97 Comments
Mar 23, 2023·edited Mar 23, 2023

The US uses broader metrics to calculate maternal mortality compared to other high-income countries (more inclusive parameters for classification as a pregnancy-related death, for up to a year postpartum vs. six weeks). I am not sure how much this may account for disparities by race. But it certainly helps explain why the US looks so much worse in this metric relative to the rest of the high-income world and to our own metrics twenty years ago, when states began adopting the “checkbox” methodology.

https://www.cdc.gov/nchs/maternal-mortality/evaluation.htm

Expand full comment

So interesting, thank you! Everyone in my family is in healthcare, either a nurse or a doctor. My older sister, a graduate from Yale with all the politics that entails, likes to remind us of these disparities. I always thought it sounded a little crazy

Expand full comment

Ditto my Princeton PhD daughter. I’m a surgeon and still don’t know if I believe that shit. It doesn’t stand the smell test.

Expand full comment

Zoom thanksgiving over the last few years must have been AWESOME.

Expand full comment

Where else have I seen this kind of thing with the US? (*dies from gunshot wound with a swab up my nose*)

Expand full comment

But where's the link to the debate?

Expand full comment

I always wondered if it had to do with the advances in high risk pregnancies and fetal maternal medicine. I have no data to back it up, however!

Expand full comment
founding
Mar 23, 2023Liked by Matt Welch

I’m glad Alvin Bragg found something he likes prosecuting

Expand full comment
Mar 23, 2023Liked by Matt Welch

"Throwing Hot Dogs at Communists" sounds like a great title for a spin off podcast in which Matt and Michael visit various fast food venues while reviewing their libraries of Communist history.

Think "Comedians in Cars Getting Coffee" hosted by Stephen Kotkin.

Expand full comment

Could "Throwing Hot Dogs at Communists" just be about the lads driving around various cities, chatting with interesting people, and then occasionally rolling down the window to throw hot dogs at communists?

It's a little on the nose, but I think would be great fun.

Expand full comment

Would they get a prize if the hot dogs literally hit these hypothetical commies on the nose? 😂

Expand full comment

Wow, I never thought we'd get angry Kmele.

Angry Moynihan? Sure, it's his natural state.

Angry Matt? Oh, he's very good at it.

But angry Kmele? I really can't wait to see the shitshow that was enough to make even him lose his composure.

Expand full comment

Sounds like some people need to step up to represent the listenership better by drinking Moynihan under the table. Not all heroes wear capes. I will volunteer myself if the opportunity ever presents itself.

Expand full comment
Comment deleted
Expand full comment

May the most Irish genes win.

Expand full comment

Would the most Irish person be drunk even before drinking any alcohol, or would they be the most sober after drinking lots of alcohol?

Expand full comment
founding

“What Killed Michael Brown” was eventually put back on Amazon. https://www.amazon.com/gp/video/detail/B08L9NZHV3/ref=atv_dp_share_cu_r

Expand full comment
founding

Refinement of my original comment: News reports from the time indicated that the movie was rejected by Amazon because it “doesn’t meet Prime Video’s content quality expectations” (as quoted in WSJ oped of Oct 14, 2020) That decision was then changed (after outcry). In other words, Amazon did not put it up, take it down, and then put it back as my original, quickly-worded comment mistakenly indicated.

Expand full comment

Def a good watch. The call the urge to believe “hands up don’t shoot” despite evidence to the contrary “poetic truth” and that speaks volumes about activism

Expand full comment

Oooh, I'm legit going to check this one out! Thanks for the link :)

Expand full comment

Kmele, please please please (this is me begging pathetically) interview Brian May about space. I think you would love talking to him, and he seems to love talking to young, serious space/telescope enthusiasts. He is lovely. You are lovely. And that conversation, especially in person, would be spectacularly freaking awesome!

Expand full comment

I'd bug you on Twitter about this, instead of getting lost in comments.. but I give up Twitter for Lent.

Expand full comment

I’m hoping the Stanford Dean’s letter starts a wider trend across law schools. I’m a recent law grad and the ideological uniformity of my law school is a major reason I was drawn down the dark and drunken path to this podcast.

Expand full comment

Is there a place we can find a video of the forum in which Kmele participated?

Expand full comment
founding

It will be on NPR as an episode of their intelligence squared partnership series. I think it’s supposed to be aired this weekend.

Expand full comment
Mar 23, 2023·edited Mar 23, 2023

5:00: I am so happy you brought this up. I am very weird and just happened to be reviewing this info the other day (Racial differences in mortality during childbirth).

• 41.4 deaths per 100,000 live births for non-Hispanic Black persons.

• 26.5 deaths per 100,000 live births for non-Hispanic American Indian or Alaska Native persons.

• 14.1 deaths per 100,000 live births for non-Hispanic Asian or Pacific Islander persons.

• 13.7 deaths per 100,000 live births for non-Hispanic White persons.

• 11.2 deaths per 100,000 live births for Hispanic persons.

*CDC 2016-2018*

You can see that there are in fact differences that are noteworthy but you have to wonder how racist a society really is in which 99.959% of black women survive childbirth and 99.986% of white woman survive. Further, what could lead to that? i.e. what are the causes of death during childbirth?

From same source:

"While the contributions of hemorrhage, hypertensive disorders of pregnancy (i.e., preeclampsia, eclampsia), and anesthesia complications to pregnancy-related deaths declined, the contributions of cardiovascular, cerebrovascular accidents, and other medical conditions increased.7 Studies show that an increasing number of pregnant persons in the United States have chronic health conditions such as hypertension,8,9 diabetes,9-12 and chronic heart disease.7,13 These conditions may put a person at higher risk of complications during pregnancy or in the year postpartum"

Do black women, for example, have higher rates of diabetes, hypertension and chronic heart disease? And why are less Hispanic women dying in childbirth than White and black? It's a complicated and worthwhile discussion but to settle on "Black women die 3X as often in childbirth, so...racism" seems a rather simple conclusion.

Expand full comment
founding

Those numbers are actually pretty shocking in context. The murder rate in the US declined from 10 per 100,000 in 1990 to around 5 per 100,000. In Mexico it's 24.6 per 100,000. In El Salvador is 48.7. (Numbers as of 2020, obviously there have been some changes since then). I wouldn't say El Salvador is safe because you have a 99.9513% chance of not being murdered.

Expand full comment
founding

But I agree that the disparity is not because doctors hate black people or something.

Expand full comment

They don’t hate them, they are implicitly biased against them by systemic structures of oppression and white supremacy. Passed my DEI training...

Expand full comment

I agree. I'm sure someone with more knowledge on this topic can explain why (I just reviewed a couple studies)...but it does seem bad / wild / insane that so many women are dying due to childbirth in United States. I am curious to know more about Kathleen's comment above about how the USA counts deaths within a year of childbirth and many European countries only include deaths within 6 weeks of the birth. Perhaps that is a part of it? Either way, it's sad.

Expand full comment

I’m not sure it’s so straightforward and also it’s more to do with the constrained coding of the traditional system vs the broader parameters of the checkbox system. There’s a good argument that the Euros, etc are undercounting a bit. Lyman Stone ( economist, super-natalist) is a good data source about this.

Expand full comment

“Do black women, for example, have higher rates of diabetes, hypertension and chronic heart disease?”

Yes they do. The response to that though is that the discrepancy in disease incidence is also due to racism.

I can’t help but think that there are more proximate causes than that and studying those causes might lead to more effective interventions than simply assuming practitioner prejudice.

Expand full comment

I think in addition to Kmele, I’ve heard Coleman Hughes and Glenn Loury discuss how there are cultural differences that contribute to these different outcomes - cultural norms re diet and exercise, for example. Perhaps there are genetic dispositions. Again, jumping to racism as the cause is unproductive and divisive.

Expand full comment
Mar 24, 2023Liked by Matt Welch

I can’t believe KMW let Matt write five pages about baseball (movies).

Expand full comment
author

She deserves a medal.

Expand full comment

It’s too bad the controversy around a $130k hush money payment threatens to eclipse what is really a very beautiful love story.

Expand full comment

love at first sight (of the envelope on the dresser)

Expand full comment

Gentlemen: I’m listening to you discuss Kmele’s debate, America’s pessimism about race relations, and 2014 as a possible pivot point. Glenn Loury and John McWhorter had a similar conversation, posing the question, “Why now?” Which seems to be at the heart of your conversation also. If you can stay awake for the whole thing, below is a theory I proposed for one of their Q&As last year.

***********************************

Dear Glenn and John,

In your August 7, 2021 conversation, you explored the question “Why now?” with respect to the country’s ‘racial reckoning.’ Glenn listed the killing of Trayvon Martin (2012) and acquittal of George Zimmerman (2013); the police-involved homicides of Eric Garner (July 2014), Michael Brown (August 2014), and Tamir Rice (November 2014); and the protests at the University of Missouri (Fall 2015) [which sits so close to Ferguson that one has to wonder how many Mizzou students had a direct, emotional connection to Ferguson/the surrounding area, a connection perhaps so roiling with anger after 2014 that the anger needed to be released (displaced?) somehow]. Glenn then speculated whether those years sparked a nationwide sense that anti-black animosity was rising in the white working class which would find expression in the election of Donald Trump.

While I believe Trump is a cancer on our politics, I believe he drop-kicked into the stratosphere a moral panic that had begun just prior to his candidacy (officially, in August 2014 with Ferguson and the widespread buy-in of that ‘poetic truth’) and that has roots extending well before Trump. I believe that the moral panic has myriad causes – some recent, some generations-old. And I suspect one of those causes – one answer to “Why now?” – is underappreciated for its connection to the present moment: the dashed hope of Obama’s presidency.

I have long understood that a debate once existed (exists?) in the African-American community between one camp that argued more political representation would advance black interests (similar to the Irish) and another camp that argued more social capital would advance black interests (similar to the Jewish and Asian communities). So, I was not surprised by Jason Riley’s contention (at 11:11 in this conversation – https://www.youtube.com/watch?v=bi2hqL5KkHc) that the former camp arguably prevailed coming out of the 1960’s. It seems reasonable to wonder, then, how frustrating it might be to some people that African-Americans achieved the pinnacle of political representation with Obama and yet the wealth gap did not disappear, the scholastic achievement gap did not close, the fraught relationship between African-Americans and the police was not an agenda item (despite, or because of, the Gates incident/Beer Summit, which I think was the first big drop in Obama’s approval ratings among Independents), black-on-black crime did not abate to match the rates of other races, etc.

I recall an article during the Occupy Wall Street protests (2011) which reported that many of the protestors were former Obama campaign volunteers, many of whom expressed sentiments such as, “We can’t trust government to address inequality; we must do it ourselves.” I recall a Bernie Sanders profile in Vanity Fair which quoted a few young African-American supporters who had critical words for what they perceived as Obama’s failures; their attraction to Sanders was rooted in an angry desire to recommit where Obama had let them down.

And George Packer wrote the following in The Atlantic in October 2019: “Around 2014, a new mood germinated in America – at first in a few places, among limited numbers of people, but growing with amazing rapidity and force, as new things tend to do today. It rose up toward the end of the Obama years, in part out of disillusionment with the early promise of his presidency – out of expectations raised and frustrated, especially among people under 30, which is how most revolutionary surges begin. This new mood was progressive but not hopeful. A few short years after the teachers at the private preschool had crafted Obama pendants with their 4-year-olds, hope was gone.”

I wonder whether BLM, which was born as a hashtag the morning after George Zimmerman’s acquittal and exploded into national consciousness with the conflagration in Ferguson, is the heir to Occupy Wall Street’s frustration and fury.

By contrast, recall the 2008 campaign and the ecstatic deification of Obama. How many times did we hear the phrase ‘second coming?’ I remember one Washington Post reporter wrote about a rally and how, at the end of Obama’s speech, he asked the sobbing woman next to him what she had heard him say. The woman responded through her tears, “I don’t know! I’m just so happy!” I expected the punchline of the article to be a jab at how Democrats were acting like the teenage female fans of the Beatles. But this reporter – a political journalist, no less (usually among the most cynical) – wrote that, as he strolled home, he too did not remember what Obama had said but he was “just so happy.”

During the brutal Democratic primary, Clinton argued that the higher the expectations, the harder the fall. I cringed every time David Axelrod crowed that Obama was like a blank slate – everyone could project their hopes and dreams onto him. He seemed not to see the danger that Obama would disillusion and shed fans with each word he uttered, as voters came to know this political newcomer and to realize he couldn’t meet each of their unrealistic expectations. (I am not an anti-Obama critic; I voted for him twice. But I also feared the consequence of Americans falling wildly in love with someone who had been in the Senate for all of 25 months before announcing his candidacy for President.)

I agree with so many insights you have shared over the years – the religious nature of woke-ism, the role of social media, the group fellowship that can arise from shared victimhood, etc. As you have also noted, the historic influx of successful immigrants over the last few decades and the frustratingly persistent disparities 50 years after the Civil Rights Revolution could put pressure on the need to explain the disparities, perhaps a little more pressure with each passing year. Racial exclusion from power was always part of the explanation for the disparities, and Obama’s election diminished (however much one wants to argue) the power of that explanation. Not only did Obama’s presidency fail to end the disparities, it complicated the ability to use racism to explain them.

You two have critiqued former President Obama many times. To oversimplify what I have heard: Glenn usually regrets the opportunities Obama missed to speak in slightly more conservative ways; John shifts between empathy for Obama’s dilemma of responding on race and disappointment with some of Obama’s missed opportunities. But I don’t think I have heard either of you directly connect that disappointment to the frustration and fury fueling the current ‘racial reckoning.’ So, I wonder if you think the dashed hope of the Obama presidency might be part of the answer to “Why now?”

Expand full comment

This is neither here nor there except that both Michael and Jonah G recently mentioned this on podcasts and I just finished reading it, here's a link to MM's review of Jonah's Liberal Fascism: https://reason.com/2008/07/14/crying-wolf/?comments=true#comments

Expand full comment

It's always interesting to hear TFC namechecked on other podcasts. We're Not Wrong with Andrew Heaton, Justin Robert Young, and Jen Briney namechecked TFC this week as well!

Expand full comment

I heard Jonah mention how Moynihan’s pissed him off. Definitely was caught off guard by that, haha

Expand full comment
founding

Michael's review was fair and spot-on, but I'd be pissed too if a book I wrote was compared to one written by Naomi Wolf!

Expand full comment
founding

Nice find.

'Radical Islamists are lazily labeled "Islamofascists," not because they possess an interest in corporatism but because they are brutish and dumb and harbor fantasies of exterminating Jews.'

I wonder if Hitch gave Michael an earful about this line!

Expand full comment

The gang brought up banning vapes in New York again, so I figured I'd chime in with some news from San Francisco.

There's a new-ish bill proposed where California lawmakers want to eventually ban all tobacco sales in the state by making it illegal to sell cigarettes and "other products" to anyone born after Jan. 1, 2007.

My issues:

1) We're going to try the prohibition route on tobacco products? In a place where nearly every other drug is effectively legal?

2) "Other products" is a nice umbrella term that includes basically any nicotine product (cigarettes, but also vapes, pouches, etc). I haven't seen super compelling research that its nicotine is the problem -- just the delivery mechanisms.

AND, the evergreen point:

3) The state went from a surplus of $29 billion to a deficit of $23 billion in SIX MONTHS. And we are worried about making sure that people born after Shrek 3 can't buy nicotine products?

Living here because it's pretty, but it drives me up a wall. I don't even smoke but now I want to.

Expand full comment

In so many ways Kmele is a benchmark, but I would like to highlight one more.

His response to bad faith actors is the proper way to handle such behavior. Treat everyone with politeness and dignity right up until they disrespect you. Respond with the belt and do not hesitate to give the necessary discipline.

A proper lashing is needed in these instances, not for the satisfaction of the aggrieved, but for the betterment of aggressor.

This is the way.

Expand full comment