Super four-pack of links July 11, 2017: the five percent and healthcare money, video game addiction, exercise to prevent diabetes, activity inequality, and evil coconut oil

Super-user sounds great, right? Who doesn't want to be super at something? Only this video (in Memphis-style) refers to the 5% of Americans that account for ~50% of health care spending in a year.

To paraphrase the end of the video: "There's almost nothing insurance companies won't charge, and Americans won't pay." How do you keep yourself from becoming a super-user? Everything medical is a matter of risk, so don't believe anyone who tells you there's a rock-solid simple way to keep from falling into that 5%, at least temporarily. But overwhelmingly, if you can keep a steady job you don't hate, if you can abstain from smoking, if you can get even a small amount of daily exercise (more is better, obviously), if you can keep your alcohol intake to a minimum, if you can abstain from recreational drugs (this includes marijuana, obviously), and if you can choose to eat mostly plant-based foods in semi-sane quantities, you're gonna stay out of The Five Percent.

What does excess immersion into video games mean for young men?

I've tried to set the Weeds audio above to play at about the 46 minute mark. But if that doesn't work, fast forward to the 46 minute mark. Not because the discussion of what "Trumpism" is isn't interesting (it is), but because the discussion that follows helped me think more deeply about the problem of excess immersion into video games that young people, especially young men, are experiencing. I've blogged about this before, and I talked about it at a recent speaking engagement. We seem to be creating a generation of youths who are increasingly isolated in very immersive video games, and then they're growing up into increasingly isolated and lonely people, particularly after age 40. As Ezra Klein says in the piece: if this were a problem of drug abuse, I think we would be acting collectively to do something about it. That's an apt comparison, since game addiction and drug addiction seem to have some physiology in common. But since the solution to technological problems currently seems to be "more technology," we are kinda-sorta just plowing ahead and hoping that video games fix themselves. I'm not optimistic. I think we need to start introducing programs to help kids moderate their exposure to video games and increase their exposure to the world at a young age. Dylan Matthews, who generally defends the idea of video games as a pacifying technology for people who can't or won't work, ends with this quote: "When we're in our eighties, we're all gonna be doing, like, flight simulator stuff. That's, like, how we'll spend--or, VR stuff, at least--that's what retirement's going to look like." Yuck. No. No. No. 

A new meta-analysis shows that African-Americans who exercise may not derive the same protective benefit from type 2 diabetes as other races

(brief Healio write-up here)

 I'm not ready to sign on to this point; race is a very blunt instrument when it comes to genetics. As the cost of gene sequencing falls, I think we'll not only be able to tease out drug effects in people with specific genetic features; we'll be able to more precisely target interventions like physical activity. Maybe certain people in this collection of studies would have benefited more from strength training, while others needed more endurance-oriented activities. Maybe some would have benefited from a specific combination of drug and activity. We don't know the answers to these things now, but we will soon. 

Smartphone data shows that countries with the highest "activity inequality" are more likely to have large obese populations: 

More differences in activity within the population equals more obese people. 

More differences in activity within the population equals more obese people. 

So it isn't a surprise that the same investigators found that the higher the walkability of a city, the lower the "activity inequality":

Texas is not a place with a great deal of walkability. 

Texas is not a place with a great deal of walkability. 

The cynical take on this study is something like, "Of course people who are inactive weigh more!" Fair enough. But the obvious policy implication of the study is that, to affect the activity level of the inhabitants of a city, the built environment must give opportunities for activity.

ADDENDUM (make it a five-pack): How coconut oil got a reputation for being healthy in the first place. I don't love coconut oil, but even if I did, I'd think of it like I think of butter: an ingredient to be used sparingly, mostly for flavor. 

2. Social media is a set of common platforms to draw out our worst tendencies

(note: this is a continuation of a rant from a couple weeks ago)

I know it's absurd for me to be talking about "social media" as though it's some homogenous monolith. I'm sure aficionados could tell me the subtle differences between platforms the way a sommelier could tell me the difference between a Malbec and a Cabernet. But at the end of the day, those are just two varieties of red wines, and like them, Instagram and Twitter are more similar than they are different. And one of their similarities is they tend to bring out the worst in us.

Before my departure from social media, I saw people on Facebook joining or "liking" pages devoted to searing hatred of immigrants. These same people in some cases had testified at deportation hearings for undocumented family friends. What was it about the choice architecture of that "like" button that made the sort-of-evil decision the easy one? 

This isn't that different from the other happiness-draining things our consumerist society throws at us with the promise that we'll be happier if we use them. Tobacco, junk food, and social media all want the same thing from you: they want to take away your control over your life, health, and happiness. But while we've made strides to combat tobacco and junk food, like smoke-free laws and taxes on bug juice, we seem stuck in a self-sustaining vortex that tells us that more connection, more technology, will solve our problems instead of creating new ones. If a drug hit the market and prompted some of the behaviors that we see with social media, would we applaud it?

And the children. The children. We're training our kids to avoid boredom at all costs. How many kids have you seen dialed into a phone at a restaurant? How many staring into a screen at a playground? How many being beseeched to turn down their phones while at a restaurant or basketball game?

These are not behaviors that any of us are proud of. Were you to point them out to the very people exhibiting them, they would be ashamed, right after they got done telling you off and posting on Facebook about what a jerk they just ran into at the restaurant. But pride aside, there is probably real harm being done here. I'm frankly suspicious of any claim that the fake news on social media swayed the last US Presidential election, but it certainly didn't lead to a more erudite, informed electorate, either. But a kid who sits at a restaurant with earbuds in, staring at a screen, is being trained that boredom is unacceptable. What will happen to this person the first time he's confronted with a situation that requires delayed gratification or an attention span? 

So even though I'm a bit of an anti-incrementalist, I'm hoping to see just a series of small ticks in mobile/social media use. Comedian Chris Rock is having fans lock up their phones at his shows. Jack White has been doing it for a while now. I don't think these guys are doing it out of general fuddy-duddyness; they're trying to bring out the best in their audiences and to make sure everyone has a shared experience. Schools, historically afraid of parent backlash to less-than-100-percent-available kids, are even in on the act, establishing "phone free zones" with the same technology Chris Rock is using.