Ageing, health care, and sustainability – memes vs. evidence

One of the frequently-raised buzzwords in discussions of the Canadian health care system is the idea of ‘sustainability’. It is a bogeyman argument that crops up every now and then, particularly as a way of softening the rhetorical ground for increased private-sector involvement in health care. The argument often invokes the spectre of a meme called the ‘Grey Tsunami’. The argument goes something like this:

  • Canada’s population is aging
  • Health care costs are increasing faster than GDP
  • Older people use more health care resources than younger peopleTherefore, there is a rapidly approaching point when the expansion of health care costs, due to increased usage by older people, will become too large to sustain and will collapse the health case system.

The implication is usually that the only way to control health care costs is to increase privatization (which doesn’t work) or to introduce a parallel public option (which also doesn’t work). Since the premises are all true, people nod sagely and cluck their tongues and say ‘what a shame’, as though the conclusion followed logically. It’s entirely possible that the conclusion might follow logically from those premises, but it’s not necessarily the case. What would strengthen the argument is some actual evidence.

Luckily, such evidence is recently forthcoming:

To shed new empirical light on this old debate, we used population-based administrative data to quantify recent trends and determinants of expenditure on hospital, medical and pharmaceutical care in British Columbia. We modelled changes in inflation-adjusted expenditure per capita between 1996 and 2006 as a function of two demographic factors (population aging and changes in age-specific mortality rates) and three non-demographic factors (age-specific rates of use of care, quantities of care per user and inflation-adjusted costs per unit of care).

…

We therefore conclude that population aging has exerted, and will continue to exert, only modest pressures on medical, hospital and pharmaceutical costs in Canada. As indicated by the specific non-demographic cost drivers computed in our study, the critical determinants of expenditure on healthcare stem from non-demographic factors over which practitioners, policy makers and patients have discretion.

This is a particularly cleverly-designed study done by some colleagues of mine at the University of British Columbia. They used a statistical procedure to model the relative contributions of population age, age-specific mortality, cost of dying, and cost of surviving (within a given age range). Their analysis also included variables to account for resource utilization and cost that are separate from age. British Columbia keeps excellent electronic records for all provincial residents, meaning that they were able to apply this model to a cohort of over 3 million people, using actual real-world expenditure rather than relying on evidence from clinical trials.

Their analysis found that aging has contributed only minimally (1%) to total medical expenditures between 1996 and 2006. Using forecasts from the provincial ministry of health, they estimate that these expenditures will return to current levels beyond 2026. The major factors for health care system expenditure increase had more to do with policy decisions and the purchase cost of equipment, drugs and other technology than it did with a ‘grey tsunami’.

Another article in the same issue says the same thing, albeit a bit differently:

Conventional wisdom holds that Canada suffers from a physician shortage, yet expenditures for physicians’ services continue to increase rapidly. We address this apparent paradox, analyzing fee-for-service payments to physicians in British Columbia in 1996/97 and 2005/06. Age-specific per capita expenditures (adjusted for fee changes) rose 1% per year over this period, adding $174 million to 2005/06 expenditures. We partition these increases into changes in the proportion of the population seeing a physician; the number of unique physicians seen; the number of visits per physician; and the average expenditure per visit. Expenditures on laboratory and imaging services, particularly for the elderly and very elderly, have increased dramatically. By contrast, primary care services for the non-elderly appear to have declined. The causes and health consequences of these large changes deserve serious attention.

Using a similar data set and a different method of analysis, McGrail and colleagues found that, like overall spending, physician-specific spending was increasing. However, there has not been a corresponding increase in those users of the health care system who are not older adults. Even given this increase, the percentage of health care expenditure that is attributable to aging is small.

Given what we know about health care costs – namely, that the increase in price is due largely to the cost of innovation, we have powerful policy levers we can use to make appropriate changes that will preserve the ‘sustainability’ of the system for years to come. Our growing paranoia about the effect of the aging population does not seem to be supported by evidence from actual increases in health care expenditure. While we will undoubtedly have to change the way we think about and practice health care in light of an aging population, it does not follow that we will have to necessarily abandon the way the system is currently structured.

Above and beyond this direct message, I want to take the time to point out that health services and policy research is an important avenue of inquiry. We should make our policy decisions – health or otherwise – based on what is evident, not what is obvious. Whatever our endeavour, we should be constantly asking ourselves questions and measuring our level of success or failure honestly. The authors of this paper, rather than accepting what has been more or less ‘orthodoxy’ when it comes to the health care system, have found ways of directly testing the ‘grey tsunami’ hypothesis. This is a good thing – we should always be challenging our entrenched ideas. Failing to do so will result in us tilting at imaginary windmills, chasing ghosts and false ideas to the point where our efforts are legitimately unsustainable.

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Belief and self-limiting allegiance: crabs in a barrel

One of the recurrent topics of discussion within the freethinking community has to do with how one should treat religious groups with similar humanistic goals. Should we, for example, work with the Campus Crusade for Poseidon and the Hatmehyt Society to preserve ocean fisheries, even though their beliefs are opposed to our own (and each other’s, but we’ll get there later)? Is there ground to be gained by putting aside our fundamental differences to accomplish a mutually-beneficial outcome? Most people at this point of the conversation say ‘well of course’, but there is a second part to this question. Should we stop talking about our differences in order to foster ‘respect’?

This is an important questions, because it underlies the entire enterprise of working together. If our would-be allies are so turned off by criticism of their position, we’d surely lose their support. It would be therefore advantageous to treat them with kid gloves, right? It’s better than trying to ‘go it alone’ and have cumulative parts that are weaker than the whole trying to tackle a major problem, isn’t it?

This is the part where I (and those like me) part ways with this line of argument. It does me no good to have an ally with whom I cannot be honest, particularly if the areas in which we disagree are relevant to our work. Does the CCP want to preserve ocean fisheries so that they can ultimately defeat the Crab People of the Marianas Trench? Is the Hatmehyt Society trying to re-establish the lost kingdom of Atlantis? Yes, our stated goal of conservation might be similar, but our ultimate goals are diametrically opposed. Must I sell out the long-term problem of the fact that my allies are insane in order to solve the short-term problem of overfishing? Do I only begin to attack them when we’ve accomplished the short-term goal? What happens when my participation is no longer useful to them?

There is a real danger to allying yourself with people who disagree with you, unless you are able to make your differences clear and resolve them somehow. There is an even greater danger in following the old adage of keeping your enemies closer, and allying with people who outright hate your guts:

Liveprayer.com, an interactive Christian website with over 2.4 million subscribers, is calling for a boycott of Christian TV network TBN, according to a press release. Bill Keller, the leader of the site, issued the call after prominent Christian leaders such as Pastor John Hagee and David Barton expressed their support for Glenn Beck’s “restoring courage” campaign on the network.

“It is absolutely ridiculous for a supposed Christian TV Network, that purports to be propagating the gospel, like TBN, with major Christian figures like John Hagee and David Barton, to be supporting and advocating for a member of a satanic cult,” said Keller to The Christian Post. Glenn Beck, a professed Mormon, frequently identifies himself with other religious people such as Christians, feeling they all have similar values and can work together on “common interests.” However, to believers like Keller, this is deceitful behavior since he believes Mormonism is a satanic cult or a counterfeit form of Christianity, and that true believers should not align themselves with these types of faiths.

My first reaction when reading this story was to chuckle and enjoy a deserved glass of delicious schadenfreude as the extreme wing of the religious right begins to tear itself apart. After all, I pointed out the potential for this kind of fracturing within the supposedly-monolithic edifice of America’s nascent theocratic movement many moons ago:

The only people who would benefit from an erosion of state sovereignty by the religious establishment is those who agree completely with the leading class’ views. History shows us again and again that fractions will appear within religious communities as they grow larger and more powerful. There is no long-term benefit to the rule of religion – there will always be a group that is seen as heretical until there is only one absolute ruler. Religion knows no satiety in its appetite for power.

And while I do so enjoy being correct when it comes to matters like this, I will tamp down my instinct for self-congratulation and allow this news item to serve a different purpose. I will invite you, however, to take a moment and ponder that this is one of those few examples of a religious disagreement that is based solely on denominational/doctrinal grounds. Oftentimes, apologists for religion will say that ‘religious conflicts’ are ethnographic conflicts with the veneer of religion brushed over them. For the most part I will accept this explanation as valid (with the caveat that religion makes this kind of conflict much easier and more deeply entrenched). This is not the case, however, in the split between TBN and Liveprayer.

It’s also useful to consider how diametrically opposed this kind of backbiting is diametrically opposed to the more ecumenical version of religion that many apologists like to put forward as its ‘true face’. These are two groups that, in all likelihood, agree on 95% of their politics and theology. I don’t know who is more admirable here: Glenn Beck for attempting to build bridges between dissenting factions, or Bill Keller for at least having the integrity to be honest and forthright about his beliefs.

That dealt with, I do want to point out the minefield that these political marriages of convenience can pose. Aligning yourself with someone who disagrees with everything you stand for because your interests happen to overlap on some arbitrary topic is a tricky tightrope to walk. It’s made even trickier when that person is leaping up and down on that tightrope, threatening to throw you off every time you make a misstep. It is inevitable that we will disagree with each other from time to time, and we do have to find ways to compromise to get things done. However, when our disagreements go all the way down to the core issues, it may be in our self-interest to let that particular team pitch pass us by.

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Questions, answers, and the search for meaning

One of the common statements made in favour of religion is that it provides us with answers to life’s deepest and most important questions: why are we here? how should we behave? what is the ultimate purpose of life? A commenter here once expressed dissatisfaction at my explanation of where morality comes from if not from a deity, saying that my naturalistic and philosophical explanations of the origin of morality were not going to provide “meaning” to people’s lives. I suppose the criticism assumes that religious-based morality does provide that kind of “meaning”. Atheism and science are, the criticism goes, not equipped to answer the ‘big questions’. A quote that I used to like, and would press into service in my own criticisms of atheism goes something like: Science tells you how; religion tells you why.

It’s a nice, pat phrase that allows believers to smugly assert that despite the fact that their beliefs have no basis in fact, they provide an existential framework that science simply does not address. Religious beliefs provide the kinds of answers that are ‘spiritually’ satisfying, allowing people to quiet the constant questioning that happens in the backs of their minds so that they can get on with their lives. This kind of thinking bothers me for three main reasons, which I will go to in detail.

1. They do not answer anything

Imagine for a moment you asked me why tomatoes are red, and I answer “because rain falls upwards in the southern archeosphere”. Technically, in a very shallow sense of the term, I have given you an ‘answer’. You have asked me a question, and I have given you a sentence in response that starts with the word ‘because’. The problem, immediately discernible, is that what I have told you is utter nonsense. First of all, rain doesn’t ever fall upward, regardless of where you are relative to the globe – the very concepts of “fall” and “up” are diametrically opposed. Second, the word ‘archeosphere’ is completely made up – it has no value semantically. Finally, even if my statement was valid, it has nothing at all to do with tomatoes. What I have given you is a completely useless answer.

It is the same with the answers that religion gives. “Why shouldn’t I kill?” “Because God says that it is wrong.” The definition of the word ‘God’ is vague and applied equally to any number of different semantic concepts. Saying that “God” says something in particular is in no way an answer to the question – it does not provide us with any information.

2. They presume uniformity of belief

But if we, for the sake of argument, grant a particular definition of a deity (and this is a major concession on my part), religious “answers” still do not reach the status of an actual answer. If you were to ask me why it is that European countries are far better off than African countries, I could give you a facile response: “it’s pretty obvious once we recognize that white people are genetically superior and predisposed to excellence.” Now, this would be an answer to your question provided that we agree on the genetic superiority of the white race. However, assuming that you aren’t a white supremacist, you’re likely going to (correctly) label my answer as non-legitimate.

It is the same for religious answers to questions. We have no reliable evidence that even if there were a deity, that your particular interpretation is correct. The response completely fails to give a meaningful answer to the question, because it is based on the assumption that all people believe in the same gods that you do. An earthquake and a hurricane on the eastern coast of the United States is an unlikely event, and many people have pronounced that it is evidence of their god’s judgment for some transgression or another. The problem, of course, is that there are a variety of imagined slights that are supposedly being punished or warned about. Not only that, but many people who agree on the basic concept of their god disagree that she/he would use such an oblique method as an earthquake and a hurricane to send her/his message. The response fails to address the question accurately.

3. They beg the question

Back in high school I took a course in philosophy (roughly the equivalent of a 1st-year university survey course). One of the assignments we had to do was to construct our own ‘argument, refutation, counter-refutation’ essay on a philosophical topic of our choice. I’m sure Mr. Peglar would be proud to know how much that class informed not only this blog, but my thought process more generally. One of the essays written by a classmate of mine concerned teaching an artificial intelligence to learn to use and interpret language. His basic thesis was that there are a number of ways that words in the English language can be arranged that are syntactically correct, but semantically meaningless – for example: penguins often ward intrinsically argumentative pacifism’. Sure, the words each make sense, and the way they are arranged is grammatical, but it doesn’t make any sense.

I feel the same way about many of the “big questions” we are supposed to turn to religion to solve. “What is the meaning of life” is perhaps the most egregious culprit for this one. The question entirely presupposes the existence of a ‘meaning’ for life, and then demands that we identify it. Why would we suppose that there is something at all like ‘a meaning’ for life? I could paraphrase and produce similarly faux-profound koans: “where does the sound a soul makes go?”, “who created sunlight?”, “why can’t we weigh time?” Yes, they’re all questions that make sense in English, but they don’t make anything even approaching sense. Assuming the existence of an answer bypasses the more important question: is there an answer?

So whenever people tell me that they gain a great deal of meaning from their religious beliefs, or that religion is how they find answers to the big questions in their lives, I am always mystified. Without exception, the ‘answers’ that religions provide are based on shaky evidence at best, and complete incomprehensibility at worst. We can develop ways of answering real questions, but as anyone who works in the sciences will be able to tell you, formulating these questions properly is 90% of the difficulty. We should never accept pat, simplistic, and evidence-free answers to complex questions, no matter how comforting we may find it to do so.

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Apologies, apologies, one thousand apologies

You know what I didn’t feel like doing when I got back from my 3-day outdoor concert?

ANYTHING

I am back to my old self and recharged. I promise that this will be the last trip I take for a little while, so there shouldn’t be any more interruptions. I will work triple hard tonight and get lots of new content for you by tomorrow.

A Gorge-ous Monday to you!

So I done messed up.

I usually write posts for the coming week on the weekend. Except I spent this weekend (which is a long weekend – Monday is a holiday here in Canada) at the Washington Gorge in George, Washington (yes, that’s actually the name of the town). I got most of today’s post done, but then I forgot to finish it. Stupid me.

Anyway, today’s post will be late. To make up for it, I leave you with this video:

Mmm, that’s good Hitchslap.

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Movie Friday: Mlodinow vs. Chopra

As not only someone who believes in the usefulness of science as a way of understanding the universe, but who also tries to bring his limited understanding of science to bear in his day-to-day life, there is very little that irritates me more than pseudoscience. Science is elegant in its simplicity, but demands rigor and complexity of thought to implement properly. Pseudoscience is a bastardization of science. It requires nothing more than a smattering of understanding the results of the scientific process, and then the wedding of those concepts to draw a completely erroneous conclusion.

I have personal friends who engage in pseudoscience professionally. I can’t talk to them about their jobs, or I will become so enraged that I risk doing harm to the friendship. Luckily for me, I can draw a bit of vicarious satisfaction from exchanges like this:

Leonard Mlodinow is a theoretical physicist who has devoted his professional life to translating the products of actual science into a form that can be grasped by laypeople. Because of how bizarre theoretical physics is, it can be really though to get a firm handle on what exactly the universe is. Theoretical physicist design intricate and brilliant methods for making things that happen far below the level of our comprehension, let alone detection, exert influence that we can see and measure. As someone whose scientific work is incredibly macro, I have nothing but the deepest respect for people who are willing and able to delve into the deepest mysteries of existence, and who are skilled enough to bring something back to share with the rest of us.

To contrast, Deepak Chopra is a mystic. He’s a witch doctor that takes phrases or slices of concepts and twists them 90 degrees to fit into his bizarre world view. One of the most infuriating things he does (all the time) is to attempt to redefine concepts in such a way as to completely divorce them from any coherent usage, like he does with “consciousness” in the video. Saying that “consciousness” is “superposition of possibilities” is a complete nonsense phrase, and Mlodinow aptly and deservedly skewers Chopra for his babbling. Regular long-time readers will know that I’ve had my run-in with Deepak before, and he’s still beating that dead horse of falsehoods that don’t quite reach the level of honesty required to lie.

Of course Chopra has flogged his sideshow of bullshit to the tune of several million dollars, and he has done this by presenting himself as a “deep thinker”, or a guru who is wedding the more esoteric aspects of physics and biology to the ultimate questions of life. What he’s actually doing is giving pat answers to complex questions that fall apart underneath even casual scrutiny. As Mlodinow points out, the phrase “superposition of possibilities” contains words that are comprehensible, but arranged in such a way as to completely negate any semantic meaning. This is a typical Chopra-ism – something he has in common with Ray Comfort.

It takes hard work and diligence to discover the truth. One has to enter with ideas that are open to being corrected by observation, and an ego capable of recognizing when you’re wrong. These are not things that come easily to humans, but are crucial if we want to find real answers to tough questions. Deepak Chopra has none of these – just a slick tongue and a gullible audience.

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Behind the 8 ball

This morning I went on a bit of a tear about the ludicrous idea of a ‘culture of poverty’. I suppose calling it ludicrous is not fair, since on the surface, if you’re ignorant of a lot of facts, the idea at least has some superficial credibility. What I didn’t get around to is the illustration of what might be a better explanation. It will probably come as an eye-rolling lack of surprise to most when I point to racism as a potential explanation. I am not referring simply to the active kind of racism whereby black and brown kids are discriminated against by teachers, or wherein employers don’t hire people with funny sounding names. No, the kind of racism I am referring to is far more structural and ephemeral than that.

Imagine you were born with a limp. In our modern society, that’s certainly not a major hurdle to overcome. We have, through conscious effort as a consequence of advocacy, built mechanisms into our infrastructure to allow people with mobility issues to live fulfilling and productive lives. We have actively reduced structural discrimination against people who, through no fault of their own, have a disadvantage. Now sure, you’re not going to be an Olympic sprinter or anything like that – your physical condition precludes that. But, there’s no reason you couldn’t be a physicist or a spot welder or any other occupation that doesn’t require extraordinary leg strength or mobility.

Contrast what your life would be like if you had been born with the same limp in, say, ancient Sparta. Because you would need full mobility to participate in even the basic parts of your society, you’d be in serious trouble. Not only would you be unable to access things you need to live, but you’d be excluded from involvement in social and political life – not because you couldn’t do them, but because you’d spend all your time struggling just to keep your head above water. Your inability to thrive would likely be seen as some kind of curse from the gods, or worse still as your own fault. If you want to succeed, you have to work harder than your more able-bodied peers to achieve anything.

These are the two different models of society we can contrast – one that puts the necessary effort to ensure that physical traits like a limp don’t preclude you from engaging in activities for which a limp is not a real handicap, and one in which no attempt is made to overcome a disability in such a way as to make it essentially impossible to participate even in those things that your disability doesn’t apply to.

Which society do you think we live in when it comes to race?

Click image to enlarge

I put it to you that being born black or hispanic puts you at a disadvantage. That being in one of these groups, even before we get into issues like a ‘culture of poverty’, places extra hurdles in your way. Not hurdles that are actually related to your success, but hurdles that prevent you from reaching it nonetheless. This kind of systemic racism operates in the background without any kind of conscious intent or active discrimination on behalf of a secret cabal of bigots. It has the same force as active racism though, since your racial identity is a strong predictor of your chances of success, even though this connection is highly erroneous.

The question we must ask ourselves is whether or not we’re interested in fixing this problem. If we’re content to allow this state of affairs to continue, then there’s no reason to make any changes. Of course, as I suggested before, this ends up hurting everyone. It would be much better for all members of society for there to be fewer poor people. If we’re interested in seeing that happen, then we have to work to reduce these inequalities. Otherwise we’ll have a segment of society still stuck behind the 8 ball, with no hope of getting ahead.

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Culture of poverty: complete nonsense

Discuss race long enough, and you will eventually come across someone who says that black people are the authors of their own downfall. That laziness and a ‘culture of poverty’ that discourages people from making positive economic choices is the reason for the wide income disparities that fall along racial lines. No evidence is ever forthcoming to support this contention – it is merely asserted as a self-evident truth. After all, anyone can look into the ghettoes of the United States and Canada and see that poor people are lazy and have bad attitudes. Millions of dollars are spent on programs targeting these groups, and yet the disparities still persist. What other explanation could there be?

I’m not a sociologist, and I’m sure this little factoid is apparent to any readers of the blog that are sociologists. I try my best to reserve my comments to topics I understand, and based on fields of inquiry with which I have at least some familiarity. Insofar as I am not trained as a sociologist, I usually try and avoid interpreting the primary literature. However, insofar as I can appreciate the scientific method present in that type of inquiry, I do occasionally dip my toe into this realm. Such dabbling is made far easier when someone does all the heavy lifting for me:

[Oklahoma State Senator Sally] Kern was simply advancing one of the most enduring and pernicious untruths in America’s political economy. It holds that poverty – in general, but especially within communities of color – doesn’t result from purely economic factors. Rather, the poor are where they find themselves as a consequence of some deep-seated cultural flaws that keep them from achieving success. They’re held back, the story goes, by what is known alternatively as a “culture of poverty,” or a “culture of dependence.” It’s a popular fable for the right, as it absolves the political establishment for public policies that harm the working class and the poor.

It’s also thoroughly and demonstrably untrue, flying in the face of decades of serious research findings.

It’s a myth that should be put to rest by the economic experience of the African American community over the past 20 years. Because what Kern and other adherents of the “culture of poverty” thesis can’t explain is why blacks’ economic fortunes advanced so dramatically during the 1990s, retreated again during the Bush years and then were completely devastated in the financial crash of 2008.

In order to buy the cultural story, one would have to believe that African Americans adopted a “culture of success” during the Clinton years, mysteriously abandoned it for a “culture of failure” under Bush and finally settled on a “culture of poverty” shortly after Lehman Brothers crashed. That’s obviously nonsense. It was exogenous economic factors and changes in public policies, not manifestations of “black culture,” that resulted in those widely varied outcomes.

I will attempt to translate: the ‘culture of poverty’ hypothesis suggests that poverty cannot be affected by social programs – that the problem is one that must be addressed culturally (however one does that) rather than through the application of policy effort. The counter to that hypothesis states that cultural factors do not explain poverty, and that policy will decrease disparity. That appears to be precisely what happened:

But a little-known fact is that even before the recession hit in 2008, blacks had already taken a huge step back economically during the 2000s. By 2007, African Americans had already lost all of those gains from the 1990s. That year, sociologist Algernon Austin wrote, “On all major economic indicators—income, wages, employment, and poverty—African Americans were worse off in 2007 than they were in 2000.”

Although the Great Recession obviously hit everyone hard, it didn’t cause everyone equal pain. In 2007, the difference between white and black unemployment rates fell to the lowest point in years: just 3 percentage points. Yet as the economy fell into recession, that gap quickly grew again, and by April 2009 it had doubled, reaching a 13-year high.

“So what?” You might be saying. “All that proves is that when you give black people more money, they have more money. It could still be evidence that a culture of failure exists, which is why they lost it all again when the policy changed.” I’ll admit that was my first thought. But as I’ve pointed out before, poverty is not simply a lack of money – it’s a lack of opportunity and access. The way to measure whether or not a ‘culture of poverty’ exists is to look directly at attitudes and behaviours that are different between those at the top and those at the bottom:

Gorski did an exhaustive literature review on the culture of poverty meme. Are poor people lazier than their wealthier counterparts? Do they have a poor work ethic that keeps them from pulling themselves up by their bootstraps? Quite the opposite is true. A 2002 study by the Economic Policy Institute found that among working adults, poorer people actually put in more hours than wealthier ones did. As Gorski noted, “The severe shortage of living-wage jobs means that many poor adults must work two, three, or four jobs.”

So under direct measurement, there does not appear to be a difference in attitudes towards work, education, or even alcohol and drug use between the wealthy and the impoverished. Even attitudes toward marriage (the article goes into more detail, but I don’t really see why) are based more on economic security than a culture of poverty – suggesting quite the opposite of the central thesis that underpins the ‘culture of poverty’ mythos: that poor people are poor because they fail to make good decisions.

So maybe there’s something to be gleaned from this idea that the reason poverty falls along racial lines is because black people are just lazier than average, and don’t put in the work to pull themselves up out of the hole. After all, if they were serious about getting out of poverty, wouldn’t they take advantage of things like retraining and job fairs? Or at least start their own businesses? Yes, that’s exactly what they’d do:

So let’s look again at the evidence. AARP did a study of working people over 45 years of age (PDF), and found that “African Americans surveyed were more likely than the general population to be proactive about jobs and career training.”

They took steps such as training to keep skills up-to-date (30% versus 25%), attending a job fair (18% versus 7%), and looked for a new job (24% versus 17%) in the past year at rates higher than the general sample. A sizeable share also indicated that they plan to engage in these behaviors. More African Americans relative to the general population plan to take training (38% versus 33%), look for a new job (27% versus 24%), attend a job fair (26% versus 11%), use the internet for job-related activities (30% versus 23%), and start their own business (13% versus 7%).

The unemployment rate for African Americans between 45-64 years of age stands at 10.8 percent; the rate for whites of the same age is just 6.4 percent. Older black workers have the drive, and report putting in more effort to land jobs or start businesses than their white counterparts – they embrace a “culture of success” — yet their unemployment rate remains 40 percent higher.

Now this article does not completely rule out the ‘culture of poverty’ hypothesis. There may in fact be some differences in narratives that were not explicitly measured by these studies between black people and the general population. Certainly there is something to be said for the aspirations of success among many black groups, particularly those living in urban environments where opportunities are scarce and ‘success’ has a very different definition. What this article does do, however, is strongly suggest that we cannot ascribe much explanatory power to the idea either that poverty is explained by laziness and poor work ethic, nor can we exclude policy as a useful method of alleviating poverty.

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