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Thursday, September 26, 2019

Ageism

book-im-not-done.jpg a;t=image: book im not done

Is Ageism the Last Socially Acceptable Ism? A New Book Argues Yes

By Nicole Cardos
WTTW
April 25, 2019

As many as 25,000 complaints claiming age discrimination have been filed each year since 2008, according to the U.S. EQUAL EMPLOYMENT OPPORTUNITY COMMISSION.

That’s one of the reasons why PATTI TEMPLE ROCKS, a senior partner and head of client engagement at marketing agency ICF Next, calls ageism the last socially acceptable “ism” in our culture.

“We should talk about it. It’s the one ‘ism that will ultimately affect us all,” she said. “We’re all going to get old, were all going to age.”

Temple Rocks makes the case for increased awareness about ageism and age discrimination in her new book, I’M NOT DONE: IT’S TIME TO TALK ABOUT AGEISM IN THE WORKPLACE

The book details stories of employees in their 40s, 50s and 60s who’ve experienced ageism in the workplace, and tips for business leaders who wish to address it.

Temple Rocks joins us in discussion. 

Below, an excerpt from “I’m Not Done”

Chapter 4: The Dollars & Sense of Ageism in the Workplace

The other type of age discrimination claim turns on wrongful termination. Wrongful termination isn’t always a clearly identifiable firing or layoff. More commonly, its the “make them so miserable they will quit” approach, which I’ve discussed previously. This can take many forms, such as excluding an older worker from some meetings all of a sudden, giving younger workers plum assignments, better sales territories, or better technology, and making an older worker feel forced to accept a role that isn’t a good fit. If there is a pattern of such behavior, it can be interpreted as age discrimination.

Employers take this approach because they don’t want to fire the older worker and hope that either the older worker will solve the problem for them by quitting. Sometimes they use the “miserable job” as a place to put a worker they deem disposable. More often than not, this is an older employee. One gentleman I spoke with had this happen to him; in the back of his mind, he knew the company wanted him to leave for financial reasons, but he needed the job. As such, when he was asked to take the “miserable job,” he said yes. After many months, he asked for a change, and he was told by HR, “Well, you lasted a lot longer than we thought you would!” That was followed by HR telling him there was no other suitable role, so they would accept his resignation.

This type of ageism is often preceded by psychological damage and general diminishment of the person. Back to my ever-so-wise attorney friend Sue Ellen, who observed:

All of sudden, once-valued employees feel less valued they are forced into a role that no longer utilizes their strengths, they aren’t invited to key meetings, they are literally and figuratively being muted if not silenced, and it can become a self-defeating cycle because the natural reaction when this happens is to doubt yourself when in reality nothing has changed about your abilities as much as the organization’s natural inclination to gravitate towards the next shiny thing. And once that starts to happen to someone it can really wear them down, so this idea of leaving either voluntarily or not - starts to sound like a plausible idea.

This is essentially what is meant by the infamous phrase “put out to pasture,” and it happens much more often to older workers. They are just not involved in the way that they used to be involved, so it becomes this self-defeating cycle of yuck. Because if you’re not in the thick of things, your opinions are not going to be as well-informed. Then when you do get the chance to participate or give an opinion, it might not be as savvy or as spot-on as it used to be because you have started to doubt yourself and your ability to deliver value.

As humans, we are at our happiest when we feel involved, valued, and needed. When you no longer feel that in your workplace, particularly as an older worker who has been invested in a career for 30 or 40 years, it feels almost like a loss of identity. It’s almost like the stories you hear of one spouse dying followed quickly by the other. And after interviewing dozens of people, I can confirm that it hurts. A lot. Their hurt was palpable in each and every one of my interviews.

It’s a real ego blow to be treated this way. It’s hurtful. These are people who have spent most of their careers being highly valued, and then they all of a sudden get to a place where they start to wonder, when did I become invisible?

I think that’s partly why I opted to move on when I experienced this myself. I got some really good advice from a senior-level recruiter who I’ve known for a long time: he said, “The minute it [staying in the job] starts to erode your self-confidence, you have to get out of there.”

“I’m blessed with a fair degree of self-confidence, and it’s a lot easier for me than I think it is for a lot of people. I was also in a position where I could quitthat’s not true for everyone.”

Age discrimination also takes a heavier toll than other forms of discrimination on the health of victims. Boomers who want to keep working often need the income and health insurance that comes with full-time employment. Taking that away from them places a greater burden on public resources. In a statistic that shocked and horrified me, according to the AARP, those who lose their jobs past age 58 are at the greatest health risk, and on average, lose three years of life expectancy if they dont find another job.

A work study conducted by AARP in 2017 found that age is the leading reason for negative treatment by an employer. Participants were asked: “Thinking about how you are personally treated in the workplace, would you say the following generally caused your employer to treat you better, worse or no differently: age, race/ ethnicity, gender, disability, sexual orientation, religion, veteran status? Notably, age was the leading reason, and it was nearly double race and more than double gender. This underscores the negative psychological and physical effects experienced by older workers subject to age discrimination.

SOURCE

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Has the Law Evolved Enough To Combat Pervasive Age Discrimination?
While #MeToo has become a large focus in corporate America, the law surrounding age discrimination and the HURDLES TO LITIGATION are largely ignored.

By Kathryn Barcroft
Law Dot Com
September 11, 2019

Activist organizations have been hard at work studying the pervasiveness of age discrimination in corporate America and have noted the difficult legal standards to prove it, which leave many workers without options in the workplace after a certain age. While #MeToo has become a large focus in corporate America, the law surrounding age discrimination and the hurdles to litigation are largely ignored. The issue is of particular importance as employees are living longer and choose or need to work later in life, rather than having the means to retire with a sizeable pension. The realities of age discrimination are a real concern for all races and genders in the workforce as they plan their careers and are sometimes illegally forced to leave a company due to age discrimination.

Ageism is a worldwide problem that can affect the employment status of older workers. The issue has garnered the attention of the World Health Organization (WHO), an organization that has noted in relation to their upcoming study on ageism that “age discrimination is an incredibly prevalent and insidious problem.” Paula Spain, Ageism: A Prevalent and Insidious Health Threat, New York Times (April 26, 2019). Further, unlike other forms of discrimination - [it] is socially accepted and usually unchallenged, because of its largely implicit and subconscious nature. Alana Officer and VԢnia de la Fuente-Nuez, A global campaign to combat ageism, World Health Organization (March 9, 2018). A full report on WHO’s findings is anticipated in 2020.

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Posted by Elvis on 09/26/19 •
Section Revelations • Section Dying America • Section Workplace
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Wednesday, September 18, 2019

Your MRI

image: hippa

Maybe this explains why:

The treatment consent form included text that gives the hospital the ok to share any medical and personal information with any third party they wish, without restriction.
- Florida Hospital insists I let them do whatever they want with my medical records

Millions of Americans Medical Images and Data Are Available on the Internet. Anyone Can Take a Peek.
Hundreds of computer servers worldwide that store patient X-rays and MRIs are so insecure that anyone with a web browser or a few lines of computer code can view patient records. One expert warned about it for years.

ByJack Gillum, Jeff Kao and Jeff Larson
ProPublica
September. 17, 2019

Medical images and health data belonging to millions of Americans, including X-rays, MRIs and CT scans, are sitting unprotected on the internet and available to anyone with basic computer expertise.

The records cover more than 5 million patients in the U.S. and millions more around the world. In some cases, a snoop could use free software programs or just a typical web browser - to view the images and private data, an investigation by ProPublica and the German broadcaster Bayerischer Rundfunk found.

We identified 187 servers - computers that are used to store and retrieve medical data in the U.S. that were unprotected by passwords or basic security precautions. The computer systems, from Florida to California, are used in doctors’ offices, medical-imaging centers and mobile X-ray services.

“It’s not even hacking. It’s walking into an open door,” said Jackie Singh, a cybersecurity researcher and chief executive of the consulting firm Spyglass Security. Some medical providers started locking down their systems after we told them of what we had found.

Our review found that the extent of the exposure varies, depending on the health provider and what software they use. For instance, the server of U.S. company MobilexUSA displayed the names of more than a million patients all by typing in a simple data query. Their dates of birth, doctors and procedures were also included.

Alerted by ProPublica, MobilexUSA tightened its security last week. The company takes mobile X-rays and provides imaging services to nursing homes, rehabilitation hospitals, hospice agencies and prisons. “We promptly mitigated the potential vulnerabilities identified by ProPublica and immediately began an ongoing, thorough investigation,” MobilexUSA’s parent company said in a statement.

Another imaging system, tied to a physician in Los Angeles, allowed anyone on the internet to see his patients echocardiograms. (The doctor did not respond to inquiries from ProPublica.)

All told, medical data from more than 16 million scans worldwide was available online, including names, birthdates and, in some cases, Social Security numbers.

Experts say it’s hard to pinpoint who’s to blame for the failure to protect the privacy of medical images. Under U.S. law, health care providers and their business associates are legally accountable for securing the privacy of patient data. Several experts said such exposure of patient data could violate the Health Insurance Portability and Accountability Act, or HIPAA, the 1996 law that requires health care providers to keep Americans’ health data confidential and secure.

Although ProPublica found no evidence that patient data was copied from these systems and published elsewhere, the consequences of unauthorized access to such information could be devastating. Medical records are one of the most important areas for privacy because they’re so sensitive. Medical knowledge can be used against you in malicious ways: to shame people, to blackmail people, said Cooper Quintin, a security researcher and senior staff technologist with the Electronic Frontier Foundation, a digital-rights group.

“This is so utterly irresponsible,” he said.

The issue should not be a surprise to medical providers. For years, one expert has tried to warn about the casual handling of personal health data. Oleg Pianykh, the director of medical analytics at Massachusetts General Hospital’s radiology department, said medical imaging software has traditionally been written with the assumption that patients data would be secured by the customer’s computer security systems.

But as those networks at hospitals and medical centers became more complex and connected to the internet, the responsibility for security shifted to network administrators who assumed safeguards were in place. “Suddenly, medical security has become a do-it-yourself project,” Pianykh wrote in a 2016 research paper he published in a medical journal.

ProPublicas investigation built upon findings from Greenbone Networks, a security firm based in Germany that identified problems in at least 52 countries on every inhabited continent. GreenboneҒs Dirk Schrader first shared his research with Bayerischer Rundfunk after discovering some patients health records were at risk. The German journalists then approached ProPublica to explore the extent of the exposure in the U.S.

Schrader found five servers in Germany and 187 in the U.S. that made patients’ records available without a password. ProPublica and Bayerischer Rundfunk also scanned Internet Protocol addresses and identified, when possible, which medical provider they belonged to.

ProPublica independently determined how many patients could be affected in America, and found some servers ran outdated operating systems with known security vulnerabilities. Schrader said that data from more than 13.7 million medical tests in the U.S. were available online, including more than 400,000 in which X-rays and other images could be downloaded.

The privacy problem traces back to the medical professions shift from analog to digital technology. Long gone are the days when film X-rays were displayed on fluorescent light boards. Today, imaging studies can be instantly uploaded to servers and viewed over the internet by doctors in their offices.

In the early days of this technology, as with much of the internet, little thought was given to security. The passage of HIPAA required patient information to be protected from unauthorized access. Three years later, the medical imaging industry published its first security standards.

Our reporting indicated that large hospital chains and academic medical centers did put security protections in place. Most of the cases of unprotected data we found involved independent radiologists, medical imaging centers or archiving services.

One German patient, Katharina Gaspari, got an MRI three years ago and said she normally trusts her doctors. But after Bayerischer Rundfunk showed Gaspari her images available online, she said: “Now, I am not sure if I still can.” The German system that stored her records was locked down last week.

We found that some systems used to archive medical images also lacked security precautions. Denver-based Offsite Image left open the names and other details of more than 340,000 human and veterinary records, including those of a large cat named ԓMarshmellow, ProPublica found. An Offsite Image executive told ProPublica the company charges clients $50 for access to the site and then $1 per study. ԓYour data is safe and secure with us, Offsite ImageԒs website says.

The company referred ProPublica to its tech consultant, who at first defended Offsite Images security practices and insisted that a password was needed to access patient records. The consultant, Matthew Nelms, then called a ProPublica reporter a day later and acknowledged Offsite ImageҒs servers had been accessible but were now fixed.

“We were just never even aware that there was A POSSIBILITY that could even happen,” Nelms said.

In 1985, an industry group that included radiologists and makers of imaging equipment created a standard for medical imaging software. The standard, which is now called DICOM, spelled out how medical imaging devices talk to each other and share information.

We shared our findings with officials from the Medical Imaging & Technology Alliance, the group that oversees the standard. They acknowledged that there were hundreds of servers with an open connection on the internet, but suggested the blame lay with the people who were running them.

Even though it is a comparatively small number,Ӕ the organization said in a statement, it may be possible that some of those systems may contain patient records. Those likely represent bad configuration choices on the part of those operating those systems.Ӕ

Meeting minutes from 2017 show that a working group on security learned of Pianykhs findings and suggested meeting with him to discuss them further. That ғaction item was listed for several months, but Pianykh said he never was contacted. The medical imaging alliance told ProPublica last week that the group did not meet with Pianykh because the concerns that they had were sufficiently addressed in his article. They said the committee concluded its security standards were not flawed.

Pianykh said that misses the point. ItԒs not a lack of standards; its that medical device makers donҒt follow them. Medical-data security has never been soundly built into the clinical data or devices, and is still largely theoretical and does not exist in practice,Ӕ Pianykh wrote in 2016.

ProPublicas latest findings follow several other major breaches. In 2015, U.S. health insurer Anthem Inc. revealed that private data belonging to more than 78 million people was exposed in a hack. In the last two years, U.S. officials have reported that more than 40 million people have had their medical data compromised, according to an analysis of records from the U.S. Department of Health and Human Services.

Joy Pritts, a former HHS privacy official, said the government isn’t tough enough in policing patient privacy breaches. She cited an April announcement from HHS that lowered the maximum annual fine, from $1.5 million to $250,000, for whats known as “corrected willful neglect” - the result of conscious failures or reckless indifference that a company tries to fix. She said that large firms would not only consider those fines as just the cost of doing business, but that they could also negotiate with the government to get them reduced. A ProPublica examination in 2015 found few consequences for repeat HIPAA offenders.

A spokeswoman for HHS Office for Civil Rights, which enforces HIPAA violations, said it wouldn’t comment on open or potential investigations.

“What we typically see in the health care industry is that there is Band-Aid upon Band-Aid applied to legacy computer systems,” said Singh, the cybersecurity expert. She said it’s a “shared responsibility: among manufacturers, standards makers and hospitals to ensure computer servers are secured.

“It’s 2019,” she said. “There’s no reason for this.”

How Do I Know if My Medical Imaging Data is Secure?

If you are a patient:

If you have had a medical imaging scan (e.g., X-ray, CT scan, MRI, ultrasound, etc.) ask the health care provider that did the scan - or your doctor - if access to your images requires a login and password. Ask your doctor if their office or the medical imaging provider to which they refer patients conducts a regular security assessment as required by HIPAA.

If you are a medical imaging provider or doctor’s office:

Researchers have found that picture archiving and communication systems (PACS) servers implementing the DICOM standard may be at risk if they are connected directly to the internet without a VPN or firewall, or if access to them does not require a secure password. You or your IT staff should make sure that your PACS server cannot be accessed via the internet without a VPN connection and password. If you know the IP address of your PACS server but are not sure whether it is (or has been) accessible via the internet, please reach out to us at “medicalimaging at propublica.org.”

SOURCE

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FDA informs patients, providers and manufacturers about potential cybersecurity vulnerabilities for connected medical devices and health care networks that use certain communication software

FDA
October 1, 2019

Today, the U.S. Food and Drug Administration is informing patients, health care professionals, IT staff in health care facilities and manufacturers of a set of cybersecurity vulnerabilities, referred to as URGENT/11,Ӕ thatif exploited by a remote attackerחmay introduce risks for medical devices and hospital networks. URGENT/11 affects several operating systems that may then impact certain medical devices connected to a communications network, such as wi-fi and public or home Internet, as well as other connected equipment such as routers, connected phones and other critical infrastructure equipment. These cybersecurity vulnerabilities may allow a remote user to take control of a medical device and change its function, cause denial of service, or cause information leaks or logical flaws, which may prevent a device from functioning properly or at all.

To date, the FDA has not received any adverse event reports associated with these vulnerabilities. The public was first informed of these vulnerabilities in a July 2019 advisory sent by the Department of Homeland Security. Today, the FDA is providing additional information regarding the source of these vulnerabilities and recommendations for reducing or avoiding risks the vulnerabilities may pose to certain medical devices.

While advanced devices can offer safer, more convenient and timely health care delivery, a medical device connected to a communications network could have cybersecurity vulnerabilities that could be exploited resulting in patient harm,Ӕ said Amy Abernethy, M.D., Ph.D., FDAs principal deputy commissioner. ғThe FDA urges manufacturers everywhere to remain vigilant about their medical productsto monitor and assess cybersecurity vulnerability risks, and to be proactive about disclosing vulnerabilities and mitigations to address them. This is a cornerstone of the FDAגs efforts to work with manufacturers, health care delivery organizations, security researchers, other government agencies and patients to develop and implement solutions to address cybersecurity issues that affect medical devices in order to keep patients safe.

The URGENT/11 vulnerabilities exist in a third-party software, called IPnet, that computers use to communicate with each other over a network. This software is part of several operating systems and may be incorporated into other software applications, equipment and systems. The software may be used in a wide range of medical and industrial devices. Though the IPnet software may no longer be supported by the original software vendor, some manufacturers have a license that allows them to continue to use it without support. Therefore, the software may be incorporated into a variety of medical and industrial devices that are still in use today.

Security researchers, manufacturers and the FDA are aware that the following operating systems are affected, but the vulnerability may not be included in all versions of these operating systems:

VxWorks (by Wind River)
Operating System Embedded (OSE) (by ENEA)
INTEGRITY (by GreenHills)
ThreadX (by Microsoft)
ITRON (by TRON)
ZebOS (by IP Infusion)

The agency is asking manufacturers to work with health care providers to determine which medical devices, either in their health care facility or used by their patients, could be affected by URGENT/11 and develop risk mitigation plans. Patients should talk to their health care providers to determine if their medical device could be affected and to seek help right away if they notice the functionality of their device has changed.

The FDA takes reports of vulnerabilities in medical devices very seriously and todayԒs safety communication includes recommendations to manufacturers for continued monitoring, reporting and remediation of medical device cybersecurity vulnerabilities. The FDA is recommending that manufacturers conduct a risk assessment, as described in the FDAs cybersecurity postmarket guidance, to evaluate the impact of these vulnerabilities on medical devices they manufacture and develop risk mitigation plans. Medical device manufacturers should work with operating system vendors to identify available patches and other recommended mitigation methods, work with health care providers to determine any medical devices that could potentially be affected, and discuss ways to reduce associated risks.

Some medical device manufacturers are already actively assessing which devices may be affected by URGENT/11 and are identifying risk and remediation actions. In addition, several manufacturers have already proactively notified customers of affected products, which include medical devices such as an imaging system, an infusion pump and an anesthesia machine. The FDA expects that additional medical devices with one or more of the cybersecurity vulnerabilities will be identified.

ғWhile we are not aware of patients who may have been harmed by this particular cybersecurity vulnerability, the risk of patient harm if such a vulnerability were left unaddressed could be significant, said Suzanne Schwartz, M.D., MBA, deputy director of the Office of Strategic Partnerships and Technology Innovation in the FDAԒs Center for Devices and Radiological Health. The safety communication issued today contains recommendations for what actions patients, health care providers and manufacturers should take to reduce the risk this vulnerability could pose. ItӒs important for manufacturers to be aware that the nature of these vulnerabilities allows the attack to occur undetected and without user interaction. Because an attack may be interpreted by the device as a normal network communication, it may remain invisible to security measures.

The FDA will continue its work with manufacturers and health care delivery organizationsԗas well as security researchers and other government agenciesto help develop and implement solutions to address cybersecurity issues throughout a device’s total product lifecycle.

The FDA will continue to assess new information concerning the URGENT/11 vulnerabilities and will keep the public informed if significant new information becomes available.

The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nationגs food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.

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Posted by Elvis on 09/18/19 •
Section Privacy And Rights • Section Dying America
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Tuesday, September 17, 2019

Suicide Redux

image: causes of death 2017

Researchers say there’s a simple way to reduce suicides: Increase the minimum wage

By Andrew Van Dam
Washington Post
April 30, 2019

Since 2000, the suicide rate in the United States has risen 35 percent, primarily because of the significant increase in such deaths among the WHITE population.

There are hints that these deaths are the result of worsening prospects among less-educated people, but there are few immediate answers. But maybe the solution is simple: pursue policies that improve the prospects of working-class Americans.

Researchers have found that when the minimum wage in a state increased, or when states boosted a tax credit for working families, the suicide rate decreased.

Raising the minimum wage and the earned-income tax credit (EITC) by 10 percent each could prevent about 1,230 suicides annually, according to a WORKING PAPER circulated by the National Bureau of Economic Research this week.

The EITC was designed to boost the wages of low-income workers, particularly families with children. Many states have supplemented or expanded the credit.

Raising the minimum wage and increasing the tax credit help less-educated, low-wage workers who have been hit hardest by what are now known as DEATHS OF DESPAIR according to the analysis of 1999-2015 death data from the Centers for Disease Control and Prevention by University of California at Berkeley economists Anna Godoey and Michael Reich, as well as public-health specialists William Dow and Christopher Lowenstein.

Deaths of despair, a phrase popularized by Princeton economists Anne Case and Angus Deaton in a pair of widely cited 2015 and 2017 papers, typically refers to rising death rates among middle-aged white non-Hispanic Americans.

In 2017, Case and Deaton wrote that those rising death rates can be attributed to “drug overdoses, suicides, and alcohol-related liver mortality particularly among those with a high school degree or less.”

To evaluate how policy choices could affect those deaths, the Berkeley team identified states that had raised their minimum wage or EITC between 1999 and 2015. They also included states whose wages were affected by federal minimum-wage increases. The researchers then measured the change in the rate for such deaths before and after the policies took effect.

To control for national trends, they compared the changes with states that hadn’t changed their minimum wage or EITC.

The researchers looked at suicides and drug overdoses. Unlike degenerative liver disease linked to alcohol abuse, those events can be connected to a single point in time.

The team found little change in drug overdoses, whether intentional or accidental, after the new policies took effect. This falls in line with the growing consensus that, unlike other deaths of despair, drug overdoses probably are linked to increased availability of addictive (and lethal) drugs.

But the number of suicides that weren’t related to drugs dropped noticeably. Among adults without a college education, increasing the EITC by 10 percent appears to have decreased non-drug suicides by about 5.5 percent. Raising the minimum wage by 10 percent reduced suicides by 3.6 percent.

“When they implement these policies, suicides fall very quickly,” Godoey said in an interview.

Although raising the minimum wage led to an immediate decrease in suicides, raising the EITC had a delayed effect, resulting in fewer suicides the following year, once the tax change came into force. In both cases, it appears as though taking home more money had a positive effect.

The effect was strongest among young women and others who were most likely to have minimum-wage jobs. Among men, black and Hispanic Americans saw the largest effect.

A March study in the American Journal of Preventive Medicine also found that a one-dollar increase in the minimum wage was associated with a 1.9 percent decrease in suicides, and that the association was strongest between 2011 and 2016, the most recent year studied.

Leading minimum-wage scholar Arindrajit Dube of the University of Massachusetts at Amherst, who shows in a forthcoming publication in the American Economic Journal: Applied Economics that higher minimum wages increase incomes for the poorest families, said the two studies provide important additional evidence on the possible impact of a higher minimum wage on the standard of living - or living at all.

The scholars are contributing to a larger body of work that links health, particularly mental health, with economic policy and outcomes.

In a 2014 analysis in American Economic Journal: Economic Policy, William Evans of the University of Notre Dame and Craig Garthwaite of Northwestern’s Kellogg School of Management found that mothers who received a higher EITC reported better mental and physical health.

In a paper to be published in American Economic Review: Insights, David Autor of the Massachusetts Institute of Technology, David Dorn of the University of Zurich and Gordon Hanson of the University of California at San Diego drew on data from between 1990 and 2014 to find that the death rate among men tended to rise in cities where jobs were vanishing because of competition from cheap foreign goods.

SOURCE

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Economic hardship tied to increase in U.S. suicide rates, especially in rural areas

By Melissa HealyStaff Writer
LA Times
Sep. 6, 2019

Whether they are densely populated or deeply rural, few communities in the United States have escaped a shocking increase in suicides over the last two decades. From 1999 to 2016, suicide claimed the lives of 453,577 adults between the ages of 25 and 64 enough to fill more than 1,000 jumbo jets.

Suicides reached a 50-year peak in 2017, the latest year for which reliable statistics are available. The vast majority of those suicides happened in the countryגs cities and suburbs, where 80% of Americans live.

But a new study shows that the nations most rural counties have seen the toll of suicide rise FURTHEST AND FASTEST during those 18 years.

The new research ties high suicide rates everywhere to the unraveling of the social fabric that happens when local sports teams disband, beauty and barbershops close, and churches and civic groups dwindle. But in rural counties, especially, it finds a powerful link between suicide and economic deprivation a measure that captures poverty, unemployment, low levels of education and reliance on government assistance.

The study also finds that in counties where health insurance is lacking, and in those where military veterans represent a larger proportion of the population, suicide rates were higher over the 18-year period studied.

And in all but the most rural counties, the more stores there are selling firearms, the higher the suicide rate ח a finding that underscores the risk that goes hand-in-hand with having easy access to guns.

At a time when surging suicide rates have contributed to a sustained decline in life expectancy in the United States, the study results suggest that efforts to rescue Americans from SELF-DESTRUCTIVE DESPAIR must focus on combating loneliness, revitalizing downtrodden communities, broadening access to healthcare and narrowing access to guns.

And it suggests that economic decline in the nations rural outposts has generated a hopelessness that must not be overlooked.

“Suicide rates in rural counties are especially susceptible to deprivation,” a team led by researchers from Ohio State University wrote in Friday’s edition of the journal JAMA Network Open. “Rural counties present special challenges and deserve targeted suicide-prevention efforts.”

Whether they are densely populated or deeply rural, few communities in the United States have escaped a shocking increase in suicides over the last two decades. From 1999 to 2016, suicide claimed the lives of 453,577 adults between the ages of 25 and 64 enough to fill more than 1,000 jumbo jets.

Suicides reached a 50-year peak in 2017, the latest year for which reliable statistics are available. The vast majority of those suicides happened in the country’s cities and suburbs, where 80% of Americans live.

But a new study shows that the nation’s most rural counties have seen the toll of suicide rise furthest and fastest during those 18 years.

The new research ties high suicide rates everywhere to the unraveling of the social fabric that happens when local sports teams disband, beauty and barbershops close, and churches and civic groups dwindle. But in rural counties, especially, it finds a powerful link between suicide and economic deprivation - a measure that captures poverty, unemployment, low levels of education and reliance on government assistance.

The study also finds that in counties where health insurance is lacking, and in those where military veterans represent a larger proportion of the population, suicide rates were higher over the 18-year period studied.

And in all but the most rural counties, the more stores there are selling firearms, the higher the suicide rate a finding that underscores the risk that goes hand-in-hand with having easy access to guns.

At a time when surging suicide rates have contributed to a sustained decline in life expectancy in the United States, the study results suggest that efforts to rescue Americans from self-destructive despair must focus on combating loneliness, revitalizing downtrodden communities, broadening access to healthcare and narrowing access to guns.

And it suggests that economic decline in the nationגs rural outposts has generated a hopelessness that must not be overlooked.

Suicide rates in rural counties are especially susceptible to deprivation,Ӕ a team led by researchers from Ohio State University wrote in Fridays edition of the journal JAMA Network Open. ғRural counties present special challenges and deserve targeted suicide-prevention efforts.

The Centers for Disease Control and Prevention has reported that the age-adjusted suicide rate rose from 10.5 deaths per 100,000 people in 1999 to 14.0 per 100,000 in 2017 - a 33% increase. SUICIDE IS NOW THE TENTH LEADING CAUSE OF DEATH FOR PEOPLE OF ALL AGES IN THE UNITED STATES. While rural counties have long led urban ones in suicide rates, the gap became even wider during those years.

Across the country, the new study found that counties whose suicide rates exceeded the national average by the greatest amount tended to be in Western states (particularly Colorado, New Mexico, Utah and Wyoming), in Appalachia (including Kentucky, Virginia and West Virginia), and in the Ozarks (Arkansas and Missouri).

A time-lapsed series of snapshots of suicide rates since the turn of this century reveals a spreading geography of despondency thats broken up by just a few islands җ virtually all of them urban where suicide rates have risen only moderately.

In a series of maps, elevated suicide rates first appear from 2002 to 2004 in pockets scattered across the American Southwest, the inter-mountain West, Appalachia and the farthest reaches of Alaska.

By 2008 to 2010, above-average suicide rates darkened much of the mountainous West and extended across Oregon and Northern California to the Pacific Coast. And they gained a solid foothold in the Midwestern heartland and in counties of the industrial Upper Midwest.

By 2014 to 2016, increased suicide rates spread across the vast expanse of the American West, sparing only most of the counties hugging the California coast from Sonoma County to San Diego. They also covered the industrial Midwest and appeared in rural counties in southern Mississippi and Louisiana, the mid-Atlantic states and New England.

Danielle L. Steelesmith, the studyגs lead author, said the findings on guns warrant further scrutiny. But she noted that this isnt the first time researchers have seen that where access to firearms is greater, so too is the number of suicides committed with a gun.

The exception was in the 20% of counties classified as rural җ those lacking a town with a population greater than 2,500. Steelesmith said the fact that the density of gun shops there was not linked with an increase in suicide risk may reflect a central fact of rural life: Most homes already have a gun, so the availability of a gun retailer may not necessarily increase gun access.

But in counties that include towns larger than 2,500, the added access that comes with more gun shops may make a difference.

ItӒs relatively small as an association, Steelesmith said. ԓIn a large metropolitan county, one additional gun shop would increase suicides by one to two people. But at the national level, thats potentially a lot of people.Ҕ

The new analysis helps explain why suicides, drug overdoses and other so-called deaths of despair have ravaged rural white populations while touching more lightly upon African Americans and Latinos, said Brookings Institution research analyst Carol Graham.

In more metropolitan counties, the long-entrenched poor including communities of color ח appear able to fend off despair by accessing shared resources like city parks, neighborhood barbershops and community churches, and by tapping into the social networks that have sustained them through generations of hardship, Graham said. Plus, they are closer to a wider range of employment opportunities.

Even in rural counties dominated by minorities, such shared institutions have long existed, helping blacks and Latinos to weather long-standing poverty, she said.

In rural counties hollowed out by more recent economic decline, the shared communities of religious congregations, Grange meetings and even high school football games have dwindled. And as residents fled, those left behind have become increasingly isolated from one another, said Graham, who studies the geography of happiness and despair as well as the social, economic and political factors that contribute to population health.

These are the places that used to be thriving rural places, near enough to cities and manufacturing hubs,Ӕ she said. TheyӒre places that accord with a stereotypical picture of stable blue-collar existence and a quite nice existence ח for whites in the heartland.

With the collapse of extractive industries such as coal mining, the departure of manufacturing jobs, and a strapped agricultural economy, “these communities just got flipped on their head,” Graham observed. “And the people in those places became unhinged. You’d have a sense of places where everything has left. And among those who stay, you see no optimism for the future.”

Steelesmith said that one of the studys findings - that social capital 0 in the form of clubs, churches, schools and group activities was associated with lower rates of suicide offers hope to rural populations reeling from economic deprivation.

Maintaining friendships and building connections with others “are something that residents can do themselves,” she said.

SOURCE

Posted by Elvis on 09/17/19 •
Section Dying America
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Friday, September 06, 2019

Call Center Worker Survey

inage: call center blues

The folks at PROPUBLICA are doing a story of those of us that work in CALL CENTERS:

We’re doing some research into what it’s like to work at customer service contracting firms

Tell your story HERE

Posted by Elvis on 09/06/19 •
Section General Reading
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Legalized Extortion

image: Uninsured

“Our deductible is so high, we practically pay for all of our medical expenses out of pocket.” Her family of four pays premiums of $1,200 a month for coverage with an annual deductible of $12,700.
- Wendy Kaplan, 50

“Obamacare, which should more correctly be called by its secret Corporate name, Baucus-care, makes 30 million people buy private health insurance, a near-worthless middleman racket that produces nothing, but is an exquisite parasite that does intrude to the max between doctor and patient for the sole purpose of extracting profit. And taxpayers have to pay for all those who can’t.”
- Op-Ed News - July 2012

No matter how worthless and expensive it may be with high deductables, copays and premiums - it may be cheaper to have insurance than not.

But, it’s NOT A GOOD THING.

Is the restaurant owner who pays the mob for PROTECTION, better off paying them or not?  Sure he won’t get his legs cut off - or business burned down - that’s why he pays.

I kinda pay the insurance company for protection too. 

On the surface it seems they protect me from heartless, price-gouging doctors.

What do I mean?

Doctors make deals with insurance companies to be IN-NETWORK - meaning they charge the insurance companies a lot less than they do everyone else.

Patients make deals with the same insurance companies for access to these in-network doctors’ prices.

Regardless how watered down and useless insurance coverage may be - just by paying these crooks middlemen, and going to an in-network doctor - you get the bargained for price, even if the insurance company pays nothing (THANKS TO big, fat yearly DEDUCTABLES) - ever - for a claim.

Then there was the day I though I had pneumonia. 

Lucky me only had to pay the in-network price for the doctor who treated my flu, but it got worse and I though I was dying, so decided to go a hospital.

Until I called the insurance company to get an idea how much it’ll cost me.

The agent said unless the hospital says it’s a “life threatening emergency,” they’ll deny all claims.

An emergency room visit, x-rays, tests, etc - can cost thousands - and if they don’t find anything that’ll kill me right away - means I gotta pay them lots of money.

If I were to roll the dice and take a chance - make sure to drive to the hospital myself - because an ambulance is considered TRANSPORTATION - a charge that may not be covered at all. 

So much for having one of the signs of an impending hear attack, and told to call 911 immediately.

I’m TOO AFRAID TO TAKE THE CHANCE.

The charge just to walk in a hospital is astronomical.

If I don’t have a heart attack now, I certainly will when the hospital bill comes in.

Even with an in-network discount.

This is worse than legalized extortion. At least if I pay the mob not to burn down my business - they won’t.

I wish our doctors would wise up and give discounts to us instead of the insurance companies screwing us all.

So, what else happened during those two months I spent on the couch coughing my brains out you ask?

The city almost took away my house because I was too sick to get out of bed to cut the grass.

$250/day fine because they said it was getting to high.

Looks like I’m not the only one getting hit with fines for that.... while our roads and bridges are COLLAPSING.

---

The Grass Gestapo Is Out of Control: 30K in Fines and Potential Foreclosure for a Too-Long Lawn

By Dagney Talbert
The Organic Prepper
August 12, 2019

A few weeks ago, I noticed a woman standing in my neighbor’s yard doing something I thought was pretty damn strange: she was measuring blades of grass with a tape measure.

Then I noticed the city truck parked on the street.

Turns out, the woman was with codes compliance or whatever they call it, apparently, her job is to drive around looking for reasons to harass and extort people for things like tall grass.

READ MORE...
Posted by Elvis on 09/06/19 •
Section Dying America
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