Healthy Advice
Reducing mask resistance among White evangelical Christians with value-consistent messages
Stephanie DeMora et al.
Proceedings of the National Academy of Sciences, 25 May 2021
Abstract:
Public health experts have advocated for wearing protective face masks to combat the COVID-19 pandemic, yet some populations are resistant. Can certain messages shift attitudes toward masks? We investigate the effect of value-consistent messages within a mask-skeptical population: White evangelicals in the United States. An experiment within a national survey of White evangelicals (n = 1,212) assigned respondents to one of three conditions: One group was given a religious message equating mask use with loving your neighbor, another was given a message by Donald Trump saying mask use is patriotic, and a control group received no message. Those exposed to the religious message were more likely to see mask use as important and were more supportive of mask mandates. Republican evangelicals exposed to the patriotism message had similar responses. These findings show that messages that align with individuals’ core values -- in this case, religious tenets and patriotism -- can shift certain views on mask use and government mask policies to combat COVID-19, even among a comparatively mask-resistant group.
Inside ILSI: How Coca-Cola, Working through Its Scientific Nonprofit, Created a Global Science of Exercise for Obesity and Got It Embedded in Chinese Policy (1995-2015)
Susan Greenhalgh
Journal of Health Politics, Policy and Law, April 2021, Pages 235-276
Context: Industry influence on health science and policy is a critical issue of our day. In 2015 the New York Times revealed that Coca-Cola paid scientists to form a Global Energy Balance Network promoting the notion that exercise, not dietary restraint, is the solution to the obesity epidemic -- a claim few accept. This article examines the organizational dynamics and policy process behind Coke's efforts to sway obesity policy -- globally and in China, a critical market -- during 1995-2015.
Methods: In-depth, qualitative research during 2013-18 involved 10 weeks of fieldwork in Beijing, interviews with 25 leading experts, analysis of newsletters documenting all major obesity-related activities in China, interviews with 10 Euro-American experts, and extensive internet research on all major actors.
Findings: This article tells two intertwined stories (institutional dynamics, science making and policy making) at global and local-Chinese levels. Coke succeeded in redirecting China's obesity science and policy to emphasize physical activity. Key to its success was the industry-funded global nonprofit International Life Sciences Institute (ILSI). Beneath ILSI's public narrative of unbiased science and no policy advocacy lay a maze of hidden channels companies used to advance their interests. Working through those channels, Coca-Cola influenced China's science making and policy making during every phase in the policy process, from framing the issues to drafting official policy.
Carceral-community epidemiology, structural racism, and COVID-19 disparities
Eric Reinhart & Daniel Chen
Proceedings of the National Academy of Sciences, 25 May 2021
Abstract:
Black and Hispanic communities are disproportionately affected by both incarceration and COVID-19. The epidemiological relationship between carceral facilities and community health during the COVID-19 pandemic, however, remains largely unexamined. Using data from Cook County Jail, we examine temporal patterns in the relationship between jail cycling (i.e., arrest and processing of individuals through jails before release) and community cases of COVID-19 in Chicago ZIP codes. We use multivariate regression analyses and a machine-learning tool, elastic regression, with 1,706 demographic control variables. We find that for each arrested individual cycled through Cook County Jail in March 2020, five additional cases of COVID-19 in their ZIP code of residence are independently attributable to the jail as of August. A total 86% of this additional disease burden is borne by majority-Black and/or -Hispanic ZIPs, accounting for 17% of cumulative COVID-19 cases in these ZIPs, 6% in majority-White ZIPs, and 13% across all ZIPs. Jail cycling in March alone can independently account for 21% of racial COVID-19 disparities in Chicago as of August 2020. Relative to all demographic variables in our analysis, jail cycling is the strongest predictor of COVID-19 rates, considerably exceeding poverty, race, and population density, for example. Arrest and incarceration policies appear to be increasing COVID-19 incidence in communities. Our data suggest that jails function as infectious disease multipliers and epidemiological pumps that are especially affecting marginalized communities. Given disproportionate policing and incarceration of racialized residents nationally, the criminal punishment system may explain a large proportion of racial COVID-19 disparities noted across the United States.
Does performance pay increase alcohol and drug use?
Benjamin Artz, Colin Green & John Heywood
Journal of Population Economics, July 2021, Pages 969-1002
Abstract:
Using US panel data on young workers, we demonstrate that those who receive performance pay are more likely to consume alcohol and illicit drugs. Recognizing that this likely reflects worker sorting, we first control for risk, ability, and personality proxies. We further mitigate sorting concerns by introducing worker fixed effects, worker-employer match fixed effects, and worker-employer-occupation match fixed effects. Finally, we present fixed effect IV estimates. All of these estimates continue to indicate a greater likelihood of substance use when a worker receives performance pay. The results support conjectures that stress and effort increase with performance pay and that alcohol and drug use is a coping mechanism for workers.
A cannabis pricing mistake from California to Canada: Government can’t tax cannabis optimally
Jason Childs & Jason Stevens
Applied Economics Letters, April 2021, Pages 779-783
Abstract:
We apply a simple three good general equilibrium model to examine the optimality of a Pigouvian tax on a legal cannabis market which faces competition from a well-established illicit market. Despite the widespread support for Pigouvian taxes on cannabis, the availability of untaxed illicit cannabis with comparable costs and higher externalities renders taxation of legal cannabis suboptimal. Our results, derived from a relatively simple model, show that the welfare improving properties of a Pigouvian tax can be undermined by illicit market competition. Based on this simple analysis, we conclude that it is impossible for the pricing policies implemented in multiple jurisdictions (including California and Canada) to achieve the optimal, welfare maximizing outcome.
Personal Belief Exemptions for School-entry Vaccinations, Vaccination Rates, and Academic Achievement
Nicole Hair, Anja Gruber & Carly Urban
Journal of Health Economics, forthcoming
Abstract:
Nonmedical exemptions from school-entry vaccine mandates are receiving increased policy and public health scrutiny. This paper examines how expanding the availability of exemptions influences vaccination rates in early childhood and academic achievement in middle school. We leverage 2003 legislation that granted personal belief exemptions (PBE) in Texas and Arkansas, two states that previously allowed exemptions only for medical or religious regions. We find that PBE decreased vaccination coverage among Black and low-income preschoolers by 16.1% and 8.3%, respectively. Furthermore, we find that those cohorts affected by the policy change in early childhood performed less well on standardized tests of academic achievement in middle school. Estimated effects on test scores were largest for Black students and economically disadvantaged students.
The Political Context and Infant Health in the United States
Florencia Torche & Tamkinat Rauf
American Sociological Review, forthcoming
Abstract:
Most social determinants of health are shaped by political decisions. However, beyond specific policies, there is limited empirical investigation into the consequences of the changing political context on population health in the United States. We examine a salient political factor -- the party of the president and governor -- as a determinant of infant health between 1971 and 2018 using a battery of fixed-effects models. We focus on infant health because it has far-reaching implications for future population health and inequality. Our analysis yields three findings: (1) Democratic presidents have a beneficial effect on infant health outcomes, with stronger effects for Black infants compared to White infants. (2) The president’s party effect materializes after two years of a Democratic transition, and remains elevated until the end of the party’s tenure in office. (3) Specific measurable social policies appear to play a minor role in explaining the beneficial effect of Democratic administrations. Our findings suggest the party in power is an important determinant of infant health, particularly among vulnerable populations, and they invite a deeper examination of mechanisms.
The safest time to fly: Pandemic response in the era of Fox News
Maxim Ananyev, Michael Poyker & Yuan Tian
Journal of Population Economics, July 2021, Pages 775-802
Abstract:
We document a causal effect of the conservative Fox News Channel in the USA on physical distancing during COVID-19 pandemic. We measure county-level mobility covering all US states and District of Columbia produced by GPS pings to 15-17 million smartphones and zip-code-level mobility using Facebook location data. Using the historical position of Fox News Channel in the cable lineup as the source of exogenous variation, we show that increased exposure to Fox News led to a smaller reduction in distance traveled and a smaller increase in the probability of staying home after the national emergency declaration in the USA. Our results show that slanted media can have a harmful effect on containment efforts during a pandemic by affecting people’s behavior.
Excess mortality in the United States in the 21st century
Samuel Preston & Yana Vierboom
Proceedings of the National Academy of Sciences, 20 April 2021
Abstract:
We use three indexes to identify how age-specific mortality rates in the United States compare to those in a composite of five large European countries since 2000. First, we examine the ratio of age-specific death rates in the United States to those in Europe. These show a sharp deterioration in the US position since 2000. Applying European age-specific death rates in 2017 to the US population, we then show that adverse mortality conditions in the United States resulted in 400,700 excess deaths that year. Finally, we show that these excess deaths entailed a loss of 13.0 My of life. In 2017, excess deaths and years of life lost in the United States represent a larger annual loss of life than that associated with the COVID-19 epidemic in 2020.
Did Playground Renovations Equitably Benefit Neighborhoods in Chicago?
Shannon Zenk et al.
Journal of Urban Health, April 2021, Pages 248-258
Abstract:
Between 2013 and 2016, the Chicago Park District renovated 327 playgrounds in need of repair across Chicago through a $44 million investment. This study evaluated whether short-term and longer-term impacts of renovations on park use and park-based moderate-to-vigorous physical activity (MVPA) differed by neighborhood income level and neighborhood concentration of Black residents. A total of 39 parks with renovated playgrounds and 39 matched comparison parks with playgrounds that needed repair but not selected for renovation in year 1 were studied. Three waves of observational data were collected at each park: baseline, 12 months post-renovation, and 24 months post-renovation. Difference-in-differences mixed-effects Poisson regression models estimated renovation effects. The effects of renovations differed by the income level and concentration of Black residents in the neighborhoods where parks were located. In low-income neighborhoods, renovations were associated with reductions in park use and park-based MVPA over the longer term. In contrast, renovations were associated with short- and longer-term increases in park use and park-based MVPA in medium-income neighborhoods and with longer-term increases in MVPA in high-income neighborhoods. Renovations were generally not associated with any changes in park use or park-based MVPA in high-percent Black neighborhoods, but they were associated with increased park use and park-based MVPA in low-percent Black neighborhoods. This study suggests playground renovations in Chicago may have had unintended consequences, increasing neighborhood income and racial disparities in park use and park-based MVPA. Future playground renovation efforts may need to allocate more resources for renovating the broader park where in disrepair, more intensely involve neighborhood residents, and employ complementary strategies such as additional park programming to ensure renovations benefit all neighborhoods.
Marijuana legalization and household spending on food and alcohol
Thanh Lu
Health Economics, forthcoming
Abstract:
Utilizing the Consumer Expenditure Interview Survey from 2005 to 2019, I study spending on food and alcohol following recreational marijuana law (RML). Exploiting differences in the timing of the passage of RMLs and employing two‐way fixed‐effects methods, I find that households located in states adopting these laws increase their quarterly spending on food, which is driven mainly by spending on food consumed away from home. Legalization of recreational marijuana also leads to increased quarterly spending on alcohol. These findings suggest a complementarity between food, alcohol, and marijuana.
Do Consumers Order More Calories in a Meal with a Diet or Regular Soft Drink? An Empirical Investigation Using Large-Scale Field Data
Sina Ghotbi, Tirtha Dhar & Charles Weinberg
Journal of Public Policy & Marketing, forthcoming
Abstract:
Diet carbonated soft drinks were introduced to help consumers lower caloric intake. However, critics suggest that these drinks can provide an excuse to consume more calories, a so-called “Big Mac and Diet Coke” mentality that is consistent with behavioral theories such as moral licensing (e.g., combining a healthy eating choice with an indulgent, less healthy one). Using individual-level food and drink consumer panel data from a major fast-food restaurant chain, we empirically examine meals with a regular carbonated soft drink (CSD) versus a diet CSD. Results after controlling for drink size and demographics show that consumers generally do not order higher total calories from a meal with a diet CSD; rather, we find significant reductions in calorie count, suggesting that within a single meal, diet CSDs can help consumers unwilling to stop drinking CSDs to reduce calories. So, despite popular beliefs to the contrary, policy makers can consider diet-CSD availability as a “calorie-reduction” strategy to lower calorie consumption within a meal.
The Impact of Connecticut's Paid Sick Leave Law on the Use of Preventive Services
Chanup Jeung, Kyung Min Lee & Gilbert Gimm
American Journal of Preventive Medicine, forthcoming
Methods: Data were obtained from the 2007-2018 Behavioral Risk Factor Surveillance System. The analyses were conducted from spring 2018 to fall 2019. This study applied a difference-in-differences model to examine preventive service use (routine checkups, influenza vaccinations, dental visits, Pap tests, mammograms, and clinical breast examinations) in Connecticut and other New England states before and after the implementation of Connecticut's paid sick leave law in 2012.
Results: The use of preventive services increased in Connecticut compared with other New England states after implementation of Connecticut's paid sick leave law. Specifically, the rate of routine checkups (2.7 percentage points, p<0.001), influenza vaccinations (2.1 percentage points, p<0.01), dental visits (2.3 percentage points, p<0.01), and Pap tests (2.6 percentage points, p<0.01) increased compared with other New England states.