Drake Bennett at the Boston Globe wrote an overview published yesterday about recent research on the beneficial impacts of recessions for population health.
Although individuals who actually lose their jobs in a recession are probably unambiguously hurt, everyone else probably works less hard. They may also behave healthier, perhaps by smoking and drinking less. Chris Ruhm at UNC Greensboro has spearheaded recent work in this area.
How else might recessions be good? Do folks spend more time with their families?
Monday, March 24, 2008
Rising inequality in health
The NY Times reported this Sunday on trends in health inequalities as revealed by county-level mortality data. The universal pattern that seems to emerge from several different recent papers is that inequalities in life expectancy have risen since 1980.
Nancy Krieger and colleagues say this is new since 1980 and may reflect the redirection of policy under Reagan. Part of the problem concerns interpreting measures of mortality. Proportional differences in mortality rates roughly translate into additive differences in life expectancy, which we tend to perceive as static health inequality. Under this definition, Krieger et al. reveal no change in inequality prior to 1980.
Nancy Krieger and colleagues say this is new since 1980 and may reflect the redirection of policy under Reagan. Part of the problem concerns interpreting measures of mortality. Proportional differences in mortality rates roughly translate into additive differences in life expectancy, which we tend to perceive as static health inequality. Under this definition, Krieger et al. reveal no change in inequality prior to 1980.
Friday, March 21, 2008
Krugman on banking panics
Paul Krugman is a fabulous macroeconomist and a halfway decent political columnist, and it really shows in his columns in the New York Times. Today he writes about the credit crunch currently underway, and his perspectives are spot-on.
The challenge facing policymakers and markets is to design a regulatory framework that encourages innovation and risk-taking while ensuring transparency. In the case of subprime mortgages, it seems pretty clear that regulators did not do a very good job of the latter. A speech by the Fed's Ed Gramlich in 2004 discusses some of the issues the Fed was grappling with prior to the meltdown.
The challenge facing policymakers and markets is to design a regulatory framework that encourages innovation and risk-taking while ensuring transparency. In the case of subprime mortgages, it seems pretty clear that regulators did not do a very good job of the latter. A speech by the Fed's Ed Gramlich in 2004 discusses some of the issues the Fed was grappling with prior to the meltdown.
Tuesday, March 11, 2008
China's One Child Policy Sticks --- for now
According to the New York Times, China's One Child Policy will remain in place for another decade or so. The population minister, Zhang Weiqin, was quoted as warning a change in the policy "would cause serious problems and add extra pressure on social and economic development.”
As the largest country population-wise, and as a developing country China obviously has some special circumstances. But a universal challenge facing human societies is a declining worker/retiree ratio, which is the natural result of population aging. Under a one-child policy, that pressure is only increased.
To be sure, rapid growth in per capita incomes works to offset that pressure to some degree. Annual growth in income per person in China has averaged about 7 percent, resulting in a doubling every 10 years or a quadrupling or more each generation.
As the largest country population-wise, and as a developing country China obviously has some special circumstances. But a universal challenge facing human societies is a declining worker/retiree ratio, which is the natural result of population aging. Under a one-child policy, that pressure is only increased.
To be sure, rapid growth in per capita incomes works to offset that pressure to some degree. Annual growth in income per person in China has averaged about 7 percent, resulting in a doubling every 10 years or a quadrupling or more each generation.
Sunday, March 9, 2008
Forecasts suggest slackening in college demand
A NY Times article reveals forecasts of a reduction in the number of public high school graduates beginning around 2009.
This appears to be solely the result of the underlying population projections, which reveal a reduction in the absolute number of 18 year-olds, for example, after 2008.
This appears to be solely the result of the underlying population projections, which reveal a reduction in the absolute number of 18 year-olds, for example, after 2008.
Friday, February 22, 2008
Equity in health care: how far?
Yesterday's NY Times published an article about access to cancer-treating drugs in Britain's National Health Service (NHS) that really lays bare the challenges faced by public health insurance systems. The article tells of Brits with cancer who are denied access to certain pharmaceutical treatments by the NHS because they are too expensive.
But it doesn't stop there. The NHS funds a set level of care for all Brits, although effective standards can vary by region based on waiting times, etc. The article described how the NHS threatened to withhold payment for any other treatment if the patient purchased the drug of her choice on the open market.
Why? The argument is that the NHS functions by providing equal care to all, period. Apparently that means choosing a particular cost structure for the average Brit and sticking with it --- even though benefits and the valuation of those benefits could vary across individuals, as do income, wealth, and education. It is the latter point that presumably riles up the NHS; folks with more money or knowledge may demand more health care.
But it doesn't stop there. The NHS funds a set level of care for all Brits, although effective standards can vary by region based on waiting times, etc. The article described how the NHS threatened to withhold payment for any other treatment if the patient purchased the drug of her choice on the open market.
Why? The argument is that the NHS functions by providing equal care to all, period. Apparently that means choosing a particular cost structure for the average Brit and sticking with it --- even though benefits and the valuation of those benefits could vary across individuals, as do income, wealth, and education. It is the latter point that presumably riles up the NHS; folks with more money or knowledge may demand more health care.
Tuesday, February 19, 2008
Trends in suicide?
U.S. vital statistics have measured suicide and all the other causes of death for quite some time. But physicians are always becoming better at categorizing causes of death, so the classification system is updated every decade or so.
As reported by the Times, data collected using the current ICD-10 system reveal an increase in suicide rates for most age groups under 65 between 1999, the first year of ICD-10 collection, and 2004. Rates among adults 45-54 rose by 20%, from 0.000139 to 0.000166.
Temporal fluctuations in mortality are certainly interesting; there is evidence that many causes of death are more prevalent during economic expansions, for example. Suicide, on the other hand, typically falls during expansions and rises during recessions. This is discussed in a 2005 article by Jose Tapia. Seen in this light, a rise in suicide between 1999 and 2004, two years of relative prosperity, is a little odd.
One wonders whether physicians need time to learn a new cause-of-death coding system.
As reported by the Times, data collected using the current ICD-10 system reveal an increase in suicide rates for most age groups under 65 between 1999, the first year of ICD-10 collection, and 2004. Rates among adults 45-54 rose by 20%, from 0.000139 to 0.000166.
Temporal fluctuations in mortality are certainly interesting; there is evidence that many causes of death are more prevalent during economic expansions, for example. Suicide, on the other hand, typically falls during expansions and rises during recessions. This is discussed in a 2005 article by Jose Tapia. Seen in this light, a rise in suicide between 1999 and 2004, two years of relative prosperity, is a little odd.
One wonders whether physicians need time to learn a new cause-of-death coding system.
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