A child in India during World Toilet Day in New Delhi, 2012. Around 130 million households in India have no toilets. Photo: Getty
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Choose your friends wisely – their friends could be bad for your health

A seriously ill patient’s condition affects not just their ­immediate family and friends but the next circle out, their children’s spouses, say, and the one after that, of those spouses’ friends.

It used to be called “dying of a broken heart” but modern scientists prefer the term “the widowhood effect”. After their spouse’s death, surviving partners have an increased risk of ­dying themselves – up to 66 per cent in the first three months, according to research last year from the Harvard School of Public Health in Boston.

The effect has been noted in dozens of studies and seems to apply to both genders. The possible reasons include the stress of caring for a sick person; grief leading to bad lifestyle decisions; and social isolation, because their partner used to be their link to friends and family. As the gerontologist Kenneth Doka put it after the Harvard study: “It’s not unusual that widowers will often say no one ever stops over any more, because they didn’t realise someone else was calling and inviting them.”

But the widowhood effect doesn’t stop with the surviving partner, as a young hospice doctor called Nicholas Christakis noticed several decades ago when he first began to practise medicine. A seriously ill patient’s condition affects not just their ­immediate family and friends but the next circle out, their children’s spouses, say, and the one after that, of those spouses’ colleagues and friends.

As he got older, Christakis became more and more interested in these “social networks” – a phrase we’ve come to associate with online environments such as Twitter and Facebook, but which are deeply embedded in our offline world, too. He now works at Yale as a sociologist, collaborating with a colleague called James Fowler, championing an obscure but fascinating discipline called “network science”.

Their research uncovered some astonishing results: obesity really is an epidemic, in the sense that it is infectious. If someone you know well is obese, you are more likely to be obese. The effect can be seen – albeit at progressively dwindling intensities – as you look at friends of friends, up to four degrees of separation from the original subject. (Christakis says the possible causes are induction – your friends get fat because you are fat; homophily – you are friends because you share a lively interest in eating biscuits; and confounding – you both live in a society where fast food is cheap and many jobs involve sitting down for eight hours a day.)

When I saw Christakis explain these ­ideas in a TED talk, the political and policy implications immediately struck me. And so, while he was on a visit to London to lecture at the Cass Business School, I met him to ask the obvious question: doesn’t this vanquish libertarianism once and for all? How can anyone argue “There’s no such thing as society”? He agrees. “My favourite example is the analogy of carbon – it has a number of forms, allotropes; one of them is graphite and one of them is diamond. If you take the carbon atoms and assemble them one way, you get carbon. Assemble the same atoms another way, you get diamond. The graphite is soft and dark and the diamond is hard and clear. Softness or hardness are not properties of the carbon atoms; they are properties of the collection of carbon ­atoms.”

Society is the same: it is just as much about the connections between individuals as the individuals themselves.

In person, Christakis is bombastically ­erudite and many of his answers are delivered as mini-lectures. His research has led him to think about the perils of a laissez-faire system of government, he says. “The function of the state is, at minimum, to address collective defence, market failure – things that individuals are not equipped to do or things that individuals, acting rationally, subvert. That’s the tragedy of the commons. Everyone is grazing their cattle on the commons and the commons collapses.”

Network theory has uses far beyond giving me ammunition to argue with people with Twitter handles such as @AynRand93, however. Christakis and Fowler create complex maps of connections between individuals in a group and use algorithms to identify the most structurally influential.

The professor gives me a concrete example: in India, women are particularly badly affected by the lack of toilet provision for 500 million of the country’s citizens. Open defecation is risky, because a lone woman is easy prey for sexual assault. In rural Bihar, where about 85 per cent of households have no sanitation, one victim this summer was an 11-year-old girl, raped when she ­visited the field at night. Many women try to avoid going to the loo at all for hours on end, increasing their risk of urinary tract infections.

So how do you convince a community that toilet provision is necessary? Even when local government or an NGO provides the funds, there is often still a cultural resistance. “If you ask people, ‘Why don’t you construct a loo?’ they’ll say, ‘But all my neighbours do the same thing,’” Christakis observes. He says the same model explains widespread tax avoidance in Greece – “If you ask people, ‘Why don’t you pay your tax?’ they say, ‘My neighbours don’t pay their taxes. What am I, an idiot?’” – and risky sexual behaviour in countries with endemic HIV.

Traditionally, you might try to win over the highest status member of the community: but he and Fowler believe you should instead target the most influential as identified by their algorithm. “That way, you can target 5 per cent of the people and 80 per cent of the people change,” he says – making scarce development funds go far further.

Christakis’s work gives him many insights into human nature, sometimes with unexpected results. Take the way that his work on obesity was reported. In America, he says, the headlines read: “Are you packing it on? Blame your fat friends.” In Europe, however, the message was different. “Are your friends fat? You are to blame.” 

Helen Lewis is deputy editor of the New Statesman. She has presented BBC Radio 4’s Week in Westminster and is a regular panellist on BBC1’s Sunday Politics.

This article first appeared in the 29 October 2014 issue of the New Statesman, British jihadis fighting with Isis

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How worried are Labour MPs about losing their seats?

Despite their party's abysmal poll ratings, MPs find cause for optimism on the campaign trail. 

Labour enters the general election with subterranean expectations. A "good result", MPs say, would be to retain 180-200 of their 229 MPs. Some fear a worse result than 1935, when the party won just 154 seats. Rather than falling, the Conservatives' poll lead has risen as the prospect of electing a government concentrates minds (last night's YouGov survey, showing the Tories a mere 16 points ahead, was an exception).

Though Conservative strategists insist they could lose the election, in an attempt to incentivise turnout, their decision to target Labour MPs with majorities as high as 8,000 shows the scale of their ambitions (a Commons majority of circa 150 seats). But as well as despair, there is hope to be found in the opposition's ranks.

Though MPs lament that Jeremy Corbyn is an unavoidable drag on their support, they cite four reasons for optimism. The first is their local reputation, which allows them to differentiate themselves from the national party (some quip that the only leaflets on which Corbyn will feature are Tory ones). The second is that since few voters believe the Labour leader can become Prime Minister, there is less risk attached to voting for the party (a point some MPs make explicit) "The problem with Ed Miliband and the SNP in 2015 was that it was a plausible scenario," a shadow minister told me. "It was quite legitimate for voters to ask us the question we didn't want to answer: 'what would you do in a hung parliament?' If voters have a complaint it's usually about Jeremy but it's not the case that he looks like he can become prime minister."

The third reason is the spectre of an omnipotent Tory government. MPs appeal to voters not to give Theresa May a "free hand" and to ensure there is some semblance of an opposition remains. Finally, MPs believe there is an enduring tribal loyalty to Labour, which will assert itself as polling day approaches. Some liken such voters to sports fans, who support their team through thick and thin, regardless of whether they like the manager. Outgoing MP Michael Dugher (who I interviewed this week) was told by an elderly woman: "Don't worry, love, I will still vote Labour. I vote for you even when you're rubbish."

Ben Bradshaw, the long-serving MP for Exter, who has a majority of 7,183, told me: "We're not anything for granted of course. On the current national polling, the Tories would take Exeter. But having covered five polling districts, although the leadership is undoubtedly a big issue on the doorstep, most people say they'll still vote for me as their local MP and we're not detecting any significant shift away from 2015. Which is slightly puzzling given the chasm in the opinion polls." Bradshaw also promotes himself as "the only non-Tory MP in the south-west outside Bristol": a leaflet shows a blue-splattered map with a lone red dot. The Labour MP warns voters not to be left in a "one-party state". 

As in 2010, Labour may yet retain more seats than its vote share suggests (aided by unchanged boundaries). But the fate of the Liberal Democrats in 2015 - when the party was reduced from 56 MPs to eight - shows that local reputations are worth less than many suppose. Theresa May has succeeded in framing herself as a figure above party interests, who needs a "strong hand" in the Brexit negotiations. At the very moment when a vigorous opposition is needed most, Labour has rarely been weaker. And when the public turn resolutely against a party, even the best men and women are not spared.  

George Eaton is political editor of the New Statesman.

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