It’s possible that I shall make an ass of myself. But in that case one can always get out of it with a little dialectic. I have, of course, so worded my proposition as to be right either way (K.Marx, Letter to F.Engels on the Indian Mutiny)
Philip Morris International has secretly funded Japanese academics
Leaked documents show the tobacco giant attempting to influence science and public health policy in Japan by covertly funding research and expert networks
UNIVERSITY OF BATH
New revelations, published inNicotine and Tobacco Research, reveal the recent activities of Philip Morris International (PMI) and its Japanese affiliate, Philip Morris Japan (PMJ). An analysis of leaked documents by the Tobacco Control Research Group (TCRG) at The University of Bath, shows that PMI, the largest transnational tobacco company in the world, and its subsidiary PMJ, secretly funded Kyoto University academics to carry out research on smoking cessation. There is also evidence that PMJ funded a life sciences consultancy, run by a Japanese professor at Tokyo University, to build a network of experts to influence public health policy.
PMJ contracted a third-party external research organisation, CMIC, to secretly fund a study on smoking cessation conducted by Kyoto University academics. No public record of PMJ’s funding or involvement in this study was found.
PMJ paid life sciences consultancy, FTI-Innovations, ¥3,000,000 (approx. £20,000) a month between 2014 and 2019 to conduct various science-related tasks, such as networking with scientists and promoting PMI’s science and products at academic events. This arrangement was kept secret both within and outside the company. FTI-Innovations is run by a professor at Tokyo University.
Despite claiming to conduct transparent science PMI has been covertly funding research and attempting to influence science and policy to create a favourable environment for its products. This contradicts PMI’s supposed transformation efforts and raises serious concerns about the company’s research ethics. We must urgently reform the ways tobacco research is funded and governed to protect science from vested corporate interests, and ensure the public and policymakers have the truly transparent and independent science they need.
"The tobacco industry's tactics still endanger our health, showing we urgently need to clean up science from their unhealthy grip. We must find ways to fund research that's honest and open, keeping tobacco's influence far away from the truth of science."
PMI has a track record of scientific misconduct and misinformation
The Foundation for a Smoke-Free World (FSFW) claims to be independent but TCRG research found it is solely funded by PMI and published by PMI-favourable research.
Journalist investigations and academic reviews of PMI’s science have raised serious concerns over the quality and ethical standing of PMI’s clinical research.
In 2022, a review by TCRG found PMI’s clinical trials on its heated tobacco products were at high risk of bias and poor quality.
A 2020 TCRG report on PMI detailed the company’s “relentless lobbying, PR campaigns and multifaceted approaches to influencing science and public health in order to manage the future direction of tobacco control.”
Dr Sophie Braznell said:
PMI continues to prioritise maximising profits rather than improving public health. The manipulation of science for profit harms us all, especially policymakers and consumers trying to make potentially life-changing decisions. It slows down and undermines public health policies, while encouraging the widespread use of harmful products.
The study also builds on TCRG’s previous research on the manipulation of science for profit. To analyse the documents, the researcher’s used the Science for Profit Model. This was developed by TCRG researcher Dr. Tess Legg who said:
We cannot ignore the alarming implications of these revelations. The tobacco industry's influence on science undermines the credibility of research and threatens public health. It is imperative that we take decisive action to protect the integrity of scientific inquiry from vested interests.
In addition to the paper, the research has contributed to work by STOP, a global tobacco industry watchdog.
JOURNAL
Nicotine & Tobacco Research
ARTICLE TITLE
“Keep it a secret”: leaked documents suggest Philip Morris International, and its Japanese affiliate, continue to exploit science for profit
ARTICLE PUBLICATION DATE
27-Jun-2024
Prenatal exposure to ethylene oxide associated with lower birth weight and head circumference in newborns
The study involving 1,106 newborns from five countries examined the impact of ethylene oxide exposure during the last three months of pregnancy on foetal development and birth outcomes
BARCELONA INSTITUTE FOR GLOBAL HEALTH (ISGLOBAL)
A study led by the Barcelona Institute for Global Health (ISGlobal), a centre supported by the "la Caixa" Foundation, provides new evidence on the adverse effects of prenatal exposure to ethylene oxide (EO) on foetal development. The results, published in Epidemiology, show that increased EO exposure in utero is associated with a reduction in birth weight and head circumference in newborns.
Ethylene oxide is a chemical used in various industrial processes and in hospitals, is known for its mutagenic and carcinogenic properties. Human exposure to EO is mainly through inhalation of tobacco smoke and air pollution produced from various household products, including cleaning and personal care products. Workers in the healthcare and chemical industries are particularly exposed to this substance, which is commonly used in sterilisation processes. Previous studies have found that women exposed to higher levels of EO at work during pregnancy had a higherrisk of miscarriage and premature birth than those with lower exposure.
This new study focused on pregnant women and newborns in the general population, rather than a specific population with known high levels of EO exposure. The research team looked at the levels of EO hemoglobin (Hb) adducts in the cord blood of 1,106 newborns from 5 countries: Greece, Spain, Norway, UK and Denmark. This measurement provides valid information on the amount of EO the foetus was exposed to during the last three months of pregnancy, which may help to better understand potential adverse effects on foetal development and birth outcomes.
The study used data from the NewGeneris project, which aimed to study genotoxic exposures in the environment on children's health by measuring several biomarkers in cord blood. Information on birth weight, head circumference, sex and gestational age was obtained from maternity records.
Higher exposure, lower birth weight and smaller head circumference
The results of the study showed that median levels of EO-Hb adducts in the umbilical cord were higher in smoking mothers compared to non-smoking mothers. Higher levels of hemoglobin adducts were associated with lower birth weight. Specifically, mean birth weight decreased by 3.30 grams with each 10 pmol/g increase in hemoglobin adducts. Increasing levels of hemoglobin adducts were also associated with a decrease in head circumference.
“Reduced head circumference has been linked to delayed neurodevelopment, and reduced birth weight increases the risk of cardiovascular disease, type 2 diabetes mellitus and osteoporosis,” says Barbara Harding, ISGlobal researcher and first author of the study.
The team found no evidence of an association between EO Hb adduct levels and the risk of being small for gestational age (SGA), a condition that can compromise a baby's short and long-term health.
"The study results highlight the importance of addressing EO exposure in both occupational and non-occupational settings. Policy changes to reduce EO exposure in vulnerable populations, such as women of childbearing age, could protect foetal health and improve birth outcomes," says Manolis Kogevinas, ISGlobal researcher and senior author of the study.
Reference
Harding BN, Agramunt, S., Pedersen, M., Knudsen, LE., Nielsen, JKS, Wright, J, Vafeiadi, M., Merlo, DF., Stayner, L., Kelly-Reif, K., Espinosa, A., Bustamante, M., Gützkow, KB., Granum, B., von Stedingk, H., Rydberg, P., Alexander, J., Törnqvist, M., Kogevinas, M. Ethylene oxide hemoglobin adducts in cord blood and offspring’s size at birth: The NewGeneris European Cohort Study. Epidemiology. 2024. DOI: 10.1097/EDE.0000000000001767
Ethylene oxide hemoglobin adducts in cord blood and offspring’s size at birth: The NewGeneris European Cohort Study
ARTICLE PUBLICATION DATE
27-Jun-2024
Monday, June 24, 2024
Among cancer survivors, LGBTQ+ individuals report higher prevalence of chronic health conditions, disabilities, other limitations
Transgender or gender non-conforming cancer survivors had higher odds of most conditions compared to cisgender cancer survivors
AMERICAN ASSOCIATION FOR CANCER RESEARCH
Bottom Line: Cancer survivors who identify as lesbian, gay, bisexual, transgender, queer, or anything other than straight and cisgender (LGBTQ+) experience more chronic health conditions, disabilities, and other physical and cognitive limitations than non-LGBTQ+ cancer survivors; however, the prevalence of most conditions was highest among transgender or gender non-conforming (TGNC) individuals.
Author: Austin R. Waters, MSPH, a doctoral candidate in health policy and management at the UNC Gillings School of Global Public Health in Chapel Hill, North Carolina and a predoctoral fellow at the Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill
Background:Prior research shows cancer survivors are more likely to have chronic diseases such as diabetes, kidney disease, liver disease, COPD, and heart disease compared to those who have never been diagnosed with cancer. Meanwhile, LGBTQ+ individuals, who represent about 7.1% of the U.S. population, have been found to face health disparities due to stigma and other social determinants of health. But few national samples that differentiate between cisgender and transgender identities have been used to study disparities among LGBTQ+ cancer survivors for chronic health conditions, according to Waters.
“Thinking about how LGBTQ+ cancer survivors’ health compares to non-LGBTQ+ cancer survivors’ is an important question because it begins to disentangle the driving forces behind inequities,” Waters said. “Notably, our analysis revealed that even when controlling for factors such as smoking status and income—factors known to be associated with poor health—LGBTQ+ cancer survivors continued to have higher odds of most chronic health conditions and other limitations.”
How the Study was Conducted: Waters and colleagues used data from the Behavioral Risk Factor Surveillance System (BRFSS), a phone survey system managed by the Centers for Disease Control and Prevention, collected in 2020, 2021, or 2022 from 23 states that administered questionnaires about sexual orientation and gender identity as well as cancer survivorship. Of 40,990 cancer survivors, 1,715 were LGBTQ+, including 638 lesbian or gay individuals, 551 bisexuals, and 458 who identified as another non-heterosexual sexual orientation, such as queer, pansexual, or asexual. Of the 114 TGNC cancer survivors, 38 identified as transgender men, 43 as transgender women, and 33 as gender non-conforming. Overall, the LGBTQ+ cancer survivors were significantly more racially and ethnically diverse, had a lower household income, and were younger both at the time of the survey and at diagnosis of their cancer.
Participants were asked to reply “yes” or “no” if they were “ever told” they had chronic health conditions such as angina or heart disease, asthma, COPD, depressive disorder, kidney disease, stroke, or diabetes as well as disabilities and physical limitations such as hearing disability, vision disability, difficulty walking, difficulty dressing, or difficulty running errands, or cognitive limitations such as serious difficulty concentrating, remembering, or making decisions due to any physical, mental, or emotional condition. Waters and colleagues compared results between LGBTQ+ and non-LGBTQ+ cancer survivors. They also broke the results down by examining TGNC and cisgender lesbian, gay, and bisexual (LGB) cancer survivors in comparison to non-LGBTQ+ cancer survivors and controlled for factors including age, race and ethnicity, smoking status, and education and household income.
Results: When adjusted for age, race and ethnicity, smoking status, and education and household income, LGBTQ+ cancer survivors overall had higher odds ratios of reporting asthma, depressive disorder, kidney disease, stroke, diabetes, vision disabilities, cognitive limitations, difficulty walking, difficulty dressing, and difficulty running errands compared to non-LGBTQ+ cancer survivors. The odds for TGNC cancer survivors, however, were substantially higher for most outcomes compared to non-TGNC survivors, with increased odds ranging from 2.34 to 6.03. The lone exception was depressive disorder. When adjusted for age, TGNC survivors also had a higher prevalence of most health conditions compared to LGB survivors except for depressive disorder as well as cognitive limitations.
Author’s Comments: “Transgender and gender non-conforming individuals are some of the most marginalized people in the LGBTQ+ community and are known to experience barriers to healthcare discrimination, more exclusion, more violence, and other factors than LGB individuals,” Waters said. “Our study highlights the challenges TGNC cancer survivors face and the need for TGNC individuals, as well as all other LGBTQ+ cancer survivors, to be prioritized in care across the continuum.”
Waters said future studies will begin to explore how some of these outcomes, such as depression and cognitive limitations, interplay with financial well-being and the ability to work after cancer to identify ways to better support LGBTQ+ survivors throughout the care process.
“While interventions like LGBTQ+-specific prehabilitation or LGBTQ+ patient navigators may minimize some inequities, ultimately societal and policy changes such as non-discrimination laws, affordable housing, and affordable health care are needed to completely address such disparities,” he said.
Study Limitations: Limitations of this study include a smaller sample of LGBTQ+ individuals in BRFSS compared to national samples, which could indicate that participants were not comfortable disclosing information about sexual orientation or gender identity or that LGBTQ+ individuals were less likely to respond to BRFSS. Additionally, cancer survivorship and sexual and gender identity survey modules are optional for states, which means the experiences of cancer survivors in states that did not elect to include this information are not reflected. The cross-sectional design of the study could have also resulted in a cohort of healthier cancer survivors with less severe disease or treatment. Further, potential recall errors are possible due to the self-reported status of cancer and chronic conditions. The study also lacks information about cancer treatments and pack-years for smokers, which may have further explained the findings.
Funding & Disclosures: Funding for the study was provided by the Cancer Care Quality Training Program at the Lineberger Comprehensive Cancer Center and the National Cancer Institute. Waters declares no conflicts of interest.
Chronic Health Conditions, Disability, and Physical and Cognitive Limitations Among LGBTQ+ Cancer Survivors
ARTICLE PUBLICATION DATE
20-Jun-2024
COI STATEMENT
Funding for the study was provided by the Cancer Care Quality Training Program at the Lineberger Comprehensive Cancer Center and the National Cancer Institute. Waters declares no conflicts of interest.
Surge in fatal opioid overdoses in Ontario shelters, report finds
INSTITUTE FOR CLINICAL EVALUATIVE SCIENCES
Researchers from the Ontario Drug Policy Research Network (ODPRN) at St. Michael’s Hospital and Public Health Ontario analyzed health data from the Office of the Chief Coroner of Ontario and ICES, and found that there were 210 accidental opioid-related toxicity deaths within shelters between January 2018 to May 2022, with the number of deaths more than tripling during the study period (48 before the pandemic versus 162 during the pandemic).
Statistics Canada data shows that the annual number of emergency beds in Ontario grew by only 15% (6,764 to 7,767) between 2018 and 2022.
“People who use Ontario’s shelter system are not only facing housing instability, but also have complex healthcare needs and unique barriers to accessing treatment and harm reduction programs,” says lead author Bisola Hamzat, an epidemiologist with the ODPRN. “This report underscores the disproportionate impact of the opioid crisis on this population.”
Trends in shelters differed from rest of Ontario
When exploring the circumstances surrounding the overdose and death, the data showed that someone was present and able to intervene for only 1 in 10 opioid-related toxicity deaths within shelters, which is lower than in Ontario overall (approximately 1 in 4). However, naloxone was administered most of the time when someone could intervene within shelters.
In the week before death, nearly half of people who died within a shelter had contact with the healthcare system, and in the five years prior to death, almost 80% had a hospital visit related for a mental health diagnosis, which is much higher than 56% of people in Ontario overall.
Several factors remained consistent with the rest of Ontario, including the rise of multiple substances contributing to death (such as benzodiazepines and stimulants), a greater tendency toward smoking and inhalation of drugs, and fentanyl from the unregulated drug supply being the most common driver of deaths.
In a secondary analysis of hotels and motels, the researchers found that opioid-related overdose deaths followed similar patterns to those in shelters but began to decline toward the end of the study period in 2022. The researchers say that the rise in deaths was likely influenced by the rapid expansion of temporary hotel-based shelters early in the COVID-19 pandemic.
Urgent need for improved response to crisis
“Our report highlights the need for improved and expanded harm reduction approaches, overdose response, as well as staff training and supports within shelters,” says co-lead author Tara Gomes, a scientist at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital and ICES, and a principal investigator of the ODPRN.
“Additionally, improved connection to community-based healthcare, treatment programs, and mental health supports are needed for people experiencing homelessness and housing instability, in combination with efforts to address upstream factors such as more accessible housing, income and employment supports, and community-based social supports across the province.”
“The report highlights what we have witnessed the last few years in Timmins. It demonstrates the need for comprehensive support across the spectrum of care for unhoused community members, and of the importance of shelter design and management to ensure services are accessible and safe for people who use drugs. An increase in deaths in the Timmins shelter system over the past two years serves as a stark reminder of this importance,” says Jason Sereda, President, Board of Directors: DIY Community Health Timmins.
The report, “Opioid-related toxicity deaths within Ontario shelters: circumstances of death and prior medication & healthcare use” was published on the ODPRN website.
About St. Michael’s
St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.
About the Ontario Drug Policy Research Network
Established in 2008, the Ontario Drug Policy Research Network (ODPRN) is a research program based out of St. Michael’s Hospital that brings together researchers, people with lived experience, clinicians, and policy-makers to generate evidence to inform effective drug policy development in Ontario.
About Unity Health Toronto
Unity Health Toronto, comprised of Providence Healthcare, St. Joseph’s Health Centre and St. Michael’s Hospital, works to advance the health of everyone in our urban communities and beyond. Our health network serves patients, residents and clients across the full spectrum of care, spanning primary care, secondary community care, tertiary and quaternary care services to post-acute through rehabilitation, palliative care and long-term care, while investing in world-class research and education.
About Public Heath Ontario
Public Health Ontario is a Crown corporation dedicated to protecting and promoting the health of all Ontarians and reducing inequities in health. Public Health Ontario links public health practitioners, front-line health workers and researchers to the best scientific intelligence and knowledge from around the world. For the latest PHO news, follow us on Twitter: @publichealthON.
About ICES
ICES is an independent, not-for-profit research and analytics institute that uses population-based health information to produce knowledge on a broad range of healthcare issues. ICES leads cutting-edge studies and analyses evaluating healthcare policy, delivery, and population outcomes. ICES knowledge is highly regarded in Canada and abroad and is widely used by government, hospitals, planners, and practitioners to make decisions about healthcare delivery and to develop policy. For the latest ICES news, follow us on X, formerly Twitter: @ICESOntario
METHOD OF RESEARCH
Observational study
SUBJECT OF RESEARCH
People
ARTICLE TITLE
Opioid-Related Toxicity Deaths Within Ontario Shelters: Circumstances of Death and Prior Medication & Healthcare Use
ARTICLE PUBLICATION DATE
18-Jun-2024
Sunday, June 23, 2024
How Capitalism really works – Grace Blakeley’s Vulture Capitalism Review
Grace Blakeley’s new book covers not only the scandals but also the structural corruption of capitalism, writes Walden Bello
“Vulture Capitalism is not just a muckraking book, a collection of juicy scandals. Where a New York Times investigation ends is where Grace Blakeley really begins her work, which is to “look at how capitalism really looks.”
Vulture Capitalism is, at one level, a really good read, for the scandals that it brings together in one volume – like the Boeing 737 MAX debacle, where the pursuit of profits, lack of regulation, and corporate cost-cutting culture resulted in two crashes that killed hundreds of people, or the ways most of the $800 million allocated by Washington for the Paycheck Protection Plan (PPP) to enable workers to get through the COVID 19 pandemic actually ended up with their employers. Among the direct or indirect beneficiaries of the PPP were House Speaker Nancy Pelosi’s husband, Senate majority leader Mitch McConnell’s wife, and Representative Marjorie Taylor Greene, the notorious far-right conspiracy theorist. All owned businesses or were part-owners of enterprises that siphoned off PPP dollars meant for workers.
But don’t get fooled by the title, which was probably the bright idea of the publisher’s marketing department. Vulture Capitalism is not just a muckraking book, a collection of juicy scandals. Where a New York Times investigation ends is where Grace Blakeley really begins her work, which is to “look at how capitalism really looks.” For her, the scandals illustrate not just the doings of corrupt individuals or corporations but the larger, deeper, more encompassing structural corruption that is embedded system of capitalism itself.
Market Versus Plan
Blakeley begins her deconstruction of capitalism by taking up the market-versus-planning debate that continues to animate the economics profession. Neoliberals make out state planning as the greatest enemy of the market, the source of all the inefficiencies, distortions, and screw-ups in what would otherwise be a plain-sailing economic journey. Keynesians say the economy must be managed or “planned” to avoid market failures. Blakeley comes out straightforwardly and declares the debate to be largely a false one. Giant corporations can have a major distorting influence on the market, and their size and resources enable them to plan production not only at a corporate but at a social level. Effective control of the market by a few giants allows them to do large-scale planning even as they compete with each other.
Blakeley is refreshingly an unapologetic Marxist, and Marx could not have articulated his insights on the relationship between the market and planning for a contemporary audience better than her:
Capitalism is a system defined by a tension—a dialectic—between markets and planning, in which some actors are better able to exert control over the system than others, but in which no one actor—let alone individual—can control the dynamics of production and exchange entirely. Capitalism is a system that teeters on the knife edge between competition and coordination; this tension is what explains both its adaptability and rigid inequalities.
So, the real conflict is not between markets and planning, but the ends of planning, with accumulating profit being the goal of planning under capitalism, and—in theory at least—the general interest being the aim of socialist planning.
Making Economics Accessible
Blakeley does not introduce a new theory about the way capitalism works. “Most of the ideas discussed in this book are not new,” she tells us right from the beginning. “My argument is constructed based on the analysis of the work of well-known economists, with which academic readers will already be familiar.” She wants to make their ideas accessible to people. Given the well-deserved reputation of orthodox economics being the contemporary equivalent of the medieval theological preoccupation with how many angels could stand on the head of a pin, this task is not to be sneered at, since the alternative that many opt for is conspiracy theory, which is the default mode of analysis in populist circles on both the Left and the Right.
But making economic theories accessible does not mean making their ideas sound simplistic. Even when it comes to economists Blakeley disagrees with, like Friedrich Hayek, Ronald Coase, and Joseph Schumpeter, she is not dismissive and accords their views the critical analysis they deserve.
In the case of Schumpeter, for instance, the notion of the process of “creative destruction” destroying monopolies may have once been a powerful reflection of the dynamics of early twentieth-century capitalism. But it is a theory that has outlived its usefulness, Blakeley contends, because today’s corporations, with their massive assets, can control the process of technological innovation, buying out or stifling the growth of innovative corporations that may threaten their stranglehold on the market.
Blakeley brings aboard not only political economists to help us understand the dynamics of contemporary capitalism. She draws on the insights of the French thinker Michel Foucault to show that neoliberalism not only seeks to shape the economy but the personalities of people as well. Foucault pointed to the creation of the entrepreneurial self or homo economicus who is engaged mainly in terms of maximizing his self-interest. This self-conceptualization has the effect of undermining the possibility of collective action, resulting in the “destruction of society itself, and its replacement with a structured competition between individual human capitals—but on a fundamentally unequal playing field.”
The State under Capitalism
According to neoliberals, the contradiction between market and planning is a manifestation of the larger conflict between the market and state as the principal organizing principle of the economy. The reality is that both the market and the state serve the interest of capital. For the most part, this is not done in a direct, instrumental fashion like extending benefits and perks to individual capitalists, though there is no lack of cases where government contracts or legislation favors particular business interests, as the cases of Boeing and the PPP debacle illustrate. More important is the fact that the state pursues the “general” and “long-run interest” of the capitalist class. Instead of conceiving the state as an instrument of the capitalist class, one must see the state as an institution or set of structured relations that “organize capitalists into a coherent group, conscious of its interests and able to enact them.”
Blakeley is expressing here the view articulated by the French philosopher Louis Althusser, the Greek-French political economist Nicos Poulantzas, and the American political sociologist James O’Connor: that the state is characterized by its “relative autonomy” from economic power relations because its primal role is to stabilize a mode of production that is marked by sharp social contradictions. Perhaps the best conceptualization of this relationship between the political and the economic was provided by O’Connor who saw the relative autonomy of the state as stemming from the tension between its two functions: that is, it has to balance the needs of capital accumulation that increases the profits of the capitalist class and the system’s need for legitimacy to maintain stability. Welfare spending by the state may cut into capital accumulation, but it is necessary to create political stability. This tension gives rise to a stratum of technocrats to manage the tradeoffs between the two primordial drives of capital accumulation and legitimation. Management of this tension, which expressed itself in, among others, the trade-off between inflation and unemployment, was erected into a “science” by the followers of John Maynard Keynes, but this drew the ire of Hayek and his followers, who regarded the Keynesians tinkering with the market as courting economic inefficiency and subverting political freedom.
But Blakeley puts things in perspective. Keynes’s technocrats may engage in social spending but the purpose is to keep the system stable and preserve the class division between those who benefit from the system because they own the means of production and those who are exploited by it despite their being the beneficiaries of some crumbs from social spending. Proponents of reform capitalism were elated by the massive government stimulus programs during the Covid 19 pandemic, but, as in the case of the PPP—where workers received one dollar for every four allocated by the program, with the rest going to business owners like the Trump fanatic Marjorie Taylor Greene—it was the corporate elite and its allied upper middle entrepreneurial and professional strata that cornered most of the benefits of the U.S. government’s fiscal spending and monetary easing policies.
Needed: Another Book
Vulture Capitalism focuses on the class division between owners and workers central to capitalism and its ramifications throughout the system. There are, however, key dimensions of capitalism that Blakely does not tackle but which are central to understanding how it operates. Among these are the social reproduction of the system, where gender inequality and patriarchal oppression play a decisive role, and the way racism stratifies and differentiates the working class, providing what the great sociologist W.E.B. Dubois called a “psychological wage” that coopts white workers into supporting the system. But there is only so much one can pack into as single volume, so it can only be hoped that Blakeley will come out with another volume that will bring to these and related issues the same clearsighted analysis and engaging style she displays in her current book.
Also deserving of further analysis is democratic planning. The final section of the book presents us with examples of exciting possibilities for progressive planning, such as the detailed plan proposed by the workers of Lucas Aerospace Corporation to turn this British arms manufacturer into a producer of socially useful commodities and the innovative “participatory budgeting” formulated by the city government of Porto Alegre that spread to over 250 other cities in Brazil. Blakeley’s discussion of various democratic and socialist initiatives is a valuable complement to the late sociologist Erik Olin Wright’s book Envisioning Real Utopias.
It would have been useful, however, for Blakeley to draw out lessons from the failure of central planning in the Soviet Union and how democratic planning would be different, since many people associate socialist planning with the Soviet Union. Here, it would also be important to contrast Soviet central planning with Chinese planning, which allowed market forces to develop non-strategic sectors of the economy while restricting foreign investment in sectors considered strategic and prioritizing the transfer of technology from transnational corporations to key industries. True, there are some major problems with China’s technocratic development model, but an annual growth rate of 10 percent over 30 years and the radical reduction of poverty to two percent of the population (according to the World Bank) is not to be ignored, even by partisans of democratic planning, especially since, despite its technocratic bias, the “Chinese Model” is finding so many partisans in the Global South. Indeed, what else can one take away from the Biden administration’s adoption of industrial policy in its effort to catch up with China except Washington’s moving away from neoliberalism and the triumph of planning?
Again, you can only pack so many topics into one volume, but I raise these concerns related to democratic planning in the hope that, whether in articles or in books, Grace Blakeley will apply to them the same analytical acuity and clear exposition she has displayed in analyzing class conflict, the market, and the state in Vulture Capitalism.
In the Introduction to this book, Grace Blakeley says her aim is to show that “capitalism is not defined by the presence of free markets, but by the rule of capital; and that socialism is not defined by the dominance of the state over all areas of life, but by true democracy.” How far does she succeed?
The first premise is amply illustrated – from the huge sums of government money thrown at the under-regulated and cost-cutting American aviation industry, to the state bailouts for the US car industry which allowed Ford and others to continue to pay huge dividends to shareholders. Embracing neoliberalism has certainly not resulted in a smaller state: what has changed under its system is who benefits.
Pandemic piñata
The Covid pandemic underlines this. The US’s “Paycheck Protection Program” saw workers receive just $1 out of every $4 distributed through the initiative. The rest went to business and has mostly never been repaid. Many of the companies involved use tax havens to cut their tax bills. Several members of Congress benefited financially from the scheme, as did lobbyists. Meanwhile, millions of workers lost their jobs or were evicted by companies that received public money.
Likewise in the UK, “dozens of large companies that had accessed government support through the Bank of England’s Covid Corporate Financing Facility went on to lay off workers and pay out dividends to shareholders.”
Similarly, all of France’s top companies received some form of government support and paid out 34 billion euros to shareholders while cutting 60,000 jobs around the world. A recent report noted that “public assistance to the private sector now exceeds the amount paid out in social welfare.”
In Australia, a colossal A$12.5 billion of government money was given to companies that were “largely unaffected “ by the pandemic. All over the world, the same picture emerges.
The precedent for such largesse was set during the financial collapse of 2008. Although the crash is often blamed on corporate greed, in reality the investment banks would never have taken the risks they did without the implicit insurance of the central bank, and behind it the government. The crisis’s global dimension “was driven as much by crooked coordination between powerful actors as it was by unrestrained ‘free market’ capitalism. And when the crisis did hit, once again the state stepped in to shield powerful vested interests from the consequences of their own greed.” Prosecutions in its wake were almost unheard of.
Permanent subsidies and rigged rules
Big corporations expect a government bailout in a crisis, but for many industries public subsidies are a permanent state of affairs. The fossil fuel industry gets a staggering $5.9 trillion of public money worldwide.
In the world of exports, ‘free markets’ don’t really explain the dominance of the companies of the Global North over poorer countries, for all the neoliberal rhetoric about free trade. Attempts by the Global South to use industrialization to escape the cycle of dependency enshrined in their export of raw materials, have repeatedly been thwarted by richer countries, whether by direct political interference – as in the US-sponsored coup in Guatemala in the 1950s – or through Western-imposed trade rules. These prevent governments in poorer countries from protecting their fledgling industries against Western imports, themselves often state-subsidised.
Investor-state dispute settlements (ISDSs) are part of this international architecture, dreamed up – and arguably rigged – by the West. When after a lengthy legal battle, the Ecuadorian courts ordered Chevron to pay $9.5 billion in compensation for a massive toxic waste spillage in the country’s rainforest, the company closed all its Ecuadorian operations and launched an ISDS claim, which overturned the judgment. To add insult to injury, the Ecuadorian government was then ordered to pay $800 million of the company’s legal costs.
Blakeley concludes: “ISDSs are part of a growing body of international law that, with the active support of powerful states, has helped to routinise corporate crime on a mass scale.” They can be used to get compensation for companies whenever a government passes a law to discourage smoking or protect the environment. Canada, Mexico and Germany have all been forced to abandon or dilute environmental regulations and pay compensation to corporate polluters in recent years.
And this is just one mechanism that allows Western capital to penetrate overseas markets on unequal terms. The state-assisted exploitation of less developed countries can be violent and barbarous. “One of the first things the US government did with occupied Iraq was sell off state assets en masse. In doing so, the planners of the 2003 US invasion sought to share the spoils of the invasion with US businesses and introduce the disciplining hand of American capital into Iraqi society.”
Blakeley is hardly the first economist to highlight capitalism’s monopolistic tendencies. But what’s new here is how today’s giant companies use their privileged position not just to corner the market or raise prices, but to establish for themselves as much sovereignty as possible. This applies not just internally, for example in the case of Amazon’s ruthless approach to suppressing trade union organisation, but also externally, as with corporations involved internationally in human rights abuses.
In this sense, modern corporations constitute a form of private government, hierarchically centralised and controlled, and often unconstrained by the national laws of weak governments – in poorer countries especially, but not exclusively. And in many fields, such companies are empowered to act using force – from private armies to outsourced contracts for immigration detention and removal activities.
Democratic alternatives
Blakeley’s focus on economic democracy as an expression of nascent socialism is a lot shorter. The 1976 Alternative Plan for Lucas Aerospace was a significant milestone, but it may be overstating its importance to say “it provided inspiration for workers all over the world for the next several decades.” In any case, as one reviewer pointed out, “it was swatted aside by management.”
However, the author does produce some interesting examples of human cooperation and democratic planning: the New South Wales Builders Labourers Federation which refused to allow its labour to be used for harmful purposes; the Union of Farm Workers’ occupation of land in Andalusia after the death of the fascist dictator Franco in 1975; the Brazilian Workers Party’s experiment in participatory budgeting pioneered in Porto Alegre in 1989, which spread to over 250 cities in Brazil and another 1,500 around the world; the People’s Plan in the Indian state of Kerala in 1996; the post-2008 Better Reykjavik initiative in which 40,000 people pitched ideas to improve Iceland’s capital in an online consultation; the Preston Council experiment in Community Wealth Building; and quite a few others. While the levels of genuine popular participation in these experiments vary considerably and most proved short-lived, they do demonstrate the potential of this kind of democratic planning.
For Blakeley, the 1970-3 Popular Unity government in Chile showed that “it is possible to begin building democratic institutions at scale.” However, it also underlined that full control of the state apparatus is vital, to prevent not just capital strikes and flight, but also the possibility of a violent military coup of the kind that toppled Allende.
Democratising society through activity in trade unions and community campaigns falls some way short of this critical goal. The author’s section on “Democratise the state” says nothing about dismantling its repressive apparatus.
Vulture Capitalism is certainly worth reading for its well-argued critique of contemporary capitalism and the historical alternatives it explores. However, as with many books in this vein, how we proceed from the current mess to a more enduring socialist alternative is less clear.
Mike Phipps’ book Don’t Stop Thinking About Tomorrow: The Labour Party after Jeremy Corbyn (OR Books, 2022) can be ordered here.
Friday, June 21, 2024
Bisexual, transgender adults nearly twice as likely to experience loneliness: CDC
Bisexual and transgender adults were more likely to report feeling stressed.
Who makes up the LGBTQ+ community? A look at the growing population The LGBTQ+ community is growing, with an increasing number of people openly identifying as something
Bisexual and transgender adults are more likely to face loneliness than straight and cisgender adults, according to a new Centers for Disease Control and Prevention study published Thursday.
Researchers looked at data from the 2022 Behavioral Risk Factor Surveillance System—which collects information on health risk behaviors, preventive health practices, and health care access—and examined links between loneliness and lack of social and emotional support and mental health variables.
Loneliness was highest among participants who identified as bisexual at 56.7% or transgender, which fell between 56.4% and 63.9% for transgender males, transgender females and transgender non-conforming.
Participants who identified as gay or lesbian also had high shares of loneliness at 41.2% and 44.8%, respectively.
Comparatively, those who identified as straight or cisgender had lower shares of loneliness at 30.3% and 32.1%, respectively, making bisexual and transgender individuals nearly twice as likely to face loneliness, according to the report.
Stock photo Johner Images/Getty Images
"We know that people that are part of the LGBTQ+ community often face isolation but this study is important in that it highlighted the degree that they are isolated compared to people not part of that community," Dr. Adjoa Smalls-Mantey, a New York-based psychiatrist, told ABC News.
Results showed that members of the LGBTQ+ community were more likely to report stress, frequent mental distress and a history of depression.
More than one-third of bisexual adults -- 34.3% -- reported feelings of stress compared to 12.6% of straight adults. Similarly, up to 37.8% of transgender adults reported feelings of stress while just 13.9% of cisgender adults reported the same.
More than half of bisexual adults and transgender adults -- 54.4% and up to 67.2%, respectively -- reported a history of depression. However, just 19.4% of straight adults and 21.4% of cisgender adults reported the same.
Smalls-Mantey said the results of the study did not surprise her because many LGBTQ+ patients she's seen have discussed feeling lonely and isolated or facing rejection.
"They [often] don't feel comfortable coming out to people that are closest to them and they may hide away, not share that part of themselves, not engaged with people that they used to. So sometimes it can be self-imposed," she said.
The study had limitations, including data only coming from 26 states, which may make results generalizable not the entire U.S. adult population. However, the authors said addressing the mental health needs of LGBTQ+ individuals should include services that focus on loneliness and the lack of social and emotional support.
"Providing access to health services that are affirming for sexual and gender minority groups and collecting data to address health inequities might help improve the delivery of culturally competent care," the authors wrote.
Dr. Judith Joseph, a board-certified child, adolescent and adult psychiatrist and clinical assistant professor at NYU Health, told ABC News that she encourages LGBTQ+ individuals to connect with people outside of the home if they don't find the support they need.
"So that could be the person at the store if you go to buy something, rather than just saying. 'Oh, thank you and have a great day,' ask that store clerk, 'So, how's your day going?'" she said. "You can start a conversation with the barista at the coffee shop. These small interactions really help a lot of my clients who have cut off people because they were not accepted by their parents."
