Most Americans are confined to a wheeled chair for many hours a week. We just call it a car, but good luck getting free of it.

(I have lived without a car for about a decade, so this comment is not expressing discontent with me feeling trapped. I escaped that trap and walking everywhere has helped me shed a lot of weight without intending to.)

Fast-forward to now and I'm seriously contemplating buying another car (which I am utterly loath to do), solely because of how unreliable public transport is in my part of the world.

Besides the above, I had a conversation with a cyclist in work earlier this week who is considering giving it up and going back to driving (also against his will) because he finds it hard to breathe with all the diesels on the road that have had the particulate filters ripped out (a law that is completely ignored here, so is commonplace).

(As a side note, if you're wondering how he knows which cars have had this done, Google "coal-rolling" and you'll understand quickly.)

This is far more nuanced (and ridiculous) than people understand. While it might be healthy in the US to walk and cycle rather than drive, in Europe it's borderline hazardous.

A couple will make 3 kids and say "I can't do without a car". But the couple never ponder the cost of making a family. The fact or having a car or not, and other matters of life style, are an after thoughs. And if you raise the issue, you are a cold robot for thinking that way instead of with your "heart".

I am super uncomfortable with statements that suggest people just need to exercise some self control and stop cranking out babies. That position is incredibly dismissive of very complex issues, including lack of access to health care in the US. Historically, health insurance that paid for Viagra did not pay for female birth control. We have this underlying assumption that men have a right to get laid, even if they need chemical help to get it up, but women do not. Yet, most of those men are getting laid with women, not with other men.

Questions of reproduction and sexual morality are incredibly complex and a very touchy subject because when two people have sex where the result may be a child, there are a great many people impacted. It isn't as simple as her rights vs his. The rights of the child are an issue, but so are the rights of the rest of society.

It really isn't a discussion I care to see injected here.

This is simply mistaken. The cost of making a family is nearly always what people are thinking about in that situation.

If you're saying that people aren't careful enough when they have sex, then yeah, that's always been a problem. But what's to be done? The kids exist now and you need to provide for them. Now what?

And no, in many places in USA a car is just about the only way how to get kids to school. Which you have to. And yep, cycling along unsafe road when you are adult and when you are 8 is not the same. So ype, familly with children needs car more then single healthy adult.

And yep, unless you want to face aging population problem later on, 3 kids should be doable. Just to get replacement level of population.

Sometimes I wonder if that's cause or correlation. That is, ill and wealthy just don't go together.

I am a strange mix of privilege and poverty. I was in gifted programs in public school and I have six years of college. I also am a woman and I have serious health issues.

I am getting healthier and I am getting more well off as a consequence. I think a lot about the details of the very complex relationship between health and wealth.

It is a really complicated thing that cannot be pinned down to any one thing. Education, social fabric, enhanced personal agency, greater de facto rights and a whole raft load of stuff tends to be involved in who is both rich and healthy and who gets access to neither.

A couple of excerpts from my food blog:

I basically live on diet coke. Coca cola products contain extract from the coca plant. This has medicinal benefits. No other cola products have this. Other cola products tend to be mostly sugar water -- though I do sometimes drink ginger ale because ginger helps with nausea.

http://miceats.blogspot.com/2016/09/diet-coke.html

Plain water has been gradually creeping into my diet here lately. This is noteworthy because I rarely drank plain water for quite a few years.

http://miceats.blogspot.com/2017/01/plain-water.html

Americans want to abuse their bodies (and minds) and expect healthcare to remain cheap. It doesn't work that way. Healthcare resources are limited. Increase demand and prices increases.