Turning to Big, Big Data to See What Ails the World

Good examples of how big data can help identity the more important issues and the consequent shift in focus from death to disability:

The disconnect between what we think causes the most suffering and what actually does persists today. It is partly a function of success. Diarrhea, pneumonia and childbirth deaths have greatly declined, and deaths from malaria and AIDS have fallen, although far less dramatically. (The charts here show the stunning improvement in health around the world. And here are similar charts tracking progress in hunger, poverty and violence — a big picture that’s an important counterpoint to the constant barrage of negative world news.) This success is partly due to changes made because of the first Global Burden reports.

The downside is that longer lives mean people are living long enough to develop diabetes and Alzheimer’s.   “What decline we’re seeing from communicable diseases, we’re seeing a compensatory increase from diabetes,” Murray said.   And neurological diseases such as Alzheimer’s now account for twice as many years lived with disability as cardiovascular and circulatory diseases together, Smith writes.

This is not simply because people are living longer. It’s also a function of worsening diet everywhere, as poor societies adopt the processed foods found in rich ones.

The most surprising information, though, came not in measuring deaths, but disability. “Major depression caused more total health loss in 2010 than tuberculosis,” Smith writes. Neck pain caused more health loss than any kind of cancer, and osteoarthritis caused more than natural disasters. For other findings that may surprise you, see the quiz.

The report is a giant compilation of “who knew?”

Based on this information, countries and international organizations have been able to change how they spend their health resources, and some ambitious countries have done their own national Burden of Disease studies.

Iran, writes Smith, found that traffic injury was its leading preventable cause of health loss in 2003, and put money into building new roads and retraining police. It also targeted two other big problems its study found: suicide and heart disease.

Australia, responding to the high impact of depression, began offering cost-free short-term depression therapy .

Mexico was one of the countries making the most use of Global Burden of Disease data, after Julio Frenk became health minister in 2000.   Frenk had been Murray’s boss at the W.H.O., and a participant in Murray’s work. He found that Mexico’s health system was targeting the communicable diseases that predominated in 1950, not what currently ailed Mexicans. In response, Frenk established universal health insurance (before that, 50 million were uninsured) and set coverage according to the burden of disease.

The program covered emergency care for car accidents, treatment of mental illness, cataracts, and breast and cervical cancer — all of which had been uncovered, even for people with insurance. “You want to cover those interactions that give you the highest gain,” ]he said.

Murray and company have now branched out beyond diagnosis to measuring treatment: How many people really have access to programs like anti-malaria bed nets or contraception? How much is being spent and what does it buy? Where are the most useful points of intervention?   Meanwhile, data from the Global Burden reports  is seeping further into health policy decisions around the world — data that saves suffering and money and lives.

via Turning to Big, Big Data to See What Ails the World – NYTimes.com.

Toronto’s income gap continues to widen, finds U of T expert

Not new, but better documented by David Hulchanski than done earlier:

Between 1970 and 1990, average incomes jumped significantly in only about 13 per cent of Toronto’s 500-plus “census tract” neighbourhoods.

Slightly more, 19 per cent, saw incomes drop significantly, while most Torontonians, in 67 per cent of the census tracts, saw earnings change only modestly.

Expanding the time frame to 1970 to 2012 exposes a dramatic shift.

Middle-income communities across the city began to evaporate. Neighbourhoods with relatively stable average income shrank by more than half, to 32 per cent of the census tracts.

The percentage of neighbourhoods where residents’ average incomes skyrocketed more than doubled. At the same time, the percentage of neighbourhoods where people were getting much poorer also doubled.

Yorkville, which transformed from downtown hippie haven to posh shopping district favoured by the jet set, saw the biggest surge in average incomes. Part of Thorncliffe Park, which became a landing pad for newly arrived immigrants, saw the biggest income drop.

When the city snapshot is narrowed to only 2012, just under half of Toronto is considered low-income — well under the $46,666-per-year average — while 21 per cent is high-income and only 30 per cent is middle.

“What I call City No. 2 — the middle-income city — is simply disappearing,” Hulchanski says.

Gentrification is only one of the root causes, he says, listing provincial and federal policy changes since 1990 that he believes were intended to further enrich society’s top earners.

This can also be mapped against visible minorities, many of whom are low-income in Toronto.

Of course, this is not just a Toronto issue as part of worldwide trend towards greater inequality.

Toronto’s income gap continues to widen, finds U of T expert | Toronto Star.

Cancer survivors income falls $5K a year, StatsCan finds

Not surprising, and mirrors my experience, although I benefitted from good government employee benefits that helped those with catastrophic illness (the government planning to roll these back).

While in the end, my particularly aggressive form of cancer made returning to work a non-starter, most people following cancer diagnosis and treatment of any kind also tend to shift their priorities towards family and friends, with career advancement becoming secondary.

While I wouldn’t go so far as the Canadian Cancer Society – we often make choices between income and other priorities – there is need to examine whether we have the right balance between benefits for those with catastrophic illness and the overall cost to governments and employers:

On average, cancer survivors earned $5,079, or 12.1 per cent, less one year after diagnosis than their counterparts who were never diagnosed with the disease. Cancer lowered the probability of working in the first year after diagnosis by three percentage points on average compared with the other group in the sample.

The effects continued but lessened in the second and third years after diagnosis.

Employees may work fewer hours after cancer treatment as they recover. Others may switch jobs to something less stressful and perhaps lower paying.

“We find cancer patients are forced into situations where they have to choose between their treatment or their income, and thats not acceptable,” said Lauren Dobson-Hughes of the Canadian Cancer Society.

The society would like to see an increase in sickness benefits beyond 15 weeks and an increase in the amount thats provided beyond 55 per cent of salary. Theres also currently a two-week waiting period for EI, which Dobson-Hughes said isnt sustainable for many patients.

Cancer survivors income falls $5K a year, StatsCan finds – Health – CBC News.

‘Mental Prisons,’ the Public Service and Gilles Paquet

In the spirit of Paquet's call for the "highest and best use of irony and irreverence" and "methodological and intellectual cruelty."

In the spirit of Paquet’s call for the “highest and best use of irony and irreverence” and “methodological and intellectual cruelty.”

My review of Gilles Paquet’s Super-Bureaucrats as Enfants du siècle in the Hill Times:

Ralph Heintzman provoked considerable debate in his Canada 2020: Renewal of the Federal Public Service arguing for an independent, arms-length public service. Ruth Hubbard countered it with The real problem with the public service, arguing that the real problem is competency, not the relationship between the political and bureaucratic levels. Maryantonett Flumian reminds us that politicians are elected, officials are not, and they have to implement government priorities as long as they do not break the law in How public servants support democracy: a response to latest Canada 2020 study.

Gilles Paquet adds his voice in Super-Bureaucrats as Enfants du siècle, which, while focused on officers of Parliament, casts his critique more broadly.

Paquet’s language, as always, pulls no punches. The “tribe” of super-bureaucrats form an “oligarchy.” They have a “sense of superior expertise and total infallibility.” They are agents of “counter-democracy” and impose their “technocratic and ideological views … usurping the role of elected officials.”

Officials practise “active or passive disloyalty” and are guilty of “sabotage.” The “fairy tale” of political reliance on anecdotes versus official reliance on anecdotes led to a “destructive … misuse of power,” which “translated in subterranean efforts to block, derail, or deflect the efforts of fairly able politicians.”

But apart from the tone, what is Paquet’s argument?

That super-bureaucrats, starting with officers of Parliament, but including adjudicatory bodies and the courts, have largely usurped the authority of the government and Parliament through “mandate creep with gusto.”

Their ideology or “diktats of indiscriminate compassion” allow them to portray themselves on the “side of the angels” while pursuing an “unlimited increase of the resources dedicated to the bureaucracy.”

“Super-bureaucrats and higher courts judges have often made unwarranted claims based much more on hubris than on superior competence, and couched in drama-queenesque rhetoric …”

Media and academics have been “defending tooth and nail the sacredness of the super-bureaucrats.”

Other critiques of officers of Parliament have been expressed more in terms of the diminished role of Parliament than of deference to the government (Donald Savoie).

But let’s take Paquet’s argument at face value that the super-bureaucrats and others, including “low-level bureaucrats” like he mentioned, have been actively undermining the government.

I wrote Policy Arrogance or Innocent Bias: Resetting Citizenship and Multiculturalism as more critical of the public service than the government because I felt that we had failed in our role to provide neutral and impartial advice.

We did not acknowledge our ideological and value biases, our evidence base was too slanted towards these biases, and we clung to a narrow interpretation of risk.

But the government also shares some responsibility. It arrived to government with a stronger ideological focus, one that often coloured its perception of evidence and preference for anecdotes (e.g., labour market shortages), and its willingness to discount risk (e.g., recent number of Supreme Court defeats).

But more fundamentally, Paquet is arguing for little or no constraints upon the government of the day.

He devalues the balance that officers of Parliament, adjudicatory bodies, and the courts provide in a context where Parliament no longer plays that role, given increased partisanship, expanded use of time allocation, and omnibus legislation. These trends predate the Conservative government, but have expanded under it.

Moreover, Paquet is also silent on the government’s silencing of those whose statutory role requires them to be a watchdog (e.g., starting with Linda Keen) or kills bodies that provide independent advice (e.g., National Round Table on the Environment on the Economy).

And does he really believe that the original version of Bill C-23, the Fair Elections Act, should not have been challenged?

Reading this paper alongside his companion article, On Critical Thinking, one is struck by just how much Paquet, so critical of others being trapped by their “mental prison,” falls into the same trap.

Is he as mindful of his own biases, ideology, and assumptions as he accuses others of “disingenuity, sophistry, and bullshit?”After all, all three can be found in the left, centre, and right-wing versions of conventional wisdom.

Heintzman’s Canada 2020 report continues to provoke debate (pay wall)

 

 

Federal government turning to Dragons’ Den to shake up policymaking

Interesting. Is this part of transition planning for a future government that may be more willing to loosen the reins?

Or is it more “make work” given that we have a government that, for understandable – if not necessarily justifiable – reasons, prefers to limit discussion and debate, and reduce the independence of watchdogs.

How much latitude does the government want bureaucrats to have, given their perception, not completely unfounded, of our biases?

Will future governments bring us “back to the good old days” (which were not so good anyway) or not?:

According to the briefing documents, some of the innovative policy ideas the government is looking to test as pilot projects could include using social media or other tools to engage or consult the public, end users and others to help inform policy development; or creating a “tiger team” to address specific, time-limited objectives.

Other examples of possible pilot projects include using open data, such as launching a challenge to design apps, or innovative “social finance instruments” to help address social problems.

The deputy ministers’ committee was created in November 2012 and originally called the DMs’ “committee on social media and policy development.” It was initially mandated to consider links between social media and policymaking, including new models for policy development and public engagement.

As of December 2013, the committee was asked to move beyond social media to examine trends and new technologies to help improve and transform policy development.

Yet, the rise of social media and its impact on how government communicates its messages and develops policy remains a concern to the government, according to the documents.

“Many governments around the world are seeing their authority decrease as autonomous networks of citizens and stakeholder groups emerge, decreasing the impact of governments on public policy. Concurrently, the public is becoming less deferential to authority,” the documents note.

The changes in ease of access to information and data are “effectively undoing governments’ monopoly on policy analysis,” says the briefing material.

“Social media is fundamentally changing the nature of citizen-state relations. Citizens increasingly expect democratic governments to be transparent, participative, responsive, and to provide customizable and digital services,” the documents say.

“The speed of social media interactions puts pressure on government to develop quick and coordinated responses, which can conflict with longer-term policy and communications planning and priority setting.”

Federal government turning to Dragons’ Den to shake up policymaking | Ottawa Citizen.

Robyn Urback: If you want to learn abstinence, go to church. Get Christian sex-ed out of secular public schools

A reminder of other forms of fundamentalism.

It is not just the anecdotes cited by Urback regarding the effectiveness of abstinence approaches; the contrast between California and Texas is striking (Texas Isn’t Keeping Up With National Drop in Teenage Births):

The Pregnancy Care Centre taught courses in about 60 Edmonton-area schools last year, according to executive director Norah Kennedy. She says that their presentations do not explicitly mention Christianity, though the Centre was founded on religious principles. “We are brought in to speak from an abstinence-based perspective; which differs from abstinence-only presentation,” she told the Edmonton Journal. “We present abstinence as the best and safest choice while also giving them a comprehensive overview of all of their options.”

That may be true (though the Dawsons’ complaints, which have yet to be proven, say otherwise). Even still, an abstinence-focused sexual education program will not offer the same wide-ranging, balanced approach to education that a class without an “agenda” can deliver. Indeed, there’s a difference between a lecturer telling students to use a condom if they must, and a lecturer showing students how to properly put on a condom, why they shouldn’t layer condoms (it happens, amazingly enough), why they should use a condom for both vaginal and anal sex (that happens in high school, too) and what to do if the condom breaks.

Students wanting to know about same-sex relationships, the morning after pill and other religious no-nos should also feel free to do so without judgment; that’s hard to do when someone from a faith-based organization is standing at the front of the class. This might be a human rights issue for Emily and her mom, but it’s arguably more an access to education issue for everyone else. Christian sex education should stay out of secular public schools.

The Edmonton School Board dropped the program offered by Pregnancy Care Centre following the complaint and publicity.

Robyn Urback: If you want to learn abstinence, go to church. Get Christian sex-ed out of secular public schools

How public servants support democracy: a response to latest Canada 2020 study | hilltimes.com

More reaction from Maryantonett Flumian to Ralph Heintzman’s Canada 2020 report:

But doesn’t there come a point where a public servant—whose ethical code requires that he or she act “in the public interest”—must say no? Indeed there does. But the threshold is high, and the public servant’s responsibility to act in the public interest does not mean the public service determines the public interest.

For an unelected official, acting in the public interest essentially means three things:

  1. not acting in one’s private interest or in the special interests of those one personally favours;
  2. bringing one’s best professional expertise to bear on the tasks one performs; and
  3. acting consistently with the agenda and direction set by one’s minister, provided it is consistent with the law, with formal government policies, and with public service values and ethics.

So, yes, a public servant could and should refuse, say, to provide support for a partisan event. But he or she could not decline to implement a policy because he or she judged it not in the public interest….

Heintzman’s concerns here are fair enough, but the public service doesn’t operate in an ivory tower. Policies and practices that embarrass governments have never been matters of indifference for public servants. What has intensified in recent years is the pressure of the public environment. Instantaneous digital technology and 24/7 media are undercutting the deliberative, process-driven way in which governments have traditionally responded to issues. “Issues management” has emerged as a growing government need and perhaps the most in-demand skill for an up-and-coming public servant. This reality makes for fine lines that demand vigilance, but it does not mean that the public service has gone political.

Interesting relative lower emphasis on “fearless advice” (from someone who was fearless!) in favour of the softer “bringing one’s best professional expertise,” a not insignificant nuance in the current context of sometimes fraught government public service relations.

How public servants support democracy: a response to latest Canada 2020 study | hilltimes.com.

Reforms to bring neutrality to public service could lead to ‘government by the unelected’: think tank | Ottawa Citizen

More on the debate over the Canada 2020 by Ralph Heintzman, this time from  Maryantonett Flumian, who reminds us of the parameters of public servants:

Maryantonett Flumian, president of the institute, a think-tank devoted to public service issues, said a debate on the nature of governance is long overdue, but the answer to the trust gap between politicians and bureaucrats isn’t to isolate the public service and protect it from politics.

“That means Canadians would have a public service that no one wants. There is already an official opposition in this country and no one wants to be governed by the unelected. That is not the role of the public service,” she said. ….

She said deputy ministers are the “linchpins” between the government and the public service. They bridge the two worlds. They have to translate the prime minister’s agenda into action by the public service. Similarly, they explain the views of the public service to politicians.

Flumian argues the Clerk, not the Public Service Commission as recommended by Heintzman, is ideally positioned to select deputy ministers who have the capabilities, skills and personalities best-suited to work “this two-way relationship” with ministers.

She argues turning these appointments over to the Public Service Commission makes bureaucrats independent of their political masters and risks politicizing the public service.

“Who will become those linchpins?” Does the deputy minister role get taken over by the ministers’ chief of staff?” she asked.

“If senior public servants are cloistered priests and nuns who don’t speak to the outside world and who don’t think their jobs is to understand the governance from the party in power, through to the prime minister and cabinet, then who will do that bridging?

Flumian believes Canada needs a neutral public service so to can work with any party in power. As a result, public servants don’t have an “independent voice” and their advice must be given in confidence “because it is the government that has a positions on issues, not the public service,” she said.

She acknowledged public servants are obliged to act in the public interest but the public interest is determined by the government and public servants must implement its policies whether they like it or.

“Politicians are elected, not public servants and they get to set the ground rules and, as long as they are not breaking the law, they are boss. That is what democracy is. “

Reforms to bring neutrality to public service could lead to ‘government by the unelected’: think tank | Ottawa Citizen.

Better data alone won’t fix Canada’s economy – The Globe and Mail

Good piece on the need for a broader and more thoughtful approach to the use of data in a “big data” environment:

The bottom line is that being data-dependent doesn’t mean responding to every wiggle in data. Nor does it mean basing our decisions solely on data or models and nothing else.Yes, we need better data.

But that’s only a start. We also need to ask precise and well-posed questions – of ourselves in our analysis and of our policy makers in their choices – particularly as “big data” increases the availability of non-conventional data sources. In addition, we need to bring new approaches to bare on data, and clearly explain the results to non-specialists.

After concerns about jobs estimates during the Ontario election, let’s hope that the lesson learned by our politicians is not to withhold economic analysis in future campaigns. Instead, let’s hope it causes them to raise their game by presenting more credible analyses.

At the same time, let’s be realistic about what better data can accomplish. This means acknowledging that data give us imprecise measurements of reality, but when used responsibly and creatively, they help us make better choices and hold governments to account for their policy decisions.

Better data alone won’t fix Canada’s economy – The Globe and Mail.

Fix the link where science and policy meet

More on the cumulative impact of Government actions on science and science policy from Homer-Dixon, Douglas and Edwards:

The federal government has severely degraded its internal scientific capacity, including its ability to perform and publicize its own scientific research, track outside scientific research, and monitor and assess policy issues with complex scientific content.

Federal ministries have created rules that require government scientists – especially those working on resource and environmental topics – to get approval from senior bureaucrats before publishing their research. They have also sharply restricted travel to scientific meetings and blocked their scientists from communicating with journalists without prior authorization, and even then often only under supervision. Across the federal government – but especially within the departments of Fisheries and Oceans, Environment, and Natural Resources – large numbers of scientists have been laid off and vital labs and libraries closed. Remaining scientists speak of a climate of fear and self-censorship.

Fix the link where science and policy meet – The Globe and Mail.