Makes me sick
XX>XY?: The Changing Female Advantage in Life Expectancy
Claudia Goldin & Adriana Lleras-Muney
NBER Working Paper, June 2018
Abstract:
Females live longer than males in most parts of the world today. Among OECD nations in recent years, the difference in life expectancy at birth is around four to six years (seven in Japan). But have women always lived so much longer than men? The answer is that they have not. We ask when and why the female advantage emerged. We show that reductions in maternal mortality and fertility are not the reasons. Rather, we argue that the sharp reduction in infectious disease in the early twentieth century played a role. The primary reason is that those who survive most infectious diseases carry a health burden that affects organs, such as the heart, as well as impacting general well-being. We use new data from Massachusetts containing information on causes of death from 1887 to show that infectious diseases disproportionately affected females between the ages of 5 and 25. Increased longevity of women, therefore, occurred as the burden of infectious disease fell for all. Our explanation does not tell us why women live longer than men, but it does help understand the timing of the increase.
Do environmental factors drive obesity? Evidence from international graduate students
Bhagyashree Katare & Timothy Beatty
Health Economics, forthcoming
Abstract:
International students offer a unique window into the role environmental factors play in driving obesity. Naïve estimates of the relationship between environmental factors and obesity are often plagued by reverse causation, sample selection, and omitted variable bias. In this study, we survey international students at 40 public universities across the United States. We use this unique data to link the weight gain of international students to the prevalence of obesity where they live. We argue that our estimates are less likely to be biased as international students have limited control over the environment to which they are exposed upon arrival in the United States. We find that students living in areas with a higher prevalence of obesity show a biologically important and statistically significantly greater increase in weight as compared to those living in areas with a lower prevalence of obesity. Results provide cautious evidence that environmental characteristics of a region can affect the weight gain of individuals.
Associations between Urban Sprawl and Life Expectancy in the United States
Shima Hamidi et al.
International Journal of Environmental Research and Public Health, May 2018
Abstract:
In recent years, the United States has had a relatively poor performance with respect to life expectancy compared to the other developed nations. Urban sprawl is one of the potential causes of the high rate of mortality in the United States. This study investigated cross-sectional associations between sprawl and life expectancy for metropolitan counties in the United States in 2010. In this study, the measure of life expectancy in 2010 came from a recently released dataset of life expectancies by county. This study modeled average life expectancy with a structural equation model that included five mediators: annual vehicle miles traveled (VMT) per household, average body mass index, crime rate, and air quality index as mediators of sprawl, as well as percentage of smokers as a mediator of socioeconomic status. After controlling for sociodemographic characteristics, this study found that life expectancy was significantly higher in compact counties than in sprawling counties. Compactness affects mortality directly, but the causal mechanism is unclear. For example, it may be that sprawling areas have higher traffic speeds and longer emergency response times, lower quality and less accessible health care facilities, or less availability of healthy foods. Compactness affects mortality indirectly through vehicle miles traveled, which is a contributor to traffic fatalities, and through body mass index, which is a contributor to many chronic diseases. This study identified significant direct and indirect associations between urban sprawl and life expectancy. These findings support further research and practice aimed at identifying and implementing changes to urban planning designed to support health and healthy behaviors.
Knowing less but presuming more: Dunning-Kruger effects and the endorsement of anti-vaccine policy attitudes
Matthew Motta, Timothy Callaghan & Steven Sylvester
Social Science & Medicine, August 2018, Pages 274-281
Method: In an original survey of U.S. adults (N = 1310), we modeled self-reported overconfidence as a function of responses to a knowledge test about the causes of autism, and the endorsement of misinformation about a link between vaccines and autism. We then modeled anti-vaccination policy support and attitudes toward the role that experts play in the policymaking process as a function of overconfidence and the autism awareness indicators while controlling for potential confounding factors.
Results: More than a third of respondents in our sample thought that they knew as much or more than doctors (36%) and scientists (34%) about the causes of autism. Our analysis indicates that this overconfidence is highest among those with low levels of knowledge about the causes of autism and those with high levels of misinformation endorsement. Further, our results suggest that this overconfidence is associated with opposition to mandatory vaccination policy. Overconfidence is also associated with increased support for the role that non-experts (e.g., celebrities) play in the policymaking process.
Market Failure in Kidney Exchange
Nikhil Agarwal et al.
NBER Working Paper, June 2018
Abstract:
We show that kidney exchange markets suffer from traditional market failures that can be fixed to increase transplants by 25%-55%. First, we document that the market is fragmented and inefficient: most transplants are arranged by hospitals instead of national platforms. Second, we propose a model to show two sources of inefficiency: hospitals do not internalize their patients’ benefits from exchange, and current mechanisms sub-optimally reward hospitals for submitting patients and donors. Third, we estimate a production function and show that individual hospitals operate below efficient scale. Eliminating this inefficiency requires a combined approach using new mechanisms and solving agency problems.
How a race to the bottom can make you fat
Gregmar Galinato & You Zhou
Applied Economics, forthcoming
Abstract:
This article measures the effect of fiscal competition on obesity rates in the United States through education and health spending. We hypothesize that fiscal competition to attract firms results in lower business tax revenues and higher public infrastructure spending which crowds out education and health spending leading to an increase in obesity rates. We empirically test this hypothesis. We find that there is significant fiscal competition to attract firms. Next, we show that when business tax revenues are lowered and public infrastructure spending favouring businesses increased, public health and education spending declines and obesity rates significantly increase. Thus, fiscal competition significantly contributes to obesity rates through the education and health spending channel.
Effects of Rosa’s Law on Intellectual-Disability Reporting
Marina Stavrakantonaki & Timothy Johnson
Public Opinion Quarterly, forthcoming
Abstract:
This study examines the effects of legislatively mandated changes in terminology for National Health Interview Survey (NHIS) questions on proxy and self-reports of an important condition. Specifically, we examine changes from the use of the term “mental retardation” to “intellectual disability” that were mandated by what is now known as “Rosa’s Law,” an act signed by President Obama in October 2010. Our analyses focus on changes in national prevalence of measures of intellectual disability during the period 2011–2016, compared to 1997–2010, for the population as a whole and for demographic subgroups. Findings show that the change in question wording implemented in the NHIS after Rosa’s Law produced a small, albeit statistically significant, increase in reporting of intellectual disabilities for adults and for children.
Factors Associated with Cell Phone Use While Driving: A Survey of Parents and Caregivers of Children Ages 4-10 Years
Catherine McDonald et al.
Journal of Pediatrics, forthcoming
Study design: National cross-sectional online survey with a convenience sample (March 2017-April 2017). Inclusion criteria: Parent/caregiver of a child age 4-10 years in their home, age ≥18 years, read and spoke English, and drove child ≥6 times in previous 3 months. Adjusted logistic regression analyses were modeled for outcome measures of previous 3-month self-report cell phone use while driving with the child.
Results: The analytic sample was n = 760. In the previous 3 months, 47% of parent/caregivers talked on a hand-held phone, 52.2% talked on a hands-free phone, 33.7% read texts, 26.7% sent texts, and 13.7% used social media while driving with their child in the vehicle. Compared with those who always used their typical child restraint system, participants who did not always use were more likely to talk on a hands-free phone (aOR 1.97, 95% CI 1.26-3.09), read a text (aOR 1.74, 95% CI 1.11-2.73), send a text (aOR 1.65, 95% CI 1.04-2.62), and use social media (aOR 2.92, 95% CI 1.73-4.94) while driving. Higher income, not wearing a seat belt (driver) on every trip, and driving under influence of alcohol also were associated with various types of cell phone use while driving.
Family health and income: A two-sample replication
Thomas Schofield et al.
Journal of Family Psychology, forthcoming
Abstract:
The current study examined psychological and family health predictors of change over time in household income, using data from longitudinal studies of African American (N = 889, 93.5% female) and Mexican origin (N = 674, 100% female) families. Participants self-reported their household income, as well as their emotional, personality, and cognitive resources. Participant behavioral and physical resources were coded from observed family interactions. Although income did not predict change in any personal resources, all five classes of personal resources (i.e., emotional, personality, cognitive, behavioral, physical) predicted change in income across a 10-year span (Study 1) and a 6-year span (Study 2). Income is potentially caused by these personal resources, or both income and these personal resources share a common cause. The dominant approach of assuming income causes personal and family health needs stronger support.
Effectiveness of public health spending on infant mortality in Florida, 2001–2014
Patrick Bernet, Gulcin Gumus & Sharmila Vishwasrao
Social Science & Medicine, August 2018, Pages 31-38
Abstract:
Studies investigating the effectiveness of public health spending typically face two major challenges. One is the lack of data on individual program spending, which restricts researchers to rely on aggregate expenditures. The other is the failure to address issues of endogeneity and serial correlation between health outcomes and spending. In this study, we demonstrate that the use of specific spending items as opposed to overall spending, combined with Generalized Method of Moments estimation technique can do a far better job in revealing the effectiveness of public health services on health outcomes. As an example, we consider the effects of infant-related public health programs on infant mortality rates. Focus on programs expressly related to maternal and infant health was made possible by a unique longitudinal dataset from the Florida Department of Health containing information for all 67 Florida counties spanning 2001 through 2014. Our empirical methodology, by addressing potential endogeneity issues along with serial correlation, allows us to estimate the causal impact of specific public health investments in maternal and infant-related programs on infant mortality. We find that a 10 percent increase in targeted public health spending per infant leads to a 2.07 percent decrease in infant mortality rates. We also find that targeted spending may be more effective in reducing infant mortality among blacks than among whites. The use of targeted spending data along with the Generalized Method of Moments technique can provide stronger evidence to guide future resource allocation and policy decisions in public health.
Self‐ownership, relational dignity, and organ sales
David Hershenov
Bioethics, forthcoming
Abstract:
Material property has traditionally been conceived of as separable from its owner and thus alienable in an exchange. So it seems that you could sell your watch or even your kidney because it can be removed from your wrist or abdomen and transferred to another. However, if we are each identical to a living human animal, self‐ownership is impossible for self‐separation is impossible. We thus cannot sell our parts if we don't own the whole that they compose. It would be incoherent to own all of your body's parts but not the whole body; and it would be arbitrary to own some but not all of your removable parts. These metaphysical obstacles to organ sales do not apply to the selling of the organs of the deceased. The human being goes out of existence at death and is not identical to the body's remains. Any objections to selling the organs of the deceased must instead be due to dignity rather than metaphysical or conceptual considerations. But the remains lack the intrinsic dignity of the human being, instead possessing, at best, relational dignity. Relational dignity would not provide sufficient reason to prohibit life‐saving sales.