It's your life
Social Cultivation of Vaccine Refusal and Delay among Waldorf (Steiner) School Parents
Elisa Sobo
Medical Anthropology Quarterly, forthcoming
Abstract:
U.S. media reports suggest that vastly disproportionate numbers of un- and under-vaccinated children attend Waldorf (private alternative) schools. After confirming this statistically, I analyzed qualitative and quantitative vaccination-related data provided by parents from a well-established U.S. Waldorf school. In Europe, Waldorf-related non-vaccination is associated with anthroposophy (a worldview foundational to Waldorf education) - but that was not the case here. Nor was simple ignorance to blame: Parents were highly educated and dedicated to self-education regarding child health. They saw vaccination as variously unnecessary, toxic, developmentally inappropriate, and profit driven. Some vaccine caution likely predated matriculation, but notable post-enrollment refusal increases provided evidence of the socially cultivated nature of vaccine refusal in the Waldorf school setting. Vaccine caution was nourished and intensified by an institutionalized emphasis on alternative information and by school community norms lauding vaccine refusal and masking uptake. Implications for intervention are explored.
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Offsetting or Enhancing Behavior: An Empirical Analysis of Motorcycle Helmet Safety Legislation
Jonathan Lee
Risk Analysis, forthcoming
Abstract:
This study uses state-level panel data from a 33-year period to test the hypotheses of offsetting and enhancing behavior with regards to motorcycle helmet legislation. Results presented in this article find no evidence of offsetting behavior and are consistent with the presence of enhancing behavior. State motorcycle helmet laws are estimated to reduce motorcycle crashes by 18.4% to 31.9%. In the absence of any behavioral adaptations among motorcyclists mandatory helmet laws are not expected to have any significant impact on motorcycle crash rates. The estimated motorcycle crash reductions do not appear to be driven by omitted variable bias or nonclassical measurement error in reported crashes. Overall, the results strongly suggest that mandatory helmet laws yield significant changes in motorcycle mobility in the form of reduced risk taking and/or decreased utilization.
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Jessica Pearlman
Social Science Research, July 2015, Pages 570-587
Abstract:
This paper will examine the impact of worker displacement on health in the United States from 1975-2004, especially the extent to which the impact of displacement on health varies according to the economic conditions in the year of displacement and the education level of the displaced worker. Findings from ordered probit and fixed effects models suggest that the negative impact of displacement on health is exacerbated by a higher unemployment rate at the time of displacement and for displaced workers with a college degree.
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The Long-Term Impact of an Early Career Recession on Health and Health-Related Behaviors
Naijia Guo & Rong Hai
University of Chicago Working Paper, March 2015
Abstract:
Using data from the restricted-access National Longitudinal Survey of Youth 1997, we estimate the long-term impact of an early career recession on various health outcomes and health-related behaviors up to age 30 for males and females by education groups. The early career recession is measured by the unemployment rate of the graduation state in the year when the individual enters the labor market upon receiving the highest degree. Because the timing of labor market entry could potentially be affected by economic conditions, we instrument the unemployment rate when entering labor market using the state unemployment rates at age 18 and age 22. Our main findings are that first, an early career recession has an adverse impact on health outcomes and health-related behaviors in general, and second, these adverse effects are especially pronounced among lower educated individuals. In particular, an early career recession increases the probability of bad health status for high school graduates, but has no effect on college graduates; it also leads to more depression for high school graduates than college graduates among males. We also find that a higher unemployment rate at early career significantly increases adverse health behaviors such as smoking, heavy drinking, and illicit drug use among high school graduates, but there is no statistically significant impact on college graduates. In addition, different gender-education groups respond differently in time use, such as time spent on exercise, sleep, and watching TV. An early career recession also reduces daily fruit intake for all males and unskilled females.
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Four Ways Life Extension will Change Our Relationship with Death
John Davis
Bioethics, forthcoming
Abstract:
Discussions of life extension ethics have focused mainly on whether an extended life would be desirable to have, and on the social consequences of widely available life extension. I want to explore a different range of issues: four ways in which the advent of life extension will change our relationship with death, not only for those who live extended lives, but also for those who cannot or choose not to. Although I believe that, on balance, the reasons in favor of developing life extension outweigh the reasons against doing so (something I won't argue for here), most of these changes probably count as reasons against doing so. First, the advent of life extension will alter the human condition for those who live extended lives, and not merely by postponing death. Second, it will make death worse for those who lack access to life extension, even if those people live just as long as they do now. Third, for those who have access to life extension but prefer to live a normal lifespan because they think that has advantages, the advent of life extension will somewhat reduce some of those advantages, even if they never use life extension. Fourth, refusing life extension turns out to be a form of suicide, and this will force those who have access to life extension but turn it down to choose between an extended life they don't want and a form of suicide they may (probably mistakenly) consider immoral.
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The Role of Education in Explaining Racial/Ethnic Allostatic Load Differentials in the United States
Jeffrey Howard & Johnelle Sparks
Biodemography and Social Biology, Spring 2015, Pages 18-39
Abstract:
This study expands on earlier findings of racial/ethnic and education-allostatic load associations by assessing whether racial/ethnic differences in allostatic load persist across all levels of educational attainment. This study used data from four recent waves of the National Health and Nutrition Survey (NHANES). Results from this study suggest that allostatic load differs significantly by race/ethnicity and educational attainment overall, but that the race/ethnicity association is not consistent across education level. Analysis of interactions and education-stratified models suggest that allostatic load levels do not differ by race/ethnicity for individuals with low education; rather, the largest allostatic load differentials for Mexican Americans (p < .01) and non-Hispanic blacks (p < .001) are observed for individuals with a college degree or more. These findings add to the growing evidence that differences in socioeconomic opportunities by race/ethnicity are likely a consequence of differential returns to education, which contribute to higher stress burdens among minorities compared to non-Hispanic whites.
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In fatal pursuit of immortal fame: Peer competition and early mortality of music composers
Karol Jan Borowiecki & Georgios Kavetsos
Social Science & Medicine, June 2015, Pages 30-42
Abstract:
We investigate the impact of peer competition on longevity using a unique historical data set of 144 prominent music composers born in the 19th century. We approximate for peer competition measuring (a) the number or (b) the share of composers located in the same area and time, (c) the time spent in one of the main cities for classical music, and (d) the quality of fellow composers. These measures suggest that composers' longevity is reduced, if they located in agglomerations with a larger group of peers or of a higher quality. The point estimates imply that, all else equal, a one percent increase in the number of composers reduces composer longevity by ∼7.2 weeks. Our analysis showed that the utilized concentration measures are stronger than the personal factors in determining longevity, indicating that individuals' backgrounds have minimal impact on mitigating the effect of experienced peer pressure. The negative externality of peer competition is experienced in all cities, fairly independent of their population size. Our results are reaffirmed using an instrumental variable approach and are consistent throughout a range of robustness tests. In addition to the widely known economic benefits associated with competition, these findings suggest that significant negative welfare externalities exist as well.
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Polling Places, Pharmacies, and Public Health: Vote & Vax 2012
Douglas Shenson et al.
American Journal of Public Health, June 2015, Pages e12-e15
Abstract:
US national elections, which draw sizable numbers of older voters, take place during flu-shot season and represent an untapped opportunity for large-scale delivery of vaccinations. In 2012, Vote & Vax deployed a total of 1585 clinics in 48 states; Washington, DC; Guam; Puerto Rico; and the US Virgin Islands. Approximately 934 clinics were located in pharmacies, and 651 were near polling places. Polling place clinics delivered significantly more vaccines than did pharmacies (5710 vs 3669). The delivery of vaccines was estimated at 9379, and approximately 45% of the recipients identified their race/ethnicity as African American or Hispanic. More than half of the White Vote & Vax recipients and more than two thirds of the non-White recipients were not regular flu shot recipients.
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Texting and Driving: Can it be Explained by the General Theory of Crime?
Phillip Neil Quisenberry
American Journal of Criminal Justice, June 2015, Pages 303-316
Abstract:
There has been quite a bit of media attention devoted recently to the topic of distracted driving generally, and texting and driving specifically. Recent studies by scholars, as well as the Department of Transportation, have continued to demonstrate the dangers of texting while driving. Previous studies have found that texting while driving reduces reaction and control times even more than drinking and driving. At least one study found that drivers who text are 23 times more likely to crash relative to non-distracted drivers. Tougher laws may be alluring as a deterrent to this behavior, but according to the data in this study, 96 % of respondents knew it was against the law but continued to text and drive anyway. This finding casts doubt on the effectiveness of any new distracted driving laws. The general theory of crime (Gottfredson & Hirschi, 1990) posits that levels of self-control are tied to deviant behaviors such as texting while driving. Other studies have also found that levels of self-control were significantly tied to other dangerous driving behaviors such as driving while drinking and driving without using a seatbelt. The findings in this study add support to the general theory of crime by demonstrating that, among college students in this sample, higher self-control significantly reduces the amount of texting while driving.
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Sacred Values? The Effect of Information on Attitudes toward Payments for Human Organs
Julio Elias, Nicola Lacetera & Mario Macis
American Economic Review, May 2015, Pages 361-365
Abstract:
Are attitudes about morally controversial (and often prohibited) market transactions affected by information about their costs and benefits? We address this question for the case of payments for human organs. We find in a survey experiment with US residents (N=3,417) that providing information on the potential efficiency benefits of a regulated price mechanism for organs significantly increased support for payments from a baseline of 52 percent to 71 percent. The survey was devised to minimize social desirability biases in responses, and additional analyses validate the interpretation that subjects were reflecting on the case-specific details provided, rather than just reacting to any information.
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Brandy Lipton & Sandra Decker
Health Affairs, May 2015, Pages 757-764
Abstract:
Affordable Care Act provisions implemented in 2010 required insurance plans to offer dependent coverage to people ages 19-25 and to provide targeted preventive services with zero cost sharing. These provisions both increased the percentage of young adults with any source of health insurance coverage and improved the generosity of coverage. We examined how these provisions affected use of the human papillomavirus (HPV) vaccine, which is among the most expensive of recommended vaccines, among young adult women. Using 2008-12 data from the National Health Interview Survey, we estimated that the 2010 policy implementation increased the likelihood of HPV vaccine initiation and completion by 7.7 and 5.8 percentage points, respectively, for women ages 19-25 relative to a control group of women age 18 or 26. These estimates translate to approximately 1.1 million young women initiating and 854,000 young women completing the vaccine series.
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Dennis Ownby et al.
Journal of Allergy and Clinical Immunology, forthcoming
Objective: We sought to compare the prevalence of asthma among AA youth in rural Georgia and urban Detroit, Michigan.
Methods: The prevalence of asthma was compared in population-based samples of 7297 youth attending Detroit public high schools and in 2523 youth attending public high schools in rural Georgia. Current asthma was defined as a physician diagnosis and symptoms in the previous 12 months. Undiagnosed asthma was defined as multiple respiratory symptoms in the previous 12 months without a physician diagnosis.
Results: In Detroit, 6994 (95.8%) youth were AA compared with 1514 (60.0%) in Georgia. Average population density in high school postal codes was 5628 people/mile2 in Detroit and 45.1 people/mile2 in Georgia. The percentages of poverty and of students qualifying for free or reduced lunches were similar in both areas. The prevalence of current diagnosed asthma among AA youth in Detroit and Georgia was similar: 15.0% (95% CI, 14.1-15.8) and 13.7% (95% CI, 12.0-17.1) (P = .22), respectively. The prevalence of undiagnosed asthma in AA youth was 8.0% in Detroit and 7.5% in Georgia (P = .56). Asthma symptoms were reported more frequently among those with diagnosed asthma in Detroit, whereas those with undiagnosed asthma in Georgia reported more symptoms.
Conclusions: Among AA youth living in similar socioeconomic circumstances, asthma prevalence is as high in rural Georgia as it is in urban Detroit, suggesting that urban residence is not an asthma risk factor.
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Deepak Hegde & Bhaven Sampat
Management Science, forthcoming
Abstract:
Private interest groups lobby politicians to influence public policy. However, little is known about how lobbying influences the policy decisions made by federal agencies. We study this through examining lobbying by advocacy groups associated with rare diseases for funding by the National Institutes of Health (NIH), the world's largest funder of biomedical research. Disease group lobbying for NIH funding has been controversial, with critics alleging that it distorts public funding toward research on diseases backed by powerful groups. Our data reveal that lobbying is associated with higher political support, in the form of congressional "soft earmarks" for the diseases. Lobbying increases with disease burden and is more likely to be associated with changes in NIH funding for diseases with higher scientific opportunity, suggesting that it may have a useful informational role. Only special grant mechanisms that steer funding toward particular diseases, which comprise less than a third of the NIH's grants, are related to earmarks. Thus, our results suggest that lobbying by private groups influences federal funding for biomedical research. However, the channels of political influence are subtle, affect a small portion of funding, and may not necessarily have a distortive effect on public science.
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Internal migration, area effects and health: Does where you move to impact upon your health?
Mark Green et al.
Social Science & Medicine, July 2015, Pages 27-34
Abstract:
Evidence surrounding the importance of neighbourhood on health has been mostly restricted to observational data analyses. However, observational data are often the only source of information available to test this association and can fail to accurately draw out casual effects. This study employs a pseudo-experimental design to provide a novel test for the evidence of neighbourhood effects on health, using migration as a mechanism for assessing the role of neighbourhood. Coarsened exact matching was employed on the British Household Panel Survey (2006-2008) to analyse the association between migration (by area type, measured using a classification of mortality patterns) and health. Although an overall significant positive association between migration and health was observed, once the effect was disaggregated by location and destination it disappeared. Rather, evidence of health selective migration was found whereby individuals of poorer health migrated to areas that displayed poorer health and social characteristics (and vice versa). Migration is an important process that through the social sorting of individuals in terms of their health, contributes to the growing polarisation and inequality in health patterns. The study helps to build upon previous research through providing a new and stronger form of analysis that reduces the influence of bias on results. Incorporating this under-utilised methodology and research design in future studies could help develop public health and geographical research.
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Not a Problem: A Downside of Humorous Appeals
Peter McGraw, Julie Schiro & Philip Fernbach
University of Colorado Working Paper, February 2015
Abstract:
Public service announcements (PSAs) are traditionally designed to elicit negative emotions that spur problem-solving behavior. However, in order to improve their reach, some social marketers are forgoing traditional strategy by creating PSAs that are humorous. Because of humor's positivity and association with non-serious situations, we hypothesized that humorous appeals can decrease problem perception and problem-solving behavior. Study 1 examined problem perceptions using matched pairs of humorous and non-humorous PSAs. Respondents judged a social issue as less important to solve after viewing the humorous version of the pair. Study 2 examined problem-solving behavior through a partnership with a non-profit organization seeking to improve young adults' sexual health knowledge. Humorous PSAs were less effective than a non-humorous version at spurring people to search for health information. The inquiry revealed a previously unaddressed tradeoff: using humor to benefit a message's reach creates a potential cost to solving a personal or societal problem.
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The Perils of Marketing Weight-Management Remedies and the Role of Health Literacy
Lisa Bolton, Amit Bhattacharjee & Americus Reed
Journal of Public Policy & Marketing, Spring 2015, Pages 50-62
Abstract:
This research explores the impact of weight-management remedy marketing on healthy lifestyle behaviors. Three studies demonstrate that exposure to drug (but not supplement) marketing for weight management encourages unhealthy consumer behavior as a result of consumers' reliance on erroneous beliefs about health remedies. The authors explore the possible mitigating role of two dimensions of healthy literacy: nutrition knowledge and remedy knowledge. Whether measured or manipulated, the results show remedy knowledge to be more effective than nutrition knowledge at lessening the effect of weight-management drug marketing on unhealthy behavior. The authors close with a discussion of the theoretical and substantive implications of this research for consumer welfare.
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Trends in U.S. life expectancy gradients: The role of changing educational composition
Arun Hendi
International Journal of Epidemiology, forthcoming
Background: I examined age patterns and the role of shifting educational distributions in driving trends in educational gradients in life expectancy among non-Hispanic Whites between 1991 and 2005.
Methods: Data were from the 1986-2004 National Health Interview Survey with mortality follow-up through 2006. Life expectancies were computed by sex, period and education. Age decompositions of life expectancy gradients and composition-adjusted life expectancies were computed to account for age patterns and shifting educational distributions.
Results: Life expectancy at age 25 among White men increased for all education groups, decreased among the least-educated White women and increased among White women with college degrees. Much of the decline in measured life expectancy for White women with less than a high school education comes from the 85+ age group. Educational gradients in life expectancy widened for White men and women. One-third of the gradient is due to ages below 50. Approximately 26% (0.7 years) and 87% (0.8 years) of the widening of the gradient in life expectancy between ages 25 and 85 for White women and men is attributable to shifting education distributions. Over half of the decline in temporary life expectancy among the least-educated White women is due to compositional change.
Conclusions: Life expectancy has increased among White men for all education groups and has decreased among White women with less than a high school education, though not to the extent reported in previous studies. The fact that a large proportion of the change in education-specific life expectancy among women is due to the 85+ age group suggests changes in institutionalization may be affecting estimates. Much of the change in education-specific life expectancy and the growth in the educational gradient in life expectancy is due to the shifting distribution of individuals across education categories.
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Erin Todd Bronchetti, David Huffman & Ellen Magenheim
Journal of Economic Behavior & Organization, forthcoming
Abstract:
Preventive health behaviors like flu vaccination have important benefits, but compliance is poor, and the reasons are not fully understood. We conducted a large study across six colleges (N=9,358), with a methodology that offers an unusual opportunity to look at three potential factors: Inattention to information, informed intentions to not comply, and problems following through on intentions. We also tested three interventions in an RCT. We find that inattention to information is not the primary driver of low take-up, while informed decisions to not get the vaccine, but also lack of follow-through, are important factors. A financial intervention increased take-up and had persistent, positive effects on intentions for vaccination in future years. Two low-cost "nudges" did not increase vaccination rates, although the peer endorsement nudge increased exposure to information, especially if aligned with social networks.
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Mark Cullen et al.
NBER Working Paper, April 2015
Abstract:
Sex differences in mortality (SDIM) vary over time and place as a function of social, health, and medical circumstances. The magnitude of these variations, and their response to large socioeconomic changes, suggest that biological differences cannot fully account for sex differences in survival. We document "stylized facts" about SDIM with which any theory will have to contend. We draw on a wide swath of mortality data, including probability of survival to age 70 by county in the United States, the Human Mortality Database data for 18 high-income countries since 1900, and mortality data within and across developing countries over time periods for which reasonably reliable data are available. We show that, in each of the periods of economic development after the onset of demographic and epidemiologic transition, cross-sectional variation in SDIM exhibits a consistent pattern of female resilience to mortality under adversity. Moreover, as societies develop, M/F survival first declines and then increases, a "SDIM transition" embedded within the demographic and epidemiologic transitions.