“We’ll never survive!”

“Nonsense. You’re only saying that because no one ever has.”

— William Goldman, "The Princess Bride”

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THIS WEEK

What are the four — fine, six — things you need to survive?

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What do you need to survive?

There are a default group of problems that exist in our society because of the basic needs required to be a human.

They are:

• Air
• Water
• Food
• Sleep

These, our most primal needs, are more or less biologically inarguable, and the good news is, we understand them very well and have made enormous progress to ensure they are accessible to a greater percentage of humans than ever before.

There have been tradeoffs along the way, of course, including plundering most of the solar system’s single habitable planet’s resources.

Anyways I’m very interested in using these essays to ask questions like “Yes, that’s true, but what about everyone else?” or “What else happened during that time?” or “What part of the story isn’t being told?” or “But what were the costs of progress?” and of course “If X is where we want to go, what systems do we need to design to get there, and what legacy bullshit do we have to stop?”

Regarding the latter, and the availability of clean air, water, food, and sleep, “where we want to go” is often “back to the future”, that is before industrialization.

Before you get all in a huff, please understand I am aware that things were never easy, and I’m equally in agreement that Paleo diets are stupid and industrialization very clearly had its net benefits! I am not that much of a moron.

Since we first swung down from the trees, obstacles have existed to hinder or even prevent us from getting what we need, including rocky topography, nasty weather, a lack of tools and/or shiny things to barter with, racism, slavery, and of course, being downright delicious to a variety of predators.

With progress, incentives, and a real disinterest in tallying up the actual costs of both, accessibility has exploded, but quality has become more varied as well, ranging from “Star Trek” to “Meh, it’ll do” to “I’m warning you Timmy, if you drink that, it will fucking kill you.”

If you’re here, it shouldn’t surprise you that despite our very real successes, our societal and economic systems have developed over time not to explicitly guarantee basic, unfettered, equitable access to what we need, but to gamify the process of acquiring what we need to survive. This includes building and reinforcing power structures who often exist to increase the quantity, variety, and magnitude of those obstacles.

Without fulfilling our most basic requirements, we can’t truly move into the future, no matter how much one small but powerful group wants to skip ahead to electric planes or flying cars or extended life spans.

Everything we build is a choice, another layer on top of our fundamental needs: industrialized meat, cars, blood tests, public transportation, maternal care, a connected grid, carbon offsets, CRISPR, ocean acidification — these are all choices we’ve made to make the whole thing more complicated, to poison the well, to make up for deficits where there shouldn’t be any, or to invent something better when what we often need is less bad and more.

I want to get to the future as fast as anyone, but without equal access and enjoyment of these make-or-break requirements, there’s simply no bootstraps to pull yourself up by, no ground to stand upon, much less to collectively reach higher.

Air

‍

Why we need it

• When we inhale, the oxygen hits our lungs and bloodstream, where cellular respiration keeps the cells bangin’. Without that, it’s game over

The ideal version

• Preferably clean from the start, preferably not stale, and if inside, preferably run through a filter

How it got complicated

• Clean air probably started to go downhill when we decided to start cooking inside, often with wood, which a lot of folks still do either by choice, or because they suffer from cooking-related energy poverty (about 40% of the world). Over 4% of global deaths can be attributed to inside air pollution. Feels unnecessary!
• Outside air remained pretty choice for a while, except for the waste and dead bodies piled up out back, but once industrialization got under way, things went bad, fast. Factories, coal mines, cars, roads, smoking, cooking inside with wood, cooking inside with gas — all not great for lungs that evolved to live to their fullest on pristine air.
• We had a pretty good idea these things weren’t good for us, but the incentives to ignore that and build economies vastly outweighed the costs. Almost 8% of global deaths can now be attributed to outside air pollution.
• The economic math became even more lopsided when we realized we could park factories next to and pave roads through the communities of the historically marginalized, stripping those communities of trees, while increasing heat and reducing air quality in about seven different ways.

How we improve it

• One great thing about air pollution is how quickly we can make it go away. Like, immediately. Overnight. Or faster! Unlike carbon or even methane emissions, removing a source of air pollution inside or outside a home, school, restaurant, or workplace instantly improves the well-being of everyone in the surrounding area.
• So we should do more of that.

Water

Why we need it

• To remain hydrated and to regulate body temperature. Cells need it, tissues need it, we all need it. Electrolytes are great and keep our sodium and potassium up to snuff. Water also helps keep our temps in check through some pretty swell processes like sweating and evaporative cooling.
• But also it turns out water helps us clean ourselves, and especially our hands, cook our food, to travel on and transport goods, to put out fires, grow food, and for Slip ‘N Slides.

The ideal version

• Fresh water, not salty. Not brackish either, dammit, I said fresh.
• Great, now we need to filter out common contaminants like lead, atrazine, arsenic, mercury, nitrates. and a variety of fun pathogens, and then usually we add a bit of chlorine to purify it and fluoride so you teeth don’t fall out (unsafe water is responsible for about 1.2 million deaths a year)

How it got complicated

• Access-wise, we’ve always instinctively built villages and towns and cities near drinking water, but obviously not everybody can do that and so that got contentious, fast.
• Quality-wise, we used to just use the bathroom directly in our drinking water, so. But even after we moved on from that embarrassing stretch, we still dumped dead bodies and other waste in our precious streams and rivers, and later, a huge variety of industrial, pharmaceutical, and farm-related chemicals and poisons joined the pot.
• We also built a lot — a lot — of pipes with lead, because it didn’t corrode as much as alternatives. We eventually realized lead in the bloodstream reduces IQ and have made huge progress to reduce exposure, but we’re definitely not all the way there, which is stupid.

How we improve it

• Well, first, we could just all agree to stop dumping shit in our water, directly or indirectly, like fertilizer runoff.
• Once we do, we’ve got our work cut out for us, from cleaning up major water sources like the Erie Canal and Hudson River on the east coast, to the New River on the west coast, and all of the many tributaries into the Mississippi in between.
• In addition, we’ve still got a whole hell of a lot of leaky pipes, and those aforementioned lead pipes, and replacing them will take a very long time and a whole hell of a lot of money. It’s not the sexiest use of our cash, but again, these are fundamental make-or-break requirements — there’s no better way to spend it.

Food

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Why we need it

• Because it’s delicious AND we need it to convert into energy.
• We digest food, absorb what we need, and then process it through glycolysis etc into mitochondria and, combined with a little hit of that sweet sweet oxygen in a process called cellular respiration, we make ATP, and then like magic, it’s Thursday all over again and you can get out of bed to face the sum of your lifetime decisions.

The ideal version

• Nutrient-dense, affordable, accessible.
• Over time we’re finding out how our microbiomes define what diet is best for each of us — though we’ve just gotten started on understanding the gut — but broadly, most science agrees that less meat, less dairy, less sugar, basically no processed food, and way more legumes and vegetables is the way to go.

How it got complicated

• Chasing our food was always a bit dangerous. Agriculture has a lot of pros and A LOT of cons, including serfdom and slavery, and specific crops requiring a specific set of recurring weather conditions, which was even more complicated when we thought heavy rains and drought were the gods punishing us.
• Industrial farming has made more food accessible to more people, but reduced the quality of what’s available and prioritized the wrong foods, making people, animals, and soil drastically less healthy overall.
• There are way more people than before in geographies that are more likely to live in poverty (9% of the world’s population is “severely food insecure”, which is a huge improvement, but we’ve got a long way to go)
• Oh, and a disturbing percentage of what we grow — say, corn or soy — isn’t even fed to humans. It’s either fed to enormous cows or chickens after an antibiotics appetizer, or turned into syrups or ethanol, both of which are no bueno, all of which requires massive amounts of — you guessed it — not-salty water.
• Worldwide demand for meat has dominated land-use, driven deforestation at home and abroad, and created a massive amount of carbon emissions (see chart above)
• Instead of prioritizing access to affordably nutrient-dense food, we…don’t do that…and let a dangerously unregulated supplements industry thrive

How we improve it

• The incentives for what we grow and what we eat have to change, and that’s going to require a kitchen-sink approach, including:
• Returning land to Indigenous tribes
• Drastically expanding Black ownership of farm land
• Incentivizing cover crops, multi-crops, and no-till farming
• Taxing or reducing water-intensive crops like almonds
• Taxing the shit out of sugar
• Banning sugar-related advertising to children
• Funding plant-based and cell-based meats
• Reducing fertilizer use wherever we can
• Breaking up the FDA
• Taking some real lessons from the Blue Zones research
• Regulating supplements

Sleep

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Why we need it

• One, because sleep’s fucking amazing, and two, it’s amazing because it:
• Helps restore and repair basically everything inside our soft meat sacks
• Helps us consolidate memories
• Regulates hormones so we grow, and regulates mood through some processes with neurotransmitters that I definitely don’t understand
• And of course, conserves our energy

The ideal version

• Everybody’s a little different but seven to nine hours a night seems like the Goldilocks Zone, with a little more for teenagers. A dark, cold room, no screens, as few interruptions as possible.

How it got complicated

• We work too much
• We’re too stressed out
• We stay up too late
• We eat too much and too close to bedtime
• We drink a shit ton of caffeine late in the day
• And Black and Brown people often live in homes they can’t cool down and/or are overcrowded.

How we improve it

• Do the opposite of all of those things? There’s a lot we can do system-wide to improve sleep via reducing stress, including:
• Being measurably less racist!
• Paying a living wage
• Requiring paid leave, paid sick leave, paid family leave, and health care (1 in 4 parents reported being fired last year thanks for a breakdown in child care for their kids)
• Develop systems to help people move more and eat healthier, so they sleep more, and don’t have high-blood pressure, the world’s number one risk factor for death
• And building (no joke) about four million new homes.
• I’m not sure how we convince people to stop eating and put their screens away a few hours before a reasonable bedtime, but whatever it is, we should do that, too.

Leveling Up

Sure, going from single-cell to multi-cell was probably the biggest boost of all, but figuring out shelter and power probably felt pretty pretty pretty good.

Shelter

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Why we need it

• Pretty straight-forward! Shelter helps us protect ourselves from harsh conditions - sun, wind, rain, cold, heat. But shelter doesn’t just protect us, it also protects our food and other essentials.

The ideal version

• Water-tight, insulated — and not with toxic materials, please — affordable, with plumbing, so the air doesn’t get poisoned, and near a fresh-water source.

How it got complicated

• Well, once we moved on from branches and leaves to rock overhangs and caves — which, when you’ve got nothing else are pretty great — upgraded shelters required not only more sophisticated understanding and tools to build, but more resources from which to build them, like woven fibers, animal hides, wood, steel, and more.
• And those required more extensive bartering or, eventually, some form of money. If you couldn’t build something new or buy your own, you had to rent or be a serf or a slave.
• To build shelter requires land, and after colonizers stole the land from indigenous people everywhere, the best land became more scarce, unaffordable, or just unattainable in some way, mostly because of greedy, asshole warlords, slave-owners, slumlords, or landlords.
• Terrible single-family zoning practices in the US made the suburbs off-limits to more dense housing, public transportation, and marginalized families

How we improve it

• I’m not kidding when I say we need to build four million new affordable homes across the U.S. and then power them all with clean electrify, SPEAKING OF—

Power

Why we need it

• I mean we really started to use power when we started to rope carts to animals to plow fields and take us and our goods around the neighborhood, which must have been super fun.
• For today’s purposes though, I’m talking water, wind, steam, whale oil for a while — which fucking sucks — and eventually electrical power.
• These tools helped us to see in the dark, which, again, revelatory, and to enhance shelter — to warm and cool our shelter and bodies, to to heat and chill (and preserve) food, and to charge our kids’ iPads to play Minecraft.

The ideal version

• Affordable, clean, renewable power transmitted over a gazillion new long-distance power lines and backed up with community and residential batteries

How it got complicated

• Fossil fuels powered the 20th century. The companies that mined or drilled, refined, and distributed them realized with ALARMING SPECIFICITY that they’d cause global warming and then lied about it for 60 years
• Fossil fuels are a finite resource trapped under certain states or countries or parts of the ocean so we’ve fought over them a lot or bribed horrific dictatorships to please drill more
• 13% of the world doesn’t have access to electricity

How we improve it

• By transitioning to affordable, clean, renewable power transmitted over a gazillion new long-distance power lines and backed up with community and residential batteries
• Mining the minerals and metals we need is already complicated all over again, but hopefully we’ve learned something from last time?

Wellness, or “health care”

Why we need it

• Even if you’ve got all of the essentials covered, you’re going to get sick, or hurt. That’s life.

The ideal version

• Something comprehensive and affordable that includes trusted community health workers who know you and who can provide you with guidance, checkups, vaccines, and more so you’re less frequently surprised when something comes up, and who can connect you with specialists as needed.

How it got complicated

• Well, we got way more access to everything above, but then it was access to less-good versions of those, which made people sick, and then because of profits we focused way more on medicine and specialty medicine than public health and wellness
• Our food makes us sick
• And now it costs a small fortune to have your wisdom teeth removed, if you can find a bus that’ll take you to the dentist, who is probably booked six months out and is short many nurses, oh and dental isn’t usually a part of your health insurance
• And that’s before COVID, which has become much more survivable over time, but which continues to kill 130,000+ Americans a year, and potentially contributes to tens of thousands of extra deaths we really can’t figure out

How we improve it

• Emphasize prevention and value-based care (38% of US people polled said they delayed care due to costs last year)
• Build and staff a million community health clinics
• Mandate paid sick leave
• Add a single-payer health insurance option
• Increase the percentage of Black doctors and nurses
• Pay nursing teachers much more
• Expand telehealth
• Reduce the cost of drugs
• Expand Medicaid everywher
• I don’t know, stop sacrificing children at every turn?

Conclusion

As you can see, this isn’t really rocket science. But we do have to redesign the incentives to provide everyone with high-quality versions of these very basic and very important items.

— Quinn

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From My Notebook

Health & medicine

• Is this why lung cancer doesn’t respond to immunotherapy?
• The first federal gun crime report in 20 years dropped
• New blood donation rules will loosen restrictions on gay and bisexual men
• Prenatal exposure to air pollution is associated with neurodevelopmental outcomes at just 2 years of age

Climate

• The US Treasury made more cars eligible for tax credits, and still there’s nothing for e-bikes and other micromobility options
• The Colorado River crisis is not going swimmingly as seven states just can’t agree on cuts
• Europe’s fossil fuel use should plummet this year

Food & water

• CRISPR could help feed the world but boy genome editing in crops is a tad bit controversial
• The FDA rolled out a plan to re-org the food side and not everyone is pleased
• How road salt is poisoning Michigan’s water

Beep Boop

• A new group called Health3PT is trying to address ransomware attacks along hospital supply chains
• GPT is coming to…everything
• The ACLU is suing the US intelligence community to try and further expose abuses of a warrantless surveillance program

COVID

• Vaccine makers kept $1.4 billion in prepayments for canceled COVID shots for the world’s poor and I am losing my mind
• VA Senator Tim Kaine, suffering from Long COVID, pushes for more research and treatments
• A good piece on we need an air-quality revolution

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