One small data study, a few small surprises

Early this summer, I wrote a column about Red Deer's project to count the users of our trails network in certain areas. I suggested that people would be surprised by the numbers, perhaps even me.

Well, I have to admit I am surprised. While the city parks department seems pleased that there are more than 200,000 crossings a year at the CPR pedestrian/bike bridge (based on usage in the three-month study), I actually thought the numbers would be double or triple that — or more.

I had no doubt that the Three Mile Bend off-leash dog park would rank highly on user counts, as would Bower Ponds — which always seems to be busy. And it should surprise no one that trail usage at McKenzie Trails — as pretty a park as any in this town — would count fairly low (more on that later).

It's just that, as good as the numbers appear for trails usage in the city, I expected more.

I really thought that there would be points on our trails network that would peak above 1,000 crossings on some days. The CPR Bridge, for instance, is a major transportation route for non-motorized traffic accessing our city centre, and it was declared “busy” with an average of 560 crossings a day.

(Again with the due notice: I serve on the board of the Central Alberta Regional Trails Society, and am president of Red Deer Association for Bicycle Commuting. My bias is clear and unapologetic, as is my interest in this topic.)

City parks superintendent Trevor Poth reported one interesting item the study uncovered: trails usage is an everyday occurrence, not just a weekend or good-weather thing. There are peaks and surges in places, of course, but the study found that overall, we use our trails pretty well the same every day.

This is probably the most important finding of the trails count study so far. Red Deer rightly regards our trails network that links our city parks as a recreational and active-living gem. It is that, and more.

Our trails system is also a transportation corridor for people moving through the city to take care of the necessary tasks of their daily lives. As such, it is woefully incomplete and will never achieve its potential until it is made so.

We are all very sensitive to the costs of things in local government. Most of all, in no other area than in sustainable non-car transportation.

So, as Poth noted in his talk with Advocate reporter Crystal Rhyno this week, knowing the numbers is vital to planning our spending for repairs, upgrades and expansion of our trails network.

But I would caution planners that trails usage is not a popularity contest. The CPR Bridge is busy because it is useful. The trail to the McKenzie Recreation Area is less busy because it is less useful.

McKenzie Trails is an end-of-the-road destination. Unless you are willing to climb almost straight up the river escarpment trail to reach Garden Heights, there is no place else to go.

Bower Ponds is a nice destination, too, but from there you can easily reach Riverside Meadows, Oriole Park, Fairview, Heritage Ranch, West Park and downtown without having to reverse course. No knock against McKenzie Trails; the numbers there merely reflect usage of visitors for one purpose: to enjoy the park.

A far larger number of people pass the electronic counters at Bower Ponds because they are going somewhere. The same applies to the Devonian Trails near Sunnybrook. I suggest that trail is a transportation link as much or more than anything else — and the numbers reflect that.

Here's a point I want to highlight from this study so far: in the absence of separated bike lanes to make non-car transportation pleasant and safe, our so-called recreational trails are carrying people who choose not to drive to every errand they conduct in their daily lives. Therefor, in order to be useful, the trails need to be linked and networked to the places where people want to go.

In many places, they are not. Along the south bank of the river past the Riverlands construction project the trail is closed and will be for quite some time.

There is a trail in the long-term plan for access from the new roundabout on 67^th Street to the Riverbend Recreation Area, as well as all the new housing developments to the south and east. But it's not complete now, and therefor the existing trails cannot be fully used.

Access from the city's north side across 67^th Street to the whole of the rest of the city is extremely restricted and I see no priority solutions for that in the city's long-term plans. It's a barrier many would-be cyclists and pedestrians choose not to cross.

All these things affect usage, which is not accounted for (yet) by the city's otherwise very good study.

In 2013, filmmaker Andreas Mol Dalsgaard produced a watershed documentary titled The Human Scale. You can find it on Netflix and it's worth a watch. It's premise, proved by actual experience in several cities, is that planners hugely underestimate the benefits of trails and bike lanes — when they are networked to places where people actually want to go in their daily lives.

That, I think, is the biggest surprise when we continue our study that we have yet to discover.

Death versus dollars and a cheap sub sandwich

Another week, another release of scientific studies calculating the risk of everyday activities that might kill you. This week, we have two: one regards for-profit nursing homes, and another looks at pastrami sandwiches.

It is so easy to inappropriately condense years of study over thousands of complex cases into a catchy headline. I'm often tempted to ask for a meta-study on the relationship between steady consumption of news reports regarding everyday health risks and depression.

There is a fair amount of salt to be taken with these kinds of news reports — which itself is probably not good for your health.

Especially, we are told, when it comes to salted or cured meats. The France-based International Agency for Research on Cancer now rates processed meats (hot dogs, sausages, smoked meats or fermented meats) as Group 1 carcinogens.

What's a Group 1 carcinogen? It is something that exhibits a strong link to cancer that can be proven in studies, but not the actual risk of how much cancer it causes. Tobacco is in Group 1, as are diesel fumes. So, if you're a long-haul trucker who smokes and eats ham sandwiches every day, that can't be good.

It's not good, but you have to compare risks — and that's what these studies do not really tell you. For each 50 grams of processed meats that you would eat daily, says the IARC, your risk of colorectal cancer rises by 18 per cent.

But what's the risk of getting colorectal cancer generally per 100,000 people? Well, it's the second highest cause of cancer death in the U.S.; 10 deaths per 100,000, according the list on Wikipedia. Bad, but way down the list of all causes of death. You are almost twice as likely to die in a car accident, for instance (19.1 deaths per 100,00). But who is out there striking fear in your heart about that?

If you want to fear anything, watch out for cardiovascular disease and heart disease, which together kill 385 people per 100,000 per year. Get your exercise, that's all I can say.

So, an 18-per-cent increase in risk, if you eat one hefty sub sandwich a day? People live with a lot worse things, smoking for one.

Red meat is a Group 2a cancer risk, along with glyphosphate (a widely-used weed killer) and diazinon (a widely-used bug killer). That means the evidentiary link between these things and cancer is pretty good, but not as strong as the link between tobacco or salami and cancer.

Is any of this going to change your behaviour? Personally, I love a smoked-meat sandwich once in a while.

Here's another study which might give you pause, along with government policy-makers. And here's another research institute with a long name: the Institute for Clinical Evaluative Sciences.

They found that mortality and instances of hospitalization within one year of being admitted to a for-profit long-term care facility is statistically higher than if you are admitted to one run by the government or a charity.

To boil the risk down to a headline: if you assign a value of 1 to the risk of death or hospitalization in a non-profit seniors care facility in Ontario, the risk hazard in a for-profit institution is 1.10 for mortality and 1.25 for hospitalization after one year.

Why in Ontario? Because of the laws. In Ontario, all core care is paid equally in seniors long-term care residences, whether it is for-profit or not. It is illegal to charge people more for core care services just to make a profit .

That eliminates a major variable in comparing outcomes of care. Of the 640 care facilities compared in this study, 60 per cent were for-profit, and 40 per cent were not. This compares well with both the U.S. and U.K., where the majority of long-term care beds are in for-profit institutions.

The study followed 53,739 admissions from 2010-2012, and examined outcomes at 3 months, 6 months and 1 year. They recorded who died, went to the hospital, or were transferred someplace else (like hospice — in which cases they were not part of follow-up study).

In my mind, the differences are statistically there, but I would still take the first bed locally available, when my need arose.

This is more a thing for government and care advocates. Tax-paid health care costs for seniors are rising. If there is a 25-per-cent less chance of needing to pay for someone's hospitalization when a government opts for government-run facilities versus allowing more for-profit investment in that area, it makes a strong case to do that.

Strong enough to do the math anyway. If the extra cost risk for health care is so many millions, is it still cheaper to have for-profit investors to put so many millions into long-term care beds, which taxpayers (and seniors themselves) pay back over a long period of time?

When we ask governments to absolutely balance their budgets each year, this is the kind of math that they have to do.

Perhaps they might keep the ham and hot dogs lower on the menus. But when I'm in my 90s, I'm gonna say the heck with it and bring me a pizza.

Anything but the will of the majority: democracy failed us under first-past-the-post

Canada's longest election campaign in a century has produced a first-ever result: a third-place party vaulting to a landslide win. As Western provinces will appreciate, this was not exactly the will of the electorate.

But that's political irony for you. As Eastern provinces would appreciate, the previous three federal elections did not exactly reflect the will of the people, either. And before that, the West spent a long time on the outside looking in.

In fact, in living memory, no federal election has ever fully reflected the will of the majority of Canadian voters.

Fortunately, that record has a good chance of ending soon. In this election, about 62 per cent of Canadian voters cast their ballot for a party that had promised immediate electoral reform as part of their platform. (That would be all the parties, minus the Tories, who reject any such notion and the Bloc which was silent on the matter.)

With just 39.5 per cent of the popular vote, the Liberal Party and leader Justin Trudeau secured 184 seats in an expanded Parliament of 338 seats. Proportionally, that's close enough to the result gained by the Conservatives under Stephen Harper last time around.

In each case, more than 60 per cent of Canadians had voted for something other than the party that won. In Canada we call that democracy, and it generally serves the incumbents pretty well.

In the hours before polls closed in Quebec, Ontario and the prairie provinces, pundits had a lot of time to watch the Red Wave gather in Newfoundland and the maritime provinces. A total Liberal victory in every riding, with popular support around 70 per cent. Anyone would call a result like that a democratic return.

The pundits and party reps around the shiny glass tables on the TV networks bantered at length whether Liberal support in the rest of Canada would prove a mile wide and an inch deep. They suggested solid core support in other parties in many ridings might rally over widespread but soft support for the Liberals.

Well, we found otherwise, didn't we? In Canada, an inch deep is all you need to form a majority government.

In the campaign, Trudeau repeated whenever asked that the 2015 election “will be the last conducted under the first-past-the-post system.” If his promises are to be fulfilled, look for an all-party committee to recommend changes to our election system within 18 months.

NDP leader Thomas Mulcair — whose support is deep but not very wide — lost the great gains made from wide-but-shallow support for Jack Layton in the previous election. Mulcair favours straight-out adoption of proportional representation, which would have given his party 66 seats this time around, instead of 43.

But even that would have been a drop from the 71 MPs the NDP would have elected in the last Parliament, if seats had been allocated according to national popular vote.

The Green Party under Elizabeth May are electoral reformers in a hurry. Under proportional representation, there would be 11 Green MPs in Ottawa this time around, instead of just one. She wants an all-party committee to come up with a full-blown report on electoral reform, including draft legislation, within a year.

My political acumen may be neither deep nor wide. But my impression of the campaign was that Canadians were not in the mood to re-elect a fourth-term Conservative government. No electorate in our history has ever elected four straight governments of the same party. Three terms mark the best-before date of any leader.

Just the same, the alternatives were never straightforward. My reading suggested Canadians were convinced that a minority government was the most likely outcome, and if so, a Liberal minority, backed by the NDP was the better choice. That's how I read it, anyway.

So it seems that enough people wanted a Liberal minority, enough in fact to give them a majority. Just a few ticks under 40 per cent of voters cleared the mark.

Under any type of reform, Canada would probably have a Liberal minority government today, instead of a majority. The dynamic in the next Parliament would have been different.

There would have been less “strategic” voting. People could vote for the party platform they preferred, knowing their wishes would be fully represented no matter who their local MP might be.

That's in contrast to what we saw: people voting against a party whose leader had worn out his welcome, even among many in his own rank-and-file.

Knowing that a new Parliament would require some co-operation between parties would also have tempered the personal attacks and base negativity of the campaign we've just endured.

And I think Canadians would have gotten more exactly what they voted for — which is a better democracy.

Angus Deaton wins a devil of a Nobel

When I read that Angus Deaton, a professor at Princeton University, had won this year's Nobel Prize in Economics for his work studying poverty in developing countries, I was intrigued. What did the world learn from his studies?

Basically, we've learned that the world is a better place today than it used to be. Poverty is down, life expectancies are up, disease is down and fewer families are watching their children die soon after birth.

But how do we apply what Deaton has discovered? Well, the devil is in the details, and Deaton apparently has a great love of detail. Excruciating detail, explained in mathematics.

I noodled around a bit, trying to find some of that detail explained in plain English. Much of my information (and subsequent speculation) comes from the Nobel committee itself, which published two surveys of Deaton's work: one for economists, and one for the rest of us. You can find the general summary at: http://www.nobelprize.org/nobel_prizes/economic-sciences/laureates/2015/popular-economicsciences2015.pdf

Poverty, says Deaton, is in how you measure it. Put more accurately, the result of policies designed to improve the lives of the poor cannot be predicted by the macroeconomic theories that we've previously relied upon. Deaton suggests that using the wrong tools to measure poverty has over-stated the numbers of people living below the poverty line by as much as half a billion people.

Instead of studying big-picture measures like GDP to assess whether governments are doing the right things by their people, Deaton employed large numbers of house-to-house surveys and compared patterns of household consumption over long periods of time.

He found the greatest devil that tortures economics: that people are not always rational. He found that it's better to measure and predict things by looking at the behaviour of individuals upward, than to predict the behaviour of whole populations from the top down.

His theories (and the basis of his Nobel award) are contained in theory called The Almost Ideal Demand System, which I can assure you I have not studied.

Here's a Deatonian issue that might apply in Alberta: would the poor be better off in Alberta, and incomes less unequal if we had a provincial sales tax?

My personal bias leads me to say yes. Taxes on consumption tend to equalize after-tax incomes because the rich can consume so much more. They also tend to stabilize government revenue, which leads to more predictable funding of services like schools, etc., which benefits people on low incomes.

Ah, but then there's the devil of irrational behaviour. Deaton's detailed questionnaires of families helped him formulate mathematical equations that would tell a government just how much a one-point adjustment in a sales tax (or sales tax cash rebate) would affect purchases of food, clothing or other goods by poor families, by changing that family's after-tax income.

These equations predict who wins and who loses — and by how much — with each change.

In fact he has separate equations for each type of consumer commodity, which I am quite sure our federal government did not apply when it decided to lower Canada's GST by two points.

Previous economic theories suggest people generally spend less and save more when they expect their incomes to drop. But we've found in Canada that people are entering lower-income retirement in record-setting levels of debt. Irrational, but true.

What, if anything, should governments do to encourage more saving? Call professor Deaton, I guess.

One surprising thing I learned is that Deaton is no great fan of international economic aid from rich countries to poor ones.

He says the practice undermines the ability of countries to grow their economies, and that if we feel we ought to do something to help the poor in those countries the something we should do is to stop giving them aid.

As well, Deaton says the fact that family incomes grow unequally in developing countries is not necessarily a bad thing. Inequality, he says, is a consequence of progress, proof that progress exists.

No doubt someone is hard at work writing a movie script about all this, the way they did for John Forbes Nash Jr. who developed Game Theory and inspired the movie A Beautiful Mind.

I expect such a movie would have to involve a conversation with the devil of details.

Follow Greg Neiman's blog at Readersadvocate.blogspot.ca

Huge savings to be found in health and the justice systems

A recent letter to the editor in the Advocate has suggested it's a bad idea to spend public money on a provincial wellness initiative, when there are so many non-profits able to handle that portfolio for the province, at a much cheaper cost.

Since the new Alberta government is about to release its first provincial budget, I thought I might point out a local community wellness project to remind us that community wellness has a pretty high return on investment. And that if we want to maximize profits from these investments, it makes sense to “go big” and have them cover the entire province.

I recently attended the annual general meeting for the Red Deer Canadian Mental Health Association. When you volunteer, you're a member (my wife also works for CMHA).

One of the duties performed at an AGM is to recognize exemplary work within the organization and hand out awards. The first award given this year was to Red Deer's Police and Crisis Team (PACT).

Actually, Red Deer has two such teams, and there is a push on to both create a third Red Deer team, and also to demonstrate the need for a regional team outside the city. That's if the organizers can find the money (which in this case means investment from Alberta Health Services).

A PACT team consists of two members: a full-time RCMP member and a registered nurse with mental health training. They are called to cases where mental health issues are involved, or where people under significant stress may harm themselves or others.

The police staff are paid out of the general policing budget. It's a full-time placement — they have no outside policing duties. Red Deer's Primary Care Network has found budget for the nursing side. So, as far as spending for mental health services goes, it's a pretty cheap deal.

The problem is that the PACT teams are so successful, a third team needs to be added. Red Deer RCMP have already said they would find staff budget internally for a third officer, but PCN cannot expand the program with their current funding.

More, the success of the program has extended beyond city's RCMP jurisdiction. Red Deer police cannot fund a regional program, but depression, anxiety, suicide and other mental illnesses do not respect city boundaries.

We were told that last year, the Red Deer PACT teams attended to 805 cases. Where previously they would generally have ended in arrest or a forced visit to the hospital emergency ward, in 740 cases — 92 per cent — people were instead put in touch with local support services instead.

The savings to taxpayers in both our health and the justice systems are huge.

Without PACT, when a situation comes to the point where police are called, arrest or a trip to emergency ward are pretty well the only two possible outcomes. Police are not trained to make mental health assessments and are not trained to bring people to other services.

I was able to find that a visit to an Alberta emergency ward costs taxpayers on average between $150 and $225 per visit. When police take people to the emergency ward, they must stay with their charges until medical staff can take over responsibility for them. The wait can last hours, adding to the cost to taxpayers, and taking police away from other duties.

Anyone with a calculator can make a rough calculation of the cost of 700 or so emergency ward visits, and only guess at the staff costs for the hours spent by police sitting, waiting.

I was also able to find that in 2004/05 there were 40,000 emergency visits for mental health reasons in Alberta. Another provincial site posted that 12-15 per cent of all health disorders are for mental health.

Yet, in much of the province, a mental health crisis is dealt with by police alone, and people who are sick end up in the criminal justice system. That's what police are trained to do with someone who's at risk of harm to themselves or others.

The tax cost of this is nearly impossible to calculate, not just the cost to taxpayers of this misuse of the justice system, but of the lost opportunities for well-being of people who shouldn't have gone into the justice system in the first place.

The current practice criminalizes mental illness, delays treatment and raises needless fears in the community that people who are mentally ill are dangerous. We've seen these fears played up even in the current federal election campaign.

The cost of all this can easily be prevented, if we invest in a cross-provincial PACT program. Locally, we could at least free up more emergency ward time for local patients, and clear court time for other cases, if we expanded this wellness program here.

But it's not the job of non-profits to do this on their own. They must be funded. With tax dollars. And if we want to save hundreds of millions we now spend in Alberta's emergency wards, on jails, courts and police time, a few million spent on a provincial wellness program isn't such a bad idea at all.

Freer trade and poverty reduction may be the same story

The close timing of two of the world’s most important news stories of the year seems almost too good to be coincidental. I believe they are connected and hold lessons for Canada.

In the past few days, 12 nations — including Canada — signed an agreement to form the Trans Pacific Trade Partnership, creating the second largest trading bloc in the world (after the European Union). Trade barriers will fall in the coming years, opening markets to global competition that till now have been been protected by restrictive tariffs.

Also in the past few days, the World Bank announced that for the first time in history, the number of people living in extreme poverty is expected to drop below 10 per cent of total world population. Their report flags some significant numbers: in 1990, more than a third of the world subsisted on less than US $1.25 a day; today, a new accounting system adjusted the rate to $1.90/day, but while global population has risen, the portion living below that line has dropped from the 1990 level of 1.95 billion people, to 702 million today.

Jim Yong Kim, president of the World Bank Group calls it the “best story in the world today.” In 2013, shortly after Kim became president, the World Bank adopted two goals. One was the eradication of extreme poverty by 2030; the other was to boost the rate of the globe’s shared wealth, by raising the incomes of the world’s bottom 40 per cent.

Where were the greatest gains made? In two nations that were taking away a lot of North American manufacturing jobs: China and India. Where were the poorest gains made? In countries that have less manufacturing and which are mostly reliant on natural resource exports.

Makes you think, doesn’t it?

My reading of the coverage of this report finds little or no mention of their second goal, but I can’t help imagining that increasing the wages of the bottom half of workers created conditions that elevated the incomes of the poorest of the poor. This wasn’t charity alone, it’s business.

Consider India, which still has the world’s largest population living on less than $1.90 a day. The Times of India had trouble reporting the World Bank’s story because of this. Which is more significant: that the greatest gains since 1990 in eliminating extreme poverty were made in India (the lowest population percentage of countries with the largest numbers of very poor people), but while it brought millions out of extreme poverty, India just happens to have a very large population. So the number of those in extreme poverty in India is still the lion’s share of the Asian group of countries.

Or China. In 1990, the Chinese tiger was just discovering its potential. Two decades since of hyper-fast urbanization has fed an army of newly-educated workers into their factories to produce stuff at a fraction of the wages being paid in the wealthy West.

Good news? Bad news? Depends on whether you were dirt poor in China before you got a job making auto parts, or were paying down a big mortgage in Canada before you got laid off doing the same thing.

My point is we need perspective. Canada lost jobs and a fair amount of economic potential when the BRICs stole away much of our manufacturing sector. But if we only look at our losses, we miss a bigger picture.

The world is a better place with fewer really poor people in it. Rather than moaning about businesses relocating their manufacturing to low-wage India, China or other developing countries, we may need to adjust our sights as to what our own income expectations are. Our middle-class salad days may be behind us — we need to start competing again.

One way to do that is to level the playing field between nations in how we conduct international trade. Developing countries discovered that a good way to treat wealthy neighbours was to sell them stuff — including their labour.

If wealth were more evenly distributed, perhaps we could begin to do the same.