Promoting action with ethnic numbers

The practice of managing diseases, can not avoid the underlying reality; you have to micro-manage the personal lives of individuals and promote segregation, hatred and bigotry in order to make it effective. Ignorance of human rights and personal freedom can never be overlooked or simply ignored in hopes they will just go away.

Medical interventions are in effect; the treating of patients, who neither asked for, or ever wanted to be treated, by politicians acting as Doctors, who are trained and determined to treat individuals as the disease. Taking us right back to witch burning campaigns, protections and paternalisms in three easy lessons.

While investigating the overreaching effects of Public health reforms, in sustainable development efforts, a disturbing reality is starting to emerge. Can we separate personal allotments of blame, in "managing disease", from the eventuality of bigotry and enhanced stereotypical racism as a result of biological reference, which we know will always result?

Can we interpret "disease management" as an admission of failures in abandoning the search for causes and cures, at a time with new technology available today, we might finally accomplish those goals. We seem to be on a track which proposes; we know enough and physical science can offer us no more knowledge. Is in now sufficient to say; lofty calculations are sufficient proof to provide us with a stance, we know what causes all diseases. By pretending the matter is settled, we find justification enough, to now allot the blame and the punishments.

Can a Social Marketing [See Propaganda] effort, aimed at adjusting health outcomes avoid the charges; that they punish some cultures and communities with scorn and exclusions, which are unequal in both application and in the resulting divisions, among those being targeted and of course, those being "protected".

A negative campaign of hatred and isolation is defined by Simon Chapman and B Freeman in a recent report as the creation of a "spoiled identity". The study seems to laud the efficiencies gained, in promoting the personal negatives. Associating, in the campaign process, a negative perspective to all aspects of a smoker’s life, recognition of any claim to equitable human rights, security of the person or even a basic "normal" identity.

Lobbyists are defining a negative judgment, demonstrated in the act of smoking alone, as a huge barrier to the enjoyment of life, which should be deliberately maintained. Scientific certainty with no alternate views allowed, is implying; smoking will lead and should always lead, to poor health, poverty, ill repute and social ostracism. Many references are applauded in the study demonstrating how those defined as "smokers" have been punished and driven to isolation. A pattern which apparently by all medical interpretation, should aggressively continue.

Today many smokers avoid medical treatments, which will almost certainly include demeaning and insulting paternalist lectures. Many similarly will avoid mental health treatments, simply because the institutions demanding smoke free status would be a further challenge to an already difficult situation to face. Inflexibility by legislation, results in a reality that many will refuse to voluntarily accept beneficial treatments
Further the numbers of reality are distracted, when we realize the non or poor application of other variables tremendously delineate the numbers discussed.


http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1523368

"Disability weights reflect the relative severity and impact of a disease and theoretically range from 0 (no disability) to 1 (death)"

"Making no adjustment for comorbidity is equivalent to assuming that effects of comorbidity on disability are additive. Thus, if a person has more than one disease his total disability weight equals the sum of the disability weights for those diseases. However, in this interpretation individual disability weights may add up to more than one. This cannot be interpreted in a plausible way because it would imply that more than one year of health is lost when living for one year with those diseases."

“Comorbidity complicates estimations of health-adjusted life expectancy (HALE) using disease prevalence’s and disability weights from Burden of Disease studies. Usually, the exact amount of comorbidity is unknown and no disability weights are defined for comorbidity.”

“Comorbidity, defined as the presence of two or more diseases in one person, complicates HALE calculations for two reasons. The first one is that the exact amount of comorbidity is unknown since all data on disease incidence, prevalence and mortality gathered in Burden of Disease (BOD) studies are disease specific [6]. The second reason is that there are no disability weights defined for comorbidity”

"Then, patients decide for themselves how the total disability that is caused by all concurrent diseases influences their functioning and quality of life. Therefore, empirical results of studies using self reported generic measures could be used to develop a more general theory as to how comorbidity influences disability. For instance, a question that needs to be answered is whether two comorbid diseases from different "disease clusters" (such as a physically limiting disease combined with a mental disease) leads to more disability than two or more diseases from one "disease cluster""

Medical research is largely dependent on stores of analytical numbers, such as the SEERS Stat database. When those numbers only reflect a narrow scope, defining human populations absolutely as Black, White or Hispanic how beneficial can the research be when evaluating total populations? The numbers are utilized religiously, despite the obvious omissions of major population groups, significant groups which do not fit well, biologically or socially in any of these descriptions. The immediate questions which arise would be in what classification would an Asian National fit into? Would African cultures in the third world have similar health perspectives to Caribbean or Asian Blacks? Does the perspective remain constant after residing in the Americas as second or third generation populations?

The reality found in a compressed view, is an ignorance of the diversities which exist in real populations with mixed diversity, which should be obvious. What we are told, in relation to disease pontificating, has to be weighed; in not only the view of what is divulged but what is not divulged or worse what is being consciously withheld,

Those deliberate and almost demanded withholdings can be found gratuitously, in epidemiology research complimenting the views of its financiers. Calculations representing opinions which are no longer chained to biological or even time line viability, but are now driven by demands of convenient purpose, to sensationalize what can never be more than the researcher’s limited or limiting scope. Those observations are utilized in dramatic media declarations, of “new” science discoveries almost daily, to empower a dangerous process of divisions and social change. That dominated process should also be examined in minuet detail. In the larger perspective; can such efforts, as campaigns against smoking, which prescribe, by a medical community no less, a punishment to find the end goal, be seen as anything more than a deceptive promotion of bigotry" Rekindled in the medical hierarchy is an ill advised effort to cleanse our genetic pool.

The cold clinical realities we see consistently in medical observations are biological impediments in some groups which by medical demands, should be punished, which we know ethically is a crime against humanity no matter the purpose or the advantage gained. If we allow the example to be set, how then can we deny the furthering of such actions? The population view conveniently disguises what is actually happening in the real view of community interactions. The increased violence and poverty can not be simply cured by interventions into diverse communities with linear perspectives.

Health care interventions, evaluating the Anti smoker campaign as a perfect example, seek to marginalize portions of the community, utilizing majority groups of communities in agreement with the stated goal. Lobbies have been deliberately and irresponsibly using smoking as a cultural wedge to separate once much more harmonious communities. Compared to perspectives only 20 years ago, the effect is truly frightening by its unbridled international scope alone. The pressures of fear and a duty to the protection of children are employed as legitimate tools, even when no harm can be, or could ever be demonstrated. This has an effect in producing biologically sustainable and scientifically acceptable racial lines, drawn by instigating fears. Once again science explores promoting the stereotypes of eugenics, with racism quietly acceptable and under wraps. Already the smoking bans have been announced as a resounding success and a model for further interventions.

The questions to be asked would be; if Asian communities who comprise the highest smoking prevalence and the lowest incidence of smoking related diseases had been included, how fearful would the resulting numbers look? And how successful would the anti smoker campaign have been? The questions which would have to come next would have to do with the reasons, Asian populations were left out of the perspectives or how much power to shame smokers would have existed had those numbers been included in the research which is claimed today as irrefutable and consistent.

The Bigots used to call them “Human Ballast” today they are called "spoiled identity". Those who will not be driven by fear mongering, will now become the victims of it. Law abiding citizenry are currently redefining themselves as criminals, in the eyes of unjust albeit targeted laws, which support the very worst in all of us. The realities of disease management and the RIO Summit defining what is termed as “Health care reform” can not elevate itself above the measures of bigotry as the final solution regardless of media partnerships and broad campaigns of deceptions. Governments attempting to reform communities are always held at the will of those communities. If Bigotry is at the heart of community want, that civilization is one in desperate decline. That civilization needs to be challenged as one more failure, among many in history, at the hands of irresponsible although financially expedient, human experimentation.


Proof, is not even difficult to find;
"In 1975 Sir George Goober, British delegate to the World Health organization
presented his blueprint for eliminating tobacco use worldwide by changing
social attitudes.

"..it would be essential to foster an atmosphere where it was perceived that
active smokers would injure those around them, especially their families and
any infants or young children who would be exposed involuntarily to EST.."


http://tobaccocontrol.bmj.com/cgi/content/full/17/1/25
S. Chapman and B. Freeman et al; Tobacco Control, BMJ report 2008,
“As smoking becomes increasingly denormalised and communities vocal about their dislike of smoking, there is abundant evidence that smokers internalise this negativity. In nations with advanced tobacco control, smokers have almost universal regret about having commenced smoking.19 After health concerns, the social unacceptability of smoking is nominated by most ex-smokers as their main motivation for quitting.20 Denormalising smoking is also associated with protecting others from second-hand smoke. Among factors that positively predicted having a smoke-free home was "believing smoke free was normative" (high acceptance of denormalising beliefs about smoking)”


http://omega.twoday.net/stories/297097/
"In his first Rock Carling Fellowship Lecture in June 1967, Richard Doll stated clearly that prevention of cancer was a better strategy than cure."


Prevention in action; assigning the blame…
http://www.imt.ie/news/2008/02/polish_smokers_need_help.html
“The dramatically high prevalence of heavy smokers among Poles will result in an ‘economic disaster’ for Ireland, a prominent respiratory physician has told Irish Medical Times. Prof Luke Clancy said rates of heavy smoking in the Polish population — the largest group of immigrants in Ireland - means they’ll lose productive years of their life while requiring increased care for chronic respiratory and cardiac problems. Prof Clancy, Director General of the Research Institute for a Tobacco Free Society, directed a study on Polish smoking rates. The study, which looked at more than 1,500 Polish smokers and ex-smokers, found that 61 per cent of males and 47 per cent of females have smoked at least once a day for the last six months. “These are not casual smokers,” said Prof Clancy. The study also found that while women between the ages of 20 and 25 were most likely to want to quit smoking, only eight per cent had sought advice. Prof Clancy said there ought to be more Polish-language help for quitting, such as a Polish-language ‘quitline’. “It’s not just a Polish problem. It’s our problem,” said Prof Clancy, who said that the loss in productive years of their lives, coupled with the resources it will take to keep people with chronic diseases and health problems alive, will result in an ‘economic disaster’.”


http://www.ajph.org/cgi/content/full/93/4/642
“Important potential gains in understanding both tobacco risk behavior and immigrant adaptation have been forestalled by the lack of suitable data. The primary deficiency has been the absence of large data sets that include questions on both smoking behavior and immigration status. The tobacco use supplements of the CPS, which were sponsored by the National Cancer Institute in a series of data waves collected in 1985, 1989, 1992–1993, 1995–1996, and 1998–1999, allow such analyses to be conducted. Standardized immigrant status questions began to be included in the main CPS questionnaire in 1994, and the subsequent tobacco use supplements provide the data needed to link smoking behavior and immigrant status.27,28 Using the CPS tobacco use supplements from 1995–1996 and 1998–1999, we sought to calculate smoking prevalence estimates by race/ethnicity and by immigrant status. We decomposed these estimates further, by country of birth, for Asian/Pacific Islander immigrants to illustrate the heterogeneity that exists within race/ethnicity and immigrant groups.”


Lying defined as more prevalent by ethnicity.
http://www.ajph.org/cgi/reprint/80/9/1057
“To compare self-reported cigarette use with a biological marker of smoking behavior, we evaluated the serum cotinine levels in 547 Mexican American smokers who participated in the Hispanic Health and Nutrition Examination Survey (HHANES) in the South-western states.”
“Differences in cotinine metabolism and extremely efficient smoking are alternative explanations that can not be ruled out with these data. We believe, however, that a proportion of Mexican American light smokers may under report the quantity of cigarettes smoked per day, and may truly be moderate or heavy smokers. (Am J Public Health 1990; 80:1057-1061.)”


Biological observations in many other perspectives, avoiding what should be obvious.
http://www.ajph.org/cgi/reprint/84/9/1439
“In a study of young Black and White smokers, Wagenknecht et al. found that Blacks had cotinine levels that were 83.3 ng/mL higher than those of Whites after controlling for several characteristics, including number of cigarettes, inhalation frequency, age, and education.6 After controlling for similar factors in our study of pregnant women, we found that Black smokers had cotinine levels that were 27.4 ng/mL higher than those of White smokers. Like Wagenknecht et al., we also found that Black smokers had higher serum cotinine levels at each level of self-reported cigarette consumption.”


Again;
http://jama.ama-assn.org/cgi/content/full/280/2/135
“cotinine concentrations were substantially higher among black smokers than among white or Mexican American smokers at all levels of cigarette smoking. Whites and Mexican Americans had similar serum cotinine levels when they smoked up to 5 cigarettes per day, but serum cotinine levels increased significantly more for whites than for Mexican Americans with each additional cigarette smoked.”


The Battle lines are drawn.
http://aje.oxfordjournals.org/cgi/content/full/153/8/807
“Compared with self-reported smokers, self-reported non-smokers comprised a higher proportion of persons who were female, were aged 65 years or older, had 13 or more years of education, and did not live below the poverty level”

“We can also postulate a number of explanations for the discrepancy between self-reports and the results of biochemical assessment among self-reported non-smokers. First, Blacks, as compared with Whites, may be highly exposed to environmental tobacco smoke or may differ in terms of nicotine pharmacokinetics. These two possibilities would help to explain why Blacks who reported themselves to be non-smokers were more likely to have a cotinine level greater than 15.0 ng/ml. Indeed, several studies have found differences in serum cotinine concentrations between Black and White non-smokers. In these studies, Blacks had higher cotinine levels than did Whites, even after environmental tobacco smoke exposure and other factors were taken into account. Because racial differences in nicotine pharmacokinetics and genetic polymorphisms involved exist, different cut-off points are probably needed for each racial group”


NHAINES ethnic numbers omitted to enhance the prognosis;
http://jama.ama-assn.org/cgi/content/full/280/2/135
“Our study sample was limited to participants aged 17 years or older who described themselves as non-Hispanic blacks, non-Hispanic whites, or Mexican Americans, who had a serum cotinine measurement and provided tobacco use information in the MEC, and who did not use any other significant sources of nicotine in the previous 5 days. Of the 12391 persons selected, 2271 refused the interview; 1315 were interviewed at home and did not visit the MECs; 281 did not answer the MEC tobacco questionnaire; 682 had no cotinine measurement; 434 reported using other significant sources of nicotine in the previous 5 days; and 226 were other than non-Hispanic white, non-Hispanic black, and Mexican American.”


Acknowledged, yet applauded; Public health devolving to a cult of “normal” by decree.
A “normal” perspective, which delegates by ethnic divisions, genetically superior races.
http://tobaccocontrol.bmj.com/cgi/content/full/17/1/25
“Several authors have suggested that Erving Goffman’s classic analysis of stigma and its resultant "spoiled identity" is consonant with how the meaning of smoking has changed in societies with widespread tobacco control. Goffman described stigmatisation as the transformation "from a whole and usual person to a tainted, discounted one", writing that "Stigma is a process by which the reaction of others spoils normal identity". Writing in 1963 before the first US Surgeon General’s report on smoking was published, Goffman did not list smoking as a stigmatized behavior but did list "blemishes of individual character" that included addiction and alcoholism.”

In discussions of increased health risk if we take the perspective that risks are additive we would have to believe risks can exceed the level of the highest listed risk available. On a scale of 0% [no risk] to 100% [Death] as consistent with the general public interpretation, additive risk would easily surpass 100% which can make no sense.

In claims casual or even lifetime risks of second hand smoke increases health risk by 30% [immediately or long term] in this perspective we can see when added to other risks such as the increased lifetime risk of smoking 89% the total would exceed 100% making any amount of casual exposures of second hand smoke, to a smoker immediately fatal. How is it in the same promotion the lobbies tell us only half of smokers die from smoking related diseases of all causes regardless of smoking? You can imagine where that would place the notion of risk from second hand smoke yet the public has been conditioned to believe much more.

For the general public it is not well understood the difference between risk and cause which is definitive. There are thousands of risks you will encounter through an average lifespan, which if taken literally would end that life immediately by theoretic calculations. It is no miracle the estimates so many times miss the mark, the nature of the process and the odds of probability tell us they should be wrong many times more than they are right, when using a linear model to calculate non linear data, The amount of variables in play some not even realized as yet, leaves more room for error than we could ever have for certainty.

By promoting the idea second hand smoke could impose an immediate and permanent health risk based on current methods and to such a degree it could ever be seen to rise above the other risks available, which we can not avoid is mischievous at best, and delusional fanaticism at worst. The risk of second hand tobacco smoke can never truly exist when it can be demonstrated a comorbidity factor of higher value is present. Such values by direct comparison would be outdoor pollution, Fireplaces, Cooking, Fragrances and colognes, and a host of thousands more, which if compared by identical methods would exhibit risk increases which would dwarf any enthusiastic numbers we see in the media every day, primarily produced by the Lobby inspired numbers of smoking patch salespeople.

What is being established in dividing communities in use of fear and coercion is the promotion of a conscious norm, which includes justification for laying blame for health costs of community. The back room efforts are forming a new set of calculations which demonstrate how those extra costs can also be assigned to racial groups, who will be allotted blame and exclusions in the same way as we now afford generally to smokers. That reality is growing and becoming much more public, within the Tobacco Control Lobby as we see already in the trial balloon in Ireland, permission is being given, to take a step too far.

Now consider what people really believe;. Governments and lobby groups who are supposedly convinced of the deadly nature of this risk factor, are pushing hard to have smoking in a car where a child is present made illegal. The demands made of protecting children from the dangers of child abuse as claimed, presuming all smoking parents are guilty, to such a degree a law is necessary. Those promotions are somewhat questionable, when observing the sentence proposed for child abuse, in limiting the courts to a fine of twenty five to one hundred dollars on average. What does that say to the victims of real abuse and the anguish they suffer? Will we be asked to allow the same leniency to child rapists soon? No one including the lobbies really believes what they are claiming. What is evident, many who don’t like the smell of the smoke are simply latching on to a proposal of child protection, which makes their lives more comfortable, in a way that they can justify their own angst of conscience, with plausible deniability, conveniently leaning on the words of others.