Fitness, Health, Risk

February 8, 2010

Popular discourses on fitness, health and risk are filled with confusion, misunderstanding, and sometimes willful ignorance. Let this quick post be your guide to sorting out the three concepts.

Fitness. Generally speaking, fitness is capability to perform a certain task. Therefore, “fit” is fairly useless as a descriptor, because it does not specify what the person in question is fit to do. “Are you fit?” can always be answered with “fit for what?” There exist many “fitness” standards – for cardiovascular fitness, strength, flexibility, and so forth. Arguably, the bare minimum of fitness is being fit enough to sit on the couch without keeling over and dying. However, neither this nor any other fitness standard gives a good estimate of health, more on which below.

Health. Unlike fitness, health is a state of being, generally understood as a state in which the body is not suffering from disease. Depending on your relationship with postmodernism, you can add qualifiers such as “socially constructed disease,” etc. “Being healthy” is somewhat more informative than “being fit,” although again the operationalization of health varies considerably. In some cases, health is summarized as just a handful of measures, while in others, it is used to mean the state of the entire body. Using the latter maximal definition of health, or some approximation thereof, we can evaluate fairly accurately whether an individual is healthy (in fact, medical professionals do this daily with their patients), but unfortunately we may not be able to ascertain an individual’s risk for future problems.

Risk. Unlike health or fitness, risk does not reside within the individual. In discussing the risks of developing future health problems, it is important to clarify two points. First, what is the outcome for which risk is being computed? Second, is the risk to be computed as is, or net of other effects? The importance of the first question is self-evident: risk for early mortality is quite different from risk for chronic diseases, which is quite different from risk for low self-reported health. The importance of the second question is more elusive. Risk can be computed simply by correlating a predictor variable with an outcome variable: this is “as is” risk. This basic correlation can be controlled for confounding factors – gender, socioeconomic status, health behaviors, and age, to name a few – yielding (theoretically) the true net effect of the predictor on the outcome. For example, the “as is” risk of mortality is greater among underweight people relative to “normal weight” people (using standard BMI categories), but controlling for factors such as smoking and disease explains this association and results in a much smaller “net” risk. Risk, by its nature, cannot be computed from a single case. It requires referencing studies of large and representative samples to make a well-validated estimate. By the same line of logic, risk cannot be assessed from either fitness or health without appealing to robust statistical findings.

The final point to keep in mind is that these three concepts carry very different standards of proof. At one extreme, “fitness” for a task can be proven simply by doing that task. At the other extreme, the estimated risk of a certain outcome for a given person is always open to revision by newer and more sophisticated definitions and analytical techniques, but cannot be “tested” through personal anecdote. Beware when discussants switch concepts to down- or up-shift the standard of proof to their own advantage.


The Bones of an Idol

December 16, 2009

Health care reform is starting to look as sickly as the health care system it is supposed to fix. First, the public option vanished quietly a week ago. That was supposed to be OK, because Senate Democrats introduced the Medicare expansion which was supposed to cover more previously uninsured people, anyway – and have a greater chance of making it into the law books. Now the Medicare expansion is on the chopping block, too. What, then, is left of health reform?

The exact answer is likely to shift from day to day with the ebb and flow of Congressional politics, but the rough outline is this. First, the individual mandate is alive and well. Americans are required to have minimal health insurance, or else pay a fee. Second, the insurance exchanges are poised to become the biggest change to how consumers buy insurance. In these exchanges, consumers would be able to shop for health insurance much as employers can shop for company-based health insurance today. Third, a number of new regulations for health insurance companies have endured so far in the proposed bills: for example, requiring coverage for pre-existing conditions or capping differences in premiums or coverage by age or by salary. Fourth, as Jamelle writes today, there are “dozens of small measures and experiments aimed at controlling costs while also improving outcomes.”

Substantively, I am afraid, health care reform is falling apart. I have written before on the conflict between expanding health insurance coverage and cutting costs. The problem with health care reform used to be that it tried to do both – aggressively expand coverage while promising to cut costs. The problem with health care reform today is that it will probably do neither. Let’s look at the pieces still standing:

1. The individual mandate. Without further reform, an individual mandate only serves to drive the uninsured into a broken market. Even with generous subsidies, an individual mandate alone props up the status quo by giving insurance companies more customers without giving them incentives to change the way they do business.

2. The insurance exchange. Any insurance exchange. An insurance exchange presumes either that (A) the existing market works fine, or (B) the competitive pressures from the exchange’s creation will be so great as to make the existing market work better. (A) is untenable as a premise for insurance reform. (B) is an odd proposition, because insurance companies already compete to some extent. The exchange-based competition is only a question of degree. While it is a libertarian article of faith that more competition is always more better, actual evidence on competition’s effect on efficiency in the health insurance market is mixed in its implications for the insurance exchange.

3. New “fairness” regulations for the insurance market. These involve highly uncertain tradeoffs between cost containment and increased coverage, as I discussed here.

4. The “small experiments.” These are just that – small experiments, not far-reaching reform. They may well point the way to future improvements in the provision of health insurance and health care, but their place in a reform bill is auxiliary by definition.

To be fair, no reform bill will ever come with the guarantee that costs will be reduced or coverage will be expanded. The modern incarnation of health care reform began as a mishmash of policy proposals, which taken together may well have achieved some improvement over the status quo. Then, the legislative process got to work, axing parts of health care reform when it became politically expedient to do so. The bill that will eventually pass will contain the last policies standing, rather than the best policies to achieve the stated goals.

I consider this a natural outcome of the way we have been talking about health care and health reform. I remember passing a street demonstration this summer where people chanted and held signs to the effect of “Health care reform now!” Well, what kind of reform? Making all doctors wear Mickey Mouse ears on the job would reform health care, but probably not in the way these protesters had in mind. From the very outset, we had committed ourselves to talking about health reform either as all things that are good, or as the worst thing in the whole world. “Health care reform” became a mirror which reflected our personal ideas of what we thought reform should or should not look like. Because the actual bills failed to rally around a single proposal – “insurance exchanges now!” or “Medicare expansion now!” – their details became mere inconveniences in a larger ideological battle between Left and Right.

If this was still a policy debate, I would have suggested that we try to at least agree on a single goal to pursue for now – but pursue doggedly, until it is achieved. Cost control – through regulation, tort reform, or any other possible means – might be one such “compromise goal.” Unfortunately, the struggle over health care reform has ceased to be about achieving either lower costs, increased coverage, or any other substantive policy goal. It has become (or maybe it always was) about flexing political muscle. The credibility of President Obama and Congressional Democrats, and, by extension, electoral success in 2010, are what’s really at stake. So I wouldn’t be surprised, once the administration succeeds in getting a “health care reform” bill through Congress, if the result will bear only faint resemblance to the promises of efficient health care provision and equitable access to health insurance.

College sports and the business of education – Updated

November 28, 2009

(Scroll to the end for an update on this post.)

Writing for the Times, Gilbert Gaul gives new voice to the old complaints about collegiate athletics: they spend too much and siphon money away from the “education” part of post-secondary education.

The rise of College Sports Inc. didn’t happen by accident. Administrators at many universities have allowed athletic departments to operate independently, like stand-alone entertainment divisions. They have separate budgets, negotiate their own TV deals and, in some cases, employ hundreds of coaches and staff. And as long as they continue to collect ever-larger sums from ticket sales, boosters and television, who is going to tell them to spend less?

Gaul holds that college sports use up too much money. I agree. But I can’t get behind his proposal to curb this spending:

If college presidents really wanted to halt the college sports machine, they could try two options. They could insist that athletic departments operate within their university budgets, like the English or biology departments; or they could ask Congress to rescind the tax breaks on the commercial income earned by athletic programs.

The “college sports machine” is not a monolith. This machine has two parts: revenue-generating blockbuster sports, which are run as a business (usually football and men’s basketball), and nonrevenue sports, which are run as a charity. The dominant business model in collegiate athletics has the former supporting the latter, and, ideally, kicking back a few bucks to the academic departments. When we talk about overspending in college sports, we conflate egregious spending on the moneymaking team (five-star hotel stays for football players) with “ordinary” spending on nonrevenue sports. Many if not most collegiate football programs in this country, for example, would probably be able to stand on their own. If most collegiate athletic departments need outside support, then perhaps it is spending on nonrevenue sports – and not excessive investment in revenue-generating ones – that is to blame.

I suspect that propping up nonrevenue sports is what’s hobbling collegiate athletic programs. Gaul suggests that limiting how much money athletic departments can make or spend will fix their overspending problems. But it seems that dropping the financial obligations of nonrevenue programs might be a surer way of getting college sports to pay their way. While I am speaking of both men’s and women’s nonrevenue sports, there is no getting around the issue of gender equality in sports with such a proposition, which runs directly counter to Title IX as it is currently enforced today.

Title IX states that “No person in the United States shall, on the basis of sex, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any education program or activity receiving Federal financial assistance.” Because athletic departments are considered to be “education programs,” they have been required to demonstrate progress towards or accomplishment of equal opportunity in sports participation. Historically, colleges have done this by establishing new nonrevenue sports for women and cutting existing nonrevenue sports for men. If, as I propose, nonrevenue sports in general are curtailed, female student-athletes will disproportionately bear the brunt of disappearing scholarships, facilities, and staff.

That said, I don’t believe that dropping nonrevenue sports from collegiate rosters will deal any serious blow to gender equality in education or in the broader society. Remember that Title IX applies to college sports on the premise that sports represent an “education activity” that somehow contributes to a student’s education in that college. Running with this assumption, we might conclude from the numbers on sports participation that the real inequality is not between male and female student-athletes, but between student-athletes and everyone else. In 2002, fewer than 2.5% of students enrolled in any college participated in school-sanctioned athletics.* For comparison, when Rutgers and Princeton each fielded 25 men for the first football game ever, the players on the field represented over 11% of the schools’ combined student body.

But I would question even that assumption – that participation in collegiate sports offers men or women a leg up in the world, especially outside the revenue-generating programs. Competing in a varsity sport is at least as draining to a college student as holding a strenuous full-time job. Meanwhile, the socioeconomic gains from such participation are small and elusive: scholarship money is scarce, the “character-building” aspect is questionable**, and the contribution to one’s education is negligible at best, negative at worst. Thus, if participation in college sports cannot be legitimately described as “educational”, then such participation – equal or otherwise – should not be governed by Title IX***. More importantly, if participating in college sports does nothing for one’s education, then colleges have no business subsidizing nonrevenue sports and the student-athletes who compete in them.****

If you’re still not convinced, I ask you to at least get your story straight. Either participation in college athletics is essential to schools’ educational missions, in which case athletic departments should become even bigger money sinks in their quest to enroll anybody and everybody in organized sports; or playing college sports is not an educational activity, in which case it should be excluded from the purview of Title IX, allowing colleges to strip funding from no-revenue-getting teams, men’s as well as women’s. To me, the second story makes much more sense. I’ll take the real economic victory of cheaper tuition and solvent athletic programs over the fleeting moral victory of an athlete of any gender being able to get a .25 scholarship to play games that few people attend, watch, or follow.

Update (02/15/10). As Times blogger Tara Parker-Pope reports today, sports participation really does seem to improve life outcomes in adulthood. While this finding contradicts my original conclusion in this post, it leads to another less-than-rosy implication: because of low overall (organized) sports participation rates in college – see above – athletic programs should become even less profitable to level the playing field between current athletes and non-athletes.

Read the rest of this entry »

What Passes for Food

September 22, 2009

I have no real content to post, so here’s a link to an interesting blog, Food In Real Life, billing itself as:

Preaching truth to packaging. Pictures of packaged food, cooked to specifications, compared to the photo on the box.

Two things to think about:

1. How few of the packaged foods depicted look like what’s on the package (or, in the case of fast food, on the menu board). We travel through a world of delectable images but disappointing products, speaking of which…

2. How few of the package pictures – to say nothing of the actual foods – actually look like real food that might be put together using familiar ingredients. Some entries are less offensive in this regard (the rice, for example), but others are grade-A frankenfoods (Jeno’s pizza, Pop-Tarts).

One take on these images states the obvious: that we are trained and acclimated to eating the foods that we do, for better or for worse. No one is born with a genetic craving for Pop-Tarts, or, for that matter, a Pringles addiction. (Cos even they admit – once you pop, you can’t stop.)

The equally obvious corollary to this point, however, is anathema in certain circles. For all the fanfare around “intuitive eating,” (aka “eating when you’re hungry, stopping when you’re full”) the approach makes no sense in a world where eating for one’s health has been entirely cleaved from eating by one’s instincts. Anyone who has ever craved soda, or chips, or instant noodles, or, hell, any of the foods featured on FoodIRL, understands this on some level: in the present food environment, our eating instincts often lead us away from food and towards “food-product.”

And so, many people live their lives oscillating in an unhealthy Catch-22: when they eat intuitively, their eating is as disordered as the food culture at large; but when they try to “order” their eating, they end up with overly-restrictive, insufficiently-nutritious diets. If there is a way out from this, it will necessarily include curtailing to some extent our eating instincts, bent as they are towards unhealthy (and at times even unsatisfying) choices – but it cannot be so severe as to rob us of the pleasure and utility of food.

How Obamacare Might Increase Costs

September 9, 2009

For those of you following at home, the President gave a big speech on health care reform tonight. Specifically, he argued for a plan composed of three major planks:

First, …. it will be against the law for insurance companies to deny you coverage because of a pre-existing condition. As soon as I sign this bill, it will be against the law for insurance companies to drop your coverage when you get sick or water it down when you need it most. They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime. We will place a limit on how much you can be charged for out-of-pocket expenses, because in the United States of America, no one should go broke because they get sick. And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies – because there’s no reason we shouldn’t be catching diseases like breast cancer and colon cancer before they get worse. That makes sense, it saves money, and it saves lives.

[Second,] We will [create] a new insurance exchange – a marketplace where individuals and small businesses will be able to shop for health insurance at competitive prices. … For those individuals and small businesses who still cannot afford the lower-priced insurance available in the exchange, we will provide tax credits, the size of which will be based on your need.

[Third, U]nder [this] plan, individuals will be required to carry basic health insurance – just as most states require you to carry auto insurance. Likewise, businesses will be required to either offer their workers health care, or chip in to help cover the cost of their workers.

If I may sum up these points, Obama is essentially proposing to

1. Extract more value out of insurance policies, by expanding who, what, and how much is covered,
2. Improve accessibility to individual insurance policies, including a nonprofit, self-sustaining public option, and
3. Mandate that every American carry health insurance.

It’s a good plan for extending health insurance coverage to all Americans, which in itself is a worthy goal. But I am much more skeptical of its effect on health care costs. Health care reform has been billed as including powerful cost-cutting measures. But before we pour our faith into arcane budget estimates, we would do well to remember a few ways in which this plan may end up costing us more, not less, than our current (broken) system.

  • If you have insurance, you may end up getting less services for more money. This would directly contradict Obama’s promise, but it’s a reasonable possibility. Under this reform plan, insurance companies will no longer be able to save money by dropping customers or limiting their coverage. On paper, they would not be allowed to charge customers more, and would have to raid their profit margin to come up with the difference. But in practice, they will almost certainly try to get the money from customers somehow – directly through higher premiums, or indirectly through government subsidies.
  • If you don’t have insurance, you will get it (public or private, subsidized or not), and might therefore increase your utilization of health care. If people who today are being denied health care because of insurance shenanigans get the care they need, they might be healthier for it, but this care won’t come free.
  • Even if you get insurance but don’t increase your utilization of health care, you would still be paying for insurance. You might not use your new policy, but you would still be paying for it. That’s less money in your pocket, more money in the national health care expenditures column.
  • Not all of these cost increases are necessarily bad. Of course it will cost money to provide un- and underinsured Americans with lifesaving (or even just life-enhancing) health care. Of course everyone who can should pitch in to spread out the risk of ill health. If the economic times were good and (dare I dream) the federal government were running a surplus, I would gladly ignore all these factors. However, given a runaway national debt and a shaky economy, we simply cannot afford health care reform that costs more money than it saves. I have a hard time believing that Medicare and Medicaid waste and inefficiency are so great as to equal the costs of insuring the 45-some million uninsured Americans and providing improved health care for everyone.

    There are ways to improve health insurance coverage while tackling the fundamental inefficiencies of the market. I proposed one half-baked and politically unfeasible specimen a while back. In any case, if we cannot have health care reform that both expands coverage and reduces costs, then let us at least be candid about this limitation and the need for further reform. It wouldn’t have sounded as good in his speech, but President Obama would have been prudent to acknowledge that he will likely be far from the last President trying to reform a costly and inefficient health care system.

    What do we support when we support affirmative action?

    August 13, 2009

    Alternate post title: When all you have is access to the GSS dataset, everything starts to look like a GSS variable.

    To expand on my reply to Jeremy under this post, it is important to distinguish between support for (or opposition to) affirmative action in principle and support or opposition concerning concrete affirmative action programs or policies. I believe that support for affirmative action is funnel-shaped: many Americans are, to steal from George Orwell,

    … the sort of person who is in sympathy with the fundamental aims of [affirmative action], who has the brains to see that [affirmative action] would ‘work’, but who in practice always takes to flight when [affirmative action] is mentioned.

    Fewer, but still many Americans – “a plurality, if not a slim majority” – will confess their support to affirmative action in some general fashion, the vaguer the better. Then the funnel continues narrowing. Fewer support affirmative action policies, such as quotas or preferential hiring, and by the time you get down to cases, such as the misadventures of Ricci and Co. in Connecticut, the opposition to affirmative action seems insurmountable.

    I would argue that this isn’t just a matter of tricky wording on survey questions. Affirmative action policies often reflect a general desire to even out the playing field, rather than any precise or reliable data about what works or will be popular. As a result, I believe, there is a group out there of people who would support some sort of affirmative action program(s), but may oppose specific manifestations of affirmative action, particularly in high-profile cases such as Ricci, or, earlier, the University of Michigan’s infamous affirmative action system for undergrads.

    Somewhere out there is a data set better suited to addressing the empirical questions of whether this group of affirmative action proto-supporters exists, how big it is, and how much influence it might wield. Until then, all I’ve got is this half-baked analysis of data from the 2006 General Social Survey. I looked at the results for two items: one asking respondents to indicate their support for preferential hiring and promotion of blacks, and another asking respondents to indicate their support for government aid to blacks. Throughout, I make the assumption that the latter item represents a (more) general principle of affirmative action, while the former represents a (more) concrete policy or set of policies. The wording of the two questions is as follows:

    (Preferential hiring)
    Some people say that because of past discrimination, blacks should be given preference in hiring and promotion. Others say that such preference in hiring and promotion of blacks is wrong because it discriminates against whites. What about your opinion — are you for or against preferential hiring and promotion of blacks?

    (Government aid)
    Some people think that [blacks] have been discriminated against for so long that the government has a special obligation to help improve their living standards. Others believe that the government should not be giving special treatment to [blacks] . Where would you place yourself on this scale, or haven’t you made up your mind on this?

    Filtering the data for cases that have valid responses to both items, I obtained the two following tables, breaking down the frequencies of each response to the two questions. (Click for readable size.)

    Preferential hiring

    Government aid

    Forfeiting originality, here is how I interpreted this data in my earlier comment:

    So what’s going on here? By the most conservative interpretation, nine more people in the sample (1%) support generic “government aid for blacks” than the more specific (but still very vague) “preferential hiring and promotion.” More likely, this difference is greater, since the aid question included a “middle-ground” option (AGREE WITH BOTH), but the preferential hiring question did not.

    What this says to me is A.) that our best chance at broadening support for affirmative action is to reach out to the 1% (but probably more) in the middle who are sympathetic to the principle but hostile to a specific program … Sometimes, the solution will lie in modifying the affirmative action program under consideration rather than demonizing its opponents. Also, B.) that arguments in favor of affirmative action must be made differently for the principle than for specific programs: general arguments about chronic racial inequality may sway people’s minds on the principle, but they will likely win few new allies for the programs.

    Mere hours after I wrote this, I realized that there were probably more than 9 people in the sample who supported the principle but opposed the policy. The hypothesis I should have been testing was whether more people favored aid and opposed preferences than favored preferences and opposed aid. Given my limited toolkit, I reached straight for a crosstabulation of the two variables:

    Crosstab of “preferential hiring” and “government aid,” column percentages

    First things first – there is a clear (and statistically significant) positive correlation between support for preferential hiring and support for government aid. However, in the cells which buck this correlation (along the counterdiagonal) there does appear some evidence of the phenomenon I have been suspecting. To wit: 99 respondents (10.54%) support government aid but oppose preferential hiring, while only 23 respondents (2.45%) oppose government aid while supporting preferential hiring. This result is slightly more exciting than the “1%” comparison of the separate frequencies tables above.

    Again, running with the assumption that “special [government] treatment” is more of a principle and less of a policy than “preferential hiring and promotion,” this analysis seems to lend some credibility to the existence of a layer of “proto-support” for affirmative action: individuals who favor the spirit and aims of affirmative action programs, but may disagree with the implementation. To wring some implications out of this mess:

  • As above, we must be aware of the difference between support for a principle and support for a policy. As far as affirmative action goes, recognizing that there are people who favor the former and object to the latter is crucial. This means that not every defense of an affirmative action policy needs to go down as if the overarching principles are under attack. Particularly, we should reach out to anyone who might be a proto-supporter – perhaps even working with them to reform affirmative action policies so that they might become effective and palatable.
  • Taking a broader view, however, any stratum of proto-support for affirmative action seems wedged between much heftier blocks of true believers. Those who reject the idea of affirmative action may or may not be swayed by arguments about racial inequality, but they will almost certainly not be persuaded to like affirmative action policies so long as they believe their backing principles are false.
  • I suspect that tailoring the affirmative action message to these different constituencies is harder than it might seem. Tweaking and rebranding affirmative action programs might appeal to the proto-supporters, but would further convince the diehard opponents that affirmative action is being “shoved down their throats.” On the other hand, speaking directly to the roots of the hardcore opposition – “racism, ignorance, selective observation” – is likely to leave the proto-supporters feeling spurned and insulted.
  • And that’s all the original and unoriginal opinions on the matter that this no-statistical-package-having blogger cares to share at present. I should add, as I had originally replied to Jeremy,

    Of course, I could be entirely wrong and misdirected about this, and twisting the data beyond recognition, but that’s for you to decide.

    That’s what I get for cheerleading

    August 13, 2009

    In this post, I argued that Cash for Clunkers would stimulate overall consumer spending, not just spending on cars. Well, the first month of data is in, and two findings stick out:

  • Automotive sales went up.
  • However, retail sales as a whole declined unexpectedly.

    In light of this, I freely admit that I had been too optimistic about Cash for Clunkers. However, I would caution against writing off the program altogether – its effect may have been too small to counteract some other factor(s) which depressed retail sales; and some of its effects, particularly in buoying auto manufacturing, may not have come into play yet.

    The Times reports on the rest of July’s retail sales data:

    The Labor Department reported that retail sales fell by a seasonally adjusted 0.1 percent from June, and were 8.3 percent lower than a year ago. Economists, who had been expecting an increase of 0.7 percent, called the numbers a sobering reminder of the persistent weakness in consumer spending, which makes up 70 percent of the United States economy. …

    Consumers spent 2.4 percent more on motor vehicles and automotive parts last month compared with June as the government’s popular “cash for clunkers” car-purchase program got under way, but any money that flowed into the pockets of car dealers seemed to come at the expense of other businesses.

    Retail spending excluding sales of cars and car parts fell 0.6 percent. People spent less on furniture, electronics, appliances, books and music, implying that American consumers are still wary of the weak job market and an uncertain economic recovery.

  • Scoring Affirmative Action

    August 12, 2009

    Jeremy Levine, writing for the outstanding Social Science Lite, has this to say about his uncle’s brush with reverse discrimination:

    According to my uncle, his interviewer immediately apologized as he entered the room. ‘Look, I hate to say this,’ the interviewer said. ‘But there’s no way we’re going to be able to hire you. If you were a woman or black, I’d hire you on the spot. You are totally qualified, but we’ve got to fill our quotas.’ Naturally, my uncle was none too pleased, commenting plainly (but forcefully) that acts of “reverse discrimination” are unfair. I did my best to defend affirmative action policies, discussing their historical necessity, noting their negligible affect on white male employment, and even waxing philosophical about the entitlement associated with staking claim and ownership over falsely constructed “spots” in colleges or the workforce. It was all to no avail, though. Cliché as the phrase is, my uncle was “passed up” for the job, and there wasn’t much I could say. …

    See, claiming reverse discrimination is a lot like recounting your golf score. It’s always the one or two bad rounds that leave the deepest, most painful impressions. You always remember the bogey on the 9th hole, but never the birdie on the 10th. Somehow, the abundance of good holes are taken for granted, while the one or two missteps are amplified and taken as indicative of the entire round. Sure, my uncle remembers getting passed up for the job with the University of Michigan—an event that (probably) happened the way he said it did. But, in the process of recounting this single experience, he forgot about a lifetime of job interviews in which he directly benefited from his whiteness or his gender.

    I’m a fan of affirmative action, but Levine’s scoring system rubs me the wrong way. By this metaphor, we can simply tally up the successes and failures of two individuals – one white, one black – and, when their “life scores” are equivalent, we will know affirmative action has succeeded. Correspondingly, so long as their “life scores” – educational attainment, success in the labor force, wealth accumulation, etc. – remain different, we know just what to do: slap a handicap on the “higher-scoring” individual that would level the playing field. That would be the crude affirmative action program which had tripped up Levine’s uncle.

    With apologies to Keva Silversmith, sometimes golf isn’t the sport most metaphorically applicable to life. In the case of affirmative action, I think we’re dealing with something more akin to a poorly-run powerlifting meet. One competitor shows up armed with a singlet and a pair of Chuck Taylors; another – in the latest quintuple-ply squat suit, spring-loaded bench shirt, and knee wraps that could contain a small nuclear explosion. Both are expected to perform their best on the platform. At the end of the day, the geared lifter blows the raw lifter’s total out of the water. Now what?

    The geared lifter in this example is the archetypal “privileged applicant,” and his equipment stands for all the accoutrement of privilege. The raw lifter, if you will, is then the “underprivileged applicant,” and the difference between the lifters’ scores is – well, you can figure it out. In any case, here’s the issue: obviously, pitting the two against one another as is is unfair to the latter. What is not so obvious is how we might overcome this unfairness. Here’s what won’t work:

    1. Stripping privilege away from the privileged applicant. It’s impossible, from a public policy standpoint, to retroactively “cancel” privilege. It might work in theory, but there is no practical way to do it.

    2. Forbidding the privileged applicant from drawing on his privilege. Again, another option that sounds nice, but even in the most ruthlessly objective selection processes, privilege has a way of giving its holders a boost.

    3. Handicapping the privileged applicant in the selection process. This is the instance of reverse discrimination that Levine recounts. The problem is that, unlike golf, life offers no clear way to identify the right handicap for each player. Here the powerlifting counter-metaphor comes in handy: no one knows how much supportive gear adds to lifters’ totals, since this number depends on many different factors. Hence, perfectly fair competition of geared against raw lifters is not practical, since any handicap on the former is bound to be inaccurate and arbitrary. This goes double for affirmative action programs. We can tell that (most) white applicants have advantages over (most) black applicants that have nothing to do with their qualification for the position. But what we can’t tell is just how big this advantage is for any specific white applicant – let alone “white applicants” as a group. That’s why, at the end of the day, the specifics of many affirmative action programs are indefensible: these programs are written from a general aim to overcome privilege, rather than from specific information about the advantage privilege confers.

    For all this, can we even have affirmative action programs that are both fair and effective? I believe so. The key is to honor the principle of fair treatment. It is not fair to turn an applicant away on the basis of his race, no matter how this would affect the year-end Diversity Report. On the other hand, it is perfectly fair to assist underprivileged applicants before, during, and after the selection process, that they might accumulate at least some of the advantages enjoyed by their more-privileged co-workers. By extension, it is perfectly fair to target underprivileged communities to help their members with education, job search, homeownership, and so on.

    I suspect that many other supporters of affirmative action won’t like my take on it. They might rightly point out that this offers no guarantee of equal opportunity – to say nothing of equal outcome. But they would forget that equal opportunity isn’t as simple as having the same golf handicap. Under the reign of equal opportunity, everyone would have more or less the same shot at success, but owing to time and chance, some individuals would still come out way ahead. Regardless of how it is written, the successful affirmative action program will be that which preserves this individual variation in outcomes, while minimizing (in this case) the corresponding racial differential.

    Let Them Eat Cabbage

    August 11, 2009

    For an atheist, Christopher Hitchens sure does put a lot of faith in predestination. It’s not the kind about going to heaven, though; Hitchens believes that Bill Clinton need not have visited North Korea to secure the release of journalists Laura Ling and Euna Lee because – get this – the North Koreans were going to release them anyway. In the man’s own words:

    The two young women were picked up in March and released in August. That means they spent almost half a year in the North Korean prison system. Yet to judge by the photographs of them arriving back on U.S. soil, they were in approximately the same physical condition as they had been when they were first unlawfully apprehended. … Ling and Lee had obviously not been maltreated or emaciated in the usual way that even a North Korean civilian, let alone a North Korean prisoner, could expect to be. The logical corollary of this is obvious. The Kim Jong-il gang was always planning to release them. They were arrested in order to be let go and were maintained in releasable shape until the deal could be done. …

    As of last week, and as the result of a huge investment of time and energy and prestige and forced politeness, we can now claim to have reduced the North Korean prison population by exactly two, and they were going to be released anyway. In return, we have immensely gratified and flattered the man who kidnapped them and who makes a daily mockery of international law. There was even “remorse” expressed. But guess by whom? Not by the slave master who makes his territory impossible to enter and impossible to leave. A lousy day’s work.

    I don’t write much about foreign policy in this space, mostly because of my ignorance in these matters. However, even I can tell that Hitchens’ reasoning is patently stupid. First, Hitchens forgets that the role of government is to serve and protect its citizens – not least when those citizens are held captive in a hostile foreign country. By his own admission, Hitchens had been to North Korea. I doubt that if he had been detained, we would have gotten from him a heroic statement directing his government to forfeit rescue efforts. Pending any evidence to the contrary, I conclude that Hitchens views imprisonment by a brutal dictatorship as bad for Christopher Hitchens, but okay for his compatriots.

    This brings me to the second point: Hitchens’ baseless conclusion from Ling and Lee’s appearance that they were going to be released anyway. No one knows what the North Koreans would have eventually done with Ling and Lee. It is plausible that they have not been as mistreated as they might have been so far precisely for the reasons Hitchens identified. However, it is naive – especially of a curmudgeon like Hitchens – to assume that this treatment would have continued indefinitely. If and when the North Koreans ceased to see the journalists as an excellent bargaining chip, nothing would have prevented or even dissuaded them from shipping the two to a labor camp.

    Finally, Hitchens’ tone suggests that he favors either ignoring or bullying the North Korean government. Neither of these measures have succeeded in the past: when bullied, North Korea only grew more antagonistic; and when ignored, it staged dangerous, belligerent stunts to regain the world’s attention. I may not know anything about foreign policy, but I think there is a better way to deal with North Korea: reciprocity from the moral high ground, as famously articulated by Ho Chi Minh* at the start of the Vietnam War:

    Everything depends on the Americans. If they want to make war for 20 years then we shall make war for 20 years. If they want to make peace, we shall make peace and invite them to tea afterwards.

    * I am not arguing that Ho held the moral high ground, only that he had claimed it.

    But wait … there’s more!

    August 8, 2009

    Bob Herbert has a way of writing columns that pretty much sum up all the commentary I could possibly want to make about a given current event. His piece on murderer George Sodini was no exception:

    I was reminded of the Virginia Tech gunman, Seung-Hui Cho, who killed 32 people in a rampage at the university in 2007. While Cho shot males as well as females, he was reported to have previously stalked female classmates and to have leaned under tables to take inappropriate photos of women. A former roommate said Cho once claimed to have seen “promiscuity” when he looked into the eyes of a woman on campus.

    Soon after the Virginia Tech slayings, I interviewed Dr. James Gilligan, who spent many years studying violence as a prison psychiatrist in Massachusetts and as a professor at Harvard and N.Y.U. “What I’ve concluded from decades of working with murderers and rapists and every kind of violent criminal,” he said, “is that an underlying factor that is virtually always present to one degree or another is a feeling that one has to prove one’s manhood, and that the way to do that, to gain the respect that has been lost, is to commit a violent act.”

    Comparison to the Tech murders? Check. Acknowledgment that America is steeped in a culture of violence? Check. Condemnation of Sodini’s infantile but all-too-common strain of misogyny? Check. Focusing on power as a key concept in contextualizing this horrific crime? … Nope.

    Herbert follows the lead of feminist bloggers in framing Sodini’s murders exclusively as a matter of destructive misogyny. (Is there any other kind?) His conclusion reads:

    We would become much more sane, much healthier, as a society if we could bring ourselves to acknowledge that misogyny is a serious and pervasive problem, and that the twisted way so many men feel about women, combined with the absurdly easy availability of guns, is a toxic mix of the most tragic proportions.

    For comparison, here’s Jill at Feministe:

    Sodini was clearly an unbalanced and aggressive man who fixated on women and blamed them for his problems. The same cultural misogyny that enabled Sodini to blame women for his own social ineptitude and aggression also underwrites “The Game,” and informs people like Roissey’s interactions with women. It glorifies male dominance and relies on male entitlement.

    On one level, it is painfully obvious that Sodini’s acts were a manifestation of a violent hatred of women. But something doesn’t quite add up here: was misogyny all that caused Sodini’s rampage? As Jill Tubman notes, such accounts tend to ignore that Sodini’s racism seemed as powerful as his misogyny, and that his targets were just as likely to have been black men:

    Clearly [Sodini] was deeply troubled. But I’m not sure that insane really covers it this time. He knew exactly what he was doing. He wanted to kill himself and take his ex-girlfriend and a bunch of young white “bruthr”-banging “hoez” with him (in his sick mind). … This is the part of the dark secret lurking in surburbia/disturbia and should be the stuff of all our nightmares: the intense racial anxiety, confusion, fear and rage some whites are feeling & how they plan to express it.

    The point is not to discount the role Sodini’s misogyny played in spurring his acts, or to sweep under the rug the acuteness of violence against women. Rather, it is to see Sodini and his ilk in full: men who are disgruntled not only against women, but also against minorities, immigrants, people of different religions, and on and on. And what seems to stand at the origin of this hateful cascade is power, or more precisely the lack thereof.

    How could have something as nebulous as “lack of power” precipitated mass murder? Certainly, Sodini fulfilled all the requirements for privilege: white, male, heterosexual, middle-class, etc. However, judging by his blog, Sodini didn’t feel very privileged. In fact, right up until pulling the guns out of his gym bag, he more or less had been letting the world roll right over him:

    No matter how many changes I try to make, things stay the same. …

    I predict I won’t survive the next layoff. That is when there is no point to continue. RIght now, life is bearable and I can get by indefinitely. Something bad must happen. The paycheck is all I have left. The future holds nothing for me. …

    It is difficult to live almost continuously feeling an undercurrent of fear, worry, discontentment and helplessness. I can talk and joke around and sound happy but under it all is something different that seems unchangable and a permanent part of my being. I need to realize the details of what I never accomplished in life and to be convinced the future is merely a continuation of the past – WHICH IT ALWAYS has been. (emphasis added)

    From this text, it appears that what was eating George Sodini, above all, was his perceived lack of power. He couldn’t get what he wanted – one of “30 million desirable women” – and, moreover, saw no way towards getting what he wanted. How his mind ran with that thought to the conclusion of murdering innocent people is chilling and tragic, but it doesn’t tell us about the roots of this social dysfunction.

    I think – and this is where this post moves into the territory of unsubstantiated opinion – that the democratization of power in society has had the unfortunate side-effect of creating a class of people who feel entitled to power, but for whatever reason are unable to claim it. A graduation speech by Kurt Vonnegut comes to mind:

    Free Enterprise is much too hard on the old and the sick and the shy and the poor and the stupid, and on people nobody likes. They just can’t cut the mustard under Free Enterprise.

    This isn’t quite genuine “Free Enterprise” we’re dealing with here, but the idea is similar. Some men, mostly white, but sometimes not, can’t get what they feel they deserve. They might be anti-social, emotionally stunted, undateable or unemployable, but in their minds all they see is society’s unfair rejection of their claim to power, and power’s fruit – success. They might seek escape in weird subcultures, but, shamefully often, they reach for violence as a desperate means to attain fleeting power.

    The difference between this perspective on Sodini’s crime and its interpretation as “strictly” misogynistic is subtle, but I think it matters. By the latter account, if somehow someone could have re-educated Sodini out of his misogyny, he might have never gone in for mass murder. But as I see it, if it’s not one thing, it’s going to be another for his type: Sodini would have channeled his perceived powerlessness into hating, and possibly killing, someone else. Steve Albini, who started his career impersonating psychopaths with shocking accuracy, captures this sentiment best:

    I started out hating myself and when I’m through
    I’ve gotta have something to hate, and I guess it’s you
    Man’s gotta have something to hate, guess I’ll do
    And when I’m through with myself, I’ll start on you.