I have spent some time reading this summer. And a lot of time listening to Audiobooks. Not sure what my goals are, but I do like to keep on learning. I’ll track some progress and short-term targets here in this post, I guess.
- Song of Solomon
- Psalms (To Do)
- Proverbs (To Do)
- John (To Do)
- Acts (To Do)
- Various Apocrypha (To Do)
– Farewell to Arms
– Zakaria’s education book
– The Happiness Hypothesis
– The Myth of Sisyphus
– Justice (Michael Sandel)
– Capital in the 21st Century
– Dreams of My Father
– Audacity of Hope (To Do)
I’m feeling a little ambitious, but not in the “get something done” way so much as the “think abstractly about ways to improve yourself” type of ambition.
Here are some reasonable goals for the near future (<5 years?):
1) Lend to every country on Kiva (currently ~50/84). So 34 to go. I already have several hundred dollars deposited into Kiva so this won’t actually require 34×25 = 850 dollars.
2) Get >200 lbs on the big lifts (okay let’s just say bench press and squats since I can’t deadlift with good form). Currently around 165 bench press and 135 for squats (although the latter is increasing much faster than the former obviously; I struggled with getting squat form down for a while and now I’m making good progress with it). I weigh about 185 lbs right now, so this shouldn’t be very hard. God if I did five pounds extra per month with bench I’d finish this by next year.
3) Become half decent at meditation? I don’t know why it is so difficult for me to meditate consistently but it is. So I don’t know what a reasonable goal would be. Meditate consistently? Yeah. Meditate daily.
4) Read a lot of books. Okay now I am clearly in violation of the SMART concept – measurable goals. Read a book a month? Keep learning? Audible has helped me quite a bit with “reading” new books, which has been cool. I’ve spent a lot of time reading the Bible this summer, which has been a rather curious enterprise, since I’m an atheist, but an interesting one too. I’d like to become basically familiar with the major religions, so that would entail reading some of their big books. I also find Biblical Apocrypha really interesting, so it’d be cool to read some of the rejected books too (eg the Gospal of Judas!).
Using the same municipal employee data from data.nashville.gov as the previous post, here I am looking at whether there is evidence of gender discrimination in the salaries of Metro Nashville government employees. Obviously this is a pretty complicated issue, and I am only really going to scratch the surface of it. Mostly this is just a fun exercise for me.
Okay, so where to begin: First, I think, it makes sense to begin by just comparing mean salaries by gender. If this doesn’t show evidence of discrimination, then there isn’t much merit it going further.
In fact, as the next two figures show, there’s a pretty big difference in mean salaries between men and women.
The mean salary of men among municipal employees is $7,487 higher than for women. Not surprisingly, this is statistically significant, so the observed gap is more than what we would expect due to chance if mean salaries were equal. (It’s not shown but an f-test showed unequal variances between the two groups of salaries, which is why I assumed unequal variances for the t-test).
But wait – maybe men tend to be over-represented in full-time work while women tend to be overrepresented in part-time work. That could explain the observed difference, not discrimination (although I think that could still show evidence of systematic disadvantages [or at least disincentives] for women in employment).
And, indeed, it is the case that there is this kind of difference employment status between these two groups.
A difference remains. Mean salary is $46,000 for full-time women vs $52,000 for full-time men – a difference of $6,000 or about 80% of the difference we observed without any adjustment. Tangent: why part time wages for women are slightly higher is a puzzle – when I looked at median instead of mean, this went away, and so the median part-time man earns more. This probably means there are outliers distorting the picture for part-time (some part-time women is getting paid much higher than average, perhaps??).
Another important check is difference in job. Using EEOC reported job categories, I can look at whether women and men tend to be working different sorts of jobs, thus explaining the different salaries.
And indeed, there’s a visually apparent (and statistically significant; Pearson’s X^2 < 0.0001) difference in the frequencies of jobs by gender. A much larger percentage of women are doing “administrative support” ($35,000 annually) and “para-professional” ($26,000) work. A larger percentage of men are doing “Professional work” ($53,000) or “technicians” ($58,000).
So this is another thing to account for, since it could be driving differences in salaries. I think the differential prevalence of women in the professionals category could signal some important inequities but is not per se discrimination in the sense of unequal pay for the same work. To try to give a more comprehensive account of what’s driving salary, I can do a multivariate regression.
I will do this tomorrow! Oh, the suspense.
Mean Salary vs Ethnicity
Mean Annual Salary by Job Category
Interestingly, elected officials are not the highest paid category.
Metro Nashville Salaries
In total, annual salaries for Metro Nashville government employees is more than $400 million.
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A Washington Post article today reveals a new cannabis prevention campaign targeting teenagers in Colorado. Unfortunately, the state which has shown the freethinking boldness to legalize marijuana for adults is implementing some of the same, long-debunked nonsense typical of drug prevention efforts. The campaign uses human-sized rat cages, adopting the mantra that teenagers using marijuana are lab rats for the study of how weed corrupts the vulnerable teenage brain. The campaign will rear its ugly head basically everywhere a teen might go: school, malls, movie theaters, concert venues, skate parks, and Rockies games.
Unfortunately, the campaigners haven’t been keeping up with the research documenting that such media campaigns not only fail to curb teenage drug use; they actually come with a variety of negative side effects.
1. Drug prevention campaigns normalize drug use
As an article in the Journal of Epidemiological Health explains:
Since 1998, the National Youth Anti‐Drug Media Campaign in the USA has received more than US$1.2 billion of government funds to develop and deliver interventions designed to prevent primarily cannabis use in young people. Through a variety of media resources, it has tried to foster antidrugs attitudes by portraying the negative consequences (eg poor academic achievement) and by using positive peer support, role models and developing drug‐refusal skills. However, comprehensive evaluation of the campaign (validated by the US government2) found no evidence that exposure to it affected initiation or cessation of cannabis use or antidrugs attitudes. Given previous research on such didactic techniques, it is perhaps not surprising that the campaign failed to achieve positive health changes.3,4 However, this does not mean that such well‐targeted and easily recalled social marketing campaigns achieved no change at all. Importantly, greater exposure to the US anti‐drug advertisements was associated with an increase in the belief among young people that their peers used cannabis regularly (ie descriptive normalisation); individual misperceptions of higher drug use prevalence in general and peer populations are strong predictors of intention to use.5,6
In other words, teenagers will interpret the signs and messages about cannabis use – at schools, malls, skate parks, movies, public libraries, baseball games, concert theaters, and elsewhere – as indicating that many of their peers smoke weed. Basically, whenever they go out in public, they will be reminded (by the drug prevention efforts) that teenagers smoke marijuana. And, as the article says, it is well known that thinking your peers use drugs predicts an intention to start using drugs.
2. Iatrogenic Effects of drug prevention campaigns
Basically, media campaigns to reduce cannabis use among teenagers purports uncertain medical claims (e.g., cannabis causes schizophrenia; cannabis reduces motivation) as fact. This could have self-fulfilling effects through the psychological mechanisms of stereotype-threat, a kind of negative twist to the placebo effect. The Journal of Epidemiological Health article continues:
By routinely purporting mental dysfunction as a consequence of cannabis (in itself controversial), users (and even ex‐users) may begin to believe they are experiencing such effects.7 Consequently, cannabis users in the UK may suffer amotivation, memory loss or even paranoia, not as a direct result of the drug, but through psychological mechanisms induced through high‐profile social‐marketing campaigns that effectively “sell” such negative effects. Through causal attribution, primary healthcare professionals may also be less likely to explore alternative aetiologies in known substance users. Of course, real adverse phenomena associated with substance use is well documented, but research has shown that exposure of ecstasy users to suggestions of drug‐induced brain damage and memory loss is related to their performing worse in psychological tests.8 Thus, belief can be a significant component in developing ill health (akin to “worried well” effects) much as it can be in generating feelings of health through placebo effects.9 Given that over eight million people in the UK alone have used cannabis, any iatrogenic effects of campaigns in this area alone could have major repercussions for public health.
The article concludes by pointing out that governments would never consider approving a pharmaceutical without rigorous evidence of its efficacy and safety. Meanwhile, we have ample evidence that these kinds of campaigns not only fail to decrease drug use – they often increase it – but also that there are multiple reasons to worry about iatrogenic side-effects. Yet we continue to spend money on cannabis campaigns that could be spent on, say, testing rape kits.
Below are my planned remarks for the speech I gave at Houston City Hall on Tuesday, July 29, 2014. Unfortunately, due to the number of speakers, I was only allowed one minute instead of the three that I had planned, so I said something a bit different than planned. My remarks are inspired by a transportation ordinance to be issued regulating Uber and Lyft that affects people with disabilities (as ride-sharing companies tend not to provide accessible service to people in wheelchairs).
The whole hearing is online: I am in part three of four beginning around 23:45.
Before I begin, let me just take a few moments to introduce myself. My name is Michael Zoorob, and I am a student at Vanderbilt University. The views I am expressing today are my own.
This summer I had the opportunity to work at the Southwest ADA Center, a disability non-profit organization. Through my work at the Center, and also through the conversations I have had with many who work there, I think I’ve learned a lot about disability. Today I’d just like to share some of what I’ve learned.
The first thing I learned is that disability is real and prevalent
I’m 20 years old, I like to lift weights a few times a week, and disability is not something I think about as affecting me. But consider this: In Oct 2012, the NYT wrote that a 20 year old has a 30% chance of becoming disabled for more than six months before he retires. Cancer is the second biggest cause of disability – and consider how often – and how randomly – it strikes.
In fact, more than 50 million people have a disability – a number that will increase as the population ages. This isn’t something which just affects somebody else. It affects our parents and grandparents. It affects all of us. And it matters.
Disability is, like race or sex or sexual orientation, a characteristic which you cannot wake up one morning and decide to change. It is also, unfortunately, a characteristic which is often used to deny a person work or service or respect. But discrimination is just as wrong when it is done because a person is blind and uses a guide dog or paraplegic and uses wheelchair as when it is done because of a person’s skin color.
This is a civil rights issue. But it is also an invisible civil rights issue. People with disabilities are much more likely to have difficulty leaving the home – to have difficulty accessing transportation. It can be hard to realize that discrimination is happening when it traps a person within his home. But when buildings or sidewalks or cars are designed in a way which excludes some people from using them, that’s discrimination too.
The city council is to vote tomorrow on a new transportation ordinance. I hope they send the message that while equality isn’t free, civil rights are priceless.
Thank you for giving me the opportunity to speak today.
Today one of my coworkers and I got in an interesting discussion (or maybe an argument) about why relatively few medical students become psychiatrists. She just finished her first year at a pretty prestigious medical school.
I claimed that it boiled down to stigma against mental illness, while she argued that the difference is explained by other fields of medicine being “cooler,” “more interesting at least to some people,” and “more hands-on” (which I pointed out does not at all contradict the stigma explanation).
I (like most people I imagine) am not very good at faithfully and fairly recounting how arguments played out, especially when they get a bit heated. So I’ll from here on try to make this objective (by which I mean independent of my conversation with my co-worker) and just flesh out a few interesting points that came up.
Psychiatrists are paid less and research is funded less than for other specialties
As New York Times writes, “Psychiatrists rarely earn enough to compensate for their additional training. Most would have been better off financially choosing other medical specialties.” Psychiatry is among the least paid medical specialties, though it looks like the pay is increasing faster than in most other areas. Interestingly, HIV/Aids specialists receive the lowest salary of all, and they also treat a stigmatized population.
Psychiatrists are least likely to accept insurance plans, possibly because they are systematically under-reimbursed, even for the same procedures (that article also says that half of counties lack a regular psychiatrist!). Research on mental illness is significantly underfunded relative to the disease burden it creates.
Are other specialties more interesting, hands on?
Surely for some people and not others – like everything else. Maybe some people really like feet or skin or hearts or reading x-rays. But for this to make sense in explaining the shortage of psychiatrists, it has to take the stronger form that psychiatry is systematically less interesting than other forms of medicine. And that sounds a little difficult to believe to me. (I am also inclined to think that if the average psychiatrist made $340,000 a year like the average orthopedic surgeon, interest wouldn’t matter much).
The brain is an incredibly complex organ. Mental pathologies are extremely powerful and disruptive forces – they ruin lives and cause all kinds of bizarre behaviors. Additionally, considering that the lifetime prevalence of mental illness is one in two, and depression and substance abuse are higher among medical students than the general population (discussed later), it is fairly likely that a medical student has personally experienced a mental illness or observed its effects. It seems to me that, all else equal, you would be more likely to go into a field of medicine which has affected you or someone you know than not.
Anyhow, psychiatry sounds a lot more interesting to me than Orthopedics, for example (the highest paid specialty by far) or Plastic Surgery (another high payer). Surgery is a lot sexier than psychiatry (in addition to being much better paid) and I think this is a product of the stigma.
Are future doctors too sophisticated for stigma?
The hypothesis for this line of thinking is pretty intuitive: stigma comes from misunderstanding and misperception of mental illness. Medical students and doctors, who know a lot about mental illness, don’t make these mistakes, so they are less likely to stigmatize mental illness.
Unfortunately, it’s not true. Not at all.
According to an Journal of the American Medical Association study (specifically of med students at UMichigan), mental illness stigma may actually be higher among medical students, who, in addition to being more likely to be depressed than average, are more likely to attribute depression to “weak coping skills” and more ashamed about revealing their negative emotions. This sort of makes sense to me, as medical students strike me as the kind of people who endorse a very strong “protestant work ethic”, “internal locus of control” type of outlook. One that says if you want something, work hard and you get it; if you have a problem, work hard and you’ll solve it.
The implication is, unfortunately, that if you can’t solve a problem, you aren’t working hard enough. It’s your fault, something to be ashamed of. It’s not hard to see how this attitude, coupled with a high-stress, hypercompetitive environment, would be ripe for high levels of depression and self-stigmatization. After graduating, doctors tend to avoid seeking mental health care.
And in the population at large, while more people attribute mental illness to neurobiological factors than in the past, stigma is actually higher, according to an American Journal of Psychiatry report. Being able to attribute illness to neurobiology doesn’t make people more accepting of illness; in fact, it may make it seem intractable, a rigid characteristic about a person that will never go away.
Mental illness stigma deters people from Psychiatry
Furthermore, there are plenty of published anecdotes (eg here, here, here) of psychiatrists describing the stigma they received for choosing their profession. A Columbia Professor of Psychiatry writing for Scientific American describes this comment made by another faculty member: “Tell all students who get low scores on their board exams not to worry, they just need to change their career plans and go into psychiatry.”
Psychiatry is also, as far as I know, the only branch of medicine with a dedicated movement opposed to its existence. Ever heard of anti-cardiology?
Get vaccinated for the safety of you and others.