I find it difficult to believe that Dr. Singh, a university professor of anthropology, actually believed his child was “wasting”. Instead, I believe he is improving his story by enriching his recollections. I know a lot about this practice, because, as an old guy, I do it often. It’s a benevolent act designed to entertain and engage your audience.
Possibly, but I’m less sure. Not sure if this was his first child, but first-time parents often hang on the doctor’s every word and want to hear nothing so much from them as “all good.”
It's an interesting question and I am going from memory here-- the idea was that we use serum creatinine as a proxy for how well the kidneys are filtering stuff out of the blood. Measuring it more directly is expensive and invasive so instead you assume that the average person puts out x creatinine per unit time and if the kidneys aren't removing it as quickly the level will be higher. Creatinine is a metabolic product mostly (I think) from muscle so you would expect more muscular people on average to have higher serum creatinine even if their kidneys were normal. Black people are more muscular ON AVERAGE so....
The problem is that this calculated number (eGFR) could be used to decide if you get free government dialysis or even a transplant so it would have disparate impact and blah blah. You notice the article never asks if the corrected value gives more accurate numbers on average or if a lot of blacks are now getting unnecessary treatments.
BTW, I'm not saying they are or they aren't. This is a problem when you base decision points on (necessarily) group averages.
> Yeah, but that would concede that I’m not a Bad Guy, which is a big ask.<
The notion, however, that I’m not actually a horrible evil person, which seem sensible to those who know me and grasp that I’m a nice guy, strikes many progressive liberals as the ditch in which they will die.<
That's of course not why there is such resistance to the obvious.
It is because down that road a whole lot of the carefully constructed minoritarian "oppression" narrative would start falling apart. And beyond that white gentiles might start mentally bestirring themselves from this toxic fog and think that they are particular peoples, members of their own particular-quite special and excellent--genetics, culture, history and nations which are rightfully *theirs*.
The host realizing that he rightful owns himself and his patch and does not exist for other people to glom onto and loot? Can't have that! That's Hilter stuff.
The health authorities here in Hong Kong have more or less adopted a revised set of BMI standards for the local Chinese population.
For westerners, the familiar 18-25 normal; 25-30 overweight; 30 and up obese standards are retained.
But for local Chinese it's 18-23 normal; 23-25 overweight; 25 and up obese.
It makes sense, too. People here are generally very slim -- but they're also really not good at carrying extra weight. For example they get type II diabetes very easily, i.e. at weights that would be considered totally normal for westerners.
In the limited sample size of my experience, the size spectrum goes Sikh > Hindu > Jain. And I’m talking about stature here - get your minds out of the gutter!
In the first couple months of medical school you are taught that the normal ranges of lab tests (and similar observations like these growth charts) are determined by testing a large number of normal people and saying that anything outside 2 SD is abnormal. That's it. That's all it means. Next they take you through the calculation and demonstrate that if you do ten tests on a healthy person, there is a pretty good chance one of them will be abnormal.
That is why we don't treat lab tests.
Three years later 90% of docs have completely forgotten this principle.
That's why I try to persuade my primary that if I come in annually & get 31 tests and measurements, there is a large chance that eventually something will be (falsely) found that is horrible and needs expensive treatment right away. Even though I've gone into a state system with no profit motive to over diagnose and over treat, the clinicians still want to test for many conditions with no reason to suspect I have them, totaling in the hundreds as the years pass. I put up with the examinations but retain my right to refuse treatment.
Yep. There are a few tests that are a good idea, glucose being top of mind. But the rest? You keep turning well people into 'patients' that require 'workup' because you know, you can't just not work up a patient, right? I recently fell for it myself. I had two years in a row of disturbingly low neutrophil counts. I went to a hematologist and learned that mine are just sticking to the sides of my vessels and avoiding the needle stick.
They told me that while I was in the office because they did a draw after having me do jumping jacks. ALL my counts were normal. Thing is, just in case, they had also drawn what felt like a hundred vials for send away tests in case the in office neutrophil count was still low. Fucking Fellow was really itching to do a bone marrow biopsy (you know, so I wouldn't face the inconvenience of coming back if the blood work was till bad). I turned that down.
So I'm in the office and these guys are soooooo happy their initial Dx turned out right, sticky white cells...interesting but no biggie. But they they said, almost as an afterthought- but you know will still run all these other tests as long as we took the blood. I was too happy to say no. Later over the web I could see the results of 50 gazillion tests...all normal. I shudder to think what they would have wanted to do if they had found a new abnormal test to track down.
And don't get me started on the 'baseline ECG' we might as well do....
I did finally get my colonoscopy. I think that was is worthwhile. But then I have a cousin who is almost 80 and getting waaaaaay too much prostate workup done.
I dunno, I guess on balance it's great we have so much modern medicine, but most people's expectations are too high. There is no such thing as a 'clean bill of health'
“If the W.H.O. had been right to assume that children’s potential height is the same everywhere, basal height-for-age measurements should be consistent across populations.”
This ladies and gentlemen is why we are all losing faith in the institutions that are supposed to protect us. I really don’t need to ask why as I’ve been in an enough meetings where we all have to submit to the stupidest person in the room (on whatever topic being discussed), i,e. The Boss Man.
And furthermore, what percentage of doctors and other medical professionals are too stupid or brainwashed to make adjustments on the standards based on the race of their patients?
I grew up in a large Italian American community in the 70's and 80's, and something everyone noticed, and commented on, was how much taller the children, particularly the boys, of Italian immigrants were than their parents.
It was quite common to see sons being a full head taller than their native Italian fathers and mothers.
Everyone assumed it was the American diet, or that the parents had grown up in post war Italy and been deprived of adequate calories during their formative years.
During the late 60's, a second, smaller, wave of immigration from Sicily and Southern Italy took place, and those immigrants settled in already established Italian communities all over the NorthEastern U.S.
Many of the kids in my neighborhood were the children of that second wave.
I'm second generation Neapolitan American, and my grandfather arrived in 1910.
My friend Silvio in the late 1960s was the children of immigrants from Italy who arrived, I believe, in the 1950s. His father was this friendly macho guy, kind of a Joe Pesci type. Interestingly, Mr. Spezio's profession was he was a ladies' hairdresser.
Besides nutrition, Italian-Americans were less inbred than Southern Italy. Sicily and the southern mainland have rugged topography so people mostly married within their little valley. Geneticist Cavalli-Sforza did a study of how the coming of bus routes to mountain villages in Italy caused people to marry someone from further away. Inbreeding correlates with shortness.
“‘Our differences are obvious, even on the surface,’ Pontzer observes in “Adaptable.” Why should our insides be any less diverse?’ It’s a reasonable question.”
Yglesias may, as you note, think it an unseemly one. But this is in the New Yorker. It seems like since Trump’s win a lot of smart guys seem less worried about their careers getting crushed if they say (or let someone else say) something interesting. Maybe that’s not at play here given that the author is South Asian, but my impression is that there are glimmers out there. Or, all the moral preening has for the moment settled on the suddenly venerated Constitution, so a little window has opened up where everything doesn’t have to be queered up or dosed with Stephen Jay Gould.
The election marked a vibe shift. It's now (mostly) okay to say there are two sexes, that you can't change one into the other, and that human biodiversity is real.
Steve writes that "South Asians tend to be lousy athletes," but, in my trip to Wikipedia to look up Dr. Singh, I came across his namesake and fellow Indian. From the files of Wikipedia: "Manvir Singh (Punjabi: ਮਨਵੀਰ ਸਿੰਘ; born 6 November 1995) is an Indian professional footballer who plays as a winger for Indian Super League club Mohun Bagan SG and the India national team." It's not the Premier League, but it's still something.
I looked at images of “Indian soccer team” and the players were not phenotypically the Indians immigrants you tend to see in the West who tend to hail from North India.
A Perplexity Pro search confirmed this:
“The Northeast Indian states (Arunachal Pradesh, Assam, Manipur, Meghalaya, Mizoram, Nagaland, Sikkim, Tripura), which comprise just about 3.76% of India’s population, produce about one-third of players in the ISL, highlighting their disproportionate contribution to Indian football”
The remote far northeast of India, where the people look more Oriental than in most of India, seems to produce more athletes, especially in the weight class sports where being small isn't a problem. My vague impression is they are often kind of like the Hmong: tough, aggressive hillbillies.
These BMI charts are screening, not diagnostic, tools. They are supposed to flag to medical professionals possible nutritional or developmental problems.
If a child looks healthy and has hit other developmental milestones then there’s nothing to worry about.
I obsessed over my first-born’s progress because being a parent was a novelty. I barely gave it any attention with my second-born mainly because I was so tired.
The author is in a subset of a subset of a subset: high-IQ, late-starter parent of an only child.
This is typical of the kind of person the New Yorker hires to write articles but not typical of the US never mind the world.
But the assumptions of New Yorker writers often filter down over a few generations to the community college students, so it's good to see the New Yorker writing a non-hysterical article about HBD.
I think it's okay to acknowledge and account for human biodiversity affecting any number of physical characteristics, as long as we simultaneously agree that all this evolution had zero effect on the human brain. Cognitively, we are all identical blank slates with identical potentials, from the Andaman Island Negritos to Alaskan Eskimos.
The non-mentioning of the Hispanic Paradox (and similar issues with Asians) in every single prestige press story about why Systemic Racism is to blame for every single adverse health outcome for Black people is (yet another) example of how the Megaphone/Cathedral lies shamelessly, i.e. by carefully contrived omission.
"Hispanic people also suffer from poverty and discrimination, and yet, they seem rather healthy, in some ways even healthier than hereditarily racist White people? In a way that casts doubt on the monocausal attribution of poor Black health to """"""systemic racism""""""? Wow. I didn't know that, you're telling me now for the first time..."
BMI's virtue is that it is calculated from two measurements that are recorded at every annual checkup, and that anybody can readily get on their own at any time.
That's also its shortcoming. Chubby person A and muscular person B can share the same BMI, but have very different health concerns and risk profiles.
This has been obvious for a long time. Per Steve: (1) It's a useful first pass, and (2) when thinking about similar populations' average BMIs -- say, of Americans at various times over the past few decades -- it's good enough for government work.
Here's a link to an old article discussing the more sophisticated ABSI ("A Body Shape Index").
ABSI is calculated from Waist Circumference, as well as from Height and Weight. As far as I can see, its main shortcoming is that docs don't record WC at checkup, so there aren't tens of millions of data points on which to construct curves. Secondly, few people have heard of it.
Hmm, speaking as a fellow old guy, you may be mis-underestimating the influence of his wife with her first child.
That said, surely these new parents had proud grandparents who could reassure them that all was well. But maybe not in country, and this was probably pre-Zoom.
Well. My wife and I encountered growth charts. Our first child had a large head. "Macrocephaly" could be a medical issue, or a family trait. More testing!
The specialist met the proud parents, glanced at our big heads, and said, OK, I wasn't *that* worried before and I'm not worried at all now. Nor should he have been.
FWIW my fitted Yankees cap is a 7 3/4. Not comically large, but a solid XL.
I find it difficult to believe that Dr. Singh, a university professor of anthropology, actually believed his child was “wasting”. Instead, I believe he is improving his story by enriching his recollections. I know a lot about this practice, because, as an old guy, I do it often. It’s a benevolent act designed to entertain and engage your audience.
Possibly, but I’m less sure. Not sure if this was his first child, but first-time parents often hang on the doctor’s every word and want to hear nothing so much from them as “all good.”
Agree. First time parents can get pretty paranoid.
Over-fattening the next generation of dot Indian-Americans seems like a small price to pay to keep Sailer on the black--uh--bad person list.
So the '99 African kidney standard was bogus and harmful? Why was it started?
It's an interesting question and I am going from memory here-- the idea was that we use serum creatinine as a proxy for how well the kidneys are filtering stuff out of the blood. Measuring it more directly is expensive and invasive so instead you assume that the average person puts out x creatinine per unit time and if the kidneys aren't removing it as quickly the level will be higher. Creatinine is a metabolic product mostly (I think) from muscle so you would expect more muscular people on average to have higher serum creatinine even if their kidneys were normal. Black people are more muscular ON AVERAGE so....
The problem is that this calculated number (eGFR) could be used to decide if you get free government dialysis or even a transplant so it would have disparate impact and blah blah. You notice the article never asks if the corrected value gives more accurate numbers on average or if a lot of blacks are now getting unnecessary treatments.
BTW, I'm not saying they are or they aren't. This is a problem when you base decision points on (necessarily) group averages.
Thanks, now explain how they correct urinalysis concentrations for people's differing amounts of water intake and output.
> Yeah, but that would concede that I’m not a Bad Guy, which is a big ask.<
The notion, however, that I’m not actually a horrible evil person, which seem sensible to those who know me and grasp that I’m a nice guy, strikes many progressive liberals as the ditch in which they will die.<
That's of course not why there is such resistance to the obvious.
It is because down that road a whole lot of the carefully constructed minoritarian "oppression" narrative would start falling apart. And beyond that white gentiles might start mentally bestirring themselves from this toxic fog and think that they are particular peoples, members of their own particular-quite special and excellent--genetics, culture, history and nations which are rightfully *theirs*.
The host realizing that he rightful owns himself and his patch and does not exist for other people to glom onto and loot? Can't have that! That's Hilter stuff.
The health authorities here in Hong Kong have more or less adopted a revised set of BMI standards for the local Chinese population.
For westerners, the familiar 18-25 normal; 25-30 overweight; 30 and up obese standards are retained.
But for local Chinese it's 18-23 normal; 23-25 overweight; 25 and up obese.
It makes sense, too. People here are generally very slim -- but they're also really not good at carrying extra weight. For example they get type II diabetes very easily, i.e. at weights that would be considered totally normal for westerners.
Singapore also has BMI standards that differ from the American ones.
(And China uses the Singapore standards in preference to the American standards.)
Isn't Singh a Sikh name? Aren't Sikhs known for being relatively large? At least the one I knew were not small.
In the limited sample size of my experience, the size spectrum goes Sikh > Hindu > Jain. And I’m talking about stature here - get your minds out of the gutter!
“Singh” means “lion.” It’s an obligatory name for Sikh males but other Indians also use it, although not nearly as heavily.
In the first couple months of medical school you are taught that the normal ranges of lab tests (and similar observations like these growth charts) are determined by testing a large number of normal people and saying that anything outside 2 SD is abnormal. That's it. That's all it means. Next they take you through the calculation and demonstrate that if you do ten tests on a healthy person, there is a pretty good chance one of them will be abnormal.
That is why we don't treat lab tests.
Three years later 90% of docs have completely forgotten this principle.
That's why I try to persuade my primary that if I come in annually & get 31 tests and measurements, there is a large chance that eventually something will be (falsely) found that is horrible and needs expensive treatment right away. Even though I've gone into a state system with no profit motive to over diagnose and over treat, the clinicians still want to test for many conditions with no reason to suspect I have them, totaling in the hundreds as the years pass. I put up with the examinations but retain my right to refuse treatment.
Yep. There are a few tests that are a good idea, glucose being top of mind. But the rest? You keep turning well people into 'patients' that require 'workup' because you know, you can't just not work up a patient, right? I recently fell for it myself. I had two years in a row of disturbingly low neutrophil counts. I went to a hematologist and learned that mine are just sticking to the sides of my vessels and avoiding the needle stick.
They told me that while I was in the office because they did a draw after having me do jumping jacks. ALL my counts were normal. Thing is, just in case, they had also drawn what felt like a hundred vials for send away tests in case the in office neutrophil count was still low. Fucking Fellow was really itching to do a bone marrow biopsy (you know, so I wouldn't face the inconvenience of coming back if the blood work was till bad). I turned that down.
So I'm in the office and these guys are soooooo happy their initial Dx turned out right, sticky white cells...interesting but no biggie. But they they said, almost as an afterthought- but you know will still run all these other tests as long as we took the blood. I was too happy to say no. Later over the web I could see the results of 50 gazillion tests...all normal. I shudder to think what they would have wanted to do if they had found a new abnormal test to track down.
And don't get me started on the 'baseline ECG' we might as well do....
I did finally get my colonoscopy. I think that was is worthwhile. But then I have a cousin who is almost 80 and getting waaaaaay too much prostate workup done.
I dunno, I guess on balance it's great we have so much modern medicine, but most people's expectations are too high. There is no such thing as a 'clean bill of health'
“If the W.H.O. had been right to assume that children’s potential height is the same everywhere, basal height-for-age measurements should be consistent across populations.”
This ladies and gentlemen is why we are all losing faith in the institutions that are supposed to protect us. I really don’t need to ask why as I’ve been in an enough meetings where we all have to submit to the stupidest person in the room (on whatever topic being discussed), i,e. The Boss Man.
And furthermore, what percentage of doctors and other medical professionals are too stupid or brainwashed to make adjustments on the standards based on the race of their patients?
I grew up in a large Italian American community in the 70's and 80's, and something everyone noticed, and commented on, was how much taller the children, particularly the boys, of Italian immigrants were than their parents.
It was quite common to see sons being a full head taller than their native Italian fathers and mothers.
Everyone assumed it was the American diet, or that the parents had grown up in post war Italy and been deprived of adequate calories during their formative years.
Wasn’t the typical Italian-American child of the 70s and 80s third or even fourth generation?
During the late 60's, a second, smaller, wave of immigration from Sicily and Southern Italy took place, and those immigrants settled in already established Italian communities all over the NorthEastern U.S.
Many of the kids in my neighborhood were the children of that second wave.
I'm second generation Neapolitan American, and my grandfather arrived in 1910.
My friend Silvio in the late 1960s was the children of immigrants from Italy who arrived, I believe, in the 1950s. His father was this friendly macho guy, kind of a Joe Pesci type. Interestingly, Mr. Spezio's profession was he was a ladies' hairdresser.
Besides nutrition, Italian-Americans were less inbred than Southern Italy. Sicily and the southern mainland have rugged topography so people mostly married within their little valley. Geneticist Cavalli-Sforza did a study of how the coming of bus routes to mountain villages in Italy caused people to marry someone from further away. Inbreeding correlates with shortness.
“‘Our differences are obvious, even on the surface,’ Pontzer observes in “Adaptable.” Why should our insides be any less diverse?’ It’s a reasonable question.”
Yglesias may, as you note, think it an unseemly one. But this is in the New Yorker. It seems like since Trump’s win a lot of smart guys seem less worried about their careers getting crushed if they say (or let someone else say) something interesting. Maybe that’s not at play here given that the author is South Asian, but my impression is that there are glimmers out there. Or, all the moral preening has for the moment settled on the suddenly venerated Constitution, so a little window has opened up where everything doesn’t have to be queered up or dosed with Stephen Jay Gould.
The election marked a vibe shift. It's now (mostly) okay to say there are two sexes, that you can't change one into the other, and that human biodiversity is real.
Steve writes that "South Asians tend to be lousy athletes," but, in my trip to Wikipedia to look up Dr. Singh, I came across his namesake and fellow Indian. From the files of Wikipedia: "Manvir Singh (Punjabi: ਮਨਵੀਰ ਸਿੰਘ; born 6 November 1995) is an Indian professional footballer who plays as a winger for Indian Super League club Mohun Bagan SG and the India national team." It's not the Premier League, but it's still something.
I looked at images of “Indian soccer team” and the players were not phenotypically the Indians immigrants you tend to see in the West who tend to hail from North India.
A Perplexity Pro search confirmed this:
“The Northeast Indian states (Arunachal Pradesh, Assam, Manipur, Meghalaya, Mizoram, Nagaland, Sikkim, Tripura), which comprise just about 3.76% of India’s population, produce about one-third of players in the ISL, highlighting their disproportionate contribution to Indian football”
The remote far northeast of India, where the people look more Oriental than in most of India, seems to produce more athletes, especially in the weight class sports where being small isn't a problem. My vague impression is they are often kind of like the Hmong: tough, aggressive hillbillies.
The boxer Mary Kom who won gold in her weight class at the 2012 London Olympics was from one of the northeast states.
Of course, they got a popular North Indian actress to play her in the Bollywood retelling, which kind of undermined the particulars of her story.
These BMI charts are screening, not diagnostic, tools. They are supposed to flag to medical professionals possible nutritional or developmental problems.
If a child looks healthy and has hit other developmental milestones then there’s nothing to worry about.
I obsessed over my first-born’s progress because being a parent was a novelty. I barely gave it any attention with my second-born mainly because I was so tired.
The author is in a subset of a subset of a subset: high-IQ, late-starter parent of an only child.
This is typical of the kind of person the New Yorker hires to write articles but not typical of the US never mind the world.
But the assumptions of New Yorker writers often filter down over a few generations to the community college students, so it's good to see the New Yorker writing a non-hysterical article about HBD.
I think it's okay to acknowledge and account for human biodiversity affecting any number of physical characteristics, as long as we simultaneously agree that all this evolution had zero effect on the human brain. Cognitively, we are all identical blank slates with identical potentials, from the Andaman Island Negritos to Alaskan Eskimos.
Everybody who is anybody knows Steve is not a bad guy. Only those who don't know him think otherwise.
The non-mentioning of the Hispanic Paradox (and similar issues with Asians) in every single prestige press story about why Systemic Racism is to blame for every single adverse health outcome for Black people is (yet another) example of how the Megaphone/Cathedral lies shamelessly, i.e. by carefully contrived omission.
"Hispanic people also suffer from poverty and discrimination, and yet, they seem rather healthy, in some ways even healthier than hereditarily racist White people? In a way that casts doubt on the monocausal attribution of poor Black health to """"""systemic racism""""""? Wow. I didn't know that, you're telling me now for the first time..."
BMI's virtue is that it is calculated from two measurements that are recorded at every annual checkup, and that anybody can readily get on their own at any time.
That's also its shortcoming. Chubby person A and muscular person B can share the same BMI, but have very different health concerns and risk profiles.
This has been obvious for a long time. Per Steve: (1) It's a useful first pass, and (2) when thinking about similar populations' average BMIs -- say, of Americans at various times over the past few decades -- it's good enough for government work.
Here's a link to an old article discussing the more sophisticated ABSI ("A Body Shape Index").
https://shapescale.com/blog/health/why-bmi-is-wrong-and-shape-index-is-telling-the-truth/
ABSI is calculated from Waist Circumference, as well as from Height and Weight. As far as I can see, its main shortcoming is that docs don't record WC at checkup, so there aren't tens of millions of data points on which to construct curves. Secondly, few people have heard of it.
Hmm, speaking as a fellow old guy, you may be mis-underestimating the influence of his wife with her first child.
That said, surely these new parents had proud grandparents who could reassure them that all was well. But maybe not in country, and this was probably pre-Zoom.
Well. My wife and I encountered growth charts. Our first child had a large head. "Macrocephaly" could be a medical issue, or a family trait. More testing!
The specialist met the proud parents, glanced at our big heads, and said, OK, I wasn't *that* worried before and I'm not worried at all now. Nor should he have been.
FWIW my fitted Yankees cap is a 7 3/4. Not comically large, but a solid XL.