Written on 21 November 2015.

The current migration crisis in Europe and North America shows two distinct aspects:

the arrival of refugees and other migrants, and
the deportation of undesired migrants.

The former enjoys high visibility not only in the media but also as new faces continue to appear among the crowds of daily life.

The deportation is largely invisible. Over night, a foreigner who has been around for some time is missing, an entire family may have disappeared like the Jews in Germany did during Nazi years.

Deportation or “repatriation”, as the Italians prefer to call it, is the ugly side of migration. “Welcome culture” was offered in Germany to the arriving crowds – but no “disappearance culture” exists for those expelled from their dream land.

Even less of a welcome is offered to the returnees upon arrival in their country of origin or any in other place where they may have been dumped against their will. Unless a kind-hearted government or an NGO takes care of the returnee, a deported person is rarely welcomed.

For several reasons, a deportee is usually unwelcome back home because

someone who left the country is often considered a traitor or an enemy of the government;
someone who returns reduces the strength of the diaspora on whose remittances the economy depends;
a returnee is considered someone who failed to establish himself or herself abroad;
of the suspicion to have been expelled for bad behavior or for having committed a felony and done jail time.
the returning migrant has not only squandered his or her own savings but in many cases also a credit provided by family and friends to finance the northbound trip.

Understandably, immigration countries are at present mainly focused on the challenges of accepting and accommodating the migrants assumed to be refugees if they apply for asylum. In Germany, some 40 percent of current arrivals are offered asylum, the rest is expected to return voluntarily to their country of origin or to be deported.

The potential deportees, however, stay months and sometimes years in the country before they leave – if they ever do. During this period they are kept in suspended animation, can't work, can't send their children to school and are not eligible for language courses. Their cost of accommodation, food and medical treatment are borne by the country of immigration, as well as the cost of deporting them.

In addition, the country that wants to get rid of them also faces the cost of convincing another country to accept them. Most migrants arrive without papers, many lie about their country of origin, making it extremely difficult to deport them. Consequently, authorities in charge of deportation are usually quite rough in handling people. Picking them up in the middle of the night, rushing them to the airport before they can call a lawyer, forcing them handcuffed into the plane if it is a commercial flight – scenes which neither passengers nor flight personnel like to watch.

The United Kingdom, for instance, hired a fleet of 54 private jets to deport almost 3,000 people from January 2014 to June 2015, according to the interior ministry. "Charter flights are used to return illegal immigrants to destinations which have a limited number of scheduled flights or where scheduled flights have an insufficient capacity to meet demand. In general, they are used to remove those with a history of non-compliance or who pose a risk to the public,” the Home Office told the Mirror.

On arrival back home they are usually penniless, facing grim immigration procedures and possibly persecution.

In other instances they are not expelled by plane but given a one way train ticket to the country they came from. In Hungary, for instance, arriving through the border fence is considered a crime. The convicted felon is given a train ticket to return to Serbia. Since Serbia refuses to accept any returning migrants, the poor person ends up in an overcrowded Hungarian jail to wait for doomsday or for Serbia to change tack.

In the first half of 2015, Italy deported 8,500 illegal immigrants who did not qualify for asylum, who lied on their applications, or whose proposed reason to stay was not justified, according to a report by the interior ministry. Of the 200,000 illegals expected to arrive in Italy in 2015, 18,068 are considered the least wanted of the unwanted; most of them have already been expelled.

Weekly charter flights to Cairo and Tunis take illegal Egyptians and Tunisians back home. Algerians are usually put on return flights upon arrival. Moroccans can also be returned because of a bilateral agreement with the government. Similar arrangements are sought with Nigeria, Senegal and The Gambia. Illegal Albanians and other people from the Balkans are forcibly returned by locked train carriage or ferry.

Back in 2012, Europe's human rights court ordered Italy to pay damages to 24 Somali and Eritrean migrants for having deported them to Libya in 2009, saying the government in Rome put the migrants at risk of torture and persecution. In 2015, despite this ruling, 133 Syrians were dropped at the border of Lebanon and Syria, and 221 Afghans were flown to Afghanistan which refuses to accept returning refugees.

The US government is deporting undocumented immigrants back to Central America to face the imminent threat of violence, with several individuals being murdered just days or months after their return, a Guardian investigation has found.aThe Guardian has confirmed three separate cases of Honduran men who have been gunned down shortly after being deported by the US government. Each was murdered in their hometowns, soon after their return – one just a few days after he was expelled from the US. A forthcoming academic study based on local newspaper reports has identified as many as 83 US deportees who have been murdered on their return to El Salvador, Guatemala and Honduras since January 2014.

Germany is very slow in returning migrants. In 2014, some 200,000 people applied for asylum. Two thirds of them were rejected but only about 10,000 were expelled. The remainder were “tolerated” which means living in suspended animation. In the first half of 2015, only some 8,000 from over 190,000 rejected asylum seekers were returned to where they came from. Of those, 52,000 should leave Germany, the rest is tolerated for medical reasons or because they lack documents and Germany cannot identify their country of origin. As a result of the backlog and the recent and continuing mass immigration, the Bundestag adopted legislation to speed up deportation but chances are that most asylum seekers, except citizen of Balkan countries, will one way or another remain in Germany.

Switzerland is unpopular among potential asylum seekers because it practices a fast track procedure for candidates from the Balkans, deciding within 48 hours if the request is accepted. Since Switzerland has concluded bilateral agreements with Balkan countries that permit repatriation, undesirable applicants can be returned quickly. Immigrants from North Africa, Nigeria, Senegal and The Gambia are kept in federal centers maximally 140 days before deportation; other applicants with better chances of success are distributed among the Cantons and will receive the verdict within a maximum of 12 months. All asylum seekers are offered legal assistance which helps to speed up procedures.

Conclusion

With a time lag of one to several years – depending on the immigration policy of the country of asylum – the streams of migrants are reversed. For each million of arrivals a few hundred thousand are expected to return to where they came from.

Some will leave voluntarily with a small cheque in their pocket. Others will be forcibly expelled. Still others will successfully dodge deportation and stay in hiding. Some will commit suicide or die before being deported.

Although expelling countries are eager to act smoothly and silently, the scandal of forced deportation will gain in visibility as the scale of the operation grows. For every fish trawler full of migrants arriving at Europe's shores, for every train load of potential wetbacks making across the Rio Grande, one or more plane loads of returnees will leave in the opposite direction.

A costly and basically inhumane operation likely to assume a large scale as asylum policies are tightened and the northbound mass migration from Asia, Africa and Central America continues with no end in sight.

Many if not most migrants hail from countries considered safe. Experience shows that most of these countries are unwilling to take back migrants unless they are compensated for the loss in terms of remittances foregone. Deportation thus becomes doubly expensive: to the cost of transport and a possible silver handshake for the voluntary returnee, the dispatching government is forced add the cost of compensating the receiving government for the remittances lost. If this compensation is satisfactory, the latter government might even accept migrants of unknown nationality: an opportunity for the dispatching government to get rid of some of the toughest cases.

Heinrich von Loesch

Update

According to the Ministry of the Interior, Germany "repatriated" 18,363 persons who were not granted asylum during the first eleven months of 2015. During the same period, 425,000 newly arriving persons were processed for asylum request. Obviously, numbers of arrivals and numbers of departures are out of sync if deportation is supposed to limit immigration to genuine refugees entitled to asylum.

The deputy chief of the German police union, Jörg Radek, estimated the number of people obliged to leave Germany at 190,000. He criticized the Länder governments for lack of action and urged them to show "much more determination in expelling foreigners who were denied asylum."

Update II

The Afghan Minister for Refugees Hossein Alemi Balkhi has allegedly encouraged Afghans on social media to leave their country and migrate to Europe. In an interview with Sueddeutsche Zeitung (1/02/16) he considered 31 of 34 provinces "unsafe". He wants to exclude from repatriation all Afghan refugees except a few "healthy males from safe provinces."

Written on 17 November 2015.

Latinos living in the US are poorer, have harsher jobs and less access to education and health services than Whites. But their health is better. So what's behind this "Hispanic paradox" as it is called in the official literature?

The question itself demonstrates considerable bias. Paradoxical is not the observation that Latinos are healthier than Whites. Remarkable instead is the fact that non-Hispanic Whites are less healthy than American Hispanics although they are richer, have less harsh jobs, have better access to education and health services than Latinos. So what's behind this “White paradox”?

Typically, no American institution seems interested in looking at the issue from this angle. The White majority-centered academia undertook considerable research to discover why the disadvantaged Latino minority (15 percent of the total population) outlives the White or Caucasian or “European American” majority.

Whites have higher mortality rates in seven out of the most important causes of death although they are half as frequently as the Latinos considered poor and are three times as likely to enjoy health insurance. However, Whites are less obese than Hispanics and suffer less frequently from diabetes, cirrhosis and other liver diseases.

A typical American research result says: A smattering of evidence suggests that many Latino community environments discourage high-risk behaviors, such as excessive smoking, high alcohol consumption and heavy use of mind-altering chemicals that may threaten lifespans.

Instead, this could be read as: "Evidence suggests that many White environments encourage high-risk behaviors, such as excessive smoking, high alcohol consumption and heavy use of mind-altering chemicals that might threaten lifespans."

Add to this suicides, pharmaceutical and hard drugs, unhealthy food, and you get closer to an explanation for the White paradox.

In fact, there's strong evidence that the second generation Hispanics [the U.S.-born children of foreign-born immigrants] become acculturated and adopt behaviors such as smoking." Their health is more consistent with their education and poverty levels, more similar to non-Hispanic whites and African Americans.

White women residing in the wealthiest California neighborhoods will live one year less than Latinas living in poor areas. In California, 25-year old White and African American high school dropouts were in 2008 likely to live ten years less than their Hispanic counterpart.

Foreign-born Hispanics who immigrated to the United States "appear to be particularly healthy," having rates of several major chronic diseases equal to or lower than whites, another study says "Their health advantage is even more pronounced when we controlled for income and education."

This statement. If looked at it from a different angle, would read:: Poor American Whites with little education show particularly poor health if compared to foreign-born Hispanic immigrants.

Conclusion

Top longevity in the US is attained by Asian Americans with an average of 86.67 years, followed by Hispanics with 82.89 years and Native Americans with 81.17 years. Whites stay way behind with 79.71 years and African Americans with a mere 75.54 years. At state level, the highest life expectancy is recorded for Asian American women in Massachusetts with 91.60 years.

In international comparison, according to the 2010 United Nations World Population Prospects, the United States ranks 40^th among nations (behind Cuba and Puerto Rico) with a life expectancy at birth of 77.97 years. Even if the US was inhabited only by Whites, it would gain merely 0.26 years and its ranking would not change.

The White Paradox evidently requires more research to better identify and control the causes of the high mortality of this population group which affords one of the world's costliest health services and enjoys one of the highest per capita income levels. There are basically three possible explanations for the paradox:

1. 1. American medicine increases mortality instead of lowering it
  2. Rising per capita income raises mortality, for instance through lethal accidents
  3. Something is very wrong with the White life style in the US.

re 1: American medicine serves not only Whites but all races, plus numerous foreigners. Evidently successfully. Similar medicine is practiced in many countries with high life expectancy.

re 2: Other high income countries show low mortality. High income among African Americans – the lowest life expectancy group --can be accompanied by low accident rates, as is the case of the District of Columbia. Interestingly, the highest accident-prone state is West Virginia, a predominantly White state.

re 3: This is the only remaining explanation (which is dscussed elsewhere in this magazine).

Surprisingly little public attention is devoted to the consequences of an apparently unhealthy life style. The loss in terms of years of life not lived is enormous, to the tune of five to ten percent of all White American years lived. Similarly huge is the loss for the US economy in terms of education under-exploited, medical treatment wasted, family life disrupted and retirement years reduced.

Heinrich von Loesch

Written on 06 November 2015.

English

Il Territorio libero di Trieste era una sottile striscia della costa occidentale della penisola istriana, tra il fiume Timavo e il fiume Quieto

Per gli italiani Trieste era la "città irredenta" per antonomasia, per gli austriaci la finestra dell'Impero sul Mediterraneo, per gli slavi il polmone della Slovenia

Su che cosa dunque fosse il TlT, gli studiosi discutono ancora. Non era più Italia, non era Jugoslavia, ma non era neanche uno stato.

Sarebbe dovuto essere uno stato cuscinetto fra Italia e Jugoslavia previsto dal trattato di pace del 1947, posto sotto l'egida delle Nazioni Unite per evitare che i due stati confinanti si accapigliassero per farne un solo boccone. Invece, non andò così: la questione del TlT rimase una spina del fianco di Italia e Jugoslavia fino al 1954 - data in cui il memorandum di Londra cercò di accomodarla in via pratica - venne ufficialmente risolta solo con il trattato di Osimo nel 1975 e suscita ancora qualche tardiva passione.

La vicenda del TlT è stata uno degli ultimi sussulti attraverso i quali si è definito nel secolo scorso il confine orientale italiano. Nel comporre quelle spinte e controspinte si sono accavallati vari tipi di contrasti: le rivalità di potenza prima fra Italia e Austria-Ungheria e poi fra Italia e Jugoslavia, gli antagonismi nazionali fra italiani, tedeschi, sloveni e croati corposamente intrecciati ad interessi di classe, le conflittualità strategiche ed ideologiche della guerra fredda.

Prima del primo conflitto mondiale, i territori fra il fiume Isonzo e lo spartiacque alpino i tedeschi li chiamavano Litorale austriaco, gli italiani Venezia Giulia, mentre gli slavi li dividevano fra Litorale sloveno e Istria croata.

Per gli italiani Trieste era la "città irredenta" per antonomasia, per gli austriaci la finestra dell'Impero sul Mediterraneo, per gli slavi il polmone della Slovenia e, magari, di un nuovo stato degli slavi del sud. Attorno a tali differenti letture della realtà fiorivano studi più o meno scientifici, si narravano miti assai suggestivi, si componevano odi e spartiti musicali, si infiammavano i cuori e si mobilitavano le masse. Insomma, un bel concentrato, nell'ambito di una minuscola regione adriatica, delle linee di faglia che stavano per scatenare i grandi sismi dell'Europa centrale.

Il primo scossone favorì l'Italia, che dopo la Grande guerra annesse l'intera regione. Del loro trionfo, gli italiani non fecero un uso assai saggio. Il regime fascista si diede con grande impegno ad opprimere quella che era diventata la minoranza slovena e croata in Italia, con il chiaro intento di nazionalizzare integralmente il territorio dello stato.

Non era un proposito molto diverso da quello degli altri stati per la nazione europei, ma la sua gestione da parte di un regime di per sé oppressivo contribuì ad alimentare un robusto irredentismo sloveno e croato e ad inculcare nelle menti delle sue vittime una funesta equivalenza fra italiani e fascisti.

Per giunta, lo stato di Mussolini fallì clamorosamente il suo obiettivo nazionalizzatore, vuoi per la resistenza all'assimilazione delle popolazioni rurali, vuoi per i limiti stessi di un sistema meno totalitario di quanto il Duce avrebbe desiderato.

Anche il secondo scossone sembrò inizialmente beneficare l'Italia, che nel 1941, dopo aver fatto a pezzi la Jugoslavia assieme a tedeschi, ungheresi e bulgari, annesse la Slovenia meridionale, la Dalmazia e, di fatto, puranco il Montenegro. Contro i "ribelli" alla nuova situazione le truppe italiane mostrarono una spietatezza non inferiore a quella germanica. Due anni dopo però, nel settembre del 1943, l'Italia andò a gambe all'aria, trascinando nel crollo non solo il recentissimo confine imperiale, ma anche quello uscito dal primo conflitto mondiale, che i patrioti italiani avevano interpretato come la quarta guerra di indipendenza.

Seguì il caos. La regione venne posta sotto il diretto controllo germanico e si trovò risucchiata nelle terribili logiche di violenza del fronte orientale e della guerra di liberazione / guerra civile / rivoluzione jugoslava: ed ecco le stragi di "nemici del popolo" che gli italiani chiamarono foibe (dal nome delle cavità carsiche in cui venivano spesso gettati i cadaveri), la politica del terrore tedesca, gli attentati, il campo della morte della risiera di san Sabba con il suo forno crematorio.

Gli italiani passarono di colpo dal dominio all'impotenza. Il potere lo avevano i nazisti, il contropotere i partigiani comunisti jugoslavi. Alcuni italiani si schierarono con i primi, altri con i secondi. Per gli italiani fu l'inizio della "catastrofe dell'italianità adriatica", mentre sloveni e croati vivevano un'epopea risorgimentale i cui sanguinosi contorni fratricidi sarebbero stati a lungo obliati.

Mentre le frontiere di stato fluttuavano, quelle all'interno della società si irrobustivano. I principali gruppi nazionali si percepivano reciprocamente come una minaccia mortale. Anche gli internazionalisti, cioè i comunisti, si trovarono a dover scegliere fra Italia e Jugoslavia: per quelli sloveni e croati, ovviamente, il problema non si poneva, mentre quelli italiani finirono anche loro per schierarsi con la Jugoslavia che stava costruendo il socialismo piuttosto che con l'Italia destinata a rimanere capitalista.

E l'Italia dalla guerra uscì sconfitta e duramente punita: oltre a cancellarne per sempre le ambizioni di potenza - il che non fu affatto un male - il trattato di pace assegnò alla Jugoslavia quasi tutta la Venezia Giulia, lasciando in Italia solo la parte meridionale della provincia di Gorizia. Città simbolo dell'italianità adriatica, come Zara, Fiume e Pola, furono perdute.

Dopo la radicalizzazione estrema dei conflitti nazionali avvenuta negli anni precedenti, accadde agli italiani residenti nei territori passati alla sovranità jugoslava quel che già era avvenuto ai greci in Anatolia, ai tedeschi in Polonia e Cecoslovacchia, ai polacchi in Ucraina, solo per citare alcuni dei più noti fra gli spostamenti forzati di popolazione novecenteschi. Le modalità furono diverse, secondo il paradigma degli esodi piuttosto che delle deportazioni o delle espulsioni, ma il risultato fu il medesimo: la scomparsa quasi completa di un gruppo nazionale autoctono.

Sospeso rimaneva invece il futuro di Trieste, la cui sorte non dipese dalle dispute locali ma dagli interessi delle grandi potenze. All'Unione Sovietica, poco interessata al Mediterraneo, premeva semplicemente mostrare il proprio sostegno all'amico regime jugoslavo di Tito.

Stati Uniti e Gran Bretagna erano invece fermamente intenzionati ad evitare che l'unico porto dell'Austria finisse in mano jugoslava, cioè sovietica. La prima conseguenza fu l'internazionalizzazione, ma si trattava solo di un espediente temporaneo. Un anno dopo, inglesi e americani si convinsero che il TlT non sarebbe stato vitale e che, in tempi di guerra fredda, sulla garanzia delle Nazioni Unite non bisognava fare troppo affidamento.

La soluzione alternativa era a portata di mano: il trattato di pace aveva previsto che fosse il Consiglio di sicurezza a nominare il governatore - profumatamente pagato - del nuovo staterello.

Nel frattempo, l'area sarebbe stata amministrata dalle forze armate che già vi stazionavano fin dall'immediato dopoguerra, e cioè dagli anglo-americani nella zona A, con Trieste, e dagli jugoslavi nella zona B.

Dunque, bastava non mettersi d'accordo sul nome del governatore ed il gioco era fatto. Dopo un po' di schermaglie, i sovietici capirono che aria tirava e lasciarono perdere, anche se formalmente la nomina sarebbe rimasta all'ordine del giorno del Consiglio di sicurezza fino al 1975.

Su che cosa dunque fosse il TlT, gli studiosi discutono ancora. Non era più Italia (su questo solo alcuni giuristi italiani non sono d'accordo). Non era Jugoslavia. Ma non era neanche uno stato, perché mancava di tutti i requisiti della sovranità. Dunque, che cos'era? Forse nulla: res nullius, come dicono i giuristi. Però, non era affatto scomparso dalla faccia della terra: la gente ci viveva e, abbondantemente, ci litigava.

Nella zona B vennero instaurati i "poteri popolari" e chi veniva considerato "nemico del popolo" se la passava davvero male. Non casualmente, quasi tutti gli italiani lo erano.

All'inizio facevano eccezione i comunisti, che erano considerati "italiani buoni e onesti": ma erano pochini e rimasero sconvolti quando, nel 1948, scoppiò la controversia fra Tito e Stalin che portò all'espulsione della Jugoslavia dal Cominform. Ovviamente, si schierarono con Stalin e si ritrovarono trattati come i peggiori nemici del regime.

Nella zona A, la funzione del Governo militare anglo-americano era quella di difendere la democrazia liberale, però senza concederla alla popolazione, perché c'erano troppi comunisti in giro.

Così, per la prima volta si votò appena nel 1949, beninteso solo per le amministrazioni locali, ed il GMA mostrò sempre la tendenza a reagire con grande vivacità - e salve di fucileria - a qualsiasi tentativo di sfidarne l'assoluto controllo, venisse dai comunisti o dai patrioti italiani.

A differenza delle autorità jugoslave in zona B però, oltre al bastone il GMA sapeva usare anche la carota. Trieste fu inondata dai fondi dell’Ente per la ricostruzione europea, usati per combattere la disoccupazione a prescindere dall'effettiva sostenibilità economica delle nuove imprese.

Inoltre, i militari americani erano pieni di dollari e la zona A altrettanto piena di bar, sale da ballo, stabilimenti balneari e belle ragazze, parecchie delle quali riuscirono anche a farsi sposare. Nella zona B, invece, si faceva la fame.

La rottura fra Stalin e Tito mutò peraltro completamente il ruolo internazionale della Jugoslavia: non più longa manus di Mosca verso il Mediterraneo, ma possibile cuscinetto strategico dell'Occidente nei Balcani.

Agli inizi degli anni Cinquanta quindi, Washington e Londra cominciarono a premere su Italia e Jugoslavia affinché mettessero da parte le precedenti rivalità in nome dell'interesse comune.

Non fu per niente facile ma alla fine, nell'autunno del 1954, riuscirono ad inventare una soluzione abbastanza fantasiosa. Un memorandum firmato a Londra previde infatti che l'amministrazione della zona A passasse dal GMA al governo italiano e quella della zona B dal governo militare jugoslavo al governo jugoslavo.

In questo modo, di fatto il TlT veniva spartito fra Italia e Jugoslavia ma ufficialmente, e con una certa faccia tosta, i governi di Roma e di Belgrado potevano dichiarare alle proprie opinioni pubbliche di non aver rinunciato alle loro rivendicazioni sul resto del Territorio. Il trucco funzionò e negli anni Sessanta quello fra Italia e Jugoslavia divenne "il confine più aperto d'Europa" fra uno stato comunista ed uno capitalista.

Formalmente, rimaneva ancora qualche ombra e nel 1975 i due governi, entrambi preoccupati per il "dopo Tito", decisero di cancellarla con il trattato di Osimo, che sanciva ufficialmente il confine italo-jugoslavo. Delle antiche dispute le opinioni pubbliche dei due paesi si erano ormai scordate.

Si lamentarono - ovviamente - le associazioni degli italiani che erano dovuti esodare dalla zona B ed anche a Trieste vi furono proteste, ma l'Italia stava vivendo gli anni di piombo e l'attenzione era altrove. Non per questo scomparvero d'incanto le ferite della memoria, che anzi continuarono a suppurare sino alla fine della Jugoslavia. I nuovi scenari del dopo guerra fredda non influirono sugli assetti di confine tra l'Italia e i suoi nuovi vicini orientali, perché rimettere in discussione quelle frontiere avrebbe significato gettare l'Italia nell'inferno delle guerre jugoslave e questo, dopo qualche incertezza, lo compresero anche i nazionalisti più sfrenati.

Le memorie divise e occultate in nome del buon vicinato e della stabilità continentale erano invece lì, pronte a rivendicare il loro spazio, come in tante altre parti dell'Europa post-'89. Per gestirle, Italia, Slovenia e Croazia seguirono in successione due vie contraddittorie: prima - negli anni Novanta - quella delle commissioni bilaterali di esperti storici, poi - dopo il 2004 - quella della creazione di giornate memoriali.

Quest'ultima, come non era difficile prevedere, ha soddisfatto i bisogni di riconoscimento di molte delle vittime delle contese novecentesche, ma ha suscitato altrettante polemiche, che hanno finito per coinvolgere addirittura i vertici dei tre stati.

Un tanto però, nessuno se lo poteva permettere, mentre la strategia generale dei tre governi era quella dell'integrazione europea. Le diplomazie quindi si sono date da fare per spegnere ogni focolaio d'incendio, organizzando due solenni giornate di riconciliazione, l'una a Trieste nel 2010 e l'altra a Pola (ora appartenente alla repubblica di Croazia) nel 2011.

Comunque, nonostante la forte ripresa d'interesse, politico e storiografico, per le vicende del confine adriatico registratasi nell'ultimo quindicennio, nessuno ha più tirato in ballo il fantasma del TlT, fino ad anni recentissimi: in questi tempi di crisi economica infatti, a Trieste un gruppetto di nostalgici alquanto folcloristici ha deciso di impugnare nuovamente il vessillo del Territorio libero, convinto che vivere a Topolinia sarebbe un ottimo modo per eludere le tasse, che in Italia, com'è noto, sono assai alte per chi le paga.

Raoul Pupo -- eutopia

Letture di approfondimento:

Marina Cattaruzza, L'Italia e il confine orientale, Bologna, Il Mulino 2007.Franco Cecotti, toghether with Dragan Umek, Il tempo dei confini. Atlante storico dell’Adriatico nord-orientale nel contesto europeo e mediterraneo 1748-2008, Trieste, IRSMLFVG 2011.Egidio Ivetic, Un confine nel Mediterraneo. L'Adriatico orientale tra Italia e Slavia (1300-1900), Roma, Viella 2014.Raoul Pupo,The Italo-Slovenian Historico-Cultural Commission, in "Contemporary History on Trial. Europe since 1989 and the Role of the Expert Historian", edited by Harriet Jones, Kjell Őstberg, Nico Randeraad, Manchester, Manchester University Press 2007.

Written on 13 November 2015.

In most populations worldwide, life expectancy is continuously rising. But among white Americans it is decreasing in midlife. A shocking fact highlighted by a new study “Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century” by Anne Case and Angus Deaton; the latter being the new Nobel Prize winner in economics.

Death rates among middle aged white Americans are being driven not by the big killers like heart disease and diabetes but by an epidemic of suicides and afflictions stemming from substance abuse: alcoholic liver disease and overdoses of heroin and prescription opioids.

It's the economy, stupid!

was James Carville's famous explanation for Bill Clinton's victory in 1992 over George H.W. Bush. It's again the economy which is by many seen as the root cause of the unusually early deaths among middle aged whites in the U.S. between 1999 and 2013.

This change reversed decades of progress in (lowering) mortality and was unique to the United States; no other rich country saw a similar turnaround, the paper says. Well, this is not quite true. A precipitous decline in life expectancy occurred in Russia between 1988 and 2003, affecting the male and female population alike. Russian males did by 2013 not yet fully re-attain the life expectancy level they had enjoyed in 1985.

The implosion of the Soviet Union combined with rampant alcoholism is usually seen as the cause of Russia's fifteen year long epidemic of early deaths. But what has happened in the United States?

Politically, the period 1999 to 2013 covers the outgoing second Clinton presidency, the George W. Bush years and the first Barack Obama term. Nothing in politics that could help explain a major demographic shift.

However, there was the 2009 financial crisis which drove millions of Americans out of their homes and/or into personal bankruptcy. Still, the trend toward rising mortality had started a decade earlier.

The rise in deaths among middle-aged white Americans (USW) when compared to the dropping rates seen amongst hispanic Americans (USH), France (FRA), Germany (GER), United Kingdom (UK), Canada (CAN), Australia (AUS), and Sweden (SWE). Case and Deaton 2015.

Many media reviewing and discussing the study concluded that economic reasons were the main agents pushing up mortality. However, this view appears simplistic. The authors of the paper themselves said: Growth in real median earnings has been slow for this group, especially those with only a high school education. However, the productivity slowdown is common to many rich countries, some of which have seen even slower growth in median earnings than the United States, yet none have had the same mortality experience.

Instead, the authors emphasize an epidemic of pain, suicide, and drug overdoses as well as rising morbidity as the chief causes of the heavy loss of lives comparable only to the AIDS epidemic. The paper notes... the three causes of death that account for the mortality reversal among white non-Hispanics, namely suicide, drug and alcohol poisoning (accidental and intent undetermined), and chronic liver diseases and cirrhosis. All three increased year-on-year after 1998.

When trying to identify the causes of the mortality increase it would be helpful to know if there are any gender differences. Unfortunately, the paper does not break down the mortality figures by sex.

G overnment data shows that for all races life expectancy data at age 25 by sex and education level for 1996 and 2006 indicate interesting differences. In both years, at the lowest education level, male life expectancy remains unchanged at 47 years. Female life expectancy declined from 53 years to 52 years in 2006. At higher education levels males achieved slow progress in life expectancy whereas the corresponding female data shows stagnating life expectancy. Only at the highest level -- bachelor degree or higher -- female life expectancy rose by one year.

Although the data relates to all races it can be suspected that during the period under consideration white women were even more affected by rising mortality than white men at all but the highest education level. This could be a significant factor in trying to find an explanation for the American whites' exceptional mortality trend.

Source: Andrew Gelman

By not looking at men and women separately, Case and Deaton failed to see that rising mortality is especially pronounced among women. (Laudan Aron et.al.)

David A. Kindig et.al. added: We examined trends in male and female mortality rates from 1992–96 to 2002–06 in 3,140 US counties. We found that female mortality rates increased in 42.8 percent of counties, while male mortality rates increased in only 3.4 percent.

Laudan Aron: Our own analysis of the same data used by Case and Deaton shows that the average increase in age-specific mortality rates for whites age 45-54 was more than three times higher for women than men. More specifically, between 1999 and 2013, age-specific mortality rates for US white women age 45-54 increased by 26.8 deaths per 100,000 population, while the corresponding increase for men was 7.7 deaths. By lumping women and men together, the study also missed the important point that the increases in mortality are affecting women of reproductive and childrearing ages.

Our recent analysis (Nan Marie Astone et.al.) of causes of death among American women confirmed increasing death rates among non-Hispanic white women ages 15 to 54 specifically. Like Case and Deaton, we found accidental poisonings (linked to prescription opioid and heroin use) and suicides to be among the biggest drivers of this increase.

By 2008, life expectancy for black women without a high school diploma had surpassed that of white women of the same education level. (S. Jay Olshansky et.al.)

Could the trend have been triggered by a sudden deterioration of the economic situation of whites, as compared to all other races (which continue to show a rising life expectancy trend)?

The year 1998 did not bring any economic disaster for American whites. On the contrary: the chronology of major economic events notes: In 1998, the US poverty rate fell to its lowest in 20 years at 12.7 percent. Real median household income hit a record 3.5 percent growth surpassing its pre-recessionary peak in 1989, and for the first time since 1975, all four US regions experienced significant increases.

For 2000, the chronology notes: First quarter GDP grew at an annual rate of 5.4 percent with consumer spending jumping 8.3 percent, the sharpest gain in more than 17 years.

In conclusion, the starting years of the life expectancy slump were boom years. Nothing happened which could have affected the economics of the average white working class family.

It's not the economy, stupid!

O.K., what is it? What got the death epidemic started?

The big puzzle is why the recent experience of middle-aged white Americans with modest educations has been so different (from that of similar groups in other countries) ?

In 1980, the New England Journal of Medicine published a short letter titled Addiction rare in patients treated with narcotics. After this letter, some studies surfaced which minimzed the risk of becoming addicted to opioid analgesics.

Encouraged by pharmaceutical companies, outpatient doctors and hospitals started prescribing narcotics drugs – mainly intended to treat cancer pain – on a massive scale to treat neck and back pain, rheumatoid arthritis and assorted ailments. The patients loved it and quickly got addicted.

Since 1999, the amount of prescription painkillers prescribed and sold in the U.S. has nearly quadrupled, yet there was no overall change in the amount of pain that Americans report, the Centers for Disease Control and Prevention (CDC) noted.

The industry aggressively promoted the painkillers: the cute ads for Pfizer's Celebrex will be remembered by millions.In 2013, nearly two million Americans abused prescription painkillers. Each day, almost 7,000 people are treated in emergency departments for using these drugs in a manner other than as directed. Each day, 44 people in the United States die from overdose of prescription painkillers. (CDC)

Deaths from overdoses and negative side effects of opioid use shot up. Increasing doses of pain pills can even lead to increased sensitivity for pain, resulting in utter despair and even suicide. Also, difficulty encountered in procuring enough pain pills led some people to switch to hard drugs. According to the Centers for Disease Control, people who get addicted to opioid painkillers are forty times likelier to become heroin addicts than people who don’t use opioids or other drugs.

The prescription pain relief boom of the 2000s, combined with increased hard drug consumption could indeed explain the surge in premature middle age deaths. But why did it above all affect Whites, aka Caucasians?

For reasons which are not very clear, both sexes of white Hispanics traditionally enjoy a much higher life expectancy than Caucasians. Pain relief abuse is not evident among Hispanics. Also, among Whites, the highest education group (Bachelor degree or higher) did not succumb to the pain pill craze.

Perhaps both the top educated Whites and the Hispanics were better aware of the inherent danger of narcotics. Or many Hispanics were without medical insurance and therefore did not enjoy easy access to prescription drugs. Or the industry focused its marketing on mainstream English language media which Hispanics do not watch or read. More research is needed to better explore the background of this epidemic of early deaths which so heavily affected the majority population.

Shocked by the mortality data, the Federal Government and several states took steps to rein in the misuse of opioid painkiller prescriptions . It will help to reduce new addictions but it will not cure those already addicted.

Prescribing rates have leveled off since 2010, and we’ve recently seen the first decline in opioid related deaths in decades. (CDC)

John Cassidy of the New Yorker subsumed the situation: Thanks to all of the attention that the Case and Deaton study has received, this will surely change. That can only be for the good.

Conclusions

Several socio-economic theories have tried to explain the Whites' early death phenomenon. None of the theories can satisfy.

The mortality trend started to change during economic boom years which saw people happily shopping. Optimism prevailed. When a number of medical studies paralleled by the industry's heavy marketing of pain pills promised a pain free life style without the danger of addiction, many white people fell for it, above all women.

Why other races did not fall into the trap remains to be explored. Are they more immune to advertisement? Or too poor to afford drugs in addictive quantities?

The best antidote against drug abuse is, as the data shows, education. If America wants to win the War on Drugs it will have to heavily invest in education.

Heinrich von Loesch

Update

The rates of babies in rural American areas born with symptoms of opioid withdrawal has skyrocketed, illustrating another symptom of the ongoing opioid epidemic spreading through parts of the United States.

Rural babies and mothers with opoid-related conditions are more likely than urban ones to come from lower-income families, and have public insurance, according to a new study published Monday in the peer-reviewed journal JAMA Pediatrics.

CNBC

Update II

Data from the National Vital Statistics System, Mortality

The age-adjusted rate of drug overdose deaths in the United States in 2015 (16.3 per 100,000) was more than 2.5 times the rate in 1999 (6.1).
Drug overdose death rates increased for all age groups, with the greatest percentage increase among adults aged 55–64 (from 4.2 per 100,000 in 1999 to 21.8 in 2015). In 2015, adults aged 45–54 had the highest rate (30.0).
In 2015, the age-adjusted rate of drug overdose deaths among non-Hispanic white persons (21.1 per 100,000) was nearly 3.5 times the rate in 1999 (6.2).
The four states with the highest age-adjusted drug overdose death rates in 2015 were West Virginia (41.5), New Hampshire (34.3), Kentucky (29.9), and Ohio (29.9).
In 2015, the percentage of drug overdose deaths involving heroin (25%) was triple the percentage in 1999 (8%).

Deaths from drug overdose have been identified as a significant public health burden in the United States in recent years (1–4). This report uses data from the National Vital Statistics System (NVSS) to highlight recent trends in drug overdose deaths, describing demographic and geographic patterns as well as the types of drugs involved.

National Center for Health Statistics

Update III

"With the pharmaceutical lobby’s money keeping Congress on its side, regulations were rewritten to permit physicians to prescribe as many pills as they wanted without censure. Indeed, doctors sometimes found themselves hauled before ethics boards for not supplying enough."

Guardian

Update IV

"....while the public conversation has largely been on opioids and pot in recent years, alcohol use and abuse have been quietly rising.

Forbes

Update V

Life expectancy in the U.S. continues to decline, as a new report revealed:

November 26, 2019

Life Expectancy and Mortality Rates in the United States, 1959-2017

Steven H. Woolf, MD, MPH1; Heidi Schoomaker, MAEd2,3

"Findings Between 1959 and 2016, US life expectancy increased from 69.9 years to 78.9 years but declined for 3 consecutive years after 2014. The recent decrease in US life expectancy culminated a period of increasing cause-specific mortality among adults aged 25 to 64 years that began in the 1990s, ultimately producing an increase in all-cause mortality that began in 2010. During 2010-2017, midlife all-cause mortality rates increased from 328.5 deaths/100 000 to 348.2 deaths/100 000. By 2014, midlife mortality was increasing across all racial groups, caused by drug overdoses, alcohol abuse, suicides, and a diverse list of organ system diseases. The largest relative increases in midlife mortality rates occurred in New England (New Hampshire, 23.3%; Maine, 20.7%; Vermont, 19.9%) and the Ohio Valley (West Virginia, 23.0%; Ohio, 21.6%; Indiana, 14.8%; Kentucky, 14.7%). The increase in midlife mortality during 2010-2017 was associated with an estimated 33 307 excess US deaths, 32.8% of which occurred in 4 Ohio Valley states."

Update VI

Drug overdose deaths top 100,000 annually for the first time, driven by fentanyl, CDC data show.

Drug overdose deaths reached a record high in 2021, killing about 109,000 people

Dr. Nora Volkow, director of the National Institute on Drug Abuse, also said the continuing decrease of American life expectancy wasn't surprising, but it is frustrating.

"It is distressing to see a continuing negative impact of drug overdose on the life expectancy of Americans. These deaths often occur in young adults and therefore represent a tragically high number of years of life lost and devastating impact on individuals, families, and communities," she said. "We have the science and the tools available to help us reverse this trend and reduce the number of overdose deaths in this country. But these tools are not being used effectively."

Written on 05 November 2015.

The vast scale and chillingly orchestrated nature of tens of thousands of enforced disappearances by the Syrian government over the past four years is exposed in a new report by Amnesty International: "Between prison and the grave: Enforced disappearances in Syria" reveals that the state is profiting from the disappearances through a black market in which family members desperate to find out the fates of their relatives are r exploited for cash.

The government’s enforced disappearances are part of a coldly calculated, widespread attack against the civilian population. These are crimes against humanity, part of a carefully orchestrated campaign designed to spread terror and quash the slightest sign of dissent across the country.
Philip Luther, Director of Amnesty International’s Middle East and North Africa Program: “This report describes in heart-breaking detail the devastation and trauma of the families of the tens of thousands of people who have vanished without trace in Syria, and their cruel exploitation for financial gain.”

The scale of the disappearances is harrowing. The Syrian Network for Human Rights has documented at least 65,000 disappearances since 2011 – 58,000 of them civilians. Those taken are usually held in overcrowded detention cells in appalling conditions and cut off from the outside world. Many die as a result of disease, torture and extrajudicial execution.

Enforced disappearances have become so entrenched in Syria they have given rise to a black market in which “middlemen” or “brokers” are paid bribes ranging from hundreds to tens of thousands of dollars, by family members desperate to find out the whereabouts of their loved ones or whether they are even still alive. Such bribes have become “a big part of the economy” according to one Syrian human rights activist. A lawyer from Damascus also told Amnesty International the bribes are “a cash cow for the regime… a source of funding they have come to rely on”.

Those forcibly disappeared include opponents of the government such as demonstrators, human rights activists, journalists, doctors and humanitarian workers. Others have been targeted because they are believed to be disloyal to the government or because their relatives are wanted by the authorities.

In some cases, especially in the last two years, enforced disappearances have been used as a means to settle scores or for financial gain, further fuelling the cycle of disappearances.

Some families have sold their property or given up their entire life savings to pay bribes to find out the fate of their relatives – sometimes in exchange for false information. One man whose three brothers were disappeared in 2012 told Amnesty International he had borrowed more than US$150,000 in failed attempts to find out where they are. He is now in Turkey working to pay back his debts.

“As well as shattering lives, disappearances are driving a black market economy of bribery which trades in the suffering of families who have lost a loved one. They are left with mounting debts and a gaping hole where a loved one used to be,” said Philip Luther.

Family members who try to inquire about disappeared relatives are often at risk of arrest or being disappeared themselves, which gives them little choice but to resort to using such “middlemen”. One man who asked the authorities about his brother’s whereabouts was detained for three months and spent several weeks in solitary confinement. Another man who went to Damascus to look for his disappeared son was arrested at a military checkpoint on the way and has not been heard from since.

Amnesty International

Life Expectancy and Mortality Rates in the United States, 1959-2017

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