Why Is the UK’s Mortality Rate Due to Prostate Cancer So High?

As I was reading this article at the Guardian on a combined therapy for advanced prostate cancer, I was struck by this statement:

More than 27,000 men in the US and 11,000 men in the UK die of prostate cancer each year, according to the US Centers for Disease Control and Prostate Cancer UK.

To put that in some perspective, the U. S. population is about five times that of the U. K. That tells us that the mortality rate due to prostate cancer in the U. K. is about twice what it is here. That’s a big difference.

This study suggests that genetic differences give us at least part of the explanation. I wish that there were better data for West Africa (this study gives us a few tantalizing hints). This study is interesting, too, fortifying the idea of a genetic basis.

So, why is the mortality rate due to prostate cancer so high in the U. K. relative to the U. S.?

  1. Genetics
  2. Health care
  3. Diet
  4. All of the above
  5. None of the above
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The London Attacks

I would not presume to say what the Brits should do in response to the attacks in London yesterday. It was the third terrorist attack with multiple fatalities in three months.

British Prime Minister Theresa May has proclaimed “enough is enough” but I don’t know what that means in practical terms.

I do know that if the U. S. had experienced something similar Americans would react, possibly precipitously and rashly.

In each case in the UK the police have responded decisively. That doesn’t appear to have been enough to deter more attacks.

There’s something about these terrorist attacks that grab at the heart and capture the attention. I don’t know what it is. Is it their apparent unpredictability? You can’t just avoid a bad neighborhood and stay safe.

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The Status of World Terrorism

Since May 5, 2017, over the period of the last month, there have been 147 terrorist attacks worldwide. The preponderance of these have taken place in the countries of the Middle East and North Africa plus Afghanistan, Pakistan, and Nigeria. A dozen of these attacks have entailed mass fatalities.

The attacks haven’t been restricted to those countries, however. Among the continents only Australia and Antarctica have been spared.

Several hundreds of people have been killed in these attacks and many more injured.

At Geopolitical Futures Kamran Bokhari outlines the bloody history of Ramadan which began May 26:

Given this history, Ramadan is viewed as more than a religious holiday; it has always had a geopolitical dimension. Groups like the Islamic State, al-Qaida, the Taliban and others invoke this history to further their agendas. Having accused the Muslim regimes and most Muslims of abandoning Islam, the jihadists claim to be the rightful heirs to this legacy. Their narrative is infused with historical references, which the jihadists use to galvanize their fighters during the holy month. This explains why, since 9/11, jihadist attacks during Ramadan have spiked.

Ramadan has also been politicized by those representing the Sunni and Shiite sects of Islam. The two principal players in this struggle, Saudi Arabia and Iran, use this month to energize their supporters. The Saudis, who are the leaders of the Sunni Islamic world, encourage their supporters to defend their faith from the “deviant” Shiites, while Iran, which leads the Shiite sect, tries to incite hostilities as well.

To my eye terrorist attacks do not appear to have spiked this Ramadan. They’re continuing at about the same rate we’ve seen for the last year. Most just take place safely out of sight in Iraq, Syria, or Libya where we don’t notice them.

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The Dawn

Slowly, slowly the scrum is moving forward and writers at center-left journals are acknowledging openly what I presume they knew all along: that Hillary Clinton lost the election in November because of her own errors and failings. After a nod to the usual suspects (the Russians, Comey, the media) at Salon Conor Lynch outlines the evidence:

Of course, it is possible that the DNC had excellent data but was poorly managed (by Clinton loyalist Debbie Wasserman Schultz, incidentally), and that Clinton was a terrible candidate whose political baggage doomed her campaign from the start.

In other words, the problem wasn’t bad data, as Clinton chooses to believe (on top of everything else), but bad politics.

[…]

In the end, myriad factors contributed to Clinton’s defeat — and she is right to point to Comey, the Podesta email hack, “fake news” propaganda and so on. But underlying it all was an uninspiring candidate who made some horrible decisions leading up to her inevitable presidential run.

“We lost because of Clinton Inc.,” a “close friend and adviser” told Allen and Parnes. “The reality is Clinton Inc. was great for her for years and she had all the institutional benefits. But it was an albatross around the campaign.” According to the authors, a number of Clinton loyalists share this sentiment, but the majority remain in denial — or are reluctant to contradict their boss.

What is happening today, as I have been saying for some time, is a battle for the apparatus of the Democratic Party. To paraphrase LBJ, if you’ve got the party by the apparatus, the hearts and minds generally follow. Ostensibly the battle is being waged between Clinton supporters and Sanders supporters. For decades the DNC had been set up with the objective of getting Hillary Clinton elected president. They did their job, supporting her and strangling her opponents’ campaigns in the womb.

What will happen now? I have no idea. I think the present leadership has to go but I don’t see who will replace them. The present instinct—to exclude all but the most loyal—does not appear to be a willing formula to me.

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Reluctant Reaction

In this post I’m reacting, reluctantly, to President Trump’s announcement yesterday that the U. S. would begin the process of withdrawing from the Paris Agreement, the global agreement-in-principle on reducing carbon emissions. I’m commenting because it’s obviously yesterday’s biggest news story and has elicited substantial comment. Reluctant because of how little of the commentary on the move heretofore has been objective, fair-minded, empirical or, frankly, anything other than putting down markers on what you think about Trump (or the United States) and I find the entire subject a thankless task.

I think the president erred. Of the available alternatives I think the best would have been to do nothing. We could have maintained the kabuki put in place by President Obama indefinitely. As it is we’re getting the worst international press without getting much benefit from it. The editors of Le Monde are basically saying that we’re throwing in the towel on climate change and abrogating leadership:

Le monde assiste à une séquence diplomatique sans précédent. Sur l’un des sujets les plus graves de l’heure pour l’avenir de la planète – le réchauffement climatique –, l’Amérique se retire. Elle renonce à l’exercice de son « leadership ». Elle ne sera ni un exemple ni un guide. Elle rapetisse, pays continent replié sur lui-même et accusant les autres de lui vouloir du mal. Par la voix de Donald Trump, c’est l’Amérique du Charles Lindbergh de 1940, du nom du pionnier de l’aviation civile et ardent opposant à l’entrée des Etats-Unis dans la deuxième guerre mondiale, qui s’est exprimée, jeudi 1er juin à Washington.

L’Amérique, reniant les engagements pris et ardemment défendus par Barack Obama, quitte l’accord de Paris sur la lutte contre les émissions de gaz à effet de serre. Elle fuit la bataille pour le climat. Elle ne participera pas aux efforts décidés par les 194 autres pays signataires. Elle estime ne plus avoir d’obligations à cet égard – ni techniques ni financières. Elle juge que son développement économique en serait entravé, a dit M. Trump.

They characterize the move as “defeatist”. The Der Spiegel columnist Thomas Fricke follows suit:

Die Welt reagiert mit Entsetzen auf Donald Trumps Entscheidung, die USA aus dem Pariser Klimaabkommen herauszulösen. Staatschefs schimpfen, Umweltorganisationen drohen mit Klagen, selbst große Energiefirmen können nicht fassen, dass der Präsident diesen Schritt wirklich gegangen ist.

Es ist ja auch richtig: Trumps Wende ist eine Bankrotterklärung der Vereinigten Staaten in vielfacher Hinsicht. Sie ist zynisch, weil der Präsident bei einem Thema, in dem es um Leben und Tod geht, agierte, als wäre er der Macher einer Gameshow. Sie ist gefährlich, weil sie offenlegt, wie groß Trumps innerer Drang ist, der Weltgemeinschaft den Mittelfinger zu zeigen, egal, was es kostet. Sie ist verantwortungslos, weil der Präsident so tut, als sei die Haltung zum Klimawandel nicht mehr als ein Chip im Poker um geopolitischen Einfluss. Vor allem aber ist sie dumm, weil die Wende im Kern darauf basiert, die Kohleindustrie zu stärken, eine sterbende Energie. (Lesen Sie hier mehr zu den möglichen Auswirkungen der US-Entscheidung.)

calling the move a declaration of moral and political bankruptcy on the part of the U. S. The Guardian reports:

Trump’s move has been met with a chorus of disapproval from global leaders and blue chip companies including Facebook, Apple, Ford and Microsoft.

A number of the governors of US states have vowed to ignore Washington. The mayor of Pittsburgh also fired back against Trump, who told reporters on Thursday: “I was elected to represent the citizens of Pittsburgh, not Paris.”

Bill Peduto wrote on Twitter: “Fact: Hillary Clinton received 80% of the vote in Pittsburgh. Pittsburgh stands with the world and will follow Paris agreement. As the mayor of Pittsburgh, I can assure you that we will follow the guidelines of the Paris agreement for our people, our economy and future.”

The German chancellor, Angela Merkel, said Trump “can’t and won’t stop all those of us who feel obliged to protect the planet”. She said the move by the US to join just Nicaragua and Syria outside the accord was “extremely regrettable and that’s putting it very mildly”.

Li Keqiang, the Chinese premier, and Jean-Claude Juncker, the European commission president, also spoke together on Friday morning of the importance of continued international cooperation to defeat global warming.

I fail to see what the U. S. gains from the announcement.

The Paris Agreement is not a good one and never has been—mostly an exercise in feelgoodery. It relies on countries to adhere to “nationally determined contributions” on a strictly voluntary basis. The U. S. communique on its first NDC is here.

For it to have any legal standing in the United States, it should have been formally submitted to the Senate where two-thirds of the senators would have needed to vote in approval. President Obama never saw fit to expend political capital on the agreement, to lobby for it, or even to attempt to strike bargains to achieve approval.

Although the United States is frequently singled out as an offender, that’s not entirely fair. Per capita carbon emissions in the U. S. are about what they were 50 years ago. On an overall basis (the only really important statistic) China emits a total of about twice as much carbon as does the U. S. We emit carbon on a per capita basis at a high rate but our rate is lower than Australia’s and not much different than Canada’s. Our total emissions are high because we’re the most populous rich country and our per capita emissions are high because we’re rich and geographically large. Our emissions are trending in the right direction; China’s, Russia’s, and India’s aren’t.

My own views are that I think that human-produce carbon emissions probably have some effect on climate, the models tell us directionality but probably not quantity or timing, and the neoliberal strategies that have been proffered to date are both regressive and ineffective. To me the record seems to show that carbon emissions increase geometrically with income. Few would find the most obvious solutions appealing: don’t import anything from China, reduce the U. S. population, impose draconian taxes on the mega-wealthy. That’s why I tend to turn to technological solutions.

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The Poll

I’ll probably be conducting this completely unscientific poll periodically for the next several years. Which of these is most likely to happen?

  1. Trump remains in office through the end of his term.
  2. Trump resigns before the midterms
  3. Trump resigns after the midterms
  4. Trump is impeached by the House but not removed from office by the Senate
  5. Trump is impeached by the House and removed by the Senate
  6. Trump is assassinated

I’ve listed these more or less in what I think is decreasing likelihood. There’s what seems to me to be a reasonable argument for B on the grounds that governing is a lot less fun than running and that things are only likely to become less pleasant.

Wishful thinking by Democrats and establishment Republicans notwithstanding, President Trump appears to have a floor of support of just under 40% (cf. the RealClearPolitics average of polls) and that’s probably a solid majority of Republicans. If that floor gives way, anything could happen. If it doesn’t it’s too high for impeachment. The House Republicans will not fall on their swords to get rid of Trump.

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Understanding Automation

At Atlantic Derek Thompson has written the best post on the effects of automation on jobs that I’ve seen in a long time. He makes and offers evidence to support the following points:

  1. The U.S. economy is in a productivity recession.
  2. Companies don’t seem to be investing in technology nearly as much as they used to.
  3. Globalization is a much bigger deal than automation for work and wages.
  4. The U.S. economy’s creative-destruction engine is broken.

Or, in other words, there is very little evidence that robots are taking our jobs.

He also cites a fascinating case study:

In the short run, the digitization of retail has created jobs. But it’s replacing in-store salespeople—not easily automated, since who wants a robot clothing assistant?—with warehousing and transportation workers. There are nearly 2 million truck drivers and 300,000 warehouse laborers and stocking clerks in the United States, and there are rather direct efforts underway to make a great number of these jobs obsolete. Amazon has expanded its armada of warehouse robots to more than 40,000, and self-driving cars have the attention of practically every auto and technology company in the world. So, e-commerce has created jobs—ones that are quite vulnerable to automation.

Note, too, that the warehousing and transportation jobs that have been created while eliminating sales clerks are much more organized than the sales clerks ever were, arguing against yet another narrative.

If robots aren’t the job-killers that some are arguing they are, what’s happening? I would argue that the following factors explain practically everything:

  • Globalization
  • Immigration, particularly of low-skilled workers
  • Out-sized expectations of the returns of capital
  • Poorly constructed public policies, particularly of the NIMBY sort
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A Question About International Agreements

Hearts are palpitating in the news media about President Trump’s apparently imminent announcement of the U. S.’s withdrawal from the Paris climate accord. I have a question. What’s the difference between an international agreement that is unenforceable and with which you don’t intend to comply and withdrawing from the accord?

I’m serious. I really want to know.

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He’s Dreaming

I read Michael Tomasky’s piece in the New Republic up to this point:

It has been observed that today’s conservative movement, to use the old Leninist vernacular, is a “vanguardist” movement. The word referred to the revolutionary party, the one that was going to make the revolution happen. (Its weak-kneed counterparts were the “spontaneists,” who were going to sit around and wait for it to happen, being alert to the moment.) Some conservatives welcomed the comparison. In Blinded by the Right, David Brock reports that Grover Norquist had a portrait of Lenin in his home.

A movement intent on hastening the revolution develops certain habits of mind. It has enemies, to be sure. But it knows that it’s an embattled minority, so it welcomes new recruits, as long as they agree on some basic principles. That’s why every liberal who abandons liberalism to join the right—from the Irving Kristol neocons of days gone by, to David Mamet and Donald Trump—is joyously embraced. So you’ve finally seen the light! Welcome!

American liberalism is, of necessity, anti-vanguardist.

He’s dreaming. While I’m glad that he’s discovered vanguardism since it explains so much of what’s happening today, American progressivism is nothing if not vanguardist. Unless he plans to excommunicate Hillary Clinton.

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And With Guaranteed Jobs

Meanwhile, Robert Fellner argues against a guaranteed jobs program:

While a government job would certainly benefit those currently unemployed in the short term, they too stand to lose in the long run.

The longer these workers stay in make-shift jobs, the less opportunity they have to develop skills that have actual value, a harm that compounds over time.

The best thing the government can do to help those struggling to find work is to get out of the way. Repeal cronyist occupational licensing laws that lower wages and reduce employment. Stop imposing a one-size fits all monopoly form of education that is poorly suited for preparing students for today’s rapidly changing and dynamic job market. Repeal and reduce anti-business taxes and regulations so that entrepreneurs can get back to their work of making us all richer.

A government-jobs program would only make worse a problem that is, for the most part, the result of government intervention.

Unmentioned are the distortions caused by intellectual property laws, trading policies, and monetary policies which result in fewer jobs being created than would otherwise be the case and immigration policies which result in wages being lower than would otherwise be the case.

So, if a universal basic income isn’t a viable solution and neither is a guaranteed jobs program, what is?

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