Boreal B[l]og

 It’s a bone chilling March morning in Korea, and the USS ST. LOUIS is off the southeastern coast, anchored at Pohang.  I’m finishing up in sick bay, having just seen my tenth case of gastroenteritis.  The last sailor told me word is spreading on board to stock up on absorbent paper products. 

Damn.  My goal was to get through the 8-month deployment without an epidemic.

I eventually learned we had distilled water from the harbor, violating Navy Regs, so we wouldn’t have to restrict water use or get underway to distill at sea.  I had questioned the Chief Engineer about our water supply and was assured we had plenty for the boilers and personal use.  I should have known better than to believe a snipe.

Several days and 300 cases later, an 80% attack rate, I was 10 pounds lighter, but the epidemic had finally “run” its course.  We were not fully mission prepared during that time.  To those who feel that funding military strength is more important than public health, I remind them that throughout history, disease has decimated military units and affected more troops than battle.

Many forget that Americans used to die from measles, cholera, typhus, rabies and tuberculosis.  Yellow fever devastated Memphis.  Malaria was as bad an enemy as the Japanese for the First Marine Division on Guadalcanal in 1942-43.  These diseases have not disappeared.  They are still out there, waiting,    waiting for us to let our guard down, to ignore the fact that the single biggest factor increasing our longevity has been improved public health.  We fortunately live in a society where many scourges are controlled – for now.

I remember how sick and photophobic I was with measles, which can kill one in a thousand.  A brother had polio; another mumps meningitis.  My father had tuberculosis; my mother scarlet fever and pertussis.  Americans used to fear crowds in summertime because of the risk of catching polio.  Today, these conditions make headlines; back then, they were “usual childhood diseases.”

Adjusted for inflation, Pima County has not increased public health funding in 15 years, despite a near doubling of population.  They are several employees under full staffing.  A bad economy not only decreases funding but increases demand, as un- and under employment increase.  Fees for immunizations, restaurant inspections, animal licensure, family planning, STD services and TB treatment will increase, because while such tests save money and misery, people now have short term,  more important concerns, like eating.  I predict more unwanted children, a food borne illness outbreak, increase in STDs, more unlicensed dogs and Arizona keeping its top ranking among the states for congenital syphilis.  I thought we were finished with that one. 

Immunization preventable diseases, HIV, MRSA, rabies and pandemic flu have no economic boundaries.  We take for granted no disease in the food we buy or in the restaurants we visit.  This is not a coincidence or the Eleventh Bill of Rights.  But we face a cut of $1.4 million from the local public health budget.  Cryptosporidium infected 400,000 in Milwaukee in 1993 and killed 100.  That bug is not restricted to Wisconsin; cholera is not restricted to Zimbabwe; bad lettuce not restricted to California; or bad peanuts to Georgia.  Lack of regulation kills people as well as making them unemployed and broke. 

Ten per cent of Pima County’s active TB cases are homeless, and we cannot afford to house them until they are non-infectious.  Nor can we afford to pay a radiologist to read their X-Rays.  Therefore, the number who complete therapy will decrease, fostering drug resistance and setting the stage for an outbreak, first in the homeless shelters, and from there, to the community — you and me.  Maybe people shouldn’t be homeless, but they are.  That’s reality.  Financial robber barons get bonuses for ruining the economy, TB and syphilis are making a comeback, and I feel I’m back in the 19^th century. 

We must make public health a priority.  There’s a lot of bad stuff outside the walls of our civilization, waiting for us to open the gates.  And that’s exactly what will happen if we inadequately fund public health.  Sure, I believe in the value of arts and sports.  But adequate public health allows people to live long enough to become artists or play sports.  It’s time that the public learns that vaccines save many orders of magnitude (10ⁿ, where n is order) more lives than they possibly hurt.  And it is time that the public learns that many diseases aren’t prevalent today because of scientific advances in general and public health in particular, not good fortune, vibrations, touch therapy or magical thinking.

A strong public health commitment here in Arizona and across America is an important part of national security.  Tell the Supervisors public health funding saves money and lives.  The department is already severely stretched to where further cuts will impact our safety.  Tell them if we ignore the benefits that come from good public health, we will reap the consequences that will surely develop.  Count on it.  Tell them the human and dollar cost of those problems will be incomprehensible and not amenable to sending good vibes or touching each other. 

Count on that, too.

Colton had a bad week: Tuesday, his girlfriend moved out.  Wednesday, the mines laid him off.

No question that Colton and his now ex-girlfriend, too young and unmarried, never should have bought a house together.  Colton was a high school dropout who eventually got his GED, but his money managing skills were poor.  He once bought a dirt bike because he read “monthly payment of $68” and didn’t read “for 5 years.”  He finally sold it for a large loss.

Colton’s mother told me how his buying a house would be good, since he wouldn’t “throw money away on rent,” would “build equity” and other platitudes pushed by the industry (beginning with “home,” instead of “house.”)  I knew that if everything worked perfectly, which it wouldn’t, Colton was headed for trouble.

I suspect he did not realize additional costs of ownership, like insurance, taxes, utilities and repairs.  I suspect that he didn’t appreciate that $4 a pound copper wouldn’t last, and when the price fell, his job would be in jeopardy.

We bought our house in 1977, after renting for six years in three different places.  Flexibility is a big advantage of renting.  Back then, down payments were 20%.  Our combined take home pay was four times the fixed monthly payment, a good rule of thumb, and we had job security.  Colton’s foreclosure will help keep Arizona among the nation’s leaders in that category, typical of places where the major industry is the unsustainable concept of permanent growth.  But when you live where individual rights trump common sense and education is an afterthought, foreclosure rates are among the nation’s highest and there is a payday lending problem.  Maybe that is why Arizona leads the nation in congenital syphilis cases.  I can’t prove it, but we probably have more than our share of animal hoarders and breeders, too.  The irony is how much these individual rights cost each of us, like the right to implant eight embryos in a woman with several young children or having another motorcycle accident victim in the ED who had no helmet and no insurance.

Colton had neither the education nor the judgment to buy a house.  One cannot understand finance without knowing how to manipulate numbers, but I’m repeating myself.  While he was childless, he moved back with his parents and will file bankruptcy.  I recently saw a bumper sticker on a giant Lexus SUV:  “Fight Socialism, show personal responsibility.”  Even as America under a Republican president embraced corporate welfare.  But the rich are different.  Just ask them.

Not all of us have personal connections, smarts, personality or luck to have scads of money to own such a vehicle.  While some of the poor are drunk and lazy, many are hard working folk whose only crime is not being young.  But most are women and children, ironic in a country that purportedly values the latter, ranking high in the developed world in birth rate and teen pregnancies, the last especially true in Arizona.  Individual rights and lack of education win again.

But let’s be clear:  Colton didn’t cause the financial catastrophe that in dollars is at least 400 9/11s.  Yes, 400.  I believe the financial community and politicians are guilty of treason for this largely preventable mess.  We had poorly understood financial instruments like credit default swaps, rampant speculation and gambling in what may have been a $60 trillion unregulated market.  Businesses like Enron, World Com and Tyco outright lied; loans were given to people to buy houses they couldn’t afford in a clearly overvalued unregulated “free” market.  Executives received obscene bonuses, perverting etymology, with tax dollars.  As a mathematician, I am ashamed at my colleagues who created models that failed to account for the possibility that housing prices could fall and incredulous that senior executives would believe them.  But that’s what happens when we base financial policy on ideology, rather than reality.  I hear the stock market “always goes up,” based on all of six decades’ experience applied to an America that today is a lot less productive of tangible goods than it was when I was Colton’s age.

My late mother, despite being a sociology teacher and an unabashed Adlai Stevenson liberal, often said “people are no damn good.”  If people did what they were supposed to, instead of being no damn good, we wouldn’t need regulation, for everybody would act appropriately, sometimes even against their economic self-interest.  If people were perfect, practically any system would succeed.

I find it hypocritical that many who decry the nanny state remain silent about financiers who put the world economy in free fall and now get free money and a free pass.  Those of us who are fortunate in life have some responsibility to those less fortunate.  The responsibility may not be financial but rather saying “no” at the proper time.  We used do that before the free market, free rides and free fall.  I believe in capitalism, but the idea that people will invariably behave properly without somebody occasionally reining them in is ludicrous, unrealistic and contrary to human behavioral science.  Heck, anybody who ever attended a MEC meeting should know that.

I just wish Colton had rented.