Sunday, November 20, 2016

Last Call For Healthy Data Journalism

I know at this point that we're supposed to consider the data-driven pollster model dead (because garbage-in, garbage-out as far as people who said they weren't going to vote for Trump overwhelmingly breaking to him) but if the polls do have a last gasp, it's this: The Economist has found that the biggest indicator of Trump voters wasn't being non-college educated and white, the most likely Trump voters are Americans who are the least healthy.

The two categories significantly overlap: counties with a large proportion of whites without a degree also tend to fare poorly when it comes to public health. However, even after controlling for race, education, age, sex, income, marital status, immigration and employment, these figures remain highly statistically significant. Holding all other factors constant—including the share of non-college whites—the better physical shape a county’s residents are in, the worse Mr Trump did relative to Mr Romney.

For example, in Knox County, Ohio, just north-east of Columbus, Mr Trump’s margin of victory was 14 percentage points greater than Mr Romney’s. One hundred miles (161 km) to the east, in Jefferson County, the Republican vote share climbed by 30 percentage points. The share of non-college whites in Knox is actually slightly higher than in Jefferson, 82% to 79%. But Knox residents are much healthier: they are 8% less likely to have diabetes, 30% less likely to be heavy drinkers and 21% more likely to be physically active. Holding all else equal, our model finds that those differences account for around a six-percentage-point difference in the change in Republican vote share from 2012.

The data suggest that the ill may have been particularly susceptible to Mr Trump’s message. According to our model, if diabetes were just 7% less prevalent in Michigan, Mr Trump would have gained 0.3 fewer percentage points there, enough to swing the state back to the Democrats. Similarly, if an additional 8% of people in Pennsylvania engaged in regular physical activity, and heavy drinking in Wisconsin were 5% lower, Mrs Clinton would be set to enter the White House. But such counter-factual predictions are always impossible to test. There is no way to rerun the election with healthier voters and compare the results. 
The public-health crisis unfolding across white working-class America is hardly a secret. Last year Angus Deaton, a Nobel-prize-winning economist, found that the death rate among the country’s middle-aged, less-educated white citizens had climbed since the 1990s, even as the rate for Hispanics and blacks of the same age had fallen. Drinking, suicide and a burgeoning epidemic of opioid abuse are widely seen as the most likely causes. Some argue that deteriorating health outcomes are linked to deindustrialisation: higher unemployment rates predict both lower life expectancy and support for Mr Trump, even after controlling for a bevy of demographic variables.

Polling data suggests that on the whole, Mr Trump’s supporters are not particularly down on their luck: within any given level of educational attainment, higher-income respondents are more likely to vote Republican. But what the geographic numbers do show is that the specific subset of Mr Trump’s voters that won him the election—those in counties where he outperformed Mr Romney by large margins—live in communities that are literally dying. Even if Mr Trump’s policies are unlikely to alleviate their plight, it is not hard to understand why they voted for change.

Ohio, Kentucky, and Indiana in particular were hit hard in the last four years over a growing opioid epidemic.  Various state plans were tried to address the problem with varying results: Kynect and Medicaid expansion in Kentucky being dismantled by Matt Bevin, Indiana's Medicaid-hybrid "everyone has to pay something" approach from Mike Pence, and Ohio's "quiet" Medicaid expansion pushed through by John Kasich.

But none of those programs could deal with the Ohio Valley's drug problem.  In fact, Mike Pence as Indiana's governor made the problem much worse when by fighting drug abuse he effectively destroyed Indiana's ability to deal with a massive HIV outbreak in 2015 when he discontinued the state's needle-exchange program.

In conclusion, the study found that Scott County's public health crisis -- which left 181 people in Southeastern Indiana HIV positive -- was caused by a "close network" of residents injecting opioid Opana and sharing needles. It suggests that Indiana and other largely rural states should focus on prevention measures such as more HIV testing, identifying networks of intravenous drug users, increasing access to treatment, considering syringe-exchange programs and education.

"Although the magnitude of the outbreak was alarming, the introduction of HIV into a rural community in the United States was not unexpected when considered in the context of increasing trends in injection use of prescription opioid (painkillers)," the study says.

Dr. William Cooke, the lone physician in Austin, Ind., the town at the epicenter of the outbreak, said Scott County had every indication for years that the spread of HIV was possible. Cooke pointed to poverty, high unemployment, a steady flow of opioids into the community, high hepatitis C rates and adverse childhood experience.

"If we knew there was a population at risk based on the indicators mentioned, why wait for HIV to hit?" Cooke said Thursday. "... That's what we see right now with Clark and all of these other counties."

Republican governors made things worse by refusing to embrace Medicaid expansion and Obamacare.  And the people hurt the most by those Medicaid decisions by Republican governors overwhelmingly voted for Trump.

Killing thousands through denial of health care dollars and programs paid off for the GOP.  Big time.

Chuck Is Not Harry And Never Will Be

Senate minority leader Chuck Schumer is sounding a note of reconciliation with Republicans in 2017, saying there are areas of common interest with Donald Trump.  Outside those common interests, not much will happen.

Speaking on NBC’s “Meet the Press with Chuck Todd,” Schumer said Democrats will not unilaterally oppose legislation Trump sponsors. But neither will Democrats compromise “for the sake of working with him,” Schumer said.

“Surprisingly, on certain issues, candidate Trump voiced very progressive and populist opinions,” Schumer said. “For instance, getting rid of the carried interest loophole, changing our trade laws dramatically, a large infrastructure bill.”

“I hope on the promises he's made to blue collar America on trade, on carried interest, on infrastructure, that he'll stick with them and work with us, even if it means breaking with the Republicans who have always opposed these things,” he said.

But Schumer said Democrats will fight to protect legislation President Barack Obama signed but that Trump has said he wants to dismantle.

“We're not going to repeal or help him repeal Obamacare,” Schumer said. “We are not going to roll back Dodd-Frank,” the 2010 law that imposed financial regulations on Wall Street after the 2008-09 crisis.

“We're not going to help him build his wall,” Schumer said of the president-elect's proposed border wall with Mexico. “We have a comprehensive immigration reform bill that builds in much tougher border security and it had bipartisan support than he's ever called for.”

The best Schumer can do here is stall and hope Trump is so bad that in 2018 the Democrats somehow gain three seats in the Senate and take control.  The odds of that are however very slim, as it's much more likely the Republicans will end up with the 60 they need to wipe President Obama's legacy off the map and along with it classic liberalism and the social compact.

That's because there are ten Democratic senators up for re-election in 2018 in states that Trump carried in 2016:

Bill Nelson in Florida
Joe Donnelly in Indiana
Debbie Stabenow in Michigan
Claire McCaskill in Missouri
Jon Tester in Montana
Heidi Heitkamp in North Dakota
Sherrod Brown in Ohio
Bob Casey in Pennsylvania
Joe Manchin in West Virginia
Tammy Baldwin in Wisconsin.

The only Republican senator up for re-election in a Clinton state is Dean Heller of Nevada.  Needless to say, given Democratic performances in the last two midterms, if I'm Mitch the Turtle I'm feeling really, really good about my chances of getting 60 seats in 2019.

Getting the machinery going now to defend these seats and pick off Dean Heller in Nevada, and maybe, maybe Jeff Flake in Arizona, is probably a good idea.

As to Schumer, well, he's not Harry Reid, is he.

How To Steal An Election

That's a pretty bold claim in the blog post title, but that's the only possible conclusion at this point back home in North Carolina as even with a 8,000 vote lead in the governor's race, Democratic candidate and NC Attorney General Roy Cooper still has not gotten a concession from NC GOP Governor Pat McCrory.

Democrats and Republicans in this fiercely contested political battleground have regularly resorted to creative legal maneuvers and election-law changes in their efforts to wring every last vote from the state’s nearly seven million voters. But even by that standard, the disputed, hairbreadth race for governor is plowing litigious and acrimonious ground.

Scrambling to save the incumbent governor, Pat McCrory, Republicans said they were pursuing protests in about half of North Carolina’s 100 counties, alleging that fraud and technical troubles had pushed the Democratic nominee, Attorney General Roy Cooper, to a statewide lead of more than 6,500 votes. But Republican-controlled county elections boards, including one here in vote-rich Durham County, turned back some of the challenges on Friday.

The legal and political jockeying raised the specter of a recount, and it could ultimately climax in a political wild card: Mr. McCrory using a state law to contest the election in the state’s Republican-dominated General Assembly.

“We’re supposed to have an inauguration on Jan. 7,” Theresa Kostrzewa, a Republican lobbyist, said Friday. “Are we going to have a governor? That, I think, is what most people are going to start wondering pretty soon.”

The governor’s race this year was among the most bitterly contested campaigns in the country. The state was a prime battleground in the presidential election, and it has been fractured by debates about voting, transgender rights, Medicaid and abortion. Republicans largely prevailed here on Election Day: Donald J. Trump won North Carolina by more than three percentage points, and Senator Richard Burr was re-elected by a larger margin — but Mr. McCrory struggled.

The contest’s aftermath has become a protracted spectacle. Mr. McCrory’s campaign said this week that there were “known instances of votes being cast by dead people, felons or individuals who voted more than once.” A spokesman for Mr. Cooper, Ford Porter, replied that the governor had “set a new standard for desperation.”

Understand that Pat McCrory is openly saying the election results in his state, with many of the counties controlled by Republican-led election boards, are fraudulent.  And there is a method to that madness: state law may allow McCrory to steal the election by giving it to the Republican-dominated state legislature to determine.

Under state law, the legislature could order a new election or, “if it can determine which candidate received the highest number of votes,” it may declare a winner. The law asserts that the legislature’s decision in such a contest is “not reviewable” by the courts.

Mr. Diaz said talk about legislative involvement “seems to be media-driven speculation, but we’re not going to discuss possible future steps that the campaign may or may not take.”

He added, “We are extremely concerned about the voter fraud revelations that are emerging across the state and intend to ensure that every vote is counted and counted properly.”

A lawyer for Mr. Cooper, Marc E. Elias, who also played down the possibility that the General Assembly might decide the election’s outcome, said Republican challenges were “calculated at nothing other than needless delay.”

“There is nothing,” he added, “that Gov. McCrory or his legal team are going to be able to do to undo what is just basic math.”

Believe me when I say this is McCrory's plan.  He knows he has a lot of power here as Governor, and with the General Assembly in his pocket, he knows that if he can stall here long enough legally that the NC House will have to step in for "the good of the state".  That's why McCrory is saying the election is fraudulent and that the contest will have to be determined by Republicans in the Assembly, because there "won't be a way to know" otherwise who truly won...and the Assembly decision is final by law.

The mechanism for theft of an election is in place.  And Pat McCrory is going to try to use it.

Sunday Long Read: We Burned It All Down

David Remnick at the New Yorker takes a long, hard look at the first two weeks of November through the eyes of President Barack Obama as he, like the rest of us, watched in shock as America voted to undo everything he has done.

When I joined Obama on a campaign trip to North Carolina just four days before the election, Hillary Clinton was hanging on to a lead in nearly every poll. Surely, the professionals said, her “firewall” would hold and provide a comfortable victory. David Plouffe, who ran Obama’s 2008 campaign, said that Clinton was a “one hundred per cent” lock and advised nervous Democrats to stop “wetting the bed.” In battleground states, particularly where it was crucial to get out the African-American vote, Obama was giving one blistering campaign speech after another.

“I’m having fun,” he told me. But, thanks in part to James Comey, the F.B.I. director, and his letter to Congress announcing that he would investigate Clinton’s e-mails again, the race tightened considerably in its final week. When Obama wandered down the aisle of Air Force One, I asked him, “Do you feel confident about Tuesday?”

“Nope,” he said.

But then, in Obamian fashion, he delved into a methodical discussion of polling models and, finally, landed on a more tempered and upbeat version of “nope.” He was “cautiously optimistic.”

There were reasons to be so. His Presidency, after all, had seemed poised for a satisfying close. As recently as early 2015, the Obama Administration had been in a funk. He had underestimated isis; Putin had annexed Crimea; Syria was a catastrophe. His relations with the Republicans in Congress, especially since the crushing 2014 midterms, were at an impasse. Then, in a single week in June, 2015: the Supreme Court ended years of legal assaults on Obamacare; the Court ruled in favor of marriage equality; and, at a funeral following the murder of nine congregants at a black church in Charleston, Obama gave a speech that captivated much of the country. Rather than focus on the race war that the killer had hoped to incite, he spoke of the “reservoir of goodness” in the living and the dead and ended by singing “Amazing Grace.” 
A sense of energy and accomplishment filtered back into the Administration. Long before Election Day, books were being published about its legacy: an economy steered clear of a beckoning Depression, the rescue of the automobile industry, Wall Street reform, the banning of torture, the passage of Obamacare, marriage equality, and the Lily Ledbetter Fair Pay Act, the end of the war in Iraq, heavy investment in renewable-energy technologies, the appointment of Sonia Sotomayor and Elena Kagan to the Supreme Court, the killing of Osama bin Laden, the Iran nuclear deal, the opening of Cuba, the Paris agreement on climate change, two terms long on dignity and short on scandal. Obama’s approval ratings reached a new high. Clinton’s election as the first female President would complete the narrative, and Obama, his aides suggested, would be free to sit in the healing sun of Oahu and contemplate nothing more rigorous than the unrushed composition of a high-priced memoir.

Air Force One landed at Fort Bragg and the motorcade headed to a gym packed with supporters at Fayetteville State University. In shirtsleeves and with crisp, practiced enthusiasm, Obama delivered his campaign stump speech. His appeal for Clinton was rooted in the preservation of his own legacy. “All the progress that we’ve made these last eight years,” he said, “goes out the window if we don’t win this election!” He revived some of his early tropes, cautioning the crowd not to be “bamboozled” by the G.O.P.—an echo from Malcolm X—and recited the litany of Trump’s acts of disrespect toward blacks, women, Muslims, the disabled, Gold Star parents.

I was standing to the side of the stage. Nearby, a stout older man appeared in the aisle, dressed in a worn, beribboned military uniform and holding a Trump sign. People spotted him quickly and the jeering began. Then came the chant “Hil-la-ry! Hil-la-ry!”

Obama picked up the curdled vibe and located its source. “Hold up!” he said. “Hold up!”

The crowd would not quiet down. He repeated the phrase—“Hold up!”—sixteen more times, and still nothing. It took a long, disturbing while before he could recapture the crowd’s attention and get people to lay off the old man. What followed was a lecture in political civility.

“I’m serious, listen up,” he said. “You’ve got an older gentleman who is supporting his candidate. . . . You don’t have to worry about him. This is what I mean about folks not being focussed. First of all, we live in a country that respects free speech. Second of all, it looks like maybe he might have served in our military, and we’ve got to respect that. Third of all, he was elderly, and we’ve got to respect our elders. . . . Now, I want you to pay attention. Because if we don’t, if we lose focus, we could have problems.”

That night in Hershey, Pennsylvania, Trump informed his supporters that in Fayetteville Obama had been abusive to the protester: “He spent so much time screaming at this protester and, frankly, it was a disgrace.” Either Trump was retailing an account he’d found online in the alt-right media or he was knowingly lying. In other words, Trump was Trump.

And now, in two months, Trump will be President.

We all underestimated the inchoate rage of Trump voters, people who are our relatives and loved ones, people whom many of us still consider to be our friends and neighbors.

In the end, they voted for Donald Trump.  We're all going to pay a price for that.

But some of us will pay a much, much higher price than others.  And many of the people who did vote for Donald Trump are willing to pay that price if it hurts some of the rest of us even more.  They're okay with that.

And the worst part is that they still will call themselves your friends.
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