Is the US a dystopia?

some people are actually spraying cross-hatching over signs on the highway so motorists can't read them

lol i was driving up and down the 405 yesterday and today and was like "damn if i didn't know this city like the back of my hand *and* also have gps in my car i'd be so fucked rn", you simply couldn't read a single exit sign

Kate, thank you for the context.

Xpost

"America’s epidemic of chronic illness is killing us too soon"
https://www.msn.com/en-us/health/other/america-s-epidemic-of-chronic-illness-is-killing-us-too-soon/ar-AA1hCsaz

After decades of progress, life expectancy — long regarded as a singular benchmark of a nation’s success — peaked in 2014 at 78.9 years, then drifted downward even before the coronavirus pandemic. Among wealthy nations, the United States in recent decades went from the middle of the pack to being an outlier. And it continues to fall further and further behind.

A year-long Washington Post examination reveals that this erosion in life spans is deeper and broader than widely recognized, afflicting a far-reaching swath of the United States.

While opioids and gun violence have rightly seized the public’s attention, stealing hundreds of thousands of lives, chronic diseases are the greatest threat, killing far more people between 35 and 64 every year, The Post’s analysis of mortality data found.

Heart disease and cancer remained, even at the height of the pandemic, the leading causes of death for people 35 to 64. And many other conditions — private tragedies that unfold in tens of millions of U.S. households — have become more common, including diabetes and liver disease. These chronic ailments are the primary reason American life expectancy has been poor compared with other nations.

Sickness and death are scarring entire communities in much of the country. The geographical footprint of early death is vast: In a quarter of the nation’s counties, mostly in the South and Midwest, working-age people are dying at a higher rate than 40 years ago, The Post found. The trail of death is so prevalent that a person could go from Virginia to Louisiana, and then up to Kansas, by traveling entirely within counties where death rates are higher than they were when Jimmy Carter was president.

I wonder what could be the cause?/s

https://www.c-span.org/video/?153917-1/president-carter-address-crisis-confidence

it's almost as if politics were more than just a game of sneering at gaffes made by the other side

Almost

ok, a little health data nerding out here

In 2015, Princeton University economists Anne Case and Angus Deaton garnered national headlines with a study on rising death rates among White Americans in midlife, which they linked to the marginalization of people without a college degree and to “deaths of despair.”

always. always always always. it hasn't changed since 2015. look at the wapo's data. it's county by county. bonnie holloway? white. the people in the pictures accompanying the article? mostly white. the doctors aren't. most of the patients are.

and it perpetuates this grossly distorted picture of what's happening. there's this "rural purge" narrative that's emerged where everything is focused on white americans without a college degree and, you know, i feel bad for them even if their behavior is profoundly self-destructive. they're not the first or the only people to be let down by the profit-driven american medical system.

like, really, i'm not judging, i didn't understand the extent or impact of misogyny until it started happening to me... to the extent that white rural americans without a college degree can _understand_ what's happening and, you know, work with people who aren't like them to take steps to address it... which is hard. i know it's hard. particularly when you're isolated and are only used to operating in one community.

the thing is, if you look at the data, the thing that's not mentioned at all in this article, is the tremendous gap in healthcare along racial lines. which has always been there and for most of my life wasn't acknowledge, people didn't want to acknowledge race as a factor in outcomes. but it is. you want to see the starkest example of that, just look at infant mortality.

_poverty is not a white phenomenon_. i wish media narratives would fucking quit acting like it is.

the other thing you need though is a complete societal shift in how we view illness. big example: obesity. obesity is _still_ thought of as an individual moral failure even though that just isn't the fucking case. my girlfriend gets shamed a lot more for being obese than she does for being trans.

the way the healthcare system treats her... always, always always, they want her to go in for more diabetes testing, and diabetes testing is good, is important, but they _already did labs_, they found her blood sugar _normal_, her a1c _normal_, but when clinicians look at her, it doesn't matter what the data says, she's _obese_ and they can't believe their data.

incidentally diabetes is a good way to look at racial differences in medicine. my mom has had diabetes since 1981. she developed gestational diabetes while pregnant with her third child, which developed into full-blown diabetes after. she's been obese her whole live, and she's been a smoker since she was about 15. her health is overall very good, even though she's resistant to getting medical treatment.

living alone, she had an infection but wanted to tough it out, wouldn't leave. none of her relatives lived in the same town as her. my brother couldn't get her to go to the ER. finally her sister got her to do it. she didn't want to call an ambulance because ambulances are too expensive. which they are. the ambulance business is a fucking racket and everybody knows it and nobody does anything about it. i think uber and lyft probably won't even _take_ you to a hospital... how many people say they're "just visiting" rather than call an ambulance, which costs orders of magnitude more?

ambulances are a racket. private health insurance is a racket. most of us know this stuff. and it affects, it influences the care we get. my mom's career was mostly as a government employee, she retired as a government employee, so she has access to care. her diabetes is well-controlled, well-managed. all of stuff you have to worry about with diabetes? losing limbs, losing eyesight? not at risk. now, she's done the work to do that, she takes it seriously. her brother, who has done pretty well for himself, also has diabetes, and he doesn't do as much work to take care of it, and he's had more problems with it. so i don't want to underestimate the role taking care of oneself plays. that said, she also has resources available to her that most people simply don't, and that reality is _reflected in the data_. but when people _look_ at the data, it always seems to be through the lens of health disparities affecting white middle-aged rural americans without a college education, and that gives one a pretty distorted view of things.

---

focusing on... even _preventative_ medicine is the wrong approach. the focus needs to be on _trauma_ and the sources of trauma. i talk about it a lot with other people who are going through the MH system. the way the mental health system reduces things to an individual level, atomizes things, while not dealing with systemic factors in mental health.

that's not a deliberate bias. that's, like, a necessary evil. circle of control. circle of control. the therapists and the patients alike know what's happening. most of us know, at least in portland most of us know, that the problem is capitalism. overthrowing capitalism isn't the job of the mental health system. it is, however, the solution. the problem is exemplified by the washington post's owner (who i hasten to add i don't believe had any overt influence whatsoever on the focus or tone of the article), and the solution is for us to _acknowledge our differences_. i want what comes next to be what's better than we have now, and i think an important part of doing that is working to understand and care for each other now, when none of us have the resources to do so. as fucking hard as it is, in some ways it's easier, when none of us have _access_ to sufficient resources to even care for ourselves.

the united states absolutely is a dystopia. for me? for me the united states has _always_ been a dystopia. and that's the case for a lot of people. acknowledging that isn't an act of despair for me, it's realizing how much those of us living in dystopian conditions are _doing_, how much we're all working against.

_poverty is not a white phenomenon_. i wish media narratives would fucking quit acting like it is.

In a raw numbers sense, though, it is. There are a hell of a lot more poor white people than poor people of other groups, because this is still a majority white country, even if those margins are narrowing. So it's reasonable, from a certain angle, to focus on white poverty, particularly if it's been rendered less visible because of several decades' worth of media narratives about black poverty (in the cities, where all the journalists live).

So it's reasonable, from a certain angle, to focus on white poverty, particularly if it's been rendered less visible because of several decades' worth of media narratives about black poverty (in the cities, where all the journalists live).

― read-only (unperson), Wednesday, October 4, 2023 8:00 AM (one hour ago)

that's a good point and i got to really thinking about the article and the way it was constructed and the different ways in which it unconsciously replicated the racial systems of, in particular, louisville, kentucky (in that the sections dealing with race were sort of set apart from the rest of the story, and in the rest of the story race wasn't considered at all even though pretty much everybody involved was white... or when they're talking about a doctor who was born in pakistan! basically for non-white people, race was acknowledged, when it came to the experiences of white people, the story actually went out of its way to avoid pointing out that they were white)... anyway those are rough thoughts and they could use more elaboration because i decided to organize my dresser. it looks good! i have way more tops than i thought i did, which is good because portland is infamous for its top shortage. (the one true sign of a dystopia - everyone is a bottom. i think sartre came up with that one. sartre of course was famously a bottom himself.)

You want to find places where "sickness and death are scarring entire communities"? How about you take a hard look at indian reservations, WaPo, then come back and cry hot tears for us about diminishing life expectancy among whites.

Some of the darkest counties on that WaPo map were native lands.

You want to find places where "sickness and death are scarring entire communities"? How about you take a hard look at indian reservations, WaPo, then come back and cry hot tears for us about diminishing life expectancy among whites.

― more difficult than I look (Aimless)

exactly. when covid was hitting and all of the advice was coming out to "wash your hands for 20 seconds", a lot of the native population in alaska was looking at this advice and was like, ok, well, what do you do if you don't have running water? because that's the fucking reality of it for a lot of people.

Some of the darkest counties on that WaPo map were native lands.

― Elvis Telecom, Wednesday, October 4, 2023 5:06 PM (two hours ago) bookmarkflaglink

this is absolutely true and it is tragic and shameful.

but the fact that life expectancy is dropping overall -- among the majority of the population -- has to be reckoned with as well. often, people from different demographic groups are affected by similar factors.

often, people from different demographic groups are affected by similar factors.

We all eat the same garbage*, we all breathe the same air.

*Yeah, yeah, you buy organic fruit at Whole Foods and eat fish instead of red meat and drink oat milk and blah blah blah. It all gets harvested from the same chemical-soaked earth, all the fish come out of the same polluted water...

Right but the main things actually killing people early are smoking, drinking, and consuming too much sugar/the wrong kind of fat.

With carcinogens it’s true aside from smoking we’re all pretty much at risk. But there’s significantly more risk from say your new car smell or the offgassing from the plywood in your walls than from that organic lettuce.

uh

https://en.wikipedia.org/wiki/Environmental_racism

some people are more at risk than others and it breaks down along class/race lines, what a surprise

I mean this is just from North Carolina, a plethora of articles and examples

https://ncnewsline.com/author/lisa-sorg/

i done my own research check it out i know why ppl dying.

also this doesn’t mean what you think it means.

or maybe it exactly does.

the issue is that any crisis becomes a crisis when white, perhaps formerly middle class people or middle class people are feeling its effects. the crisis that these bullshit papers breathlessly rend garments over in rural and exurban white communities has been occurring in non-white communities rural and suburban and urban communities for fucking ever. anyone with a fucking ounce of analysis knows that this is the case, and that it’s not that these problems don’t need to be addressed in white communities, but that they need to be addressed in all communities , but that rarely happens because of white supremacy.

there’s plenty of factory farmed fish in artificial ponds

Folks did you know the soul weighs 21 grams? 21 grams! Isn't that wild folks. I bet my soul weighs 23-24 grams maybe!

So hard to tell who the snark sniping is directed at here. Anyway I wasn’t just pulling the claim about environmental exposure out of my butt.

https://www.kiro7.com/news/trending/new-car-smell-caused-by-chemicals-that-can-increase-cancer-risk-study-says/

But sleeve good point about the environmental racism, I didn’t intend to dismiss that but was more just addressing the “all the food gets harvested from the same toilet earth, we’re all at equal risk” trope. Some other significant cancer risks I neglected to mention are radon and vehicle exhaust. I’d guess diesel exhaust is significantly worse especially in more industrial areas so again environmental racism.

I mean this is just from North Carolina, a plethora of articles and examples

https://ncnewsline.com/author/lisa-sorg/

I grew up inhaling aerosolized fecal matter!

The world eats cheap bacon at the expense of North Carolina’s rural poor
A Stench in the Nostrils of God
Fighting Voter Suppression in Hog Country, North Carolina
How Black North Carolinians pay the price for the world’s cheap bacon

often, people from different demographic groups are affected by similar factors.

We all eat the same garbage*, we all breathe the same air.

*Yeah, yeah, you buy organic fruit at Whole Foods and eat fish instead of red meat and drink oat milk and blah blah blah. It all gets harvested from the same chemical-soaked earth, all the fish come out of the same polluted water...

― read-only (unperson)

now, see, that's an interesting way of putting it, unperson, because that's not the typical way i see it put. the way i usually see that sentiment put is something like the lyrics to quiet sun's "rongwrong":

Never let it be thought that we have nothing to share
We drink the same water and we breathe the same air

but you didn't say that. you didn't say that we drink the same water. perhaps you know that's not true. perhaps, like most of the rest of the united states, you have heard about the water in flint, michigan. and if we don't all drink the same water, well, why would you assume that we eat the same food, breathe the same air?

now if you'll excuse me, i'm off to listen to Schönberg in the bath

the issue is that any crisis becomes a crisis when white, perhaps formerly middle class people or middle class people are feeling its effects. the crisis that these bullshit papers breathlessly rend garments over in rural and exurban white communities has been occurring in non-white communities rural and suburban and urban communities for fucking ever. anyone with a fucking ounce of analysis knows that this is the case, and that it’s not that these problems don’t need to be addressed in white communities, but that they need to be addressed in all communities , but that rarely happens because of white supremacy.

― butt dumb tight my boners got boners (the table is the table

see, this is the interesting thing to me. i'm a white person, but i _don't_ see the people this article is talking about as being "like me". the wapo article works really hard to try and deracialize an intensely racialized situation, but case and deaton's princeton study, quoted in the article, is more blunt - it talks about white people without a college degree.

my background is white people _with_ college degrees. "white collar". "professional". my feeling, and the feeling i often perceived from the white people around me, was that "blue collar" workers were _not like me_. they were, well, poor white trash. beneath us. and this is consistent, i think, with the way the subjects of the article are portrayed... there's a certain amount of liberal condescension, of "othering", in the way it's portrayed. but poor white people _are_ portrayed, while people who have suffered worse and for longer are, at best, a footnote to the wapo's pity party.

who reads the washington post? who reads the new york times? white collar professionals. the rending of garments over the people we formerly dismissed (and perhaps, under our breaths, still dismiss) as "poor white trash" while going out of our way to ignore and dismiss the experiences of people who are Not Like Us, to me, displays an _exceptional_ amount of commitment to privileging whiteness over all other factors. and i think this commitment is pretty manifest in the framing of the article.

Apparently the answer is YES

Frustrated Target shopper slams retail giant after it took her an entire HOUR to shop for a 'single bag of essentials' - because all of the products were LOCKED UP to combat soaring crime
https://www.dailymail.co.uk/femail/article-12603113/Target-customer-shop-essential-items-locked-cabinet.html

lmao Walgreens already started apologizing for that when they realized no one was buying more than one thing if they’re all locked up

https://www.tampabay.com/news/education/2023/10/23/florida-rule-would-limit-talk-social-issues-public-universities/

A proposed regulation aimed at restricting diversity programs and social activism at Florida’s public universities has stirred confusion, with some saying its broadly worded passages could limit free speech.

The regulation, when approved, will determine how the state enforces the law known as Senate Bill 266, a measure pushed by Gov. Ron DeSantis that seeks to gut diversity, equity and inclusion programs at colleges and universities.

A draft version being circulated for feedback says in part that universities may not spend public money on activities that “advocate for diversity, equity and inclusion” or “promote or engage in political or social activism.”

It says political or social activism is “any activity organized with a purpose of effecting or preventing change to a government policy, action, or function, or any activity intended to achieve a desired result related to social issues, where the university endorses or promotes a position in communications, advertisements, programs, or campus activities.”

Social issues are defined as “topics that polarize or divide society among political, ideological, moral, or religious beliefs, positions, or norms.”

“I can’t think of anything that doesn’t,” said Gerard Solis, general counsel for the University of South Florida. Speaking to USF’s faculty senate on Thursday, he questioned whether that wording could prohibit commentary surrounding events like Black History Month or even American Pharmacists Month, which is observed in October.

The direct assaults on the 1st Amendment are multiplying and setting us up for SCOTUS to render a new conservative/originalist interpretation of free speech. Definitely excited to find out how many rights we get to keep!

Tipsy, I can think of a certain amendment that conservatives don't wish to dismantle. It ain't the first. Pretty sure it's the next one.

One of the effects of the Florida stuff is that frankly, while the chilling effect is there, I think the opposite also occurs. There is legitimately no way they can enforce such rules— so fuck em. I would just teach the way I’ve always taught.

yeah enforcement of classroom instruction would be spotty by necessity, but that piece says that "universities may not spend public money on activities..." which seems more troubling to me

like it wouldn't take much to get the, idk, Black Student Union shut down

I'm eager to see how eagerly they bend around this when one of the one of the trolly right wing grifters that tour college campuses gets brought in speak

I would just teach the way I’ve always taught.

Some people will, especially at the college level. But it's a lot dicier in K-12, where teachers and administrators tend to be very conflict-averse. Not many are likely to challenge even clearly unconstitutional laws, and it's already having impact in classrooms.

I'm eager to see how eagerly they bend around this when one of the one of the trolly right wing grifters that tour college campuses gets brought in speak

Not a problem. They are only after "woke" speech. They can simultaneously believe that they should be able to legally restrict left-wing ideas and mandate right-wing ideas, because their concern has nothing to do with freedom of speech and everything to do with ideology and control.

What they are attacking is the whole idea of "content-neutral restrictions," which has been the heart of free speech jurisprudence for ages.

like it wouldn't take much to get the, idk, Black Student Union shut down

― rob

i mean shit like this is already happening

one of my friends is a nurse in texas, the hospital is owned by a university which is owned by the state

for the past three years they've had a DEI committee. i mean a lot of the big places, they've had DEI committees these days. the health system i work for, which is privately owned and pretends to be nonprofit, even though it isn't actually, they have a DEI committee. i mean DEI committees... they can be frustrating to those of us who are part of those marginalized groups. i mean they don't really _do_ anything, you know? they're there to try and make us feel better about all of the shit we're going through, but they don't actually change any of the shit we're going through. they help us connect with each other and talk to each other and commisserate. it's, like, bake-sale shit. maybe you do voluntary trainings (always _voluntary_) for people who want to be educated about the issues that face us, and that feels good. i guess that does something. i guess it's easy to be frustrated that they're not doing enough.

where my friend works, they're shutting down the DEI committee. because of SB 17 down there. i mean we're not really talking about a "chilling effect", this is more than that. she sees the writing on the wall. a lot of people there do. if you can get out, you get out. she's working to get out. she's not desperate enough to just drop everything and run. yet. i've got friends who were that desperate.

i do feel lucky that i got out early, that i had the privilege to get out early. not because i was scared of _them_, but because i was scared of _myself_. i saw what people around me, ordinary people, people i thought were basically alright, were becoming, and i was terrified that i'd become like them. social contagion, doncha know. and it was stupid, the social contagion argument only goes so far. i look at my youngest sibling who lives in indiana now, and they're not doing great, but they're getting queerer and queerer by the day. they're scared of the queer (adults in their 20s, not "kids", don't call adults "kids" kate, it's rude) they hang out with, they're middle-aged and it's all weird to them but at the same time they're spending more and more time around the queer folks and... there's hope for people a lot of places, these days. austin, i heard austin is the third biggest city in the country for queer people. i mean you find safety where you can even if it's only temporary. my ex wanted us to go to canada in november 2016 and i said no, let's go to portland oregon instead, it's too hard for us to get into canada. and hopefully that's good enough.

---

and, well... i guess it's ok for me to vent about capitalism a little bit

the bandcamp thing, where they got bought out by a bigger company and then the bigger company laid off half their staff

they were a good site doing good work and people loved them. it was a niche thing but having a site on the internet people genuinely loved... it's such a rare thing

and such a temporary thing. like not by accident, that's just how tech _works_

nobody makes money unless you're owned by one of the big tech companies, google or facebook or whatever. nobody else can compete. so the way people get around it is they get venture capital, they come up with a business model and they gamble. they gamble that they can attract the attention of one of the giants, and the giants will spend what is to them very little money but is to the startup an exorbitant amount of money to buy them. that's startup culture. and it's the venture capitalists who benefit so in the meantime the people working there get a living wage for doing something they're passionate about.

the thing is, no matter what happened those people would've got laid off. the big companies would've cut them loose because they don't buy companies for the _people_, the buy them for the _brand_. bailouts like the bandcamp case, you know, you do what you can but there's only so much you can support a money loser. and if neither of those things happen, at some point the paychecks start bouncing.

it doesn't _work_. none of this fucking _works_. i mean, this boot isn't _actually_ going to be stamping on our faces forever, is it?

real life doesn't work like that. i just have to keep reminding myself that.

As a former cancer patient, it is difficult to express the range of my fury at reading articles like this:

This woman lost her arm because of the healthcare industry’s greed

First paragraph of "Why You Should Hate Capitalism" should begin with this section from the article:

In interviews, more than a dozen current and former executives affiliated with the generic drug industry described many risks that discourage a company from increasing production that might ease the shortages.

They said prices were pushed so low that making lifesaving medicines could result in bankruptcy.

fucking ghouls

Even within our currently dystopian capitalism it seems like you can just raise the prices on medications people need to survive, you don't also have to collude with the rest of the industry to keep things extra horrible

"first, do no harm...those who wish to do great physical harm to others must first step two feet to the right, on the business side of healthcare"

Another, this time about the Medicaid cliff that occurred earlier this year.

Land of the Free, Home of the Sick and Dying

Truly wish there was a way for me and my husband to renounce our citizenship and move to a place that was at least somewhat more robust in its care for its citizenry.

https://www.latimes.com/california/story/2023-12-19/750-a-month-no-questions-asked-improved-the-lives-of-homeless-people

Putting this here because every year of my life someone will run another one of these studies, the results will be the same and public policy won't move a millimeter.

not taking action on clear empirical solutions is one thing, but Kentucky can do you better:

https://www.lpm.org/news/2024-01-02/proposed-anti-crime-bill-makes-street-camping-illegal-in-kentucky

Louisville-area Republican state lawmakers plan to sponsor legislation in January that would ban street camping, add unlawful camping to Kentucky’s “stand your ground” law and cut funding for Housing First initiatives.

what's the right's beef with housing first--"they didn't earn it"?

The 'right' sees any government regulation of, or participation in, housing as interference in the free market, a horrifying crime that jeopardizes the freedom of the owning class to profit by the misery of others.

Housing First is under widespread right-wing assault. Their argument is that it's a.) not working (because hey look we still have all these homeless people), and b.) too expensive (which is obviously the real problem for them, they would much rather spend that money keeping people in jail).

https://www.nytimes.com/2023/06/20/us/politics/federal-policy-on-homelessness-becomes-new-target-of-the-right.html

Never mind that keeping people in jail is far more expensive, both in terms of dollars spent and in terms of lost opportunities.