Time to get out on the court, Derrick

Long-time Chicago sports commentator Mike North has some advice for Derrick Rose that I completely agree with:

We all have defended his stance, including myself, but with no end in sight and the possibility looming of Rose missing the entire season, the take on D-Rose just might dip dramatically.

Look, being from a tough neighborhood doesn’t automatically make you tough. D-Rose has never experienced adversity on the court of this magnitude, and there’s no doubt it has messed with his mind. He said the other day he is getting the right amount of sleep and eating right.

Hey I’m glad about that, but what’s the point here? The statement sounded like it came from a spokesperson for Michelle Obama’s obesity campaign.

When Rose gets back we will all be thrilled, but the road back seems suspect right now.

The other night I watched Joakim Noah limping around with foot problems; I saw a less-than-100-percent Kirk Hinrich gut it out. Most athletes in all the major sports play at less than 100 percent — just ask anyone of them.

I’m hearing D-Rose wants to be out there. I’m sure he does, but as his uniform hangs in his locker and he is unable to answer the bell, at least we know he is eating his spinach and getting a solid eight hours a night.

Professional athletes must play through the pain and fatigue and fear and uncertainty. Your teammates need you, and you have to fight through your fears as long as the doctors have cleared you from a physical health perspective. And this is especially so when you are the team leader, as Derrick Rose most definitely is. When the other veterans on the team are dealing with injuries and finding ways to get on the court, every day that Rose chooses to remain on the sidelines chips away at his reputation and his credibility as a leader.

And his closest advisers, like his agent and his brothers and his teammates, ought to grab the Bull by the horns right now, and have a frank discussion with Rose: “It’s time to swallow hard, take a deep breath, and get your butt out on the court. You have obligations.”

Good cholesterol (“HDL”) does not, by itself, help reduce heart attack risk

A useful reminder that correlation is not causation from Good Cholesterol May Not Be What Keeps The Heart Healthy – Science News:

Doctors often use measurements of two types of cholesterol in the blood as a tool for identifying patients facing a higher risk of heart attack. Data collected from large studies show a consistent pattern: People with high levels of low-density lipoprotein, called LDL or bad cholesterol, stand a greater than average chance of having a heart attack. Those epidemiological data have been backed up by drug studies showing that lowering LDL levels also lowers heart attack risk.

But the case for HDL has been less clear. “As a predictor, HDL is perfect. It’s unequivocal,” says Benjamin Voight, a geneticist at the University of Pennsylvania in Philadelphia and a lead author of the new study. Yet drugs that raise HDL levels haven’t performed well in clinical trials. On May 7, the drug company Roche announced that a trial of its HDL-boosting drug dalcetrapib had been stopped because the drug was not effective.

“As a predictor, HDL is perfect.” This means that over the years, we have observed that higher HDL levels correlate with lower heart attack risk: the two things go together. They are associated. They tend to occur together. It does not mean, and does not in any way imply, that higher HDL levels cause lower heart attack risk. Two completely different things, and it is vitally important to understand how different these concepts are.

The mere fact that we can find predictive ability for a given outcome from a given factor — aka, “correlation” — does not establish a single iota of proof related to whether that factor directly causes that outcome, in the sense that it happens 100% of the time when the factor is present, and 0% of the time when it is not. To say that A causes B is to say both of these things: (1) when A is present, B always occurs, and (2) when A is not present, B never occurs. It is a very high bar to clear, in the real world.

Also, just because you can measure something doesn’t mean it is important. Decades ago, we learned how to measure two components of blood cholesterol, HDL and LDL, and because HDL showed predictive behavior for lower heart attack risk, medical science has now spent how many billions of dollars trying to manipulate HDL levels. Why, exactly? Knowing what we know now, has there ever been a good reason to do that?

This seems to happen over, and over, and over again. Man learns how to measure something, and sees a correlation of some kind with some desired outcome, and then proceeds to waste time and money trying to “fix” something with a pill, when instead we could have just said “hey, stop eating so much and get up off the couch” with much better results. Not to mention the side effects of messing with intricate processes inside our bodies that perhaps we ought not touch.

Considered separately, the human body and the world we live in are two incomprehensibly complicated systems. The number of interactions between those two systems is much too huge to contemplate, much less measure or explain. Maybe HDL works with other factors that we know something about, but have not yet researched thoroughly. Or, maybe there are other factors that we don’t know about, or know how to measure. And maybe one such unknown factor exists with a known factor, or some combination of other known and unknown factors, but not in everybody everywhere. Which means in those smaller tests showing 100% correlation for HDL, and then again in the larger tests that do not, it might actually be something else leading to the good outcome. Something we don’t know about or understand well enough yet.

The number of variables in how we live our lives is essentially limitless, and unknowable. There is always, always, something we don’t know about or understand well enough yet. This is the starting point for every discussion about science, health, or any other topic based on human endeavor.

We seem much too anxious to resolve mysteries rather than accept and embrace them. Rule #1: not everything is knowable. Accept this and move on. You’d be surprised how freeing that idea is.

That is really the larger point behind stories like this: a system as unbelievably complex as the human body, and how diet, exercise, and medication affect nutrition and health, is not a simple one to objectively and scientifically measure. Can’t be done. Compare, for instance, to actual scientific experiments in a chemistry lab, where you can control every single factor, and you can run the same trial over and over and over again, and compare the results, and then offer a theory based on those trials. But you can’t do that with real live human beings. You can’t control every factor, or even most of them, and you can’t run the same exact trial over and over again. You must rely on surveys, which means people have to be 100% honest and have perfect memories and recall. You must use the current state of understanding of the human body, and of the world around us, both of which we continue to learn more about every year, so obviously, we don’t know everything yet — and we can’t even pretend to know just how much we don’t yet know. It’s the unknown unknowns that get you every time.

Studying health is not like a chemistry lab at all, and we ought to learn to stop thinking of it as a “science” in any real, meaningful way. Again, Rule #1: not everything is knowable. Accept it and move on. Also, stop eating so much and get up off the couch. It’ll do you some good.

If you need more convincing . . .

Losing weight, stopping smoking and increasing exercise — all actions that boost HDL levels — also improve other heart disease risk factors. That has made it difficult to tease out just how protective HDL is on its own. To find out, Voight and his colleagues compiled blood test results and genetic data gathered in earlier studies from more than 116,000 people, including more than 20,000 who had suffered from heart attacks. About 2.6 percent of those studied carry a gene mutation that raises HDL cholesterol levels, on average, about 7 milligrams per deciliter over levels of people who don’t carry the mutation. That increase in HDL was expected to decrease the mutation-carriers’ heart attack risk by 13 percent.

“But surprise, we didn’t find that,” says study coauthor Sekar Kathiresan, a cardiologist and geneticist at the Broad Institute of MIT and Harvard in Cambridge, Mass. People genetically endowed to make higher levels of HDL didn’t have a lower risk of heart attack.

Got that? Even those whose genetics predispose them to creating more HDL do not show lower risk of heart attacks. And even if they did, why should we assume that boosting HDL artificially, via drugs, would yield the same results in other people? People are genetically predisposed to create more HDL are probably different in other important ways, too, ways that we do not even understand yet. Do we really believe that we can isolate just one solitary factor out of an amazing complex system like the human body, and transfer it into another body with completely different genetic makeup, and watch the heart attack risk drop as if by magic? Call me crazy, but I’m pretty sure it doesn’t work that way.

To make sure the result wasn’t a fluke, the researchers compiled a genetic score for 53,813 people based on the number of 14 other HDL-boosting genetic variants the person carries. Even people with the highest genetic score, and thus the highest HDL levels, weren’t protected from heart attack. To make sure the technique works properly, the researchers also compiled an LDL genetic score and got the expected answer: higher LDL levels were associated with higher heart attack risk.

Commit it to memory, and to heart: raising HDL levels does not, by itself, do anything to reduce heart attack risk. Ignore those who claim that it does, because there is no evidence to support it.

The future in a ‘death spiral state’

Forbes.com asks, “Do you live in a death spiral state?”

For those who live in Illinois and other state government disaster areas, that answer is Yes Of Course We Do.

For reference, here’s how Forbes qualifies what “death spiral” means: (1) more takers than makers, which means more people who draw from the government rather than pay into it, and (2) a state credit situation downgraded for large debt, uncompetitive business climate, and weak home prices and employment numbers.

But what is a “death spiral”? What does it really mean to actual people? Well, I’m no expert on economics, but I do play one on this blog, and I know a thing or two about it, so here is my take on what a “death spiral” means for actual people.

First of all, abstract debt numbers like $80 or 90 billion help almost nobody, because almost  nobody comprehends them. ‘Billion’ looks and sounds like ‘million’, but a billion is 1,000 times more than a million, so it is a much larger number. It’s 1,000,000,000 vs. 1,000,000. See the difference? Nine zeros, not just six.

The majority of those who may not fully grasp the gravity of the fiscal situation in Illinois do not understand such numbers in any meaningful way – and why should they? They are irrelevant to our lives. Regular folks have no reason at all to understand them.

But regular folks do have a reason to understand that fiscal realities will eventually have a real-world impact on regular people, on our jobs, our cost of living, our taxes, our property values, and the quality of our schools, among other things. Huge debts cause lower credit ratings – which just happened again to Illinois last week - which means higher borrowing costs for the state going forward for every bond issued. Those costs are passed on to the taxpayer, of course – bonds scheduled to be issued today, in fact, will now cost the taxpayers of Illinois $95M more in interest for that single bond issue. In addition, the state income tax has already doubled, which will more than likely decrease the income to the state treasury, making the budget deficit and debt worse instead of better.

Imagine a vicious cycle of increasing tax burdens and decreasing municipal and state services which causes jobs to flee the state, incomes and property values to decline, and school quality and other community services to suffer. Each of those feeds the other, and quality of life declines in just about every conceivable way. Lather, rinse, repeat. That is what a death spiral might look like.

Need more details? How about budget cuts in the schools leading to cutting teachers, and programs like band, drama, and sports, but probably not the administrators, whose role in educating children is almost nil. Budget cuts in city and county services, like picking up garbage less often, fewer snowplows and people to man them to keep streets clear, and firing building inspectors which will slow down every real estate transaction and construction project. Higher property taxes since declining state tax revenues will impact public schools and others who rely on state funding, and the government trough has to get filled from somewhere. Higher unemployment and declining property values from all of the above, plus businesses leaving and downsizing. Add to that the many young people saddled with huge college debt that they simply can never repay (nor can they discharge it via bankruptcy), and people who cannot find work and are essentially forced to drop out of the labor force and become takers rather than makers. Lather, rinse, repeat.

People have choices in life. Those who own a business now, or would start one, have choices on where to do that. Those who have a family and career now, or are ready to start down that path, have choices on where to do that, too. They can choose a place like Illinois with a spending problem and a rather “iffy” prognosis for recovery, or a place that is stable and growing and where people have jobs and where schools are more likely to improve than to go downhill.

Is there something special about Illinois that can overcome those disadvantages? What would those be? The beautiful scenery? The fantastic climate? I don’t think so.

The rational, logical side of my brain understands this and accepts the conclusion for what it is, but the emotional side of my brain says, “this sure as hell is not the world I was counting on for my kids”.

 

The invisible crisis: educational achievement continues to decline among boys and young men

The evidence is growing that boys and young men are lagging girls and young women in many important educational measures.

Some of the details:

1. 57% of students in post-secondary education are women.
2. Girls enrolled in gifted and talented education programs outnumber boys enrolled, e.g., 8.1% of girls participated in gifted and talented education programs in 2009 compared to 7.4% of boys.
3. By a large margin, girls are much less likely than boys to be held back one year. In 2009-2010 across all grade levels, 61% of the students held back for academic reasons were boys and only 39% were girls.
4. A greater percentage of girls in 7th or 8th grade (20%) are taking Algebra I compared to boys (18%), and girls of every race/ethnicity are passing Algebra I at a higher rate than their male peers.

The really interesting thing to me is that very few people are talking about it. There’s literally a crisis going on here, and almost nobody is talking about it. And even fewer even know about it, which is a separate issue worth discussing all by itself.

Why is that? Well, maybe because our “leaders” in politics, the media, and various lobbying groups have other agendas, and are too deeply invested in goals that are in direct opposition to seeing that boys and young men thrive. While girls and young women are on the rise in nearly every way we can measure, in education, sports, and careers, it is often at the expense of boys and young men. This is not a healthy situation, for anybody.

Ask yourself why politicians, the media, and various special-interest groups demand that we obsess over how rough everything is for women, gays, and minorities, but completely ignore whether we as a nation are meeting the needs of our boys and young men. Because we are not meeting those needs, when you look into the trends and the numbers.

Boys and young men that are not doing well in school means that as they transition into adulthood, they are much more likely to suffer long-term problems with careers, income, relationships, and just about everything else. This is already happening, and is known as “failure to launch”, according to several experts who have studied this issue. 

Yet, nothing. Near-total silence. Somebody want to explain this? A cynical person might say that politicians, the media, and various special-interest groups are actually glad that boys and young men are lagging, because they are so wrapped up in outdated politics from the 1960s built on the corrosive idea that gains for one group of people must necessarily come at the expense of another group of people. Class warfare, in other words.

Actually, a realistic person might say that. Such as myself. Right here, right now.

I have three sons and obviously I want them to succeed in life – actually, you want them to succeed in life too, even if you don’t know why – and it would be swell if we as a nation could take a look around and understand what we are doing different in our culture and our schools that disrupts what should be so natural and simple: allowing boys and young men to flourish naturally. Holding up the virtues of masculinity in our culture once again would help, and I’m far from the first to suggest that.

While we obsess over counting calories expended in gym class to protect the physical health of our boys and girls, and we obsess over the emotional and mental health of our girls, we essentially ignore the mental health needs of our boys.

No media coverage, no national conversation, no questions at presidential debates. This means we either assume they have no needs at all, or that the needs they do have are not as important as the needs of others.

The first is obviously false. Are we ready as a nation to admit to ourselves that we actually believe that the needs of our boys and young men are not as important as the needs of others?

What we’re doing now is not working. We as a nation and as a culture are in the middle of a failure of leadership that impacts boys disproportionately, and we are accountable. Let’s start there.