Live long and prosper
Robin Stevens & Robert Hornik
Journal of Health Communication, forthcoming
Abstract:
This study examined the effect of newspaper coverage of HIV/AIDS on HIV testing behavior in a U.S. population. HIV testing data were taken from the Center for Disease Control and Prevention's National Behavioral Risk Factor Surveillance System from 1993 to 2007 (N = 265,557). The authors content-analyzed news stories from 24 daily newspapers and 1 wire service during the same time period. The authors used distributed lagged regression models to estimate how well HIV/AIDS newspaper coverage predicted later HIV testing behavior. Increases in HIV/AIDS newspaper coverage were associated with declines in population-level HIV testing. Each additional 100 HIV/AIDS-related newspaper stories published each month was associated with a 1.7% decline in HIV testing levels in the subsequent month. This effect differed by race, with African Americans exhibiting greater declines in HIV testing subsequent to increased news coverage than did Whites. These results suggest that mainstream newspaper coverage of HIV/AIDS may have a particularly deleterious effect on African Americans, one of the groups most affected by the disease. The mechanisms driving the negative effect deserve further investigation to improve reporting on HIV/AIDS in the media.
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Early Childhood Investments Substantially Boost Adult Health
Frances Campbell et al.
Science, 28 March 2014, Pages 1478-1485
Abstract:
High-quality early childhood programs have been shown to have substantial benefits in reducing crime, raising earnings, and promoting education. Much less is known about their benefits for adult health. We report on the long-term health effects of one of the oldest and most heavily cited early childhood interventions with long-term follow-up evaluated by the method of randomization: the Carolina Abecedarian Project (ABC). Using recently collected biomedical data, we find that disadvantaged children randomly assigned to treatment have significantly lower prevalence of risk factors for cardiovascular and metabolic diseases in their mid-30s. The evidence is especially strong for males. The mean systolic blood pressure among the control males is 143 millimeters of mercury (mm Hg), whereas it is only 126 mm Hg among the treated. One in four males in the control group is affected by metabolic syndrome, whereas none in the treatment group are affected. To reach these conclusions, we address several statistical challenges. We use exact permutation tests to account for small sample sizes and conduct a parallel bootstrap confidence interval analysis to confirm the permutation analysis. We adjust inference to account for the multiple hypotheses tested and for nonrandom attrition. Our evidence shows the potential of early life interventions for preventing disease and promoting health.
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Genetic Mechanisms in the Intergenerational Transmission of Health
Owen Thompson
Journal of Health Economics, May 2014, Pages 132–146
Abstract:
This paper uses a sample of adoptees to study the genetic mechanisms underlying intergenerational associations in chronic health conditions. I begin by estimating baseline intergenerational models with a sample of approximately 125,000 parent-child pairs, and find that children with a parent who has a specific chronic health condition are at least 100% more likely to have the same condition themselves. To assess the role of genetic mechanisms in generating these strong correlations, I estimate models using a sample of approximately 2,400 adoptees, and find that genetic transmission accounts for only 20%-30% of the baseline associations. As falsification tests, I repeat this exercise using health measures with externally established levels of genetic determination (height and chicken pox), and the results suggest that comparisons of biological and adopted children are a valid method of isolating genetic effects in this sample. Finally, to corroborate these adoptee-based estimates, I examine health correlations among monozygotic twins, which provide an upper bound estimate of genetic influences, and find a similarly modest role for genetic transmission. I conclude that intergenerational health transmission is an important hindrance to overall socioeconomic mobility, but that the majority of transmission occurs through environmental factors or gene-environment interactions, leaving scope for interventions to effectively mitigate health persistence.
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HIV Testing & Risky Sexual Behaviour
Erick Gong
Economic Journal, forthcoming
Abstract:
Using a study that randomly assigns HIV testing in two sites in sub-Saharan Africa, I examine the effects of testing on sexual behaviour. Using sexually transmitted infections as markers of risky sex, I find behavioural responses to HIV tests when tests provide unexpected information. Individuals surprised by an HIV-positive (HIV-negative) test increase (decrease) their risky sexual behaviour. I simulate the effects of testing and find under certain conditions, new HIV infections increase when people are tested. The provision of antiretrovirals (ARVs) for HIV-positive individuals immediately after testing mitigates these effects and leads to decreases in HIV infections in all cases.
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Mauricio Avendano & Ichiro Kawachi
Annual Review of Public Health, 2014, Pages 307-325
Abstract:
Americans lead shorter and less healthy lives than do people in other high-income countries. We review the evidence and explanations for these variations in longevity and health. Our overview suggests that the US health disadvantage applies to multiple mortality and morbidity outcomes. The American health disadvantage begins at birth and extends across the life course, and it is particularly marked for American women and for regions in the US South and Midwest. Proposed explanations include differences in health care, individual behaviors, socioeconomic inequalities, and the built physical environment. Although these factors may contribute to poorer health in America, a focus on proximal causes fails to adequately account for the ubiquity of the US health disadvantage across the life course. We discuss the role of specific public policies and conclude that while multiple causes are implicated, crucial differences in social policy might underlie an important part of the US health disadvantage.
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Born at the Right Time? Childhood Health and the Business Cycle
Viola Angelini & Jochen Mierau
Social Science & Medicine, May 2014, Pages 35–43
Abstract:
We analyze the relationship between the state of the business cycle at birth and childhood health. We use a retrospective survey on self-reported childhood health for ten Western European countries and combine it with historically and internationally comparable data on the Gross Domestic Product. We validate the self-reported data by comparing them to realized illness spells. We find a positive relationship between being born in a recession and childhood health. This relationship is not driven by selection effects due to heightened infant mortality during recessions. Placebo regressions indicate that the observed effect is not spurious.
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“I Think About Oprah”: Social Class Differences in Sources of Health Information
Ann Bell
Qualitative Health Research, April 2014, Pages 506-516
Abstract:
Health information influences an individual’s health outcomes. Indeed, researchers have found that communication inequalities contribute to health inequalities. We do not have a clear understanding of why and how the communication disparities exist, however, particularly the social forces behind such differences. The qualitative nature of this article reveals the nuances of health information seeking using the case of infertility. Through 58 in-depth interviews, I demonstrate how differences in social and cultural capital between women of low and high socioeconomic status (SES) result in different ways of learning about health. Women of high SES have access to support groups, physicians, and the Internet, whereas women of low SES do not discuss their health problems with their peers, and lack access to and distrust physicians. I explore how these differences in health information shape the illness experience. I conclude with policy implications.
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Ryan Edwards & Carl Mason
Preventive Medicine, forthcoming
Objective: To assess the net impact on U.S. longevity of the decision to commute by bicycle rather than automobile.
Methods: We construct fatality rates per distance traveled using official statistics and denominators from the 2009 National Household Travel Survey. We model the life-table impact of switching from auto to bicycle commuting. Key factors are increased risks from road accidents and reduced risks from enhanced cardiovascular health.
Results: Bicycling fatality rates in the U.S. are an order of magnitude higher than in Western Europe. Risks punish both young and old, while the health benefits guard against causes of mortality that rise rapidly with age. Although the protective effects of bicycling appear significant, it may be optimal to wait until later ages to initiate regular bicycle commuting in the current U.S. risk environment, especially if individuals discount future life years.
Conclusions: The lifetime health benefits of bicycle commuting appear to outweigh the risks in the U.S., but individuals who sufficiently discount or disbelieve the health benefits may delay or avoid bicycling. Bicycling in middle age avoids much fatality risk while capturing health benefits. Significant cross-state variation in bicycling mortality suggest that improvements in the built environment might spur changes in transit mode.
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Nancy Krieger et al.
International Journal of Epidemiology, forthcoming
Background: Debates exist over whether health inequities are bound to rise as population health improves, due to health improving more quickly among the better off, with most analyses focused on mortality data.
Methods: We analysed 50 years of socioeconomic inequities in measured health status among US-born Black and White Americans, using data from the National Health Examination Surveys (NHES) I-III (1959–70), National Health and Nutrition Examination Surveys (NHANES) I-III (1971–94) and NHANES 1999–2008.
Results: Absolute US socioeconomic health inequities for income percentile and education variously decreased (serum cholesterol; childhood height), stagnated [systolic blood pressure (SBP)], widened [body mass index (BMI), waist circumference (WC)] and in some cases reversed (age at menarche), even as on-average values rose (BMI, WC), idled (childhood height) and fell (SBP, serum cholesterol, age at menarche), with patterns often varying by race/ethnicity and socioeconomic measure; similar results occurred for relative inequities. For example, for WC, the adverse 20th (low) vs 80th (high) income percentile gap increased only among Whites (NHES I: 0.71 cm [95% confidence interval (CI) −0.74, 2.16); NHANES 2005–08: 2.10 (95% CI 0.96, 3.62)]. By contrast, age at menarche for girls in the 20th vs 80th income percentile among Black girls remained consistently lower, by 0.34 years (95% CI 0.12, 0.55) whereas among White girls the initial null difference became inverse [NHANES 2005–08: −0.49 years (95% CI −0.86, −0.12; overall P = 0.0015)]. Adjusting for socioeconomic position only modestly altered Black/White health inequities.
Conclusions: Health inequities need not rise as population health improves.
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Mortgage debt as a moderator in the association between unemployment and health
C. Lau & L.A. Leung
Public Health, March 2014, Pages 239–245
Objective: While homeownership is generally viewed as good for society, the consequences of the concomitant mortgage debt have not been well examined. This study investigates the role of mortgage debt as a moderator in the relationship between unemployment and health.
Study design: A cross-sectional analysis of a representative sample of US homeowners aged 38–46 surveyed in 1998–2006.
Methods: Subjects were 3667 adults living in owned homes aged 38–46 who reported being either employed or unemployed. Logistic models were performed using maximum likelihood estimation to estimate the relative risk of self-reporting fair or poor health with regard to employment status and how employment status interacted with mortgage status.
Results: Among homeowners, being unemployed for more than 13 weeks with a mortgage is associated with a higher likelihood of reporting fair or poor health (odds ratio 2.38, 95% confidence interval 1.28–4.45). Being unemployed for more than 13 weeks with a mortgage loan that is more than 80% of the value of the home is associated with a greater likelihood of reporting fair or poor health (odds ratio 8.99, 95% confidence interval 2.50–32.29).
Conclusion: Among homeowners, mortgage debt increases the association between unemployment and poor health. In an economy where periods of high unemployment are likely to coincide with periods of falling home prices, homeowners may find themselves unemployed just when their homes lose value, intensifying financial stress.
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Adverse socioeconomic position during the life course is associated with multiple sclerosis
Farren Briggs et al.
Journal of Epidemiology & Community Health, forthcoming
Background: Adverse socioeconomic position (SEP) in childhood and adulthood is associated with a proinflammatory phenotype, and therefore an important exposure to consider for multiple sclerosis (MS), a complex neuroinflammatory autoimmune disease. The objective was to determine whether SEP over the life course confers increased susceptibility to MS.
Methods: 1643 white, non-Hispanic MS case and control members recruited from the Kaiser Permanente Medical Care Plan, Northern California Region, for which comprehensive genetic, clinical and environmental exposure data have been collected were studied. Logistic regression models investigated measures of childhood and adulthood SEP, and accounted for effects due to established MS risk factors, including HLA-DRB1*15:01 allele carrier status, smoking history, history of infectious mononucleosis, family history of MS and body size.
Results: Multiple measures of childhood and adulthood SEP were significantly associated with risk of MS, including parents renting versus owning a home at age 10: OR=1.48, 95% CI 1.09 to 2.02, p=0.013; less than a college education versus at least a college education based on parental household: OR=1.28, 95% CI 1.01 to 1.63, p=0.041; low versus high life course SEP: OR=1.50, 95% CI 1.09 to 2.05, p=0.012; and low versus high social mobility: OR=1.74, 95% CI 1.27 to 2.39, p=5.7×10−4.
Conclusions: Results derived from a population-representative case–control study provide support for the role of adverse SEP in MS susceptibility and add to the growing evidence linking lower SEP to poorer health outcomes. Both genetic and environmental contributions to chronic conditions are important and must be characterised to fully understand MS aetiology.
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Education Attenuates the Negative Impact of Traumatic Brain Injury on Cognitive Status
James Sumowski et al.
Archives of Physical Medicine and Rehabilitation, December 2013, Pages 2562-2564
Objective: To investigate whether the cognitive reserve hypothesis helps to explain differential cognitive impairment among survivors of traumatic brain injury (TBI), whereby survivors with greater intellectual enrichment (estimated with education) are less vulnerable to cognitive impairment.
Participants: Survivors of moderate or severe TBI (n=44) and healthy controls (n=36).
Main Outcome Measures: Intellectual enrichment was estimated with educational attainment. Group was defined as TBI or healthy control. Current cognitive status (processing speed, working memory, episodic memory) was evaluated with neuropsychological tasks.
Results: TBI survivors exhibited worse cognitive status than healthy persons (P<.001), and education was positively correlated with cognitive status in TBI survivors (r=.54, P<.001). Most importantly, regression analysis revealed an interaction between group and education (R2 change=.036, P=.004), whereas higher education attenuated the negative impact of TBI on cognitive status. TBI survivors with lower education performed much worse than matched healthy persons, but this TBI-related performance discrepancy was attenuated at higher levels of education.
Conclusions: Higher intellectual enrichment (estimated with education) reduces the negative effect of TBI on cognitive outcomes, thereby supporting the cognitive reserve hypothesis in persons with TBI. Future work is necessary to investigate whether intellectual enrichment can build cognitive reserve as a rehabilitative intervention in survivors of TBI.
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Stephanie Ann Kovalchik
Journal of Quantitative Analysis in Sports, forthcoming
Abstract:
In 2012, 3 out of 10 singles players in the top 100 on the Association of Tennis Professionals (ATP) World Tour were 30 years old or older – nearly a four-fold increase over 20 years ago, suggesting that the “old at 30” view in men’s tennis may be an old reality. In this paper, I investigate aging patterns among top ATP singles players between 1991 and 2012 and consider how surface effects, career length, and age at peak performance have influenced aging trends. Following a decade and a half of little change, the average age of top singles players has increased at a pace of 0.34 years per season since the mid-2000s, reaching an all-time high of 27.9 years in 2012. Underlying this age shift was a coincident rise in the proportion of 30-and-overs (29% in 2012) and the virtual elimination of teenagers from the top 100 (0% in 2012). Because the typical age players begin competing professionally has varied little from 18 years in the past two decades, career length has increased in step with player age. Demographics among top players on each of today’s major surfaces indicate that parallel aging trends have occurred on clay, grass, and hard court from the late 2000s forward. As a result of the changing age demographic over the past decade, the age of tennis’s highest-ranked singles players is now comparable to the age of elite long-distance runners. This evolution likely reflects changes in tennis play that have made endurance and fitness increasingly essential for winning success.
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Morgan Levine et al.
Cell Metabolism, 4 March 2014, Pages 407-417
Abstract:
Mice and humans with growth hormone receptor/IGF-1 deficiencies display major reductions in age-related diseases. Because protein restriction reduces GHR-IGF-1 activity, we examined links between protein intake and mortality. Respondents aged 50–65 reporting high protein intake had a 75% increase in overall mortality and a 4-fold increase in cancer death risk during the following 18 years. These associations were either abolished or attenuated if the proteins were plant derived. Conversely, high protein intake was associated with reduced cancer and overall mortality in respondents over 65, but a 5-fold increase in diabetes mortality across all ages. Mouse studies confirmed the effect of high protein intake and GHR-IGF-1 signaling on the incidence and progression of breast and melanoma tumors, but also the detrimental effects of a low protein diet in the very old. These results suggest that low protein intake during middle age followed by moderate to high protein consumption in old adults may optimize healthspan and longevity.
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Walking the Dog: The Effect of Pet Ownership on Human Health and Health Behaviors
Rebecca Utz
Social Indicators Research, April 2014, Pages 327-339
Abstract:
This analysis explores whether pet owners have better physical health outcomes, and if so, whether the positive physical health benefits are explained by better health behaviors that result from having to take care of the pet’s physical needs. Data come from the National Health and Nutrition Examination Survey, a representative sample of the non-institutionalized United States population. Analyses were limited to persons living alone (n = 2,474) in order to isolate primary pet caretakers from those merely living in a pet household. Results showed that pet owners, particularly dog and cat owners, had more positive physical health outcomes when compared to non pet owners or those owning other types of pets. Surprisingly, the effect of pet ownership was not mediated by health behaviors such as recreational walking. However, the health benefits of pet ownership were largely reduced once sociodemographic variables such as age, socioeconomic status, and residential location were controlled. The positive health effects of pet ownership appear to be primarily the result of selection, not increased physical activity associated with the active caretaking of pets.
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Sharon Stein Merkin et al.
American Journal of Public Health, April 2014, Pages e48-e55
Objectives: We examined the association of childhood and adult socioeconomic status with longitudinal change in allostatic load (AL), a measure of biological dysfunction.
Methods: The study sample included 6135 participants from the Multi-Ethnic Study of Atherosclerosis, aged 45 to 84 years, recruited in 2000 from 6 US counties; 3 follow-up examinations took place through September 2011. We calculated standardized scores for several metabolic and cardiovascular components relative to accepted clinical cut points for “higher risk” and then summed them to create an overall index of AL. We used mixed effects growth curve models to assess the relationship between socioeconomic status and AL as a linear function of time passed since the baseline examination; we included random effects for the intercept and slope.
Results: Among those with lower baseline AL (< median), high adult education was associated with a significantly slower increase in AL over time, whereas there was no significant association among those with higher baseline AL.
Conclusions: The relationship between socioeconomic status and patterns of change in health parameters may vary over time and with the accumulation of biological risk.
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Mark Thompson et al.
Health Psychology, March 2014, Pages 282-291
Objective: We ask whether subjective social status (SSS) predicts rates of wintertime febrile acute respiratory illness (ARI).
Methods: 1,373 women and 346 men were enrolled from September 1 through November 30, 2010 as part of a prospective cohort study of health care personnel (HCP) at two medical centers. A questionnaire was completed at enrollment followed by 20 weeks of surveillance. ARI was an illness with fever and cough self-reported via weekly telephone or Internet-based surveillance.
Results: For both sexes, lower SSS was associated with younger age, less education, lower neighborhood household income, being unmarried, lower occupational status, working in outpatient settings, and poorer self-rated health status. Demographic and occupational covariates explained 23% and 42% of the variance (R²) in SSS among women and men, respectively. Smoking, exercise frequency, and sleep quality were also associated with SSS, but these factors explained little additional variance (3–4%). Among women HCP, lower SSS at enrollment was associated with higher rates of subsequent ARI (unadjusted β = −.21 [±.05], p < .001 for ordinal data). Adjusting for all covariates reduced the effect size of the SSS minimally (adjusted β = −.19 [±.06], p < .001). Among men HCP, there was no univariate SSS–ARI association and after adjusting for all covariates the effect was opposite of our hypothesis (adjusted β = .33 [±.17], p < .05).
Conclusions: Women (but not men) with lower SSS were more likely to report an ARI during surveillance, and the SSS–ARI association was independent of demographics, occupational status, health, and health behaviors.
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Are Well-Child Visits a Risk Factor for Subsequent Influenza-Like Illness Visits?
Jacob Simmering et al.
Infection Control and Hospital Epidemiology, March 2014, Pages 251-256
Objective: To determine whether well-child visits are a risk factor for subsequent influenza-like illness (ILI) visits within a child’s family.
Methods: Using data from the Medical Expenditure Panel Survey from the years 1996–2008, we identified 84,595 families. For each family, we determined those weeks in which a well-child visit or an ILI visit occurred. We identified 23,776 well-child-visit weeks and 97,250 ILI-visit weeks. We fitted a logistic regression model, where the binary dependent variable indicated an ILI clinic visit in a particular week. Independent variables included binary indicators to denote a well-child visit in the concurrent week or one of the previous 2 weeks, the occurrence of the ILI visit during the influenza season, and the presence of children in the family in each of the age groups 0–3, 4–7, and 8–17 years. Socioeconomic variables were also included. We also estimated the overall cost of well-child-exam-related ILI using data from 2008.
Results: We found that an ILI office visit by a family member was positively associated with a well-child visit in the same or one of the previous 2 weeks (odds ratio, 1.54). This additional risk translates to potentially 778,974 excess cases of ILI per year in the United States, with a cost of $500 million annually.
Conclusions: Our results should encourage ambulatory clinics to strictly enforce infection control recommendations. In addition, clinics could consider time-shifting of well-child visits so as not to coincide with the peak of the influenza season.
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Dorothy Dunlop et al.
Journal of Physical Activity & Health, forthcoming
Background: The harmful relationship of sedentary behavior to health may reflect an exchange of sedentary activity for moderate-vigorous activity or sedentary behavior may be a separate risk factor. We examined whether time spent in sedentary behavior is related to disability in activities of daily living (ADL), independent of time spent in moderate-vigorous activity in older adults.
Methods: The nationally representative 2003-2005 National Health and Nutrition Examinations Surveys (NHANES) included 2286 adults aged 60 years and older with accelerometer-assessed physical activity. The association between ADL task disability and the daily percentage of sedentary time was evaluated by multiple logistic regression.
Results: This sample spent almost 9 hours/day being sedentary during waking hours and 3.6% reported ADL disability. The odds of ADL disability were 46% greater (odds ratio 1.46, 95% confidence interval: 1.07, 1.98) for each daily hour spent in sedentary behavior, adjusted for moderate-vigorous activity, socioeconomic, and health factors.
Conclusion: These U.S. national data show a strong relationship between greater time spent in sedentary behavior and the presence of ADL disability, independent of time spent in moderate or vigorous activity. These findings support programs encouraging older adults to decrease sedentary behavior regardless of their engagement in moderate or vigorous activity.
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Paul Leigh, Juan Du & Stephen McCurdy
Annals of Epidemiology, April 2014, Pages 254-259
Background: Debate surrounds the accuracy of U.S. government’s estimates of job-related injuries and illnesses in agriculture. Whereas studies have attempted to estimate the undercount for all industries combined, none have specifically addressed agriculture.
Methods: Data were drawn from the U.S. government’s premier sources for workplace injuries and illnesses and employment: the Bureau of Labor Statistics databanks for the Survey of Occupational Injuries and Illnesses (SOII), the Quarterly Census of Employment and Wages, and the Current Population Survey. Estimates were constructed using transparent assumptions; for example, that the rate (cases-per-employee) of injuries and illnesses on small farms was the same as on large farms (an assumption we altered in sensitivity analysis).
Results: We estimated 74,932 injuries and illnesses for crop farms and 68,504 for animal farms, totaling 143,436 cases in 2011. We estimated that SOII missed 73.7% of crop farm cases and 81.9% of animal farm cases for an average of 77.6% for all agriculture. Sensitivity analyses suggested that the percent missed ranged from 61.5% to 88.3% for all agriculture.
Conclusions: We estimate considerable undercounting of nonfatal injuries and illnesses in agriculture and believe the undercounting is larger than any other industry. Reasons include: SOII’s explicit exclusion of employees on small farms and of farmers and family members and Quarterly Census of Employment and Wages’s undercounts of employment. Undercounting limits our ability to identify and address occupational health problems in agriculture, affecting both workers and society.
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How have Europeans grown so tall?
Timothy Hatton
Oxford Economic Papers, April 2014, Pages 349-372
Abstract:
Increases in human stature are a key indicator of improvements in the average health of populations. In this article I present and analyse a new data set for the average height of adult male birth cohorts, from the mid-nineteenth century to 1980, in 15 European countries. In little more than a century average height increased by 11 cm — representing a dramatic improvement in health. Interestingly, there was some acceleration in the period spanning the two world wars and the Great Depression. The evidence suggests that the most important proximate source of increasing height was the improving disease environment as reflected by the fall in infant mortality. Rising income and education and falling family size had more modest effects. Improvements in health care are hard to identify, and the effects of welfare state spending seem to have been small.
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M. Bélanger et al.
Public Health, March 2014, Pages 222–230
Objectives: Despite strong evidence indicating that unbalanced diets relate to chronic diseases and mortality, most adults do not comply with dietary recommendations. To help determine which recommendations could yield the most benefits, the number of deaths attributable to cardiovascular diseases and cancer that could be delayed or averted in Canada if adults changed their diet to adhere to recommendations were estimated.
Methods: A macrosimulation model was used to draw age- and sex-specific changes in relative risks based on the results of meta-analyses of relationship between food components and risk of cardiovascular disease and diet-related cancers. Inputs in the model included Canadian recommendations (fruit and vegetable, fibre, salt, and total-, monounsaturated-, polyunsaturated-, saturated-, and trans-fats), average dietary intake (from 35 107 participants with 24-h recall), and mortality from specific causes (from Canadian Vital Statistics). Monte Carlo analyses were used to compute 95% credible intervals (CI).
Results: The estimates of this study suggest that 30 540 deaths (95% CI: 24 953, 34 989) per year could be averted or delayed if Canadians adhered to their dietary recommendations. By itself, the recommendation for fruit and vegetable intake could save as many as 72% (55–87%) of these deaths. It is followed by recommendations for fibres (29%, 13–43%) and salt (10%, 9–12%).
Conclusions: A considerable number of lives could be saved if Canadians adhered to the national dietary intake recommendations. Given the scarce resources available to promote guideline adhesion, priority should be given to recommendations for fruit and vegetable intake.
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Marc Fleurbaey, Marie-Louise Leroux & Gregory Ponthiere
Journal of Mathematical Economics, March 2014, Pages 28–41
Abstract:
An early death is, undoubtedly, a serious disadvantage. However, the compensation of short-lived individuals has remained so far largely unexplored, probably because it appears infeasible. Indeed, short-lived agents can hardly be identified ex ante, and cannot be compensated ex post. We argue that, despite those difficulties, a compensation can be carried out by encouraging early consumption in the life cycle. In a model with heterogeneous preferences and longevities, we show how a specific social criterion can be derived from intuitive principles, and we study the corresponding optimal policy under various informational assumptions.