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“Why Freddie Gray Never Had A Chance”: Lead Poisoning Is Killing Inner-City Baltimore

Whenever something like the death of Freddie Gray happens, we usually get around, by the third or fourth day, to the broader poverty discussion. This debate usually boils down to the Great Society programs. Liberals say they worked, and what we need are more of them. Conservatives say they failed and the real answer is found in a sterner moral code.

Between the two, I unsurprisingly endorse the liberal view above (although I don’t think the conservatives have been 100 percent wrong, more on which later). But there’s a more constructive way to talk about poverty than to fight over 50-year-old programs; it’s to use a tragedy like this not just to defend old policies but to promote new ways of understanding poverty and the anti-social behavior that helps keep so many people trapped in it. And Gray’s sad case is a prime example.

Freddie Gray grew up with lead poisoning. A great piece in The Washington Post last week laid out the whole history, Gray’s personally and that of West Baltimore generally. Gray lived in a home where lead paint peeled off the walls.

Now certainly he had other problems—he was born prematurely to a mother who may have been using heroin while pregnant, and he spent the first few months of his life in a hospital. But even at that young age, he was tested for lead, and the tests found unusually high levels in his blood. At one point his family sued a landlord and won an undisclosed settlement. And all over West Baltimore, there were thousands of kids like him, breathing lead paint fumes, swallowing the little chips that got stuck under their fingernails, and so on.

And what did this do to him? Obviously we don’t exactly know in his case. But we’ve known for a long time that lead makes children sick and impairs mental functions. An expert is quoted in that Post piece makes this rather eye-popping assertion—no doubt exaggerating somewhat, but driving home the basic point: “All these kids that grew up in those houses, they all have ADHD.” Also, read this 2013 New York Review of Books piece by Helen Epstein, uncannily prescient today, with its emphasis on Baltimore.

But it’s not just about learning disorders. More recently, research has gone beyond that realm and has been starting to make more direct links between childhood lead poisoning and social dysfunction of the sort Gray exhibited, and even a tendency toward violence and crime.

Kevin Drum of Mother Jones has done a lot of interesting writing on this link in recent years. Research results even have people wondering, as this BBC article notes, whether removing the lead from “petrol” (car gasoline) has been the main reason crime has gone down in the last two decades. The BBC report notes that crime rose and rose across many advanced nations throughout the 20th century, until:

Then, about 20 years ago, the trend reversed—and all the broad measures of key crimes have been falling ever since.

Offending has fallen in nations whose governments have implemented completely different policies to their neighbors.

If your nation locks up more criminals than the average, crime has fallen. If it locks up fewer… crime has fallen. Nobody seems to know for sure why.

But there are some people that believe the removal of lead from petrol was a key factor.

Laugh if you want. The kinds of people who like to laugh at such things once laughed at studies warning about DDT, tobacco, refined sugar, and a hundred other malefactions.

Now let’s bring our Congress into focus. Since the passage of a big lead-reduction law in 1992, Congress has appropriated moneys to the goal of abating lead paint in buildings across the country. Predictably enough, we’ve been pretty successful in neighborhoods that are middle class and up, but not so successful in poor neighborhoods.

Congress has typically funded the lead-abatement program, run by the Centers for Disease Control, inadequately. But in 2011-2012, Congress quadrupled down on inadequate: It cut the funding for the program from $29 million to $2 million. That’s not a typo. This was a result of the sequestration targets imposed on the federal budget, largely forced on us by the Tea Partiers. By last year, cooler heads prevailed and the program got back up to $15 million. But that’s still half what it was when it was merely inadequate. As a result, cities all over the country have had to cut back. Chicago, which got $1.2 million from the feds in 2010, received $347,000 last year.

The one thing I’ll say for conservatism with respect to the poverty debate, and the crime debate, is to remind us that on some level, individuals are responsible for their own actions. If we don’t accept and impose this standard, we have moral chaos. (Of course, we ought to be imposing it on bankers, too.) Social pathologies can explain anti-social behavior but can’t excuse it. We can agree to that, although we can however do without the obnoxious right-wing preaching at poor people that cascades out of certain word processors at times like these.

But no poor person, whether his character is closer to that of Mohandas Gandhi or Charles Manson, can control how much lead is in the paint of the walls of the crappy apartment that he can afford and where he’s trying to raise his little children. Conservatives like to tell us poor people need to make better choices, but how much lead his children breathe in or swallow has nothing to do with any choices he made. It has to do with choices made by others, from his landlord on up to appropriators in Congress.

And what if, 15 or 20 years from now, the science is crystal clear on the connection between lead exposure and the kinds of problems Freddie Gray had? I’ll tell you exactly what. Liberals will say: The scientific verdict is in. Let’s do what we have to do here once and for all.

But conservatives will stand athwart history yelling stop as they always do—the moral scolds will blame single parents, and the ones who just don’t want their tax money spent on the moocher class will whistle up outfits like the Competitive Enterprise Institute to produce alternative “studies” questioning what actual science knows to be obvious, and we will be stalemated. And that will be another “choice” that people poor didn’t make that will help consign their children to society’s margins.


By: Michael Tomasky, The Daily Beast, May 5, 2015

May 6, 2015 Posted by | Freddie Gray, Lead Poisoining, Poverty | , , , , , | Leave a comment

“A Pill For Every Ill”: Consumer Drug Advertising Should Be Banned

Consumer advertising of prescription drugs is a massive public health experiment in which billions of dollars are spent each year. But this advertising is a blunt instrument where a sharp edge is needed.

Drugs have harms as well as benefits, and the harms are greater when drugs are indiscriminately prescribed. Consumer advertising, delivered to the masses as a shotgun blast, rather than as specific information to concerned patients or caregivers, results in more prescriptions and less appropriate prescribing.

There is no evidence that consumer ads improve treatment quality or result in earlier provision of needed care. Research has shown that the ads convey an unbalanced picture, with benefits and emotional appeals given far greater weight than risks. Clinicians can work to override these miscues, but this steals precious time from activities that can provide real benefit to patients. In the packed agenda of the patient visit, in which so many real concerns and evidence-based care are available to make a difference in people’s lives, the intrusion of marketing risks harm.

Advertising also provokes a subtle shift in our culture — toward seeking a pill for every ill. While there are many for whom stimulants and other medications can be a godsend, the case of attention deficit hyperactivity disorder is a prime example of how, too often, a pill substitutes for more human responses to distress. U.S. clinicians prescribe stimulant medication for A.D.H.D. at a rate 25 times that of their European counterparts. The complex decision to start a long-term medication should be motivated by the observations of teachers and parents and children, in the context of a relationship with a caring clinician − not stimulated by rosy ads.

Consumer drug advertising is banned in most of the world, although pharmaceutical companies are making a full-court press on the European Union, even while violating the limited guidelines for that advertising in the United States.

In the information age, in which more balanced sources of information on drugs should be widely available, biased pill-pushing messages are a public health menace. To advance the health of the public, the United States should follow the lead of the vast majority of countries, and ban direct-to-consumer pharmaceutical advertising.


By: Kurt C. Strange, Room for Debate, The New York Times, December 15, 2013

December 16, 2013 Posted by | Pharmaceutical Companies, Public Health | , , , , , , , | 1 Comment


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