Vulnerability
The Pandemic Brain: Neuroinflammation in non-infected individuals during the COVID-19 pandemic
Ludovica Brusaferri et al.
Brain, Behavior, and Immunity, May 2022, Pages 89-97
Abstract:
While COVID-19 research has seen an explosion in the literature, the impact of pandemic-related societal and lifestyle disruptions on brain health among the uninfected remains underexplored. However, a global increase in the prevalence of fatigue, brain fog, depression and other “sickness behavior”-like symptoms implicates a possible dysregulation in neuroimmune mechanisms even among those never infected by the virus. We compared fifty-seven ‘Pre-Pandemic’ and fifteen ‘Pandemic’ datasets from individuals originally enrolled as control subjects for various completed, or ongoing, research studies available in our records, with a confirmed negative test for SARS-CoV-2 antibodies. We used a combination of multimodal molecular brain imaging (simultaneous positron emission tomography / magnetic resonance spectroscopy), behavioral measurements, imaging transcriptomics and serologic testing to uncover links between pandemic-related stressors and neuroinflammation. Healthy individuals examined after the enforcement of 2020 lockdown/stay-at-home measures demonstrated elevated brain levels of two independent neuroinflammatory markers (the 18 kDa translocator protein, TSPO, and myoinositol) compared to pre-lockdown subjects. The serum levels of two inflammatory markers (interleukin-16 and monocyte chemoattractant protein-1) were also elevated, although these effects did not reach statistical significance after correcting for multiple comparisons. Subjects endorsing higher symptom burden showed higher TSPO signal in the hippocampus (mood alteration, mental fatigue), intraparietal sulcus and precuneus (physical fatigue), compared to those reporting little/no symptoms. Post-lockdown TSPO signal changes were spatially aligned with the constitutive expression of several genes involved in immune/neuroimmune functions. This work implicates neuroimmune activation as a possible mechanism underlying the non-virally-mediated symptoms experienced by many during the COVID-19 pandemic. Future studies will be needed to corroborate and further interpret these preliminary findings.
Faster than warp speed: Early attention to COVD-19 by anti-vaccine groups on Facebook
Seth Kalichman et al.
Journal of Public Health, March 2022, Pages e96–e105
Methods:
This study chronicles the social media posts concerning COVID-19 and COVID-19 vaccines by leading anti-vaccine groups (Dr Tenpenny on Vaccines, the National Vaccine Information Center [NVIC] the Vaccination Information Network [VINE]) and Vaccine Machine in the early months of the COVID-19 pandemic (February–May 2020).
Results:
Analysis of 2060 Facebook posts showed that anti-vaccine groups were discussing COVID-19 in the first week of February 2020 and were specifically discussing COVID-19 vaccines by mid-February 2020. COVID-19 posts by NVIC were more widely disseminated and showed greater influence than non-COVID-19 posts. Early COVID-19 posts concerned mistrust of vaccine safety and conspiracy theories.
Sulforaphane exhibits antiviral activity against pandemic SARS-CoV-2 and seasonal HCoV-OC43 coronaviruses in vitro and in mice
Alvaro Ordonez et al.
Communications Biology, March 2022
Abstract:
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), has incited a global health crisis. Currently, there are limited therapeutic options for the prevention and treatment of SARS-CoV-2 infections. We evaluated the antiviral activity of sulforaphane (SFN), the principal biologically active phytochemical derived from glucoraphanin, the naturally occurring precursor present in high concentrations in cruciferous vegetables. SFN inhibited in vitro replication of six strains of SARS-CoV-2, including Delta and Omicron, as well as that of the seasonal coronavirus HCoV-OC43. Further, SFN and remdesivir interacted synergistically to inhibit coronavirus infection in vitro. Prophylactic administration of SFN to K18-hACE2 mice prior to intranasal SARS-CoV-2 infection significantly decreased the viral load in the lungs and upper respiratory tract and reduced lung injury and pulmonary pathology compared to untreated infected mice. SFN treatment diminished immune cell activation in the lungs, including significantly lower recruitment of myeloid cells and a reduction in T cell activation and cytokine production. Our results suggest that SFN should be explored as a potential agent for the prevention or treatment of coronavirus infections.
The effect of E-cigarette indoor vaping restrictions on infant mortality
Michael Cooper & Michael Pesko
Southern Economic Journal, forthcoming
Abstract:
We estimate the effect of county-level e-cigarette indoor vaping restrictions (IVRs) on infant mortality using United States birth certificates from 2010 to 2015. We estimate difference-in-differences models and find that e-cigarette IVRs increased infant mortality by 0.39 infants per 1000 live births (12.9%). These effects were disproportionately higher for infants born to younger mothers and in locations with higher baseline levels of prenatal smoking. Infant mortality increased by 34.1% between 100 days to 1 year after IVRs. Infant mortality due to infections and neoplasms were particularly elevated.
Unemployment Insurance and Opioid Overdose Mortality in the United States
Pinghui Wu & Michael Evangelist
Demography, forthcoming
Abstract:
Over the past two decades, opioid overdose deaths contributed to the dramatic rise in all-cause mortality among non-Hispanic Whites. To date, efforts among scholars to understand the role of local area labor market conditions on opioid overdose mortality have led to mixed results. We argue the reason for these disparate findings is scholars have not considered the moderating effects of income support policies such as unemployment insurance. The present studyleverages two sources of variation—county mass layoffs and changes in the generosity of state unemployment insurance benefits—to investigate if unemployment benefits moderate the relationship between job loss and county opioid overdose death rates. Our difference-in-differences estimation strategy reveals that the harmful effects of job loss on opioid overdose mortality decline with increasing state unemployment insurance benefit levels. These findings suggest that social policy in the form of income transfers played a crucial role in disrupting the link between job loss and opioid overdose mortality.
Economic Crises and Mental Health: Effects of the Great Recession on Older Americans
David Cutler & Noémie Sportiche
NBER Working Paper, March 2022
Abstract:
We examine the effect of the Great Recession of 2007-2009 on the mental health of older adults, using longitudinal Health and Retirement Study data linked to area-level data on house prices. We use a variety of measures to capture mental health and rely on the very large cross-sectional variation in falling house prices to identify the impact of the Great Recession on those outcomes. We also account for people who moved in response to falling prices by fixing each person’s location immediately prior to the house price collapse. Our central finding is that the Great Recession had heterogeneous effects on health. While mental health was not affected for the average older adult, mental health declined among homeowners with few financial assets, who were therefore more vulnerable to falling house prices. Importantly, health impacts in this group differed by race and ethnicity: depression and functional limitations worsened among Black and other non-white homeowners and medication use increased among white homeowners. There were no measurable impacts for Hispanic homeowners. These results highlight the importance of examining heterogeneity across multiple dimensions when examining the health impacts of economic conditions.
Narratives of Outbreak and Survival in English-Language Cinema Prior to COVID-19
Lisa Wade
Socius: Sociological Research for a Dynamic World, February 2022
Abstract:
Efforts to curb the COVID-19 pandemic were hampered by the tendency of some Americans to disbelieve its seriousness, distrust social institutions, and defy public health recommendations. To contribute to understanding these responses, I look to one facet of the discursive environment faced by public health communicators: the last 25 years of commercially successful, English-language, epidemic-themed feature films. I coded a sample of 34 films for competing “outbreak narratives” and content related to evidence of serious disease, the trustworthiness of social institutions, and the prevention of infection. I find characters in films usually encounter diseases with alarming symptom profiles and infection and death rates nearing 100 percent. Social institutions are overwhelmingly portrayed as negligent or manifestly evil. And the primary method of protecting oneself and others from infection is murder. I conclude that the content of these films could influence public culture and sow disbelief, distrust, and defiance.
Death by Robots? Automation and Working-Age Mortality in the United States
Rourke O'Brien, Elizabeth Bair & Atheendar Venkataramani
Demography, forthcoming
Abstract:
The decline of manufacturing employment is frequently invoked as a key cause of worsening U.S. population health trends, including rising mortality due to “deaths of despair.” Increasing automation — the use of industrial robots to perform tasks previously done by human workers — is one structural force driving the decline of manufacturing jobs and wages. In this study, we examine the impact of automation on age- and sex-specific mortality. Using exogenous variation in automation to support causal inference, we find that increases in automation over the period 1993–2007 led to substantive increases in all-cause mortality for both men and women aged 45–54. Disaggregating by cause, we find evidence that automation is associated with increases in drug overdose deaths, suicide, homicide, and cardiovascular mortality, although patterns differ by age and sex. We further examine heterogeneity in effects by safety net program generosity, labor market policies, and the supply of prescription opioids.
Incentivizing Effort Allocation Through Resource Allocation: Evidence from Scientists’ Response to Changes in Funding Policy
Michael Blomfield & Keyvan Vakili
Organization Science, forthcoming
Abstract:
Prior research in management and economics has predominantly focused on how managers or policymakers can shape workers’ allocation of effort using output-based or effort-based incentives. In many settings, however, managers may seek to influence workers’ effort choices through resource allocation—that is, changing the cost of securing resources for different projects or activities. In this paper, we develop a formal model to investigate how a worker changes the allocation of a fixed amount of effort across different projects in response to changes in the cost of securing resources for each project. Our model shows how cutting resources available to one project, under certain circumstances, can inadvertently reduce the share of effort allocated to other projects and vice versa. We use the insights from the model to explore the effectiveness of funding strategies designed to influence the research direction of academic scientists. We specifically examine how U.S. scientists working in stem cell research responded to a 2001 policy change that restricted access to federal funding for research in the human embryonic stem cell (hESC) area. In line with our model’s predictions, we find that cutting resources for hESC research inadvertently reduced U.S. scientists’ output in non-hESC areas of stem cell research — an effect that is strongest among the highest-ability scientists. Our findings highlight the complexities of incentivizing effort allocation using resource-based incentives. In particular, we show how altering resource-based incentives in one area can have unforeseen spillover effects on effort allocation in other areas.
A Simple Incentive Mechanism to Alleviate the Burden of Organ Wastage in Transplantation
Sait Tunç, Burhaneddin Sandıkçı & Bekir Tanrıöver
Management Science, forthcoming
Abstract:
Despite efforts to increase the supply of donated organs for transplantation, organ shortages persist. We study the problem of organ wastage in a queueing-theoretic framework. We establish that self-interested individuals set their utilization levels more conservatively in equilibrium than the socially efficient level. To reduce the resulting gap, we offer an incentive mechanism that recompenses candidates returning to the waitlist for retransplantation, who have accepted a predefined set of organs, for giving up their position in the waitlist and show that it increases the equilibrium utilization of organs while also improving social welfare. Furthermore, the degree of improvement increases monotonically with the level of this nonmonetary compensation provided by the mechanism. In practice, this mechanism can be implemented by preserving some fraction of the waiting time previously accumulated by returning candidates. A detailed numerical study for the U.S. renal transplant system suggests that such an incentive helps significantly reduce the kidney discard rate (baseline: 17.4%). Depending on the strength of the population’s response to the mechanism, the discard rate can be as low as 6.2% (strong response), 12.4% (moderate response), or 15.1% (weak response), which translates to 1,630, 724, or 338 more transplants per year, respectively. Although the average quality of transplanted kidneys deteriorates slightly, the resulting graft survival one-year posttransplant remains stable around 94.8% versus 95.0% for the baseline. We find that the optimal Kidney Donor Profile Index score cutoff, defining the set of incentivized kidneys, is around 85%, which coincides with the generally accepted definition of marginal kidneys in the medical community.
Maternal diet and obesity shape offspring central and peripheral inflammatory outcomes in juvenile non-human primates
Geoffrey Dunn et al.
Brain, Behavior, and Immunity, May 2022, Pages 224-236
Abstract:
The obesity epidemic affects 40% of adults in the US, with approximately one-third of pregnant women classified as obese. Previous research suggests that children born to obese mothers are at increased risk for a number of health conditions. The mechanisms behind this increased risk are poorly understood. Increased exposure to in-utero inflammation induced by maternal obesity is proposed as an underlying mechanism for neurodevelopmental alterations in offspring. Utilizing a non-human primate model of maternal obesity, we hypothesized that maternal consumption of an obesogenic diet will predict offspring peripheral (e.g., cytokines and chemokines) and central (microglia number) inflammatory outcomes via the diet’s effects on maternal adiposity and maternal inflammatory state during the third trimester. We used structural equation modeling to simultaneously examine the complex associations among maternal diet, metabolic state, adiposity, inflammation, and offspring central and peripheral inflammation. Four latent variables were created to capture maternal chemokines and pro-inflammatory cytokines, and offspring cytokine and chemokines. Model results showed that offspring microglia counts in the basolateral amygdala were associated with maternal diet (β=-0.622, p<0.01), adiposity (β=0.593, p<0.01), and length of gestation (β=0.164, p<0.05) but not with maternal chemokines (β=0.135, p=0.528) or maternal pro-inflammatory cytokines (β=0.083, p=0.683). Additionally, we found that juvenile offspring peripheral cytokines (β=-0.389, p<0.01) and chemokines (β=-0.298, p<0.05) were associated with a maternal adiposity-induced decrease in maternal circulating chemokines during the third trimester (β=-0.426, p<0.01). In summary, these data suggest that maternal diet and adiposity appear to directly predict offspring amygdala microglial counts while maternal adiposity influences offspring peripheral inflammatory outcomes via maternal inflammatory state.
The Effect of Smoking on Mental Health: Evidence from a Randomized Trial
Katherine Meckel & Katherine P. Rittenhouse
NBER Working Paper, March 2022
Abstract:
This paper aims to identify the causal effects of smoking on mental health using data from the Lung Health Study, a randomized trial of smoking cessation treatment with five years of follow-up interviews. In the short-run, distress increases, likely reflecting the effects of nicotine withdrawal. Long-run effects on mental health are small overall, but mask heterogeneity by gender. For women, the cessation program leads to improved mental health, driven by decreases in insomnia and nervousness. Men do not experience these improvements, due in part to a small increase in severe disturbances.
How heavy is the price of smoking? Estimating the effects of prenatal smoking on child weight outcomes
Kabir Dasgupta, Keshar Ghimire & Gail Pacheco
Applied Economics, forthcoming
Abstract:
Existing evidence suggests that maternal smoking during pregnancy leads to a decline in birthweight and a higher risk of obesity during early childhood years. However, the causal nature of the latter relationship is not credibly established. This study advances the literature by estimating the causal impact of motherʻs smoking during pregnancy on child bodyweight outcomes, from birth through age five. We use a nationally representative sample of children and mothers from the United States National Longitudinal Surveys. We model childrenʻs body weight as a function of motherʻs smoking during pregnancy. Our identification technique utilizes the instrumental variable strategy to exploit plausibly exogenous variation in smoking behaviour of mothers prompted by changes in federal and state-level tobacco tax rates at the time of conception. Consistent with prior literature, our instrumental variable estimates suggest children of smokers weigh significantly less at birth than children of nonsmokers (an estimated decline of 0.53 kg). However, there is no credible evidence that these children are more likely to be overweight during early childhood.