How “normal” are you in terms of interacting with the culture around you? A continuing theme of this blog is that we can view a lot of medical and social problems as various aggregations of “probabilistic randomness.” That is, many conditions in nature at least appear to occur randomly, but with predictable patterns to that randomness. And when you see a classic bell-shaped “normal probability distribution” in the data, it most likely is the summation of numerous “over-determined” causes, each with their own different and unique probability distribution.
We can view many “community-effect” issues of health and economic well-being in this way as well. Most of us (numerically the “norm” or center of the probability distribution) face various challenges in life, and we cope well with some, but not so well with others. In the end, there are a lot of “people like us” making our way somewhat successfully through life, raising our families, paying our bills and engaging with friends and family.
On one extreme, we daily see the “super successes” in life who have more money than us, are better looking than us, are smarter than us, and who overall form the upper “tail” of society’s “normal distribution.” We may aspire to be in that “upper tail,” and sometimes we make it. Most of the time, however, we are “normal” folks coping more-or-less with the mad rush of the culture around us, somewhere in the center or the probability distribution. But the “cultural norm” seems to keep moving, and the older we get, the harder it is to keep up.
At the same time, the lower “tail” of this normal curve contains people who, for hundreds of reasons, are what I term the “casualties of culture.” They may have health conditions that keep them from full participation in the culture. They may have a lack of economic resources and opportunities, and struggle to put food on the table for their families or to keep a job. They may have various substance or behavioral addictions. They may just be aging and seeing the world move on without them. Essentially, they are “falling off the cultural curve” as it moves onward.
The probabilities of “cultural distress”
Of these hundreds of reasons why people find themselves in “cultural distress,” some are surely “their own damn fault,” but when we make that judgement we are usually missing the entire story. A back injury might result in a substance addiction and the loss of a job, and then maybe leading to the collapse of a marital relationship or even trouble with the law. Or the reverse; a minor law infraction tumbles the dominoes toward a larger “life crash.”
Substance addictions, for which we are often quick to cast blame and social scorn, are sometimes as statistically predictable as many types of cancer. In a classic example of probabilistic randomness, we usually can’t predict who, but we can often accurately predict how many new addictions will arise next year of each particular type. And with some, like opioid addictions, we can even predict the rate of increase in addictions quite accurately.
In short, “casting the first stone” onto people who are trying to cope with various addictions, is not just morally questionable, but mathematically problematic as well. Becoming a “casualty of culture” is usually an “over-determined” process, where any one problem alone might slide you off the “cultural train,” but typically multiple factors interact and reinforce one another. “Fixing” just one problem won’t cut it.
Some people have the luck, the internal fortitude, the safety net, or the benefactors to escape the downward pull when they slip off the cultural curve. But far too many don’t.
How does our society treat its “casualties of culture”?
American culture is quick to “shoot its casualties.” If you have an intellectual disability or are just old, you might be lucky enough to live in a state that has tried to keep up with its Medicaid responsibilities (the large majority of Medicaid dollars go to long-term care and to care for people with physical or intellectual disabilities). Or you might be unlucky enough to live in a state that is trying to minimize its social safety net, or trying to pass responsibility for the net to for-profit companies through privatization. The “safety net” has lots of holes.
You know, it doesn’t have to be this way. Other countries have figured a lot of this out. In the U.S., one emergency room visit for appendicitis can still send a family into bankruptcy, with a lot of “knock-on” effects that can push the family off the curve. In other countries this is not the case. How a country treats its “casualties of culture” is evident through the amounts and percentages on which the “collective commons” spends its tax receipts. 
The “holes in the net” are especially a problem if you are perceived to be in the “it’s your own damned fault” category. And it sometimes seems like we try really hard to put people into that category. America has a deeply ingrained “saved wretch” social theology that assumes that the “casualties of culture” are only a religious conversion away from robust health and financial success. This is “magical thinking” at its worst.
I don’t know about you, but it sure seems to get harder every year for me to keep up with that moving “cultural train,” and I have a lot of advantages going for me. How well do you think your children and fellow citizens will treat you if or when you “fall off the train”?
- See my earlier post on government budgets and collective morality.