[Stoves] Ghana news: Second Lady named GACC ambassador; HAP deaths "alarming"

[Nikhil Desai]

Crispin:

Clarification: The PM2.5 equitoxicity assumption is only one among many
assumptions about risk factor attributions. And it is common to say
something "kills", even if scientifically incorrect and morally wrong.

We economists have spent umpteen decades and zillion dollars on association
and causal factors of economic growth. I will not fault other abusers of
statistical methods.

Why, economists go into attributions of illness too. (A lot of PM2.5 work
is by health economists, not clinical epidemiologists). Angus Deaton and
Anne Case (a husband and wife pair at Princeton, Deaton a Nobel economist)
write about the temptation to conflate coincidences as causal links:

Much of the commentary has linked the deteriorating health of midlife
whites to what has happened to their earnings and incomes, and in
particular to stagnation in median wages and in median family incomes.
Because there has been real growth in per capita GDP and in mean per capita
income, the poor performance for middle-class incomes can be *mechanically
attributed* to the rising share of total income captured by the best-off
Americans. ... Quite apart from the question of whether, if the top had
received less, the rest would have received more, *we shall see that the
economic story can account for part of the increases in mortality and
morbidity, but only a part, and that it leaves more unexplained than it
explains. Our preliminary conclusion is that, as in previous historical
episodes, the changes in mortality and morbidity are only coincidentally
correlated with changes in income*. (Mortality and Morbidity in the 21st
Century
<https://www.brookings.edu/wp-content/uploads/2017/08/casetextsp17bpea.pdf>,
Brookings Papers on Economic Activity, Spring 2017)


They were writing about another Nobel economist, Joe Stiglitz, who wrote “When
Inequality Kills
<https://www.project-syndicate.org/commentary/lower-life-expectancy-white-americans-by-joseph-e--stiglitz-2015-12>.”
(Project Syndicate, 7 December 2015), in fact celebrating an earlier paper
by Deaton and Case.

Cause and association can always be debated. The primary problem with HAP
GBD is not one of scientific method and language, but simply that the facts
are missing.

There is no data on cookstove emissions and exposures for the average 50
million people who died every year from 1990 to 2016 worldwide. The data on
numbers and assigned causes of death and illness are also paltry as far as
developing Asia and SSA go.

With fuzzy doses and fuzzy responses, there is no point debating methods of
dose-response computations, and I stopped digging into regressions and
Granger causalities, the latter a convoluted fad in population health.

What does it matter if the HAP attributable deaths were 40,000 a year or 4
million a year and to whom, why, where? All that is rhetoric for the sake
of marketing memes.

But even a lay person should care that assignment of risk factors for the
cohorts dead has little to do with the future cohorts. That is what policy
choices are about - ignoring weak claims of loud claimants.

Which is why WHO interference in TC-285  is hugely problematic. ANSI is
acting irresponsibly trying to shove BAMG modeling on to TC-285 work.

Nikhil

On Oct 13, 2017, at 7:47 PM, Crispin Pemberton-Pigott <
crispinpigott at outlook.com> wrote:

Dear Tom

I don't want to contradict either of you on the various interpretations but
I would like to check something with you, as it is mere opinion:

"According to the World Health Organization, household air pollution from
cooking kills over 4 million people every year and sickens millions more."

Do think think the average reader of that quote realises that the quote
should be:

"According to the World Health Organization, household air pollution from
cooking contributes to the premature death of over 4 million people every
year and sickens millions more."
‎
There is ‎only one occurrence I can find in the WHO documents that says
'kills' and it misquotes another WHO document that says 'premature deaths'.

The 'kills' argument leads to [multiple cites] things ‎like, 'cooking kills
x-many women per day' and 'since we have been talking in this meeting
y-many women and children have died from cooking smoke'.

The abuse of statistics is universal but I see nothing wrong with stating
problems as they are, in a context, with realistic plans and expectations,
and competent implementation of appropriate solutions. ‎That's just me.
Maybe I am not 'Hollywood' enough.

The 'creation of memes' centered on headline-grabbing alarm and
calamity-mongering is a major distraction. I am saying *nothing* against
the central proposition about smoke and health. My father died from
cigarette-induced lung cancer. Does that qualify me to make emotional
appeals for lower performance tier target values? No.

There is a popular story in the press right now that surely no one can
miss. It is that in Hollywood there is a serious problem of sexual violence
against women who have to leave their homes daily to earn a living, or at
least make the attempt. Shall we stovers propose that if these women and
girls were provided with a commercial quality stove, pot and training to
make jam, and the opportunity to sell through a cooperative store, the
number of these assaults would be reduced? This seems to be a good
proposal. ‎There are lots of people around Waterloo who know how to make
jam.

The number of exposures to violence could be reduced if these women at
least had a coffee maker because a lot of these attacks apparently start in
a coffee shop. We have a responsibility to protect those vulnerable women
‎who are only in Hollywood because of a lack of opportunities in the rest
of the country. Some of them were already fleeing violence at home.

Please send $145 for each women you want me to save. I'll give them the
kind that makes good cappuccinos. ‎They like them (it's cultural).

‎This is the quality of argument that is being used to raise funding. There
is a well-established correlation between young girls in Hollywood meeting
producers for a drink and sexual violence. Surely a cooking device of some
kind is the solution.

Two more things:

The 'all PM2.5 causes illness and or death' is based on an *argumentum ad
ignorantium* meaning proof from ignorance: 'all PM2.5 is equally toxic
because we have not proven that it isn't.' That is the founding claim (and
wording, paraphrased) of the EPA's regulations which serves as the basis
for the WHO's calculations. Nikhil traced that to source.

‎The Kyrgyzstan winter stove pilot proved beyond doubt that getting the
smoke outside, alternatively not making as much *and* getting it outside,
reduces personal exposure, a conclusion reached without modeling any
kitchens or dispersion. It also showed that men have higher exposure to
PM2.5 than either children or women and benefitted the most from the
improved stoves and installations.

The inference here is that there is a lot more going on in Hollywood than
we supposed. ‎Details available in installments at the checkout till in
your favourite store.

Regards
‎Crispin


Nikhil,



You complain that there is no demonstrated causality between emissions
metrics (HAPS, PM2.5) and mortality and argue that therefore a stoves
program shouldn’t be based on models and estimates of mortality. For many
years the doctors in this community have advocated for more physiological
studies.  Direct causes are difficult to get from death records. For
example, my father’s death certificate lists a cause that was the
consequence of the treatment rather than the cancer that he suffered from
so he might not show up in a cancer statistic. I do know that wherever I
travel people in industry and in government are concerned about PM 2.5
levels from any combustion source. Real or imaginary a relationship is
assumed and PM 2.5 is regulated.



The stove policies and programs are based on a strong statistical
correlation between PM 2.5 and reported mortality due to respiratory or
cardiovascular causes. That correlation has been validated for some
developed and developing countries. (Every study I have seen cautions about
the shortcomings of the statistics but the correlations are strong.) If I
were a policymaker I would find enough justification in the statistical
correlation to promote healthier environments through programs like
improved cookstoves of all kinds. The estimates that you complain about are
likely based on the global rather than local statistics.



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