One possible partial explanation for this is the same reason why the Bill Gates Foundation wasted a bunch of money fostering small high schools. Smaller high schools were some of the best performing schools...but also some of the worst [0].
The answer is just that small counties have high variance. By chance some small counties will be a lot higher or lower than the national average.
I would be interested in seeing a Cox Proportional Hazards Model would show if the remaining changes are related to pollution, meth, economics, etc.
Sample-size-based variance is a nice nit to pick, but it doesn't really seem to match the data presented in the article. Outcomes are strongly correlated in adjacent counties across the map, which is not predicted by sample-size (which would produce uncorrelated noise, in inverse proportion to population density). On the other hand, there is substantial correlation between the given geographic distribution of life expectancy changes and geographic distribution of wealth, as observed in the article.
The largest life expectancy increase is in New York county, which has a population of 1.6 million, comparable to whole smallish countries - no, this is not explained by high variance in small counties.
But even the small counties have populations in the several hundreds or thousands, right? Outliers that die at 33 or 103 affect the average little when you have a population of 2,000.
Not only county-to-county. My friend did his PhD dissertation on how (at least in Rochester, NY), life expectancy varies by decades between zip codes. His research focused on urban Food Deserts and studied how the lack of access to healthy food nearby restricted diets to that available in convenience stores (chips, soda, etc). I wish I had access to his dissertation, but he just defended a month ago and cannot find it in any publications right now.
> His research focused on urban Food Deserts and studied how the lack of access to healthy food nearby restricted diets to that available in convenience stores (chips, soda, etc).
I hear this often but always wonder which way the causation arrow flows.
Do "food deserts" cause unhealthy eating? Or do groups of consumers that prefer unhealthy eating create "food deserts" with their purchasing decisions?
Hm that is really interesting. I can definitely believe that effect.
I've bought groceries from the same few places for 7 years or more. It seems obvious that people buy food 90% of the time from the 5-10 places closest to them geographically. I live in a good area and they have good food.
But if my choices were all cheap soda and snacks like I see in other places, I imagine that would have a very concrete effect on my health. A few extra calories or a few more food adulterants every meal, every day, for 7 years or 20 years really adds up.
It seems extremely unlikely that there's no consequence of the food choices of your nearby grocery, so I'm glad that someone is measuring that effect.
I would imagine that it's not just convenience stores. I frequently ponder the fact that the grocery store closest to me is a marque of a US conglomerate (I live in Canada) that manages to have "low prices" by just treating Canadian stores as part of its US logistics chain—almost all of its products are shipped here from the US, rather than locally produced under US brands. And that includes things like baked goods and produce.
Thus, everything perishable in that store is either much "older" than you'd expect (i.e. it will go bad very soon after you buy it), or is pounded with preservatives—the bread, bagels, muffins, etc. all sort of have this uniquely-bad "springy yet doughy" texture: the sort of texture that I associate with Wonderbread.
Within the same distance there are local bakeries, produce markets, butcher shops, etc. that sell good stuff. But I don't doubt for a moment that certain families ignore those and go straight for the "everything shipped from far away" supermarket for all their shopping—and are having different health outcomes because of that.
I met someone working for the city of Oakland who was researching similar things here. She pointed out that life expectancy in the 'flats' of Oakland was 7 years lower than in the 'hills' of Oakland. That geographical boundary mostly separates the wealthy from the poor (though areas of the 'flats' are rapidly gentrifying). There are also other factors, such as proximity to pollution from highways and the ports, crime rates, etc.
>Not only county-to-county. My friend did his PhD dissertation on how (at least in Rochester, NY), life expectancy varies by decades between zip codes.
Amazing. Perhaps life expectancy even varies between households or...dare I say it...individual people?
A very similar article by many of the same authors was reported in JAMA in Dec 2016.
From JAMA Arch Int Med article from today, p. E6:
"...At the same time, 74% of the variation was explained by behavioral and metabolic risk factors alone, while one marginally more variation was explained by socioeconomic and race/ethnicity factors, behavioral and metabolic risk factors, and health care factors combined."
From the WaPo article:
"Mokdad said countries such as Australia are far ahead of the United States in delivering preventive care and trying to curb such harmful behaviors as smoking. “Smoking, physical inactivity, obesity, high blood pressure — these are preventable risk factors,” Mokdad said."
In NYC, and not just Manhattan, New Yorkers are doing better because of a number of interventions initiated in 2001, when Mayor Bloomberg and Dr. Tom Frieden took over as Mayor and Health Commissioner.
Adult smoking is 14% in NYC, 24% in Louisiana. Raising the cost of tobacco contributes more than half the effect of getting smokers to quit and to stop teens from ever starting.
NYS tobacco tax is $4.35 per pack and the city is an additional $1.50. Cigarette sell for at least $12 per pack here.
The tax is $1.08 in Louisiana.
Mokdad mentions Australia, where the tobacco tax is $14 per pack plus an additional $2 sales tax.
The ACA made a huge mistake in not raising the about $1 US Federal tax to a much higher number for the 13 billion packs smoked each year.
Raising the Federal tax by $4 would raise at least $30 billion each year for helping those with high risk preexisting conditions.
"Mokdad mentions Australia, where the tobacco tax is $14 per pack plus an additional $2 sales tax."
There is something else going on as well. The young (Australians) don't see smoking as ^cool^. In fact the path to smoking is the path to being a social pariah. You can't smoke in pubs, clubs, taxis, trains, trams, in or around public buildings.
> Raising the cost of tobacco contributes more than half the effect of getting smokers to quit and to stop teens from ever starting.
Yes, though it's also created a thriving black market for cigarettes, often trafficked from other states or otherwise sold without paying end-consumer taxes[0].
Separately, it's worth noting that the age for purchasing tobacco in NYC is 21, as opposed to 18 in most other places.
Furthermore, it's also just really damn hard to smoke in NYC. It's been banned in restaurants and bars for fifteen years, long before that was commonplace in other places. More and more buildings are smoke-free, which makes it less and less convenient for people to maintain a smoking habit.
[0] The cost of having an illegal market isn't always monetary. For example, Eric Garner was killed after an encounter in which police approached him because they claimed he was selling untaxed cigarettes: https://en.wikipedia.org/wiki/Death_of_Eric_Garner
This map seems correlated with socieconomic status and all the health implications that go along with that. And it looks similar again to Republican voting districts. It's Sarah Palin's "Real America", so to speak.
One thing the Democrats would do well to focus on is the fact that there's a large portion of the country that is sick, where the statistics look more like an underdeveloped country. Those of us who live in the major cities would do well to empathize with this other part of the country and their malaise, even if for our own sake of having a more sane and less partisan government.
I couldn't help but notice that the top three counties (Summit, Pitkin, and Eagle counties in CO) are largely empty space with some of the country's best ski resorts. I suspect that the life expectancy there may largely be driven by fit retirees who move there.
Not merely ski resorts, but specifically Aspen (in Pitkin County) and Vail (in Eagle County). These are not merely fit retirees, but the richest retirees in the world.
Further, there is a bit of selection bias here in that the town of Aspen is at 8000 feet of elevation. You need to have a decent baseline of physical fortitude just to step off the plane there as an older person...
Finally, for what it is worth, day to day life in Aspen (even outside of the ski season) is extremely active and everything about the town promotes that activity.
I personally don't think there is anything actionable or interesting[1] about Aspen and Vail having high life expectancies - they are completely non-representative of any piece of the real world.
[1] Well, other than fitness and activity increasing your lifespan, but we all know that already.
Having lived in Aspen for a while (no longer) I do have to say: everyone that lives there is extremely fit compared to say... the Bay Area.
Not just the rich people - the average person (who is more likely a retail/food service worker) is just more active - going on several 1000ft hikes in spring & summer weekly, or long bike rides, etc.
It's very very easy to be healthy there: I got fitter, skinnier, and healthier in the 8 months I was there.
I really wish that journalists would learn some 3rd grade maths before writing anything with numbers in it. How does the life expectancy vary by "more than 20 years" when the difference between the counties with the highest (85) and lowest (67) life expectancies is 18 years?
Is there any reason this isn't just selection bias? Young, healthy, people with good careers travel to big cities. The rest stay behind. Do we have data to compare those who stuck around vs those who grew up there but moved away?
Rural upstate NY. Always checking out the obits. There were some weeks there when no one broke 62. Seems to stabilized, but more rural than Appalachia. The winters are brutal, MDs are hard to find.
Heck I bet within a 5 mile radius it varies. Just go to east palo alto and then go to "not east" palo alto. The reasons I think are pretty obvious and almost certainly correlated with how affluent your neighbors are. Money basically solves all problems when it comes to wealth related problems like access to good schools and healthcare. Even though in theory healthcare and education should not be so strongly coupled to money.
The "life expectancy of a county" is not a trivial thing to define if you ask me. Is it how long children born now in a county can expect to live, no matter where they live or die, does it only depend on people who die in the county, or is it somehow weighted by the time people live in the county? Maybe there's a standard definition, but my guess is that most people don't know.
>“We are falling behind our competitors in health. That is going to impact our productivity; that’s going to take away our competitive edge when it comes to the economy,” Mokdad said. “What we’re doing right now is not working. We have to regroup.”
What's the logic behind this? Out of curiosity. It's a morbid thing I hesitate to say, but from a purely utilitarian view isn't it better for a country— from a macro perspective— if people die as close as possible as they finish their working life and retire?
I might be completely off base there, and this is mostly a request for more information, not saying people should die early. As far as I'm concerned I hope we all live to 200.
Sometimes it will cause a worker (and the worker's company) to be less efficient due to health-related issues. Not to mention that caregivers (e.g., family) may also be less efficient by taking time off from work or quitting work all together.
Sometimes people will be put on disability for health reasons before they should need to retire. This is a drag on the welfare system and (often) the economy if they had been a productive member of the workforce.
There is also a potential quality of life issue (both present and expected), but that's not as easy to measure as the previous points. It also has some potentially complex implications that are beyond the scope of this post.
People often just don't die instantaneously, they get sick and require care this taking up resources. Also, some people don't die but are permanently disabled or others get better.
Oglala Lakota County which is completely contained inside the Pine Ridge Indian Reservation is served by Indian Health Service with 94%+ of the population being eligible for free, government provided medical care. I notice, other than pointing it out on the map, they didn't discuss it in the article.
Of course life expectancy is going to vary by county, because the variables that contribute to life expectancy; income, lifestyles, dietary habits, quality of health care, and access to health care are vastly different.
I assume you'd need a broad cultural shift in attitudes about food consumption, obesity, physical activity, and vast health care networks that ignore income to change it.
I didn't look into the data, but the CDC and other agencies have policies that set values to 0 in public versions of their datasets if there is a risk of inadvertent PII disclosure. This is particularly the case with smaller cities/counties and rare diseases.
Not surprised. Visited the Midwest a few years ago, and obesity was ridiculously off the charts compared to the Intermountain West or WA/CA. The are significant social factors playing out on a wide and complex scale.
My advice, if you're stuck in one an area with unhealthy habits, is to move to an area with healthy habits.
> "We are falling behind our competitors in health. That is going to impact our productivity; that’s going to take away our competitive edge when it comes to the economy"
Interesting how it seems like health itself isn't seen as the target metric. Nope, economy is what's important.
What about from country to country. I'm from the US and, at least where I live, it is rare to see someone smoking. Second hand smoke has basically become a thing of the past. But this past week we went up to Vancouver BC and we were shocked at how many people were smoking. It seemed like you couldn't go 10 feet without walking through another cloud of second-hand smoke. Apparently the anti-smoking campaigns of the US never made it up North ;-) Or maybe their socialized medicine makes it so that they don't have to worry about health consequences as much. I don't know. I just wonder if the life expectancy is lower in Canada (or at least Vancouver) since smoking seems to still be A-OK.
There haven't been "smoking sections" in Vancouver restaurants or bars for years (decades?) and we even ban smoking in public parks ... so I'm surprised to hear your observation. I recognize that I'm likely normalized to my home city but I do travel a lot and it doesn't feel like I come home to any more smoke in my city than I'd experience in San Francisco or Seattle.
One observation that I stand behind is ... in both Canada and the USA, suburban and rural smoking rates are higher than urban.
BUT ... the theory suggested here about tourists and immigrants bringing their habits with them is good. And Vancouver is a tourist destination, which is why I was curious about the neighbourhoods you noticed the smoking in.
I wonder if you were in heavily Asian areas of Vancouver? It's my impression that smoking is most popular these days in Asian countries, so more recent arrivals would be more likely to still be smokers.
I have never noticed a particularly large rate of smoking in the areas of BC I've been to.
Smoking is more prevalent in the Pacific Northwest region than it is in, say, Silicon Valley. It is still less common than some other parts of the US. This was very noticeable to me when I moved to Seattle from the Bay Area. In the Bay Area (and many other parts of California), smoking is approaching extinction.
It is a regional culture thing. Most smokers in the Pacific Northwest are strongly biased toward the lower economic strata. By comparison, in many parts of New England (for example) there are quite a few smokers in the upper half of the economic strata.
Not everything is the government's fault. Go observe the lifestyle choices and dietary choices some of these people make, and then add in the drinking and smoking.
And why is that a surprise ? The public schooling in USA has widely distorted the housing market creating ghettos where similar people will get clubbed together.
How is this a US problem? Everywhere I've ever visited, and I've been to as many countries as I have States, has quote on quote:
"Widely distorted the housing market creating ghettos where similar people will get clubbed together."
I think they call them neighborhoods. Rich people live in nicer houses than other people. Pretty sure it's been like this since one caveman had a bigger cave with bigger rocks to throw.
Sacasim aside I really think we need a national school system. In Georgia it varies by counties. Some counties compete on a national level others are dead last in the nation, if we aren't counting Mississippi.
The problem is local funding for schooling I think. If funding was state level or federal and funds would be allocated to schools that need it - I.e. schools with poor students (less help from home, perhaps language issues) will be given a lot more funding per student.
Without this, what happens is that affluent people move to good school districts. These districts then get students with better academic backgrounds, fewer parents with drug/legal problems, fewer students with lanugage problems. Its pretty obvious to be a system that spirals out of control in just a few generations, creating segregated patches.
But perhaps this is how the support for the public school system is upheld? Rich people accept the system, because they can game it? If that's the case then it might be a necessary evil. Politically viable alternatives such as voucher systems will create the same effect (I know from experience).
I create a throw away account and say this almost every time a post hints at something like this: It is commonly taught at the school of public health at Cal that "your zip code is a stronger indication of your life expectancy (and quality) than the color of your skin". This has been known for years now.
[+] [-] generj|9 years ago|reply
The answer is just that small counties have high variance. By chance some small counties will be a lot higher or lower than the national average.
I would be interested in seeing a Cox Proportional Hazards Model would show if the remaining changes are related to pollution, meth, economics, etc.
[0]http://marginalrevolution.com/marginalrevolution/2010/09/the...
[+] [-] Nacraile|9 years ago|reply
[+] [-] PeterisP|9 years ago|reply
[+] [-] flexie|9 years ago|reply
[+] [-] Perceval|9 years ago|reply
[+] [-] aaron695|9 years ago|reply
[+] [-] misiti3780|9 years ago|reply
[+] [-] binarymax|9 years ago|reply
EDIT: Not my friend's paper, but here is a similar study: https://hrs.isr.umich.edu/publications/biblio/8355
[+] [-] nostromo|9 years ago|reply
I hear this often but always wonder which way the causation arrow flows.
Do "food deserts" cause unhealthy eating? Or do groups of consumers that prefer unhealthy eating create "food deserts" with their purchasing decisions?
[+] [-] chubot|9 years ago|reply
I've bought groceries from the same few places for 7 years or more. It seems obvious that people buy food 90% of the time from the 5-10 places closest to them geographically. I live in a good area and they have good food.
But if my choices were all cheap soda and snacks like I see in other places, I imagine that would have a very concrete effect on my health. A few extra calories or a few more food adulterants every meal, every day, for 7 years or 20 years really adds up.
It seems extremely unlikely that there's no consequence of the food choices of your nearby grocery, so I'm glad that someone is measuring that effect.
[+] [-] derefr|9 years ago|reply
Thus, everything perishable in that store is either much "older" than you'd expect (i.e. it will go bad very soon after you buy it), or is pounded with preservatives—the bread, bagels, muffins, etc. all sort of have this uniquely-bad "springy yet doughy" texture: the sort of texture that I associate with Wonderbread.
Within the same distance there are local bakeries, produce markets, butcher shops, etc. that sell good stuff. But I don't doubt for a moment that certain families ignore those and go straight for the "everything shipped from far away" supermarket for all their shopping—and are having different health outcomes because of that.
[+] [-] jameshart|9 years ago|reply
[+] [-] oconnor663|9 years ago|reply
[+] [-] sxates|9 years ago|reply
[+] [-] willvarfar|9 years ago|reply
[+] [-] jliptzin|9 years ago|reply
[+] [-] hammock|9 years ago|reply
Amazing. Perhaps life expectancy even varies between households or...dare I say it...individual people?
[+] [-] davidf18|9 years ago|reply
From JAMA Arch Int Med article from today, p. E6: "...At the same time, 74% of the variation was explained by behavioral and metabolic risk factors alone, while one marginally more variation was explained by socioeconomic and race/ethnicity factors, behavioral and metabolic risk factors, and health care factors combined."
From the WaPo article: "Mokdad said countries such as Australia are far ahead of the United States in delivering preventive care and trying to curb such harmful behaviors as smoking. “Smoking, physical inactivity, obesity, high blood pressure — these are preventable risk factors,” Mokdad said."
In NYC, and not just Manhattan, New Yorkers are doing better because of a number of interventions initiated in 2001, when Mayor Bloomberg and Dr. Tom Frieden took over as Mayor and Health Commissioner.
Adult smoking is 14% in NYC, 24% in Louisiana. Raising the cost of tobacco contributes more than half the effect of getting smokers to quit and to stop teens from ever starting.
NYS tobacco tax is $4.35 per pack and the city is an additional $1.50. Cigarette sell for at least $12 per pack here.
The tax is $1.08 in Louisiana.
Mokdad mentions Australia, where the tobacco tax is $14 per pack plus an additional $2 sales tax.
The ACA made a huge mistake in not raising the about $1 US Federal tax to a much higher number for the 13 billion packs smoked each year.
Raising the Federal tax by $4 would raise at least $30 billion each year for helping those with high risk preexisting conditions.
[+] [-] bootload|9 years ago|reply
There is something else going on as well. The young (Australians) don't see smoking as ^cool^. In fact the path to smoking is the path to being a social pariah. You can't smoke in pubs, clubs, taxis, trains, trams, in or around public buildings.
The Australian curse is alcohol and drugs.
[+] [-] chimeracoder|9 years ago|reply
Yes, though it's also created a thriving black market for cigarettes, often trafficked from other states or otherwise sold without paying end-consumer taxes[0].
Separately, it's worth noting that the age for purchasing tobacco in NYC is 21, as opposed to 18 in most other places.
Furthermore, it's also just really damn hard to smoke in NYC. It's been banned in restaurants and bars for fifteen years, long before that was commonplace in other places. More and more buildings are smoke-free, which makes it less and less convenient for people to maintain a smoking habit.
[0] The cost of having an illegal market isn't always monetary. For example, Eric Garner was killed after an encounter in which police approached him because they claimed he was selling untaxed cigarettes: https://en.wikipedia.org/wiki/Death_of_Eric_Garner
[+] [-] CoolGuySteve|9 years ago|reply
One thing the Democrats would do well to focus on is the fact that there's a large portion of the country that is sick, where the statistics look more like an underdeveloped country. Those of us who live in the major cities would do well to empathize with this other part of the country and their malaise, even if for our own sake of having a more sane and less partisan government.
[+] [-] nolemurs|9 years ago|reply
[+] [-] rsync|9 years ago|reply
Further, there is a bit of selection bias here in that the town of Aspen is at 8000 feet of elevation. You need to have a decent baseline of physical fortitude just to step off the plane there as an older person...
Finally, for what it is worth, day to day life in Aspen (even outside of the ski season) is extremely active and everything about the town promotes that activity.
I personally don't think there is anything actionable or interesting[1] about Aspen and Vail having high life expectancies - they are completely non-representative of any piece of the real world.
[1] Well, other than fitness and activity increasing your lifespan, but we all know that already.
[+] [-] abritinthebay|9 years ago|reply
Not just the rich people - the average person (who is more likely a retail/food service worker) is just more active - going on several 1000ft hikes in spring & summer weekly, or long bike rides, etc.
It's very very easy to be healthy there: I got fitter, skinnier, and healthier in the 8 months I was there.
[+] [-] blacksmythe|9 years ago|reply
[+] [-] JohnGB|9 years ago|reply
[+] [-] legitster|9 years ago|reply
[+] [-] brooklyntribe|9 years ago|reply
[+] [-] dkarapetyan|9 years ago|reply
[+] [-] dainichi|9 years ago|reply
[+] [-] Zyst|9 years ago|reply
>“We are falling behind our competitors in health. That is going to impact our productivity; that’s going to take away our competitive edge when it comes to the economy,” Mokdad said. “What we’re doing right now is not working. We have to regroup.”
What's the logic behind this? Out of curiosity. It's a morbid thing I hesitate to say, but from a purely utilitarian view isn't it better for a country— from a macro perspective— if people die as close as possible as they finish their working life and retire?
I might be completely off base there, and this is mostly a request for more information, not saying people should die early. As far as I'm concerned I hope we all live to 200.
[+] [-] csa|9 years ago|reply
Sometimes it will cause a worker (and the worker's company) to be less efficient due to health-related issues. Not to mention that caregivers (e.g., family) may also be less efficient by taking time off from work or quitting work all together.
Sometimes people will be put on disability for health reasons before they should need to retire. This is a drag on the welfare system and (often) the economy if they had been a productive member of the workforce.
There is also a potential quality of life issue (both present and expected), but that's not as easy to measure as the previous points. It also has some potentially complex implications that are beyond the scope of this post.
[+] [-] tofupup|9 years ago|reply
[+] [-] protomyth|9 years ago|reply
http://www.richheape.com/american-indian-healthcare.htm
[+] [-] notadoc|9 years ago|reply
I assume you'd need a broad cultural shift in attitudes about food consumption, obesity, physical activity, and vast health care networks that ignore income to change it.
[+] [-] MR4D|9 years ago|reply
For instance, they cite almost no lung cancer deaths in Summit county Colorado, while the highest rate is found in Florida.
Well, duh - why the heck would a lung cancer patient want to try and breathe thin air at 9,000 ft??? Sea-level would be much more comfortable.
Not picking on the statistics, but they could have pointed out that some of the variation is purely logical.
[+] [-] efm|9 years ago|reply
[+] [-] rodionos|9 years ago|reply
[+] [-] pnathan|9 years ago|reply
My advice, if you're stuck in one an area with unhealthy habits, is to move to an area with healthy habits.
[+] [-] worldsayshi|9 years ago|reply
Interesting how it seems like health itself isn't seen as the target metric. Nope, economy is what's important.
[+] [-] irrational|9 years ago|reply
[+] [-] emptybits|9 years ago|reply
Vancouver (and Toronto), when looking at the urban centres, boast lower-than-national rates of smoking. Source: http://www.statcan.gc.ca/pub/82-583-x/2011001/article/11575-...
There haven't been "smoking sections" in Vancouver restaurants or bars for years (decades?) and we even ban smoking in public parks ... so I'm surprised to hear your observation. I recognize that I'm likely normalized to my home city but I do travel a lot and it doesn't feel like I come home to any more smoke in my city than I'd experience in San Francisco or Seattle.
One observation that I stand behind is ... in both Canada and the USA, suburban and rural smoking rates are higher than urban.
BUT ... the theory suggested here about tourists and immigrants bringing their habits with them is good. And Vancouver is a tourist destination, which is why I was curious about the neighbourhoods you noticed the smoking in.
[+] [-] rconti|9 years ago|reply
I have never noticed a particularly large rate of smoking in the areas of BC I've been to.
[+] [-] jandrewrogers|9 years ago|reply
It is a regional culture thing. Most smokers in the Pacific Northwest are strongly biased toward the lower economic strata. By comparison, in many parts of New England (for example) there are quite a few smokers in the upper half of the economic strata.
[+] [-] cylinder|9 years ago|reply
[+] [-] tn135|9 years ago|reply
[+] [-] wil421|9 years ago|reply
"Widely distorted the housing market creating ghettos where similar people will get clubbed together."
I think they call them neighborhoods. Rich people live in nicer houses than other people. Pretty sure it's been like this since one caveman had a bigger cave with bigger rocks to throw.
Sacasim aside I really think we need a national school system. In Georgia it varies by counties. Some counties compete on a national level others are dead last in the nation, if we aren't counting Mississippi.
[+] [-] alkonaut|9 years ago|reply
Without this, what happens is that affluent people move to good school districts. These districts then get students with better academic backgrounds, fewer parents with drug/legal problems, fewer students with lanugage problems. Its pretty obvious to be a system that spirals out of control in just a few generations, creating segregated patches.
But perhaps this is how the support for the public school system is upheld? Rich people accept the system, because they can game it? If that's the case then it might be a necessary evil. Politically viable alternatives such as voucher systems will create the same effect (I know from experience).
[+] [-] xeromal|9 years ago|reply
[+] [-] throwawaysf9|9 years ago|reply