Plagued
Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century
Anne Case & Angus Deaton
Proceedings of the National Academy of Sciences, forthcoming
Abstract:
This paper documents a marked increase in the all-cause mortality of middle-aged white non-Hispanic men and women in the United States between 1999 and 2013. This change reversed decades of progress in mortality and was unique to the United States; no other rich country saw a similar turnaround. The midlife mortality reversal was confined to white non-Hispanics; black non-Hispanics and Hispanics at midlife, and those aged 65 and above in every racial and ethnic group, continued to see mortality rates fall. This increase for whites was largely accounted for by increasing death rates from drug and alcohol poisonings, suicide, and chronic liver diseases and cirrhosis. Although all education groups saw increases in mortality from suicide and poisonings, and an overall increase in external cause mortality, those with less education saw the most marked increases. Rising midlife mortality rates of white non-Hispanics were paralleled by increases in midlife morbidity. Self-reported declines in health, mental health, and ability to conduct activities of daily living, and increases in chronic pain and inability to work, as well as clinically measured deteriorations in liver function, all point to growing distress in this population. We comment on potential economic causes and consequences of this deterioration.
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Clemens Noelke & Mauricio Avendano
American Journal of Epidemiology, 15 November 2015, Pages 873-882
Abstract:
Job loss in the years before retirement has been found to increase risk of cardiovascular disease (CVD), but some studies suggest that CVD mortality among older workers declines during recessions. We hypothesized that recessionary labor market conditions were associated with reduced CVD risk among persons who did not experience job loss and increased CVD risk among persons who lost their jobs. In our analyses, we used longitudinal, nationally representative data from Americans 50 years of age or older who were enrolled in the Health and Retirement Study and surveyed every 2 years from 1992 to 2010 about their employment status and whether they had experienced a stroke or myocardial infarction. To measure local labor market conditions, Health and Retirement Study data were linked to county unemployment rates. Among workers who experienced job loss, recessionary labor market conditions at the time of job loss were associated with a significantly higher CVD risk (hazard ratio = 2.54, 95% confidence interval: 1.39, 4.65). In contrast, among workers who did not experience job loss, recessionary labor market conditions were associated with a lower CVD risk (hazard ratio = 0.50, 95% confidence interval: 0.31, 0.78). These results suggest that recessions might be protective in the absence of job loss but hazardous in the presence of job loss.
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Health Effects of Economic Crises
Christopher Ruhm
NBER Working Paper, October 2015
Abstract:
This analysis summarizes prior research and uses national, state and county level data from the United States from 1976-2013 to examine whether the mortality effects of economic crises differ in kind from those of the more typical fluctuations. The tentative conclusion is that economic crises affect mortality rates (and presumably other measures of health) in the same way as less severe downturns: namely, they lead to improvements in physical health. The effects of severe national recessions in the United States, appear to have a beneficial effect on mortality that is roughly twice as strong as that predicted due to the elevated unemployment rates alone while the higher predicted rate of suicides during typical periods of economic weakness is approximately offset during severe recessions. No consistent pattern is obtained for more localized economic crises occurring at the state level – some estimates suggest larger protective mortality effects while others indicate offsetting deleterious consequences.
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Heather Moody, Joe Darden & Bruce Wm. Pigozzi
Sociology of Race and Ethnicity, forthcoming
Abstract:
Childhood lead poisoning in the United States remains a persistent, prevalent environmental public health problem, especially for children living in central-city neighborhoods. These neighborhoods typically are racially segregated, are in proximity to current and/or legacy lead emission sources, consist of older housing, and contain disproportionately African American or black children of low-income families. This research had two aims: (1) to determine whether average blood lead levels (BLLs) in children in the Detroit metropolitan area are related to the socioeconomic characteristics of the neighborhoods where they live and (2) to determine the estimated effect residential differences in the socioeconomic characteristics of neighborhoods have on average BLLs in non-Hispanic black and non-Hispanic white children. Data on pediatric BLLs were obtained from the Michigan Department of Community Health, and racial and socioeconomic data were obtained from the U.S. Census Bureau’s American Community Survey (2006–2010). The modified Darden-Kamel Composite Socioeconomic Index, multiple regression, and difference-of-means tests were used to determine the effect residential socioeconomic characteristics of neighborhoods have on average BLLs. Black segregated neighborhoods with lower socioeconomic characteristics were predictors of higher average BLLs in the children who lived there. When black and white children resided in neighborhoods of similar socioeconomic characteristics, the black-white gap in BLLs lessened. Significantly, after stratifying black and white children by age, living in the same neighborhoods of the lowest socioeconomic characteristics negated the black-white racial gap in BLLs entirely, but increasing levels of socioeconomic characteristics exacerbated the divide.
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Ironing Out Deficiencies: Evidence from the United States on the Economic Effects of Iron Deficiency
Gregory Niemesh
Journal of Human Resources, Fall 2015, Pages 910-958
Abstract:
Iron deficiency reduces productive capacity in adults and impairs cognitive development in children. In 1943, the United States government required the fortification of bread with iron to reduce iron deficiency in the working-age population during World War II. This nationwide fortification of grain products increased per capita consumption of iron by 16 percent. I find that areas with lower levels of iron consumption prior to the mandate experienced greater increases in income and school enrollment in the 1940s. A long-term followup suggests that adults in 1970 with more exposure to fortification during childhood earned higher wages.
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Forecasting the Economic Burden of Autism in 2015 and 2025 in the United States
Paul Leigh & Juan Du
Journal of Autism and Developmental Disorders, forthcoming
Abstract:
Few US estimates of the economic burden of autism spectrum disorders (ASD) are available and none provide estimates for 2015 and 2025. We forecast annual direct medical, direct non-medical, and productivity costs combined will be $268 billion (range $162–$367 billion; 0.884–2.009 % of GDP) for 2015 and $461 billion (range $276–$1011 billion; 0.982–3.600 % of GDP) for 2025. These 2015 figures are on a par with recent estimates for diabetes and attention deficit and hyperactivity disorder (ADHD) and exceed the costs of stroke and hypertension. If the prevalence of ASD continues to grow as it has in recent years, ASD costs will likely far exceed those of diabetes and ADHD by 2025.
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An empirical analysis of the demand for sleep: Evidence from the American Time Use Survey
Tinna Laufey Ásgeirsdóttir & Sigurður Páll Ólafsson
Economics & Human Biology, December 2015, Pages 265–274
Abstract:
Using data from the American Time Use Survey, this paper empirically examined the demand for sleep, with special attention to its opportunity cost represented by wages. Variation in the unemployment rate by state was also used to investigate the cyclical nature of sleep duration. We conducted separate estimations for males and females, as well as for those who received a fixed salary and hourly wages. The findings predominantly revealed no relationship between sleep duration and the business cycle. However, an inverse relationship between sleep duration and wages was detected. This is in accordance with sleep duration being an economic choice variable, rather than a predetermined subtraction of the 24-h day. Although the inverse relationship was not significant in all the estimations for salaried subjects, it was consistent and strong for subjects who received hourly wages. For instance, elasticity measures were −.03 for those who received hourly wages and −.003 for those who received a fixed salary.
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Disparities in Bulimia Nervosa: Who is left behind?
John Ham, Daniela Iorio & Michelle Sovinsky
Economics Letters, November 2015, Pages 147–150
Abstract:
Bulimia nervosa is a serious eating disorder affecting a large number of female teenagers. We find substantial income and racial disparities in the treatment of Bulimia. Specifically, Blacks and girls from low income families are more likely to exhibit bulimic behavior than Whites and girls from high income families, but Whites and girls from high income families are much more likely to be diagnosed with an eating disorder.
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Richard Pulsford et al.
International Journal of Epidemiology, forthcoming
Background: Sitting behaviours have been linked with increased risk of all-cause mortality independent of moderate to vigorous physical activity (MVPA). Previous studies have tended to examine single indicators of sitting or all sitting behaviours combined. This study aims to enhance the evidence base by examining the type-specific prospective associations of four different sitting behaviours as well as total sitting with the risk of all-cause mortality.
Methods: Participants (3720 men and 1412 women) from the Whitehall II cohort study who were free from cardiovascular disease provided information on weekly sitting time (at work, during leisure time, while watching TV, during leisure time excluding TV, and at work and during leisure time combined) and covariates in 1997–99. Cox proportional hazards models were used to investigate prospective associations between sitting time (h/week) and mortality risk. Follow-up was from date of measurement until (the earliest of) death, date of censor or July 31 2014.
Results: Over 81 373 person-years of follow-up (mean follow-up time 15.7 ± 2.2 years) a total of 450 deaths were recorded. No associations were observed between any of the five sitting indicators and mortality risk, either in unadjusted models or models adjusted for covariates including MVPA.
Conclusions: Sitting time was not associated with all-cause mortality risk. The results of this study suggest that policy makers and clinicians should be cautious about placing emphasis on sitting behaviour as a risk factor for mortality that is distinct from the effect of physical activity.