What's Good For You
Does Policy Uncertainty Boost Vaccine Hesitancy? Political Controversy, the FDA and COVID-19 Vaccine Hesitancy in Fall 2020
Daniel Carpenter et al.
Journal of Health Politics, Policy and Law, forthcoming
Methods: Analysis of daily changes in news reporting and social media use in 2020, combined with detailed analysis of two-large scale surveys fielded at the time, focusing on questions of COVID-19 vaccine hesitancy and safety concerns about COVID-19 vaccines.
Findings: Vaccine hesitancy in the US spiked from late August to early October 2020. We identify several plausible triggers for this spike, all pertaining to the FDA and electoral politics. Heightened vaccine hesitancy occurred among Democrats, Asian and Black citizens, as well as college-educated respondents. Turbulence mainly affected those who were initially most trusting in government and vaccines. Asian-American vaccine confidence recovered; that of Black Americans did not.
Exposure to sugar rationing in the first 1000 days of life protected against chronic disease
Tadeja Gracner, Claire Boone & Paul Gertler
Science, forthcoming
Abstract:
We examined the impact of sugar exposure within 1000 days since conception on diabetes and hypertension, leveraging quasi-experimental variation from the end of the United Kingdom’s sugar rationing in September 1953. Rationing restricted sugar intake to levels within current dietary guidelines, yet consumption nearly doubled immediately post-rationing. Using an event study design with UK Biobank data comparing adults conceived just before or after rationing ended, we found that early-life rationing reduced diabetes and hypertension risk by about 35% and 20%, respectively, and delayed disease onset by 4 and 2 years. Protection was evident with in-utero exposure and increased with postnatal sugar restriction, especially after six months when solid foods likely began. In-utero sugar rationing alone accounted for about one third of the risk reduction.
Inflammation and olfactory loss are associated with at least 139 medical conditions
Michael Leon, Emily Troscianko & Cynthia Woo
Frontiers in Molecular Neuroscience, October 2024
Abstract:
Olfactory loss accompanies at least 139 neurological, somatic, and congenital/hereditary conditions. This observation leads to the question of whether these associations are correlations or whether they are ever causal. Temporal precedence and prospective predictive power suggest that olfactory loss is causally implicated in many medical conditions. The causal relationship between olfaction with memory dysfunction deserves particular attention because this sensory system has the only direct projection to memory centers. Mechanisms that may underlie the connections between medical conditions and olfactory loss include inflammation as well as neuroanatomical and environmental factors, and all 139 of the medical conditions listed here are also associated with inflammation. Olfactory enrichment shows efficacy for both prevention and treatment, potentially mediated by decreasing inflammation.
Ridesharing and Substance Use Disorder Treatment
Conor Lennon, Johanna Catherine Maclean & Keith Teltser
NBER Working Paper, October 2024
Abstract:
We examine whether ridesharing provides a meaningful transportation alternative for those who require ongoing healthcare. Specifically, we combine variation in UberX entry across the U.S. with the Treatment Episode Data Set to estimate the effect of ridesharing on admissions to substance use disorder treatment. People needing such treatment report transportation as a barrier to receiving care. We find that UberX entry into a Core Based Statistical Area has no effect on the overall number of treatment admissions. However, we find a decline in non-intensive outpatient treatment which is fully offset by an increase in intensive outpatient treatment. Given the required relative frequency of non-intensive and intensive outpatient treatment in terms of visits per week, our findings indicate that UberX helps to reduce transportation barriers to accessing healthcare. Event-studies show parallel trends in outcomes before UberX entry and results are robust to numerous sensitivity checks.
Interactive effects of genetic liability and combat exposure on risk of alcohol use disorder among US service members
Laura Campbell-Sills et al.
Drug and Alcohol Dependence, November 2024
Methods: The sample consisted of 1203 US Army soldiers of genetically determined European ancestry who provided survey and genomic data in the Army STARRS Pre/Post Deployment Study (PPDS; 2012–2014) and follow-up survey data in wave 1 of the STARRS Longitudinal Study (2016–2018). Logistic regression was used to estimate the conditional effect of combat exposure level (self-reported in PPDS) on odds of probable AUD [alcohol use disorder] diagnosis at follow-up, as a function of a soldier’s polygenic risk score (PRS) for AUD.
Results: The direct effect of combat exposure on AUD risk was non-significant (AOR=1.12, 95 % CI=1.00–1.26, p=.051); however, a significant combat exposure x PRS interaction was observed (AOR=1.60, 95 % CI=1.03–2.46, p=.033). Higher combat exposure was more strongly associated with elevated AUD risk among soldiers with heightened genetic liability to AUD.
Impact of Vietnam-era G.I. Bill eligibility on later-life blood pressure distribution: Evidence from the Vietnam draft lottery natural experiment
Aayush Khadka et al.
American Journal of Epidemiology, forthcoming
Abstract:
We quantified the impact of Vietnam-era G.I Bill eligibility, which subsidized college education for eligible Veterans, on the later-life blood pressure distribution by exploiting the Vietnam draft lottery natural experiment. We restricted Health and Retirement Study data (2006-2018) to men born between 1947-1953 (N=1,970). We estimated intention-to-treat effects at the mean and 1st-99th quantiles of blood pressure using linear and quantile regressions. Our outcomes were systolic blood pressure (SBP), diastolic blood pressure (DBP), hypertension, and self-reported stroke. We proxied G.I. Bill eligibility using lottery-defined draft eligibility. We also conducted analyses stratified by childhood socioeconomic status (cSES) defined based on a previously validated measure. Draft eligibility reduced mean blood pressure outcomes (e.g., effect on SBP: -1.33 [95% confidence interval (CI) -2.85, 0.19]). Draft eligibility also had larger protective effects at higher quantiles of the SBP and DBP distributions relative to lower quantiles (effects on SBP at the 10th and 90th quantiles: -0.33mmHg [95% CI -2.35,1.68]; -3.00mmHg [95% CI -5.68,-0.32]). Draft eligibility had protective effects on blood pressure among low and medium cSES men but opposite effects among high cSES men. G.I. Bill eligibility reshaped the blood pressure distribution to one of lower morbidity risk, particularly among low and medium cSES men.
Couch-Locked with the Munchies: Effects of Recreational Marijuana Laws on Exercise and Nutrition
Thomas Wilk et al.
NBER Working Paper, November 2024
Abstract:
As recreational marijuana laws (RML) expanded marijuana access over the last decade, still very little is known about the impact of RML on two costly social behaviors that may arise as a consequence of marijuana consumption: unhealthy eating (i.e. munchies), and sedentary lifestyle (i.e. couch-lock). Using Nielsen IQ Consumer Panel data, we find that the passage of RML led to an increase in the number of grocery store trips that involved “junk food”, as well as the amount of respective “junk food” spending. This effect is particularly driven by an increase in snacks, cookies, and candy. Using the Behavioral Risk Factor Surveillance System (BRFSS) and the American Time Use Survey (ATUS), we find that the passage of RML led to a decrease in exercise, particularly driven by a reduction in cardio, and suggestive evidence of more time spent at home. The findings are robust to alternative methods that take into account the staggered implementation of RML. These results suggest that RMLs have an adverse effect on health through “munchies” and “couch-lock,” which pose a significant public health challenge to diet and lifestyle-related chronic conditions.
Cognitive Difficulty in Middle Eastern and North African Adults Living in the United States Compared With Other Racial and Ethnic Categories, 2017–2021
Tiffany Kindratt & Alexandra Smith
American Journal of Public Health, November 2024, Pages 1265-1274
Objectives: To estimate the odds of having cognitive difficulties among Middle Eastern and North African (MENA) American adults and compare these odds with those of White, Black, Hispanic/Latino, Asian, American Indian or Alaska Native (AI/AN), and Native Hawaiian/Other Pacific Islander adults nationally and in the 4 states with the largest MENA populations (California, New York, Michigan, and Texas) after adjusting for sociodemographic factors.
Methods: We analyzed 2017–2021 American Community Survey data (aged ≥ 45 years; n = 7 284 988), comparing presence of cognitive difficulties by race/ethnicity.
Results: MENA adults had greater odds of reporting cognitive difficulties than did White (odds ratio [OR] = 1.49; 95% confidence interval [CI] = 1.42, 1.56), Black (OR = 1.20; 95% CI = 1.14, 1.26), Hispanic (OR = 1.46; 95% CI = 1.39, 1.53), Asian (OR = 1.31; 95% CI = 1.25, 1.38), and AI/AN (OR = 1.07; 95% CI = 1.01, 1.14) adults. In all 4 states, odds of having cognitive difficulties were higher among MENA than Asian adults. Other racial/ethnic comparisons differed by state.