4/27/12

Vermonters Wrong on Vaccine Choice

It makes no public health sense to run the risk of new outbreaks of rubella and other preventable diseases.

I’m usually on the frontline when it comes to defending Vermont and its unique (and generally more humane and freer) way of life. This time, though, I must take issue with my Green Mountain friends pushing the idea of allowing parents to opt out of having their children immunized. Vermont needs to play Big Brother on this one and tell parents they cannot, in the name of small risks, expose their children and the public to much larger dangers.

This will make some people furious with me, but I’ve looked at the data and, though I agree that Big Pharma is not to be trusted, I think the books have been cooked on the claim that it’s a bigger threat than homeopathy and that adverse drug effects kill over 800,000 Americans per year. (One big way the data is cooked is to blame chemo poisoning for the deaths of already-terminal cancer patients. Another way is to quote data from the medical dark ages. Quite a few websites say, for example, that 6,000 people died from smallpox vaccines. Scary until you read the fine print; those numbers come from a 1921 study!)

Homeopathy has its benefits, but a lot of it is simply magical thinking. One takes a risk when anything is added to the human diet. I looked into red rice yeast as a substitute for Statins when my cholesterol went up. Guess what? This natural product has a higher risk of liver damage than Lipitor. Lots of people take St. John’s wort instead of Prozac, but it has so many side effects that France has banned it. Heck, when it comes right down to it, food is more dangerous than most drugs; one of six Americans gets food poisoning each year and about 5,000 die from it. 

The anti-drug drumbeat comes from an unlikely coalition of alt-lifestyle devotees and anti-government paranoia. It would be facile to argue that nobody has adverse, even deadly, reactions to drugs. Big Pharma is at its worst when a new drug comes to market; that’s when the drive for immediate profit bypasses safety valves. But this isn’t the case for most of the vaccines under question, especially the two most under the Vermont microscope: the ones for measles and for pertussis (whooping cough). Some kids don’t react well to either vaccine. But we have data–very strong data collected over decades–that tells us what difference the vaccines make. About 450 children per year died of measles before vaccines came into effect in the 1960s; when the rubella strain (“German measles”) was present, death rates soared; according to the Center for Disease Control, it killed at least 11,000 babies in the United States between 1963 and 1965. Do the math; a rubella vaccine has saved the lives of more than a quarter-million infants since then. Vaccines have nearly eradicated measles of all varieties; since 2000 there have been about five dozen cases per year and no deaths.

A major reason for the reduction in deaths is that most new measles cases are isolated; that is to say, it’s no longer a public infectious disease that weakens public health overall (especially in those little disease incubators we call “public schools”). Whooping cough is even more dramatic; before a vaccine became widely available after World War II, about 175,000 Americans (disproportionately children) got whooping cough each year and an average of 700 died. By the 1990s there were just several thousand cases per year. Alas, anti-vaccine forces have contributed to dramatic rise and there are now more than 25,000 whooping cough victims per year.

Let us imagine a world without vaccines. Do we want a repeat of Spanish influenza like the one that killed 100 million people in 1918 (675,000 in the USA–three times the number of U.S. soldiers killed in World War I)? Do we want a return to pre-vaccine smallpox epidemics, polio outbreaks, bubonic plague and cholera endemics? I wish a mumps vaccine had been available when I was a kid; my bout left me with hearing loss. 

Parents, naturally, think they should have the right to make vaccine decisions. Christian Scientists say the same thing! I say that fear is just as bad a foundation for public policy as loony beliefs. We must view health as a public issue, not a private decision. 93% of Vermont children were immunized for whooping cough in 2005; now it’s just 83% and the disease is on the rise (102 cases in then first four months of 2012). This is fair neither to other Vermonters, nor to the children catching the disease.

Vaccines can indeed cause negative reactions, but the decision to immunize should be made by doctors, not frightened parents. By all means have children tested before immunization, but let those with expertise make life-and-death decisions. If I might put it crudely, if a doctor makes the wrong call, that individual is culpable. But who would want to be the parent who said “no” to the vaccine that would have saved their child’s life? 

4/25/12

Comes a Time: Affirmative Action Outmoded?

Could affirmative action actually reduce the number of women entering college?

The U.S. Supreme Court is about to hear a California case that could determine the fate of affirmative action in college admissions and, by extension, in all of American society. The kneejerk liberal response is one of alarm and disgust–just another backdoor assault on multiculturalism and a way for rich white boys from the Power Elite to assure their entrances to Harvard and Yale. Allow me to commit liberal heresy by saying that this liberal male thinks it may be a good thing for multiculturalism if the court trashes affirmative action. It’s an ideal that’s long past its sell-by date.

“What!?” you cry. Let’s start with this. If the court upholds that ideal that race can be used as an admissions criterion in California, the immediate effect will be that qualified Asian students will be wait-listed and lesser-qualified white students will take their place. Asian-heritage individuals constitute just 5.6% of the U.S. population, but they will make up 46% of next fall’s incoming class at UCal Berkeley (as opposed to just 30% Caucasian). Taking fewer Asians would have some effect on black and Latino admissions, but California data shows that only 15% of African Americans and 13% of Latinos obtain a bachelors degree. (The graduation rate for whites is 31%; it’s 62% for Asians.) Put another way, there simply aren’t enough qualified black and Latino students to make up the gap if California were to halve the number of Asian students it accepts. It couldn’t even fill the classrooms with good students if it was truly “diverse” and dropped the acceptance rate to something close to Asian Americans’ overall representation in society.

To evoke the title of a Neil Young song, comes a time–and this may be it for affirmative action. Not because inequity has been erased from American society, but because affirmative action is no longer the proper vehicle for addressing it. Consider another angle. Affirmative action was also designed to protect women and it has certainly helped them knock down social barriers (though it’s only dented the glass ceiling). Liberals too often view the present through the eyes of the past when it comes to correcting historic patterns of injustice. Here’s a modern reality: by nearly every educational standard, girls outperform boys in American schools. It’s not even close–girls are kicking male butt! What this means is that if affirmative action were to be replaced by race- and gender-blind admissions, way more women would be in college and far fewer males would be admitted. That wouldn’t be a bad thing. They already outnumber males 57% to 43%, but they also continue their performance dominance. (Just over half of students entering college earn a degree within six years, but the degree obtainment rate is 10% higher for women.) This is to say that affirmative action targets may be doing more to protect Ivy League slots for the male offspring of the Power Elite than blind admissions would yield.

Liberals need to consider that well-intended affirmative action policies may actually being perpetuating the slowness by which multiculturalism and social justice intersect. Perhaps we have spent too much time worrying about making places like Harvard and Yale “look like America.” This is a distraction; one generally goes to places such as these because one has little interest in being part of the hoi polloi. We can bemoan it from here to Sunday, but after decades of affirmative action we’re still left with this: it’s the Ivy League for the rich, state colleges for the middle class, and community colleges for the poor. Affirmative action too often addresses problems hard to solve because–to evoke an old slogan–the horse has already left the barn. It does nothing to tackle the question of why there are, relatively speaking, so few qualified students among African Americans, Latinos and, yes, white males.

Comes a time. Liberals should consider giving up an outmoded concept (affirmative action) and embracing some things that would really matter: a new war on poverty, equal funding for all school districts, state-mandated curriculums, tighter high school graduation requirements, an end to college legacy admissions, caps on college tuition, and increased public funding for colleges.

As unpalatable as it may sound, it may also be time for liberals to stop excusing  the inexcusable and get on board with some cultural issues that would improve educational achievement. Bill Cosby has long been vocal in asserting that hip-hop culture often promotes violence, sexism, irresponsibility, and oppression psychosis among black males and has the net effect of producing Stepin’ Fetchits rather than George Washington Carvers. I’ll let him speak for the black community, but I’ll say that white American males are also in trouble if we continue to accept the idea that, in high school,  books are for girls and sports are for boys. Don’t get me started on the myriad ways in which popular culture and partisan politics make stupidity a badge of honor! That’s a whole other rant.

To return to the issue at hand, although I’m sure that many of my fellow liberals will disagree, I’ll say it again–affirmative action was a noble idea that has outlived its original purpose. It’s time for new strategies. Comes a time.

4/23/12

Women Take the Plunge!

This review originally appeared in NEPCA Journal.


Fighting the Current: The Rise of American Women’s Swimming, 1870-1926. By Lisa Bier. Jefferson, NC: McFarland, 2011. ISBN 978-0-7864-4028-3. 220 pp. + photos, notes, bibliography, index.

Who knew that the simple act of taking a dip would make such a splash in reconfiguring American gender roles? Lisa Bier, a librarian at Southern Connecticut State University, reminds us that today’s female Olympians owe their right to compete to a pioneering generation of strong-willed women who pushed beyond societal disapproval and slowly shed clothing layers, sexism, and Victorian strictures.
Bier opens with a refreshingly honest admission–that she’s a slow writer and researcher. Her original intent was to write a biography of Gertrude Ederle, the plucky 20-year-old who, in 1926, became the first woman to swim the treacherous English Channel. Before she could complete that work, however, several other biographies hit the market. Much like Ederle, who failed in her first attempt at the Channel, Bier rethought her plan. We can be glad that she did; Fighting the Current gives Ederle’s feat a deeper context than it might otherwise have had.
Swimming is, today, such a routine activity that it may surprise readers to learn that aquatic women were rare for much of Western history. Indeed, among the joys of Bier’s book are the small details that we often overlook. Even most fishermen’s wives knew how to swim, though they lived by the coast and routinely rowed out to sea in small boats. Clothing proved a major obstacle. Boys and men often stripped naked to take the plunge, but society would countenance no such boldness from women. Many readers have probably laughed at old photos of 19th century bathing costumes for women, but have we stopped to consider that these were for the beach, not the water? As Bier relates, many of these were made of wool and, once wet, would have added as much as 45 pounds to a swimmer’s body weight. That is, if she could stay afloat at all; many of the costumes billowed and filled with water. Late Victorian water maidens fought knockdown battles with moralists merely for the right to strip off stockings and ditch attached skirts! Those who wished to swim competitively–as opposed to paddling about in sex-segregated bathing platforms in an age before most homes had running water–faced challenges such as aspersions on their femininity, dire medical prognoses, and a host of structural obstacles.
Obstacles came in both physical and ideological forms. There were few swimming pools in the late 19th century, nor were there many water treatment facilities. Urban swimmers, such as those who formed the influential New York Women’s Swimming Association, dove into rivers fouled with sewage, dead animals, and toxic waste. And even when young women proved their mettle in various amateur races and exhibitions they faced institutional discrimination. Pierre de Coubertin created the modern Olympic games in 1896, but women were barred; none would swim until the 1920 Antwerp games.
Bier’s story is one of women’s steely determination to dive through gender barriers. It was this, after all, that made Ederle’s feat possible in the first place. Ederle is the focus of the final third of the book, but most readers are likely to find more revelations in the short biographies of less-remembered pioneers such as Charlotte Boyle, Ethel Golding, Annette Kellerman, Helen Meany, Rose Pitonof, Ailenn Riggin, and Helen Wainwright. As for Ederle, the story of her post-Channel life is, in many ways, as fascinating as her big swim. Suffice it to say, Ederle was an early victim of celebrity and what we today call paparazzi culture.
Bier is strongest when telling stories and recounting detail, though one longs for a bit more hard-hitting analysis in the book. For instance, the National Women’s Lifesaving League helped smooth the waters for competitive swimmers. Placing it in the context of social housekeeping theory would help illumine why that was able to do so. Nor does Bier pay attention to sexuality; part of the brief against women’s swimming clubs involved whispered rumors of lesbianism. Nonetheless, this seemingly modest book is so rich that it sneaks up on you like a racer making a charge to the finish.
Rob Weir