You Cannot Take Health or Safe Food For Granted

Today is World Health Day, as proclaimed by (guess who!) the World Health Organization. This year's theme is safe food:

“Food production has been industrialized and its trade and distribution have been globalized,” says WHO Director-General Dr Margaret Chan. “These changes introduce multiple new opportunities for food to become contaminated with harmful bacteria, viruses, parasites, or chemicals.”

Dr Chan adds: “A local food safety problem can rapidly become an international emergency. Investigation of an outbreak of foodborne disease is vastly more complicated when a single plate or package of food contains ingredients from multiple countries.”

Unsafe food can contain harmful bacteria, viruses, parasites or chemical substances, and cause more than 200 diseases - ranging from diarrhoea to cancers. Examples of unsafe food include undercooked foods of animal origin, fruits and vegetables contaminated with faeces, and shellfish containing marine biotoxins.

Keeping food safe requires oversight, typically by (honest) government regulators. This is not something with which the the free market can likely be trusted. The same thing, in my opinion, goes for health care, in general. Indeed, in the United States this is National Public Health Week, as organized by the American Public Health Association. They have produced a very nice infographic reminding Americans that we may think of ourselves as a healthy nation, but we are not, at least not in comparison with almost every other rich country. We have never been first--Sweden and Japan have vied for that honor for decades, but the U.S. is down at 34th in life expectancy, according to the APHA. We leave health care largely to the private sector and do not want the government too involved, except of course for huge government-sponsored programs like Medicare and Medicaid. A better model is the health maintenance organization such as Kaiser Permanente. Their "business" model is a classic insurance model, but with a twist. You pay a fee every month and they make money if you DON'T need intensive medical care. The healthier you are, the more money they make. Contrast that with the fee-for-service model that dominates health care in the U.S.--providers make the most money when you are sick, not when you are well. The twist with Kaiser is that they spend money encouraging you to be as healthy as possible. This should have been the model for health reform in this country...maybe some day.

California's Drought Versus Agriculture: Lessons for the Future?

California is the most populous state in the Union, with almost 12 million more people than Texas, which is #2. California also has the biggest economy--so big that it would be the 7th biggest in the world, if California were a nation-state instead of just a state. That's all well and good, except for the water problem. 

The 25 percent cut in water consumption ordered by Gov. Jerry Brown raises fundamental questions about what life in California will be like in the years ahead, and even whether this state faces the prospect of people leaving for wetter climates — assuming, as Mr. Brown and other state leaders do, that this marks a permanent change in the climate, rather than a particularly severe cyclical drought.

The problem is that we ordinary citizens don't use most of the water. Granted, here in Southern California we have to import 90 percent of our water from other places (think snow in the Sierra Nevada mountains of central and northern California and snow in the Rockies, coming to us via the Colorado River). But almost all of this water is surface water and it is at least relatively easy to monitor and price. Very few residents of California are dependent upon wells dug to tap into groundwater. But that is not true for farmers, whose use of surface and ground water is critical to the state's problems. Agriculture uses 75-80 percent of the state's water and the politics of water in California's agricultural sector are legion and are not going to be dealt with easily, as a follow-up story in today's NYTimes makes clear. Agriculture accounts for only about 2 percent of the state's economy, but the global impact is enormous. Ninety percent of the wine produced in the U.S. comes from California's grapes, and the rice, nut, fruit and vegetable production is greater than countries such as Canada, Mexico, Germany and Spain, according to a report from the University of California, Davis--the state's land grant university. 

The economic stakes are high, but the critical issue is whether the model of overusing water to grow food for a growing population is a sustainable model. 

California’s greatest resource in dry times is not its surface reservoirs, though, but its groundwater, and scientists say the drought has made the need for better controls obvious. While courts have taken charge in a few areas and imposed pumping limits, groundwater in most of the state has been a resource anyone could grab.

Yet putting strict limits in place is expected to take years. The new law, which took effect Jan. 1, does not call for reaching sustainability until the 2040s. Sustainability is vaguely defined in the statute, but in most basins will presumably mean a long-term balance between water going into the ground and water coming out. Scientists have no real idea if the groundwater supplies can last until the 2040s.

If the drought is genuinely a product of global climate change and not just part of a cycle, the answer is more likely "no" rather than "yes." And that means that we need to rethink what we grow--and thus what we eat--not just in California but everywhere. And, on top of that, how much we are going to have to pay for it. In particular, a diet that includes a lot less meat would mean not wasting water on growing food for animals that are then sent off to be killed for human consumption...

Muslims Are Increasing in Number at a Faster Pace Than Other Religious Groups

Conrad Hackett at the Pew Research Center has headed up a group of researchers at Pew, aided by the researchers at the International Institute for Applied Systems Analysis (IIASA0 in Vienna and the Vienna Institute of Demography to produce a very eye-opening set of population projections broken out by religion. This analysis deserves a lot more attention than I can give to it in one blog post, so here I am just going to hit the highlights (more highlights at CNN) and then I will dig into more details in subsequent posts.

The projections suggest that by 2070 the number of Muslims in the world will catch up with Christians, if current trends continue. They also suggest that by 2050 Muslims could account for 10% of Europe's population and that in the United States "Christians will decline from more than three-quarters of the population in 2010 to two-thirds in 2050, and Judaism will no longer be the largest non-Christian religion. Muslims will be more numerous in the U.S. than people who identify as Jewish on the basis of religion."

Furthermore, four out of every 10 Christians in the world will live in sub-Saharan Africa, but this is also the region of the world with one of the highest rates of growth among Muslims and the growing friction and tension is felt in the recent shooting of Christian college students by Islamic extremists in Kenya.

Overall, the global numbers could shift a bit depending upon what happens in China:

For example, China’s 1.3 billion people (as of 2010) loom very large in global trends. At present, about 5% of China’s population is estimated to be Christian, and more than 50% is religiously unaffiliated. Because reliable figures on religious switching in China are not available, the projections do not contain any forecast for conversions in the world’s most populous country. But if Christianity expands in China in the decades to come – as some experts predict – then by 2050, the global numbers of Christians may be higher than projected, and the decline in the percentage of the world’s population that is religiously unaffiliated may be even sharper.

The key element here is especially the trend of the birth among Muslims, in particular, in various regions of the world--a topic that I have been following for a long time and which I referenced yesterday with respect to Iran. 

Would Lifting Sanctions Raise the Birth Rate in Iran?

Iran currently has one of the lowest fertility rates of any predominantly Muslim country. The United Nations estimates that the average woman in Iran is having 1.9 children--below replacement level. However, there are so many young women of reproductive age because of past high fertility that the population is nonetheless projected to grow from its current 80 million to 100 million by 2050. I have suggested in the past that one of the causes of the steep fertility decline in Iran is the economic uncertainty facing the country as a result of world-wide sanctions imposed on the country to try to stop its nuclear enrichment program. But today an agreement was reached that sets up a framework for an eventual end to those sanctions, as the BBC reports:

The framework agreement, struck after intensive talks, aims to prevent Tehran making a nuclear weapon in exchange for phased sanction relief. Iran and the six world powers involved must now finalise the deal. Iranians have been celebrating in the streets but Israel says the deal threatens its survival.

The US first imposed sanctions after the revolution in 1979, at a time when there were 39 million Iranians and the total fertility rate was 6.5. Other sanctions have been imposed along the way, including in 1995 when the US Congress passed the Iran-Libya Sanctions Act, and in 2006 when the United Nations imposed a broader set of sanctions. All this time the birth rate has been dropping, but the question remains as to whether a lifting of sanctions--if it ultimately happens--will increase economic prospects for young people in sufficient quantity to encourage a rise in the birth rate. We know that the Iranian government is hoping so. On the other hand, the experience in East Asia and in Eastern and Southern Europe seems to be that when birth rates drop to replacement level or below, couples become accustomed to the higher standard of living and personal freedom that small families bring them, and so it may be unlikely that the birth rate would respond. Perhaps a celebratory rise, and then back down? Time will tell. No matter which way the fertility rate goes, though, Iran is on track to add millions more people to an already troubled region. That might be reason enough for Israel to worry.

World's Oldest Person Dies at 117--Will You Make it?

At any given moment, the world's oldest person is a moving target (figuratively, not literally, of course). We know that the oldest authenticated age at death is 122 years and 164 days. This was older than Moses who reportedly died at 120, but I have had several students over the years point out that the Bible says that Abraham lived to be 175... Anyway, Misao Okawa died yesterday in a rest home in Osaka, Japan, of heart failure at age 117 years and 26 days. USA Today noted that:

Okawa, the daughter of a kimono maker, was born on March 5, 1898, in Osaka and was recognized as the oldest person in the world by Guiness World Records in 2013.
Okada [of the rest home] said Okawa lost her appetite about 10 days ago. She celebrated her birthday in March at her nursing home, wearing a pink kimono with cherry blossom prints. During her birthday, she was quoted as saying she was "very happy" to be that age.

Very happy and very lucky, in the sense that an incredibly small number of humans have ever come even close to that age. And that reminds to thank Lynnda Jordan for pointing me to an article suggesting various ways by which you might try to determine your own likely age at death. This is really an article that should be read from the bottom up, because at the end of the article it has links to a variety of websites on which you can evaluate your likely death day, as I point out in Chapter 5 of my text. The key to all of these is your age and sex, with a few obvious caveats thrown in--the "real causes of death"--smoking, alcohol abuse, and not wearing seat belts, for example. These numbers come largely from life tables generated by the U.S. Centers for Disease Control. If you live outside the U.S. you can adjust your age at death upward if you live in Japan or most places in western and northern Europe, and adjust it down for most other places in the world.

The first part of the article, however, seems like it is telling a different story because it discusses the use of a treadmill index to estimate a person's likely number of years left. The research is reported as follows:

Want to know if you'll survive the decade? Hop on a treadmill. Johns Hopkins researchers analyzed more than 58,000 stress tests and concluded that the results of a treadmill test can predict survival over the next 10 years. They came up with a formula, called the FIT Treadmill Score, which helps use fitness to predict mortality.

But if you follow the link in that paragraph to the original article, the real results are a bit different:

After age and sex, peak metabolic equivalents of task and percentage of maximum predicted heart rate achieved were most highly predictive of survival (P<.001).

The research article is behind a subscription not covered by the SDSU library, and no longer available in NIH's PubMed Central (not sure why not), so I can't get to the entire article, but my guess is that "after age and sex" there is very little left to explain. There may be a tiny bit of influence from the treadmill test (note that given the large sample size, almost any effect will show up as statistically significant), but not enough to do you very much good in improving your guess once you put in your age and sex. So, my advice is that if you want to know how long you are likely to live, just look up a life table and find the answer. It really is that simple, but remember not to bet too much money on dying at an exact age--a lot of stuff can happen between now and then.