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Book Reviews: The Science and History of Studying Epidemics

Note: This post consists of the following two sections:

  1. An essay version of the reviews, written for my library newsletter.
  2. A more detailed version that explains more about my motives and offers more details, book-by-book. I intend to add updates at the end as I review more of the genre. If you intend to read this section, you can probably just skip the first section as redundant.



Book Review: The Science and History of Studying Epidemics

by Carl V Phillips, PhD

Epidemiology (the study of health outcomes and their causes) is the science that you most often encounter in the news and that has the most immediate impact on people’s lives. But readers with a taste for science books probably understand particle physics and population genetics better than they understand epidemiology. There are just not many books, and most of them are bad. I decided to journey through the HSL stacks to identify books about the science and historical development of epidemiology that would be useful to lay readers and that would be a good supplemental reading in an undergraduate class. While that history is not sufficient for understanding modern epidemiology, it is useful start. (The full version of this review plus more detail appears below (those reading a non-clickable version of this can use:

The one sentence version of what I found: Read Patient Zero; solving the mysteries of deadly epidemics, by Marilee Peters (2014). Continue reading

A few notes on soda taxes (a footnote to @cjsnowdon’s work)

I was just reading this post by Chris Snowdon, about jurisdictions that impose taxes on soda, ostensibly in the name of fighting obesity. He notes that this is patent bullshit, since they typically impose the same taxes on energy-free versions of those drinks (“diet sodas”) also. In that post, he suggests that it is purely a money-grab. Even with that incentive, I suspect the “moralizing” aspect, the disdain from certain people toward those of us who indulge in the sins of soda, is not purely a rationalization. I suspect that those in power are true believers in the moralizing, not just taking advantage of it to find an easy revenue source. I also suspect Chris has said exactly the same thing in his extensive analyses of the point. If you are looking for points about the subject in general, in other words, look to him, not me. I just have a couple of additional observations that are basically a footnote to his writing.

Soda taxes, like any consumption tax for something that is not strongly a luxury good (in the technical sense), are highly regressive. Indeed, proponents often indirectly concede that they consider it a feature, rather than a bug, that cigarette excise taxes are brutally punishing for poor people even though wealthier people can shrug them off. They delight in how much pressure they are exerting on the poor in particular. One might think this means that these — soda taxes, cigarette taxes, and the like — are always pushed by the upper-class elitists, like those who comprise the global tobacco control jet-setters. These are the elites who are just oh-so-concerned about the plight of the poor, by which they mean the poor actually trying to seek fulfillment in their lives rather than acting like proper serfs.

Perhaps this is the case for the soda tax in France that Chris mentions. But one thing to realize about the U.S. situation is that when urban governments enact these measures, they are often led by, and certainly supported by, the black political machines that dominate parts of those cities. (I suppose I should say “African-American political machines”, but I am already going third-rail with this, so why bother?) Yes, those leaders are also are much wealthier than their constituents, but it is not really the same motivation. The black churches and urban black oligarchs are quite often extreme true-believer puritan moralists. Much more so than the jet-setter moralists who drink, smoke weed, fornicate, etc., even as they are punishing smokers and cola drinkers. This does not necessarily affect the analysis, but someone trying to understand the politics should keep it in mind.

So what actually happens in the cities? Here I can get more concrete based on geography. It turns out that the regressiveness is much greater than a simple analysis of “soda purchases as a portion of income” analysis would suggest. Chris mentions Philadelphia, Oakland, and Seattle. I have lived in the first two and spent a lot of time in the third. I can tell you that there is basically no normal middle (or higher) class person in the Philadelphia or Oakland who does not shop outside the city limits, at least a few times per month, and many do most of their shopping outside the city. (That “normal” is meant to exclude the car-eschewing and/or urban sophisticate type, people who are clearly not the target for these sin taxes. Note that I am not casting any aspersions here — I have been both of those types, as well as the typical commuter, at various points in my life.) So if they care about this tax at all, if the money matters to them or they are otherwise inclined to avoid paying it, they can buy all their retail soda outside the taxation zone. In Oakland they would also have to avoid buying when they shop in neighboring Berkeley also, but that does not change the equation much. For Seattle, I would guess that more of the middle class does all their shopping within the city limits, but they are still much more likely to be able to avoid this tax without burden than poor people.

So it is the poor — people who do not drive beyond the city limits for commuting or recreation, and who do not go shopping at the upscale malls, Wegmans, and Ikeas that are just out of town — who are left paying the tax when they shop locally. This includes the people we normally think of as the urban poor, along with the elderly, teenagers, and college students. Again, the perpetrators of these punitive taxes probably are not bothered by this. They know these are the people who might actually change their behavior in the face of the punishment, rather than shrugging it off.

If the taxes get high enough that they really hurt, we will get the same phenomenon we have with cigarettes. Someone will drive to wherever they can buy pallet-loads cheapest, within a few hundred miles, and then sell them out of the back of their truck for less than the local price would have been, even without the tax.

All this is about retail purchases. Restaurant or convenience purchases do not allow for such evasion. So we are back to the standard regressiveness calculation. Except we are talking about people who can indulge in such expenditures in the first place, and are probably not too price sensitive.

But wait. How are soda prices in restaurants set? (The analysis is similar for vending machines and other convenience sellers.) They are not the competitive prices for grocery retail purchases, where sellers cannot charge much more than their competitors. Restaurants have a monopoly on the soda purchases of their customers. The purchase price is almost pure profit. The marginal cost to the seller of a $2 soda is in the order of ten cents. So how do they set their price? The monopolist’s profit-maximization involves jacking up the price, losing a lot of buyers who would have made the purchase for $0.20, to the point that net revenue from lost buyers (who at that point are really not paying much attention to a few tens of cents more) exceeds the extra per-unit net revenue. But that actually seems like the naive economist talking. I suspect that restaurants really do not know what the monopolist price is, but instead raise the price to the level they can get away with without offending their customers, because it seems dickish to charge that much, causing them to stick to water on principle even though the cost is really no big deal to them, or even avoid the establishment entirely. Thus it is “just” $5 at an expense-account restaurant that charges $15 for a beer and $50 for an entree, even though $10 would increase their profits, and just $1.89 at McDonalds.

So what happens when the restaurants have to pay $0.20 for the inputs, due to the tax, rather than $0.10? Nothing. The dickishness threshold is not changed. Since these sales are to people who are less poor, this further increases the regressiveness.

A cautionary lesson in amateur fact-checking: What was wrong with Sarah Kaplan’s article


So in my last post, I recounted how I was attacked, by name, as collateral damage in a smear piece on PEOTUS Trump. The culprit was the Washington Post, in the person of reporter Sarah Kaplan (@sarahkaplan48 if you want to offer your assessment of this on Twitter). It was an effort to sling mud at Trump (and that really is the right way to put it) for citing some of my work about the harm to the health of nearby residents caused by industrial wind turbines (IWTs). Not only did Kaplan clearly have no understanding of the science on the topic, but she intentionally identified me only with what was obviously intended to be a smear, rather than with my credentials.

Kaplan and WaPo ignored my comment on the article and my email. But after three or four rounds of tweets demanding a response (perhaps because they got a lot of retweets and likes — thank you all for that), I finally received this:

Interestingly, it was only on the same day that I saw this bit of wisdom in my feed:

Granted, Mr. Whittier is being a bit over-general there. For example, the many cases of Trump saying “I never said that” and someone presenting a recording of him saying it — or a recording of what he really said, and how that was not really what was claimed — are well within the forensic skills of the self-styled fact-checkers. Misrepresentations of specific statistics, effects of laws, etc. are similar. But it indeed descends into opinion journalism — usually very ill-informed opinion — when it is about the existential truth of a substantive matter. It becomes particularly problematic in cases where “everyone” “knows” something is true and it turns out that the only people who disagree are the ones with the greatest expertise. That is when the self-styled fact-checkers tend to fall on their faces. Needless to say, areas of unsettled science present the biggest minefields for nonexperts.

Of course, they are not the only minefield. I was reminded of this quote I tweeted:

So, minefield.

But moving onto the question, Ms. Kaplan asked what was “untrue” in her article. Perhaps she expected me to try to tweet the answers, but instead I will respond with this. After all, Twitter is an even worse place to try to engage in scientific discourse than the Washington Post.

Before getting to the specifics, it is important to note that something can be untrue without being a factually incorrect sentence. Those who read will know that I have addressed this point quite extensively. For example, I can state that Kaplan does not seem to be guilty of more than two cases of manslaughter resulting from her history of DUI. Of course, I actually assume she is not guilty of even a single such case, and I have no affirmative reason to believe she has ever once driven under the influence. But that technically factual sentence I wrote untruthfully implies two or more manslaughter events. Less generically, I could point out that Kaplan, who dismissed my research on the health effects of IWTs, is employed by a giant multinational business empire that is heavily invested in IWTs. That is factually true, and saying it tends to imply she wrote what she did because she has been ordered to smear critics of wind power under the guise of doing honest reporting. While I would certainly not rule that out, it is not actually my belief about why she messed up so badly — and I have no evidence to support the unstated but inevitable interpretation of the observation. My actual belief is that she, as a non-scientist, had a Dunning-Kruger problem of not even realizing how little she understands.

The first paragraph of Kaplan’s article is proper reporting:

In the hours after the election of Donald Trump, Michael Lubell, director of public affairs for the American Physical Society in Washington, told the journal Nature that Trump will be “the first anti-science president we have ever had.”

That is the type of information — that someone with particular credentials made an accusation — that news reporters can convey accurately. (Of course, that itself might communicate untruth if the quoted individual is not really so expert or has ulterior motives. But that problem, of reporters acting as stenographers for those in power, is not the topic for today.)

But in the second paragraph:

But Trump and Vice President-elect Mike Pence do not have a great track record. In the course of their careers and this campaign, they have made several false claims about science, eliding complexity and sometimes outright rejecting the conclusions of the vast majority of researchers.

I would not doubt that they have made “false claims about science” but that is quite different from making a false scientific claim, which is what Kaplan makes the fundamental mistake of trying to argue in what follows. The former is an example of that simple “he was, in fact, recorded saying just that” fact-checking that any competent reporter can do. The latter is a very problematic claim, because an existential scientific assertion itself is characterized only by degrees of (subjective) confidence, never falsity. That is, you can accurately say it was false when Kaplan claimed about science that “reviews of the research on the purported health impact of ‘infrasound’ [sic]  from wind farm turbines found that there was none”, since it is literally impossible for any review of any evidence to ever establish there is no risk. You can also make narrow technical claims like, “it is false to say that the data from this particular study suggests there is a health risk from e-cigarettes.” What you can never claim is something like, “he falsely says humans are not causing global warming” because the nature of science is such that the author cannot know that position is false.

And that is still true if the “vast majority of researchers” think it is true. Notice that this means that some researchers also reject the conclusions. More important, history is littered with hypotheses that are now overwhelmingly believed to be false that once were believed by the vast majority of researchers.

As for “eliding complexity”, irony much? (Oh, also, a note from someone who did not major in English but is perhaps better at communicating as a result: “omitting” would be a better word choice, and “glossing over” would be far better still.)

Kaplan leads off with the issue that is basically the only reason anyone is even bothering with Trump’s statements about other scientific topics, climate change. There are a few specific quotes from Trump, but they are fairly immaterial because he has made hundreds of climate change skeptic statements of various sorts. Kaplan responds:

In September, hundreds of U.S. researchers, including 30 Nobel laureates, published an open letter criticizing Trump for his stance on climate change and highlighting the risks of failing to comply with the Paris climate accord. Studies published in peer-reviewed journals find that at least 97 percent of all actively publishing scientists believe that global warming in the past century is a consequence of human activity.

So if Kaplan were restricting herself to her what she (presumably) can do right, report what people are saying, that first sentence would be fine. Lots of scientists disagree with Trump’s claims and policy statements. That is true. But she falls apart completely in the second sentence. First, there is no plural there — it was just one paper. More important, that statistic has been quite thoroughly excoriated as bullshit junk science (example). That is not to say that Trump has not endorsed positions on this topic that are indefensible. It is to say that even in spite of that that, Kaplan still wrote a critique of his position that was patently untrue, relying entirely on a baseless pop factoid. (Note: To avoid any more lame ad homs from Kaplan here, I will point out that I happen to believe, at the level of a skilled scientist but nonexpert on the particular topic, that people are causing a level of global warming that is somewhat threatening to humanity and quite threatening to the rest of the ecosystem. Of course, even if I didn’t, what I just said would still be true.)

The next bit is about Trump repeating the vaccines-autism claim in one of the debates. Kaplan’s response is basically adequate for a dumbed-down news story. But this is supposed to be a critique of someone else’s scientific claims, so the standards are a wee bit higher. As with everything else, she grossly oversimplifies it (sorry, elides complexity), and she endorses the always unsupportable zero-risk position.

The next one is about Trump doing some drama-queen panic about Ebola-infected patients being transferred to U.S. hospitals in 2104. It is just silly. The one after that is about me, and I have already covered that and will circle back.

The next one is pretty trivial, but still telling about Kaplan:

Lightbulbs and cancer 

Trump tweet from 2012: “Remember, new “environment friendly” lightbulbs can cause cancer. Be careful– the idiots who came up with this stuff don’t care.”

Kaplan response: Compact fluorescent lamps, which use 25 to 80 percent less energy than traditional incandescent lightbulbs, do contain small amounts of mercury — but the total quantity is 600 times less than the amount in a traditional thermometer. They need to be carefully handled and properly disposed of, but by reducing energy usage, they also reduce overall mercury emissions from coal-fired power plants, the single-largest U.S. source of mercury pollution. A 2012 study also found elevated UV radiation from damaged CFLs, but the dose is low — no more than you would receive standing in direct sunlight. The FDA recommends that any risks from UV can be avoided by buying double envelope bulbs and not spending prolonged periods directly in front of the light.

Notice the misdirection Kaplan leads with. Trump did not indicate what pathway from the bulbs to cancer he was claiming, but she implied that by dismissing one possible pathway, she was denying his claim. This is untruth of a different sort. The second bit actually implicitly concedes Trump is right, albeit only to a degree that would make his statement one of those technically true untruths.

The next section recounts how Trump made a truly boneheaded statement about ozone depletion on the campaign trail. Kaplan’s response is such a hash that I am mostly going to gloss over it (you can read it if you want). She actually does not hone in on his actual stated error (that only releasing a highly stable gas inside a building magically keeps it from getting into the atmosphere), though she hits it in passing. She also grants him credit for getting something right that he did not actually say (he claimed hairspray no longer exists; it does, just not with CFC propellants). She then goes on to make an assertion — based on a single source, a common fatal problem with non-scientists trying to make scientific claims — about the danger of ozone depletion. It seems quite possible Trump doubts that broader claim too, but what she quoted from him does not actually indicate he does not.

In the next section, Kaplan quotes a 2013 tweet from Trump. (Notice a pattern here? I wonder how well the WaPo would stand up to a cherrypicking of dumb statements it made over the last five years.) Trump wrote “Fracking poses ZERO health risks…”, a paraphrase of the (genuinely bad) Daily Caller guest commentary he is tweeting out. Zero risk is indeed an absurd claim (careful readers will already be noting a certain irony here). Kaplan fails to notice this. Instead she quotes a few studies that suggest there are measurable and quantifiable risks. But what she reports is so specific that anyone familiar with the problems in epidemiology (which, of course, I have been writing about for most of two decades) has to laugh. I am not familiar enough with the topic to be able to offer any specific response. But I am pretty confident that Kaplan has absolutely no idea whether those cherrypicked references are representative of the overall evidence, let alone has the skills to assess whether the studies appear sound.

Kaplan finishes with a cheap shot about Pence, the only actual mention of him despite the claim the article was about both of them. The criticism is of his dogmatic (that is not a slur — look it up) belief in the literality of the Hebrew creation myth. It is a cheap shot because it is not really about science, but about metaphysics. I seem to recall that Pence has made criticism-worthy scientific statements about various topics relating to sexuality and reproduction. These seem to be rather better targets. The fact that a lot of people simply deny the scientific method as a way to explain the nature of biology is not exactly news. Kaplan’s response reads like a dutiful middle school exam answer about what scientists agree upon and what it means. This again would be fine if she had stuck to her competency as a reporter of what other people say. But she makes the mistake of declaring one epistemic view to be right because those who accept that epistemic view agree it is right. I suspect that even after reading this she will not recognize why that is a fundamental error.

At this point, some readers may think I am being unfairly brutal to the poor kid. But let’s keep in mind that this was not a college term paper. She presumed to publish this deep dive into way-the-fuck-over-her-head-in-eight-different-ways in a national newspaper. At that point, everything is fair game. Of course, if she had not personally attacked me, no one would have ever bothered to write this much-deserved excoriation. Without that attack, I would not have bothered even if I had happen to read the article anyway (note: there is no chance I would have read the article anyway).

But tell you what: I will offer to apologize for being so brutal, and I will even delete this post (something I have never done before), in the charitable spirit of not tarnishing someone’s permanent record for a stupid mistake she made one day. I will do that if the WaPo posts a proper correction. (Note that I am not terribly worried about having to violate having to violate my policy of not deleting over this. See above observation about heavy investment in IWTs.)

What would be the proper correction? Or put another way, what was untrue about what Kaplan said related to me? Much of that appeared in the previous post (so Kaplan’s question about what was untrue is rather disingenuous, and also practically asking me to pile on) and above. But to itemize:

  • No study, and thus no review, can ever establish an exposure causes no risk, so her main claim about my research conclusions (“Multiple reviews of the research on the purported health impact of “infrasound” from wind farm turbines found that there was none…”) is patently false. One might find it interesting that she seems to understand this about issues where understanding it favors her apparent political preferences.
  • The “multiple reviews” she refers to cites just one paper which was not really a review and was written by the industry’s hired consultants. To the extent that other reviews have also dismissed the harm, they too have patently dismissed the evidence that I point out is the most compelling that exists. (And they have been written by those with a financial or political stake in denying the evidence, if you prefer to think that way about things.) Meanwhile, there are other reviews that reach the opposite conclusion. As I noted in the previous post, Kaplan pretends there is settled science that Trump is wrong (which, presumably, she mistakenly believes), when the most she could possible say is there is controversy (even ignoring that it is manufactured controversy).
  • There is an ever-growing body of evidence (recall she was going back years to populate her attacks) about the health effects of wind turbines. One has to be either completely ignorant or in full-on shill mode to pretend it does not exist.
  • Infrasound does not belong in petty scare quotes; it is a well-defined scientific term referring to sound energy that is too low in frequency to be detected by the human ear. More important, no study of effects can be sure whether the infrasound produced by IWTs or some other hypothesized pathway was the cause of the observed health effects. I note that explicitly in my work, and even the industry consultants who wrote the paper pretty clearly get it. Thus the unsupported inclusion of an assumption of a single candidate pathway is in itself an untruth. The fact that Kaplan presumably has no understanding of anything in this bullet, but presumed to declare The Truth on this topic is an untruth of a different sort.
  • And, of course, the personal note: I should be identified with my credentials, not the cheap attempted smear, “a wind power opponent who previously worked as a paid expert for the tobacco industry.” It is an untruth (elidition of complexity?) to say I am an opponent; the accurate statement would be that I am a proponent of not covering up the harms. It is pathetic to note the tobacco industry work — which I am also quite proud of by the way — as at all relevant. It is also untruth, since the average reader will think that rather than my work being about encouraging the use of low-risk substitutes for smoking, I am a lung cancer denier or something. Kaplan undoubtedly knew that when she wrote that bit of defamation.
  • Trump’s tweet was perfectly valid, and most certainly not Wrong, as Kaplan portrayed it.

Oh, and one more thing that I did not go into previously, and is too big for a bullet. That sentence I quoted in the first bullet ends, “…aside from annoyance that could contribute to stress.” What Kaplan does not understand (and maybe her paymasters do not want her to understand — no, sorry, see above) is that “annoyance” in this context is technical jargon for any harm to people caused by noise that is not actual physical damage. So, for example, the practice of blasting loud noises at prisoners as a form of torture is the inflicting of annoyance, in the technical sense — i.e., you are not bursting their eardrums. The stress that can result from such annoyance is one of the worst negative health effects someone can suffer, as I have explained in detail in my analyses (which Kaplan undoubtedly did not actually read before dismissing them). Breaking your eardrum, or even your spine, does not destroy your life. The stress from noise can and does. Kaplan, in her comfortable elite urban life, does not have to worry about that happening. A lot of other people, who she would presumably never deign to talk to, do.

In conclusion, I will note that Trump’s election has caused a lot of soul-searching by the thoughtful proponents of globalization who casually dismissed the harm it has inflicted on some people. But at least they had solid theory that showed the net effects are positive (assuming you count as a positive making a billionaire richer by two dollars at the expense of making a hungry family poorer by a dollar). I am not expecting any similar soul-searching by IWT proponents because, frankly, I have never seen any evidence any of them are thoughtful. And they do not even have a solid theory that there is any benefit. (Really. There is not a single serious study that shows the net environmental effect of IWTs is positive, let alone cost-effective.) Support for IWTs is either pure rent-seeking or naive virtue-signaling by urban elites like Kaplan and her boss. PEOTUS Trump is still a blank slate in terms of actual policies. It is perfectly reasonable to fear that he will do much that scientific evidence suggests is not a good idea. But in this case, it is nice to hope he will eliminate something that scientific evidence suggests is not a good idea.