Our current way of dealing with poverty is inefficient at best, with mountains of forms, paperwork, weighed down by bureaucracy and procedures. At worst, it’s stigmatising and judgemental, keeping people in poverty rather than giving them opportunities to break free and elevate themselves out of poverty. One possible solution is providing individuals with a Basic Income (click link for my previous post on the subject).
A selling point for Basic Income is that it can save the government money. By streamlining select government services into one agency, it can reduce inefficiency. In fact, this is something that people on both sides of the political spectrum can agree on – both those who want small government and those who want the government to support our most vulnerable citizens. One example is in Ontario, where a recently published report titled “Finding a Better Way: A Basic Income Pilot Project for Ontario” by Hugh Segal reported that a basic income guarantee would replace Ontario Works and the Ontario Disability Support Program, giving everyone an income of $1320 a month, with an extra $500 for those with a disability. This would effectively replace those two programs with one larger, more comprehensive program that doesn’t require the same intensive oversight and monitoring.
In public health, we rely heavily on samples, as measuring everyone you are interested is often impractical. However, this requires a lot of thought and development in order to avoid unintentionally biasing your sample, as was the case for the USC Dornslife/LA Times Daybreak poll.
Last week, a story came out about how one 19-year old black man in Illinois was single-handedly changing the standings of the US Presidential election. This was based on the results from the USC Dornsife/Los Angeles Times Daybreak, a survey of voter attitudes on “a wide range of political, policy, social and cultural issues.” In this survey, Donald Trump has generally held the lead, until last week, when Hillary Clinton came out in front. Interestingly, this is markedly different than most other national polls, that have shown Clinton is generally ahead, or a much closer contest than that poll would have you believe. So what happened?
A wise man once said that “mo’ money, mo’ problems” (Wallace, 1997). However, despite increases in supposed problems, one of the major benefits is increasedlife expectancy.
New research published in JAMA last week examined how big a difference earning more money makes in life expectancy, as well as how this changes by geographic location across the United States. Researchers collected tax records from 1.4 billion individuals from 1999 to 2014 aged 40 to 76. Of these, around 4 million men died, compared to 2.7 million women (mortality rates of 596.3 and 375.1 per 100 000 respectively). They examined these data to look at what predicted life expectancy at age 40, after adjusting for race and ethnicity.
What makes New York different to other US cities? | Photo credit Kah-Wai Lin (click for more)
One of the most important issues facing public health today is obesity. Worldwide, approximately 30% of adults are obese, and costs around $2 trillion annually. A health concern with complex determinants and many intertwined causes, there’s no single magic bullet solution to the rising prevalence of obesity. A new report by the McKinsey Global Institute studied 74 interventions to see what was effective. They studied 74 interventions that target obesity, which range from subsidizing school meals, adding calorie and nutrition labels, as well as restrictions on advertising high-calorie food and drinks.
The report covers areas one would expect, such as energy balance and changing dietary and physical activity behaviours. While these issues are important and do require study, the authors also looked at the environment and how that impacts obesity. There’s a lot of literature that shows that your environment plays a large role in obesity, and simply telling someone to “eat less and move more” is an ineffective strategy at best, and one that further stigmatizes at worst. It’s something we’ve discussed in relation to poverty, and illustrated with the retailer IKEA.
The best findings in science aren’t the ones that make you go “cool!”, they’re the ones that make you go “huh?”
A study in the Proceedings of the National Academy of Sciences reported a strange and unexpected finding. By looking at data from the CDC, researchers were able to evaluate mortality rates per 100,000 individuals, and compare this between ethnic groups. While there’s generally been a decrease in all-cause mortality, they found an increase in the mortality of middle-aged white non-Hispanic men and women in the US between 1999 and 2013 (solid red line below). This finding was unique to middle-aged White Americans – data from other countries also reported a drop in death rates.
So what makes White, middle-aged, non-Hispanic Whites unique?
When I was 6 or 7, my uncle gave me a book of Aesop’s Fables. I liked their imagery, and the idea of talking animals with anthropomorphized human traits appealed to my child sensibilities. Recent news about Turing Pharmaceuticals raising the price of Duraprim, a potentially life-saving drug, from a paltry $13.50 to an astonishing $750 brought one of these fables vividly back to mind: the story of the Scorpion and the Frog.
I’m back! I took an extended hiatus from the blog while I finished up my PhD, but, at the end of March, I successfully defended my PhD, and after making the changes suggested by the examining committee I submitted in the middle of April and started working. Those of you following along on Twitter will recognize the change in my Twitter handle from @MrEpid to @DrEpid; those of you who know me in real life will have heard me go on about it for the last few months as I prepare. For those wondering, I will eventually change the URL of my blog as well so they all match 🙂
For those unaware of the process, the PhD defence is an oral exam. At Queen’s (the process may differ at other universities), you submit your thesis, and then have to wait (a minimum) of 25 business days for the exam. The exam consists of 4 examiners; an examiner external to your university, one external to your department, one from your department, and the final examiner is your department head (or a department head delegate). You also have a chair from another department from your institution, as well as your supervisors there. After you give a 15-20 minute presentation, the examiners ask their questions. Typically, there are two rounds of questions, after which you leave, and the examiners deliberate. You’re then called back in, and they let you know their decision, and any changes you have to make before submitting your final thesis. My examiners were amazing, and while the questions were tough, they were fair. I actually really enjoyed the discussion I had with my examiners during my defence, and they ranged from the details of my analysis, to the concept of “ethnic identity” and what it actually means in terms of my research.
I want to thank everyone for their support over the past 4 and a bit years. As per prior precedents (Janiszewski, 2010; Saunders, 2013), I will be copy-pasting the acknowledgements section from my thesis below. I’d also like to thank the PLOS Blogs network, especially Victoria Costello for giving me the opportunity to join the network, and Travis and Peter for their support and encouragement when I started blogging. In addition, thank you to my co-authors Beth and Lindsay here who picked up the slack when I took a hiatus this year to focus on finishing up.
Finally, a special thank you to all the readers of the blog. It’s been a privilege to write for you, and it means a lot when you tell me how much you enjoy my work. Thank you, and I’m looking forward to getting back into writing more regularly.
Acknowledgements
I would like to start by thanking my supervisors, Dr. Will Pickett and Dr. Ian Janssen. I am grateful to have had the opportunity to learn from you both, and appreciate your support through my PhD journey. Your honesty, integrity, and willingness to always provide me feedback and support was always appreciated. Will, I look forward to our teams meeting in the playoffs again (hopefully with better results for me this time!)
I would also like to thank those in the Department of Community Health and Epidemiology/Public Health Sciences and the Clinical Research Centre for their support, with a special thank you to Lee Watkins and Deb Emerton for their help. Thank you also to the Clinical Research Centre Student Group. Your antics, customized t-shirts, snack breaks, and random dance parties always kept me entertained, and it’s been a pleasure working with all of you. The Thought Tub is richer for having you.
This work would not have been possible without the financial support of Queen’s University, the Ministry of Colleges, Training and Universities Ontario Graduate Scholarship, and the Canadian Institutes of Health Research Frederick Banting and Charles Best Canada Graduate Scholarships Doctoral Award.
I would also like to thank my friends and colleagues, especially Anne, Kim, Raymond, Sarah, Alison, Hidé and Marion who have been unwavering in their support over the years. I also owe a special debt of gratitude to Rim, Lydia, Liam, Hoefel, Brian and the Gong Show/Danger Zone family for ensuring that I always get some physical activity, and that yes, I do even lift.
Finally, thank you to my family. Your love, support, guidance, and willingness to listen to me at all times of the day have allowed me to complete this project. Thank you.
The editorial staff at Gradifying decided that this month we would describe our experience in graduate school, especially given how different our experiences are. Last week, Amanda discussed her experiences as a graduate student, describing her “field season” and “the outdoors” and “early mornings.” My life is completely different. While Amanda spends her days knee deep in mud, I spend mine exploring databases. While Amanda is taking an ATV through abadoned fields and forests, I’m traversing the internet for PDFs and programming code. While Amanda is worried about mosquitos and horseflies, my biggest health concern is bad posture from being hunched over a keyboard all day.
My desk: Where the science happens!
So lets talk about a regular day for me. Three of my projects use data housed at KGH that I can access 24/7, and so my schedule is completely up to me. There are no external forces at work – I can work all day and all night if I want to, or I can leave for weeks at a time. The only limitation is that I can’t take my data off site, and so I need to work in my office. As you can imagine, this means I have to be SUPER DISCIPLINED. When nothing mandates I be in the office, I have to be that force. While many people would hate working with data all day every day, I love it. Trance/techno/dubstep (courtesy di.fm), a large double-double and a database? That’s a pretty awesome day in my books.
In addition to my main database, this year I started working with another database housed at the Research Data Centre (RDC) at Stauffer Library. The RDC is an excellent resource for those interested in using Statistics Canada data, and provides you access to very detailed data about the health and behaviours of the Canadian population. However, this level of information comes with serious security. Since the data available have individually identifying information available, you need Government of Canada Security Clearances to access these data. The Centre is not connected to the outside world through the internet, so if you don’t know something, you have to leave the facility to check or Google it. Finally, no electronics are allowed inside the RDC, which includes MP3 players. So if you’re one of those people who likes to listen to music while they work (see trance music comment above), you can’t unless you can get your hands on a Walkman or Discman somehow. In addition to these levels of security, the Centre is only open from 10am to 4:45pm Tuesday through Thursday. So when it’s open, you need to maximise your time there.
Simba and the Happy Hack(ey sack) give me company while I’m working.
One thing I decided when I started my PhD was that I never wanted to bring work home. I’ll work late in the office, but, to paraphrase the great urban poet Kei$ha, once “I leave for the night, I ain’t coming back.” So I settled into a pattern of working from 9am to 5/6pm in the office every day, then hitting the gym and heading home, thus leaving my evening free for writing, watching sports (Go Sens! Go Texans!), whatever I want. I’m fortunate in that I can treat my PhD like a job, and can work those hours. The only time I’ll bring work home is if I have a presentation, and then it’ll just be practising it once or twice in the evening in my living room to see how it flows. One suggestion for those who need motivation to go to the gym: Purchase “greys” from the ARC. For around $18 /month, you get your own locker, as well as clean socks, shorts, t-shirt and a towel from the gym every time you go. If you leave shoes there, then there’s really no excuse to not go to the gym. You just show up and it’s all there. I highly recommend it.
Lego Batman reminds me that EVERYTHING IS AWESOME! (except for the angle of this photo, which I can’t figure out how to rotate) (Thanks Kim!)
Outside of grad school, I keep myself busy with various other activities. As you know, I write for Gradifying, but I also am the Editor for PLOS Blogs Public Health Perspectives as well as a Science Writer for PLOS Blogs Sci-Ed. The former focuses on Public Health and issues related to the health of societies, while the latter is focused mainly on science communication – how do we, as scientists, communicate to the public and explain complex ideas in ways that resonate with them. When I’m not writing, I’m usually playing ultimate frisbee through Kingston Ultimate, which takes up most of my free time through the spring/summer, between practice, training and games. If you’re ever walking through City Park on a Sunday morning and see a bunch of people doing laps, wind sprints and various other crosstraining activities, that would be us.
Last week, I was forwarded an opinion piece written by the Honorable Leo Glavine for the King’s County News. Now, if there’s one thing that I hate, it’s when people who are in positions of power, wealth and/or privilege tell “the others” how to live their lives – whether that be “work harder,” or “be healthier,” with absolutely no idea or acknowledgement about their own privilege.
In short, the road to health that many prescribe to the unhealthy is a two step model:
1) Be healthy
2) Don’t be not healthy
Which is why, when I read pieces that blame the poor or unhealthy for their situation, it makes me very angry. And you wouldn’t like me when I’m angry.
But lets get back to Mr Glavine’s commentary. In case you didn’t know, Mr Glavine is the Minister of Health and Wellness for the Province of Nova Scotia, and has been in politics since 2003. Prior to that, he was a school teacher. By all metrics, he’s very popular in his riding – winning the last election with a whopping 74% of the votes.
Mr Glavine starts off his piece rather innocuously, stating that the objectives of government are to represent the people, to provide services, and to take care of their health. We’re in agreement there. He also points out that they have to do more with less funding, and that will require creative and innovative thinking to continue to provide services for the populace. So far, we’re on the same page, and I don’t envy how difficult it is to balance all those demands.
Mr Epidemiology 
