---December 31, 1998---
CHANGES THAT HURT
Politicians in Washington say the economy did well in 1998, citing such facts as these:
** The stock market continues to return phenomenal profits to investors. As 1998 came to a close, the S&P 500 (an average of 500 large firms) had returned an average of 29% per year to investors for the fourth year in a row.[1]
** Executive salaries have never been higher. The NEW YORK TIMES reported recently that Michael Eisner, chairman of the Walt Disney Company, was paid $471.5 million for his work in 1998; Sanford Weill, chairman of Citigroup, received $227.3 million for his year's effort; Eugene Isenberg, chairman of Nabors Industries, received a paycheck of $209.7 million in 1998; Eckhard Peiffer, chairman of Compaq Computer, was paid $192.5 million in 1998; Mark Ruben, chairman of Colgate-Palmolive received $170.6 million; Eli Broad, chairman of Sun America, $149.8 million; Charles Heimbold, chairman of Bristol-Myers Squibb, $146.6 million; General Electric's chairman, John Welch, made do with $138.6 million in 1998. For his efforts (notably unsuccessful) to expand the sale of sugar water worldwide, Summerfield Johnston, Jr., chairman of Coca Cola, received $132.4 million in 1998... so life is good in the executive suites.[2]
For real people doing real work, on the other hand, the situation in 1998 was somewhat different, according to the NEW YORK TIMES:[3]
** Despite strong hiring since 1993 and record-setting low unemployment rates, the number of Americans living in poverty is now just where it was in 1990. People have jobs, but many of those jobs pay poverty wages.
** The middle class has not gained either. Despite a steady expansion of the economy for 8 years, says the TIMES, "While wealthier families enjoyed big gains, particularly from the booming stock market, most households find that their incomes, adjusted for inflation, are no higher today than they were in 1989, when the last expansion ended. Americans, for the most part, have been running in place for 25 years," says the TIMES.
** "As the Federal budget deficit has turned into a surplus, private indebtedness, particularly for consumers, has risen to record levels, giving the economy the sort of boost that Government deficits did in the 1980's.
"But that debt accumulation has come at a cost," says the TIMES. "By one estimate, 5 percent of all the nation's households have filed for bankruptcy protection [during] the last five years."
** In 1990, 16.1% of the non-elderly lacked health insurance coverage. Today the figure has risen to 18.3% -- a 14% increase in the medically uninsured in the past 8 years.
** After adjusting for inflation, the median family income (half earn more, half earn less) was $37,005 in 1997, just about where it was in 1989, and only $1260 higher than it was in 1973. In other words, purchasing power grew 0.14% per year, 1973-1997. The NEW YORK TIMES says, "Many households in the 1960's added more to their incomes in a single year than their counterparts today have added in 25 years. And they did it with one wage earner, not two or three, working fewer hours than the average jobholder does today. Such changes hurt. Even in good times, the long working hours strain family life."[3]
Even conservative, market-oriented economists are now saying that the performance of the '90s economy demonstrates that government action is needed to alleviate poverty and inequality.
Robert Lucas, the Nobel prize winning economist at the University of Chicago, told the TIMES, "We are living through a period of sustained economic growth without inflation, and the unemployment rate has come down to levels I never thought I would see again in the United States. But there are obviously plenty of problems. Poverty and income inequality are two. These are problems that cannot be addressed by the markets. They have to be addressed by specific government programs offering specific solutions," Lucas said.
Unfortunately the so-called "conservatives" (of both parties) who control this Congress have their minds elsewhere.
"A VAST DELUSION OF DENIAL"
The National Cancer Institute (NCI) announced in March[4] that the incidence of cancer (all types combined) decreased during the period 1990-1997 at an annual rate of 0.7%. The cancer death rate (all types combined) also declined during the period, NCI said. This was the first multi-year decline in cancer rates ever reported.
The NCI's upbeat report said incidence rates declined for both males and females and for most ethnic groups. Two exceptions to the trend were black males and Asian and Pacific Islander females; in these two groups, the incidence of cancers (of all types) continued to increase.
Unfortunately all this good news was thrown into question by a study published in the JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION in October, showing that more than 40% of cancers are never diagnosed among people who die in hospitals. Thus, many cancers are never counted in the nation's cancer statistics.[5]
The study, of 1105 autopsies (654 men and 451 women) over a 10-year period, found 250 malignant cancers in the 1105 cadavers but 103 of the 250 cancers (41%) had not been diagnosed prior to autopsy. Furthermore, of the 103 undiagnosed cancers, 57 (or 55%) were the immediate cause of death, so cancer incidence and cancer deaths are both seriously under-reported. The average age of the 1105 cadavers was 48.3 years; the average age of the people who died with an undiagnosed malignancy was 54.3 years.
This study examined autopsies completed during the period 1986-1996 at the Medical Center at New Orleans, a major teaching hospital for medical students at Tulane and Louisiana State universities.
Importantly, the study pointed out that autopsy rates have declined, nationwide, from an average of 50% in the mid-1960s to about 10% today in teaching hospitals and 5% in community hospitals. The "autopsy rate" means the percentage of people dying in a hospital who are autopsied.
If we accept that the average autopsy rate in the U.S. is now somewhere between 10% and 5% (say, 7.5%), then we can calculate that the autopsy rate has declined at an annual rate of 5.2 percent per year for the past 35 years.[5] Since autopsies are needed to discover 40% of the cancers in those who die in hospitals, it seems entirely possible that the decline in the autopsy rate completely explains the recently-reported declines in both cancer incidence and cancer deaths in the U.S. Indeed, one might legitimately ask whether U.S. cancer rates are, in actual fact, continuing to climb steadily, with the trends hidden by misdiagnosis and the absence of autopsies.
Commenting on the Louisiana study, the editor of the JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, George D. Lundberg, says, "The autopsy rates for hospital deaths at nonteaching hospitals nationally now average below 9%; many hospitals have autopsy rates at or near 0% despite many deaths."[6] Dr. Lundberg points out that in 1965 Chicago-area hospitals ("a reasonable sample for urban areas") autopsied 50% of those who died. Now they autopsy about 10%.
Why has the autopsy rate declined? The autopsy has fallen by the wayside, Dr. Lundberg says, because it provides an uncomfortable truth about disease -- a truth that contradicts the medical community's wishful thinking about the ability of high-tech medicine to diagnose illness accurately.
"The autopsy is not dead, but it slumbers deeply, apparently the victim of a vast cultural delusion of denial," Dr. Lundberg says. "It is not exactly a conspiracy of silence or necessarily a massive intentional cover-up, but it is a movement with millions of players, all in complicity for widely varying reasons with the final result of 'do not bother me with the truth' on the sickest patients--the ones who die."
Dr. Lundberg recommends that the government require at least a 30% autopsy rate for any hospital wishing to participate in the Medicare program, and that the Joint Commission on Accreditation of Health Care Organizations require at least a 25% autopsy rate as a condition of hospital accreditation. He says these measures are needed to return to a "hospital culture that values medical truth rather than values hiding it."
GOING AFTER A CORPORATE CHARTER
In September, a coalition of 30 citizens' groups petitioned the Attorney General of California to begin proceedings to revoke the charter of the Unocal Corporation (Union Oil Company of California).[7]
The 127-page petition charged that Unocal has consistently broken the law, devastated the environment in California and around the world, committed hundreds of violations of occupational safety and health regulations, violated human rights in Afghanistan and Burma, and "usurped political power."
California's attorney general, Dan Lundgren, a so-called "conservative," took less than a week to reject the petition in a 3-sentence letter: "we decline to institute legal proceedings at this time," he said without offering any reasons.
The petitioners say they were not surprised and they will continue to try to revoke the charters of recidivist corporations.
To keep abreast of activism about corporations, join the E-mail
list corp-focus. Send E-mail to listproc@essential.org containing
the following information on a single line: subscribe corp-focus
THE NEWS OF 1998, PART 1
It's time for our 1998 wrap-up.
Evidence continued to accumulate during 1998 that your diet can
drastically alter your chances of getting heart disease and
cancer, including breast cancer.
The good news is that eating monounsaturated fats (the kind
found in olive oil, canola oil, and nuts) seems to have a
protective effect against these major diseases.[1] The nuts
highest in monounsaturated fats are hazelnuts, macadamias,
pecans, almonds, pistachios, Brazil nuts, walnuts, and peanuts.
The bad news is that hydrogenated vegetable oil and partially
hydrogenated vegetable oil can have major harmful effects,
increasing your chances of heart attack and cancer, including
breast cancer. It is the trans-fatty acids in hydrogenated
vegetable oils that seem to be the culprits.[2]
Hydrogenated vegetable oils are mainly found in margarine and
vegetable shortening, which in turn are common ingredients of
bread, cookies, crackers, chips, candy bars, and many baked
goods such as doughnuts. Many french fries are now cooked in
hydrogenated vegetable oils. If you eat a normal American diet,
it is hard to avoid large doses of hydrogenated or
partially-hydrogenated vegetable oils, but the evidence is
mounting that they are really bad news and should be avoided
whenever possible.
Alberto Ascherio at the Harvard School of Public Health estimates
that trans-fatty acids are now killing at least 30,000 Americans
every year.[3] Read the label and purchase wisely.
Breast Cancer Prevention
During 1998, evidence continued to accumulate indicating that a
significant portion of female breast cancer is preventable
because it is caused by exposure to cancer-causing agents
(chemicals and radiation -- including hydrogenated vegetable
oils) added intentionally or unintentionally to the environment
and food. (See REHW #571, #572, #573, #574, #575.)
About 182,000 new cases of breast cancer occur in American women
each year, and 46,000 deaths occur annually from the disease.
In the U.S., the occurrence of breast cancer has increased
steadily at the rate of one percent each year for the past 40
years.
The "cancer establishment" -- the cluster of government agencies
and private corporations that controls the flow of cancer
research dollars (see REHW #571, #572) -- is feeling tremendous
pressure to demonstrate a preventive approach to breast cancer.
Accordingly, the National Cancer Institute announced in April
that a drug called tamoxifen had cut the occurrence of new
breast cancers by 45% in a group of 13,388 women who were
thought to have a high probability of getting the disease.[4]
Government regulators acted swiftly and the news media trumpeted
the story. A committee of the U.S. Food and Drug Administration
(FDA) announced in September that it was recommending that the
FDA approve tamoxifen as a drug for "reducing the risk" of
breast cancer. A spokesperson for the FDA told the NEW YORK
TIMES that "potentially tens of millions of women" could be
candidates for tamoxifen treatments at a cost of $80 to $100 per
month per person. Tamoxifen is marketed under the name Nolvadex
by Zeneca, the chemical company that sponsors Breast Cancer
Awareness Month each year. Tamoxifen has been used for breast
cancer chemotherapy for two decades.
The FDA committee carefully avoided using the words "prevent" or
"prevention" because it said tamoxifen may merely delay the
onset of cancers and not actually prevent them; it is too early
to tell. Still, the message from the cancer establishment was
unmistakably one of prevention. The NEW YORK TIMES ran a
front-page story saying tamoxifen's approval by FDA "would be a
milestone in efforts to prevent cancer."[5] Even before the
tamoxifen study was published, the TIMES wrote an editorial
about it, calling tamoxifen "a breast cancer breakthrough."
"For the first time, scientists have demonstrated that breast
cancer can not only be treated but actually prevented," the
TIMES editorial said.[6]
Unfortunately, it is not clear that tamoxifen represents a real
victory for most women. The TIMES acknowledged in its editorial
that, if 1000 women took tamoxifen for 5 years, 17 breast
cancers would be avoided, and bone fractures from osteoporosis
would be reduced; however in the same 1000 women during the 5
years tamoxifen would cause an additional 12 endometrial cancers
(cancers of the lining of the uterus) and at least 10
potentially-fatal blood clots. The published study also
reported an increase in strokes and eye cataracts among those
treated with tamoxifen, compared to a control group.
In its news story, the TIMES reported that the FDA committee
"said it did not yet have enough information to determine which
women were at high enough risk of breast cancer to make the
drug's hazards, including potentially fatal blood clots as well
as cancer of the uterine lining, worth its benefits."
The National Cancer Institute has released a computer "risk
disk," a diskette containing a program intended to help women
judge their risk of getting breast cancer. The diskette is
available in both PC and Macintosh formats; telephone
1-800-4-CANCER or sign up to receive the diskette by mail at
https://cancertrials.nci.nih.gov.
Of course, no one should rely on a computer program -- or on
information they read in the news media -- to make decisions
about their health without consulting a qualified medical
specialist.
Two smaller studies of tamoxifen and breast cancer were
published in September and neither of them showed any benefits
from tamoxifen treatments.[7,8,9] Differences in criteria for
recruiting women into the studies may have produced the
contradictory results. Nevertheless, definitive evidence of
tamoxifen's benefits and dangers must await further study.
In late April, the NEW YORK TIMES reported on two unpublished
studies of a drug called raloxifene. According to the TIMES,
both studies show that raloxifene can reduce a woman's chances
of getting breast cancer without increasing her chances of
getting endometrial cancer. A study is now under way to compare
the effects of raloxifene vs. tamoxifen.[10]
To us, the tamoxifen and raloxifene studies reveal a curious
shift in the cancer establishment's view of "prevention." To
most people, cancer prevention means preventing exposures to
cancer-causing agents. Instead cancer "prevention" is coming to
mean treating a woman with a potent drug year after year, in an
attempt to counteract the effects of her lifelong exposure to
carcinogens. The eagerness of the NEW YORK TIMES to promote
this new view of prevention on page 1, and in its editorial
columns (often relying on preliminary data from unpublished
studies), is, itself, curious and worrisome. It is as if the
cancer establishment has abandoned the struggle to get
carcinogens out of the environment and the nation's food supply,
relying instead on drug treatments. It occurs to us that there
is simply no money to be made in old-style prevention. It is
hard to make a living by reducing women's exposures to radiation
and carcinogenic chemicals. But getting FDA approval for a new
drug can be extremely lucrative even if its benefits hardly
outweigh its dangers.
To us, the most interesting study of 1998 was never reported in
the NEW YORK TIMES or any other of the mass media. In
September, researchers at the University of Birmingham in
England reported exposing pregnant rats to small amounts of
dioxin on the 15th day of pregnancy.[11] [Dioxin is a
highly-toxic, chlorinated byproduct of combustion, incineration,
metal smelting, and the manufacture of many chemicals, including
pesticides. All Americans carry amounts of dioxin in their
bodies that the U.S. Environmental Protection Agency considers
dangerous. (See REHW #390, #391.)]
The female offspring of the dioxin-exposed pregnant rats were
born normal, but by the time they were 7 weeks old, their
mammary glands had developed an unusually high number of
"terminal end buds" -- the places in a breast where breast
cancers develop. Four studies have shown that there is a direct
correlation between the number of terminal ends buds in a breast
and its susceptibility to breast cancer.
The Birmingham researchers went on to expose these young rats
(and a control group) to a well-known carcinogenic chemical
(dimethylbenz[a]anthracene). Sure enough, the dioxin-exposed
young rats developed many more breast cancers than did the
control group.
This elegant study shows that (a) timing of exposure to dioxin
(and presumably to other toxicants) is critical; (b) exposure to
a chemical before birth can predispose an animal to breast
cancer later in life even if the chemical itself is known to
INHIBIT breast cancer when exposure occurs later in life, as is
the case with dioxin; (c) present methods of testing chemicals
for their cancer potential are missing the boat, failing to ask
the right questions about the
There are important opportunities to prevent breast cancers, and
other cancers, in this world, and they do not require us to
expose tens of millions of women to powerful chemotherapy drugs
year after year. They simply require us to develop the
political will to clamp down on the murderous practices of
industrial polluters and the food industry.
Descriptor terms: cancer; breast cancer; prevention; vegetable
oils; hydrogenated vegetable oils; partially hydrogenated
vegetable oils; canola; nuts; diet and health; food safety;
heart disease; mortality statistics; tamoxifen; raloxifene;
endometrial cancer; dioxin; chemotherapy;
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--Peter Montague, Editor
---December 24, 1998---
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