Heat: Climate and Politics: Is It Time to Move Back Up North?

 A recent article in The Economist sheds some light on trends in the US housing market: America’s housing market is shuddering.  It indicates that trends established during the pandemic are receding and, perhaps, reversing.  For a long period, a desire for undertaxed, underregulated southern cities led to a booming housing market.  That is no longer happening. 

The article focuses on traditional market factors for explaining any changes.

“Prices are still creeping up in the north-east and the mid-west, but the west and, in particular, the south are hurting (see map). Pity the homeowner in Dallas or Phoenix who bought last year. They are carrying a beefy mortgage rate of 7% or so and the value of their house is already down a few percentage points in nominal terms, or more after accounting for inflation.”

“Worse, public perception of the cities has changed. Austin and Miami failed to attract enough superstar firms when they were in favour; few tech bros today tout them as the new Silicon Valley.”

“The state that fares worst of all…adds a few peculiarities of its own. It is Florida, where prices have fallen by 4% in the past year. Aziz Sunderji, an independent analyst, points to high and rising home-insurance premiums owing to climate change ($11,000 or so a year in Florida, versus $2,400 nationwide). Other reasons are a sharp drop-off in demand from rich Canadians (a surprising number of whom flee cold winters to Florida) and expensive new safety rules that came in after a condominium in Surfside, a Miami suburb, collapsed in 2021.”

The major factor in housing prices is the demand for housing.  One of the seemingly safe assumptions has been that people from the cold states will continue to move to friendlier climates in the sunbelt.  However, with global warming, northern regions will benefit from milder temperatures while the southern states will get ever hotter.  Could we reach a point at which that trend will reverse?  Consider this chart that the article provided. 

  

At the current moment, it seems net migration to the three sunbelt states is diminishing, while the northern and western giants of New York and California are losing people at a slower rate.  If these trends continue, the flow could be reversed in a year or two. 

It should be noted that people considering moving to a new place face not only climate temperature gradients but also political temperature gradients.  When assessing the potential quality of life in a location, local climate and local politics must both be considered, and both are changing rapidly.

There is a phenomenon that psychologists refer to as schismogenesis.  It was observed when two individuals argue over an issue and in the process, with each determined to gain dominance, the argument will spread to other concerns over which there may have been no previous disagreement.  David Graeber and David Wengrow, in their book “The Dawn of Everything,” observed examples of neighboring societies where each developed cultures that seemed intended to be exact opposites.  One would develop a practice that would annoy or infuriate the other and the other would respond in a similar fashion.  This type of relationship does not usually end well.  One example posed by those authors was the ancient pair of Sparta and Athens, which eventually led to warfare.  We, in the United States, seem to be splitting our population into two cultures with each found infuriating by the other.  It is frightening to consider how this might end.

A response to such a situation is for each culture to collect in specific geographic locations.  That is what has been occurring over the last few decades.  In choosing a location, one doesn’t want to be stuck in the wrong culture. 

Changing climate factors into which culture makes sense in a given location.  The southern coastal states appear to be the most at risk from climate change.  Increasing temperatures invite unfamiliar tropical diseases to migrate into these warmer regions.  An AI query of tropical diseases invading the southern US provides these examples: Chagas disease, Leishmaniasis, Melioidosis, Dengue fever, and Chikungunya.  As these invasions develop, the favored administration in these regions is attacking vaccines and vaccine science, implying that vaccinations are dangerous and science can’t be trusted.  Past diseases assumed long gone are beginning to reappear as vaccination rates fall.  Those of us who predate polio vaccines remember the fear that spread through families each summer during the polio season, and how grateful we were for the vaccine.  Some attitudes make no sense, but they do infuriate political opponents.

Temperatures are rising and the favored administration in the south is determined to keep them rising by supporting fossil fuel consumption over the development of carbon free energy sources.  If this trend continues it is possible that our children will see a day when southern Florida is underwater and most of the Gulf coast is as well.

It is best to think carefully when considering a location in which to live.  Current housing price is not the only consideration.

 

New Insight into Mental Illness: Autoimmune Psychosis

 Dealing with mental illnesses in our societies is fraught with uncertainties.  At one time, psychiatry and neurology were two approaches to understanding the same health threats.  Over time, however, the two disciplines split off with neurology focusing on mental conditions known or thought to be determined by measurable conditions in the brain such as dementia.  Those for which there were no known physical indicators of disease, including schizophrenia, depression, anxiety, and others were left to psychiatrists who drifted toward treatments with medications in hopes not of curing a disease but of managing symptoms of the various conditions.

Rachel Aviv provided an interesting article for The New Yorker that indicates neurology is back in the mental health business: Mary Had Schizophrenia—Then Suddenly She Didn’t.

Some conditions such as depression and anxiety are relatively easy to identify, but schizophrenia is an example of a disease that is less easily diagnosed. 

“For decades, scientists have been searching in vain for a biological marker that would confirm whether someone has schizophrenia. Last year, in a paper in Schizophrenia Research, seventeen international experts concluded that schizophrenia was defined by no single etiology, symptom, or biological mechanism. “It is prudent to wonder if the construct around which we are organizing this information is fundamentally flawed,” the authors wrote.”

Recently, some startling medical turnarounds have been observed for people diagnosed as suffering from schizophrenia.

“A 2017 study in Frontiers in Psychiatry described a woman with a twenty-five-year history of schizophrenia. She also had a skin disease, for which she was given drugs that reduced inflammation and suppressed her immune response. Her doctors noticed a pattern: when they treated her skin lesions, her psychosis went away. They hypothesized that the rash and the psychosis had been caused by a single autoimmune disorder, and were cured by the same drugs.”

“Another paper in Frontiers in Psychiatry described a man with ‘treatment-resistant schizophrenia’ who developed leukemia. After a bone-marrow transplant, which reconstituted his immune system, he startled his doctors by suddenly becoming sane. Eight years later, the authors wrote, ‘the patient is very well and there are no residual psychiatric symptoms’.”

“…a Washington Post article from 2023 about a woman named April, who had fallen into a catatonic state at the age of twenty-one and been diagnosed with schizophrenia. Sander Markx, a professor of psychiatry at Columbia, first encountered April at a psychiatric hospital on Long Island when he was a medical student; twenty years later, he was dismayed to find her at the same hospital, in the same condition. ‘She has not been outside for twenty years—out of sight,’ he said, at a symposium at Weill Cornell’s medical school. He and his colleagues gave her an extensive workup and found that she had lupus, an autoimmune disorder that, in rare cases, can induce inflammation in the brain, causing symptoms that are indistinguishable from those of schizophrenia. After undergoing immunosuppressive therapy, including rituximab, April emerged from, essentially, a ‘twenty-five-year-long coma, and was able to tell us everything,’ Markx said. ‘We don’t have a script for this. We don’t see patients coming back from this condition’. 

Aviv identifies April’s case as the one that finally got neurologists back in the mental health business.

“April’s case helped give momentum to the founding, in 2023, of the Stavros Niarchos Foundation (S.N.F.) Center for Precision Psychiatry and Mental Health, at Columbia, which is working to uncover biologically distinct subtypes of illness that have been obscured by the broad categories in the DSM.”

DSM stands for the Diagnostic and Statistical Manual for Mental disorders, a handbook published by the American Psychiatric Association.

Neurologists are on the move proposing a new category of mental illness labeled “autoimmune psychosis.”

“The S.N.F. Center is embarking on a project, beginning this fall, to screen all the patients hospitalized in the New York State mental-health system for autoimmune, metabolic, and genetic disorders, to see if there are people whose symptoms can be traced to a distinct biological mechanism.”

Considerable progress has already been made, but there is likely a long way to go.

“…scientists have identified more than twenty new antibodies linked to psychiatric symptoms… Christopher Bartley, the chief of a unit at the National Institute of Mental Health which investigates the role of immune dysfunction in mental illness, said that the twenty known antibodies may be a ‘drop in the bucket.’ There could be countless targets in the brain that antibodies attack, some subset of which may alter people’s perceptions and behavior. ‘We have to have epistemic humility and accept that there are alternative models of disease,’ Bartley said. 

This new focus on autoimmunity as a source of psychoses has produced dramatic improvements in the health of affected persons.  There are two questions still too early to answer.  First, how prevalent is autoimmune psychosis, and how many other physical conditions will be found to contribute to psychoses.

“Bartley estimates that between one and five per cent of people who have been diagnosed with schizophrenia actually have an autoimmune condition—a figure he based on his own lab’s research, which has not yet been published, and also on a German study of a thousand patients, the most extensive study of autoimmune psychosis so far. ‘Even one per cent ends up being almost a million people in the world who should be treated with a different kind of medicine,’ he said.”

This development in the field of mental illness reminds us that in the fields of medical science there have been endless numbers of surprises and there are many more yet to come.  We need to encourage our best people to participate and provide them the resources to continue to extend our knowledge.