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  • Jonathan V. Last: MAHA Is a Fraud

    Jonathan V. Last: MAHA Is a Fraud


    Jonathan V. Last writes for and edits one of the liveliest and most informative sites on the Internet: The Bulwark. That is home base for a significant number of Republican Never Trumpers. In this post, he explains that Robert F. Kennedy Jr. is not only unqualified in medical issues but his ignorance puts all of us in danger.

    America has never been healthier. Going backwards is going to mean more people getting sick and dying.

    (Composite / Photos: GettyImages / Shutterstock)

    1. The Past Sucked

    I had a great conversation with Your Local Epidemiologist, Katelyn Jetelina, yesterday. It’s here if you missed it.

    As she was explaining the state of play with measles outbreaks and falling vaccination rates, I asked her if there was any analog to this moment in the history of public health. She couldn’t think of one.

    What America’s new public health establishment—by which I don’t mean actual public health experts but their dilettante conspiracist bosses—is doing is choosing to move the country backwards. Less medical research, a pull-back on life-saving vaccines, turning away from science and embracing folk medicine.

    Our new health establishment is explicit about wanting to go backwards. It’s right there on the hat: Make America Healthy Again.

    Again.

    Meaning: America used to be “healthy” and now is not.

    I’m sorry, I know we’re supposed to meet people where they are and give them a loving truth sandwich, but this is the stupidest fucking thing I’ve ever heard.

    Does anyone remember what “health” looked like in America a generation or two ago? Half the country smoked. People dropped dead at 50 on the reg. Child birth was dangerous. Seatbelts were suss. Drug use was off the charts.

    Dangerous communicable diseases were still around. Cancer was a death sentence. AIDS looked like an unstoppable tsunami.

    Food? Do remember what grocery stores looked like in 1980? Aisles of canned vegetables, processed foods, and frozen TV dinners. Fresh produce? Good luck. That section of the Acme was a shoebox.

    But that’s all anecdotal. Let’s look at the data. Because it shows—absolutely, unequivocally—that this is the healthiest period in American history.

    Let’s start with the dumbest possible metric: life expectancy.

    We’ve had a slight downtick in the last year or two largely driven by COVID. You know why a lot of people died from COVID? Because they refused to follow public health advice during the pandemic and then refused to get vaccinated once we had vaccines in hand. So it was precisely the MAHA idiocy that moved our life expectancy backward.

    Let’s zoom out and look at America compared to the rest of the developed world:

    You want to “Make America Healthy Again”? Get the fucking COVID vaccine like everyone else in the civilized world did.

    How about infant mortality? That’s another excellent marker of health in a society. Oh, look—it’s incredibly low: 5.61 deaths per 1,000 live births. This is up slightly from 2020 because, again, COVID. But it’s still a historic low.

    When do you think the golden, “healthy” past was? In 1980, the infant mortality rate was more than double what it is today (12.0). In 1960 it was more double that number (25.9).

    Real problems do exist. For instance: Access to healthcare for African-American women. The black infant mortality rate is double that of white Americans and the maternal mortality rate for African-American women has been rising sharply for a generation.

    These statistics are absolutely shameful. Yet you don’t hear a lot about them from the beef-tallow crowd, do you?

    How about infectious diseases? In 1900 half of all deaths in America were from communicable diseases. Through medical advances—especially vaccines—we got that number down to about 5 percent—until COVID. All by itself COVID accounted for 12 percent of all deaths in the United States in 2021.

    So again: If you want America to be healthy you’d do exactly the opposite of what the Trump administration is doing and urge everyone to get vaccinated.

    And while we’re talking about healthy habits: Americans don’t smoke like they used to.

    Also, forty years ago less than a fifth of people in cars used seatbelts. Today that number is well over 90 percent.

    2. The Big C

    Let’s talk about cancer. You ever feel like, “Man, people are getting cancer like crazy these days?”

    Here’s what happened. There was a huge spike in the incidence of cancer diagnoses from 1975 to 1995. Why? Two things.

    First, people were living longer and you have to die of something. Since people weren’t dying from polio, measles, and communicable diseases, they were living long enough to get cancer.

    Second, medical science developed more tools to detect cancer. Inventing effective tests and screenings means finding more incidences. Donald Trump knows this.

    So when you look at this graph the solid lines are cancer incidences. You see that they go up, and then down. But I want you to look at the dotted lines:

    The dotted lines are the cancer mortality rates. And what you see is that in the early 1990s, people started surviving cancer at higher rates even as the incidences of cancer increased. And from 1995 to 2000, as the cancer incidence rate peaked, the mortality rate fell off a cliff.

    Why?

    Because better tests = more cancer diagnoses = earlier interventions + therapeutic advances = much higher survival rates.

    The pattern we see with cancer incidence describes a lot of our health challenges today. Why do so many people get dementia or Alzheimer’s now? Because they’re surviving cancer and—again—something is going to get us eventually.

    Why so many autism diagnoses? Because 40 years ago doctors didn’t understand what they were seeing in kids who had ASD. Now they do. Once medical science understands what it’s looking at, you’re going to get more diagnoses. This isn’t hard to understand.

    Look: There are some things that have legitimately gotten worse over time. The incidence of Type 2 diabetes has increased dramatically since 1950. Some of this is linked to increasing obesity.

    What’s the answer? Diet and exercise, which you may recall Michelle Obama talking a lot about (and getting ridiculed by Republicans for her trouble). Semaglutide drugs show tremendous potential for helping curb obesity and reduce the incidence of diabetes.

    You may be surprised to hear that MAHA does not like this class of pharmaceuticals.

    So what’s going on here? Why does the “Make America Healthy Again” movement romanticize the health outcomes of the past (which were worse) and misunderstand the health outcomes of the present (which are significantly better along the most important vectors and continue to improve over time)?

    Why do people like RFK Jr. oppose medical practices that create better outcomes (vaccines; the Ozempic-class drugs)?

    I don’t know. Maybe you have a theory and can discuss it in the comments.

    But at the end of the day, the “why” doesn’t matter. What matters is the results. And the results are going to be bad.

    3. Worse Than Fraud

    Buildings used to catch on fire all the time in America. It was a serious problem. That’s why cities had as many fire stations as churches.

    Over time, we cut way down on the number of fires. We switched construction materials. We came up with safer mechanisms for delivering gas and electricity. We developed best-practices and enshrined them in building codes. The big thing was the invention of the sprinkler system.

    The result was that even as the total number of buildings in America kept growing, the annual number of structure fires kept going down. Dramatically.

    Imagine a movement that looked at this data and decided America didn’t need sprinkler systems anymore.

    Modern building costs are too high. There’s too much red tape. We spend billions on sprinkler systems every year that are never used. Let’s go back to the old ways. Make Buildings Great Again.

    After all, we don’t have to worry about fires anymore.

    The MAHA movement is like that. Except that while trying to get rid of sprinkler systems and building codes, they are also walking around carelessly tossing lit matches.

    These people aren’t just frauds. They’re arsonists. And right now they run the U.S. government, the CDC, the NIH, and the fire department, too.



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  • One-third of Native American students in California were chronically absent last year

    One-third of Native American students in California were chronically absent last year


    With the vast majority of students at Algodones Elementary School in New Mexico residing at San Felipe Pueblo, the school and the Bernalillo school district are making efforts to turn around the high rates of school absenteeism in Native American communities. Pictured are Kanette Yatsattie , 8 , left, and his classmate Jeremy Candelaria, 10, hanging out by a board depicting the race for best attendance at the school on October.

    Credit: Roberto E. Rosales / AP Photo

    As chronic absences have steadily decreased in California schools, the rate among Native American students remains consistently higher.

    Persistent high chronic absence rates have resulted in schools increasing their focus on addressing students’ basic needs, emphasizing mental health support, and boosting outreach efforts to reconnect with students amid the fallout from the Covid-19 pandemic, which closed California public schools beginning March 2020 and didn’t reopen until spring 2021.

    Many Native American youth face challenges similar to other marginalized communities — such as poverty, systemic discrimination and poor health — but often with the added barrier of historical mistrust in state school systems due to the lingering impacts of removing Native American youth from their communities and confining them to federal boarding schools.

    “With quite a few of our Native American learners, we’ve recognized that there has been a lot of trauma in the family,” said Heather Golly, superintendent of Bonsall Unified in San Diego County. “It affects everyone in the family when there is trauma.”

    Chronic absence is defined as missing 10% or more of students’ expected attendance, whether for excused or unexcused reasons. For students on a typical 180-day school calendar, this totals to about one month of missed school in a given year. High chronic absentee rates concern educators and researchers alike as they reflect a significant loss of instructional time.

    Chronic absenteeism among Native American students during the 2023-24 school year was much higher, at 33%, than the statewide rate of 20.4%, according to data from the California Department of Education (CDE). The statewide chronic absenteeism rate has been declining for Native American students since 2021-22, when numbers peaked at 43.6%.

    The absentee rate disparity did not start with the Covid pandemic: The pre-pandemic rate of chronic absences was 21.8% for Native American students and 12.1% for all students.

    The state Education Department recently published its annual School Dashboard, which shows lower rates for chronic absenteeism statewide because it includes only grades K-8. The state education data used throughout this story includes all grades, from TK to 12.

    Every Native American student is a direct descendant or relative of someone who attended federal boarding schools from the mid 1800s until the mid 20th century, according to Ashley Rojas, policy director for Indigenous Justice. Native American students forced to attend boarding schools had their language, culture and family stripped from them, and Rojas sees echoes of that in contemporary American public schools.

    Rojas said that every year, she hears from students who are taught the history of California statehood or missions in a way that erases Native American perspectives. She noted there are still many schools with mascots based on stereotypes of Native American people. Even though it is against California law, Native American students tell Rojas about being barred by their school administration from representing their heritage and spirituality during graduation.

    “Every year, we deal with districts trying to remove this right from our young people, trying to tell them, ‘You can’t wear your feathers, you can’t wear your beads. You must fit into our image of a graduate,’” Rojas said. “Given the historical and ongoing traumatization of our students and communities by these systems, we just can’t stand for that.”

    About 26,000 or about 0.4% of the state’s nearly 6 million students enrolled in public K-12 schools, including charter and alternative schools, are Native American. This number is likely an undercount because Native Americans are much more likely than any other group to identify themselves as belonging to two or more races, according to the Brookings Institute. They may be counted alongside other multiracial students with different backgrounds.

    State education law lists several reasons for excusing students, but most excused absences, school officials say, are related to illness and mental health.

    Native American students in California missed an average of 18.5 days of school in 2023-24 — more than any other race or ethnicity. Unlike the average California student, their absences were more likely to be unexcused than excused, according to the CDE, an issue pervasive across the state as noted in a recent PACE report.

    Unexcused absences often mean students lacked documentation such as a note from a doctor or they provided no reason for their absence, or the reason they provided does not qualify as an excusable absence. A student can be labeled truant after more than three unexcused absences in one school year.

    While all absences can hamper students in their academic and personal development given the loss of instructional time, only truancy involves the potential for punitive measures for parents, such as fines and jail time.

    Colonization and repression has meant that many surviving Native American students are disconnected from their heritage and communities, said Rojas. But those who are still engaged with their communities will partake in spiritual ceremonies that include communal dancing, praying and time with elders. These holidays aren’t acknowledged by California school calendars, so students can rack up unexcused absences, putting them at risk of being considered criminally truant.

    “When your school already makes you feel like you don’t belong, and then they’re going to punish you for going to the only places that you do belong, it’s really going to be difficult to convince a young person that it’s important to be there,” Rojas said.

    Absences reflect remnants of traumatic history

    Chronic absences are often the result of systemic challenges, such as inconsistent transportation, food instability, violence in the home, homelessness, undiagnosed disabilities and more. Higher rates of suspensions are also a factor. Out-of-school suspensions for Native American students accounted for 1.5% of absences compared with the state average of 0.9%.

    Some of the highest chronic absence rates for Native American students in the state are along the state’s Northern coast. In Humboldt County, a larger proportion of students are Native American — 8.7% compared to 0.4% statewide — and 55.4% of them were chronically absent last year, compared with 27.3% countywide.

    “Failing Grade: The Status of Native American Education in Humboldt County,” a report published by the American Civil Liberties Union (ACLU) Northern California and the Northern California Indian Development Council, examined the county’s “egregious” disparities in chronic absenteeism, as well as academic performance and discipline, noting that the troubled and violent history of federal boarding schools has left a lasting imprint on Native American communities in Humboldt.

    The boarding schools, operated nationwide for about 150 years up until at least 1969, had a practice of separating Native American children from their families, cutting them off from their communities and cultures.

    Some of the documented forms of abuse include solitary confinement, withholding of food, prohibiting Indigenous languages and cultural practices, and more. A report from the U.S. Department of the Interior in July found that nationwide, at least 973 Native American students died while at boarding schools, though the number is considered an undercount.

    Federal boarding schools were “specifically designed to erase Native American people and Native American culture,” said Colby Smart, deputy superintendent of the Humboldt County Office of Education. “That doesn’t go away in one year, and it doesn’t go away in one generation.”

    Native American communities today are still facing serious problems — including the legacy of colonization — that can contribute to chronic absentee rates among students. In Humboldt County, 75% of Native American students are socioeconomically disadvantaged, according to the California Department of Education. Smart also pointed to high suicide rates, substance abuse, health problems and poverty in local Native American communities.

    Klamath-Trinity Joint Unified is located in Hoopa, a small town that is the site of the Hoopa Valley Tribe’s federal reservation and the former home to one of a dozen federal boarding schools in California.

    The district has 774 Native American students, which is not just the majority of the district but more Native American students in a district than any other in the state. During the 2023-24 school year, 70% of these students were chronically absent, and Native American students missed an average of 36 days.

    Notably, the most recent data shows that the opposite occurred in Klamath-Trinity Joint Unified, where it increased by 7 percentage points between 2023-24 and the year prior.

    Partnerships with tribes offer solutions

    High chronic absentee rates do not signal that Native American communities don’t value school or education, according to Rojas with Indigenous Justice.

    “Indigenous people are super pro-education, but they just want to be sure that what is being learned is not going to cause further harm,” Rojas said.

    A key factor in ensuring Native American students feel welcome and engaged at school is working in partnership with local Native American communities. There are large Native American communities in the Central Valley and Del Norte where students don’t have access to the same resources as Native American students in Humboldt County, where the Yurok Tribe is more politically engaged.

    The Humboldt County Office of Education aims to help local districts tackle high chronic absentee rates through “pull” factors that engage parents and students, and make them feel welcome, even excited to attend school. For instance, local high schools offer the Indigenous language Yurok as a class that puts students on track for college, while connecting them with their heritage.

    “If students feel like they belong, not only do kids go to school more, but their academic outcomes improve,” Smart said.

    Culturally relevant curriculum can be an important way to engage Native American students, Smart said. The Humboldt County Office of Education is partnering with the San Diego County Office of Education as well as over 100 California tribes, Native American organizations and scholars to develop a state curriculum model for Native American studies. This curriculum is expected to be released next September.

    In this curriculum, kindergartners might count acorns, a dietary staple, while learning the Yurok language; a middle school student can learn about traditional foods of Native Californians, while a high school student may study federal boarding schools.

    In northern San Diego County, Bonsall Unified and the Pala Band of Mission Indians entered a partnership last year to better support Native American students. The agreement allows the district to share attendance information with key tribal leaders and hold joint meetings to discuss potential support for students and their families, all to increase school attendance.

    If a student is missing school due to inconsistent transportation, the tribe might offer to sponsor the students’ bus fee. There is a new position in the works, a Pala attendance support specialist, whose job will include making home visits to chronically absent students and offering solutions based on each student’s needs.

    During 2023-24, Bonsall Unified improved its chronic absence rates among Native American youth across all grades to 41% from a high of 50.9% in 2021-22.

    The improvements have not only come from the agreement, which was spearheaded by district trustee Eric Ortega and Chairman Robert H. Smith of the Pala Band of Mission Indians, but from the groundwork that was laid over the course of several years.

    About eight years ago, Bonsall Unified schools began hosting Pala Valley Day, an annual event for students to learn about local Native American history, with some of the presentations being made by Native American students.

    Efforts since then have continued to foster a sense of belonging among Native American students. Middle and high school students recently took a field trip to visit the American Indian Studies department at Cal State San Marcos, and there is a mural in the works that will feature Native American students.

    “When they belong — when they feel like they belong — they’re more in tune with being happy to be there and wanting to be there,” said Ortega about the district’s Native American students.

    Many Native American students have faced challenges like inconsistent transportation, lack of tutoring and the need for counseling, which most other students statewide have also experienced in recent years.

    In increasing their focus on collaboration with the Pala Band of Mission Indians, Golly and her staff have also found that students and their families are much more receptive to accepting support when offered by their tribal community.

    As chronic absences steadily decrease, Golly attributes much of the success of those partnerships to the support from tribal leaders such as Chair Smith, who she said is “a wonderful partner, and he believes strongly in the power of education.”

    The district also established a Native Learner Advisory Committee that schedules its meetings on the Pala reservation. They coordinated with the Pala learning center and with the tribal council to ensure meetings were scheduled at a time when more people can attend.

    Golly, district superintendent, said it has been important for the district to show it is listening to requests from their Native American families, as well as returning to committee meetings “with something actionable” in response to feedback.

    More recently, at an all-staff meeting, a panel of five Native American students presented to the entire certificated staff, sharing what they want their teachers to know about their culture, when they feel like they belong, and when they feel they don’t belong.

    As Ortega put it, building trust is ongoing work that requires time and collaboration at multiple levels, from school leaders to tribal leaders to parents.

    “We are right on the precipice of what we’re doing, and so anything can make it go wrong. It’s not perfect, but we want this to be our culture, our way of life,” he said about the partnership. “The more and more we do it, the more positive results we have, the better we’re going to be.”

    EdSource data journalist Daniel J. Willis contributed to this report.





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  • Conflict over race, LGBTQ issues cost schools more than $3 billion last school year

    Conflict over race, LGBTQ issues cost schools more than $3 billion last school year


    Conservative groups and LGBTQ+ rights supporters protest outside the Glendale Unified School District offices in Glendale on June 6, 2023. Several hundred people gathered at district headquarters, split between those who support or oppose teaching that exposes youngsters to LGBTQ+ issues in schools.

    Credit: Keith Birmingham/The Orange County Register via AP

    Conflicts between parents, teachers and school leaders over parental rights policies focusing on LGBTQ+ students, limitations on teaching about race and racism, and book bans have come with a cost — both socially and financially.

    The conflicts are disrupting school districts, negatively impacting schools and classrooms, and costing districts money that could be used to better serve students, according to “The Costs of Conflict, The Fiscal Impact of Culturally Divisive Conflicts on Public Schools in the United States,” released last month.

    Researchers from UCLA, the University of Texas at Austin, American University and UC Riverside conducted a national survey of K-12 public school superintendents from 46 states — 467 in all — and found that these conflicts are prevalent.   

    Since the 2020-21 school year, uncivil discourse and hostile political rhetoric at school board meetings and on school campuses has been an ongoing problem. Two-thirds of the school superintendents surveyed for the study said they have experienced moderate to high levels of culturally divisive conflict in their districts, including misinformation campaigns, violent rhetoric and threats.

    Cultural conflicts cost U.S. school districts about $3.2 billion last school year, according to the study. Researchers estimate that districts with high levels of conflict spent about $80 per student. Districts with moderate levels of conflict spent $50 per student, and districts with low conflict spent $25 per student.

    “This is costing us general fund dollars,” said a superintendent from a midsize school district in a Western state. “In the 2023-24 school year, the district spent an additional $100,000 on security, hiring armed plainclothes off-duty officers … because people coming to the board meetings are unpredictable and sometimes violent.” 

    Researchers allowed superintendents to remain anonymous in the report.

    The superintendent also said the district spent more than $500,000 in legal fees on lawsuits associated with a board member and a campaign against the LGBTQ+ community, and lost $250,000 in outside funding from social services organizations because of the dispute. It also spent $80,000 on recruiting and training new staff to replace teachers, counselors and administrators who left because they did not want to work in such a divisive setting. 

    “Culturally divisive conflicts have substantial costs to the public and to our capacity as a state to mount quality learning experiences for all students,” said John Rogers, director of the UCLA Institute for Democracy, Education and Access and lead researcher on the report. “It has a fiscal cost that we’ve tried to lay out with some specificity, and it has broader social costs as well — there’s an undermining of social trust, there’s a deepening sense of stress and all of this is hugely consequential for how educators experience public schools and how young people are experiencing public schools.”

    Costs of conflict can’t always be counted in dollars

    Average-sized school districts of about 10,000 students spent about $811,000 each last school year to cope with cultural division, according to the study. The money was spent on legal fees, added security, additional staff time and on community, school board and government relations. Districts also incurred indirect costs because of staff turnover related to the conflict and because staff had to take time away from their other duties to deal with discord.

    According to the survey, the largest expense for districts with cultural conflict came from staff turnover, with districts of about 10,000 students spending between $148,000 and $461,000, depending on the level of conflict. 

    One superintendent said that cultural conflict has caused “incredible stress on leaders and teachers as they navigate imaginary slights and online drama in the community.” A Pennsylvania superintendent called the emotional stress and anxiety “nearly crippling.”

    “This research makes clear that culturally divisive conflicts in the nation’s schools are generating fear, stress and anxiety that is disrupting school districts and taking a personal toll on the educators and staff members who work in them,” Rogers said. 

    The stress has also led to increased staff absenteeism at schools, even in districts with lower levels of conflict, according to the report.

    Half of the superintendents surveyed said they had been personally harassed at least once during the school year. Ten percent reported being threatened with violence, and 11% had their property vandalized.

    As a result, superintendent turnover has also increased — from 14.2% to 17.1% — over the past four years. More than 40% of the superintendents who left their jobs in the last year said their decision was related to conflict, stress and politics, according to the report.

    “The relentless demands of leading a district can easily overshadow their own well-being, which, if neglected, not only affects their personal health but also the health and stability of students, educators, and families they serve,” said Rachel S. White of the University of Texas at Austin in a statement. “Reducing the extent to which superintendents experience unwarranted divisiveness is an important step to change the trajectory of increasing superintendent churn.”  

    Superintendents who were surveyed expressed concern that the time they spent managing cultural conflict, including responding to Freedom of Information Act requests, and unsubstantiated rumors and misinformation, is keeping them from focusing on improving instruction.

    California not immune to divisive conflict

    Rogers said that while cultural conflict wasn’t as common in California as in other parts of the country in 2021-22, it has grown over the last few years.

    Donald Trump’s election is likely to bring more cultural division to school campuses, Rogers said.

    “I think that a Trump victory will lead some on the right to take a message that these sorts of cultural attacks, that have been playing out across the United States and across California in the last couple of years, are an effective strategy for mobilizing the base and for energizing the electorate,” said Rogers, in an interview the day before the election.

     “A Trump victory will mean that Donald Trump will have more of a presence in our public life in the months to come. And so, that too will mean that he will be using language and framing that will further activate attacks on public schools around these culturally divisive issues.”





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