Following a bit of simple but impeccable logic, the Department of Health recently took the first step toward preventing untimely deaths in San Francisco by recording, in meticulous detail, why people die here. The resulting "mortality analysis" sketches a readily recognizable profile of life in this city: By our demise ye shall know us. Even though the general configurations aren't likely to surprise anyone, some of the specifics are jarring, like the purple blemish of Kaposi's sarcoma on a handsome face.
To prepare the report, city and county health researchers assembled the death certificates of all 48,424 San Franciscans who died during the six years between 1990 and 1995, and divided them according to sex, age, ethnicity and ZIP code, as well as the cause of their death. They compiled more than 100 pages of tables and figures, containing a wealth of discrete data. A kind of Morbid Trivial Pursuits. We discover, for example, that a total of 722 women died of breast cancer, more than half of them (439) over 65. That arteriosclerosis was the big killer of Pilipino men, claiming 300 lives. That male suicide rates were highest in the Polk/Russian Hill area, where 94 men took their own lives.
But the Burden of Disease and Injury Work Group didn't stop there. To accent and highlight the pointillist picture, the researchers introduced a second layer of information pinpointing the underlying causes of fatal diseases and injuries. The effects of these commonsense "determinants" --- such as tobacco consumption, poor diet and exercise, alcohol consumption, infectious agents, environmental toxins, firearms, unsafe sex, motor vehicles and drugs --- must be mitigated before lives can be prolonged. The report raised red warning flags for some readers by suggesting possible directions for future policy in the form of "laws to reduce exposures to second-hand tobacco smoke, to limit cigarette advertising, or to permit the provision of clean needles and syringes to injection drug users," practices that might either salvage lives or debase them, depending on the attitude of the legislators in charge. But its inclusion of "socioeconomic conditions, especially poverty," gave proper due to the interrelationship of individual health issues with the rest of city life.
Pretty dry stuff.
But wait. The group interjected one more measure, which transformed the report from an arrangement of black-and-white numbers to a setting for vivid human drama. It's called SEYLL, "standard expected years of life lost." The standard life expectancy at birth devised by the World Health Organization is 82.5 years; SEYLL describes any death that occurs before that age. It stands for years that might have been, years when healthy men and women might have lived and loved, might have created countless wonders that can never now exist. The death of a young person obviously carries a larger SEYLL than one that occurs in old age. And a disease or injury that brings death to a few young people carries a larger SEYLL than one that fells large numbers near the natural end of life.
In the six years between 1990 and 1995, San Franciscans lost a total of 1.07 million expected years. Among them,
- 6,832 people died of AIDS/HIV: 300,755 SEYLL
- 11,010 died of arteriosclerosis: 141,184 SEYLL
- 2,455 died of lung cancer: 45,351 SEYLL
- 3,374 died of stroke: 41,182 SEYLL
- 735 died of drug poisoning: 33,023 SEYLL
- 845 died from suicide: 32,729 SEYLL
- 557 died from homicide: 28,571 SEYLL
The population did not share these lost years evenly. During the period of the study, African-American males had a life expectancy at birth of only 60.0 years; the nationwide life expectancy of African-American males in 1993 was 64.6. The figure for white males in San Francisco was 64.9 years, compared to a 1993 nationwide life expectancy of 73.1. At the other end of the scale, local Latinas had a life expectancy of 87.9 years.
As individual causes of death ripple across different ethnic groups, they bring the statistical profile to life. In general, women tend to die at a later age, most commonly from heart disease. It's male lives that are being lost early.
- 626 African-American males died of AIDS/HIV, losing an average of 44 years
- 198 African-American males died from homicide, losing an average of 53 years
- 104 Asian-American males died of AIDS/HIV, losing an average of 45 years
- 47 Asian-American males died from homicide, losing an average of 57 years
- 641 Latinos died of AIDS/HIV, losing an average of 46 years
- 95 Latinos died from homicide, losing an average of 57 years
- 5,162 white males died of AIDS/HIV, losing an average of 44 years
- 371 white males died of drug poisoning, losing an average of 46 years
They inhabited "the best place on earth."
Surely by now, firing across Clinton's synapses, is the cognition of his very own Tonkin Gulf, and the Tet that followed. Somehow one knew that the the oeuvre of his foreign policy ineptitude would, in time, encompass just such a fiasco as Kosovo. The distended moral hollowness of the man is assumed; but in this case we (and the Kosovan recipients of his high-minded statecraft) had at least every right to expect a semblance of ethics in the implementation of the intervention against Serbia.
By day four of the bombing one could only wonder why in hell there were no elite ground troops --- if only as symbolic tokens of a rational battle plan --- offering head-on skirmishes with the Yugoslav army. In the half-dozen areas in central and northern Kosovo where the Serbs have concentrated their purification rites, NATO Airmobile troops and Special Forces --- preceded, perhaps, by Vietnam-era spotter planes --- would have exhibited an initial modicum of tactically intelligent resolve. Instead, as the refugee numbers approach 100,000 and Milosevic's goons scorch uncontested terrain, U.S. Joint Chiefs' spokesmen-ghouls drone on in cadenced martialspeak about the planned "phases" of the air war. This is the same crew, by the way, who endlessly warned through four decades of the Cold War that the inevitable Soviet strategic breakout across the North German plain into Western Europe would have to be halted by NATO within five days. (Of course, this "Fulda Gap" scenario of supposed Soviet intentions was a rank fiction, as our designated defenders would admit in their most private moments. And we assume on faith that they have them.)
When this is all done, in that extended gurgle of incrimination which will follow and where the word "evil" is thrown about ever so casually, Milosevic will have a full complement of complicit actors in this shared theater of bloodletting. Forget the degrees and gradations of malevolence. Otherwise one founders in the morass of weighing a grotesque, romantic populist-nationalism against an automatonic unilateralist globalism with built-in blinders. One, preferring the intimacy of a face-to-face, perfects the technique of yoke and rape; the other, witnessing the victim's peril, attacks the assailant's car --- "degrades" his "assets," as it were, "robustly" assuring that he will be denied a means to his foul ends. The wise field generals you might engage in conversation at the bus stop this morning would probably explain it exactly that way.
* * *
Globalism and its warriors view our spinning sphere from on-high. Theirs is a stealth economy, precision-guided and usually undetectable until it's too late. In that realm, phenomena are manipulated in nanoseconds, and the bottom line is the guiding light. Efficiency is non-circuitous and time-tested. No muss, no fuss, and world views thus beget world orders. Except when they don't. Clinton ran into that sort of variable this week.
The moral casuistry of intervening in the Balkans (as opposed to, say, effecting a homeland for the Kurds, or the Palestinians, or the...) is of course commensurate with primary U.S. strategic designs. Without an official enemy, and with the mission of our intelligence agencies now designated as industrial espionage, our adversaries are simply those who stand in the way of our accumulating as much wealth as we can. One can, without much difficulty, espy Serbia as an obstacle along that path. With the flames of Serbian intrusion in Bosnia and Croatia now banked --- two countries now presumably free to be entranced with the baubles of the West --- Milosevic's dismembered nation has only Russia remaining as a confidant and potent ally. Russia, in turn, now faces a reenergized NATO and its new members Hungary, Poland and Czechoslovakia pushing up against Russia's borders. Certainly Serbia, by dint of its antipathy to Germany and historical resentment of the West's exploitation of Balkan natural resources, is no candidate for NATO membership. Thus it remains a rogue outside NATO's newly pliant Central European axis of former Warsaw Pact allies who will form a curtain against the spillover of rage from Russia when the latter finally self-destructs. Eastern European workers similarly disenchanted with the glorious capitalism which has made paupers of Russian workers, will have homegrown NATO cops around to admonish them about the pitfalls of espousing independent economic sovereignty. The quick-fix dispensing of Serbia that the U.S. expected would have solidified that protective cordon. No doubt by defending Kosovo Clinton also counted on currying favor with Muslim countries, thus diminishing the possibility of terrorist attacks.
This ongoing debacle throws all of that craftiness into disarray. The
integrity and purpose of NATO is now in question. Even a prostrate Russia
seems to have achieved a reprieve. While Primakov groveled for the latest
IMF handout in exchange for calling on Milosevic to renew negotiations,
Russian officials continued to criticize NATO, and Moscow realizes it is
the crucial player in ultimately bringing about a cease-fire. It will surely
enjoy watching Clinton squirm in the aftermath of his rejection of Milosevic's
offer yesterday to stop the fighting. The quagmire may be relatively short-lived,
but of sufficient length nonetheless. Time enough, that is, for turnabout.
It's something Lyndon Johnson finally grasped. And something for which Bill
Clinton ought to finally feel ashamed.
Public hearing: Dramatic Expansion of Ferry Service in the Bay Area. Thursday, April 8, 1999, 7:00 p.m. Joseph P. Bort MetroCenter, 101 Eighth Street, Oakland.
It's an old story, but one worth retelling. For much of its history, San Francisco lived to the rhythm of the water that nearly surrounded it. The arrival and departure of seaworthy ships claimed the attention of both maritime workers and landlubbers. And a fleet of ferries skittered back and forth across the bay like giant water skates, linking passengers and goods from cities all along the shore.
Although the ferries arrived first, by the time of the Civil War they found themselves in the service of the brand new railroads. Soon the octopus that controlled most of California held them in its grasp as well. A report in the Chronicle of July 14, 1898 crowed, "The new union ferry depot was opened yesterday to the Southern Pacific Company, and the Harbor Commissioners were interested observers and expressed themselves as delighted with the satisfactory manner in which everything worked." In 1930, at the height of ferry travel, Southern Pacific and its colleague companies could boast of the largest operation in the world, as their 43 vessels transported 40,211,535 people and 6,117,186 vehicles across the bay. The broad-beamed ferries became as vivid a symbol of San Francisco as the little cable cars. From the very beginning, they also acquired a local lore. In 1871, a glamorous boardinghouse keeper from Virginia City chose the upper deck of a ferry to shoot her married lover. For her crime, Laura D. Fair received the first death sentence imposed on a woman by the State of California. And an impoverished Scotsman named Robert Louis Stevenson --- "a strange-looking shabby shack of a fellow," according to his landlady --- whiled away the days on board a ferry during the winter of 1880.
But when bridges spanned the bay in the late 1930s, they made the ferries seem old-fashioned and irrelevant. Key System train tracks on the lower deck of the Bay Bridge made commuter connections with the Oakland Mole unnecessary (although a few ferries remained in service until 1958 to meet passengers arriving in Oakland on transcontinental trains). Eventually, the bridges --- along with the freeways that delivered drivers onto them --- deep-sixed the ferries and elevated the Age of the Automobile.
Until recently. Now it's the highways that are drowning in cars. Constructing new roads requires a lot of money --- at least $32 million per mile. Relying on the railroad is even worse --- expanding BART would cost more than $70 per mile. Now once again, thoughtful planners are looking to the water for salvation.
The Metropolitan Transportation Commission is feverishly revising its 1992 Regional Ferry Plan. But its work is overshadowed by the energetic activities of a Blue Ribbon Task Force "spearheaded" by the Bay Area Council and the Bay Area Economic Forum. The task force intends to "develop a world-class water transit system in the Bay Area for the 21st Century." More concretely, it envisions starting with about 70 high-speed ferries carrying 12 million to 18 million passengers a year, and expanding to 120 vessels, 40 terminals, and 30 million riders over the next 20 years. Not only would such a program alleviate traffic congestion; it would also provide hundreds of service and construction jobs.
And profits for the companies involved. The development of transportation networks in the Bay Area has historically been tied to commerce, and the new proposal is no exception. The Bay Area Council is a CEO-led organization whose work for more than 50 years has been based on the "understanding that free enterprise and private-sector innovation have produced one of the world's most vibrant regional economies. The most effective public policy respects these economic forces."
The Blue Ribbon Task Force, which was commissioned by the state in accord with legislation introduced by Senator Barbara Lee, reflects the council's approach to economic development. In addition to the directors of the ports of Oakland and San Francisco, the director of the San Francisco airport and a number of mayors, the group includes the CEOs of two prominent Bay Area ferry companies, Ron Duckhorn, of the Blue & Gold Fleet, and Thomas C. Escher, of Red & White. But why not? A powerful entrepreneurial drive, greased with a little self-interest, can be a wonderful engine for progress.
The question is, of course, progress for whom? When government and business collaborate, is there a place for the public? In the complex, rapidly changing city of San Francisco, it's all too easy to leave ordinary citizens back at the dock, particularly if the captain of the vessel isn't attentive to their interests.
Let me give an example. The chairman of the Bay Area Council is Ronald H. Cowan, whose Harbor Bay Isle Associates has developed an up-and-coming residential and technology park in Alameda. No matter that the park lacks easy access to major highways. Cowan is also in the ferry business, and his Harbor Bay line carries about 2,000 passengers to and from San Francisco every week. Smart thinking. Even smarter: Cowan has instituted ferry service between the East Bay landing and Candlestick. When the city winds up the paperwork on its $2 million federal grant for a two-berth ferry service at PacBell Park and gets around to choosing an organization to operate it, he'll be first in line. And when the new ferry routes are being handed out, you can be sure he'll be there, too.
So Ron Cowan is a sensible businessman. He's also a former law client
of Willie Brown's. And in 1997, the two men became business associates,
when Brown acquired stock in Cowan's Harbor Bay Realty Company valued, according
to Brownís financial disclosure, in the range of $10,000--$100,000.
But Brown is also mayor of San Francisco, the city that awards many of the
ferry contracts. And he is one of the vice chairmen of the Blue Ribbon Task
Force. Cowan says, "We wouldn't do anything that would compromise the
mayor or us." Looks like the mayor can do that for himself.