Friday Fun: Rush LImbaugh and Camilla Paglia in The Same Earful!

Content warning:  If you listen to this audio your ears will detach, circle the whole globe and reattach themselves on the wrong sides of your head.  Upside-down and backwards.

Any logical parts of your brain will explode in blue smoke, after trying to make some sense out of the garbled word-salad and the odd juxtapositions and the utter total impression that you are consuming the equivalent of a scraped-from-the-kitchen-floor gourmet dinner, prepared by a mad-hatter-chef.  Well, two of those.

Finally, the assertion that Paglia is a feminist makes you scream so loud that your vocal cords will turn into a very small British pork pie.

But other than that, go ahead and have a good listening experience!

No children? You're Gonna Die Young!

Here's an interesting Danish study and its popularizations for you!  When I was going through several of the popular media summaries I had to go and bang my head against the garage door, to get some relief from the inanity of much of it.  To see why:

Let's start with some of those popularizations:

First:

By Maggie Fox, NBC News
They may feel like they are going to be the death of you, but having kids may not take years off your life. In fact, a study published Thursday shows that people who tried but failed to have children are two to four times more likely to die young than parents.
The startling findings support other research that shows childless couples don’t live as long as parents. They also add another piece to the puzzle: This one looks at people who either adopted children, or had them through fertility treatments.

Second:

People who have never had children are more likely to die prematurely and develop mental problems than those who have had children, researchers from Aarhus University, Denmark, reported in the Journal of Epidemiology and Community Health.

The authors added that the link between shorter lifespans, mental health and childlessness is particularly noticeable among women.

The belief that having children may shorten our lives is a myth, the researchers explained, as the reverse seems to be the case.

Third:

Dec. 5, 2012 -- Many parents might good-naturedly scoff at the notion, but a new study shows that being a parent may help you live longer.
Danish researchers compared men and women who had children with those who did not to see if the childless were more likely to die early.
They were. "Childless couples are at increased risk of dying early of all causes," says researcher Esben Agerbo, PhD, associate professor at Aarhus University in Aarhus, Denmark.
The benefit of parenthood on longevity was stronger for women than for men, says Agerbo.
The study findings echo those of previous research. It is published in the Journal of Epidemiology and Community Health.

Look at those url codes in more detail!  The-secret-to-a-long-life-children!  Having-kids-doesn't-kill-you-after-all!   And note how we are offered  a causality going like this:

having children > you live longer

Not all the popularizations I read were that bad.  (That second one above is a real humdinger, making false claims, as is the whole piece it comes from).  But some that stuck closer to the abstract about the study included interesting little jabs and pushes which may be even worse.  Here's the now-with-more conservatism BBC website on the study:

Involuntary childlessness may increase the likelihood of early death, the Journal of Epidemiology and Community Health reports.
The Danish study looked at more than 21,000 couples seeking IVF treatment.
They found women who were unsuccessful in having a child were four times more likely to die prematurely than women who had been mothers.
Critics stress that the risk of early death was low - with just 316 people in total dying over the 11 year study.
The authors of the paper also point out that their research suggests a link between childlessness and premature death and not a cause. They wrote: "Mindful that association is not the same thing as causation, our results suggest that the mortality rates are higher in the childless."
The researchers based their findings on data obtained from various population registers in Denmark on births, deaths and IVF procedures from 1994 to 2005.
During this time 21,276 childless couples registered for IVF treatment, 15,149 children were born and a total of 96 women and 220 men died.
Four times more likely
After analysis, the results suggested having a child cut the risk of early death, particularly among women.

That's the beginning of their piece.  A little bit later down it notes that mortality rate among the men was twice as high in the group which failed to have a baby.   This makes it certain that we see the problem as one of being a mother or not.   Then note this sentence in the above quote:

They found women who were unsuccessful in having a child were four times more likely to die prematurely than women who had been mothers.

Very sloppy writing, given that the whole sample in this study consisted of couples who sought fertility treatments.  A better way of writing it would be:

They found women who were unsuccessful in having a child were four times more likely to die prematurely than women who were unsuccessful in that endeavor.

If there is a propaganda story here it is one which suggests that women would live longer if only they had children. 

That's enough about the popularizations, though I would like to point out that even though the BBC asked other experts for their opinions, those experts pretty clearly were not aware of the actual piece of research they were asked to comment.  I base this on the fluffiness of their comments.

Then to the study itself. 

 Or to its abstract because I haven't obtained access to the study:

Background Childlessness increases the risk of premature mortality and psychiatric illness. These results might, however, be confounded by factors that affect both the chance of parenthood as well as the risk of premature death and psychiatric illness. 

Methods Using population-based health and social registers, we conducted a follow-up study of 21 276 childless couples in in vitro fertility treatment. 

Results The crude death rate ratio in women who become mothers to a biological child is 0.25 (95% CI 0.16 to 0.39). In other words, childless women experience a fourfold higher rate of death, that is, 4.02 (2.56 to 6.31). The analogous death rate in fathers is approximately halved: 0.51 (0.39 to 0.68) and 0.55 (0.32 to 0.96) associated with having a biological child and an adopted child, respectively. With substance use disorders being the exception, none of the crude rates of psychiatric illness in parents of a biological child were statistically distinguishable from the rates in the childless. These findings were slightly confounded by age, calendar year, income, education, somatic comorbidity and marital breakup. 

Conclusions Mindful that association is not causation, our results suggest that the mortality rates are higher in the childless. Rates of psychiatric illness do not appear to vary with childlessness, but the rate of psychiatric illness in parents who adopt is decreased.

With all due respect and understanding for those who write in a foreign language, that is an awfully poorly written abstract.   The first three sentences of the Results section must have something missing (that "in other words" bit)  and the "analogous" term doesn't refer to anything in what goes before.

I couldn't get very far with the abstract alone.  But what I have been able to gather from various sources is that the study looked at the death rates among 21 276 couples who had resorted to in vitro fertility treatments.   Here's one popularization on the data and study design:

In the study, which was published in the Journal of Epidemiology and Community Health, the scientists from Aarhus University looked at data from more than 21,000 couples who underwent IVF treatment between 1994 and 2005. They saw that 15,000 children were born and almost 1,600 were adopted during that time period. Unfortunately, 96 women and 200 men who were included in the study died.
Statistically, the death rate for childless women was four times as high as those who gave birth to their own child, while childless men were twice as likely to meet an early death. These findings caused the researchers to conclude that a couple who cannot conceive is at increased risk of early death.
Study co-author Esben Agerbo, an associate professor at Aarhus University in Aarhus, Denmark, pointed out that his team simply found a correlation and not a cause-and-effect relationship.
“My best guess is health behaviors,” he told WebMD. “When people have kids, they tend to live healthier.”
He suggested that having children promotes healthier and more responsible living as parents feel the need to both provide and set an example for their children.
The study also examined the mental health aspects of failing to conceive and found that childless couples were twice as likely to suffer mental illness as those who adopted children.

Can we trust that popularization?  Note that the abstract states that with the exception of substance abuse,  there was no difference between the mental health indicators of couples who succeeded in having a biological child and couples who did not succeed.   Yet the popularization tells us in that last sentence that there was!

Never mind.  Let's assume that the study was carried out properly, that it did, indeed find four times higher crude death rates among the women who failed to conceive after the treatment and twice as high crude death rates among the men whose partners failed to conceive after the treatment. 

What does this all mean?  

1.  Can we generalize from this study to everyone in the world?  Is a sample of people who are all seeking in vitro fertilization treatment just the same as a random sample of from the general population?   Is it OK for those popularizations (far above in my post)  to say what they did say : that children help us live longer, given that the sample in this study consisted of only people for whom fertility was large enough a problem that they resorted to in vitro fertilization?

I can think of a whole bunch of reasons why that would not be the case.   

First,  the infertility of some of the couples, at least, could have been caused by pre-existing ill health.  This ill health could make conceiving via in vitro fertilization less likely and it also could make premature death more likely.

Second, the infertility treatments themselves may have health risks for women.  Those who conceive stop any hormone treatments, for example, but those who have failed to conceive may continue the treatments for several more rounds.  The overall impact of the treatments themselves could cause fatal illness in some women among the failed-to-conceive group.

Third, wanting a child when one cannot have it may be a major stress factor in a person's life.  Major stress factors are a known health risk, and the longer they last the more likely it is that they affect either behavior or the health of the body itself.  Couples who failed to conceive live in that stress longer than couples who conceived early in the treatment.


2.  You may have noticed that my three points above all suggest reverse causality to explain the findings.  I'm not arguing that my suggestions are the correct ones, just that we cannot run quickly to the other extreme and argue that having children protects us from dying young. 

Esben Agerbo, one of the study co-authors, does warn us about correlation not necessarily being causation, and so does the study abstract.  Yet in that last quote where he is interviewed he offers a causal explanation for lower death rates of those who succeeded in the fertilization treatments:

Children promote healthier and more responsible living.

And that is probably true.  But is it the major causal arrow which explains these findings?  Let's put this into a diagram.  We have two simple options for the main arrow directions:

childlessness  >>>  ill health

ill health >>> childlessness

These simple options are not meant to be the only two possibilities.  My guess is that the lower one is the explanation which accounts for more involuntary childlessness, because most individuals born with severe health conditions never have children, for instance.  But the general explanation allows for a smaller arrow going in the direction, from having children to better health behavior, say.

You may have noticed that my three points about why the Danish sample cannot be seen as a perfect microcosm of the general population are all about the possibility that the causality mostly runs from ill health to childlessness or that at least the meaning of "childlessness" is closer to something of a major life trauma than the absence of children as such.

Conclusions

My apologies for not covering the actual study.  I couldn't get hold of it without paying thirty dollars.  But I suspect that it does what I've been able to glean from the various (though rather imprecise) popularizations.  What would have been interesting is to see what role suicides played in those death rates, but one study author notes that the information is absent from the official records.

If you care to read this post again (as if!), note how many errors the popularizations make.  The abstract tells us that the mental health indicators, with the exception of substance abuse, did not differ between those who conceived in the in vitro fertilization and those who did not.  Yet two of the popularizations I quote do state that they differed, and one states that they did so especially so for women.

One final comment:  I have never really thought about the possible correlation between having children and longevity, but had you asked me about it before I started waded in this mud puddle I'd have supposed that those without children might live longer.  That's because of anecdotal evidence from my own life and should be discounted.  Still, having children has real health risks for women, and a proper study of the relationship between having children and health should take those into account. 

It should also compare like with like.   If we wish to measure any impact having children has one one's health, then the pre-existing health states of the individuals in the study should be the same.  If they are not the same, the study tells us nothing much, because those with chronic conditions may simply be less likely to partner with someone and also less likely to have the physical health needed to conceive and, for women, to give birth.

On Guns, Victim Blaming and Conservative Interpretations Of Kasandra Perkins' Death

Content:  Violence

Sometimes watching Fox News is like being offered a glimpse from another reality altogether.  Here's Dana Perino suggesting, probably in the context of the Jovan Belcher case,  that women who are victims of violence should have made better decisions:


http://mediamatters.org/video/2012/12/05/perinos-advice-to-women-who-are-victims-of-viol/191702

There are people whose detectors are not well-tuned when it comes to danger in general.  But to suggest that better decisions would keep *someone* from becoming the victim of a violent crime is just bunkum/buncombe.  For one thing,  a person bent on committing violence would find another victim if the first choice "made the correct decision."  Then Perino could scold the second person as not having made good decisions.  And so it goes.

If we go down that route, it's the perpetrator of a violent act who should have made better decisions.  That would protect everyone!

This whole thing veers so close to victim-blaming that the two are identical twins.

Elsewhere at the  Daily Caller, Louise Trotter from the Independent Women's Forum (a gals' auxiliary to wingnuttery)  tells us that Kasandra Perkins died because she wasn't armed or that she may have died because she wasn't married to Jovan Belcher but just cohabited with him.  Given that Trotter's main point in the piece is to attack what she considers  a false causal argument:  that guns cause people to die, her own proposed causal chains are enjoyably suspect.

For instance,  several sources suggest that the Perkins-Belcher residence contained eight guns.  Unless they were locked away from Perkins, she did indeed have access to firearms.  Also, at least one study suggests that the presence of a gun in the home increases the likelihood of homicide rather than reverse (note that I haven't checked this study for accuracy). 

Then there's Trotter's argument that being  "healthily" married protects a woman from violence:

Imagine that the real reasons for this crime were conclusively shown to involve a complex interplay of factors including drug and alcohol abuse, domestic abuse, sexual competition and a lack of a healthy marriage relationship. In that case, is there any doubt that liberal elites would suddenly lose interest in the admissibility of causation? “Move along, folks, nothing to see here.”

I have never seen any studies which would have proven such a causality, and seriously suspect that the causality runs the other way:  One can't have a healthy relationship with a person who is bent on abusing you and even killing you.  Whether you are married or not.

Trotter's focus is on defending guns.  I don't think anyone believes that guns sneak away from a locked cabinet in the middle of the night and go out on a killing spree without any humans being involved in any of it.  So, using the old NRA argument, guns do not kill people but people kill people. 

What that saw ignores is the fact that guns make people extremely effective killers.  The killing happens almost instantaneously and there is no way of going back to the moment before that first shot, no time to reconsider.  Likewise, guns make killing many people in a row possible.  That would be extremely unlikely an outcome if a person tried to do it bare-handed or even equipped with a knife.

The high US murder rates are directly related to the availability of guns.  Alternative explanations would require Americans to be much more violent than otherwise similar people living elsewhere.  Which I don't believe.

Trotter's advice to women is to be armed.  She writes "Guns make women safer." 

But her opinion piece doesn't say anything about learning to handle a gun, practicing shooting or role playing various forms of attack to make sure that one doesn't shoot an innocent bystander or someone who came to the door trick-or-treating.  The police trains a lot with guns and police officers still sometimes kill innocent bystanders.  IF guns were ever to keep women (or any other population group) safe a lot of real training would be required.

But if gun-carrying amounts to something akin to quasi-religion, such concerns are unimportant.

The Scent of A Woman. Science Thursday At Echidne's.

This is a tale of two studies.  The first, by Saul L. Miller and Jon K. Maner,  was published in 2010 and you may remember it.  Here's the abstract:

Adaptationist models of human mating provide a useful framework for identifying subtle, biologically based mechanisms influencing cross-gender social interaction. In line with this framework, the current studies examined the extent to which olfactory cues to female ovulation—scents of women at the peak of their reproductive fertility—influence endocrinological responses in men. Men in the current studies smelled T-shirts worn by women near ovulation or far from ovulation (Studies 1 and 2) or control T-shirts not worn by anyone (Study 2). Men exposed to the scent of an ovulating woman subsequently displayed higher levels of testosterone than did men exposed to the scent of a nonovulating woman or a control scent. Hence, olfactory cues signaling women’s levels of reproductive fertility were associated with specific endocrinological responses in men—responses that have been linked to sexual behavior and the initiation of romantic courtship.

Sniffing sweaty t-shirts worn by women near ovulation caused a higher testosterone response in men than sniffing either clean t-shirts worn by nobody or t-shirts worn by women not near ovulation, get it?  Testosterone is associated with sexual desire in both women and men, so the results suggest that men can smell ovulation, on some deeply unconscious level.

Now fast-forward to the present.  Another study, actually completed before the Miller-Maner study summarized above, didn't find any such relationship between men's testosterone and smelling the sweat of ovulating women.  From this recently published study, by  James R. Roney and Zachary L. Simmons:

Unlike Miller and Maner (2010), we did not find more positive testosterone
responses in men after exposure to ovulatory chemical stimuli than after exposure to
control stimuli. Importantly, our study was not an exact replication of the Miller and Maner
(2010) study, and so should not be construed as a direct replication failure. Nonetheless, the
discrepancy in findings raises important issues regarding which differences in methods may
have led to the distinct outcomes.

...

A second difference between the studies concerns the male participants’ knowledge
of the stimulus source. As explained in the Introduction, male participants in Miller and
Maner (2010) were explicitly told that they were smelling shirts worn by women, and this
knowledge may have triggered mental images that contributed to the observed hormonal
responses. In the present study, men appeared to be in a state of uncertainty regarding the
identity of the odor stimuli: men were not significantly more likely to report detection of
human odors in the experimental as opposed to the control condition, and participants
generally reported detection of nonhuman odors more often than detection of human odors.
Even in cases in which men reported detecting sweat or body odor, there was never any
reference to women’s scents in particular, such that there is little reason to think that the
male participants were visualizing women. Differential likelihood of having visualized
women thus stands as another possible explanation for the discrepant findings between the
two studies: perhaps chemoreception of ovulatory cues is by itself insufficient to trigger a
neuroendocrine response in human males, which may instead require additional stimuli,
such as visual images triggered by knowledge of the stimulus source.

The bolds are mine.


Get it?  The Roney-Simmons study found no increase in the testosterone levels of  men who smelled the sweat of a near-ovulation woman as opposed to just water. 

As the authors state, this is not an actual replication of the original Miller-Maner study, but it is better in at least some ways, and the most important one of those is that the study subjects were not primed by telling that what it is they are smelling is the body odors of women.  If the conclusions of the Miller-Maner study really are about some subtle biological cues women's sweat offers about how close those women are to ovulating, then the Roney-Simmons study basically finds those conclusions rejected.

Why am I writing about these two studies?  Because the popular media prioritizes the first type of studies.  I'm willing to bet you almost anything that this new study doesn't make Fox News change what it wrote about the earlier study:

Forget Perfume, Ovulation Is the Way to Attract Men, Study Says
Published February 15, 2010


Perfumes and scented lotions only go so far when it comes to attracting a man; the body does the rest, MyFox National reported Monday.

According to a study done by researchers at Florida State University, men are unconsciously attracted to the natural scent of a woman, even more so when the woman is ovulating, Discovery News reported.

This is what is wrong with the popularizations.  They don't popularize studies which have null findings or which disprove earlier, gender-clickable ones.  And of course all that about a perfume is utter rubbish.  The initial study had nothing to do with perfumes and could not make any kind of statement about their value in attracting men.

Because of those popularization biases, the general public gets a distorted view of what the studies actually find, and are practically never told about a study which has been found quite wrong.

 

On Mammograms

The background for this debate:

Last week The New England Journal of Medicine published a study with the potential to change both medical practice and public consciousness about mammograms.
Published on Thanksgiving Day, the research examined more than 30 years of United States health statistics to determine, through observation, if screening mammography has reduced breast cancer deaths. The researchers found that, as expected, the introduction of mammogram screening led to an increase in the number of breast cancers detected at an early stage. 

But importantly, the number of cancers diagnosed at the advanced stage was essentially unchanged. If mammograms were really finding deadly cancers sooner (as suggested by the rise in early detection), then cases of advanced cancer should have been reduced in kind. But that didn’t happen. In other words, the researchers concluded, mammograms didn’t work. 

This is a bold claim for an observational study. There are countless reasons why conclusions from such studies are commonly fraught with error. What if, for instance, the lion’s share of advanced cancers occurred among women without access to screening mammograms—a fact often not available in health statistics? Or what if mammography successfully prevented a major increase in advanced cancers, leaving the health statistics unchanged? 

Hippocrates, the father of medicine, called experience “delusive.” He recognized that uncontrolled observations may lead to faulty conclusions. For centuries the flawed logic of observational data seemed to validate bloodletting, an unhelpful and often harmful therapy. But most who were bled eventually improved—no thanks to the bloodletting—an observation that led medical authorities to believe in the practice. 

Fortunately, we have learned something about bad logic. Today we seek studies designed to neutralize illusions. By enrolling people in a study and assigning them randomly to treatments, for instance, groups tend to be evenly balanced in every way except one: the treatment. Controlled studies led to the discovery that bloodletting is harmful rather than helpful, and randomized trials of screening mammography would therefore be a worthy gold standard to answer once and for all the question of whether the test saves lives.
It may be surprising, therefore, to learn that numerous trials of mammography have indeed randomly assigned nearly 600,000 women to undergo either regular mammography screening or no screening. The results of more than a decade of follow-up on such studies, published more than 10 years ago, show that women in the mammogram group were just as likely to die as women in the no-mammogram group. The women having mammograms were, however, more likely to be treated for cancer and have surgeries like a mastectomy. (Some of the studies include trials from Norway, the Netherlands, Sweden, and this major review of the data.)

In other words, mammograms increased diagnoses and surgeries, but didn’t save lives—exactly what the researchers behind last week’s observational study concluded.

Those European trials and the recent observational study might not be enough to conclusively determine that mammograms don't do very much to cut back breast cancer mortality.  But what if they are correct?  What then?

These questions obviously matter.  They bring up agonizing arguments about women losing the one tool of secondary prevention (i.e. screening) they thought they had against breast cancer.  IF mammograms are of limited value in prolonging survival, what can women do instead?  Just wait for a lump in the breast tissue?

But they also suggest that  mammograms as a secondary prevention tool might never have done very much prevention, that the cancer survivors who thank an early mammogram and consequent early treatment for their survival may, in fact, have had one of the cancers which doesn't advance very rapidly or at all.

This is tricky ground, mostly because our understanding of the possible types of breast cancer is so limited.  Perhaps some types of tumors remain small and never spread much?  Perhaps some types of tumors might even disappear on their own?  Perhaps the most aggressive (and often lethal) cancers develop so very rapidly that a mammogram is of value only if it happens to be performed at the exactly right moment?

There is something distasteful about those arguments.  But on the opposite side, consider the potential distastefulness of spending vast amounts of money providing routine mammograms to all women above a certain age if mammograms, indeed, turn out not to have much value in reducing mortality rates.  Those funds could be used for developing alternative screening methods or better treatments for breast cancer.

Then consider the radiation risks from mammograms every year or two and the financial costs and medical risks from potentially unnecessary treatments those mammograms may cause.

Clearly, something better than hope or entrenched industry interests is necessary to justify routine mammograms.  What is needed are proper prospective randomized trials where women are randomly assigned to a group which will have regular mammograms and a group which is somehow kept from having them.  Ideally, the two groups would otherwise be as similar to each other as possible.  A follow-up of these groups for a few decades might give us decisive information about the value of mammograms.

But studies of that sort are an impossibility in most places.  Mammograms are widely available and the control group could not be ethically kept away from having them, too.   And I'm sure that many would find such a study unethical,  because it would keep one group of women away from what is regarded as an established part of breast cancer prevention.   (That's the snag, of course.  If we truly are not sure about the mortality-reducing effects of mammograms, then they probably shouldn't be part of the established prevention pattern.)

All this may be premature.   It could be that new, and better, studies find mammograms of greater value in reducing breast cancer mortality or it could be that better understanding of the etiology of the disease allows us to use mammograms more efficiently.  Some alternative way of diagnosing breast cancer early might be developed and make mammograms but a part of medical history.

Still, when I was writing those musings I felt that odd kind of discomfort.  Even wondering about the validity of mammograms makes me feel like a traitor, like someone who would abandon an orphan in a life-boat in the middle of the Atlantic Ocean, like a callous and mean-minded Echidne.  But then looking at the other side of the arguments makes me feel pretty miserable, too.

Yet what ultimately matters is whether mammograms work or not.  That should be distinguished from the general efficacy of various forms of medical screening.  Some, such as the PAP-smears for cervical cancer, are very effective and fairly low-cost. Recommendations about others, such as prostate cancer screening,  are now more qualified.  We may simply not have sufficient information on breast cancer to make the best recommendations about who should get mammograms and when.

Where does that leave us, as individuals?  Trying to muddle through the best we can, I guess, with the help of those health care professionals who base their advice on the most recent state of relevant knowledge.


 

More on Kasandra Perkins' Death

The one thing you may not have read but should read is this one (violent content).  The piece ends:

So in closing, because I can never say this enough, the person responsible for Kasandra Perkins' death is Jovan Belcher. There was nothing Miss Perkins could have done to cause Mr. Belcher to murder her in cold blood. He pulled the trigger the 1st, 2nd, 3rd,4th,5th,6th,7th,8th, and 9th time he shot her.

That ending is necessary because of the many, many stories which discuss the possible role of drugs, alcoholism and brain injury in what made Jovan Belcher kill Kasandra Perkins.  One piece even suggests that Perkins was a "catalyst" to her own killing.

I understand the search for explanations and the search for hypothetical scenarios where Kasandra Perkins might not have died.  But these very easily shift into victim-blaming or something equally nasty:  The apparent justification of a killing.

The Decadence of It All! Ross Douthat on the Baby Dearth.

Ross Douthat has written the predictable piece about the baby dearth in the United States.  Sadly, he has to use euphemism in lots of places because it's not kosher to call the race wars race wars in the New York Times.

Thus, Douthat argues for "more babies!" by giving these reasons:

IN the eternally recurring debates about whether some rival great power will knock the United States off its global perch, there has always been one excellent reason to bet on a second American century: We have more babies than the competition.

Based on that argument, some rather unexpected countries could become the next United States.  Birth rates were very high in Iran, until quite recently, for instance, and they are high in many African countries.

Douthat confuses two different things:  The population size of a country and its birth rate.  Sure, one might ultimately be able to create a large country just through atypical population growth.  But most giant countries were created by the invasion and combination of many smaller countries.

Or put in another way, the European Community intends to have a role not dissimilar from the United States, not by birth rates but through accepting more member states.

The rest of Douthat's piece wonders what might happen if the drop in fertility becomes permanent.  He even hesitantly suggests public sector support for families with children but not the kind of support which has been shown to raise birth rates:  Paid parental leaves and subsidized daycare.  Those were probably omitted because they allow women to work in the labor force AND have more children.  But anything which does NOT support women's ability to remain in the work force will not affect the reduced fertility rates.

Whether high birth rates are desirable, from a global point of view, is a different question.  Douthat limits his viewpoint to competition between countries, failing to ask how many people this earth can support if, as is most likely, all of them wish to have a style of living which is currently available for only the wealthier parts of the world.

Be as it may, what I truly enjoyed about Douthat's column was when he got going on decadence!  Stuff like this:

Beneath these policy debates, though, lie cultural forces that no legislator can really hope to change. The retreat from child rearing is, at some level, a symptom of late-modern exhaustion — a decadence that first arose in the West but now haunts rich societies around the globe. It’s a spirit that privileges the present over the future, chooses stagnation over innovation, prefers what already exists over what might be. It embraces the comforts and pleasures of modernity, while shrugging off the basic sacrifices that built our civilization in the first place.
Such decadence need not be permanent, but neither can it be undone by political willpower alone. It can only be reversed by the slow accumulation of individual choices, which is how all social and cultural recoveries are ultimately made.

Wonderful!  I imagine all those decadent individuals reclining in bedrooms covered with dark-red velvet, incense burning in lamps shaped like naked women!  Everyone wears nothing but tiny smoking jackets and everyone smokes long black cigarettes at the end of those 1920s holders.  Monocles!  Brothels!  Wombs arid like stone!  Decadence.

Sorry.  It's odd how even the term "decadence" evokes ideas from the Victorian era, its brothels and the men who were their customers.  Note that this is the era of the history which presumably created the comforts and pleasures of modernity.

What really bothers Douthat is that such "decadence" might now have been adopted by those uppity women who aren't breeding enough.  The basic sacrifice he talks about surely must be that one?  It's women, after all, who must give birth to all those large families, and in Douthat's reality it's women who must take care of all those multiple children the greatness of America demands.

But of course any woman who decides to have, say, twelve children, just on Douthat's say-so will have no time to enjoy the comforts and pleasures of modernity.  Except in few cases, she is going to find herself and her family in poverty.  The Republican Party is opposed to policies which would support her.

Hence the need to evoke shame, the real function of the term "decadence" in this context.

The Kasandra Perkins Case

Kansas City Chiefs' starting linebacker Jovan Belcher killed his girlfriend, then drove to the football training facility and killed himself in front of the coach and the general manager of the team.

When I first read about this awful story, I found the reports one-sided.  It was as if the death of Kasandra Perkins was almost accidental, something to be skimmed past quickly in order to get to the main topic:  the suicide of yet another football player.  After giving the fact that Belcher killed Perkins the rest of the stories were about him:  What a gentle person, what a great athlete, how very sad it all was and so on.

An example:

"Pioli and Crennel and another coach or employee was standing outside and appeared to be talking to him," Snapp said. "The suspect began to walk in the opposite direction of the coaches and the officers and that's when they heard the gunshot. It appears he took his own life."
The coaches told police they never felt in any danger.
"They said the player was actually thanking them for everything they'd done for him," Snapp said. "He was thanking them and everything. That's when he walked away and shot himself."
Members of the Chiefs mostly laid low Saturday, but a few reacted on Twitter.
"I am devastated by this mornings events," Pro Bowl linebacker Tamba Hali wrote. "I want to send my thoughts and prayers out to everyone effected by this tragedy."
A large group of Belcher's friends and relatives gathered Saturday at his boyhood home on Long Island.
His family turned the front yard into a shrine, with a large poster of Belcher, an array of his trophies, and jerseys and jackets from Kansas City, Maine and West Babylon High.
"He was a good, good person ... a family man. A loving guy," said family friend Ruben Marshall, who said he coached Belcher in youth football. "You couldn't be around a better person."
At least 20 people gathered for a large group hug in the driveway.
"He was a tremendous player and all those things, and his accolades speak for themselves, but he lit up when he spoke about his mom, or when he hugged his family after games," said Dwayne Wilmot, who was Belcher's position coach at Maine and is now an assistant coach at Yale.
"It's difficult to talk about Jovan in the past tense," he told the AP. "There's going to be unanswered questions, the why's of this tragedy. It'll never be truly known to us."
Wilmot said he'd stayed in touch with Belcher the past few years through social media.
"He was someone who took genuine pleasure in bringing happiness to others," Wilmot said. "I was so excited when he became a father, because I knew he'd be a great father."
His girlfriend's Facebook page shows the couple smiling and holding the baby.
Belcher is the latest among several players and NFL retirees to die from self-inflicted gunshot wounds during the past few years. The death of star linebacker Junior Seau, who shot himself in the chest in at his California home last May, sent shockwaves around the league.

There was even one story where an economist explained why Belcher's suicide was rational!  This one day after Perkins was killed.  I find that in poor taste.  In any case, to explain Belcher's suicide as rational would seem to require a similar explanation for Perkins' killing.

It may be only my impression that the coverage of the murder-suicide improved a little over the hours.  I may have just happened on the worst treatment early.  But later coverage was more objective, i.e., covering the case the way it would be covered if the killer was someone unknown. 

You may have spotted, though, that I had to dig for those stories.  Most stories stay firmly on Jovan Belcher, because he was the famous one, because he was the gladiator we want to see face the lions (at a very good price) every day.  That the team decided not to cancel the game after one of the players turned out to be a killer tells me a lot.  The Business Of Football Must Go On.

Skimming through the headlines now I see stories about the large numbers of suicides in the NFL, stories asking questions about brain injury (but not about the use of steroids?).  These stories (including questions about gun availability) are looking for a cause for the events outside the person who killed someone and then killed himself.

That's fair, assuming that it can bring some change in the future.  But Kasandra Perkins still remains an unintended casualty in these stories, someone who got killed because Belcher didn't get the help he needed or perhaps someone who got killed because she fought too much with Belcher and so on.  She is made to play a bit part in her own death. 

What causes this biased coverage?  Some of it may have the flavor of the general way domestic killings are covered:  What made him do it?  Did he lose his job?  Was she cheating on him?  But mostly this is about celebrity and what happens when a killer or a suspected killer is the celebrity.  The publicity lens fogs up, needs to be adjusted, and suddenly writers are faced with how to cover a killer who only yesterday was their hero.

The killed ones tend to be forgotten if they are not also celebrities.  I have always felt that the coverage of the O.J. Simpson trial committed that sin.  Do you remember the name of the second victim in those deaths?

Ronald Goldman.  He and Nicole Brown Simpson died that night.