Findings

Healthy Discussion

Kevin Lewis

February 16, 2020

Confirmatory bias in health decisions: Evidence from the MMR-autism controversy
Mengcen Qian, Shin-Yi Chou & Ernest Lai
Journal of Health Economics, forthcoming

Abstract:

Since Wakefield et al. (1998), the public was exposed to mixed information surrounding the claim that measles-mumps-rubella vaccine causes autism. A persistent trend to delay the vaccination during 1998–2011 in the US was driven by children of college-educated mothers, suggesting that these mothers held biases against the vaccine influenced by the early unfounded claim. Consistent with confirmatory bias, exposures to negative information about the vaccine strengthened their biases more than exposures to positive information attenuated them. Positive online information, however, had strong impacts on vaccination decisions, suggesting that online dissemination of vaccine-safety information may help tackle the sticky misinformation.


The Effects of Jargon on Processing Fluency, Self-Perceptions, and Scientific Engagement
Hillary Shulman et al.
Journal of Language and Social Psychology, forthcoming

Abstract:

In this experiment (N = 650), we integrate ideas from the literatures on metacognition and self-perception to explain why the use of jargon negatively affects engagement with science topics. We offer empirical evidence that the presence of jargon disrupts people’s ability to fluently process scientific information, even when definitions for the jargon terms are provided. We find that jargon use affects individuals’ social identification with the science community and, in turn, affects self-reports of scientific interest and perceived understanding. Taken together, this work advances our knowledge about the broad effects of metacognition and offers implications for how the language of science may influence nonexpert audiences’ engagement with complex topics in ways beyond comprehension.


Price and Prejudice: An Empirical Test of Financial Incentives, Altruism, and Racial Bias
Kristen Underhill
Journal of Legal Studies, June 2019, Pages 245-274

Abstract:

Many argue that paying people for good behavior can crowd out beneficial motivations like altruism. But little is known about how financial incentives interact with harmful motivations like racial bias. Two randomized vignette studies test how financial incentives affect bias. The first experiment varies the race of a hypothetical patient in need of a kidney transplant (black or white), an incentive ($18,500 or none), and addition of a message appealing to altruism. Incentives encouraged donation but introduced a significant bias favoring white patients. The second experiment assesses willingness to donate to a patient (black or white) without an incentive and then introduces incentives varying in size ($3,000, $18,800, or $50,000) and source (charity, government, or patient’s own funds). Incentives encouraged donation but were significantly more effective in encouraging donation to white patients. Biasing effects are most pronounced for medium-sized incentives. Incentives may have an inadvertent biasing effect for altruistic behavior.


Has the prevalence of overweight, obesity and central obesity levelled off in the United States? Trends, patterns, disparities, and future projections for the obesity epidemic
Youfa Wang et al.
International Journal of Epidemiology, forthcoming

Methods: We examined OB patterns and time trends across socio-economic and geographic parameters and projected the future situation. Large national databases were used. Overweight (OW), OB and severe obesity (SOB) were defined using body mass index cut-points/percentiles; central obesity (CO), waist circumference cut-point in adults and waist:height ratio cutoff in youth. Various meta-regression analysis models were fit for projection analyses.

Results: OB prevalence had consistently risen since 1999 and considerable differences existed across groups and regions. Among adults, men’s OB (33.7%) and OW (71.6%) levelled off in 2009–2012, resuming the increase to 38.0 and 74.7% in 2015–2016, respectively. Women showed an uninterrupted increase in OB/OW prevalence since 1999, reaching 41.5% (OB) and 68.9% (OW) in 2015–2016. SOB levelled off in 2013–2016 (men: 5.5–5.6%; women: 9.7–9.5%), after annual increases of 0.2% between 1999 and 2012. Non-Hispanic Blacks had the highest prevalence in women’s OB/SOB and men’s SOB. OB prevalence in boys rose continuously to 20.6% and SOB to 7.5% in 2015–2016, but not in girls. By 2030, most Americans will be OB/OW and nearly 50% of adults OB, whereas ∼33% of children aged 6–11 and ∼50% of adolescents aged 12–19 will be OB/OW. Since 1999, CO has risen steadily, and by 2030 is projected to reach 55.6% in men, 80.0% in women, 47.6% among girls and 38.9% among boys. Regional differences exist in adult OB prevalence (2011–2016) and across ethnicities; South (32.0%) and Midwest (31.4%) had the highest rates.


The Impact of the Philadelphia Beverage Tax on Prices and Product Availability
John Cawley et al.
Journal of Policy Analysis and Management, forthcoming

Abstract:

In recent years, numerous cities in the U.S. have enacted taxes on beverages to promote health and raise revenue. This paper examines the impact of Philadelphia's beverage tax, enacted in 2017, on the prices and availability of both taxed and untaxed beverages. Using original data we collected in late 2016 and again one year later, we estimate difference‐in‐differences regressions of the change over time in beverage prices and availability in stores in Philadelphia relative to stores in nearby counties. We find that, on average, distributors and retailers fully passed through the tax to consumers. Pass‐through is higher for individual servings than for larger sizes. There is also heterogeneity in the pass‐through rate among stores; it is greater among stores that are in higher‐poverty neighborhoods, located farther from untaxed stores outside Philadelphia, and that are independent as opposed to part of national chains. We also find that the tax reduced the availability of taxed beverages and increased the availability of untaxed beverages, particularly bottled water, in Philadelphia stores.


 

Association Between High School Personality Phenotype and Dementia 54 Years Later in Results From a National US Sample
Benjamin Chapman et al.
JAMA Psychiatry, February 2020, Pages 148-154

Design, Setting, and Participants: Cohort study in the United States. Participants were members of Project Talent, a national sample of high school students in 1960. Individuals were identified who received a dementia-associated International Classification of Diseases, Ninth Revision (ICD-9) diagnosis code during any year between 2011 and 2013. The dates of our analysis were March 2018 to May 2019.

Exposures: Ten personality traits were measured by the 150-item Project Talent Personality Inventory. Socioeconomic status was measured by a composite based on parental educational level, income, occupation, and property ownership. Participants were also surveyed on demographic factors and height and weight.

Main Outcomes and Measures: Medicare records were collected, with dementia diagnoses in the period of 2011 to 2013 classified according to the US Centers for Medicare & Medicaid Services ICD-9–based algorithm. Cox proportional hazards regression models estimated the relative risk of dementia based on the 10 personality traits, testing interactions with SES and adjusting for demographic confounders.

Results: The sample of 82 232 participants was 50.1% female, with a mean (SD) age of 15.8 (1.7) years at baseline and 69.5 (1.2) years at follow-up. Lower risk of dementia was associated with higher levels of vigor (hazard ratio for 1 SD, 0.93; 95% CI, 0.90-0.97; P < .001). Calm and maturity showed protective associations with later dementia that increased with SES. At 1 SD of SES, calm showed a hazard ratio of 0.89 (95% CI, 0.84-0.95; P < .001 for the interaction) and maturity showed a hazard ratio of 0.90 (95% CI, 0.85-0.96; P = .001 for the interaction).


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