OK, a little help please.

TAPPED was nice enough to link to my latest irritated screed at the media’s poor coverage of military suicide rates.

Once the statistic’s initial shock value wears off, it’s clear that–as Winds of Change notes in its calculations–the figure is fairly misleading. Taking the national rate of suicide (about 13 per 100,000) and applying it to the 1.6 million U.S. troops that have to date served, the figure comes out to 8,409 — a little less than twice the number of U.S. casualties in Iraq. More an artifact of the comparatively low casualties the U.S. has suffered in Iraq than anything else.

They then go on:

The more compelling statistic is the one revealed in an independent CBS analysis last November, namely that veterans aged 20-24 (that is, those who’ve served in current wars) have a suicide rate up to four times higher than civilians the same age.

So we go over to the CBS analysis:

So CBS News did an investigation – asking all 50 states for their suicide data, based on death records, for veterans and non-veterans, dating back to 1995. Forty-five states sent what turned out to be a mountain of information.

And what it revealed was stunning.

In 2005, for example, in just those 45 states, there were at least 6,256 suicides among those who served in the armed forces. That’s 120 each and every week, in just one year.

Dr. Steve Rathbun is the acting head of the Epidemiology and Biostatistics Department at the University of Georgia. CBS News asked him to run a detailed analysis of the raw numbers that we obtained from state authorities for 2004 and 2005.

It found that veterans were more than twice as likely to commit suicide in 2005 than non-vets. (Veterans committed suicide at the rate of between 18.7 to 20.8 per 100,000, compared to other Americans, who did so at the rate of 8.9 per 100,000.)

One age group stood out. Veterans aged 20 through 24, those who have served during the war on terror. They had the highest suicide rate among all veterans, estimated between two and four times higher than civilians the same age. (The suicide rate for non-veterans is 8.3 per 100,000, while the rate for veterans was found to be between 22.9 and 31.9 per 100,000.)

OK, I’m pretty deeply puzzled here.

Back when I did my first post on suicide, here’s what I found:

So in 2004, there were a total of 14,328 suicides in the US in the age group 20 – 44 (the group that I think pretty well covers the population in Iraq – some are younger, some are older). the total population in 2004 in that age group was 104,259,000 – so the rate/100,000 population was 15.25.

And since the rate in the military is higher – significantly higher at 17.3/100,000 overall and 19.9 for those serving in Iraq and Afghanistan – I was darn concerned.

And then I asked one more question.

Well, the suicide rates by sex are pretty different, I recalled. I wonder what happens if I sex-norm the suicide rates in the military?

Here’s an approximation (because the of women in reserves is slightly higher, and I didn’t find the serving in Iraq).

According to the DoD, approximately 17% of US active-duty forces are women.

According to the CDC, the 20 – 44 population had 14,328 suicides in 2004. Of those, 11,460 were men, and 2,868 were women. The census gives an estimate for 2005 population from 20 – 44 as 52,513,000 men and 51,746,000 women.

By my math, this gives a suicide rate of 21.82/100,000 for men, and 5.54/100,000 for women.

If I norm the suicide rates by multiplying the sexes rate by the population in the military, I get (21.82*83%)+(5.54*17%)=19.06/100,000.

So let’s go to the CDC data, and see what the numbers for ages 20 – 24 look like.

They show 2,599 suicides in that age range in 2004. There are, per the census, 21.05 million Americans that age; that gives a raw rate of 12.35/100,000.

Note the article states that the rate is 8.9. OK, I’m puzzled – how the heck did he get that?

Now let’s take a moment and sex-norm the rate, as I did in the original post.

Per the census, the 20 – 24 age group has 10.86 million males, and 10.20 million females. The suicide number for males in this group was 2,105; the rate was this 20.22/100,000. For females, there were 404 suicides, for a rate of 3.96/100,000.

Assuming the same ratio of males/females in the military (which is for the Army, and hence somewhat high), we have 83% male, 17% female. So sex-norming the rations, we’d get 83% * 20.22 + 17% * 3.96 for a total rate of 17.46/100,000.

The actual rate, per Rathburn, is between 22.9 and 31.9/100,000. Now I’m not sure how he got such a huge variance, but I’ll also suggest that the number of veterans between 20 and 24 is pretty small. The VA says there are 287,400 veterans in that age group. This would suggest that there were between 66 and 92 suicides in 2005 in this group.

Let’s look at the overall population. There were a total of 24.5 million vets as of 2005, and the CBS study shows 6,256 suicides in 2005, for a rate of 25.51/100,000. Assuming a sex-normed overall population, the rate (using the 83%/17% ratio, which is high, but close enough) would be 15.5/100,000. So – looks like the rate is significantly higher – which means there is some damn serious work to do.

But – I’m seriously puzzled about where the doc got his statistics. I’ll look for an email for him and ask him directly. Meanwhile, here are my sources:

US Census

NCIC

VA

I’m open to sources. I know he’s a professor of epidemiology, and I’m some guy with Excel and a web browser. But his numbers make no sense to me.

Note: my son is in the military, and I’m darn concerned about his well-being. But I want to have a fact-based discussion; I don’t think vaguely-sourced or wrong numbers make for good discussion.

Every time I try and convince myself that I’m being oversensitive to the drumbeat of ‘damaged soldiers’ stories – which I am at root convinced are about the notion that war is simply too damaging to the delicate sensibilities of our troops to actually, you know, send them into combat – the press steps to the plate and hits the ball right at me.

Here’s the latest piece at Bloomberg:

The number of suicides among veterans of wars in Iraq and Afghanistan may exceed the combat death toll because of inadequate mental health care, the U.S. government’s top psychiatric researcher said.

Community mental health centers, hobbled by financial limits, haven’t provided enough scientifically sound care, especially in rural areas, said Thomas Insel, director of the National Institute of Mental Health in Bethesda, Maryland. He briefed reporters today at the American Psychiatric Association’s annual meeting in Washington.

Insel echoed a Rand Corporation study published last month that found about 20 percent of returning U.S. soldiers have post- traumatic stress disorder or depression, and only half of them receive treatment. About 1.6 million U.S. troops have fought in the two wars since October 2001, the report said. About 4,560 soldiers had died in the conflicts as of today, the Defense Department reported on its Web site.

Based on those figures and established suicide rates for similar patients who commonly develop substance abuse and other complications of post-traumatic stress disorder, “it’s quite possible that the suicides and psychiatric mortality of this war could trump the combat deaths,” Insel said.

Well, d’ooh. Welcome to the magic of bad statistics. If the 1.6 million troops who have been to Iraq or Afghanistan during this war have exactly the same rate of suicide as the general population for the rest of their lives – more of them will die than died in the war. The national rate of suicide in 2005 for ages 15+ was 13.14/100000. Assume that the average age of the soldiers is 30, this gives them ~40 years of exposure to the risk of suicide – so 1.6 million * 13.14/100,000 * 40 years = 8,409 suicides. The issue is that the rate of combat deaths is so low that by comparison to other low-probability events – they seem remarkably high.

Men apparently have a 1:34 lifetime chance of dying of prostate cancer (it’s dropping now, thankfully); that means some 40,000 of the returning troops will probably die of prostate cancer. If you look at the CDC’s ’cause of death by age’ table, suicide ranks 11th for all ages – and it’s doubtless lower for veterans who have a lower suicide rate than the average population. The article suggests that we should spend more on counseling – and we doubtless should. But shouldn’t we balance that consideration against the consequences for our veterans of – say – better prostate cancer screening?

So the article is a twofer – on one hand, it helps drive home the notion that veterans are irremediably damaged by their exposure to war – something that is popular in movies, but just not borne out by the facts, not post-WW II, not post-Vietnam, and I will wager, not post-this war. And on the other, it manages to try and drive public policy by using veterans to suggest that we invest more in public mental health (which might be good to do, balanced against other priorities) – it’s the ‘poster-child’ school of policy making, which ignores facts in favor of dramatic incidents.

Some veterans will be damaged, and we should absolutely do what we can to help them overcome it, and make thoughtful decisions on investment to improve counseling and their access to the help they need.

And maybe, just maybe, one of the things I’ll suggest is not treating them – contrary to the facts – like they are going to go psycho any second..

NZ Bear reminds me that Patti Patton-Bader, founder of Soldiers’ Angels, is one of the fifteen semi-finalists in NBC’s “America’s Favorite Mom” contest. There are five categories, and she is nominated with two other mom’s in the “military mom’s” category. The winner receives a $250,000 cash prize, and Patti has said she’d like to use the money to build a ranch for soldiers and their families to vacation at with assistance from Angel families.

Tomorrow, Patti will be featured in the morning on NBC’s Today Show, and all day today (but ONLY today) folks will have the opportunity to vote for her at http://www.nbc.com/Americas_Favorite_Mom/ . Allegedly everyone can vote up to ten times per email address, so I’m hoping folks will vote early and often!

I’ve ‘adopted’ soldiers through Soldiers Angels, and donated to Project Valor-IT which provides speech-activated laptops to wounded solders – so I unqualifiedly support her and her work. Regardless of how you feel about the war, I’d hope we can all agree that the soldiers – particularly the wounded ones – deserve all the help we (and the government – but that’s another story) can give them.

Here’s Dave Meyer at OpenLeft getting it pretty much – from my point of view – completely wrong:

I’m not exactly surprised that the administration’s military propaganda program has received so little attention. The establishment has never demonstrated any understanding of the war in Iraq, of why it’s such an incoherent, doomed venture. The propaganda program revealed last Monday is not a sideshow. It’s an essential component of the only remaining strategic rationale for the continuation of the war — preventing damage to America’s image.

In the last year of her life, Hannah Arendt offered a retrospective on Vietnam; Home to Roost is printed in the Responsibility and Judgment collection published back in 2003. Her prescient insight was that the entire “not very honorable and not very rational enterprise was exclusively guided by the needs of a superpower to create for itself an image which would convince the world that it was indeed ‘the mightiest power on earth.'” Eventually, the war was maintained solely “to avoid admitting defeat and to keep the image…intact.”

Well, yes, that’s partly true. But it stops a little too soon, because it doesn’t ask why it matters that we had the image as the mightiest power on earth. Because that answer matters more than a bit; and the simple answer is that as Handel talks about Sun Tzu in Masters of Modern Warfare:

Among the force multipliers recommended by Sun Tzu are maneuver; reliance on intelligence; the extensive use of deception and diversionary measures to achieve surprise; the ‘indirect approach’; and the use of psychological measures to undermine the enemies will to fight.

We were, in the 1960’s and 1970’s, in a conflict which was very real. Winning that conflict – as we did – could have involved the direct application of force, which in the case of two nuclear-armed superpowers would have been catastrophic, and so there were a series of indirect, smaller conflicts of which Vietnam was one.

Now I’ve talked about Vietnam more than once, and will talk about it again soon. But let’s accept for a moment that that’s what Vietnam was actually about, and put aside the legitimate moral qualms about pushing back the Soviets over the bodies of dead Vietnamese for later discussion.

But let’s not – as Meyers does – casually dismiss the issue of ‘image’ as something that’s really about the self-image of a bunch of leaders (although it is, as well), but as one of the tools in any conflict or negotiation.

The official obsession with image developed over time in the Vietnam era.

That’s just so historically inaccurate that I don’t know what to say except ‘bullshit’. We officially started shaping image in World War I, but Lincoln was active in doing it doing the Civil War, and John Adams did a little bit of it himself.

With Iraq, it was central from the beginning. Before the war, Andy Card told Elisabeth Bumiller that “from a marketing point of view, you don’t introduce new products in August.” Tom Friedman thought invading Iraq would communicate a useful “Suck. On. This.” Jonah Goldberg glowingly attributed to Michael Ledeen the idea that “every ten years or so, the United States needs to pick up some small crappy little country and throw it against the wall, just to show the world we mean business.” There are countless examples, from high government officials to low pundits, of endorsements of Iraq for the message it would send, as an easy way to dispel the myth of American weakness. The Iraq war is a multi-trillion dollar public relations campaign, aimed at persuading hostile forces of our “strength.”

Well, that could be seen as a good thing. Here’s noted pro-war commentator Armed Liberal in March 2003, just before the invasion:

The reality is that Clinton’s team was highly focused on terrorism…but on terrorism as crime, as opposed to as an instrument of war. We focused on identifying the actual perpetrators, and attempting to arrest them or cause their arrest.

This is pretty much the typical liberal response to 9/11. Send in SWAT, pull ’em out in cuffs, and let’s sit back and watch the fun on Court TV.

I’ve been ambivalent about whether this is a good strategy conceptually, and looking at the history…in which we’re batting about .600 in arresting and trying Islamist terrorists…I have come to the realization that the fact is that it hasn’t worked. The level and intensity of terrorist actions increased, all the way through 9/11 and the subsequent invasion of Afghanistan.

And a part of what I have realized is that as long as states – particularly wealthy states – are willing to explicitly house terrorists and their infrastructure, or implicitly turn a blind eye to their recruitment and funding, we can’t use the kind of ‘police’ tactics that worked against Baader-Meinhof or the Red Army Faction. The Soviet Union and it’s proxies offered limited support to these terrorist gangs, but they didn’t have a national population to recruit from and bases and infrastructure that only a state can provide.

So unless we shock the states supporting terrorism into stopping, the problem will get worse. Note that it will probably get somewhat worse if we do…but that’s weather, and I’m worried about climate.

There are a number of engines fueling the Islamist movement, one of which is the belief by its members that they can win, and by their state sponsors that supporting them is a good idea.

Now I’ll point out that the latter hasn’t worked out so well so far, for a variety of reasons – one of which is, in fact, the fact that we are so deeply divided internally about this war. Now the antiwar left can shrug and suggest that saying this is a variant of the ‘Green Lantern’ theory (there hasn’t been a Green Lantern movie yet, so I’m not 100% sure how this metaphor works) but they need to own up to the notion that it’s real (it may be that they were right – I’m not presuming that as a condition of my argument, because if they are right or wrong about the war, it’s still true that public opposition to the war isn’t without impact).

So let’s not discount public-relations campaigns; and let’s accept the fact that shaping the views of our opponents may be more important and effective than killing them.

One nice thing about all the traveling I’m doing right now (other than making me appreciate TG and home all the more) is that there is a bitchen used-book store right in Milwaukee airport, Renaissance Books.

I manage to stop by there pretty much every trip, and find all kinds of interesting stuff.

This trip, I wandered back to the math area because Middle Guy and I are trying to teach each other more about fractals. No Mandelbrot, sadly, but next to it was the military area, so I scanned quickly and almost bought a really nice copy of Clausewitz for Biggest Guy but it was huge to carry. I did trip over an interesting book that I bought, though – ‘Premises for Propaganda‘ by Leo Bogart (autographed by him, BTW, with an inscription to one Dick Leonard). Subtitled ‘The United States Information Agency’s Operating Assumptions in the Cold War’, it’s a 1976 summary of a study done on the USIA in 1953-4.

And it’s a fascinating look at the nuts and bolts of an active ‘information war’. Here is an excerpt from the preface (written in 1976):

Twenty years ago, when this study was made, memories of World War II and of its horrors were still vivid, and the political emotions of Europe were direct continuations of those that prevailed in wartime. These bitter feelings have faded in intensity. A generation of Eastern Europeans, reared under Socialism, has come to accept many of its institutions as permanent and desirable. In the Soviet Union, the opposition, restrained rather than crushed, has found new voices, and foreign broadcasts are no longer obliterated by jamming.

The development of the great schism in the Communist camp has been followed by an unprecedented Soviet tolerance of minor deviationism in the policies of individual national parties. The economic recovery of Western Europe and Japan has created strong independent forces within the American system of alliances. A capacity for autonomous political action has been manifested in the succession of wars in the Middle East, the display of economic power by the oil-producing nations, the emergence of independent African states, the growth of guerilla movements in Southeast Asia, and the long agony of Indochina. All these familiar strands of recent history have made the tasks of propaganda, like those of diplomacy, incredibly more complex than they were at the height of the Cold War, when the world was politically polarized.

The political rhetoric of that period was still, at least to a substantial degree, an outgrowth of the ideological self-righteousness of World War II, when terms like “freedom,” “democracy,” and “the Free World” could be used without a trace of cynicism or self-consciousness and with the expectation that they would strike a responsive chord. Sophisticated political observers could speak unblushingly of the war to win men’s minds and souls. There was strong belief in the power of words and ideas to influence events.

As President Eisenhower said in an address to the staff of the Agency in November, 1953, “We are now conducting a cold war. That cold war must have some objective, otherwise it would be senseless. It is conducted in the belief that if there is no war, if two systems of government are allowed to live side by side, that ours, because of its greater appeal to men everywhere, to mankind, in the long run will win out. That it will defeat all forms of dictatorial government because of its greater appeal to the human soul, the human heart, the human mind.”

“In the contest for men’s minds,” wrote former Assistant Secretary of State Edward W. Barrett, “truth can be peculiarly the American weapon.” Senator Homer Capehart put it more bluntly a few years later when he said the job of the Agency “is to sell the United States to the world, just as a sales manager’s job is to sell a Buick or a Cadillac or a radio or television set.”

It was generally assumed that throughout the world, public opinion could be influenced, could be shaped, and that ultimately it would have to be heeded by those who ruled, no matter how evil and ruthless they might be. Who today still maintains this faith? Instead, there has come about, on the part of America’s government, its intellectuals, and its general public, a reawakened appreciation of the uses and importance of power, divorced from ideals or ideology. In part, this change in outlook reflects the realities of the nuclear standoff and uneasy awareness of the possibilities of disaster. In part, it reflects the processes of fractionation in international politics to which I have just referred. This very fractionation has reduced the level of dependable and unquestioning support enjoyed by the United States among a variety of former client countries around the world. The illusion of being on the side of the angels becomes more difficult to sustain when few others share it. A succession of regional wars and civil wars in Asia and Africa has further weakened the proposition that international conflicts are essentially expressions of the great division of the world into its Communist and “anti-Communist” components. The “Good Guys” often have turned out to be suspicious or hostile toward the United States, and, in any case, the “Good Guys” don’t always win.

In a world in which the triumph of justice and truth is as often as not impeded by naked force, the power of public opinion fades, and the very concept of public opinion may be disregarded as a force in international politics.

Not so much any more.

The book directly addresses many of the challenges that are being discussed today as we discuss our ideological conflict with the Islamist movement. How can a democratcy – founded in the open flow of discussion and information, deliberately shape information so as to combat an opponent who is not so restrained? How do we have political accountability without political meddling (McCarthy was tearing apart the USIA as the study was being written)? How do we balance the desire to simply show the reality of who we are with the desire to sell our beliefs?

What do we do about promoting freedom as our core value to the peoples of unfree allies?

It’s a truly interesting book, and a reminder that there is litte that we have to deal with that we can’t learn something about from the past.

A definite find.

In 2005, reporter James Sheeler published an article in the Rocky Mountain News called ‘Final Salute‘ about the transport of a soldier’s remains back from Iraq to his home for his funeral.

I’m often critical of casualty-focused reporting, because I see in those stories a reporter’s effort to make a political statement by standing on the bodies of the wounded or dead. But when I read this story, I was so moved by the pure humanity it expressed, and the scrupulous and very real effort the reporter made to show us what he was seeing, rather than the point he wanted to make, that I wrote Sheeler and complimented him – kind of effusively.

Well, he just wrote back, and the article has been extended to a book – also called ‘Final Salute,’ which came out yesterday. As safe as Biggest Guy is today, it’ll still be a hard read for me, but I’ll read it regardless.

I want to respond a bit to Joe’s post on Obama, because I think he nails the strongest critiques of Obama from the right.

Joe asked how we could believe that someone who:

(1) was utterly supine and silent for 20 years in his own church as racial hate was propagated by the pastor; (2) who refuses to condemn a prominent supporter and fundraiser for whom bombing American sites is still seen as a good thing, and (3) who has said not a single word on the campaign trail as his party heavyweights removed post-Abramoff earmark reforms…

could be trusted to be a real change agent in power.

And that Michelle Obama’s comments that:

“Because Barack Obama is the only person in this race who understands that. That before we can work on the problems we have to fix our souls. Our souls are broken in this nation…. Barack Obama will require you to work. He is going to demand that you shed your cynicism. That you put down your divisions. That you come out of your isolation, that you move out of your comfort zone. That you push yourselves to be better. And that you engage. Barack will never allow you to go back to your lives as usual, uninvolved, uninformed.”

bring Joe to fear that she’s bringing a kind of all-encompassing politics that really is totalitarian at root.

Here’s what I think about this.

First, I think that Obama is – above everything else – a deeply ambitious politician. Look, no one gets to play at that level without being clinically insane is some fashion; Fred Thompson’s root problem as a candidate was that he wasn’t crazy enough about the job. That means that, along the way, Obama’s made deals with shady financiers, local ethnic powerbrokers, a string of corrupt local politicians that involved the giving and taking of favors that helped him accrete the power that positioned him to stand where he is today. To think that someone not like that is going to successfully run for office – a Mike Bloomberg who didn’t have to trade away scruples – is just a fantasy. And you know what, part of me thinks that we’re better off for it; I’ve developed a whole new respect for machine politics as opposed to the politics of wild idealism.

Second, what I want is a politician like Tom L Johnson – who is idealistic at core, but willing to get his hands dirty in the back and forth of the reality of politics.

I do think that the – spiritual – aspects of American politics have been neglected, and that they are absolutely necessary to the success of the American project. That project involved both a politics of ‘a right not to give a damn,’ as Joe describes it and a politics of being deeply passionate and attached to the American Project and the freedoms and covenant that come with it.

And so what matters is what it is that Obama’s call to politics is about. It’s not an explicit call to transform America in a specific way; it’s a call for us to all talk to each other. And I’ll suggest that that call can be a powerful one for all of us, even if it’s made by an ideologically jejune, passionately ambitious politician.

Let me talk for a second about Obama’s ideology. It’s clear that he’s the product of the ’68 crowd his mother was a part of, and that he’s attached to and most comfortable in a crowd of people who sit around and reminisce about the Revolution That Almost Was (in their dreams). But it’s important to recognize that he never lived it; he’s an acolyte. The Revolution for him is kind of like Woodstock; a matter of values, to be sure, but something that’s as much a matter of history as a living presence.

And I know I’d ducking the fact of his core political values here – but I think you have to remember that he has two values that trump those core values: he wants to be elected, and once he is, he wants us all to talk.

And I think that’s a damn good thing. How is it that a church like Wright’s – a pastor like Wright – can be so successful, so powerful? How is it that members of the black community can stand and cheer when Wright spouts obvious nonsense? How? Well, because we don’t all talk. Because members of the church talk to each other, people on Daily Kos only talk to each other, we on Winds only talk to each other. The kind of insane beliefs that Wright espouses wouldn’t stand up to an honest discussion in the light of day, but because none of us feel the need to stop him and say – with respect, and care – that he’s saying things that make no sense at all.

Yesterday was the anniversary of the North Vietnamese conquest of South Vietnam.

I’ve been reading and thinking a lot about Vietnam recently, for relatively obvious reasons. While history never repeats itself, it’s doubtless true that people look to history and model their behavior – for better or worse – on the models they have of history.

Watch for a post next week on this issue.