7 ms·

Not to confuse things: There quite simply is a long list of things that can kill an infant and we get increasingly better evidence for what's on there and what

Not to confuse things: There quite simply is a long list of things that can kill an infant and we get increasingly better evidence for what's on there and what is not. Avoiding death at all cost is ludicrous, but for a child born in the 1950s in high income countries the mortality rate was ~5%. 1 in 20 kids dead before the age of 5. For contrast, now it's closer to 1 in 300. That's not a coincidence but a lot of compounding things we understand better today. Are there missteps? Certainly. Figuring out what is effective, what has bad secondary effects (fragility, allergies etc) and what is simply wrong is an ongoing effort and that's great, but less dying is a pretty nice baseline and progress on that front is inarguable.

staplers 1y ago
I wish society at large could be on par with this nuanced and rational opinion. I miss when science was celebrated.
- aeternum 1y ago
  Rational and science might be pretty far apart. Flying a key in a thunderstorm for example isn't the most rational decision. Neither scraping open your family's arms and applying cowpox pus. Pretty irrational, but definitely celebrated.. eventually
  - sokoloff 1y ago
    Risky and irrational are different in my mind. If the best available means to perform an experiment carries some risk, it could still be entirely rational to do it rather than forfeit the knowledge gained from the experiment.
    - aeternum 1y ago
      Rational/risky experiments are illegal currently. For example take the famous mask debate. It could easily be solved by having volunteers willing to stand in a room with people with covid at various distance, each using randomized masks/no mask. There would be plenty of volunteers for such a study but there's no way it would be approved. The FDA doesn't count lives lost due to inaction and slow approval of new drugs and treatments. As Munger always said "show me the incentive and I'll show you the outcome." By any rational calculus, that one Thalidomide win by the FDA has caused incalculable death, pain and suffering by pushing out the timeline on not only recently discovered cures but all those built on top. Imagine for example the number of lives saved if GLP-1 was purchasable over the counter in the 1990s when it was first discovered.
- gottorf 1y ago
  > I miss when science was celebrated. One could argue that science being celebrated too much leads to this type of present-day outcome. Science can tell you how to do something, but not why, or even what we should do to begin with.
- tim333 1y ago
  There seem to be some quite powerful forces acting in the opposite direction - social media maximising engagement by pushing divisive stuff and politicians trying to demonize the other team. Not quite sure what the answer is. I feel there should be some tech type solution. At least LLMs at the moment by taking in the whole internet seem fairly neutral although Musk seems to be trying to develop right wing versions.
rocqua 1y ago
To be a bit morbid, one could also explain OPs observation that "people are more fragile" by the lower child mortality by the hypothesis that these more fragile people wouldn't have made it through infancy before. I don't particularly believe this, but it fits Occam's razor, so it seems to deserve some examination.
- Hendrikto 1y ago
  > but it fits Occam's razor How? You can use that to decide between two (or more) explanations, but you only presented one.
  - Spare_account 1y ago
    It was implicit, at least to my eye, that other explanation which was being offered a counterpoint was the grandfather comment. For clarity, I will include both here: The two explanations for increased adult fragility are: forgotoldacc> Parents shelter their children too much and have created adults that have additional allergies as a result of lack of childhood exposure rocqua> Increased sheltering of children has allowed more of the fragile ones to survive to adulthood, increasing the number of fragile adults we observe today.
    - rsynnott 1y ago
      What’s this increase in fragile adults you’re talking about? Are you sure it’s a real thing? Are you aware how staggeringly high rates of institutionalisation were in most western countries in the early to mid 20th century? And then there were the adults who were considered ‘sickly’. Like, _fainting_ wasn’t considered dramatically abnormal behaviour until quite recently. A lot of people who today would be considered to have a condition which is entirely treatable by doing (a), taking (b), not doing/avoiding (c), etc, would, a century ago, have just been kind of deemed broken. Coeliac disease is a particularly obvious example; it was known that there was _something_ wrong with coeliacs, but they were generally just filed under the 'sickly' label, lived badly and died young. (And it generally just gets worse the further you go back; in many parts of the world vitamin deficiency diseases were just _normal_ til the 20th century, say).
repeekad 1y ago
It’s not just save as many lives as possible at all costs, saving 20 kids but 2 will develop debilitating peanut allergies isn’t worth it. Progress must be done slowly ensuring no harm is done along the way. Science failed here.
- jbstack 1y ago
  What on earth are you saying? It's better to kill 20 children than to risk that 2 of them develop peanut allergies? I don't see how this can even begin to be an arguable position to take. And that's ignoring the fact that it isn't even a correct assertion in this case.
  - repeekad 1y ago
    They’re not mutually exclusive options, we can save the 20 kids safely while having a mindset that values doing no harm. Telling anxious parents to have their kids avoid peanuts caused harm that wouldn’t have happened otherwise. I guess it’s valuable to better understand allergies, but learning at others’ expense isn’t worth it.
- pbhjpbhj 1y ago
  So you avoid things like electricity and the internet, because they've caused children's deaths too?
  - repeekad 1y ago
    I’d prefer to live in a world where the same technology developed in such a way that they didn’t have to die, yes.
- lurk2 1y ago
  > It’s not just save as many lives as possible at all costs, saving 20 kids but 2 will develop debilitating peanut allergies isn’t worth it. Your math isn’t checking out here.
  - 1y ago
cma 1y ago
Large scale antibiotic production wasn't until the 40s in the US, maybe a while to spread to all other wealthy countries. Was that the main factor?
- jstummbillig 1y ago
  Quick look into it, in the 50s: - Before the age of 1, top cause of death were defects (prematurity/immaturity, birth injuries) and congenital deformations. - Age 1-4 it was accidents (e.g., drownings, burns, traffic) followed by influenza/pneumonia.
  - cma 1y ago
    But if you got into an accident, wouldn't antibiotics help with the injury, surgery etc.? A bad burn could get infected etc. And possibly similar for some birth injuries and birth defects, and bacterial pneumonia for sure.
dan-robertson 1y ago
I think most of the change in death rate is improved medicine (and maybe wealth too – plenty of people in the US in the 50s were very poor by modern standards) rather than parents knowing about many potentially harms. (Maybe I’m wrong? Happy to be corrected here)
- lurk2 1y ago
  This is the conclusion I lean towards, but anecdotally one of my grandparents knew something like 3 or 4 kids who died before the age of 15, all in preventable accidents. Disease got at least a few more. It’s possibly just a coincidence but hearing the stories of how inattentive people could be to their children back then, I’ve always suspected current helicopter parenting norms must have accounted for at least some of the decline. There’s been a similar shift with people letting their dogs roam free. When I was a kid I remember hearing stories about a dog getting run over by a car every year. I rarely hear these stories anymore because people usually keep their dogs supervised or in a fenced yard. I don’t have any hard data, but I suspect there’s something to these cultural shifts.
- Tuna-Fish 1y ago
  Vaccinations and better antibiotics reduced death rates a lot, but in 1950 accidents were still 30% of the death rate for children, killing 5 times as many children than die today for all causes.
  - lurk2 1y ago
    Do you have a source for that?
  - AnthonyMouse 1y ago
    The death rate for children aged 5-14 is is 14.7 per 100,000, i.e. 0.0147%. That's basically zero and five times that much is still basically zero. By comparison, the death rate for the 35-44 age group was 237.3 per 100,000. Also, the most common type of accidental death is car accidents. So is even that difference from kids not getting to play outside anymore, or is it radial tires and crumple zones?
AnthonyMouse 1y ago
> for a child born in the 1950s in high income countries the mortality rate was ~5%. 1 in 20 kids dead before the age of 5. Essentially all of this was infant mortality, i.e. kids who died before the age of 1, and that in turn was more related to things like sanitation and vaccines and pre-natal screening.

staplers 1y ago

I wish society at large could be on par with this nuanced and rational opinion. I miss when science was celebrated.

aeternum 1y ago
Rational and science might be pretty far apart. Flying a key in a thunderstorm for example isn't the most rational decision. Neither scraping open your family's arms and applying cowpox pus. Pretty irrational, but definitely celebrated.. eventually
- sokoloff 1y ago
  Risky and irrational are different in my mind. If the best available means to perform an experiment carries some risk, it could still be entirely rational to do it rather than forfeit the knowledge gained from the experiment.
  - aeternum 1y ago
    Rational/risky experiments are illegal currently. For example take the famous mask debate. It could easily be solved by having volunteers willing to stand in a room with people with covid at various distance, each using randomized masks/no mask. There would be plenty of volunteers for such a study but there's no way it would be approved. The FDA doesn't count lives lost due to inaction and slow approval of new drugs and treatments. As Munger always said "show me the incentive and I'll show you the outcome." By any rational calculus, that one Thalidomide win by the FDA has caused incalculable death, pain and suffering by pushing out the timeline on not only recently discovered cures but all those built on top. Imagine for example the number of lives saved if GLP-1 was purchasable over the counter in the 1990s when it was first discovered.
gottorf 1y ago
> I miss when science was celebrated. One could argue that science being celebrated too much leads to this type of present-day outcome. Science can tell you how to do something, but not why, or even what we should do to begin with.
tim333 1y ago
There seem to be some quite powerful forces acting in the opposite direction - social media maximising engagement by pushing divisive stuff and politicians trying to demonize the other team. Not quite sure what the answer is. I feel there should be some tech type solution. At least LLMs at the moment by taking in the whole internet seem fairly neutral although Musk seems to be trying to develop right wing versions.

rocqua 1y ago

To be a bit morbid, one could also explain OPs observation that "people are more fragile" by the lower child mortality by the hypothesis that these more fragile people wouldn't have made it through infancy before. I don't particularly believe this, but it fits Occam's razor, so it seems to deserve some examination.

Hendrikto 1y ago
> but it fits Occam's razor How? You can use that to decide between two (or more) explanations, but you only presented one.
- Spare_account 1y ago
  It was implicit, at least to my eye, that other explanation which was being offered a counterpoint was the grandfather comment. For clarity, I will include both here: The two explanations for increased adult fragility are: forgotoldacc> Parents shelter their children too much and have created adults that have additional allergies as a result of lack of childhood exposure rocqua> Increased sheltering of children has allowed more of the fragile ones to survive to adulthood, increasing the number of fragile adults we observe today.
  - rsynnott 1y ago
    What’s this increase in fragile adults you’re talking about? Are you sure it’s a real thing? Are you aware how staggeringly high rates of institutionalisation were in most western countries in the early to mid 20th century? And then there were the adults who were considered ‘sickly’. Like, _fainting_ wasn’t considered dramatically abnormal behaviour until quite recently. A lot of people who today would be considered to have a condition which is entirely treatable by doing (a), taking (b), not doing/avoiding (c), etc, would, a century ago, have just been kind of deemed broken. Coeliac disease is a particularly obvious example; it was known that there was _something_ wrong with coeliacs, but they were generally just filed under the 'sickly' label, lived badly and died young. (And it generally just gets worse the further you go back; in many parts of the world vitamin deficiency diseases were just _normal_ til the 20th century, say).

repeekad 1y ago

It’s not just save as many lives as possible at all costs, saving 20 kids but 2 will develop debilitating peanut allergies isn’t worth it. Progress must be done slowly ensuring no harm is done along the way. Science failed here.

jbstack 1y ago
What on earth are you saying? It's better to kill 20 children than to risk that 2 of them develop peanut allergies? I don't see how this can even begin to be an arguable position to take. And that's ignoring the fact that it isn't even a correct assertion in this case.
- repeekad 1y ago
  They’re not mutually exclusive options, we can save the 20 kids safely while having a mindset that values doing no harm. Telling anxious parents to have their kids avoid peanuts caused harm that wouldn’t have happened otherwise. I guess it’s valuable to better understand allergies, but learning at others’ expense isn’t worth it.
pbhjpbhj 1y ago
So you avoid things like electricity and the internet, because they've caused children's deaths too?
- repeekad 1y ago
  I’d prefer to live in a world where the same technology developed in such a way that they didn’t have to die, yes.
lurk2 1y ago
> It’s not just save as many lives as possible at all costs, saving 20 kids but 2 will develop debilitating peanut allergies isn’t worth it. Your math isn’t checking out here.
- 1y ago

cma 1y ago

Large scale antibiotic production wasn't until the 40s in the US, maybe a while to spread to all other wealthy countries. Was that the main factor?

jstummbillig 1y ago
Quick look into it, in the 50s: - Before the age of 1, top cause of death were defects (prematurity/immaturity, birth injuries) and congenital deformations. - Age 1-4 it was accidents (e.g., drownings, burns, traffic) followed by influenza/pneumonia.
- cma 1y ago
  But if you got into an accident, wouldn't antibiotics help with the injury, surgery etc.? A bad burn could get infected etc. And possibly similar for some birth injuries and birth defects, and bacterial pneumonia for sure.

dan-robertson 1y ago

I think most of the change in death rate is improved medicine (and maybe wealth too – plenty of people in the US in the 50s were very poor by modern standards) rather than parents knowing about many potentially harms. (Maybe I’m wrong? Happy to be corrected here)

lurk2 1y ago
This is the conclusion I lean towards, but anecdotally one of my grandparents knew something like 3 or 4 kids who died before the age of 15, all in preventable accidents. Disease got at least a few more. It’s possibly just a coincidence but hearing the stories of how inattentive people could be to their children back then, I’ve always suspected current helicopter parenting norms must have accounted for at least some of the decline. There’s been a similar shift with people letting their dogs roam free. When I was a kid I remember hearing stories about a dog getting run over by a car every year. I rarely hear these stories anymore because people usually keep their dogs supervised or in a fenced yard. I don’t have any hard data, but I suspect there’s something to these cultural shifts.
Tuna-Fish 1y ago
Vaccinations and better antibiotics reduced death rates a lot, but in 1950 accidents were still 30% of the death rate for children, killing 5 times as many children than die today for all causes.
- lurk2 1y ago
  Do you have a source for that?
- AnthonyMouse 1y ago
  The death rate for children aged 5-14 is is 14.7 per 100,000, i.e. 0.0147%. That's basically zero and five times that much is still basically zero. By comparison, the death rate for the 35-44 age group was 237.3 per 100,000. Also, the most common type of accidental death is car accidents. So is even that difference from kids not getting to play outside anymore, or is it radial tires and crumple zones?

AnthonyMouse 1y ago

> for a child born in the 1950s in high income countries the mortality rate was ~5%. 1 in 20 kids dead before the age of 5. Essentially all of this was infant mortality, i.e. kids who died before the age of 1, and that in turn was more related to things like sanitation and vaccines and pre-natal screening.