Novel Estimates of Mortality Associated With Poverty in the US

That the poor have worse health is as near to a universal finding as you will get but is it a major cause of death and illness? The study below found that the relationship was surprisingly weak: Hazard ratios of less than 2.0. It is only one of many adverse factors

David Brady et al.

The US perennially has a far higher poverty rate than peer-rich democracies.1 This high poverty rate in the US presents an enormous challenge to population health given that considerable research demonstrates that being in poverty is bad for one’s health.2 Despite valuable contributions of prior research on income and mortality, the quantity of mortality associated with poverty in the US remains uknown. In this cohort study, we estimated the association between poverty and mortality and quantified the proportion and number of deaths associated with poverty.

Methods

Statistical analyses were conducted on February 17, 2023. We analyzed the Panel Study of Income Dynamics 1997-2019 data merged with the Cross-National Equivalent File (eTable 1 in Supplement 1).3,4 This longitudinal survey3 observed mortality from surviving family members and was validated with the National Death Index. Innovatively, our higher-quality household income measure included all income sources, cash and near-cash transfers, and taxes and tax credits and was adjusted for household size.5 With use of leading standards in international poverty research, poverty was measured relatively as less than 50% of the median income.1 Current poverty was observed contemporaneously in each year, and cumulative poverty was the proportion of the past 10 years. Cox hazards regression models were estimated using Stata, version 17.0 (StataCorp) for 18 995 respondents aged 15 years or older (135 790 person-years) (eAppendix 2 in Supplement 1). Analyses were robust to adjustment for self-rated health, overweight or obesity, smoking, acute health events, chronic disease, other confounders, and a wide variety of alternative details (see eTable 2 in eAppendix 2 and eFigures 1 and 2 in eAppendix 3 in Supplement 1). We used secondary unidentifiable archival data, so institutional review board approval was not needed.

Results

Current poverty is associated with a greater mortality hazard of 1.42 (95% CI, 1.26-1.60). Cumulative poverty—being always in poverty vs never in poverty in the past 10 years—is associated with a greater mortality hazard of 1.71 (95% CI, 1.45-2.02).

Figure 1 shows that survival of individuals in poverty mainly begins to diverge from survival of individuals not in poverty at approximately 40 years of age. The gap in survival between those in poverty and those not in poverty increases until a peak near 70 years when it begins to converge.

Figure 2 compares the number of deaths associated with poverty with other major causes and risk factors of death. In 2019, among those aged 15 years or older, 6.5% (95% CI, 4.1%-9.0%) of deaths and 183 003 deaths (95% CI, 116 173-254 507 deaths) were associated with current poverty, and 10.5% (95% CI, 6.9%-14.4%) of deaths and 295 431 deaths (95% CI, 193 652-406 007 deaths) were associated with cumulative poverty.

Current poverty was associated with greater mortality than major causes, such as accidents, lower respiratory diseases, and stroke. In 2019, current poverty was also associated with greater mortality than many far more visible causes—10 times as many deaths as homicide, 4.7 times as many deaths as firearms, 3.9 times as many deaths as suicide, and 2.6 times as many deaths as drug overdose.

Cumulative poverty was associated with approximately 60% greater mortality than current poverty. Hence, cumulative poverty was associated with greater mortality than even obesity and dementia. Heart disease, cancer, and smoking were the only causes or risks with greater mortality than cumulative poverty.

Discussion

Because the US consistently has high poverty rates, these estimates can contribute to understanding why the US has comparatively lower life expectancy. Because certain ethnic and racial minority groups are far more likely to be in poverty, our estimates can improve understanding of ethnic and racial inequalities in life expectancy. The mortality associated with poverty is also associated with enormous economic costs. Therefore, benefit-cost calculations of poverty-reducing social policies should incorporate the benefits of lower mortality. Moreover, poverty likely aggravated the mortality impact of COVID-19, which occurred after our analyses ended in 2019. Therefore, one limitation of this study is that our estimates may be conservative about the number of deaths associated with poverty. Ultimately, we propose that poverty should be considered a major risk factor for death in the US.

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2804032

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The worm has turned on woke trans issues: Spineless Dem politicians now look anti-women

By Piers Morgan

Sometimes, revolutions begin in unexpected places.

One such example came on Friday night at Bill Maher’s TV studio in Los Angeles where I was appearing on his “Real Time” show alongside rising Democratic star Rep. Katie Porter — the woman who wants to replace Dianne Feinstein as senator for California.

We debated the backlash to 26-year-old transgender influencer Dylan Mulvaney’s controversial promotion of Bud Light beer, and I made the point that far more concerning was Mulvaney’s mockery of sportswomen in a new Nike commercial.

I said that for someone who identified as a gay man until last year to be sporting a women’s sports bra, despite having no breasts, as “they” pranced around like a clueless non-athlete, mimicking how a misogynist would scornfully depict a woman doing sport, struck me as a slap in the face to actual women.

And to my surprise, given how liberal Maher’s audience tends to be, my comments were met with loud applause.

The same thing happened when I interrupted Porter’s disingenuously deflecting defense of trans people’s rights to say: “Nobody’s questioning trans rights to fairness and equality, what I would question is where trans rights to fairness and equality begin to erode or even destroy, as we’re seeing in women’s sport, the rights of women to fairness and equality.”

The audience again clapped enthusiastically when I reminded Porter, who by now was staring at me with withering contempt, what just happened in Scotland, where First Minister Nicola Sturgeon was forced to quit after endorsing a male rapist being sent to a women’s prison because he identified as a woman at his trial.

It was then that a rattled Porter exposed the shocking fragility at the heart of the woke defense of the indefensible when it comes to transgender athletes in sport, by saying she strongly disagrees with Riley Gaines, the swimmer who spoke out against trans rival Lia Thomas’ physical advantage over biological females and who last week was physically attacked by a mob of trans activists at San Francisco State University.

“What do you disagree with, out of interest?” I interjected. “What is it she’s said that’s actually wrong?”

Porter looked startled before stammering, to silence, that Gaines was only campaigning “to get likes and get clicks.”

“That’s not what she’s doing,” I said. “All I’ve seen her do is stand up for women’s rights for fairness and equality.”

“Riley is speaking up for herself,” said Porter. “And that is her prerogative and I respect her free speech.”

“I think she’s speaking up for pretty much every female athlete in the world,” I retorted, to yet more loud applause.

Within minutes, our exchange was trending on Twitter. It felt like a moment of reckoning, when an insane ideology hits the buffers of basic common sense, and the public knows it.

As Maher observed, also to big claps: “Wokeness is the opposite of what I grew up [with] as liberalism. Liberalism was, ‘Let’s give the women an equal shot,’ this is like, ‘Let’s put a male in the swimming pool with women.’ I don’t get it.”

Nor do most people.

Many viewers commented on social media that it was shocking to witness two middle-aged men vociferously stand up for women’s rights, and not the only woman at the desk.

I’d go further and say it was shameful.

Porter’s Senate bid launch video boasted that “California needs a warrior in Washington … I speak hard truths … I demand justice…”

But not, it seems, when it comes to defending her own sex.

On her website, she describes herself as “smart, tough, fearless.”

Yet by so spectacularly failing to defend women on such a clear-cut issue, she came across as unintelligent, weak and cowardly.

Of course, Porter was just following the lead of Democratic leaders like President Biden and Vice President Kamala Harris, whose endless transgender virtue-signaling includes recently proposing a new rule legally barring schools from prohibiting most biological male trans athletes from competing with females.

By doing this, they’ve become active participants in eroding women’s rights, which is beyond parody for a supposedly “progressive” administration.

https://nypost.com/2023/04/17/spineless-dems-now-look-anti-women/

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Scholastic forced to apologize for telling author to edit ‘racism’ out of kids book

Children’s publishing house Scholastic has apologized to the Asian-American writer of a children’s book about the internment of Japanese-Americans during World War II for asking her to remove a reference to “virulent racism” from an author’s note.

Maggie Tokuda-Hall, whose 2022 children’s book “Love in the Library” was inspired by how her grandparents first met while they were confined to an internment camp in Idaho during the war, wrote a blog post detailing the publisher’s demands.

“They wanted to take this book and repackage it so that it was just a simple love story,” Tokuda-Hall wrote in the blog post, which was titled “Scholastic, and a Faustian Bargain.”

“Nothing more.”

She added: “Not anything that might offend those book banners in what they called this ‘politically sensitive’ moment.”

In the April 11 blog post, Tokuda-Hall included a screenshot of the author’s note with the suggested edits.

The words “virulent racism” are crossed out, as are references to “the deeply American tradition of racism.”

Tokuda-Hall wrote that her deal with Scholastic was “contingent” upon the changes.

She refused and ended up signing with Candlewick.

In response to the blog post, Scholastic President and CEO Peter Warwick offered an apology and said that the publisher would like to license the book without the suggested edits.

Warwick said in a statement that the publisher was “wrong” to have insisted on the edits, which were “not in keeping with Scholastic’s values.”

“We don’t want to diminish or in any way minimize the racism that tragically persists against Asian-Americans,” Warwick wrote Friday. “Please know that we will always stand against censorship.”

Tokuda-Hall, who was picked by Scholastic as part of its “Rising Voices” series called “Amplifying Asian Americans and Native Hawaiians / Pacific Islanders,” accused Scholastic of “demanding that I strangle my own voice.”

“They want to sell our suffering, smoothed down and made palatable to the white readers they prioritize,” she wrote.

“And excuse my language, but absolutely the f–k not.”

Tokuda-Hall then posted a copy of the letter she sent to Scholastic in which she declined the publisher’s offer to license the book. In the letter to Scholastic, Tokuda-Hall hit out at Scholastic’s “deeply offensive offer” and edit.

“To say yes, we’d like to sell your grandparent’s [sic] story but not in a way that connects them to the suffering of those just like them now for fear of potential bans is, to put it lightly, cowardly,” she wrote.

“They will not have the right to sell this story because they’ve proven to me that they’re not up to the responsibility of it,” she wrote.

Tokuda-Hall ended the letter by writing: “So, to Scholastic, with all due respect: absolutely not.”

“I wish them the best of luck finding safe AANHPI books that cater to the white readership they prioritize.”

https://nypost.com/2023/04/17/scholastic-forced-to-apologize-for-telling-author-to-edit-racism-out-of-kids-book/

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Democrats Dismiss NYC Crime Victims

There are none so blind ...

We’ll say this about House Republicans: They’ve upped their marketing game.

We don’t say this as a disparagement; we mean it as a compliment. And we say it because yesterday, members of the House Judiciary Committee headed up to Federal Plaza in Manhattan, there to hold a “field hearing” — and to thereby shine a bright light on the soft-on-crime policies of Soros-funded New York City District Attorney Alvin Bragg.

The four-hour hearing was the second of its kind in recent weeks, with the first involving a field trip to McAllen, Texas — right on the border, right in the heart of the Rio Grande Valley, right where the nation’s illegal immigration catastrophe is at its worst. And it might be that Republicans are beginning to get under the skin of their Democrat colleagues because while Democrats skipped the border hearing in March, they attended this one.

Of course, it may simply be that woke, wealthy, elitist Democrats feel much more at home in tony Manhattan than they do in hardscrabble McAllen.

In any case, this examination of the Democrats’ “pro-crime, anti-victim” policies was led by Ohio Republican and House Judiciary Committee Chairman Jim Jordan, and it featured numerous real-life victims of violent crime, which has surged in Democrat-run cities nationwide, and particularly in New York City under the successive Democrat leadership of former Mayor Bill de Blasio and current Mayor Eric Adams.

New York City has “lost its way when it comes to fighting crime and upholding the law,” said Jordan. “Here in Manhattan, the scales of justice are weighed down by politics. For the district attorney justice isn’t blind — it’s about advancing opportunities to promote a political agenda — a radical political agenda.”

Toward the beginning of the hearing, committee members heard impact statements from several city residents who’ve experienced violent crime up close and personally. Democrat New York City Council member Robert F. Holden also spoke, and he criticized Bragg’s policies.

“On his first day in office, Bragg issued a memo that would decriminalize a broad range of offenses and reduce charges for violent crime,” Holden said. “This was a signal for every criminal that it was open season on law-abiding citizens in New York. … These failed progressive policies reverse 30 years of law and order delivered to the city by the hardworking men and women of the NYPD and professional prosecutors that put victims’ rights ahead of criminals.”

Predictably, Democrats and their colleagues at The New York Times denounced the hearing as a “junket,” a “sham,” a “stunt,” a “MAGA Broadway production,” and an “outrageous abuse of power.” They even called it “an exercise in retribution directed at the prosecutor who indicted the former president on 34 [redundant and ridiculous] felony counts earlier this month” — which is an odd characterization given that Republican committee members didn’t mention Donald Trump’s name once.

Indeed, New York Democrat Congressman Daniel Goodman called the hearing “a charade” to protect Trump. But Madeline Brame, a witness whose Army veteran son was fatally stabbed nine times in 2018, wasn’t in any mood for it. “Don’t insult my intelligence,” she said. “This is why I walked away from the plantation of the Democratic Party.”

We can’t imagine losing a child to a violent crime, but this woman has lived it. And the Democrats dismissed her testimony as part of a charade. Shame on them. What is it that Democrats always say about “moral authority”? Or does that only apply when the witness is one of their own?

“Victims can care less about anyone’s political ideology or party,” Brame said. “Neither do criminals. They don’t roll up to a person and ask them if they’re a Democrat or a Republican before they bust them in the head, or before they push them in front of the train, or before they stab them to death.”

In addition to the Times’s Praetorian Guardsmen, the Democrats also had the usual “fact-checking” suspects out in their defense yesterday. One of their pet peeves is when we mention, rightly, that Alvin Bragg is a Soros-funded DA.

Our Nate Jackson fact-checked this fact-check recently, and it turns out that an anti-police group called the Color of Change PAC announced in May 2021 that it was backing Bragg’s candidacy for DA with $1 million. And it also turns out that, days later, George Soros cut Color of Change a check for $1 million.

Mere coincidence? We think not. “Anyone can see exactly what happened here,” said another fact-checking fact-checker, columnist Matt Palumbo, “yet the fact-checkers were more than happy to further demolish their credibility in arguing the contrary with pure semantics. The fact-checker’s case that Soros didn’t fund Bragg amounts to nothing more than ‘Soros didn’t fund him — the PAC did!’”

“Experts say no legal link between Soros donation, Bragg,” say the fact-checking experts at The Washington Post and PolitiFact and elsewhere.

To which we say: What would we do without experts? And what would New York City’s criminal class do without a soft-on-crime Soros DA like Alvin Bragg?

https://patriotpost.us/articles/96596-democrats-dismiss-nyc-crime-victims-2023-04-18

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Australia: Aged care rules ‘to set off collapses’

This is typical of Leftist thinking. They think they can just pass a law and make something happen that they want to happen. That is rarely so.

The problem is that they do not first do the hard work of undertanding how or why the existing situation exists. It will almost always be the result of several interracting pressures and failing to account for those pressures will cause "unexpected" results.

The situation discussed below is a simple example of that. We would probably all agreee that nursing homes for the aged would ideally have a large, well-trained staff to give individual attention to each resident when required. And the ALP is trying to make that happen by legislation. But it won't happen

To understand why you need to look at the existing situation, where a small staff of not mostly not very bright people are all that are availble in such homes. And why is that so?

Cost. Employing staff is expensive and the normal way of coping with that is to pay only minimal wages. And the only people who will accept such wages are people who do not have much to offer in the way of skills and abilities

So mandate that staff must be paid nore? You can do that but what will be its effect? The care offered by the home will be so expensive that few elderly will be able to afford it. It would cast many frail elderly onto the streeets. You just can't do that.

And the proposal most discussed below is an example of that. A qualified nurse gets wages well above the minimum so where are you going to get the money to pay her? Short of government subsidy you cannot do it. The home could well go broke trying.

So the nurse "shortage" is mainly a shortage of nurses who will acccept nursing home pay. There will be such a shotrage for a long time. The mandate will be unenforceable and will mainly result in a REDUCED availability of nursing home care. Nursing home care will become the preserve of rich families only

It's a devil and the deep blue sea phenomenon. To get assured good care, you have to pay a lot. But not everyone can pay that much so you get the distressingly poor treatment of some residents that we often read about


The chief of the peak nursing professional body says it could take five to 10 years for the sector to ­recruit enough staff to meet ­Anthony Albanese’s target for 24/7 nurses in residential aged care facilities, warning there is “absolutely no way” the industry will meet Labor’s July 1 deadline.

Australian College of Nursing chief executive Kylie Ward also expressed concern that providers would be forced to shut down under the legislated requirement to have at least one registered nurse on site at all times.

The warnings come as the Aged & Community Care Providers Association, the overarching body representing residential, home and community care, said the government needed to ensure the pace of change was manageable for aged care providers and did not “exacerbate an already challenging situation”.

The sector is scrambling to ­implement a suite of reforms including mandated minutes of care per resident, quality and safety standards, and full-time nursing requirements as it adjusts to a new funding model bought in last October as recommended by the Aged Care Royal Commission.

The overhaul comes as financial troubles plague the sector, with the latest figures from the Quarterly Financial Snapshot of the Aged Care Sector revealing 66 per cent of private providers are operating at a loss, with facilities losing an average of $28 per resident each day.

For-profit and not-for-profit providers, which represent 90 per cent of all homes, returned a collective net loss before tax of $465.3m for the September 2022 quarter, off revenues of $5.3bn.

As the sector grapples with a major shortfall of workers and ­a deteriorating financial outlook, a number of aged care facilities have been forced to close their doors. Aged care provider Wesley Mission was the latest facility to close, announcing on Thursday the shutdown of all Sydney homes, citing difficulties in attracting and retaining staff.

The closure, to take effect next month, will displace about 200 residents but the facility said it was committed to ensuring the elderly had other suitable accommodation.

Professor Ward said the aged care sector was facing a shortfall of 10,000 nurses ahead of Labor’s July 1 deadline, and urged the government to invest in attracting overseas-trained nurses to ensure a sustainable supply of workers to help meet targets. She said the college, which had been fighting for facilities to have a registered nurse to be on site for years – had told the government of the projected staffing shortfalls ahead of the deadline.

“There is absolutely no way the sector is going to meet its legislated target by July 1,” Professor Ward said. “We needed a minimum of 10,000 workers before this came into place … where are the nurses coming from?

“If the government doesn’t start looking at developing skilled migration, or a broader approach to developing a new workforce then you’re never going to meet that target.”

Professor Ward said providers were fearful they may have to close their doors if they were unable to meet the legislated targets.

“I can guarantee you they will close. I have spoken to CEOs who are distressed and say they won’t be able to meet the requirement … the modelling of care needs to be considered as we transition to these reforms but we can’t just pluck these people out of thin air,” she said.

Aged Care Minister Anika Wells said the government would not force the closure of facilities that were unable to meet nursing targets and would work with providers to help them meet new standards. Last month, Ms Wells conceded about one in 20 aged care homes would not meet Labor’s July 1 deadline, but said about 80 per cent had already achieved the target.

Ms Wells said the “vast majority” of residential facilities would meet 24/7 nursing requirements and that around the clock nursing was needed to properly care for some of the nation’s most vulnerable. Exemptions would be available for a small number of facilities in regional and remote areas if they were unable to fulfil the requirements.

Opposition aged care spokeswoman Anne Ruston attacked Labor for failing to consider the challenging circumstances the sector faced due to severe ­workforce shortages “in their rush to tick and flick election commitments” after the Prime Minister promised to “fix the crisis in aged care”.

Senator Ruston seized on the closure of Wesley Mission’s homes, arguing residential facilities were not adequately supported during the transitional period.

Sue McLean Bolter, whose 98-year-old mother Moira McLean has been a resident of the Wesley Mission home in Narrabeen since 2019, was first informed of the provider’s closure on Tuesday.

She has been scrambling to find suitable accommodation for her mother, having recently flown in from the US to celebrate Ms McLean’s birthday. So far she has been unsuccessful.

“It’s been very stressful … it’s just been horrible … my sister who lives here has been furious,” Ms McLean Bolter said.

“Had (Wesley) even notified the government that they had been planning to close and why were we given just six weeks ­notice?

“This is the northern beaches where people have their families, doctors and hospitals so to send them over to the other side of Sydney is almost unthinkable. You can’t just drop by to meet your mum, you might have to drive two hours across Sydney in traffic.”

Wesley Mission chief executive Reverend Stu Cameron said Labor’s new national staffing requirements had created challenges for the home as a smaller provider. “The aged care sector is experiencing challenges to workforce and flow-on impacts from the national reforms to aged care,” Reverend Cameron said.

“Wesley Mission supports these once-in-a-generation reforms, improving quality for all care users. It is, however, a challenging environment to be a smaller provider.’

Aged care provider Whiddon chief executive Chris Mamarelis said the Wesley closure was “unsurprising” given the financial pressures many providers were under and forecast more failures.

https://www.theaustralian.com.au/nation/aged-care-rules-to-set-off-collapses/news-story/4eebd2a2ecbdce4829aafdc1d94fdc61

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My other blogs. Main ones below:

http://dissectleft.blogspot.com (DISSECTING LEFTISM)

http://edwatch.blogspot.com (EDUCATION WATCH)

http://antigreen.blogspot.com (GREENIE WATCH)

http://australian-politics.blogspot.com (AUSTRALIAN POLITICS)

http://snorphty.blogspot.com/ (TONGUE-TIED)

http://jonjayray.com/blogall.html More blogs

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