next page, Robert Putnam is quoted unquestioningly. *sigh* Repeat after me, everyone: Robert Putnam is a Bad Source. Never, ever, ever quote from _Bowling Alone_; it makes you look like an ideologue who cannot be bothered to figure out which sources are not supposed to be quoted when outsiders might be paying attention.

ETAYA: on the subject of monkey see, monkey do and that horrible movie and the resulting incidents involving kids lying down on the highway lines: "Think for a moment of how difficult it would be to persuade anyone, at any age, through any technique of persuasion you can imagine, to lie down in front of a moving car."

I'm a mother. This actually does not even sound difficult to me. I'm thinking these authors must be really young, or way more autistic than even me. (I agree with the point they are making: people do shit they see in movies, which is a problem, given the stuff people show in movies.)

ETA still more: "Because TV programmers want to nail us to the set until the next commercial, they tend to reach for images that are arousing, particularly violence and sex. The formula works, has always worked, and will always work. As media wizard Brandon Tartikoff said, "All of television boils down to excisable elements that you can put in twenty second promos. If you can't have Starsky pull a gun and fire it fifty times a day on promos [because of citizen pressure against violent content], sex becomes your next best handle."

This fully explains in every detail the massive decline in casual violence in children's television shows -- and, for that matter, the drastic reduction in gun battles on police procedurals. [<-- Sarcasm.] The formula actually evolves and, amusingly in contrast to the argument being made, the most sexual and violent shows on television are on channels that don't have ads during the show. (Amirite, all of you Game of Thrones fanatics? You're not sitting through ads.)

ETA file under FFS:

"As advertising philosopher [sic] David Ogilvy wrote, "Give people a taste of Old Crow and tell them it's Old Crow. Then give them another taste of Old Crow, but tell them it's Jack Daniels. Ask them which they prefer. They'll think the two drinks are quite different. They are tasting images."

Really? You're going to silently reproduce the Beam conglomerate vs. the Jack conglomerate without even mentioning that? And on top of that, you're going to compare the cheaper Beam choice to the mid-range Jack choice?

Also, I used to drink Old Crow. It really wasn't bad at all (Maker's Mark obvs better for only a little more money), provided you had the sense to not put ice cubes in it. If you were going to put ice in it, you'd better be mixing it, too. And there's no way in hell you'd be able to serve me the same whisky back to back and tell me it was two different whiskeys. It's been tried.

"In surveys average television viewers say they enjoy watching TV about as much as they enjoy housework and cooking -- enjoy it less, in fact, than working."

And this is how we know that survey instruments are flawed.

Oooh, also, the foot note goes to Putnam's Bowling Alone!!!!! Aaaaargh!

I may have to abandon this book. I _love_ the premise (we should create a bunch of policy -- voluntary programs and regulations and laws -- that makes it easier for everyone to eat somewhat healthier, get a bit more exercise, etc.). But if this is the best argument in favor of that premise, I'm just going to wind up changing my mind, which I have absolutely no intention of doing. I'll go looking for a better argument instead.

I am so disappointed. I am _so_ disappointed.

Also: http://www.nhk.or.jp/bunken/english/reports/pdf/10_no8_06.pdf

Still more complaining (really, it's bad enough that I'm reading this -- why are you?):

"Men are now taking in 168 more calories a day than they were thirty years ago, and women are gobbling up 335 calories more." Really? With the gratuitously slanted language by gender? The source is the CDC. I'm sort of wondering how the CDC calculated this, actually.

Source appears to be NHANES. I have no idea if that questionnaire is reasonable.

This says it is (like virtually all questionnaires) not reasonable.


Medscape summary of same:


Complete with critique from Walter Willett. Interestingly, in this case I'm taking the not-Willett side. I think. I could be talked out of it.

Today's Activities Include: sick, canceled, Hollywood Studios, swim, Magic Kingdom

This morning at 3:45, T. started being sick. He kept being sick, at roughly 15 minute intervals for many hours. We gave him a little Zantac and later Zyrtec and they both helped -- we think something he ate was bad and also that he has a lot of phlegm and the cough is setting off the vomiting. He also has some of R.'s reflux.

A. and R. went to Hollywood Studios where they saw the Belle and Sebastian show. They went on Star Tours and Midway Mania. They came back and went swimming and then back to the Magic Kingdom. They stayed late.

T. did eat some fries and drank some milk. I am skeptical if this will stay down, but he hasn't thrown up for over 2 hours so he got to pick what he wanted to eat. He sensibly decided to wait on the cookie. He did not eat the chicken nuggets; we are saving those for later, perhaps never.

I am glad I had groceries; I had lunch in the room.

We are going to go to the Magic Kingdom tomorrow.

I had to cancel the sitter and the dinner our for R. and me; they are rescheduled to Thursday. Hopefully we will all be well at the same time. The sitter and the restaurant were really nice about it and the reschedule/cancel/restaurant switch at least isn't going to cost me anything more, which is sort of amazing given we were within the 24 hour window.