Health inequality recap

On SCOTUS’s ACA D-Day, here is a quick recap of some health inequality posts.

Percentage of Adults Aged 18-64 Who Did Not Get Needed Prescription Drugs Because of Cost, by Poverty Status: National Health Interview Survey, 1999-2010
From 1,000 women diagnosed with breast cancer over 11 years in Washington, D.C.: The number of days between the discovery of an anomaly and the diagnosis, by race/ethnicity and insurance status.

 

Children with asthma are almost twice as likely as all children to be below the poverty line, and less than half as likely to live at 4-times the poverty line or higher.

 

All groups of countries are showing improvement in maternal mortality rates except the U.S.
The U.S. lags seriously behind almost all European countries on infant mortality (most of which is caused by preterm births, the result of women’s poor health).
Estimated Percentage of Persons Who Delayed Seeking or Did Not Receive Medical Care During the Preceding Year Because of Cost, by Respondent-Assessed Health Status

OK, that’s enough! You can see all the health care related posts here.

Sell that (stale) narrative [off topic]

Tonight in the Washington Post I read, with a sense of relief:

But then I realized I’d been sold this focus story before:

  • April 4, 2012: “Mr. Romney looked beyond the Republican primary fight and focused his anger exclusively on Mr. Obama.” —New York Times
  • March 31, 2012: “Obama, Romney shift focus to general election” —Washington Post
  • Feb. 7, 2012: “Campaigning in Grand Junction, Colo., Romney kept his focus on Obama” —L.A. Times
  • January 3, 2012: “[Romney] has stayed focused primarily on Obama and the November general election.” —USA Today
  • August 18, 2011: “Romney keeps focus on Obama, not Perry” —International Herald Tribune
  • June 14, 2011: “Romney was able to keep his focus on Obama in large part because the others decided not to go after him.” —Washington Post

What women own: U.S. business edition

The other day President Obama celebrated women owning businesses, as well as the problems they face:

More women are also choosing to strike out on their own.  Today, nearly 30 percent of small business owners are women.  Their businesses generate $1.2 trillion last year. But they’re less likely to get the loans that they need to start up, or expand or to hire — which means they often have to depend on credit cards and the mounting debt that comes with them.

Those figures come from data I already was looking at on the question of what women own globally. Most recently, I took a shot at home ownership, with the surprising (to me) finding that women own (or are buying) more homes than men in America. No such luck with business ownership.

Women do own 29% of businesses, as of the Census Bureau’s 2007 Survey of Business Owners. But their share of business receipts — the total size of businesses, as measured by income — is much less: just 4%.

Source: My calculations from the Survey of Business Owners.

The survey defines ownership based on 51% of stock or equity.  So of course there are lots of women with partial ownership of all those other businesses. But the vast majority of businesses in the survey are tiny, with few or no employees. As a measure of wealth, then, owning a business is a bad indicator. Plenty of these people would make more money using their skills working for someone else, if they could (and investing their money in stocks).

Unsurprisingly, there is a distinct pattern of ownership by industry — that is, what the businesses produce. The only industry in which women own a majority of businesses is health care and social assistance, although they are also close in education (think daycare services):

Source: My calculations from the Survey of Business Owners.

Obama went on:

Just 3 percent of Fortune 500 CEOs are women.  Fewer than 20 percent of the seats in Congress are occupied by women.  Is it possible that Congress would get more done if there were more women in Congress?  (Laughter and applause.)  … I think it’s fair to say.  That is almost guaranteed.  (Laughter.)

For some reason this is often a laugh line. As in, “Am I right? Just ask my wife!”

Anyway, I would hate to judge Congressional effectiveness by the quantity of work done, and the evidence that women in Congress do get more done is not clear. But in the world of business our own research (here and here), as well as newer work, does suggest that U.S. women in workplace management positions increase the gender equality around them.

Gingrich’s anti-Semitic code words, too

New Gingrich has used racist code words for a long time, before the current food stamp and no-work-ethic mantras. Now he’s onto something new with a “Saul Alinsky radical” drumbeat. Here he is from last night in South Carolina:

The centerpiece of this campaign, I believe, is American exceptionalism versus the radicalism of Saul Alinsky [chants of “USA! USA!”] … We are going to argue American exceptionalism, the American Declaration of Independence, the American Constitution, the American federalist papers; the founding fathers of America are the source from which we draw our understanding of America. He draws his from Saul Alinsky, radical left-wingers and people who don’t like the classical America.

Here he is in a December debate on Fox:

Who is Saul Alinsky? And what kind of first name is “Saul,” anyway? Jewish. And who Googles “alinsky”? I don’t know for sure, but I do know that whoever they are, they live in the same states as people who Google “obama citizenship” at a correlation of .73:

Some other searches that have the highest correlation  with “Alinsky” across states (all .68 or better):

  • charles krauthammer
  • conservative blogs
  • drudge
  • drudgereport.com
  • fairness doctrine
  • greta van susteren
  • health care bill text
  • hr 1388
  • mccain for president
  • national firearms act
  • natural born citizen
  • presidential order
  • trilateral commission

My guess is that hardly anyone in Gingrich’s intended audience knows who Saul Alinsky is. But I think he’s giving them enough information to know what kind of person he is. In December he put it this way:

…if you look at his background, he’s really a lot more Saul Alinsky and radicalism than he is anything to do with the traditional American models.

FYI, this morning someone removed the description of Alinsky as Jewish from the opening line of his Wikipedia entry, which was added in December.

No family-caregiver-citizenship for you

Add to the No Family For You mantra of the Defense of Marriage Act — which includes denial of immigration (or citizenship) to legal spouses of U.S. citizens — denial of a primary caregiver.

As reported in the San Francisco Chronicle:

Citing the Defense of Marriage Act, the Obama administration denied immigration benefits to a married gay couple from San Francisco and ordered the expulsion of a man who is the primary caregiver to his AIDS-afflicted spouse.

Bradford Wells, a U.S. citizen, and Anthony John Makk, a citizen of Australia, were married seven years ago in Massachusetts. They have lived together 19 years, mostly in an apartment in the Castro district. The U.S. Citizenship and Immigration Services denied Makk’s application to be considered for permanent residency as a spouse of an American citizen, citing the 1996 law that denies all federal benefits to same-sex couples.

Further on:

The agency’s decision cited the Defense of Marriage Act as the reason for the denial of an I-130 visa, or spousal petition that could allow Makk to apply for permanent U.S. residency. “The claimed relationship between the petitioner and the beneficiary is not a petitionable relationship,” the decision said. “For a relationship to qualify as a marriage for purposes of federal law, one partner must be a man and the other a woman.”

Obama and Attorney General Eric Holder decided earlier this year that the law, commonly known as DOMA, is unconstitutional on equal protection grounds and that the administration would no longer defend it in court.

And so it goes.

Divorce, handguns, Obama, Top Chef, Tea Party

I’ve done some experimenting with “rapid response demography,” using Google tools to track time trends for marriage and divorce, recession and divorce and unemployment. Beyond time, we also could look at spatial variation, less for trends than for clues to cognitive, cultural, or subtle demographic patterns we weren’t expecting. Since my thinking is exploratory, and this is a blog, I’ll share what I found without attempting to draw conclusions. This uses the Google Correlate tool, a free tool (login required) described in some detail in this whitepaper.

With the new American Community Survey marital event data, for the first time we have recent divorce incidence data for every state (the weak vital records apparatus for divorce in the US is slower, inconsistent, and doesn’t include all states). I combined 2008 and 2009, and calculated the rate of divorce per 1,000 married women.

So, what were people searching Google for in the states with the highest divorce rates? Handguns.

This isn’t just a fluke with Colt 45. Out of the 90 terms most correlated – across states – with the divorce rate, 28 are about guns, and not the hunting kind but things like “kel-tech sub 2000” and “glock custom.” I don’t see a clear pattern in the rest of the list, though “splenda cake” and “low carb thanksgiving” are intriguing.

Way down the list, though, at #93, with a correlation of only .60, is “tea party.” After #90, Google doesn’t give you a state map, so I made this scatterplot:

The states where people search for “tea party” are also those where the divorce rate is higher. Which made me think of politics, and the simple correlation between divorce and the red-state-blue-state thing. Some writers have reported that red (politically conservative) states have high teen marriage/pregnancy and divorce rates, which is partly because of how much Evangelical Christians get pregnant and married at young ages.* But I haven’t seen a direct comparison with recent data. So here is the divorce rate with the Obama vote in 2008:

The states with higher divorce rates gave smaller shares of the vote to Obama in 2008. But this correlation isn’t so strong, just -.48 on a scale of 0 to 1. What if you put the Obama vote into the blender and ask what Google searches follow the Obama pattern? The answer is overwhelming: Top Chef:

Again, not a fluke. No less than 13 of the top 90 correlated search terms are about Top Chef (“bravo top chef,” “top chef episode,” etc.). Someone who has seen this show might have to give me some hypotheses for why Top Chef states went for Obama.**

Aside: Am I just cherry-picking results according to some preconceived agenda? No and yes. The green graphs are by Google, and they represent the #1 search correlations with the real-world state indicators I uploaded (divorce and Obama votes). The blue scatter plots are things that struck me as interesting, that I chose to pursue. That’s how exploration works: look at the pattern, dig around, repeat.

* Jennifer Glass and Philip Levchak presented a paper at the Population Association of American conference this year which analyzes divorce rates in all U.S. counties as a function of a variety of factors, including religious affiliations. The paper, which does not seem to have been published yet, concludes in part:

The results here show that communities with large concentrations of religious conservatives actually produce higher divorce rates than others. … The major pathway linking religious conservatism and divorce seems to be the tendency of conservative Protestantism to encourage the early cessation of education in favor of marriage and childbearing. [Although, they add, much of the conservative Protestant effect remains unexplained in their models.]

** Two nights ago, a Tweet from @MrBrwnIYZ: “Well ain’t this about a bitch… President Obama decides to do an address to the nation when Top Chef comes on!”

The marriage rights dominoes fall

Constitutional amendment or bust.

In 2004, with the first U.S. legal recognition of homogamous marriages looming, President George W. Bush issued a characteristically keen legal analysis. To save marriage as an exclusive institution involving a legal bond between one man and one woman, a Constitutional amendment was the only recourse. With the Obama administration’s decision to bail out on defending the Defense of Marriage Act, the prescience of that position has become even more clear.

Bush said:

Activist courts have left the people with one recourse. If we are to prevent the meaning of marriage from being changed forever, our nation must enact a constitutional amendment to protect marriage in America. Decisive and democratic action is needed, because attempts to redefine marriage in a single state or city could have serious consequences throughout the country.

The Constitution says that full faith and credit shall be given in each state to the public acts and records and judicial proceedings of every other state. Those who want to change the meaning of marriage will claim that this provision requires all states and cities to recognize same-sex marriages performed anywhere in America. Congress attempted to address this problem in the Defense of Marriage Act, by declaring that no state must accept another state’s definition of marriage. My administration will vigorously defend this act of Congress.

Yet there is no assurance that the Defense of Marriage Act will not, itself, be struck down by activist courts. In that event, every state would be forced to recognize any relationship that judges in Boston or officials in San Francisco choose to call a marriage. Furthermore, even if the Defense of Marriage Act is upheld, the law does not protect marriage within any state or city.

For all these reasons, the Defense of Marriage requires a constitutional amendment…

Obama’s legal position proves the point. There is simply no way, within the Constitution, to legitimately defend extending a series of rights and privileges to marriages of one gender composition and not another, as Judge Walker wrote so beautifully in the California Proposition 8 decision, Perry v. Schwarzenegger. The experience in that case — when the Schwarzenegger administration backed out of defending Prop. 8 — and the current round of cases, show the difficulty of defending the principle of gender inequality in the case of marriage.

As Jeffrey Toobin summarizes:

The arguments against DOMA are virtually identical to the arguments against bans on same-sex marriage. As the Proposition 8 trial in California demonstrated, there are very few, if any, justifications for denying gay and lesbian people the right to get married. Judge Vaughn Walker applied a rational basis test to Prop 8 and struck it down. He said it was completely irrational to discriminate against gay people in this manner.

The challenge for Scalia, Thomas and company, if they intend to uphold marriage inequality, is steep. This is not really a case of activist judges creating a new right to gay marriage. Rather, to continue the federal government’s ban on recognizing homogamous marriage — on recognizing some marriages granted by the states but not others, on the basis of the gender and sexual orientation of the participants — is to create an exclusive right for heterogamous couples that is not in the Constitution, and then deny it to protected classes of people. That’s difficult. Not that Scalia can’t find a way, but it won’t be pretty.

As for a Constitutional amendment, somehow that doesn’t seem to be high on the anti-homogamy agenda these days. If that’s your only issue, there is no other choice. But as part of a conservative coalition, a simple analysis of public opinion by generation shows that it’s a weak plank in the platform:

And time is not on their side. If they want a Constitutional amendment to ban homogamous marriage, it’s probably too late.

For families, and…?

Someone should tell President Obama about Unmarried and Single Americans Week, coming up Sept. 19-25.

USA Week doesn’t get much attention, and the third week of September is a crowded one; last year it featured National School Internet Safety Week, National Childcare Week, National Flower Week, Deaf Awareness Week, Women in Construction Week, National Dog Week, National Farm Animals Awareness Week, and National Farm Safety Week.

But maybe this year is a good time for his refresher. Wall Street reform, of all things, brought this out in him. He said of his proposal, “This reform is good for families; it’s good for businesses; it’s good for the entire economy.” That followed up on his early declaration that it was “good for families and … those fair and honest credit providers who play by the rules and can now face a level playing field.”

That was after health care reform was intended to “give families and businesses more control over their health care,” and the stimulus package brought “relief for families and businesses” during tax season.

As the Census Bureau reports, there are about 100 million unmarried adults, and 32 million people living alone; one-in-four households is just a person living alone, up from 17% in 1970. Since 1880, depending on how you slice it, non-family households are the fastest growing type — including people living alone, and groups that are not related by marriage, birth or adoption (some are cohabiting partners or married homogamous couples, still not officially “families,” though that could change).

Source: My analysis of U.S. Census data from IPUMS.

This is just rhetorical, naturally. In fairness, the priorities are not so narrow. For example, the most recent budget sought to assist a long list of good Americans, including:

  • Middle Class Families
  • Military Families
  • Cities and Metropolitan Areas
  • The LGBT Community
  • Every Child
  • Rural America
  • Our Nation’s Seniors
  • All Americans
  • America’s Workers

That includes everyone good except the poor and minorities, who have no one else to vote for, so they can be expected to read between the lines (e.g., “cities”).

And maybe the president’s focus is understandable, as his corporate critics have always called his policies “bad for families,” as in, “The Administration’s tax plan puts the economic burden on hard-working Americans and their families.”

Wouldn’t it be nice if more of the burden fell on people who don’t work as hard?

Whose right to sex education?

The principle of equality for children is fundamentally at odds with the American interpretation of the principle of equality for adults. We defer parenting to parents at the cost of equality for their children. This happens in myriad ways, lots of which involve education. Just as adults are free to donate thousands of dollars to just our neighborhood school’s PTA, to benefit our children and evade responsibility for those of our non-neighbors, we may be free to dictate the terms of the education our children receive.

The right of the parents to control their children is great when it’s great. And the denial of that right is often egregious when it’s taken away from parents who are disenfranchised or oppressed, to the detriment of parents and children alike. But when it’s exercised poorly, the right of parental control is too-often protected by law.

Take sex education. Most states let parents “opt” their children out of what little sex education is still offered. A new report from the Guttmacher Institute lists 37 states and the District of Columbia that permit parental opt-outs for education about sexually-transmitted infections (3 more require affirmative consent before any education on the subject may be delivered). And, before you think better of those without opt-out provisions – most of them only teach abstinence anyway. (Even when parents “opt in,” what do they get? Teachers may have permission to teach about contraception while being blocked from its “advocacy or encouragement.”)

In the last 15 years, the public provision of real sex education has been drastically curtailed in this country. In the short period from 1995 to 2002 the percentage of adolescents receiving formal instruction on birth control methods dropped from 81% to 66% for boys, and 87% to 70% for girls. This was driven by the political movement for “abstinence only” education, abetted by $1.9 billion in federal and mandatory state matching funds.

What did we get for $1.9 billion? Nothing good. Abstinence only education has been shown to have no effect on how much teenagers have sex – none. It also has no effect on the number of partners teenagers have if they do have sex, and no effect on birth control use, pregnancy rates, or sexually transmitted disease infection. Not that these programs don’t accomplish anything. Like virginity pledges, abstinence-only programs do help spread myths that discourage condom use. The opt-out provisions for sex education are intended to permit parents to raise their children according to a particular moral code, and their children’s free access to lifesaving knowledge is a secondary concern.

The last year has seen progress toward broadening sex education, including federal efforts to break the political stranglehold of the abstinence-only movement. But even where such reforms are on the table, as in Wisconsin, more comprehensive sex education still includes a parental opt-out provision. Maybe this is politically unavoidable. But shouldn’t children have rights to real education that are not alienable?