Health Facts

Kevin Lewis

October 08, 2021

Effects of political versus expert messaging on vaccination intentions of Trump voters
Christopher Robertson et al.
PLoS ONE, September 2021

To increase COVID-19 vaccine uptake in resistant populations, such as Republicans, focus groups suggest that it is best to de-politicize the issue by sharing five facts from a public health expert. Yet polls suggest that Trump voters trust former President Donald Trump for medical advice more than they trust experts. We conducted an online, randomized, national experiment among 387 non-vaccinated Trump voters, using two brief audiovisual artifacts from Spring 2021, either facts delivered by an expert versus political claims delivered by President Trump. Relative to the control group, Trump voters who viewed the video of Trump endorsing the vaccine were 85% more likely to answer “yes” as opposed to “no” in their intention to get fully vaccinated (RRR = 1.85, 95% CI 1.01 to 3.40; P = .048). There were no significant differences between those hearing the public health expert excerpt and the control group (for “yes” relative to “no” RRR = 1.14, 95% CI 0.61 to 2.12; P = .68). These findings suggest that a political speaker’s endorsement of the COVID-19 vaccine may increase uptake among those who identify with that speaker. Contrary to highly-publicized focus group findings, our randomized experiment found that an expert’s factually accurate message may not be effectual to increase vaccination intentions. 

Excess mortality from COVID and non-COVID causes in minority populations
Christopher Cronin & William Evans
Proceedings of the National Academy of Sciences, 28 September 2021

The 2020 US mortality totaled 2.8 million after early March, which is 17.3% higher than age-population–weighted mortality over the same time interval in 2017 to 2019, for a total excess death count of 413,592. We use data on weekly death counts by cause, as well as life tables, to quantify excess mortality and life years lost from both COVID-19 and non–COVID-19 causes by race/ethnicity, age, and gender/sex. Excess mortality from non–COVID-19 causes is substantial and much more heavily concentrated among males and minorities, especially Black, non-Hispanic males, than COVID-19 deaths. Thirty-four percent of the excess life years lost for males is from non–COVID-19 causes. While minorities represent 36% of COVID-19 deaths, they represent 70% of non–COVID-19 related excess deaths and 58% of non–COVID-19 excess life years lost. Black, non-Hispanic males represent only 6.9% of the population, but they are responsible for 8.9% of COVID-19 deaths and 28% of 2020 excess deaths from non–COVID-19 causes. For this group, nearly half of the excess life years lost in 2020 are due to non–COVID-19 causes. 

Mortality Rates by College Degree Before and During COVID-19
Anne Case & Angus Deaton
NBER Working Paper, October 2021

It is now established that mortality and excess mortality from COVID-19 differed across racial and ethnic groups in 2020. Less is known about educational differences in mortality during the pandemic. We examine mortality rates by BA status within sex, age, and race/ethnic groups comparing 2020 with 2019. Mortality rates have increasingly differed by BA status in the US in recent years and there are good reasons to expect the gap to have widened further during the pandemic. Using publicly available provisional data from the National Center for Health Statistics we find that mortality rates increased in 2020 over 2019 for those with and without a BA, irrespective of age, sex, or race/ethnicity. Although mortality rates increased by more for those without a BA, the ratio of mortality rates for those with and without a BA changed surprisingly little from 2019 to 2020. Among 60 groups (sex by race/ethnicity by age) that are available in the data, the ratio of mortality rates of those without a BA to those with a BA fell for more than half of the groups. Our results suggest that differences in the risk of infection were less important in structuring mortality by education than differences in the risk of death conditional on infection. 

Public Service Announcements and Promoting Face Masks During the COVID-19 Pandemic
Steven Greene et al.
PS: Political Science & Politics, forthcoming

Wearing face masks to combat the spread of COVID-19 became a politicized and contested practice in the United States, largely due to misinformation and partisan cues from masking opponents. This article examines whether Public Service Announcements (PSAs) can encourage the use of face masks. We designed two PSAs: one describes the benefits of using face masks; the other uses a novel messenger (i.e., a retired US general) to advocate for them. We conducted two studies. First, we aired our PSAs on television and surveyed residents of the media market to determine if they saw the PSA and how they felt about wearing face masks. Second, we conducted a randomized experiment on a diverse national sample. Both studies suggest that exposure to our PSAs increased support for face masks and induced greater compliance with public health advice. These findings have implications for how governments might fight pandemics. 

Pandemics Initially Spread Among People of Higher (Not Lower) Social Status: Evidence From COVID-19 and the Spanish Flu
Jana Berkessel et al.
Social Psychological and Personality Science, forthcoming

According to a staple in the social sciences, pandemics particularly spread among people of lower social status. Challenging this staple, we hypothesize that it holds true in later phases of pandemics only. In the initial phases, by contrast, people of higher social status should be at the center of the spread. We tested our phase-sensitive hypothesis in two studies. In Study 1, we analyzed region-level COVID-19 infection data from 3,132 U.S. regions, 299 English regions, and 400 German regions. In Study 2, we analyzed historical data from 1,159,920 U.S. residents who witnessed the 1918/1919 Spanish Flu pandemic. For both pandemics, we found that the virus initially spread more rapidly among people of higher social status. In later phases, that effect reversed; people of lower social status were most exposed. Our results provide novel insights into the center of the spread during the critical initial phases of pandemics. 

Teen Driving Restrictions and School Closures in Times of COVID-19
Jaesang Sung & Qihua Qiu
Georgia State University Working Paper, August 2021

With the fourth COVID-19 wave on the rise as the Delta variant rages and schools reopening across the United States since August 2021, debates over re-closing schools have arisen. School closures were the first and fastest adopted among social distancing measures to prevent coronavirus transmission in spring 2020. Meanwhile, the Graduated Driver Licensing (GDL) program imposes driving restrictions on teenagers, such as limiting the number of youth passengers allowed in a car and/or prohibiting nighttime driving. We expect GDL to have some social distancing effects that may help reduce coronavirus transmission among teenagers when off campus, which could benefit their entire households and therefore population of other ages. Using a difference-in-difference method, we examine how GDL restrictions affect county-level COVID-19 cases and deaths, taking advantage of the timing of statewide school closures. We find reducing one passenger in the car decreases COVID-19 cumulative cases per 100,000 by 5.8%-6.6%. An event study shows that, three weeks after school closures, reducing one passenger in the car lowers cumulative cases per 100,000 by nearly 15.7%. This paper adds to the COVID-19 literature by introducing a plausibly exogenous “quasi-social-distancing-policy”, GDL, and highlighting that the efficacy of school closures may vary by local circumstances. 

What doesn't kill you makes you “Smarter”: The long-term association between exposure to epidemic and cognition
Sha Wen, Hong Zou & Hongwei Xu
Social Science & Medicine, forthcoming

Emerging epidemics have devastating impacts on people's lives and livelihoods. However, acting as a severe health shock, exposure to an epidemic may induce positive changes in health behaviors among survivors, thereby leading to long-lasting improvement in population health. This study examined the long-term association between exposure to the 2002–2004 severe acute respiratory syndrome outbreak and middle-aged and older Chinese adults' cognition assessed in 2011–2015. Drawing on data from the 2011–2015 China Health and Retirement Longitudinal Study, we found that community exposure to the outbreak was associated with significantly higher scores on episodic memory, after adjusting for demographic characteristics, adulthood socioeconomic status and health, and community socioeconomic conditions. No such a significant association was found for mental intactness. Mediation analysis showed that community exposure to the epidemic was associated with increased participation in social activities, maintaining close family relationships with adult children and grandchildren, and increased participation in regular physical exercise, all of which were positively associated with cognitive functioning in middle-aged and older Chinese adults. These findings suggest that positive post-epidemic behavioral changes are possible and may have long-term health benefits for survivors. 

Human mortality at extreme age
Léo Belzile et al.
Royal Society Open Science, September 2021 

We use a combination of extreme value statistics, survival analysis and computer-intensive methods to analyse the mortality of Italian and French semi-supercentenarians. After accounting for the effects of the sampling frame, extreme-value modelling leads to the conclusion that constant force of mortality beyond 108 years describes the data well and there is no evidence of differences between countries and cohorts. These findings are consistent with use of a Gompertz model and with previous analysis of the International Database on Longevity and suggest that any physical upper bound for the human lifespan is so large that it is unlikely to be approached. Power calculations make it implausible that there is an upper bound below 130 years. There is no evidence of differences in survival between women and men after age 108 in the Italian data and the International Database on Longevity, but survival is lower for men in the French data. 

Cross-sectional association of Toxoplasma gondii exposure with BMI and diet in US adults
Joel Cuffey et al.
PLoS Neglected Tropical Diseases, October 2021

Toxoplasmosis gondii exposure has been linked to increased impulsivity and risky behaviors, which has implications for eating behavior. Impulsivity and risk tolerance is known to be related with worse diets and a higher chance of obesity. There is little known, however, about the independent link between Toxoplasma gondii (T. gondii) exposure and diet-related outcomes. Using linear and quantile regression, we estimated the relationship between T. gondii exposure and BMI, total energy intake (kcal), and diet quality as measured by the Health Eating Index-2015 (HEI) among 9,853 adults from the 2009–2014 National Health and Nutrition Examination Survey. Previous studies have shown different behavioral responses to T. gondii infection among males and females, and socioeconomic factors are also likely to be important as both T. gondii and poor diet are more prevalent among U.S. populations in poverty. We therefore measured the associations between T. gondii and diet-related outcomes separately for men and women and for respondents in poverty. Among females <200% of the federal poverty level Toxoplasmosis gondii exposure was associated with a higher BMI by 2.0 units (95% CI [0.22, 3.83]) at median BMI and a lower HEI by 5.05 units (95% CI [-7.87, -2.24]) at the 25th percentile of HEI. Stronger associations were found at higher levels of BMI and worse diet quality among females. No associations were found among males. Through a detailed investigation of mechanisms, we were able to rule out T. gondii exposure from cat ownership, differing amounts of meat, and drinking water source as potential confounding factors; environmental exposure to T. gondii as well as changes in human behavior due to parasitic infection remain primary mechanisms. 

Measuring the impact of calorie labeling: The mechanisms behind changes in obesity
Rodrigo Aranda, Michael Darden & Donald Rose
Health Economics, November 2021, Pages 2858-2878

Learning the true calorie content of fast food may induce consumers to change behavior, yet recent evidence is mixed on whether calorie labels cause consumers to order healthier meals. Especially for individuals for whom consumption of highly caloric fast-food is habitual, a rational response to calorie labeling may instead be to maintain consumption levels but increase physical activity. Using American Time Use Survey data from 2004 to 2012, we show that the 2008 New York City Calorie Labeling Mandate significantly improved several measures of physical activity, including overall metabolic equivalents of task units and minutes of sedentary activity. Our results translate to an average extra 28 calories burned per day or a 0.6 kg weight decrease for the average person over one year. These results provide a plausible mechanism for calorie labeling mandates to lower obesity rates, which we demonstrate in the New York City context.

Exposure to Cigarette Taxes as a Teenager and the Persistence of Smoking into Adulthood
Andrew Friedson et al.
NBER Working Paper, October 2021

Are teenage and adult smoking causally related? Recent anti-tobacco policy is predicated on the assumption that preventing teenagers from smoking will ensure that fewer adults smoke, but direct evidence in support of this assumption is scant. Using data from three nationally representative sources and cigarette taxes experienced as a teenager as an instrument, we document a strong, positive relationship between teenage and adult smoking: specifically, deterring 10 teenagers from smoking through raising cigarette taxes roughly translates into 5 or 6 fewer eventual adult smokers. We conclude that efforts to reduce teenage smoking can have important, long-lasting consequences on smoking participation and, presumably, health. 

Public health impact of a US ban on menthol in cigarettes and cigars: A simulation study
David Levy et al.
Tobacco Control, forthcoming

After calibrating an established US simulation model to reflect recent use trends in cigarette and NVP [nicotine vaping product] use, we extended the model to incorporate menthol and non-menthol cigarette use under a status quo scenario. Applying estimates from a recent expert elicitation on the behavioural impacts of a menthol ban, we developed a menthol ban scenario with the ban starting in 2021. We estimated the public health impact as the difference between smoking and vaping-attributable deaths and life-years lost in the status quo scenario and the menthol ban scenario from 2021 to 2060.

As a result of the ban, overall smoking was estimated to decline by 15% as early as 2026 due to menthol smokers quitting both NVP and combustible use or switching to NVPs. These transitions are projected to reduce cumulative smoking and vaping-attributable deaths from 2021 to 2060 by 5% (650 000 in total) and reduce life-years lost by 8.8% (11.3 million). Sensitivity analyses showed appreciable public health benefits across different parameter specifications.


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