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December 04, 2006

Comments

Well...if you lived in a place where the consequence of sex is venereal disease, wouldn't you start to think that sex really is evil?

I'm glad syphillis rates are comparatively low overall.

Guess it's time to get myself checked.

Maybe even past time.

Any stats in Herpes, Trichimoniasis, AIDS, Genital warts, etc?

Do these numbers estimate unreported cases?

Yet another reason to hope your kids lock themselves in their room and play video games for "fun".

Is Slart a man about town? Or the relationship philosophy "Trust, but verify"?

In any case, I don't recommend killing the bugs by freezing them.

I'd like to see how these numbers track to condom usage and abstinence-only sex education programs.

DaveC, my friend, I understood Slartibartfast's comment as an ironic comment on the general predictors for STIs given his geographic location.

HOWEVER: getting oneself checked regularly for STIs is commonsensical medical practice. Most women have the option of running complete tests on their yearly pap-smear, and if the tests are included in the fee, why the hell not take them?

"I'd like to see how these numbers track to condom usage and abstinence-only sex education programs."

I wonder how they track SES or educational level or general health expenditure or health insurance.

I wonder how they track SES or educational level

So the wiser people are being checked more often and therefore are showing a larger incidence of reported cases?

Italics off now? Preview my neglected friend.

DaveC - that was one thing I wondered (though I wouldn't say wiser tracks wealthier). Hopefully though the study doesn't suffer from such obvious selection bias.

Also I imagine that people in groups benefiting from better healthcare are less subject to infection by their peers simply because they are checked more regularly and successfully diagnosed and treated more frequently - which might lead to riskier behaviour. Anyway I can probably think of positive and negative effects for many groups.

Why are the red states objectively supporting terror by not keeping themselves fit to fight? When you think about it, terrorism is like a venereal disease: its secret weapons are sneak attacks and dirty fighting.

Yet another reason to hope your kids lock themselves in their room and play video games for "fun".

Free condoms.

I wanted to suggest 'syphillitics for Bush', but now I wonder what the equivalents for gonorrhea and chlamydia would be.

I wanted to suggest 'syphillitics for Bush', but now I wonder what the equivalents for gonorrhea and chlamydia would be.

Nah, that steps over the line into unfunny. People get infected with STIs not because they're lowlife scum with no moral values, but because they live in a state which does not sufficiently care about the health of its citizens to provide free condoms/gloves and water-based lube for all, explicit safer sex advice available to everyone, and free STI tests available on demand.

(I spent the last weekend discussing public health issues in the UK. One of the issues under discussion was the equation of getting infected with an STD with having a moral failing: good people don't get bad diseases. This is clearly stupid when laid out like that, but an amazing number of people evidently still make that association, and base their own private health decisions and public health care policies on it. As a result, I lost my sense of humor about this.)

I'm with Jesurgislac here; this kind of statistic makes me more angry than amused. Much of this is probably the effect of rural poverty and poor education and health care in states that went heavily for Bush.

In general, red state/blue state comparisons have a tendency to invert socioeconomic effects. While rich people tend to vote Republican, the richest states tend to vote Democratic in presidential elections. The apparent paradox is not hard to explain: poor states tend to be rural and Republican, the richest Americans tend to be surburban and Republican, but the suburban vote in rich states tends to be outweighed by the heavily Democratic urban vote.

So reminders that red states have bigger problems with STDs and disintegrating families, get more federal handouts per capita, etc., are still useful, but I get uncomfortable when they're just used as funny partisan cheap shots. Another way to think about it is that cultural conservatism plays well in poor red states because it's seen, rightly or wrongly, as a response to the intractable social problems that are happening there.

Sorry for being too brief, the thought came up and led to the other one of why we have a word for one but not the other two, and I wanted to explain why the thought came up. I don't think I would have put it up as a one liner.

Googling got this site, which raised more questions. I assume that syphillitic exists because it is a more noticiable disease, but the usage in the homeopathy sites is completely new to me. I see that I misspelled it, and the more standard spelling gives more of the pages I would expect. Any insights?

Syphilis was a major killer, disabler and general scourge of Western society for centuries, so it's not surprising that it would have a larger effect on the language than other STDs. Imagine, for instance, what effect an unchecked AIDS pandemic would have on culture and language after 300 or 400 years.

While chlamydia is common, I think it only got a lot of publicity in the 1980s and later, as Angry Bear speculates.

Mind you, gonorrhea is more colloquially known as "the clap", so terms related to that might be fruitful to look at.

I wanted to suggest 'syphillitics for Bush'

I guess that's fair game, if "felons for Gore" ever was.

I'd guess venereal disease frequency is more related to ignorance combined with religious discomfort with taking precautions (or even discomfort with discussing sex), more than the state not caring. If residents don't want the state's intrusion, what can the state do?

And I'd guess that it's stronger in the religious-discomfort axis, although it certainly could be argued that the result of not wanting to learn is ignorance.

Not all that surprising that chlamydia is more widespread, given that it's asymptomatic in women. I've had it, and I wasn't exactly promiscuous.

Bumper stickers to watch for:

(1) "Republicanism Is a Social Disease"

(2) "Burning Bush? Vote Bush!"

That last has a certain triple-entendre um...flavor to it that I admire even while being revolted by it.

I'm a little revolted myself, particularly since Google suggests I've inflicted that single-handedly upon the internet.

Anderson - that's right up there with "crunchy and screamy." Nice work.

The juxtaposition of Moses with gonorrhea...genius. Evil genius, sure, but genius.

The "burning bush" bit reminds me of the not entirely dissimilar Onion report, "Voice of God Revealed to Be Cheney on Intercom."

In a transcript of an intercom exchange recorded in March 2002, a voice positively identified as the vice president's identifies himself as "the Lord thy God" and promotes the invasion of Iraq, as well as the use of torture in prisoner interrogations.

Google's not helping me much on "crunchy & screamy," Ugh -- what's the provenance?

Crunchy and screamy.

It would be interesting to see the breakdown of men and women. If there is a higher incidence of women with these diseases in 'the red' states, I might suspect that somewhat more of them are in the "Hey, I'm in a committed relationship how the hell did I get this" situation than in the 'blue states'.

Seb: tables here. As best I can tell at a quick glance, the South has higher rates for more or less everything -- it's particularly striking for gonorrhea, where the top states are, in order: Mississippi, Louisiana, South Carolina, Alabama, Georgia, North Carolina.

I've inflicted that single-handedly upon the internet.

thus giving a sound new meaning to one hand clapping

These stats also explain why Baptists don't recognize each other at the liquor store or at Hooters.

one hand clapping

[Anderson achieves enlightenment, walks away from Internet forever.]

--Ah, thanks Ugh.

--I don't know how Miss. managed to lock up the gonorrhea and chlamydia championships, yet flubbed syphillis so badly. Maybe it's hard to get people to sleep with you when you're exhibiting symptoms from the first two. Or maybe we're underreported. And what is up with Maryland? (Okay, okay, "Baltimore." Got it.)

Matt McI wrote:

"So reminders that red states have bigger problems with STDs and disintegrating families, get more federal handouts per capita, etc., are still useful, but I get uncomfortable when they're just used as funny partisan cheap shots."

When Paul Krugman wrote that column several years ago about how red states had higher murder, teenage pregnancy, and federal handout rates, I was amused enough to verify the first two for myself. But you're right, of course. When you're talking about an overall difference of less than 1 in 1000, it is not that stark. It is perhaps more useful as a reminder that these problems are ubiquitous.

I've inflicted that single-handedly upon the internet.

or, to continue the metaphor:

you've singlehandedly infected the internet with that.

Planned Parenthood has been run out of the South. They used to provide full service gynycology clinics for modest fees. I don't imagine the Boards of Health have been filling the gaps. As a result, patients with STD's probably wait longer to see a doctor in red states than in blue, spreading infection meanwhile.

I doubt this is a red state - blue state sort of thing. I used the posted stats to compare Blue Washington and Oregon to Red Idaho, Montana and North Dakota and found its far safer (at least as far as communicable diseases go) to screw around in the local Red states here. Montana may not need it but this has immense tourism possibilities for North Dakota.

% as likely to contract a std as in the USA as a whole in 2004

MO 34%
ND 35%
ID 40%
OR 45%
WA 59%

243,

MO is post office abbreviation for Missouri. MT is for Montana.

MO is post office abbreviation for Missouri

That explains why my mail always goes missing. Thx

Quoth Slartibartfast:

If residents don't want the state's intrusion, what can the state do?
What about when reisdents wouldn't necessarily mind being told about the information they'd need to avoid STI, but their government is dictating that its agencies and school systems follow the Bush administration's abstinence-only model of sex education, which makes it more likely, rather than less, that people will spread diseases?

Reposted, without the formatting error:

Quoth Slartibartfast:

If residents don't want the state's intrusion, what can the state do?
What about when reisdents wouldn't necessarily mind being told about the information they'd need to avoid STI, but their government is dictating that its agencies and school systems follow the Bush administration's abstinence-only model of sex education, which makes it more likely, rather than less, that people will spread diseases?

Perhaps the high level of STD's in the South is just part of the region's generally unhealthy status. United Health Foundation does a yearly survey of the states and here's the money paragraph:

Louisiana dropped to 50th from 49th last year. The others in the bottom 10 included last year's cellar-dweller Mississippi, South Carolina, Tennessee, Arkansas, Alabama, Oklahoma, West Virginia, Georgia and Florida.


What about when reisdents wouldn't necessarily mind being told about the information they'd need to avoid STI, but their government is dictating that its agencies and school systems follow the Bush administration's abstinence-only model of sex education, which makes it more likely, rather than less, that people will spread diseases?

Ah, well now you're talking about something other than Jesurgislac's uncaring-state hypothesis. Not that there's anything wrong with that, but it's not well related to what I was responding to.

243, you just found the other dimension of this: Southern states are generally poorer and in worse shape than the sparsely populated Republican states of the West. So, no, it's not entirely a red state/blue state thing, since the special case of the South is such a large contributor to the comparison.

Matt: 243, you just found the other dimension of this: Southern states are generally poorer and in worse shape than the sparsely populated Republican states of the West.

I'm not sure that this is totally true. The south may well be in worse shape but its not significantly poorer than some of the states I listed according to:
http://www.census.gov/hhes/www/income/income05/statemhi2.html
Montana, for instance, has household income of $36,202 in 2005 which puts it just ahead of Mississippi and West Virginia for third place (first being lowest). ND is 12th, OR 19th, ID 26th & WA (with the worst std rate of the 5) is the wealthiest at 39th. I think there is something more going on, and am really hesitant to try to define it, not knowing much about Southern culture and presuming that is a factor.

Hmmm, interesting. I think there is some interaction between rural/urban and household income, so it is not as surprising that Montana and Idaho are low, but should Louisiana and Mississippi be as low?

Oregon and Washington also shouldn't be considered monolithically blue. The blue section is the coastal areas with the Eastern sections begin rather conservative. Obviously the population is skewed towards the coast, but there really are two different worlds contained. Oregon is interesting because the left influence in places like Eugene and Portland match up well with the libertarian strains in the east, so that many of the initiatives like drug decriminalization and right to die are much less things from the left, and more from the principles of 'leave me the hell alone'.

Prodigal: What about when reisdents wouldn't necessarily mind being told about the information they'd need to avoid STI, but their government is dictating that its agencies and school systems follow the Bush administration's abstinence-only model of sex education, which makes it more likely, rather than less, that people will spread diseases?

Slarti: Ah, well now you're talking about something other than Jesurgislac's uncaring-state hypothesis.

No: I'd say that's an excellent example of the state not caring that people will acquire and spread diseases.

Evidence from both US and UK is that, regardless of religious affiliation, if it's made possible for people to practice safer sex, they will. Conversely, again regardless of religious affiliation, as in Prodigal's example, if it's made difficult to impossible for people to practice safer sex, they won't.

The best means of driving down teenage pregnancy and STIs in any area of the UK has been shown to be provision of a Brook Advisory Centre (a health clinic which will provide condoms or the pill and health advice to anyone who asks, guaranteed confidentiality, no matter the age of the person who asks) which anyone in that area can easily and anonymously access. I will bet a cup of hot chocolate with a sloosh of Cointreau that STI infections, teenage pregnancy rates, and abortion rates, got proportionally higher in areas of the US from which pro-life terrorists and activists drove Planned Parenthood.

LJ, I agree with your assessments of WA & OR, although it is interesting that in WA, Seattle has a std rate of 1.66* times the state's std rate. Portland has a whopping 2.98* ratio to the OR's std rate. In fact Seattle seems the safer place of the two, both being at least twice as safe as New Orleans. If we assume that in both cases the rural areas of the states are the most conservative and the cities are the most liberal then there is something going on besides a liberal/conservative dichotomy. I suspect it may be more about income disparity within the communities themselves, but I neither have the time or the stats to figure this out.

* rates figured as the sum of the City to state ratios for each std and divided by three. As a ratio of total incidents per 100,000 the ratios are : Seattle - 1.14, Portland 2.24. That is if I cut and pasted everything correctly. :-)

Quoth Slaritibartfast:

Ah, well now you're talking about something other than Jesurgislac's uncaring-state hypothesis.
I'd argue that I'm doing anything but. We may be dealing with a difference in degrees (between some hypothetical state that doesn't fund any kind of sex ed and the one we actually exist in, where the Bush administration doesn't want any of the education it's funding to address the fact that abstinence-only just doesn't work), but that's just different ways for a lack of concern to be expressed.

and the one we actually exist in

You live in Florida?

See, I was talking about states. Same issues occur at the federal level, too, but you'd expect the richer-and-healthier states to dilute the effect of the poor-and-syphilitic ones, to some extent.

Note from yesterday's browsing the stats: the rates for syphilis among blacks and Native Americans are way, way higher than for other groups, higher enough that it seemed to be driving a lot of the statistics when I looked yesterday.

One thing that irks me about this sort of discussion is that I don't think rank-ordering is meaningful when talking about these issues. What's important is not that, say, "Louisiana dropped to 50th from 49th last year" but whether incidence rates are on the rise or how the distribution is changing (both geographically and demographically). I know that inflicting such absolutism necessarily means I don't have much to say, never having thought about what rate should constitute "too high" in these matters, but it's the only way to tackle the question IMO.

Hilzoy: Note from yesterday's browsing the stats: the rates for syphilis among blacks and Native Americans are way, way higher than for other groups, higher enough that it seemed to be driving a lot of the statistics when I looked yesterday.

Yeah, of the 16 states with higher than the US average African/American population (excluding DC), All of them Fall with in the top 25 for 2004 syphilis rates. OTOH the bLack rate of syphilis seems to be declining 25% from 2000 -2004 12->9 per 100,000 whereas the white rate has increased 320% .5->1.6 during the same period. Again I'm reluctant to draw any sort of firm conclusion here. Population stats here

it is interesting that in WA, Seattle has a std rate of 1.66* times the state's std rate. Portland has a whopping 2.98* ratio to the OR's std rate. In fact Seattle seems the safer place of the two, both being at least twice as safe as New Orleans. If we assume that in both cases the rural areas of the states are the most conservative and the cities are the most liberal then there is something going on besides a liberal/conservative dichotomy. I suspect it may be more about income disparity within the communities themselves, but I neither have the time or the stats to figure this out.

I know nothing about the statistics here, and very little about the Pacific Northwest, but historically, cities have always had worse health than the surrounding countryside. (In many cases, in fact, the death rate in cities was so high that they would have shrunk to nothing if not for the constant inflow of migrants from rural areas.) Partly this was due to crowding and poor sanitation, but partly, also, it was because the city was where people went to engage in exotic practices less often found in the countryside, such as education, culture, (unsafe) sex, and drugs. It's self-selective migration, which is often unhealthy. (*)

Comparisons, therefore, between mortality/morbidity in the city and those in rural areas cannot with any usefulness be linked to the differences between city/country "culture" unless we are able to distinguish between "city born and bred" and "migrants to the city." Most of our data aren't broken down thus.

(*) Imagine two teenagers in rural Oregon, one of an entirely conventional outlook, imbued with the values of his/her community, and the other eager for adventure, experimentation, seeing More Of Life, &c. Which of these two is more at risk? Which is more likely to wind up in Portland?

dr ngo: Imagine two teenagers in rural Oregon, one of an entirely conventional outlook, imbued with the values of his/her community, and the other eager for adventure, experimentation, seeing More Of Life, &c. Which of these two is more at risk?

The one with the entirely conventional outlook, obviously. Far less likely to take sensible precautions before having sex with someone whose STI status they do not know.

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