Baylor University Medical Center Proceedings April 2017 - 251

extract. Now, with fewer young people to support larger numbers
of retirees, President Xi Jinping relegated the one-child policy to
the Communist Party's scrap heap of discarded dogma-pivoting
from punishing couples for having a second child to encouraging
reproduction.
HOTTEST YEAR
The average temperature in 2016 was the hottest recorded
since 1880, when records started being kept (13). In 2015, the
temperature was the hottest up to that point, and in 2014, the
hottest up to that point. According to the National Oceanic
and Atmospheric Administration, the average surface temperature in 2016 was 0.07°F warmer than 2015 and featured
eight successive months (January through August) that were
individually the warmest since the agency's recording began.
That the earth is heating up is a point long beyond serious
scientiﬁc dispute, and one becoming more evident each year.
Temperatures are rising toward levels that many experts believe
will pose profound threats to both the natural world and to
human civilization. In 2015 and 2016, the planetary warming
was intensiﬁed by the weather pattern known as El Niño, in
which the Paciﬁc Ocean released a huge burst of energy and
water vapor into the atmosphere. The biggest factor in setting
the records, however, is the increasing levels of carbon dioxide
and other greenhouse gases. The heat extremes were especially
pervasive in the Arctic where temperatures in the fall ran 20° to
30°F above normal. Sea ice in that region has been in precipitous decline for years. Arctic communities are already wrestling
with enormous problems, such as rapid coastal erosion, caused
by the changing climate.
Since 1880, the planet has now warmed about 1.1°C or
2°F. That is very signiﬁcant because the global community has
been striving to limit overall warming to considerably below a
2°C rise, and even, if possible, to hold it to a 1.5°C increase.
That is now only about 0.4° away.
The warming in 2016, of course, was not limited to the Arctic.
Oﬀ the coast of Northeastern Australia, the Great Barrier Reef
experienced its worst coral bleaching on record. Extremely high
temperatures were seen in India-where the city of Phalodi
recorded temperatures of 124°F in May-and Iran, where
temperatures of 127°F were recorded in Delhoran on July 22.
El Niño has now ended, and climate scientists almost universally expect 2017 to be cooler than the year before. But the
scale of the heat burst has been startling to many experts, and
some of them fear that an accelerated era of global warming
could be at hand over the next few years. Even at current temperatures, billions of tons of land ice are melting or sliding into
the ocean. The sea is also absorbing most of the heat trapped
by human emissions. These factors are causing the ocean to rise
at what appears to be an accelerating pace, and coastal communities in the US are now spending billions of dollars to ﬁght
increased tidal ﬂooding.
SLOWING US POPULATION GROWTH
The US population in 2016 grew at its lowest rate since
the Great Depression, and the population of the State of New
April 2017

York shrank for the ﬁrst time in a decade (14). An uptick in
deaths, a slowdown in births, and a slight drop in immigration all damped US population growth for the year ending
July 2016. The 0.7% increase, to 323 million, was the smallest on record since 1936-1937. Americans continue to leave
the North for Western states, with Utah, Nevada, Idaho, and
several others in the region topping the country in percentage growth. Besides New York, Pennsylvania and Illinois also
shrunk, with Illinois losing more people than any other state.
About 593,000 people left the Northeast and Midwest to move
to the South and West in 2016, slightly more than during the
prior 1-year period.
SELF-DRIVING CARS
The race to get humans to give up the wheel is picking up
speed (15). Self-driving cars have rapidly moved from science
ﬁction to actual fact and will start hitting the road within
5 years. After 7 years and >2 million miles of road testing,
Google's self-driving car project, "Waymo," which uses sensors
and processors to drive a car without human input, will be sold
commercially for a variety of uses by the end of 2017. Plenty
of carmakers are getting ready to build their own driverless
cars: Tesla Motors, BMW, Ford Motor Company, and Volvo
Cars have all promised to have fully autonomous cars on the
road within 5 years. The technology is expected to transform
transportation as mobility becomes a service one orders from
an app, rather than an expensive machine bought and mostly
stored in a parking space. The use of self-driving cars could
drastically reduce urban congestion and dramatically reduce
or even eliminate the 1.25 million road deaths a year globally.
Human error is the cause of 94% of roadway fatalities, and
robot drivers never get drunk, sleepy, or distracted. These
autonomous vehicles are presently being tested on the streets
in Pittsburgh, Boston, and Singapore.
IF TEXAS WERE A COUNTRY
Only nine countries and one US state (California) have
a larger gross domestic product than Texas (16). The 2015
gross domestic product in trillions is as follows: USA, 17.9;
China, 11.0; Japan, 4.1; Germany, 3.4; United Kingdom, 2.8;
California, 2.5; France, 2.4; India, 2.1; Italy, 1.8; Brazil, 1.8; and
Texas, 1.6. Public education is underfunded in Texas. Among
the US states in 2015, it ranked 43rd. It is also behind in health
care availability. No state had more to gain from Obamacare,
and Texas lawmakers fought it at every turn. They rejected
Medicaid expansion, even though the feds covered over 90%
of the costs. Access to health care for over 1 million low-income
residents of Texas apparently is lacking.
MONEY AND AGING
Spending tends to decline as we age (17). Spending tends
to peak in our early 50s and then it declines until it levels out
in our mid 80s. With the exception of medical spending, our
costs decline across the board: shelter, food, cars, clothing, and
entertainment-all of it. The decline is not due to running out
of money to spend. It is due to changes in what is important to

Facts and ideas from anywhere

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Table of Contents for the Digital Edition of Baylor University Medical Center Proceedings April 2017