The Consequences of More People Living Later into Old Age

For the past week there has been an emphasis on aging in this blog--not necessarily related to the fact that I recently had a birthday! The Smithsonian article I mentioned three days ago included results from a Pew Research survey finding that most people are actually a bit cautious about wanting to live too long. We want to be healthy, but living a lot more years beyond 100 isn't necessarily the thing that most people are thinking about. 

When the Pew Research Center asked Americans in 2013 whether they would use technologies that allowed them to live to 120 or beyond, 56 percent said no. Two-thirds of respondents believed that radically longer life spans would strain natural resources, and that these treatments would only ever be available to the wealthy.

But if these treatments were more widely available, there would be severe economic consequences. A recent report from the Social Security Administration suggests that too many people aged 65 and older in the U.S. are too reliant on Social Security for their income.

This note examines reliance on Social Security bene ts among people aged 65 or older as mea- sured by the 2015 CPS and two other major surveys. All three surveys report that roughly half of the aged popu- lation live in households that receive at least 50 percent of total family income from Social Security and about one-quarter of the aged live in households that receive at least 90 percent of family income from Social Security.

The problem, of course, is that many people aren't saving enough for their own retirement (as I discuss periodically), but even if they are, that savings plan is based on an expected number of years lived that is well below even 122, much less something beyond that number. And why aren't we saving enough? There are many answers to this question, but a big one revolves around the fact that we live in a society whose economy is based on consumption, not production. Today's Economist Espresso has a short piece on the American economy with the following comment: "Consumers are responsible for almost 70 cents of every dollar spent in America. So when consumption grew only slowly at the start of 2017, growth sagged to 1.4%."

We consume instead of produce in part because lower wages in developing countries (especially China) have made goods cheaper than they were when we were producing them at a higher cost. That seems like a rise in our standard of living, but that is ephemeral. We can buy more, but since we're not producing like we used to, we go into debt more. This is not a sustainable model. As I discuss in the book, in the long run we need to come to grips with the fact that a planet with finite resources cannot tolerate growth forever. That might have seemed possible when we had many fewer billions of people, but it certainly is not now true. 

So, the consequences of more people living later into old age will almost certainly be economically catastrophic if we don't dramatically change our way of thinking about the economy in general. On that note, have a good weekend...

Update to "What If We Can't Possibly Live Past Age 122"

Two days ago I blogged about the possibility (a distant one, to be sure) that humans might live to be 1,000 years old. Yesterday, I blogged about a study published a few months ago in Nature suggesting that we have hit the limit of human lifespan and it is 122. Eddie Hunsinger quickly emailed me to point out that I had suggested in yesterday's blog that Jim Vaupel and Jay Olshansky both thought that the limit of human lifespan was 122, but in fact only Vaupel had made that assertion. Eddie was absolutely correct and so I am updating my thoughts here to get them in line with what the article in Retraction Watch actually said:

Jim Vaupel, a gerontologist at the Max Planck Institute for Demographic Research in Rostock, Germany and one of the authors of one of the BCAs, was one of the harshest critics. He told Retraction Watch: The “findings” stem from their naive use of inappropriate data…The balance of evidence suggests that if there is a limit, it is above 120, perhaps much above and perhaps there is not a limit at all. Whether or not there is a looming limit is an important scientific question. Because they used weak statistical methods to analyze inappropriate data, they contribute nothing useful to deeper understanding of human life expectancy and human lifespan.

Whereas:

Jay Olshansky, of the University of Illinois at Chicago — who both reviewed the original article and wrote a “News and Views” piece accompanying it, told Retraction Watch that the authors of the rebuttals are “missing the point:” The rebuttals are mostly focused on slightly different ways of looking at the same limited data; basically, if you tilt your head a little to the left or right and look at the same old age mortality/survival statistics for all humans, you might come to slightly different conclusions. They quibble about how to deal with the mathematics of small numbers at extreme old age, and they fail to realize the obvious, staring them right in the face: the number of people surviving to extreme old age is so small because there is a biologically based limit to life operating on our species, and what they’re quibbling about is the byproduct of the very phenomenon they think does not exist.

Olshansky's conclusion is OK if we are seeking evidence only from the past record of ages at death. But, there are two problems with that, one of which was noted by the Retraction Watch article:

Vaupel also...told Retraction Watch that maximum age at death was even the wrong statistic — instead, the authors should have been looking at the oldest person alive in a given year: In many years the maximum lifespan attained in that year is greater than the maximum age at death–because someone is still alive at an age greater than the maximum age at death. An analysis of maximum lifespans should focus on the oldest age attained over time. As the graph we cite in our note shows, maximum lifespans have tended to steadily rise over time with no looming limit in sight.

And that, of course, it exactly the point I was trying to make. If new advances in the science of aging are taking place, people are going to be staying alive longer, rather than dying. Now, to be sure, as Eddie and I discussed, the potentially dramatic changes in old age science could really alter the picture of human lifespan--or they may just make us healthier until we die at an age no older than 122. Only time will tell.

What If We Can't Possibly Live Past Age 122?

Thanks to Rebecca Clark for pointing to a "widely publicized Nature study" that I had admittedly missed last October, but which is now the subject of a lot of controversy, as summarized in Retraction Watch. In their letter (not quite a paper), the authors from the Albert Einstein College of Medicine in New York, argue that ever since Jeanne Calmest died in France in 1997 at age 122, there have been on older ages at death. Therefore, the rise in the oldest age at death (which we define as the human lifespan) appears to have leveled off, and maybe will never go above 122.

Two of the key people arguing that this is an unfounded conclusion are Jim Vaupel of the Max Planck Institute for Demography in Germany and Jay Olshansky of the University of Illinois, Chicago. Both are foremost authorities on the topic of aging and are widely cited in my text. The major point here is that new scientific ways of dealing with aging, including regenerative medicine and other approaches, as I discussed yesterday, offer at least the suggestion that the oldest age at death could be pushed to higher--maybe even a lot higher--ages. To ignore that science seems, well, unscientific...

What If We Could Live to Age 1,000?

Yes, that's what I asked, and no, this is not April Fools Day! Thanks to my long-time friend Larry Freymiller for giving me his copy of the June issue of The Smithsonian which has an article by Elmo Keep about a Silicon Valley non-profit research organization whose goal is ostensibly to stretch human lifespan to 1,000 years. Aubrey de Grey has a PhD in biology from Cambridge and his work is aimed at extending the ideas in his 1999 book "The Mitochondrial Free Radical Theory of Aging, in which he argued that immortality was theoretically possible. Since then, he’s been promoting his ideas from prominent platforms—the BBC, the pages of Wired, the TED stage. He delivers his message in seemingly unbroken paragraphs, stroking his dark brown wizard’s beard, which reaches below his navel. Unlike most scientists, he isn’t shy about making bold speculations. He believes, for example, that the first person who will live to be 1,000 years old has most likely already been born."

Mr. Keep keeps it real, however, by interviewing others who suggest that while de Grey puts that idea out there to attract funding, he probably doesn't really believe it. Keep also asks him some hard questions about the whole concept of extending human lifespan in a way that he thinks might be possible:

I ask de Grey about how the world would change—socioeconomically especially—if no one ever died. Would people still have children? If they did, how long would the planet be able to sustain billions of immortals? Wouldn’t every norm predicated on our inevitable deaths break down, including all the world’s religions? What would replace them? At what point might you decide that, actually, this is enough life? After decades? Centuries? And once you made that decision, how would you make your exit? 

“I find it frustrating that people are so fixated on the longevity side effects,” de Grey says, clearly irritated. “And they’re constantly thinking about how society would change in the context of everyone being 1,000 years old or whatever. The single thing that makes people’s lives most miserable is chronic disease, staying sick and being sick. And I’m about alleviating suffering.”

Longevity "side effects"? An interesting way to think about what would probably be the most radical change ever to occur in human society. Think about it. What would your answer be?

 

Most of Us Will Not Live to See the World's Population Stop Growing

Last week the United Nations Population Division released its latest round of World Population Prospects: The 2017 Revision. Although there was nothing dramatically new in here, it provides a good overview of where we stand demographically. In particular, the report itself, along with CNN's reporting of the findings, remind us of the key role that Africa is playing in the world's demographic future. If you have read my book and followed this blog, you already knew that Nigeria has been on track for quite a while to displace the U.S. as the third most populous country by the middle of this century. But Nigeria is not alone in Africa in terms of its rate of growth--it just happens to be the most populous of Africa's countries. I have copied below two of the graphs from the UNPopulation Division report. The first shows the projected trajectory of world population growth through the rest of this century.

The medium-variant projection shows the world's population approaching a point of leveling off by the year 2100--83 years from now. Since life expectancy at birth in the United States is currently lower than that for both males and females, you can appreciate that only a relatively small fraction of people currently alive in this country--and in most other countries, as well--will be alive to see the world's population stop growing, unless something dramatic happens in the meantime. What would that dramatic thing be? The second graph offers the clue:

The current age structure is very young--largely because of Africa. What the world needs now is a huge effort to rapidly reduce the birth rate in Africa. 

World Refugee Day Recap

I wasn't able to blog last Tuesday, which was World Refugee Day, as declared by the United Nations. In recapping what we know, the sad truth is that the refugee situation is worse than last year, which was arguably the worst ever until now. CNN summarized the situation as follows:

We are in the midst of the WORLD'S WORST refugee crisis in history. A crisis that brings with it overwhelming numbers, huge challenges for countries and communities affected, untold misery -- and hope.

More than 65 MILLION people are now counted as forcibly displaced by the United Nations. That's like the entire population of the UK or France, or about as many as everyone in New York state, Texas and Florida -- all forced from their homes. Just over one-third are refugees, people forced to flee their countries because of persecution, war, or violence.

As they did last year, the Humanitarian Information Unit of the U.S. State Department has prepared an infographic summarizing our current knowledge of the global refugee situation. I have copied it below. Note that the map itself highlights the sources of refugees--the darker the shade of blue the more refugees there are from that country. The middle of Africa, and the area from Syria to Pakistan are the major contributors. The graph in the lower left shows the countries hosting the greatest number of refugees. Turkey and Jordan lead that list, and this is due largely to the Syrian crisis, although Jordan also hosts a population of displaced Palestinians. If you compare the map of where refugees are leaving, and the graph of where they are going, you see the complexity of situation--many countries that are generating refugees are also hosting refugees from elsewhere. This is true, for example, of the Democratic Republic of the Congo (currently the largest source of refugees into the U.S.), Pakistan, Iran, Ethiopia, and even Syria (which hosts refugees from Iraq, even as hundreds of thousands of its own people have fled the country.

Fertility is on the Rise in Egypt

Thanks to Abu Daoud for linking me a to a story about census workers in Egypt finding more babies than they expected. The latest census is underway--a year late (the last census was in 2006 and Egypt has been conducting censuses every ten years; this one got delayed a bit) and there are more young kids being found than were expected.

Census workers going door to door in Egypt’s teeming neighborhoods and crowded towns are discovering a new country — of more than 20 million people born in the last decade alone.

Family planning efforts have lapsed over the past decade, particularly during the chaotic years following the 2011 uprising that toppled Hosni Mubarak. Today the government is mainly focused on combatting Islamic militancy and repairing the tattered economy.

But the staggering growth rate in the most populous Arab country, already home to more than 93 million people, could worsen both problems by giving rise to yet another bulging generation with few job prospects and widespread reliance on dwindling government assistance.

“In 10 years, we’ve made what can be considered an entirely new country,” said Hussein Sayed, the coordinator of the national census. The results will be finalized and released in August.

Now, to be fair, if you are a regular reader of this blog, you won't be surprised by these findings, since they were heralded by the 2014 Egyptian Fertility Survey, which revealed an unexpected rise in Egyptian fertility over the past few years, as I noted at the time. 

Nonetheless, to have the census confirm this finding is important and, with luck, when the results are made available we should be able to track the spatial demographic patterns of changing fertility in this important and populous country.

Is Growing Old a Societal Blessing or Curse?

I have been absorbed for the past several days by two simultaneous court cases in which I am an expert witness (I have been involved in more than 200 of these over the years, drawing upon my demographic and statistical background), and so today I have the very pleasant task of sorting through blog post ideas that several of you have sent me. Since I recently turned yet another year older, I'm going to go first with the suggestion from Justin Stoler, who pointed to a story in Bloomberg called "The Old Are Eating the Young," written by Satyajit Das--a 60-year old Australian of Indian descent. The basic point is a familiar one if you have read my book and follow this blog--the older population is currently increasing at a faster rate than the younger population in virtually all richer countries, and the burden of paying for a dependent older population will fall on that younger population and it's going to be a bigger burden per person than in the past.

This growing burden on future generations can be measured. Rising dependency ratios -- or the number of retirees per employed worker -- provide one useful metric. In 1970, in the U.S., there were 5.3 workers for every retired person. By 2010 this had fallen to 4.5, and it’s expected to decline to 2.6 by 2050. In Germany, the number of workers per retiree will decrease to 1.6 in 2050, down from 4.1 in 1970. In Japan, the oldest society to have ever existed, the ratio will decrease to 1.2 in 2050, from 8.5 in 1970. Even as spending commitments grow, in other words, there will be fewer and fewer productive adults around to fund them.

But you know how to cope with this--work long and save. That latter point is really important, as the Bloomberg article points out. Global economies are based on consumption, not on saving.

A significant proportion of recent economic growth has relied on borrowed money -- today standing at a dizzying 325 percent of global gross domestic product. Debt allows society to accelerate consumption, as borrowings are used to purchase something today against the promise of future repayment. Unfunded entitlements to social services, health care and pensions increase those liabilities. The bill for these commitments will soon become unsustainable, as demographic changes make it more difficult to meet.

Somehow we have to get past the idea that it is OK to borrow money to buy "stuff" when we're not really sure how we're going to pay that money back. Naturally we all want a high standard of living, but my old-fashioned (and tested) idea is that you can't afford it, don't buy it. Work hard, save, and then buy it when you can afford it. Try it, it works! 

The point here is that the old are not actually eating the young. If everyone of all ages worked and saved instead of borrowing against the future, the economy would adjust accordingly.

The Case for Deporting Nonimmigrants

If you haven't done so already, you really have to read the only slightly tongue-in-cheek article by Bret Stephens in the NYTimes titled "Only Mass Deportation Can Save America." The basic point is that the sociodemographic characteristics of nonimmigrants are not as oriented toward "Making America Great Again" as are those of immigrants. Here's a taste of what he's saying:

On point after point, America’s nonimmigrants are failing our country. Crime? A study by the Cato Institute notes that nonimmigrants are incarcerated at nearly twice the rate of illegal immigrants, and at more than three times the rate of legal ones.

Educational achievement? Just 17 percent of the finalists in the 2016 Intel Science Talent Search — often called the “Junior Nobel Prize” — were the children of United States-born parents. At the Rochester Institute of Technology, just 9.5 percent of graduate students in electrical engineering were nonimmigrants.

Religious piety — especially of the Christian variety? More illegal immigrants identify as Christian (83 percent) than do Americans (70.6 percent), a fact right-wing immigration restrictionists might ponder as they bemoan declines in church attendance.

Business creation? Nonimmigrants start businesses at half the rate of immigrants, and accounted for fewer than half the companies started in Silicon Valley between 1995 and 2005. Overall, the share of nonimmigrant entrepreneurs fell by more than 10 percentage points between 1995 and 2008, according to a Harvard Business Review study.

Despite the Trump administration rhetoric about undocumented immigrants--which helps fuel resentment of immigrants--a Pew Research analysis shows that 75% of immigrants in the U.S. are legal immigrants. Although Latino immigrants tend to be less well educated than the average nonimmigrant in the U.S., Asian immigrants are considerably better educated than nonimmigrants and they now account for a greater share of immigrants than Latinos. Stephens reminds us that it has been immigrants across every generation that made America great, and that is as true today as it ever was. 

Population Overshoot Well Illustrated

Bill Marsh at the NYTimes just put out a very nice set of graphics under the title of "Overpopulation and Underfed: Countries Near a Breaking Point." The data go beyond that, though, to illustrate the fact that the world is in Overshoot mode, whether we want to admit it or not (and most people are overshoot deniers, let's face it). 

Mass migration, starvation, civil unrest: Overpopulation unites all of these. Many nations’ threadbare economies, unable to cope with soaring births, could produce even greater waves of refugees beyond the millions already on the move to neighboring countries or the more prosperous havens of Europe. The population crisis is especially acute in Africa, as Eugene Linden writes in the accompanying article, but it spans the globe, from Central America to Asia.

Curbing poverty in some countries would require unheard of economic growth. Even maintaining the economic status quo, a very low bar, is beyond reach.

In many countries, the population of desperately impoverished has grown to far exceed their total population as of 1970. When conditions worsen, the numbers stricken are staggering, and Malthusian concerns come back with a vengeance.

Take a careful look at this graphic. It shows a set of the world's most impoverished countries by their population in 1970, their population in 2015, and the number (in millions) of the most impoverished in that total population as of 2015. In every case, the number of impoverished people is a very high percentage of a population that has grown typically about three times its size since 1970. This can't be sustained.

The point above about even maintaining the economic status quo in some countries being "beyond reach" is what we mean by overshoot, as I noted a couple of years ago.

Demographics of the Recent UK Election--Age Matters

Thanks to Stuart Gietel-Basten at Oxford for linking us to a just-out report from YouGov.com on the demographics of the general election in the U.K. in which Prime Minister Theresa May's Conservative Party received an unexpected whipping. Indeed, she called the snap election thinking that it was going to increase her majority in Parliament. Oops! (Several of her close advisors have resigned over this). Data come from a survey of more than 50,000 voters, so we can anticipate that the results have meaning. 

In electoral terms, age seems to be the new dividing line in British politics. The starkest way to show this is to note that, amongst first time voters (those aged 18 and 19), Labour was forty seven percentage points ahead. Amongst those aged over 70, the Conservatives had a lead of fifty percentage points.

In fact, for every 10 years older a voter is, their chance of voting Tory increases by around nine points and the chance of them voting Labour decreases by nine points. The tipping point, that is the age at which a voter is more likely to have voted Conservative than Labour, is now 47 – up from 34 at the start of the campaign.

However, as they note, the problem for politicians is that young people are less likely to vote than older people and, of course, the older population is currently growing at a more rapid rate than the younger population. To be sure, those two facts may have inspired Conservatives to think that the snap election was a good idea. Other factors were obviously at work here because the tipping point age from Labour to Conservative, as noted in the paragraph above, went up during the course of the election campaign. Who knew it would be so complicated?

US Census in Peril Puts the Economy in Peril

It has been more than a month since the Director of the U.S. Census Bureau resigned, and no one has been called upon to fill the job yet. The Deputy Director job is also vacant. As we get ever closer to the 2010 census, we really need people pushing the administration and Congress for enough money to fund a good census. The U.S. had led the world in the quality of its censuses for more than two centuries, but this is in peril, as the Huffington Post detailed in a very good article a couple of days ago. If you haven't read it, you need to.

When most people think of the U.S. Census Bureau, they probably don’t think of an agency that supercharges the profitability and efficiency of American businesses. Nor do they realize that one of the economy’s best secret weapons is facing its greatest crisis since James Madison and Thomas Jefferson created it in 1790.

But then again, most people haven’t built a $4.5 billion fortune based on Census data, the way Jack and Laura Dangermond have. The Dangermonds, sweethearts since high school, had an epiphany about data while they were graduate students at Harvard in 1967, a time when the university was awash in protests and political strife. They were both working in a lab developing the nascent field of computerized mapping, now better known as geographic information systems.

I've personally been using GIS to map and analyze census data for the last 30 years, and demographic science and a lot of other segments of the economy depend upon high quality georeferenced census data.

The world today is all about analytics, and the Census Bureau provides systematic and science-based information about the demographic profile of Americans,” Dangermond said. “Census data is in many ways the lifeblood of these kinds of organizations.”

That’s not an exaggeration ― and it’s why the U.S. Chamber of Commerce spends a lot of time trying to persuade Congress and the White House to keep the bureau and its data production well-funded.

Indeed, the businesses that use this government data generate up to $220 billion a year in economic activity, according to a U.S. Department of Commerce study.

We all need to step up our efforts to contact our Senators and Member of the House of Representatives and remind them that as a nation we can't afford not to do a good job with the 2010 census. We need a good new director and we need a genuine boost in funding. 

There Are More Child Marriages in the US Than You Might Think

Tens of thousands of children--mainly girls--are married every year in the United States. That's the conclusion of Fraidy Reiss, founder of Unchained At Last, a nonprofit organization trying to end the practice. She was interviewed this morning on NPR's Weekend Edition Sunday:

We at Unchained At Last, last year, went and collected marriage license data from across the United States. We were able to get the data from 38 states. The other 12 don't even track marriage age. And in those 38 states just between 2000 and 2010, more than 167,000 children as young as 12 were married - almost all of them girls married to adult men. And so extrapolating from what we found, we estimate that nearly a quarter million children were married across all 50 states in that decade.

It turns out that all 50 states allow child marriage. In most, as here in California, you need parental consent and a court order if you are under 18, but that doesn't mean it can't happen.

Weirdly enough, as Reiss points out, this is going on in the U.S. even though we know that on a global scale child marriage is a bad thing:

...the U.S. State Department in setting its foreign policy established that marriage before 18 is a human rights abuse. And the U.S. State Department lists ending marriage before 18 globally as a key strategy toward empowering adolescent girls. And yet, somehow state legislators have not gotten this message that marriage before 18 is a human rights abuse.

Indeed, as a society we are sufficiently uninterested in these things that the National Center for Health Statistics stopped collecting detailed data on marriage and divorce more than twenty years ago. To be sure, teenage marriages are much less common now than were back when I wrote my doctoral dissertation on the topic, but we are still seeing girls not yet even in their teens being married. Something is wrong here.

New Attempts to Combat Gerrymandering in the U.S.

Gerrymandered districts have been increasingly in the news in the U.S. as legislators at the state level try to draw Congressional and state legislative boundaries in a way to improve their own party's chances in elections. But people are fighting back. Not just people, but mathematicians, according to a recent story in Nature.

Leaning back in his chair, Jonathan Mattingly swings his legs up onto his desk, presses a key on his laptop and changes the results of the 2012 elections in North Carolina. On the screen, flickering lines and dots outline a map of the state’s 13 congressional districts, each of which chooses one person to send to the US House of Representatives. By tweaking the borders of those election districts, but not changing a single vote, Mattingly’s maps show candidates from the Democratic Party winning six, seven or even eight seats in the race. In reality, they won only four — despite earning a majority of votes overall.

Mattingly’s election simulations can’t rewrite history, but he hopes they will help to support democracy in the future — in his state and the nation as a whole. The mathematician, at Duke University in Durham, North Carolina, has designed an algorithm that pumps out random alternative versions of the state’s election maps — he’s created more than 24,000 so far — as part of an attempt to quantify the extent and impact of gerrymandering: when voting districts are drawn to favour or disfavour certain candidates or political parties.

The story goes on to quote political scientists and others doing similar work. Now, to be honest, I tend to think of these tasks as being in the realm of spatial demography. I myself submitted sets of maps for local redistricting here in San Diego a few years ago when my wife was serving on San Diego County's Redistricting Commission. I was thanked for the effort and the County Board of Supervisors then ignored them, so I think it is a very good thing that more and different kinds of people get into the business of keeping everyone aware of the way in which district boundaries can affect the functioning of a democracy.

The Politics of Population Counts in Pakistan

Almost exactly two months ago I noted that census-takers had been attacked in Pakistan as that country embarked on its first census since 1998. A suicide bomber blew himself up next to a van carrying census-takers and their military escort. Of course, it tells you a lot that the enumerators needed military protection in the first place. The census is complete now, in all events, and thanks to a link from Abu Daoud, we can get a glimpse of the things that might be at stake as we wait for the results. The writer is a former member of the Pakistani cabinet and a former official at the World Bank, and thus seems well-qualified to offer these thoughts:

There will be losers and winners as the seats are redistributed on the basis of the 2017 count. It is understandable that those who are embedded in the established political order prefer the status quo. Now that a census has been held, we should see a fairly significant impact on the distribution of political power in the country. To begin with, we will see greater urban participation in the legislative process at the federal as well as provincial levels.

Federal dollars in Pakistan are also distributed to provinces within the country on the basis of population count, so that is clearly an issue of importance--again there will be winners (urban areas, in particular) and losers (probably the more rural areas suffering from out-migration to cities). The author, Shahid Javed Burki, promises to keep readers of the Express Tribune informed about results as they become available. I could be wrong, but I think we'll be waiting several months for these data.

Justin Stoler on the Linkages Between Violence, Poverty and Policy

Thanks to Tom Boswell for pointing me to an Op-Ed in today's Miami Herald by Justin Stoler and Tanya Zakrison. They build on a research article published earlier this year on gun violence in Miami to lay out the path for creating community change that can, in particular, replace guns with jobs. What a concept! Here are some highlights:

Gun violence has become a silent epidemic among select Miami-Dade communities, leading to hundreds of intentional injuries every year. We call it “silent” because most of the burden is borne by just a handful of communities — ones that have been marginalized for decades.

How did this happen? Surely analysis of other hospital records and police reports would show the same trends, though gun violence research has been stifled for years by the gun lobby’s efforts to limit the collection of gun-related data. But social issues such as race and poverty — long embedded in Miami politics — have deprived many communities of resources needed to strengthen communities from within. This has created a legacy of structural violence — the avoidable impairment of fundamental human needs — that has led to an entire generation of impoverished youth for whom violence and the “code of the street” are a way of life, while remaining invisible to those in power.

A truly holistic response to gun violence requires a multipronged approach to ending the school-to-prison pipeline. We need basic food security, hands-on youth mentoring and educational programs, and economic opportunities that offer parents meaningful employment and that allow leisure time to care for their children. Most of all, we also need to work with organizations in affected communities (churches, schools, social service providers) to understand and prioritize their needs. These organizations stand ready and willing to promote proud messages of empowerment with local law enforcement as community partners, not enforcers of an unjust status quo.

We need a society--and communities within that society--where it is easier to get a job than a gun.