Well, ok, not me specifically. At least not anymore. See back a few weeks ago I worked at small and very noble non-profit organization. Since then I went from Average Joe’s to more of a Globo-Gym. Bills to pay and new opportunities and oh, yeah, my non-profit finding got cut and I went out looking for some job security. The point of this article has nothing to do with that. It has everything to do with me telling you how to spend your hard earned dough this giving season.
Every year I hear people make excuses about not giving money to this or that charity. “I hear only like 30 pennies out of every dollar actually goes to the people I am trying to help. I am not giving money to some corrupt non-profit that is stealing money from kids…and I heard the President of the Red Cross makes like $400K a year! I am not going to pay for some fat cat’s salary!” So let me explain to you why you should give them money anyway.
1. Sorry to break it to you, but you aren’t actually funding the good stuff anyway in the first place.
The thing is, the money that you donate to non-profit organizations is not the money that funds their sexy change-the-world work. Let’s say I run a company that brings mosquito nets to kids in Africa and also gives out vaccinations. Now, to fund these projects, I am going to need TENS of MILLIONS of dollars to buy the nets and the vaccines and pay for offices in Africa and hire staff that I have to train and fly over there and make deals with local governments to let me work there and probably include some training for local workers so that when I leave, the work might continue. If I want to do that, I don’t call you and beg for your spare change to help the poor children. No. I write a giant mother fucking 120 page grant proposal and ask some huge foundation or the federal government or another bigger non-profit to give me the money. And people who give me grant money are just like you, in that they only want to pay for the sexy stuff, like the actual child saving nets, vaccines, and airplane tickets. So who pays for the poor grant writers to ask for the money in the first place? Who pays for the Microsoft Office Suites so we can make some incredible PowerPoint presentation to get the millions of dollars? That is where your measly $35 dollars comes in. THE REASON THAT YOUR DONATIONS ARE SO IMPORTANT IS BECAUSE THEY ARE UNRESTRICTED. I cannot emphasize that enough. Grant money saves the babies. You pay for the grant to be written in an office with lights. You pay the electric bills. But the funders with the grant money won’t do that, their money is restricted not to include this overhead. So without you there is not grant money and the babies all die. So give them your money!
You are not on this chart.
2. Good programs require good people
So here is the most sensitive issue for me. Non-profits are required to disclose a lot of information for the sake of transparency and preventing corruption. Awesome. But sometimes this information includes salary information and lo and behold, us non-profit workers aren’t being paid in the form of thankful hearts and warm handshakes. The entry level workers get entry level salaries, what you expect for a college educated idealist in 2012- about $30K. Enough to start paying off your student loans, as long as you still keep your crappy apartment from college. And for these kids, you are also getting valuable experience (seriously), and you aren’t yet reliable or that valuable, so that is fair. But once you start going up the chain, you see salaries can start going up a pretty steep curve. For the people who are designing and managing and evaluating these programs, they are making a lot more. Enough that they don’t even have to live in a group house anymore! These are the salaries that get people angry. But listen to me here: in order for these programs to be effective and targeted and actually worth spending money on, we need people with a certain set of skills… and those skills are going to cost money. These positions require a Master’s degree at least, if not a PhD and 8-15 years of experience, depending on the project. Because those are the people who write comprehensive and thorough programs that go beyond showing up in the poor part of town and throwing fistfuls of change at the most downtrodden. There is actually a lot of statistics and scientific theory to the art of helping people. My Master’s in Public Health cost $90K for two years of schooling. And if we want anyone to go out and work in the field of improving our miserable lives, then we need to pay them for their work. And give them raises, just like in the real world.
If you want all your non-profits to cap their employee salaries at $40K or whatever you think is reasonable, then these organizations will be run by a bunch of inexperienced 22 year olds. And they all believe that most of our problems can be solved by planting community gardens. If alleviating poverty and feeding the hungry, and improving education opportunities, and growing more food, and providing job training, and giving every child the perfect Christmas was easy, DON’T YOU THINK WE WOULD HAVE DONE THAT ALREADY?? Development requires people with great minds, not just big hearts. And warm feelings and the satisfaction of being a part of the greater good does not pay my student loans.
3. Big jobs require big salaries
This goes double for people running these organizations. If you want to run a multi-national, multi-million dollar organization with thousands or even tens of thousands of employees, you better not fuck it up. These men and women need to be highly experienced, with multiple degrees and accolades and be able to talk to heads of government and a new mother who needs help in the same day. They work EVERY BIT AS HARD AS SOME COMMERCIAL CEO and deserve to get paid for it. When you buy shoes, you don’t go find out how many TENS of MILLIONS of dollars the CEO of the company makes every year by shipping jobs overseas and exploiting child labor do you? Oh, but the person trying to help that child get an education should really be held to a higher standard. THAT IS SOME BACKWARDS SHIT. I think it is ok to give the president of an organization like Red Cross that provides medical care to millions of people in crisis situations deserves like 10% of that CEO’s millions.
4.You are just going to spend it on beer anyway
Not only that, but you are probably going to bring the shitty beer or some bottle of Yellow Tail to the Christmas party then spend all night drinking Glenfiddich. You asshole.
After getting my Masters in Public Health, I did what every post grad-school student does: take a job vaguely in my field that my degree in no way prepared me for. Don’t get me wrong- I am plenty qualified in that I know how to use Microsoft Word and I know the difference between a hospital and an airplane hangar, but apart from that, I spent a long of time this past year learning about my new field: health care quality.
I have learned how to recognize quality health care when I see it. And good health care is always shirtless.
Now, it may sound pretty boring, but there are some pretty sexy and controversial concepts involved and today I would like to talk about my favorite: DEATH PANELS. THE official death panel, made up of 21 doctors, pharma reps, insurance companies, and even patients, is called PCORI or the Patient-Centered Outcomes Research Institute. I am really not sure how they decided that 21 people make up an entire “institute”, because that makes my local Tuesday trivia match practically a university, but we will let that go because that isn’t the controversial part.
PCORI, at best, identifies outdated, costly, and ineffective treatments and suggests that your doctor no longer needlessly perform them on your body. That sounds like a pretty good idea, especially for those with a doctor that still insists on blood-letting and using whiskey instead of anesthetic.
PCORI: Reducing the amount of sawing completed per doctor visit.
But at worst, PCORI comes to your grandma’s house and literally steals her heart medication out of her arthritic hands. The members then return to their “institute”, get into their standard Death Panel robes and drink the blood of the dead.
Ok, that is an exaggeration. The actual worst case scenario is John Grisham’s Rainmaker. Like the poor kid battling leukemia, you will not be able to get a treatment that might work for you because the insurance company considers it to be ineffective or doesn’t have the research to support its use.
So here is the dilemma- insurance companies and hospitals are spending huge amounts of money on treatments that, according to research, don’t work but if we start restricting treatment, then some people will…um…probably die. Statistics, amirite? The reason this hasn’t come up in the past is that unlike most professions, doctors are fairly unregulated and have always made their own decisions about what treatment to give which patients. The only regulations were basically unenforceable recommendations from AMA and law suits in case you really fucked up. Pair that with a system that gives more money for more treatments and we have a healthcare system spinning out of control with costs.
So the answer is we rely on this panel to protect us from antiquated and ineffective treatments and reduce costs but some of us might be denied treatment that we (or our doctor) want to have and might actually save our lives because it works sometimes but not all the time. So it is a win-win! Unless you die!
So that is your health policy lesson for the day. And in all seriousness, I wrote this because I read about this stuff all the time and I really wanted to post this article, but I thought you would dismiss it as a boring policy article. Suckers!
I admit, this might be my nerdiest blog post to date, but I can’t take it anymore. Hopefully, after you read this, never will you ever listen to someone describe an expensive, well-designed, statistically significant study and snub your nose to the results only to reminding the story teller that this study is worthless because “That’s correlation, NOT causation”. People use this statement as some kind of dismissive ‘case-closed’ reaction to rebuke the results of practically every social science study there is (by social science I mean psychology, sociology, and public health). Before we begin, let me explain briefly the difference between the two though I am sure most of you know already, considering how many people I have heard make this arrogant statement.
Not all correlations are meaningful.
Correlation is all about likelihood. Basically when two things are highly correlated, it means one thing is likely to happen when another thing happens. One really simple example is freckles and redheads. Not ALL redheads have freckles, but usually, when you see a redhead, you will also see freckles. Freckles and red hair would be considered highly correlated. Other examples include: Ed Hardy shirts and douchebags, rain and rain boots, office workers and broken dreams, you get the picture. Causation, as you might suspect, is when one thing causes another. The only way you can PROVE CAUSATION is through a randomized controlled study. This is when half the study participants get Treatment A (like medicine) and the other half get Treatment B (like a placebo) and the likelihood of being chosen for one group or another is equal. The treatments are randomly assigned. Ok, so are we all on the same page? Good. Now here is why you are a dick for thinking you are so smart:
THE PEOPLE DESIGNING THE STUDIES ARE ALSO FAMILIAR WITH THESE CONCEPTS. Probably more so than you. In fact, when these academic types do these studies, they recognize that simply measuring freckles and red hair is not very helpful to anyone. Study design is extremely complex. For most any social science degree, you usually have to take at least two courses in study design and one or more in statistics to measure the different designs so you can make tables like the one below. And that is just for your Bachelor’s degree.
For example, if you want to measure what effect a smoking pregnant woman has on her child’s health, you have to measure the pregnancy and smoking and the baby’s health. But you also can measure any other factors you can think of like age, income, obesity, Cheetos intake, ugliness, or whatever else you think could have an effect on the baby’s health besides the mother smoking. I am not going to explain how, but you can rule out these factors when you are doing the study. Because the people designing studies realized how complicated it could be to measure what one thing has to do with another, they can actually account for a lot of other factors in the study design. Then they get to manipulate the information even further through statistical analysis. Statistics are a magical thing. And for a correlation study to be statistically significant, it has to be less than a .001% chance that it is wrong. That is the scientific standard. So shut your mouth. And more importantly…
IT IS OUTRIGHT UNETHICAL TO PROVE CAUSATION IN MOST CASES. Let’s go back to the irresponsible mother, shall we? The things we are measuring in this study are smoking rates and pregnancy and we are suggesting when these happen together, the baby’s health is compromised. The outcome we are measuring is the health of baby. The factors to measure are smoking rates and pregnancy. So in order to find out if smoking really CAUSES health problems in babies, we would have to randomly select a group of women, impregnate all of them , and then force half of them to smoke and refuse to let the other half have any cigarettes. There. Is that the kind of study you want going on, you sick bastard? Because if we can’t do that, then a correlational study will have to do, you fucking Nazi. You see, in many cases, what social scientists study is going to be education levels, parents’ income, child abuse, crack addiction, etc. And none of these things can ethically be manipulated. Which is why they came up with all these crazy statistics and study designs- so we could have some insight into these social constructs.
Forcing moms to smoke is the only real pleasure I get out of this work.
HOW DO YOU KNOW ASS-TO-MOUTH IS BAD? That’s right, correlation. In fact, all epidemiology is correlation. The genius doctors in Outbreak? All they study is correlation. It all started with a man named John Snow. In London back when people thought you got sick from the fog, this guy figured out that drinking shitty water near the sewage drains was causing people to contract cholera and die. He figured this out by making a map of people who died and figured out they almost all lived by this pump that was contaminated with massive amounts of human waste. Before this guy figured out the CORRELATION between drinking poo-water and cholera, humans didn’t even know that diseases could be spread by water. Again, this is correlation and not causation. Yet the medical community has never found the need to randomly select a group of healthy citizens, feed half of them feces, and the other half none, then wait for them to die of cholera. It is so weird that correlation and not causation can help us learn important things about the world we live in.
This is an illustration of cholera from an Iraqi newspaper.
THE LAB AND THE REAL WORLD. Finally, it is important to realize that most of the time, what a social scientist is looking for is how things play out in the real world, not in the lab. We kind of need all these other factors to be there, like job status, history of heart disease, foster homes. Because without them, we would be studying what happens in a lab and it wouldn’t matter in the real world where everything exists together. So when someone is talking about the HIV rates of black men in DC between the ages of 40 and 49 (10%, if you are interested), no one is suggesting that being black gives you HIV 10% of the time. But that provides researchers with a question- why is the HIV rate so high among this group? Was it something that happened in schools when they were still teens? When did the clean needle programs start in DC? Was there some social icon all these men idolized who talked about hating condoms? Who knows? But it is worth studying in order to make some intelligently informed conclusions and provide some insight that might actually help people. We can study how HIV looks in a lab, but it is more important to know how it looks everywhere else.
So you are right. Correlation does not imply causation. But that doesn’t mean that all correlations are worthless. Correlation is just another tool that we all use to understand the world around us. And if you are so adamant that causation studies are the only things that matter, go drink some poo-water and enjoy your cholera. I have a date with John Snow
The other day during my lunch break I was walking down Connecticut Ave. and I saw this guy in a suit. He was about my age, fairly attractive, and he looked really familiar. Now, there was a time in my life where the first thing that would have crossed my mind would be “Hmmm. How do I know this guy? Did we drunkenly make-out at a keg party?” But those days are long gone. My first thoughts were “Hmmm. What conference/meeting did I attend with this guy?” Turns out it was the National Conference in Denver. God I am lame.
Would you like to share an intimate evening discussing marketing strategies for the adoption of improved use of public report websites?
There comes a time - once a year - a woman has to make a certain doctors appointment. It’s pretty much dreaded by every woman. At least I have yet to meet a woman who has said, “I love my yearly physical!
Neither of these people really want to be here.
When I first graduated college I moved back home. I was still covered under my parents insurance for a few more months and not knowing if I would have health insurance before their coverage ran up, I made my yearly appointment. I couldn’t see my regular doctor so I agreed to see Dr. Calico, his assistant.
Looking back, I could feel the awkwardness in the room. She came in and we exchanged pleasantries. I told her how I had just graduated from college and how I was living with my parents. She told me that I had good blood pressure. We were off to a great start. How quickly the time came when she said, “Alright, the gown is on the table. Just put that on and we’ll get you examined and outta here.” And she left the room.
A few minutes later Dr. Calico re-enters and the awkward level in the room rises as we begin.
Seriously, how is this supposed to be comfortable?
Now it’s not unusual for doctors to talk during everything. So I wasn’t too surprised when Dr. Calico started talking. What surprised me was her question:
“So tell me about your parents…”
My immediate thought, as I’m staring at the ceiling waiting for this to be over was, Huh!? What the…my parents? That seems a little inappropriate. But because I’m Minnesotan, I comply.
“Oh, they’re really good. I’m really lucky that we get along so well. We hangout. Go out for walks together. And every Friday and Saturday night at 5:00 is cocktail hour. We have a good time together…” I start trailing off because Dr. Calico has stopped moving and I know the exam isn’t finished. I break my staring contest with the ceiling to look at what is happening thinking, Oh, god what is wrong?
I see Dr. Calico poking her head around my leg with a puzzled look on her face. All she said was, “I said, periods.”
“Oh… OH! I thought… I thought you said PARENTS!” wishing that real life could be edited and we could cut to the scene of me driving away.
“No. I said, tell me about your periods.”
So yes, I told my Doctor I’m really lucky that I get along well with my period. We go on walks together and hangout. We also have cocktails together every Friday and Saturday at 5:00. Where is that kind of relationship in the tampon commercials?
The answer? No, it would not be nice.
So, I don’t like to tell a lot of people this, but in college I was a wanna-be hippie, teetering toward full-blown hippie my sophomore year at the University of Kansas. Apart from drinking cheap whiskey, engaging in Phish vs. String Cheese Incident arguments, and finding all of my own ideas to be incredibly profound and meaningful to the universe, I also used to go barefoot. Not just around the park playing hacky sack, but like, to class and to bars. My reasons were twofold; 1.) If I ever got busted by the fuzz or had to run for my life for some reason, I could do so with or without shoes and 2.) I grew up in the Ozarks and we never had to wear shoes and it really was fairly comfortable for me. Oh yeah, and also to shove my stupid hippie non-conformist views in people’s faces. What can I say? I really thought I was enlightened and the first person to REALLY understand Kerouac. God, hippies are dumb.
I don’t subscribe to any religion, but I am really spiritual, like, with energy.
Anyway, after all these years, I am working in an office now, wearing normal young professional clothes and spending all kinds of money on fancy shoes that look nice, but don’t cause me serious pain. And I have come to a horrible conclusion. I FUCKING HATE WEARING SHOES. All of them. I pretty much abandon heels long ago except for situation where I don’t have to walk much (which is nowhere in DC). I even spend $250 on a pair of “the most comfortable heels ever made” from a store called Comfort One that only sells “comfortable” shoes and guess what? They gave me blisters on the tops of my toes. WHAT?! True, they didn’t hurt my ankles or the balls of my feet, but they still crippled me by the end of the day. Finally, last week, I bought a pair of Crocs. That right, Crocs. Shoes that they don’t even try to make look attractive because their only goal is be comfortable. I got the little mary jane “style” ones. And guess what? Within 15 minutes I had a blister about 2 inches long on the outside of my ankle. By the end of the day, there were two more on the inside of my foot. WTF, CROCS?!
Yeah, I know, it is disgusting.
After I traded beauty for comfort, I still failed and therefor have come to the conclusion that I Fucking Hate Shoes. Unfortunately, I have no more hippie friends to encourage me to just do what feels good and I work in a damn office and walk to work on burning hot asphalt every day so I am at a loss. I am just totally and completely fucked forever. Am I descendent of some pansy royal line? The modern princess and the pea where my fragile lady skin is so sensitive it tears open at the lightest touch? NO. I lived in the middle of the Goddamn Sahel Desert for two years. I am not dainty or sensitive or even that sensitive to pain. But women’s shoes are nothing short of pure torture for me. There are two exceptions. My bright pink Puma sneakers and my Haviana flip flops. Neither of which are particularly appropriate for almost any given situation.
Where would I ever wear these? I don’t care, I love them.
I really thought that at the beginning of the summer, I could get get all these blisters, then they would heal, then I would have some kind of robo-foot that is safe from future blisters. I was wrong. I thought I could train my feet, or break in my shoes, or get used to the pain or something but no. I was WRONG. So here are my options: become a hippie again or wear socks with sandals. AKA joins camps that completely alienate me from society. In fact, maybe I am still a hippie, because I am starting to believe that there is a conspiracy against women in America to keep them down and physically disabled. And I am pretty sure the Free Masons are involved.
* Side Note by NYC Blogger: We (myself & friends) were very relieved when DC Blogger finally “caved” and started wearing shoes again. Why? Because when someones walks around all day, everyday barefoot, their feet get fucking disgusting and then they like to rest them on the furniture. Just the memory of those charred black feet resting on a throw pillow, where my face was just moments before, makes me cringe. We finally convinced her to wear shoes, not by letting her know it grossed everyone out immeasurably, but because we were concerned for her SAFETY, “you know, there’s broken glass out there and you could really hurt yourself if you stepped on something”. We didn’t want to hurt her feelings or undermine her life’s philosophy - we were her friends. But thank the gods she’s wearing shoes, even if they’re crocs.
** Side Note by DCBlogger. Sometimes I got glass and nails or thumb tacks in my feet but it only made them stronger. Glass can come out immediately, but blisters last seemingly forever. Barefoot Revolution!
“Never ride your bike with open palms, a bee WILL sting you”
Thank you DC Blogger, I feel I am a more well-rounded adult because I took this advice to heart.
- NYC Blogger