Findings

Sickly

Kevin Lewis

September 29, 2015

How Disgust Influences Health Purity Attitudes

Scott Clifford & Dane Wendell
Political Behavior, forthcoming

Abstract:
Food and health regulations are increasingly being pushed onto the political agenda, with rising concerns about genetically modified foods, obesity rates, and vaccination. Public beliefs and attitudes on these issues often conflict with the scientific evidence, yet we know relatively little about what influences opinion on these issues. The public lacks clear partisan cues, and many food and health attitudes cut across the ideological spectrum. We argue that these issues represent new 'purity' attitudes that are driven by the emotion of disgust. Across three studies, both by measuring individuals' trait disgust sensitivity and experimentally inducing an emotional state of disgust, we demonstrate the impact of disgust on food and health policy attitudes. Our results show that greater sensitivity to disgust is associated with support for organic foods, opposition to genetically modified foods, and anti-vaccination beliefs. However, we find only limited evidence that experimentally manipulated disgust affects attitudes toward genetically modified and organic foods. Overall, our results demonstrate that disgust plays an important role in attitudes regarding public health and broadens our understanding of purity attitudes.

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A Legislative History of the Shotgun Quarantine

Polly Price
Emory University Working Paper, August 2015

Abstract:
The recent Ebola threat from western Africa raised unanswered questions about the scope of the U.S. federal government's quarantine authority. For decades, a widespread assumption has existed that states have absolute control over quarantines imposed within their boundaries. This article suggests that the presumption of limited federal authority is overly restrictive and not constitutionally mandated. The history of the "shotgun quarantines" imposed during the yellow fever epidemics of the late 19th and early 20th centuries offers an alternative constitutional interpretation. This fascinating but previously untold account reveals that leading politicians of the day believed the federal government had a broad constitutional authority. The human suffering and disruption to commerce caused by the local shotgun quarantine led the South to implore Congress for legislation to remedy it - the only significant instance in which the post-Civil War South united in favor of ceding state's rights to the federal government. The controversy faded as effective measures against yellow fever were found, only to emerge again when Ebola confronted public health policy makers a century later. Because Congress never acted, we have largely forgotten the history of these legal debates over interstate quarantine authority. In recovering that history, this Article offers a new perspective on how to manage public health crises in our federal system. The need for regulatory standards that could preempt an unnecessary, parochial local quarantine requires Congress to act.

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Trends in Socioeconomic Inequalities in Motor Vehicle Accident Deaths in the United States, 1995-2010

Sam Harper, Thomas Charters & Erin Strumpf
American Journal of Epidemiology, 1 October 2015, Pages 606-614

Abstract:
Motor vehicle accident (MVA) mortality has been declining overall, but little is known about trends by socioeconomic position. We examined trends in education-related inequalities in US MVA death rates from 1995 to 2010. We used mortality data from the National Center for Health Statistics and population estimates from the Current Population Survey, and we calculated vehicle- and person-miles traveled using data from the National Household Travel Survey. We used negative binomial regression to estimate crude and age-, sex-, and race-adjusted mortality rates among adults aged 25 years or more. We found larger mortality decreases among the more highly educated and some evidence of mortality increases among the least educated. Adjusted death rates were 15.3 per 100,000 population (95% confidence interval (CI): 10.7, 19.9) higher at the bottom of the education distribution than at the top of the education distribution in 1995, increasing to 17.9 per 100,000 population (95% CI: 14.8, 21.0) by 2010. In relative terms, adjusted death rates were 2.4 (95% CI: 1.7, 3.0) times higher at the bottom of the education distribution than at the top in 1995, increasing to 4.3 times higher (95% CI: 3.4, 5.3) by 2010. Inequality increases were larger in terms of vehicle-miles traveled. Although overall MVA death rates declined during this period, socioeconomic differences in MVA mortality have persisted or worsened over time.

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Psychological and Cognitive Determinants of Mortality: Evidence from a Nationally Representative Sample Followed over Thirty-five Years

Amelia Karraker, Robert Schoeni & Jennifer Cornman
Social Science & Medicine, November 2015, Pages 69-78

Abstract:
Growing evidence suggests that psychological factors, such as conscientiousness and anger, as well as cognitive ability are related to mortality. Less is known about 1) the relative importance of each of these factors in predicting mortality, 2) through what social, economic, and behavioral mechanisms these factors influence mortality, and 3) how these processes unfold over long periods of time in nationally-representative samples. We use 35 years (1972-2007) of data from men (ages 20-40) in the Panel Study of Income Dynamics (PSID), a nationally representative sample in the United States, and discrete time event history analysis (n=27,373 person-years) to examine the importance of measures of follow-through (a dimension of conscientiousness), anger, and cognitive ability in predicting mortality. We also assess the extent to which income, marriage, and smoking explain the relationship between psychological and cognitive factors with mortality. We find that while follow-through, anger, and cognitive ability are all associated with subsequent mortality when modeled separately, when they are modeled together and baseline demographic characteristics are controlled, only anger remains associated with mortality: being in the top quartile for anger is associated with a 1.57 fold increase in the risk of dying at follow-up compared with those in the bottom quartile. This relationship is robust to the inclusion of income, marriage, and smoking as mediators.

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The Indirect Impact of Antiretroviral Therapy: Mortality Risk, Mental Health, and HIV-Negative Labor Supply

Victoria Baranov, Daniel Bennett & Hans-Peter Kohler
Journal of Health Economics, forthcoming

Abstract:
To reduce the burden of the HIV/AIDS epidemic, international donors recently began providing free antiretroviral therapy (ART) in parts of Sub-Saharan Africa. ART dramatically prolongs life and reduces infectiousness for people with HIV. This paper shows that ART availability increases work time for HIV-negative people without caretaker obligations, who do not directly benefit from the medicine. A difference-in-difference design compares people living near and far from ART, before and after treatment becomes available. Next we explore the possible reasons for this pattern. Although we cannot pinpoint the mechanism, we find that ART availability substantially reduces subjective mortality risk and improves mental health. These results show an undocumented economic consequence of the HIV/AIDS epidemic and an important externality of medical innovation. They also provide the first evidence of a link between the disease environment and mental health.

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Flu and Finances: Influenza Outbreaks and Loan Defaults in US Cities, 2004-2012

Jason Houle, Michael Collins & Maximilian Schmeiser
American Journal of Public Health, September 2015, Pages e75-e80

Objectives: We examined the association between influenza outbreaks in 83 metropolitan areas and credit card and mortgage defaults, as measured in quarterly zip code-level credit data over the period of 2004 to 2012.

Methods: We used ordinary least squares, fixed effects, and 2-stage least squares instrumental variables regression strategies to examine the relationship between influenza-related Google searches and 30-, 60-, and 90-day credit card and mortgage delinquency rates.

Results: We found that a proxy for influenza outbreaks is associated with a small but statistically significant increase in credit card and mortgage default rates, net of other factors. These effects are largest for 90-day defaults, suggesting that influenza outbreaks have a disproportionate impact on vulnerable borrowers who are already behind on their payments.

Conclusions: Overall, it appears there is a relationship between exogenous health shocks (such as influenza) and credit default. The results suggest that consumer finances could benefit from policies that aim to reduce the financial shocks of illness, particularly for vulnerable borrowers.

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Geographic distribution of insufficient sleep across the United States: A county-level hotspot analysis

Michael Grandner et al.
Sleep Health, September 2015, Pages 158-165

Introduction: Insufficient sleep is associated with cardiometabolic risk and neurocognitive impairment. Determinants of insufficient sleep include many social and environmental factors. Assessment of geographic hot/coldspots may uncover novel risk groups and/or targets for public health intervention. The aim of this study was to discern geographic patterns in the first data set to include county-level sleep data.

Methods: The 2009 Behavioral Risk Factor Surveillance System was used. Insufficient sleep was assessed with a survey item and dichotomized. Data from n = 2231 counties were available. Tests for significant spatial concentrations of high/low levels of insufficient sleep (hotspots/coldspots) used the Getis-Ord G* statistic of local spatial concentration, chosen due to the nature of missing data.

Results: Eighty-four counties were hotspots, with high levels of insufficient sleep (P < .01), and 45 were coldspots, with low insufficient sleep (P < .01). Hotspots were found in Alabama (1 county), Arkansas (1), Georgia (1), Illinois (1), Kentucky (25), Louisiana (1), Missouri (4), Ohio (7), Tennessee (12), Texas (9), Virginia (6), and West Virginia (16). Coldspots were found in Alabama (1 county), Georgia (2), Illinois (6), Iowa (6), Michigan (2), Minnesota (1), North Carolina (1), Texas (7), Virginia (12), and Wisconsin (6). Several contiguous hotspots and coldspots were evident. Notably, the 17 counties with the highest levels of insufficient sleep were found in a contiguous set at the intersection of Kentucky, Tennessee, Virginia, and West Virginia (all P < .0002).

Conclusions: Geographic distribution of insufficient sleep in the United States is uneven. Some areas (most notably parts of Appalachia) experience disproportionately high amounts of insufficient sleep and may be targets of intervention. Further investigation of determinants of geographic variability needs to be explored, which would enhance the utility of these data for development of public health campaigns.

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Countering antivaccination attitudes

Zachary Horne et al.
Proceedings of the National Academy of Sciences, 18 August 2015, Pages 10321-10324

Abstract:
Three times as many cases of measles were reported in the United States in 2014 as in 2013. The reemergence of measles has been linked to a dangerous trend: parents refusing vaccinations for their children. Efforts have been made to counter people's antivaccination attitudes by providing scientific evidence refuting vaccination myths, but these interventions have proven ineffective. This study shows that highlighting factual information about the dangers of communicable diseases can positively impact people's attitudes to vaccination. This method outperformed alternative interventions aimed at undercutting vaccination myths.

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Public transit generates new physical activity: Evidence from individual GPS and accelerometer data before and after light rail construction in a neighborhood of Salt Lake City, Utah, USA

Harvey Miller et al.
Health & Place, November 2015, Pages 8-17

Abstract:
Poor health outcomes from insufficient physical activity (PA) are a persistent public health issue. Public transit is often promoted for positive influence on PA. Although there is cross-sectional evidence that transit users have higher PA levels, this may be coincidental or shifted from activities such as recreational walking. We use a quasi-experimental design to test if light rail transit (LRT) generated new PA in a neighborhood of Salt Lake City, Utah, USA. Participants (n=536) wore Global Positioning System (GPS) receivers and accelerometers before (2012) and after (2013) LRT construction. We test within-person differences in individuals' PA time based on changes in transit usage pre- versus post-intervention. We map transit-related PA to detect spatial clustering of PA around the new transit stops. We analyze within-person differences in PA time based on daily transit use and estimate the effect of daily transit use on PA time controlling for socio-demographic variables. Results suggest that transit use directly generates new PA that is not shifted from other PA. This supports the public health benefits from new high quality public transit such as LRT.

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The Effects of Two Influential Early Childhood Interventions on Health and Healthy Behaviors

Gabriella Conti, James Heckman & Rodrigo Pinto
NBER Working Paper, August 2015

Abstract:
This paper examines the long-term impacts on health and healthy behaviors of two of the oldest and most widely cited U.S. early childhood interventions evaluated by the method of randomization with long-term follow-up: the Perry Preschool Project (PPP) and the Carolina Abecedarian Project (ABC). There are pronounced gender effects strongly favoring boys, although there are also effects for girls. Dynamic mediation analyses show a significant role played by improved childhood traits, above and beyond the effects of experimentally enhanced adult socioeconomic status. These results show the potential of early life interventions for promoting health.

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Daylight Saving Time and incidence of myocardial infarction: Evidence from a regression discontinuity design

Weily Toro, Robson Tigre & Breno Sampaio
Economics Letters, November 2015, Pages 1-4

Abstract:
Limited evidence suggests that Daylight Saving Time (DST) shifts have a substantial influence on the risk of acute myocardial infarction (AMI). Previous literature, however, lack proper identification necessary to vouch for causal interpretation. We exploit Daylight Saving Time shift using non-parametric regression discontinuity techniques to provide indisputable evidence that this abrupt disturbance does affect incidence of AMI.

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The Effect of Early-Life Education on Later-Life Mortality

Dan Black, Yu-Chieh Hsu & Lowell Taylor
Journal of Health Economics, December 2015, Pages 1-9

Abstract:
Many studies link cross-state variation in compulsory schooling laws to early-life educational attainment, thereby providing a plausible way to investigate the causal impact of education on various lifetime outcomes. We use this strategy to estimate the effect of education on older-age mortality of individuals born in the early twentieth century U.S. Our key innovation is to combine U.S. Census data and the complete Vital Statistics records to form precise mortality estimates by sex, birth cohort, and birth state. In turn we find that virtually all of the variation in these mortality rates is captured by cohort effects and state effects alone, making it impossible to reliably tease out any additional impact due to changing educational attainment induced by state-level changes in compulsory schooling.


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