Yes we can’t ignore these issues. I always challenge people to attempt all kinds of mitigations upstream, before medicating downstream. This is also true for diabetes and autoimmune diseases — for example, stop buying food from factory farms, or fruits with tons of genetically engineered sugar or foods with tons of high-fructose corn syrup or aspartame, and tell our government to tax negative externalities, rather than “ag-gag” laws that criminalize exposing it. Your media will rarely talk about the role of actual sugar intake in diabetes, preferring to focus on “inherited” and “intrinsic” factors, and same with many other medical issue the pharma industry will medicate downstream.

The government specifically works with industry to allow corporations to get away with saving a buck at the expense of the wider public, while the wider public is given a medications and bandaids downstream that decades later turn out to be scams: https://magarshak.com/blog/?p=362

Once you see it, you can’t unsee it. Like when the government allows Coca Cola and Snapple bottling companies to switch to metric tons of non-biodegradeable plastic, while individuals are told they can’t have a plastic straw or bag, and can save the world by recycling plastic (a scam by the plastic industry to distract from the upstream problem, nearly all of the “recycling” consisted of shipping to China).

Or how factory farms are now causing more negative externalities, which we are now finding out last month:

https://amp.theguardian.com/society/2023/apr/25/use-of-antib...

https://amp.theguardian.com/commentisfree/2023/mar/01/why-ar...

I invite you to consider the same dynamic with autoimmune diseases and others. It’s the same question of whether kids always had this level of gender dysphoria and ADHD and autism, or did something happen in the environment, or did the industry start to overdiagnose them?

The truth is probably somewhere in the middle, but activists on either side insist on their explanation being the dominant one, or perhaps the only one. Similarly to how other activists might insist on systemic sexism or racism to explain a gender pay gap, or systemic antisemitism to explain criticism of Israel, etc. (Disclaimer: I’m a Jewish straight cis male.)

This is an impulse by people with a specific agenda / issue to make sure their agenda “wins”. In every case, there are real problems that need to be solved upstream, but the focus by well-meaning activists is only on downstream solutions (eg prescribing amphetamines to ADHD-diagnosed kids) rather than upstream solutions (eg shortrr school days and allowing kids to climb trees like in Finland, where ADHD has far less diagnosed). They will spend decades advocating the same thing and expect a different result — it’s not collective insanity, it is actually learned helplessness.

It is common to think this way when one’s “tribe” is involved. To illustrate it, I will touch on an issue with dynamics that have affected many people on HN. I hope it’s alright to mention it, because that is the only way you’ll see that the “downstream focus” even concerns many sacred cows.

So — to hit home, this even happened on HN with depression. I have seen it for years, where any attempts to attribute some diagnosed depression to upstream causes like diet and exercise and environental factors are met with “you just don’t understand, clinical depression is completely different, and you should be quiet”.

In each of these issues, the science shows that the theory that promotes medical interventions downstream is often wrong, eg in 2022 we found this out when it comes to the theory of chemical imbalance / low serotonin explaining depression:

https://www.nature.com/articles/s41380-022-01661-0

https://amp.theguardian.com/society/2022/jul/20/scientists-q...

On the other hand there is a ton of studies on everyone from young girls to middle aged people getting far more sad and depressed:

Teen girls: https://www.nytimes.com/2023/02/13/health/teen-girls-sadness...

20% of all middle-aged women is on antidepressants (surely it can’t all be explained by a chemical imbalance, right?) https://www.wkbw.com/news/local-news/cdc-states-1-in-5-women...

Opioid epidemic in men, once again much of it is due to capitalism, both from an employment and a pharma industry side: https://www.cdc.gov/opioids/basics/epidemic.html

But it’s easy for society to just prescribe medications to people rather than fixing systemic issues, eg implementing a UBI or 20 hour workweek overtime protections so people can spend more time with their family. In capitalism we’d rather allow companies to social problems with surveillance capitalism, social networks and AI to optimize clicks, because that’s what the market demands.

On the other hand there are tons of studies and books on how the market and new technology has led to the breakdown of American social and family life. Starting with “Bowling Alone” by Robert Putnam back in the early aughts. People in big cities don’t even know their own neighbors. They live alone with their cats, order in netflix and uber eats, they stick their kids in public schools and parents in nursing homes, but hey, the economy is good right?

https://www.nytimes.com/2023/04/20/opinion/microplastics-hea...

Anyway to end with autoimmune diseases… notice how much more effort it would take for our society to stop producing plastics in clothes, that break down into microplastics on every wash, aren’t caught in drains and now find themselves everywhere, humans accumulate more and more microplastics. Rather than confront these environmental issues head-on (as we did once with CFCs and Toronto Protocol, the one big win for solving collective action problems) we allow the microplastics to accumulate in all biological beings, including us, throw up our hands and wonder aloud what could be causing autoimmune diseases? Meanwhile it is more convenient to open a new plastic spoon from a plastic package shipped from china, than wash a metal one. Instead of refilling bottles like our ancestors, we buy new ones every day and chuck them in the “recycling” LOL. Oh, and polyester is just so stretchy and convenient, as is teflon non-stick coating on our pans, why demand our government tell the industry to phase out nonbiodegradeable stuff and research biodegradeable alternstives? Nah that’s too hard to do as a society. So the problems get worse every year and “activists” arise who attribute it to a systemic issue like sexism or racism — they think they’re a great ally but rather than fighting each other we should band together to demand our govenrnment aggressively tax negative externalities upstream with Pigouvian taxes.

Fiscal policy btw would be a great way to remove stimulus and UBI money from the economy. Certainly much nore targeted and better than crude monetary level the Fed has, raising interest rates on everyone. But our politicians are scared to raise taxes on industries, or go up against Big Ag or Big Pharma. So we as a society allow Day Zero to occur in cities, antibiotic resistant bacteria to grow, etc. all because of regulatory capture and cowardice. It will continue unless people recognize that the real problems are upstream, stop fighting each other and clearly spell out how we can organize to demand our government raise taxes on industries externalizing costs to others. If there was ever a proper role for government, it is that!

PS: with AI, experts say 10% chance that humanity is wiped out… yet we can’t stop the competition and progress, and certainly when people are affected we’ll have industries to help them out downstream. Just another example, perhaps may be the biggest and fastest one soon.