Morbid curiosity
The long run health returns to college quality
Jason Fletcher & David Frisvold
Review of Economics of the Household, June 2014, Pages 295-325
Abstract:
The link between education and health is one of the most robust empirical relationships in the social sciences. However, little research has examined the effects of educational quality on health outcomes. We estimate the long run relationship between health behaviors and graduating from a selective college in the 1960s using the Wisconsin Longitudinal Study, which has tracked siblings for over 50 years. Importantly, we control for measures of health endowments, ability, and time preferences before college enrollment as well as shared family and environmental factors. We find large effects of college selectivity on reducing overweight for individuals in their 60s.
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Access to Treatment and Educational Inequalities in Cancer Survival
Jon Fiva et al.
Journal of Health Economics, July 2014, Pages 98–111
Abstract:
The public health care systems in the Nordic countries provide high quality care almost free of charge to all citizens. However, social inequalities in health persist. Previous research has, for example, documented substantial educational inequalities in cancer survival. We investigate to what extent this may be driven by differential access to and utilization of high quality treatment options. Quasi-experimental evidence based on the establishment of regional cancer wards indicates that i) highly educated individuals utilized centralized specialized treatment to a greater extent than less educated patients and ii) the use of such treatment improved these patients’ survival.
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The impact of early-life economic conditions on cause-specific mortality during adulthood
Gary Yeung et al.
Journal of Population Economics, July 2014, Pages 895-919
Abstract:
The aim of this study is to assess the effects of economic conditions in early life on cause-specific mortality during adulthood. The analyses are performed on a unique historical sample of 14,520 Dutch individuals born in 1880–1918, who are followed throughout life. The economic conditions in early life are characterized using cyclical variations in annual real per capital gross domestic product during pregnancy and the first year of life. Exposure to recessions in early life appears to significantly increase cancer mortality risks of older males and females. It also significantly increases other mortality risks especially for older females. The residual life expectancies are up to about 8 and 6 % lower for male and female cancer mortality, respectively, and up to about 5 % lower for female cardiovascular mortality. Our analyses show that cardiovascular and cancer mortality risks are related and that not taking this association into account leads to biased inference.
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Unemployment and Mortality: Evidence from the PSID
Timothy Halliday
Social Science & Medicine, July 2014, Pages 15–22
Abstract:
We use micro-data to investigate the relationship between unemployment and mortality in the United States using Logistic regression on a sample of over 16,000 individuals. We consider baselines from 1984 to 1993 and investigate mortality up to ten years from the baseline. We show that poor local labor market conditions are associated with higher mortality risk for working-aged men and, specifically, that a one percentage point increase in the unemployment rate increases their probability of dying within one year of baseline by 6%. There is little to no such relationship for people with weaker labor force attachments such as women or the elderly. Our results contribute to a growing body of work that suggests that poor economic conditions pose health risks and illustrate an important contrast with studies based on aggregate data.
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Equity in the Receipt of Oseltamivir in the United States During the H1N1 Pandemic
Jessica Franklin et al.
American Journal of Public Health, June 2014, Pages 1052-1058
Objectives: We assessed the relationship between individual characteristics and receipt of oseltamivir (Tamiflu) in the United States during the H1N1 pandemic and other flu seasons.
Methods: In a cohort of individuals enrolled in pharmacy benefit plans, we used a multivariate logistic regression model to measure associations between subscriber characteristics and filling a prescription for oseltamivir during 3 flu seasons (October 2006–May 2007, October 2007–May 2008, and October 2008–May 2010). In 19 states with county-level influenza rates reported, we controlled for disease burden.
Results: Approximately 56 million subscribers throughout the United States were included in 1 or more study periods. During pandemic flu, beneficiaries in the highest income category had 97% greater odds of receiving oseltamivir than those in the lowest category (P < .001). After we controlled for disease burden, subscribers in the 2 highest income categories had 2.18 and 1.72 times the odds of receiving oseltamivir compared with those in the lowest category (P < .001 for both).
Conclusions: Income was a stronger predictor of oseltamivir receipt than prevalence of influenza. These findings corroborate concerns about equity of treatment in pandemics, and they call for improved approaches to distributing potentially life-saving treatments.
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Education as “the Great Equalizer”: Health Benefits for Black and White Adults
Christopher Holmes & Anna Zajacova
Social Science Quarterly, forthcoming
Objective: Many social policies and academic studies assume that education is “the great equalizer” that is capable of counteracting the unequal social resources of different demographic groups. This study aims to determine whether non-Hispanic whites and racial/ethnic minorities indeed experience comparable health benefits with greater educational attainment.
Methods: Data from the National Health Interview Survey 1997–2012 were used to conduct ordered logistic models comparing the self-rated health of 518,288 non-Hispanic whites and racial/ethnic minorities aged 30–65 across the full spectrum of educational attainment.
Results: Educational attainment was found to affect the health of whites more than minorities, even with the inclusion of a wide range of potential sociodemographic, behavioral, and economic mediators.
Conclusion: We discuss the possibility that unmeasured variables, such as childhood environment and other individual characteristics, are responsible for the stronger effect of education for whites than minorities, and what the implications are for future policy and research.
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Sleep Behavior and Unemployment Conditions
Marina Antillón, Diane Lauderdale & John Mullahy
Economics & Human Biology, July 2014, Pages 22–32
Abstract:
Recent research has reported that habitually short sleep duration is a risk factor for declining health, including increased risk of obesity, diabetes and coronary heart disease. In this study we investigate whether macroeconomic conditions are associated with variation in mean sleep time in the United States, and if so, whether the effect is procyclical or countercyclical. We merge state unemployment rates from 2003 through 2012 with the American Time Use Survey, a nationally representative sample of adults with 24 hour time diaries. We find that higher aggregate unemployment is associated with longer mean sleep duration, with each additional point of state unemployment associated with an additional average 0.83 minutes of sleep (p < 0.001), after adjusting for a secular trend of increasing sleep over the time period. Despite a national poll in 2009 that found one-third of Americans reporting losing sleep over the economy, we do not find that higher state unemployment is associated with more sleeplessness. Instead, we find that higher state unemployment is associated with less frequent time use described as “sleeplessness” (marginal effect = 0.05 at 4% unemployment and 0.034 at 14% unemployment, p < 0.001), after controlling for a secular trend.
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Cause of Death and Development in the US
Casper Worm Hansen
Journal of Development Economics, July 2014, Pages 143–153
Abstract:
Exploiting cross-state variation in infectious causes of death, along with time variation arising from medical innovations toward the middle of the twentieth century, this study examines the consequences of a positive health shock in the US. It establishes that states with higher levels of mortality from infectious causes prior to the onset of the era of big medicine experienced greater increases in life expectancy, population, and total GDP after its onset, whereas per capita GDP remained largely unchanged. Together the evidence suggests that the rise in life expectancy had no significant effect on living standards in the US during the time period 1940–1980. These results are robust to controlling for initial health and initial economic conditions.
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Mariana Arcaya et al.
Circulation, forthcoming
Background: No studies have examined the effects of local foreclosure activity on neighbors' blood pressure, despite the fact that spillover effects of nearby foreclosures include many known risk factors for increased blood pressure. We assessed the extent to which living near foreclosed properties is associated with subsequent systolic blood pressure (SBP).
Methods and Results: We used geocoded 6,590 observations collected from 1,740 participants in the Framingham Offspring Cohort across five waves (1987-2008) of the Framingham Heart Study to create a longitudinal record of exposure to nearby foreclosure activity. We distinguished between Real Estate Owned foreclosures (REOs), which typically sit vacant, and foreclosures purchased by third party buyers, which are generally put into productive use. Counts of lender-owned foreclosed properties within 100 meters of participants' homes were used to predict measured SBP and odds of being hypertensive. We assessed whether self-reported alcoholic drinks per week and measured BMI helped explain the foreclosure activity-SBP relationship. Each additional REO located within 100 meters of a participant's home was associated with an increase in SBP of 1.71 mm/hg (p=.03; 95%CI = 0.18 - 3.24) after adjusting for individual- and area-level confounders, but not with odds of hypertension. The presence of foreclosures purchased by third party buyers was not associated with SBP nor with hypertension. BMI and alcohol consumption attenuated the effect of living near REOs on SBP in fully adjusted models.
Conclusions: Real Estate Owned foreclosed properties may put nearby neighbors at risk for increased SBP, with higher alcohol consumption and body mass index partially mediating this relationship.
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Thomas Mayrhofer & Hendrik Schmitz
Journal of Population Economics, July 2014, Pages 841-856
Abstract:
In this paper, we show a simple correction for the aggregation effect when testing the relationship between income inequality and life expectancy using aggregated data. While there is evidence for a negative correlation between income inequality and a population’s average life expectancy, it is not clear whether this is due to an aggregation effect based on a non-linear relationship between income and life expectancy or to income inequality being a health hazard in itself. The proposed correction method is general and independent of measures of income inequality, functional form assumptions of the health production function, and assumptions on the income distribution. We apply it to data from the Human Development Report and find that the relationship between income inequality and life expectancy can be explained entirely by the aggregation effect. Hence, there is no evidence that income inequality itself is a health hazard.
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Shawn Bauldry
Social Science & Medicine, June 2014, Pages 94–100
Abstract:
A college degree is associated with a range of health-related benefits, but the effects of higher education are known to vary across different population subgroups. Competing theories have been proposed for whether people from more or less advantaged backgrounds or circumstances will gain greater health-related benefits from a college degree. This study draws on data from the National Longitudinal Study of Adolescent Health (Add Health) and recently developed models for analyzing heterogeneous treatment effects to examine how the effect of obtaining a college degree on the self-rated health of young adults varies across the likelihood of obtaining a college degree, a summary measure of advantage/disadvantage. Results indicate that a college degree has a greater effect on self-rated health for people from advantaged backgrounds. This finding differs from two recent studies, and possible reasons for the contrasting findings are discussed.
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Gopal Singh & Mohammad Siahpush
Journal of Urban Health, April 2014, Pages 272-292
Abstract:
This study examined trends in rural–urban disparities in all-cause and cause-specific mortality in the USA between 1969 and 2009. A rural–urban continuum measure was linked to county-level mortality data. Age-adjusted death rates were calculated by sex, race, cause-of-death, area-poverty, and urbanization level for 13 time periods between 1969 and 2009. Cause-of-death decomposition and log-linear and Poisson regression were used to analyze rural–urban differentials. Mortality rates increased with increasing levels of rurality overall and for non-Hispanic whites, blacks, and American Indians/Alaska Natives. Despite the declining mortality trends, mortality risks for both males and females and for blacks and whites have been increasingly higher in non-metropolitan than metropolitan areas, particularly since 1990. In 2005–2009, mortality rates varied from 391.9 per 100,000 population for Asians/Pacific Islanders in rural areas to 1,063.2 for blacks in small-urban towns. Poverty gradients were steeper in rural areas, which maintained higher mortality than urban areas after adjustment for poverty level. Poor blacks in non-metropolitan areas experienced two to three times higher all-cause and premature mortality risks than affluent blacks and whites in metropolitan areas. Disparities widened over time; excess mortality from all causes combined and from several major causes of death in non-metropolitan areas was greater in 2005–2009 than in 1990–1992. Causes of death contributing most to the increasing rural–urban disparity and higher rural mortality include heart disease, unintentional injuries, COPD, lung cancer, stroke, suicide, diabetes, nephritis, pneumonia/influenza, cirrhosis, and Alzheimer’s disease. Residents in metropolitan areas experienced larger mortality reductions during the past four decades than non-metropolitan residents, contributing to the widening gap.
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Are Investments in Disease Prevention Complements? The Case of Statins and Health Behaviors
Robert Kaestner, Michael Darden & Darius Lakdawalla
Journal of Health Economics, July 2014, Pages 151–163
Abstract:
We obtain estimates of associations between statin use and health behaviors. Statin use is associated with a small increase in BMI and moderate (20% to 33%) increases in the probability of being obese. Statin use was also associated with a significant (e.g., 15% of mean) increase in moderate alcohol use among men. There was no consistent evidence of a decrease in smoking associated with statin use, and exercise worsened somewhat for females. Statin use was associated with increased physical activity among males. Finally, there was evidence that statin use increased the use of blood pressure medication and aspirin for both males and females, although estimates varied considerably in magnitude. These results are consistent with the hypothesis that healthy diet is a strong substitute for statins, but there is only uneven evidence for the hypothesis that investments in disease prevention are complementary.
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The Impact of Michigan's Text Messaging Restriction on Motor Vehicle Crashes
Johnathon Ehsani et al.
Journal of Adolescent Health, May 2014, Pages S68–S74
Purpose: The purpose of this study was to determine the effects of Michigan's universal text messaging restriction (effective July 2010) across different age groups of drivers and crash severities.
Methods: Changes in monthly crash rates and crash trends per 10,000 licensed drivers aged 16, 17, 18, 19, 20–24, and 25–50 years were estimated using time series analysis for three levels of crash severity: (1) fatal/disabling injury; (2) nondisabling injury; and (3) possible injury/property damage only (PDO) crashes for the period 2005–2012. Analyses were adjusted for crash rates of drivers' aged 65–99 years, Michigan's unemployment rate, and gasoline prices.
Results: After the introduction of the texting restriction, significant increases were observed in crash rates and monthly trends in fatal/disabling injury crashes and nondisabling injury crashes, and significant decreases in possible injury/PDO crashes. The magnitude of the effects where significant changes were observed was small.
Conclusions: The introduction of the texting restriction was not associated with a reduction in crash rates or trends in severe crash types. On the contrary, small increases in the most severe crash types (fatal/disabling and nondisabling injury) and small decreases in the least severe crash types (possible injury/PDO) were observed. These findings extend the literature on the effects of cell phone restrictions by examining the effects of the restriction on newly licensed adolescent drivers and adult drivers separately by crash severity.
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Pregnancy and the risk of a traffic crash
Donald Redelmeier et al.
Canadian Medical Association Journal, forthcoming
Background: Pregnancy causes diverse physiologic and lifestyle changes that may contribute to increased driving and driving error. We compared the risk of a serious motor vehicle crash during the second trimester to the baseline risk before pregnancy.
Methods: We conducted a population-based self-matched longitudinal cohort analysis of women who gave birth in Ontario between April 1, 2006, and March 31, 2011. We excluded women less than age 18 years, those living outside Ontario, those who lacked a valid healthcard identifier under universal insurance, and those under the care of a midwife. The primary outcome was a motor vehicle crash resulting in a visit to an emergency department.
Results: A total of 507 262 women gave birth during the study period. These women accounted for 6922 motor vehicle crashes as drivers during the 3-year baseline interval (177 per mo) and 757 motor vehicle crashes as drivers during the second trimester (252 per mo), equivalent to a 42% relative increase (95% confidence interval 32%–53%; p < 0.001). The increased risk extended to diverse populations, varied obstetrical cases and different crash characteristics. The increased risk was largest in the early second trimester and compensated for by the third trimester. No similar increase was observed in crashes as passengers or pedestrians, cases of intentional injury or inadvertent falls, or selfreported risky behaviours.
Interpretation: Pregnancy is associated with a substantial risk of a serious motor vehicle crash during the second trimester. This risk merits attention for prenatal care.
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Rashmi Singh et al.
Journal of the American Medical Association, 14 May 2014, Pages 1883-1888
Objective: To assess the relationships of concussion history and years of football experience with hippocampal volume and cognitive performance in collegiate football athletes.
Design, Setting, and Participants: Cross-sectional study conducted between June 2011 and August 2013 at a US psychiatric research institute specializing in neuroimaging among collegiate football players with a history of clinician-diagnosed concussion (n = 25), collegiate football players without a history of concussion (n = 25), and non–football-playing, age-, sex-, and education-matched healthy controls (n = 25).
Results: Players with and without a history of concussion had smaller hippocampal volumes relative to healthy control participants (with concussion: t48 = 7.58; P < .001; mean difference, 1788 μL; 95% CI, 1317-2258 μL; without concussion: t48 = 4.35; P < .001, mean difference, 1027 μL; 95% CI, 556-1498 μL). Players with a history of concussion had smaller hippocampal volumes than players without concussion (t48 = 3.15; P < .001; mean difference, 761 μL; 95% CI, 280-1242 μL). In both athlete groups, there was a statistically significant inverse relationship between left hippocampal volume and number of years of football played (t46 = −3.62; P < .001; coefficient = −43.54; 95% CI, −67.66 to −19.41). Behavioral testing demonstrated no differences between athletes with and without a concussion history on 5 cognitive measures but did show an inverse correlation between years of playing football and reaction time (ρ42 = −0.43; 95% CI, −0.46 to −0.40; P = .005).
Conclusions and Relevance: Among a group of collegiate football athletes, there was a significant inverse relationship of concussion and years of football played with hippocampal volume. Years of football experience also correlated with slower reaction time. Further research is needed to determine the temporal relationships of these findings.
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Reduced Fatalism and Increased Prevention Behavior After Two High-Profile Lung Cancer Events
David Portnoy et al.
Journal of Health Communication, May 2014, Pages 577-592
Abstract:
The positive impact of media coverage of high-profile cancer events on cancer prevention behaviors is well-established. However, less work has focused on potential adverse psychological reactions to such events, such as fatalism. Conducting 3 studies, the authors explored how the lung cancer death of Peter Jennings and diagnosis of Dana Reeve in 2005 related to fatalism. Analysis of a national media sample in Study 1 found that media coverage of these events often focused on reiterating the typical profile of those diagnosed with lung cancer; 38% of the media mentioned at least 1 known risk factor for lung cancer, most often smoking. Data from a nationally representative survey in Study 2 found that respondents reported lower lung cancer fatalism, after, compared with before, the events (OR = 0.16, 95% CI [0.03, 0.93]). A sustained increase in call volume to the national tobacco Quitline after these events was found in Study 3. These results suggest that there is a temporal association between high-profile cancer events, the subsequent media coverage, psychological outcomes, and cancer prevention behaviors. These results suggest that high-profile cancer events could be leveraged as an opportunity for large-scale public heath communication campaigns through the dissemination of cancer prevention messages and services.
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Using Friends as Sensors to Detect Global-Scale Contagious Outbreaks
Manuel Garcia-Herranz et al.
PLoS ONE, April 2014
Abstract:
Recent research has focused on the monitoring of global–scale online data for improved detection of epidemics, mood patterns, movements in the stock market political revolutions, box-office revenues, consumer behaviour and many other important phenomena. However, privacy considerations and the sheer scale of data available online are quickly making global monitoring infeasible, and existing methods do not take full advantage of local network structure to identify key nodes for monitoring. Here, we develop a model of the contagious spread of information in a global-scale, publicly-articulated social network and show that a simple method can yield not just early detection, but advance warning of contagious outbreaks. In this method, we randomly choose a small fraction of nodes in the network and then we randomly choose a friend of each node to include in a group for local monitoring. Using six months of data from most of the full Twittersphere, we show that this friend group is more central in the network and it helps us to detect viral outbreaks of the use of novel hashtags about 7 days earlier than we could with an equal-sized randomly chosen group. Moreover, the method actually works better than expected due to network structure alone because highly central actors are both more active and exhibit increased diversity in the information they transmit to others. These results suggest that local monitoring is not just more efficient, but also more effective, and it may be applied to monitor contagious processes in global–scale networks.
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Income and Income Inequality as Social Determinants of Health: Do Social Comparisons Play a Role?
Patrick Präg, Melinda Mills & Rafael Wittek
European Sociological Review, April 2014, Pages 218-229
Abstract:
Two of the most prominent phenomena in the study of social determinants of health, the socio-economic gradient in health and the income inequality–health association, have both been suggested to be explainable by the mechanism of status comparisons. This, however, has rarely ever been tested in a direct fashion. In this article, we explicate and test this mechanism by assessing the role of social comparison orientation. Research has shown that individuals vary in their propensity to engage in social comparisons, and those with a higher propensity are also more likely to be affected by the outcomes of such comparisons. In our analysis, we check whether the tendency to compare one’s income to that of others can contribute to explaining socio-economic disparities in health. Using individual-level data (N = 18,356) from 23 European countries on self-rated overall health and psychological well-being, we show that a high-income comparison orientation neither moderates the negative effect of income inequality on health nor the health differences by relative income. Our findings cast doubt on the crucial role that researchers such as Wilkinson and Pickett (2010) have attributed to the mechanism of status differentiation as the link between social stratification and health outcomes.
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When Does Education Matter? The Protective Effect of Education for Cohorts Graduating in Bad Times
David Cutler, Wei Huang & Adriana Lleras-Muney
NBER Working Paper, May 2014
Abstract:
Using Eurobarometer data, we document large variation across European countries in education gradients in income, self-reported health, life satisfaction, obesity, smoking and drinking. While this variation has been documented previously, the reasons why the effect of education on income, health and health behaviors varies is not well understood. We build on previous literature documenting that cohorts graduating in bad times have lower wages and poorer health for many years after graduation, compared to those graduating in good times. We investigate whether more educated individuals suffer smaller income and health losses as a result of poor labor market conditions upon labor market entry. We confirm that a higher unemployment rate at graduation is associated with lower income, lower life satisfaction, greater obesity, more smoking and drinking later in life. Further, education plays a protective role for these outcomes, especially when unemployment rates are high: the losses associated with poor labor market outcomes are substantially lower for more educated individuals. Variation in unemployment rates upon graduation can potentially explain a large fraction of the variance in gradients across different countries.
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Resveratrol Levels and All-Cause Mortality in Older Community-Dwelling Adults
Richard Semba et al.
JAMA Internal Medicine, forthcoming
Importance: Resveratrol, a polyphenol found in grapes, red wine, chocolate, and certain berries and roots, is considered to have antioxidant, anti-inflammatory, and anticancer effects in humans and is related to longevity in some lower organisms.
Objective: To determine whether resveratrol levels achieved with diet are associated with inflammation, cancer, cardiovascular disease, and mortality in humans.
Design: Prospective cohort study, the Invecchiare in Chianti (InCHIANTI) Study (“Aging in the Chianti Region”), 1998 to 2009 conducted in 2 villages in the Chianti area in a population-based sample of 783 community-dwelling men and women 65 years or older.
Results: Mean (95% CI) log total urinary resveratrol metabolite concentrations were 7.08 (6.69-7.48) nmol/g of creatinine. During 9 years of follow-up, 268 (34.3%) of the participants died. From the lowest to the highest quartile of baseline total urinary resveratrol metabolites, the proportion of participants who died from all causes was 34.4%, 31.6%, 33.5%, and 37.4%, respectively (P = .67). Participants in the lowest quartile had a hazards ratio for mortality of 0.80 (95% CI, 0.54-1.17) compared with those in the highest quartile of total urinary resveratrol in a multivariable Cox proportional hazards model that adjusted for potential confounders. Resveratrol levels were not significantly associated with serum CRP, IL-6, IL-1β, TNF, prevalent or incident cardiovascular disease, or cancer.
Conclusions and Relevance: In older community-dwelling adults, total urinary resveratrol metabolite concentration was not associated with inflammatory markers, cardiovascular disease, or cancer or predictive of all-cause mortality. Resveratrol levels achieved with a Western diet did not have a substantial influence on health status and mortality risk of the population in this study.
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Targeted Health Department Expenditures Benefit Birth Outcomes at the County Level
Betty Bekemeier et al.
American Journal of Preventive Medicine, June 2014, Pages 569–577
Purpose: This study used unique, detailed LHD [local health department] expenditure data gathered from state health departments to examine the influence of maternal and child health (MCH) service investments by LHDs on health outcomes.
Methods: A multivariate panel time-series design was used in 2013 to estimate ecologic relationships between 2000−2010 LHD expenditures on MCH and county-level rates of low birth weight and infant mortality. The unit of analysis was 102 LHD jurisdictions in Washington and Florida.
Results: Results indicate that LHD expenditures on MCH services have a beneficial relationship with county-level low birth weight rates, particularly in counties with high concentrations of poverty. This relationship is stronger for more targeted expenditure categories, with expenditures in each of the three specific examined MCH service areas demonstrating the strongest effects.
Conclusions: Findings indicate that specific LHD investments in MCH have an important effect on related health outcomes for populations in poverty and likely help reduce the costly burden of poor birth outcomes for families and communities. These findings underscore the importance of monitoring the impact of these evolving investments and ensuring that targeted, beneficial investments are not lost but expanded upon across care delivery systems.
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Public Estimates of Cancer Frequency: Cancer Incidence Perceptions Mirror Distorted Media Depictions
Jakob Jensen et al.
Journal of Health Communication, May 2014, Pages 609-624
Abstract:
Compared with incidence rates, certain cancers are over- or underrepresented in news coverage. Past content analytic research has consistently documented these news distortions, but no study has examined whether they are related to public perception of cancer incidence. Adults (N = 400) completed a survey with questions about perceived cancer incidence, news consumption, and attention to health news. Cancer incidence perceptions paralleled previously documented news distortions. Overrepresented cancers were overestimated (e.g., blood, head/brain) and underrepresented cancers were underestimated (e.g., male reproductive, lymphatic, thyroid, and bladder). Self-reported news consumption was related to perceptual distortions such that heavier consumers were more likely to demonstrate distorted perceptions of four cancers (bladder, blood, breast, and kidney). Distortions in risk perception and news coverage also mirrored discrepancies in federal funding for cancer research. Health care professionals, journalists, and the public should be educated about these distortions to reduce or mitigate potential negative effects on health behavior and decision making.
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Bríain Ó Hartaigh et al.
Journal of Epidemiology & Community Health, forthcoming
Background: Resting heart rate (RHR) is an independent risk factor for mortality. Nevertheless, it is unclear whether elevations in childhood and mid-adulthood RHR, including changes over time, are associated with mortality later in life. We sought to evaluate the association between RHR across the life course, along with its changes and all-cause mortality.
Methods: We studied 4638 men and women from the Medical Research Council (MRC) National Survey of Health and Development (NSHD) cohort born during 1 week in 1946. RHR was obtained during childhood at ages 6, 7 and 11, and in mid-adulthood at ages 36 and 43. Using multivariable Cox regression, we calculated the HR for incident mortality according to RHR measured at each time point, along with changes in mid-adulthood RHR.
Results: At age 11, those in the top fifth of the RHR distribution (≥97 bpm) had an increased adjusted hazard of 1.42 (95% CI 1.04 to 1.93) for all-cause mortality. A higher adjusted risk (HR, 95% CI 2.17, 1.40 to 3.36) of death was also observed for those in the highest fifth (≥81 bpm) at age 43. For a >25 bpm increased change in the RHR over the course of 7 years (age 36–43), the adjusted hazard was elevated more than threefold (HR, 95% CI 3.26, 1.54 to 6.90). After adjustment, RHR at ages 6, 7 and 36 were not associated with all-cause mortality.
Conclusions: Elevated RHR during childhood and midlife, along with greater changes in mid-adulthood RHR, are associated with an increased risk of all-cause mortality.
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Sub-therapeutic Antibiotics and the Efficiency of U.S. Hog Farms
Nigel Key & William McBride
American Journal of Agricultural Economics, April 2014, Pages 831-850
Abstract:
A substantial share of U.S. hog producers incorporate antimicrobial drugs into their livestock's feed or water at sub-therapeutic levels to promote feed efficiency and weight gain. Recently, in response to concerns that the overuse of antibiotics in livestock could promote the development of antimicrobial drug-resistant bacteria, the U.S. Food and Drug Administration adopted a strategy to phase out the use of antibiotics for production purposes. This study uses a stochastic frontier model and data from the 2009 USDA Agricultural Resource Management Survey of feeder-to-finish hog producers to estimate the potential effects on hog output and output variability resulting from a ban on antibiotics used for growth promotion. We use propensity score nearest neighbor matching to create a balanced sample of sub-therapeutic antibiotic (STA) users and nonusers. We estimate the frontier model for the pooled sample and separately for users and non-users — which allows for a flexible interaction between STA use and the production technology. Point estimates for the matched sample indicate that STA use has a small positive effect on productivity and production risk, increasing output by 1.0–1.3% and reducing the standard deviation of unexplained output by 1.4%. The results indicate that improvements in productivity resulted exclusively from technological improvement rather than from an increase in technical efficiency.