SDOH Archives

Social Determinants of Health

SDOH@YORKU.CA

Options: Use Forum View

Use Monospaced Font
Show Text Part by Default
Show All Mail Headers

Message: [<< First] [< Prev] [Next >] [Last >>]
Topic: [<< First] [< Prev] [Next >] [Last >>]
Author: [<< First] [< Prev] [Next >] [Last >>]

Print Reply
Subject:
From:
Robert C Bowman <[log in to unmask]>
Reply To:
Social Determinants of Health <[log in to unmask]>
Date:
Wed, 10 May 2006 14:18:53 -0500
Content-Type:
text/plain
Parts/Attachments:
text/plain (152 lines)
In the US in the 1960s and 1970s, the nation had events that caught the
attention of the nation and this was used effectively in education, health,
and the War on Poverty. All geographic segments had 30 - 40% growth of
economics and income (1959, 1969, 1979 income in 1989 dollars)

A nation looking for a way to deal with the realities of today should look
at what the nation accomplished before. The priority on education and
economics allowed the nation to afford a war on communism, a war on
poverty, a war on health equity, and funding for the poor and senior
citizens that moved seniors from last to first in health and income, and
the nation sent a man to the moon, also boosting education, economics, and
technology.

In the 1980s it was defense, foreign policy, and energy. The energy
situation was already due, but was set in motion by Nixon changes in
currency and finance that cost OPEC nations, but taught them about
economics, which later ended up in a collaboration. (see wikipedia sites on
defense spending and energy/oil prices.) In the 1980s growth of income and
population was flat except for areas of the US with over 1 million people.

There was some improvement during parts of the 1990s, but now back to the
1980s with energy, deficits, foreign policy, defense, and cuts in education
and health or at least smaller increases relative to others and needs. The
Gini indexes continue to climb and the most population dense areas of the
United States, those over 2500 people per square mile, have been losing
population. The declines are dramatic in the cities with some of the most
inequitable indices in income and education and professionals.

The most simple explanation is that places like DC, Philadelphia,
Milwaukee, New Orleans and even much of entire states became "people
wastelands" where the rich no longer wanted to support the programs and the
middle class moved out and the poorest of the poor and the most
dysfunctional were left behind, making the systems ever more complicated
and dysfunctional and costing more and more to "wall off" those who were
different in extra costs for security, etc. but also easier to wall off
people personally, out of sight, out of mind, etc. Also easier to
rationalize worthlessness and to presume welfare fraud, etc.

Now that resources are more limited, tough choices
1. pay the deficit to free our children from this future bondage
2. invest in education and health at the earliest levels helping out the
lower and middle classes but not much help for the rich and powerful and
controlling that
3. attempt to invest in high school and higher education, but mainly
rewarding the few that survive to use such resources (great for top 30%
though)
4. help other nations with education and economics to truly ease the
immigration problem
5. while you still can, attempt to rein in the senior, retirement, high
income, professional, managerial, stockholder, entertainment, media lobby
that has a vested interest in cutting taxes (read investments in
infrastructure) and maintaining the status quo as is, waiting for more
adverse events that are certain to come. These events will only undermine
trust in authority and leadership since too little was done too late.

Only major investments in education and equity can allow us to attempt to
generate the economics necessary.

Case in point for events to come other than earthquakes, manmade disasters,
and hurricanes. In my birth city in Texas City Tx, the near miss of
hurricane Rita last summer was a blessing. Sadly Port Arthur and Beaumont
took a hit, virtually unseen by the nation because they were too small and
the refineries recovered fairly rapidly, in no small part to people
recovering their lives and working too. But these are vulnerable areas and
20 feet of water goes a long way across the land, even near misses will
cause damage again.

A Category 4 or 5 Hurricane hitting Galveston directly would put out
refineries in Texas City, the Houston Ship Channel, Beaumont, Port Arthur,
and possibly some in either direction on the coast. Refining & Marketing
(Downstream)

Texas Refineries: Distillation capacity of 4,627,611 Barrels Per Calendar
Day (BCD) (2005)      (The US used 20 million barrels per day in 2003)
Age Refining, Inc. (San Antonio @ 10,308 BCD)
Alon USA LP (Big Spring @ 61,000 BCD)
BP Products North America, Inc. (Texas City @ 437,000 BCD)
Citgo Refining & Chemical Inc. (Corpus Christi @ 156,000 BCD)
ConocoPhillips (Borger @ 146,000 BCD)
ConocoPhillips (Sweeny @ 229,000 BCD)
Crown Central Petroleum Corp. (Pasadena @ 100,000 BCD)
Deer Park Refining LTD Ptnrshp (Deer Park @ 333,700 BCD)
Dow Haltermann Products (Channelview @ -0- BCD*) *880 BCD Idle on 1/1/05
ExxonMobil Refining & Supply Co. (Baytown @ 557,000 BCD)
ExxonMobil Refining & Supply Co. (Beaumont @ 348,500 BCD)
Flint Hills Resources LP (Corpus Christi @ 288,126 BCD)
La Gloria Oil & Gas Co. (Tyler @ 55,000 BCD)
Lyondell Citgo Refining Co. LTD (Houston @ 270,200 BCD)
Marathon Ashland Petroeum LLC (Texas City @ 72,000 BCD)
Motiva Enterprises LLC (Port Arthur @ 285,000 BCD)
Premcor Refining Group Inc. (Port Arthur @ 255,000 BCD)
South Hampton Refining Co. (Silsbee @ -0- BCD*) *Asphalt plant
Total Petrochemicals Inc (Port Arthur @ 233,500 BCD)
Trigeant LTD (Corpus Christi @ -0- BCD*) *Downstream capacity only
Valero Energy Corp. (Sunray @ 158,327 BCD)
Valero Energy Corp. (Three Rivers @ 90,000 BCD)
Valero Refining Co. Texas (Corpus Christi @ 142,000 BCD)
Valero Refining Co. Texas (Houston @ 83,000 BCD)
Valero Refining Co. Texas (Texas City @ 209,950 BCD)
Western Refining Co. LP (El Paso @ 107,000 BCD)

The bolded items would take hits and some of the others might be disrupted
with a glancing blow.

The nation invested millions already in a levee for Texas City with 20 foot
height. Not the flimsy ones that attempted to save space in New Orleans but
wide expanses with lots of mass that would hold in all but huge direct
hits, except for one problem. The approaches at either end are only a few
feet above sea level. The pumps are inadequate in major rains, much less
topping or flanking.

When BP in Texas City was out, the nation felt the loss of production at
400,000 a day, the total impact would be major. All of our concentration on
New Orleans has not helped us prepare for other potential events that could
cause much more devastation.

Galveston is actually above sea level, thanks to General Roberts (Roberts
Rule of Order) and the city leaders. They rebuilt the city at a reasonable
elevation but not as much as needed over time. A similar event would
devastate the medical school, the indigent referral center for the State of
Texas, and much of the city. Galveston no longer is the 2nd or 3rd
wealthiest US city as it was in 1900 before the Great 1900 storm and the
nation would not be able to sustain the repair. Also Galveston is only
70,000 people and would disappear from the media radar map in a few days,
much as the area outside of New Orleans and New Orleans itself when it
ceased being a major city.

Robert C. Bowman, M.D.
[log in to unmask]

-------------------
Problems/Questions? Send it to Listserv owner: [log in to unmask]


To unsubscribe, send the following message in the text section -- NOT the subject header --  to [log in to unmask]
SIGNOFF SDOH

DO NOT SEND IT BY HITTING THE REPLY BUTTON. THIS SENDS THE MESSAGE TO THE ENTIRE LISTSERV AND STILL DOES NOT REMOVE YOU.

To subscribe to the SDOH list, send the following message to [log in to unmask] in the text section, NOT in the subject header.
SUBSCRIBE SDOH yourfirstname yourlastname

To post a message to all 1000+ subscribers, send it to [log in to unmask]
Include in the Subject, its content, and location and date, if relevant.

For a list of SDOH members, send a request to [log in to unmask]

To receive messages only once a day, send the following message to [log in to unmask]
SET SDOH DIGEST

To view the SDOH archives, go to: https://listserv.yorku.ca/archives/sdoh.html

ATOM RSS1 RSS2