Category Archives: Decline of the west

Anne Case and Angus Deacon: Deaths of Despair

Decline of the west, Drugs, Health, Substance Abuse

Dr. Sanjay Gupta for his HBO special and Nicholas Kristof and Cheryl WuDunn for the New York Times, all interviewed Anne Case and her husband Angus Deacon. Both of them are economists from Princeton University but we won’t hold that against them. As she said, “Whites are reporting poorer and poorer health, more and more pain, and more and more social isolation. More depression. Along with this increase in mortality from drugs, alcohol, suicide there is just a lot more morbidity, pain, and social isolation.” Anne Case came up with the expression “deaths of despair” and it has become very popular.

Anne Case and Angus Deaton, conducted an important study of mortality and wrote the book, Mortality and Morbidity in the 21st Century. Dr. Gupta interviewed them for the television show. In that book they described “deaths of despair” as “death by drugs, alcohol and suicide.” According to them, so many people have died from deaths of despair to equal all the people who have died of AIDs since the beginning of the AIDs crisis. Those deaths were enough to cause life expectancy to fall first for whites and then for the entire population. That is a very unusual event.

These people were the children of the people that won the world war and were expected to live glorious lives in the land of the free and the brave. The parents expected their children to do even better than they did. Those expectations were often not met. As Deaton put it, “They were promised the earth but they did not inherit it.” Case said, “in every state but 2, cirrhosis of the liver and alcoholic liver disease went up. And in every state drug poisoning went up. In every state between 1999 and 2015 suicide rates went up for people aged 22 to 64. If you treat people in a really shabby way for long enough bad things happen to them. That happened to African Americans forever and it started to happen to whites with a High School degree or less, starting probably in the mid-seventies. And now bad things are happening to both of those groups.

Dr. Gupta that if we wanted to know the effects of economic decline all we had to do was visit the American Rust Belt.  There they produced more steel than the rest of the world put together. 24 hours a day, 7 days a week smog from those plants went into the atmosphere of American cities.

Swissvale Pennsylvania , according to Eric Horgos, is the valley that is  “the epicenter of the greatest industrial collapse in the entire developed world in the 1980s. 1983 is when economic Armageddon hit them.”

Is it surprising that people who lived a certain way that they liked for 30 years and then had the rug pulled out from under them wanted to commit suicide? Is it any wonder they turned to alcohol or drugs? Is it any wonder that they despaired? Is it any wonder that they gave up on politicians that that they had once respected, and then turned instead to a demagogue?

Constant Change

Decline of the west, Drugs, Health, Substance Abuse

 

Americans, like Canadians, are living in a world that is changing faster than ever before. And that is change is constant. As a friend of mine always says, ‘Change is the only constant”.  And such constant change can be stressful.

There are all kinds of health problems out there. I know some of them too personally for my taste. People are obese.  It is astonishing how obese people are in the richest nation on earth. In Arizona where I spend a lot of time in recent years, we see it all the time. People have heart conditions. They have cancers. Yet, there is something harder to define. What Dr. Sanjay Gupta called the “real state of stress” in his HBO special.

And everyone wants a pill to solve their health problems. People want quick solutions to their problems. So do I of course. Americans take more drugs than the people of any other country on earth. And Canada is not far behind. Those drugs served a really useful purpose. They can save lives. They can ease pain. Yet, as Dr. Gupta pointed out, in the US  “50 people die every day from prescription pain killers!”

Shown on Dr. Gupta’s special, Angela Glass was a mother in Victoria Texas. She knew that stress can be ugly. It can cause issues in every area of your life. Wherever you already have problems, stress can make them worse. Stress compounds the problem. Angela was prescribed a huge cocktail of drugs every day for her stress. She took pain medication–hydrocodone. She took other drugs for anxiety.  Things got worse. She lost a child. She took way more drugs than she was supposed to. She had suicidal thoughts. She considered taking all her pills and ending the pain once and for all. She couldn’t sleep. She was haunted. How many Americans and Canadians have been led down this path to drug dependence? How many Americans and Canadians have died as a result? In one year more Americans died from drug over doses than died in the entire Vietnam War! Since that happened in the United States, it has happened again!

 

Dr. Gupta believes that all this chronic stress, the pain which comes with the stress, and the desire to make that pain go away have combined to create a toxic brew that is destroying America and Canada. Many take medications even when they know it could take their lives.

This is dangerous stuff.

Chronic Stress

Decline of the west, Health

 

As Dr. Sanjay Gupta pointed out, in his CNN special, One Nation Under Stress,  in the United States, the self-proclaimed leader of the Free World,  “we are 4.7% of the world’s population and take 80 to 90% of the world’s OxyContin and hydrocodone. And I’m pretty sure that we don’t have 80-90% of the world’s pain.” How could this happen in the richest country in the world?

Another thing is that epidemic of drugs is mostly affecting whites aged 35 to 55. Stress should be listed as a contributing cause to many deaths. Why whites? Why so much stress in the richest country in the world?

Stress of course is a natural phenomenon.  As Robert Sapolsky, a neuroscientist from Stanford University said,

 “When you look at the stress hormones we secrete exactly the same chemicals as a lizard and a fish and a bird. This is ancient, ancient biology. For 99% of the beasts out there what stress is about is 3 minutes of some screaming crisis when somebody is very intent on eating you or you are very intent on eating somebody, and everything your body does at that time makes perfect sense. You increase your heart rate, your blood pressure, your breathing rate, you turn off everything that is not essential and you shut down growth, tissue repair. When a lion is chasing you and you are running for your life and one of the things you are doing is all sorts of metabolic stuff to divert energy to your thigh muscles. Oh my god you think you only have 3 months until your taxes are due and you divert energy to your thigh muscles. That makes no sense whatsoever and that’s where you pay the price.”

 

Robert Sapolsky who wrote a book Why Zebras Don’t Get Ulcers points out that when a lion is chasing a zebra it needs stress to get away. Stress is entirely good in that situation. Yet once the zebra gets away the stress level returns to normal. That also happens quite quickly. Life is good again. The zebra relaxes. The stress was entirely good.  It saved the zebra’s lie.

As Dr. Gupta said, “Stress is not the enemy. It’s the constant never-ending toxic stress–that’s the stress that’ll kill you.” Chronic stress in other words is what we should be stressed out about. Sapolsky says he has learned a lot about stress from the baboon world. What he learned is,

“What makes psychological stress really corrosive is lack of control, lack of predictability, lack of social support. You might say insecurity is the problem. If you are chronically stressed you will chronically increase your blood pressure and you are going to get more liquid turbulence into your blood vessels and hit the walls. They pound the walls and they cause microscopic bits of scarring, tearing, and inflammation there. And you get plaques and you get the whole cascade there. It’s a fairly straight biological line from chronic stress to your blood pressure that is chronically elevated. It’s a much more indirect route to liver sclerosis.”

 

 

Sapolsky was convinced that stress is the common cause of liver sclerosis, suicides, and opioid overdose.  They are all related. Stress is the root problem, he is convinced. “Our lives are more psychologically corroded by stress. Stress: am I valued? Stress: do I have a meaningful place in the community? Stress: is there even a community I can rely upon. Stress: why am I here?”

Note all these questions point to social issues. This is what chronic stress is all about.

American on the Edge of Fascism

American Fascism, Death of Democracy, Decline of the west, Populism

 

I posted about a judge in Colorado evaluating all of the evidence, hearing arguments from both sides and concluding that Donald Trump was engaged in insurrection.  As a result I submitted that it was astonishing to think that Trump supporters  still don’t believe that he was engaged insurrection. To me it seems obvious.

The judge however said she was not sure that this section applied to the presidency so refused to ban Trump from the upcoming presidential ballot in 2024.

The American Constitution, unlike the American people,  takes insurrection very seriously. In s. 3 to the 14th amendment to that constitution it says:

“Section 3

No person shall be a Senator or Representative in Congress, or elector of President and Vice-President, or hold any office, civil or military, under the United States, or under any State, who, having previously taken an oath, as a member of Congress, or as an officer of the United States, or as a member of any State legislature, or as an executive or judicial officer of any State, to support the Constitution of the United States, shall have engaged in insurrection or rebellion against the same, or given aid or comfort to the enemies thereof. But Congress may by a vote of two-thirds of each House, remove such disability”

 

What does this section mean? Donald Trump’s lawyers argued that this meant the section did not apply to the president. It only applies to every other officer of the United States, the lawyers argue.

In effect if Trump wins this argument then he has absolute immunity from criminal prosecution for conspiring to overturn the 2020 election. Think about that, a former president is arguing in court that he cannot suffer any legal consequence for participating in an insurrection!

Laurence Tribe a well known Harvard Professor of law and constitutional expert said this decision by the Colorado Judge was “bizarre.” I am not that bold because I find the wording in s. 3 perplexing, but Professor Tribe had no such doubt. This is what he said when interviewed by PBS Newshour about this decision:

“it would turn the presidency into a dictatorship. It would basically mean that the revolution that we fought against King George failed, and that the American experiment in constitutional democracy, with no one being above the law, lasted 225 years, and then ended. I don’t want that to happen.”

 

Now I have to agree with Professor Tribe that this would be bizarre, but frankly I find many aspects of the American Constitution, which so many in America consider Holy Text, to be bizarre. Remember that according to constitution the president  has the authority to pardon anyone from a a criminal offence without giving any reasons or justification. Trump used this last time he was in office to pardon a slew of his corrupt cronies. Some have even argued that the Constitution would allow Trump to pardon himself if he was convicted. What could be more bizarre than that? Sometimes I really wonder if the US can be said to have the rule of law at all. Like so much holy writ, the American Constitution is far from perfect.

We have already heard that Trump will make it his job to destroy all of his enemies if elected. How could he be stopped?

This is what Professor Tribe says about the possibility that Trump’s argument succeeds:

“I think it would be a disaster for the freedom of every one of us to have anybody completely above the law. We have in this case someone who said he would terminate the Constitution. He will make his presidency about vengeance. It’s what fascists do.

 

That is precisely what fascists do all right, and America seems to be headed in that direction thanks to the undying support of millions of Americans for Donald Trump. No matter what he does they will continue to support him. It doesn’t matter if he engages in insurrection. It doesn’t matter if he shoots someone in Times Square. It doesn’t matter if he sexually abuses a woman in department store, his true believers will continue to believe.

Trump Calls for Insurrection (Again)

2018 Trip to Iceland, Death of Democracy, Decline of the west, Trump, Trumpism, Tyranny and Fascism

 

On September 15, 2022 Donald Trump was asked what would happen if he was indicted. This is what he said,

“I think if it happened, I think you’d have problems in this country the likes of which perhaps we’ve never seen before. I don’t think the people of the United States would stand for it.”

 

Then he was asked by Mr. Hewitt, “what kind of troubles, Mr. President?” Trump responded this way: “I think they’d have big problems. I just don’t think they’d stand for it.”

Don Lemon, when he was on CNN,  asked Phillip Mudd, a CNN analyst and former counterterrorism analyst if that was a threat.  Mr. Mudd’s answer was about as direct as you can get.  His answer was “Yes.”  Yet, Mr. Mudd went further. He added this,

“I don’t know if that is a subtle enough answer, Don. That’s a yes Don. Let me be clear about what this is.  In the world of extremism which I followed for decades that is what I would refer to as validation… You don’t have to tell someone to go out there and commit an act of violence for them to say, ‘Well if we were robbed then it is my constitutional right and responsibility to go to the Congress and storm it.’ That is the president of the United States having witnessed January 6th saying, ‘Well let me have a redo of that. That redo will happen if I ever get indicted.’  To me as an extremist follower that is not a political statement, that is a statement that anybody who follows extremists can understand. That is validation…”

 

Juliette Kayyem a CNN National Security Analyst agreed completely. She said,

“It is not even hinting anymore. We used to use the word “dog whistle” when we talk about Trump. This is now directing. Don’t just listen to Trump’s words. Imagine what his supporters are hearing. They are hearing the call to action…We need to call it what it is that we have a former president who is inciting violence as an extension of his political defeat. That’s what it is now.”

 

I know Trump’s supporters don’t believe anything CNN says, but I think CNN got this right from Trump’s own words. I agree with the CNN interpretation. This was the only logical interpretation of what Trump said. This was a call to violent action without mentioning the word. The message was absolutely clear, just as his words were absolutely clear to his supporters on January 6th. They knew what to do. And Trump was threatening to do it all over again if he was charged! This was doing what Donald Trump always does when he is cornered. He does not back down. He doubles down.

In November of 2023 a Colorado judge District Judge, Sarah B. Wallace, after hearing all the evidence and arguments from lawyers for Trump, and the District Attorney, and then ruled that former President Donald Trump “engaged in insurrection” during the Jan. 6, 2021, attack on the U.S. Capitol but rejected an effort to keep him off the state’s primary ballot because it’s unclear. The judge rejected the claim that the constitutional amendment that bars insurrectionists from public office applies to the presidency, but that is irrelevant.  The judge clearly said Trump was an insurrectionist based only on evidence.

This was not a judgement by the libs. This was not the “failing New York Times” claiming that Trump was an insurrectionist. Nor was it “fake news” CNN.  Nor was it a “biased House of Representatives committee. This was the decision of an impartial judge after weighing all the evidence and listening to the argument of the lawyers. Is this not something Republicans, and in fact all Americans, should take seriously? That judgment makes it absolutely clear, beyond any doubt in my view, that Trump was guilty of insurrection? Yet, as far as I know, his support among Republicans in the current presidential election campaign has not dropped! How is that possible?

Millions of Americans are prepared to elect an insurrectionist as President of their country! They don’t care!

I recall Trump once said that he could shoot someone in Times Square New York City and it would not affect his support. It looks like he was absolutely right!

Americans must realize what Trump is doing. He is doing the same thing Hitler did after the German Reichstag burned down. The German people continued to support Hitler. We must always remember that Germans elected Hitler because they wanted him to make Germany great again,

Now the question is what will the American people do? Will they acquiesce with  this dangerous slide into fascism?  I know many of his supporters will do that. They will accept that with the enthusiasm they showed on January 6, 2021.

I am not sure of what the majority of Americans will do, but I am uneasy.

Deeply uneasy.

 

Chronic Stress

Decline of the west, Drugs, Health

 

As Dr. Sajay Gupta pointed out on his HBO documentary, in the United States, the self-proclaimed leader of the Free World,  “we are 4.7% of the world’s population and take 80 to 90% of the world’s OxyContin and hydrocodone. And I’m pretty sure that we don’t have 80-90% of the world’s pain.” Another thing is that epidemic of drugs is mostly affecting whites aged 35 to 55. Stress should be listed as a contributing cause to many deaths. Why whites?

Stress of course is a natural phenomenon.  As Robert Sapolsky, a neuroscientist from Stanford University said,

” When you look at the stress hormones we secrete exactly the same chemicals as a lizard and a fish and a bird. This is ancient, ancient biology. For 99% of the beasts out there what stress is about is 3 minutes of some screaming crisis when somebody is very intent on eating you or you are very intent on eating somebody, and everything your body does at that time makes perfect sense. You increase your heart rate, your blood pressure, your breathing rate, you turn off everything that is not essential and you shut down growth, tissue repair. When a lion is chasing you and you are running for your life and one of the things you are doing is all sorts of metabolic stuff to divert energy to your thigh muscles. Oh my god you think you only have 3 months until your taxes are due and you divert energy to your thigh muscles. That makes no sense whatsoever and that’s where you pay the price.”

 

Robert Sapolsky who wrote a book Why Zebras Don’t Get Ulcers points out that when a lion is chasing a zebra it needs stress to get away. Stress is entirely good in that situation. Yet once the zebra gets away the stress level returns to normal. That also happens quite quickly. Life is good again. The zebra relaxes. The stress was entirely good.  It saved the zebra’s lie.

As Dr. Gupta said, “Stress is not the enemy. It’s the constant never-ending toxic stress–that’s the stress that’ll kill you.” Chronic stress in other words is what we should be stressed out about. Sapolsky says he has learned a lot about stress from the baboon world. What he learned is “What makes psychological stress really corrosive is lack of control, lack of predictability, lack of social support. If you are chronically stressed you will chronically increase your blood pressure and you are going to get more liquid turbulence into your blood vessels and hit the walls. They pound the walls and they cause microscopic bits of scarring, tearing, and inflammation there. And you get plaques and you get the whole cascade there. It’s a fairly straight biological line from chronic stress to your blood pressure that is chronically elevated. It’s a much more indirect route to liver sclerosis.”

Sapolsky was convinced that stress is the common cause of liver sclerosis, suicides, and opioid overdose.  They are all related. Stress is the root problem, he is convinced. “Our lives are more psychologically corroded by stress. Stress: am I valued? Stress: do I have a meaningful place in the community? Stress: is there even a community I can rely upon. Stress: why am I here?” Note all these questions point to social issues.

 

Sink or Swim

Decline of the west

 

 

Kuper Island Residential School survivor Belvie Brebber told CBC’s team investigating conditions at that school, about her five years at Kuper Island Residential School, a time filled with fear told  them about  cruelty and sexual violence there. Belvie made it out alive, but her younger brother Richard Thomas did not. She described a terrible phone call that shattered her family forever, and why she never believed the school’s story that her beloved brother died by suicide.

 

Belvie hated the school at Kuper Island, but many children in many places hated school.  She wanted to run away and did stay away for a while, but her father got a warning letter from the government that if she did not return to school her father would be put in jail. They also said he would lose custody of all of his children, and they and he would have to pay a $500 fine. Not only that, but the children would not be able to go to school anywhere else in the province. Those were pretty big threats. According to Duncan McCue,

“It wasn’t an idle threat. Police regularly went to Indigenous parents to enforce  orders  and  the indigenous people were told they would have to pay a fine if they did not comply. If parents couldn’t pay a fine, they faced jailtime and risked losing all their kids.”

 

So her parents drove her to the ferry and shipped her off to school. For indigenous people it was usually easier to acquiesce.

 

Is Social Liberalism the problem?

Decline of the west, Health, Liberalism, Social Media

 

I am still looking at the issue of why there are so many youth suicides. What happened?

Ross Douthat of the New York Times thinks Jonathan Haidt, the social psychologist, did not go far enough. He should have looked more at the society into which this new technology fell. Douthat said this:

“One answer is that social media entered into a world that was experiencing the triumph of a certain kind of social liberalism, which the new tech subjected to a stress test that it has conspicuously failed.”

 

We must realize that by “social liberalism” he did not mean exactly what you might think. He is not talking about the woke culture that Republicans are currently constantly criticizing. He does not think anti-racism or diversity equity inclusion (‘DEI’) is the real problem. He thinks it is the liberalism that preceded it—the individualism of the 1960s that included secularization, which replaced the decline of religion in the 2000s. From Douthat’s point of view, which is clearly Christian and conservative, (though not in the Trumpian sense), is that social and sexual permissiveness, widespread and open pre-marital sex, out-of-wedlock child rearing, and marijuana use all contributed to the problem. I would point out that Douthat has not backed up his claims with the rigorous kind of evidence Haidt did, but his ideas have some attraction. All of those factors which might even have been morally justified and rational, might very well have contributed to the moral instability of youth, particularly young girls.

Douthat saw such liberalism this way:

“All of which has made social liberalism look much more unsustainable and self-undermining than it did in 2008. It’s threatened not just by political radicalism and returning disorder, but by a collapse of familial and romantic and even sexual connection, a terrible atomization and existential dread, a chasing after ever stranger gods.

These modern technologies fell on soil that was fertile to growing insecurity and anxiety and thus wrecked havoc on our youth. Freedom can be difficult for anyone, let alone youth and children.  They needed a moral foundation to support these liberal freedoms, which was often absent as parents did not know how to supply them, often relying solely on religious teachings and dogma that were not always adequate for the purpose. This combination of new exciting technologies, exhilarating freedom, and dubious religious instructions did not give youth the solid grounding they needed. Freedom alone can be hell.

Douthat concluded this way:

“If you were comfortable with the world of the early Obama years, it makes a lot of sense to focus on the technological shock that brought us to this place, to lament and attempt to alter its effects.

But those effects should also yield a deeper scrutiny as well — because what looked stable and successful 15 years ago now looks more like a hollowed-out tree standing only because the winds were mild, and waiting for the iPhone to be swung, gleaming, like an ax raised with less family stability and weak attachments to religion, with a strong emphasis on self-creation and a strong hostility to “normativity” — to enter and forge a new social world. And they went forth and created the online world we know today, with its pinball motion between extremes of toxic narcissism and the solidarity of the mob, its therapy-speak unmoored from real community, its conspiracism and ideological crazes, its mimetic misery and despairing catastrophism.”

 

I think Douthat’s analysis provides some helpful supplements to Haidt’s scientific analysis. In other words, in my view, new technologies, new freedoms without a solid moral foundation is what left youth unanchored, and weak religious teachings combined to create the debacle of the 2010s. And sadly, that all started a chain reaction which has fed a steady stream of youth suicides. And we are not over it yet.

Why are North American Teens Miserable?

Decline of the west, Health, Social Media

 

I have already commented on a big problem with youth in North America. In particular, I referred to significant work done by Jonathan Haidt and his team of researchers. Unfortunately, there is more to say on th e issue.  It is time to meander back.

Based on the recent CDC Youth Risk Report Ross Douthat commented as follows in the New York Times:

“American teenagers, and especially American teenage girls, are increasingly miserable: more likely to entertain suicidal thoughts and act on them, more likely to experience depression, more likely to feel beset by “persistent feelings of sadness or hopelessness.”

 

We must remember that every generation worries about and complains about the generation that follows them. My parents did, I did it, and my kids will do it. The next generation is never considered as good as our generation. The only other thing we like to blame as much as the youth is modern technology. Yet now, perhaps surprisingly, at least there is some evidence to support this worry.

 

Jonathan Haidt a leading social psychological researcher has done extensive scientific study on the issue of what is happening to our youth. He has testified about it to the United States Senate. He bases his statements on scientific evidence, not bias. He has shown that based on many indicators there has been a severe darkening of the mental health of youth occurred in the early 2010s. These, of course, in the US were the Obama years. His research lab has actually pinned it down to that time. He saw a worrying change that has continued to the present.

 

Haidt bases his claims on the fact that this is exactly the same time when social media changed significantly.  I have seen the effects of social media on young girls and it is not pretty. Ross Douthat who concurs with Haidt said, “The timing of the mental health trend fits the smartphone’s increasing substitution for in-person socialization.” Douthat also said this:

“Then data aside, having lived through the online revolution as both a participant and a parent, it seems obvious that social media has worsened the coming-of-age experience relative to the halcyon 1990s — creating a “sense of another consciousness that’s welded to your own consciousness and has its own say all the time,” as my fellow teenager-of-the-’90s Freddie DeBoer wrote recently, which makes the general self-consciousness of adolescence feel much more brutal.”

 

It has always been tough being a teen.  But social media has greatly exacerbated the problem. This problem is not confined to the United States. Similar evidence of severe mental health issues have been seen in Canada and throughout the west.  I think this indicates  a severe decline in the west.

Social Cancer

Decline of the west, Drugs, Health, Social Issues

 

Nicholas Kristof and Sheryl WuDunn writing in the New York Times in 2020 said there was “a cancer growing at the heart of the nation.” They meant the USA of course, but really as Jonathan Haidt showed it goes much wider than that. I clearly includes Canada and other countries such as the UK and Australia.

It is that social “cancer” that I want to look at. To do that, I must find it. That may not be easy.

Kristof and WuDunn have a suggestion of where to look:

We have deep structural problems that have been a half century in the making, under both political parties, and that are often transmitted from generation to generation. Only in America has life expectancy now fallen three years in a row, for the first time in a century, because of “deaths of despair.” [They wrote this in 2020]

 

I had heard that expression before. I think it was another physician, Dr. Sanjay Gupta. Dr. Gupta is both a physician and a television medical analyst. He had some very interesting things to say on a fascinating television documentary.

 

The trigger for Dr. Gupta’s documentary  was another startling fact that as far as I was concerned had gone under the radar. As he said, “In the 1960s Americans had among the highest life expectancy in the world. Today [2019] the U.S. ranks at the bottom of major developed nations.”

In that documentary, Dr. Gupta interviewed another physician a forensic pathologist Dr. Cyril Wecht, in Greenburg Pennsylvania, who said “the previous year I did 356 autopsies. Of those more than 300 were drug deaths. And this is what is being experienced throughout the country.” He also said, “this is far greater than what we experienced with AIDs. It is a very significant epidemic of monstrous proportions.” As Dr. Sanjay Gupta said, “what we are dealing with in fentanyl is 50 times stronger than heroin.” Drugs are part of the problem, but I actually think they are more a symptom than the cause. I will post more about this in the future. It is a fascinating issue.

As Dr. Gupta said, “In the United States life expectancy is dropping faster than any other demographic in the world.” According to the Center for Disease Control, “Middle-aged whites are the highest increase in the deaths of despair.” This group also has very high rates of drug overdose. Whites?  Who would have thought that?

What is going on here? That is what we must figure out. What is the cancer at the heart of the United States and Canada?