The "Food Desert" Idea is a Useless or Harmful Myth

The narrative of the food desert goes something like this: grocery stores are where you get produce and healthy food. Grocery stores are physically difficult for some Americans to get to, often because of distance. These Americans rely on convenience stores and fast food and suffer obesity and related health problems as a result.

This is no longer a tenable idea.



1) The image above is from a food desert map discussed on Wired, which uses line length and thickness to represent distance from grocery stores. You will note that the thick long red lines in grocery-stores-are-far-away-land are exactly where people are fittest (Rocky Mountain states) and the most grocery stores are in the Piedmont South and Black Belt, exactly where people are most obese. If you're trying to show that food deserts cause people to be healthy, you couldn't do a much better job than this map.

2) As if that's not enough, there has also recently been work (two studies in this article) showing that the idea that low socioeconomic status neighborhoods in American cities are not, after all, food deserts.

The food desert-obesity connection is a myth, and people should stop believing in it.

Physicians and Status: "A Certain Mystique About Their Judgment"

From Philip Tetlock, emphases mine.

One of the reactions to my work on expert political judgment was that it was politically naïve; I was assuming that political analysts were in the business of making accurate predictions, whereas they're really in a different line of business altogether. They're in the business of flattering the prejudices of their base audience and they're in the business of entertaining their base audience and accuracy is a side constraint. They don't want to be caught in making an overt mistake so they generally are pretty skillful in avoiding being caught by using vague verbiage to disguise their predictions.

...Things that bring transparency to judgment are dangerous to your status.  You can make a case for this happening in medicine, for example. In so far as evidence based medicine protocols become increasingly influential, doctors are going to rely more and more on the algorithms–otherwise they're not going to get their bills paid. If they're not following the algorithms, it's not going to be reimbursable. When the healthcare system started to approach 20 to 25 percent of the GDP, very powerful economic actors started pushing back and demanding accountability for medical judgment.  The long and the short of the story is that it's very hard for professionals and executives to maintain their status if they can't maintain a certain mystique about their judgment. If they lose that mystique about their judgment, that's profoundly threatening.

Of course there's the counterargument from most medical professionals, which in so many words is, "We're special and economics doesn't apply to us.  It just doesn't."  We're finding out.

British Columbia Court Upholds Physician-Assisted Suicide

If you don't own yourself, what else matters?  In most of the developed world we aren't allowed to ask a medical professional to help us decide when we no longer want to exist - the state thinks it's wiser in this regard.  One more sub-national entity is on the side of reason, for now.

SCOTUS: Bone Marrow Donors Can Be Compensated

Reported by Alex Tabarrok here. Egg donors might be next, then kidneys? There are coercive kidney donations going on already in East Asia; clearly this exchange does occur already elsewhere and is not morally optimal.

Obesity and the Bad Stripe

Maps here. Obesity splits into two bands in the eastern U.S.; one is the Bad Stripe and one is the Black Belt. I originally noticed the Bad Stripe when it shifted more Republican for president in the 2008 election (the opposite of the rest of the country) and then when the same shape continued to appear in maps of other indicators. My initial surprise about the Bad Stripe is that it was not the Black Belt, which can be clearly seen on the obesity map.

Guatemalan Tuskegee

It's a good sign (though too late for many) that today Tuskegee seems unthinkable. It turns out that the same organizations were doing the same thing in Guatemala too.

I've always found it frustrating that in criticisms of corporate pharmaceutical research, Tuskegee invariably comes up. It's useful to clarify that Tuskegee (and this Guatemalan project) were carried out by government organizations. Corporate America can be proud because it has never undertaken anything remotely as immoral as that. (And as historians dig, there's apparently more still to come.) So if you're worried about how people are treated in medical studies, history would strongly suggest that you should look at those carried out by government organizations rather than private companies.

No one wants more Tuskegees. The best way to ensure that is to know your history.

Medicare and Bush's Tricks

Unfortunately, Bush's tricks are now Obama's tricks too. Just as Bush put out budgets that had little to do with reality (especially regarding projected deficits and using unrealistically rosy best-case scenario projections) Obama's Medicare cost projections are dangerously unrealistic. Medicare's chief actuary says: "There is a strong likelihood that the cost projections in the new trustees report under current law understate the actual future cost that Medicare will face. A strong likelihood." More here.

If Bush's budget fantasies bothered you - and they should have - then so should this.

"Doctors Tea Party" In San Diego

Because I will be a doctor in 3 years if things go according to plan, I'm of course concerned about any and all changes to the medical marketplace that state programs will bring about.

Given that I have libertarian leanings, I was interested to learn that an organization of physicians critical of the Obama administration's current and planned changes to medicine - the American Association of Physicians and Surgeons - is meeting where I live, in San Diego, tomorrow.

Then I clicked on the event website and saw the speakers: among them Christianist Sharron Angle, and Joseph Farah from the unhinged World Net Daily.

So here's an open letter to organizers: you have now alienated one of the few pro-free-market medical students in my class at UC San Diego by choosing these kinds of openly theocratic clowns to represent you. I'm a capitalist but I'm sorry to say I want nothing to do with your organization as long as I'm excluded based on religion, and as long as you seem as confused as you are about what's more important, economics or faith. Good luck trying to appeal to any demographic but middle-aged and older straight white Christian males.