Month: October 2021

Understanding the Rise in Life Expectancy Inequality

By Gordon B. Dahl

We provide a novel decomposition of changing gaps in life expectancy between rich and poor into differential changes in age-specific mortality rates and differences in “survivability”. Declining age-specific mortality rates increases life expectancy, but the gain is small if the likelihood of living to this age is small (ex ante survivability) or if the expected remaining lifetime is short (ex post survivability). Lower survivability of the poor explains between one-third and one-half of the recent rise in life expectancy inequality in the US and the entire change in Denmark. Our analysis shows that the recent widening of mortality rates between rich and poor due to lifestyle-related diseases does not explain much of the rise in life expectancy inequality. Rather, the dramatic 50% reduction in cardiovascular deaths, which benefited both rich and poor, made initial differences in lifestyle-related mortality more consequential via survivability.

Via the excellent Kevin Lewis.  And RAD from the comments: “Greater survivability of cardio vascular events allows lifestyle choices to catch-up with people.”

Optimism about Mexico a story of compounding returns

Current per capital income measures at about 19k PPP.  Apply 2.2% growth for 30-35 years and Mexico then approaches the living standard of today’s UK or South Korea!  Since 1994, Mexico’s average growth rate has been 2.09%, including Covid times, so that is hardly outlandish as an assumption.

Here is my latest Bloomberg column on that topic.  Here is one excerpt:

In the meantime, there are reasons to be bullish on Mexico right now. One is that economic globalization has been somewhat halted, and in some areas even reversed. To the extent Americans do not trust Chinese supply chains, the Mexican economy will pick up some of the slack. Mexico is also the natural lower-wage supplier to North American industry. (Its main problem in this regard is that its wages are no longer so low, but that too reflects its progress.)

And if tourism in Asia and Europe remains difficult or inconvenient, Americans will visit Mexico more and grow accustomed to holidaying in locales other than Cancun. Some of those habits are likely to stick.

I do also cover the ifs, and, or buts.  And:

Mexico, like much of Latin America, also has a burgeoning startup scene, especially in ecommerce and fintech. Mexico City might end up as the technology capital of [Spanish-speaking] Latin America. That would help with one of Mexico’s chronic economic problems, namely that small firms decide to stay small to escape regulations and taxes. Successful tech startups, in contrast, can scale more easily and face fewer regulations on average than manufacturing firms.


My Conversation with Stanley McChrystal

Here is the audio, video, and transcript.  Here is part of the CWT summary:

He joined Tyler to discuss whether we’ve gotten better or worse at analyzing risk, the dangerous urge among policymakers to oversimplify the past, why being a good military commander is about more than winning battlefield victories, why we’re underestimating the risk that China will invade Taiwan, how to maintain a long view of history, what set Henry Kissinger apart, the usefulness of war games, how well we understand China and Russia, why there haven’t been any major attacks on US soil since 9/11, the danger of a “soldier class” in America, his take on wokeness and the military, what’s needed to have women as truly senior commanders in the armed forces, why officers with bad experiences should still be considered for promotion, how to address extremists in the military, why he supports a draft, the most interesting class he took at West Point, how to care for disabled veterans, his advice to enlisted soldiers on writing a will, the most emotionally difficult part and greatest joys of his military career, the prospect of drone assassinations, what he eats for his only meal of the day, why he’s done writing books, and more.


COWEN: If we had to shrink one capacity of the military, say, by 50 percent, and double the capacity of another, what would you pick to shrink and what to expand?

MCCHRYSTAL: This is always the tough one. I tend to think that the maneuver warfare part that we have created for ground warfare in Europe or in the Mideast is probably somewhere where we have to accept some risk. We have to have fewer capabilities there. You could even argue maybe the number of aircraft carriers — big capital things.

I think where we can’t afford — and therefore, I would invest — is in really good people. Now, that seems like a simplistic answer, but we are going to need very crafty people at things like cyber warfare. We’re going to need very innovative people. We’re going to need people with cultural acuity, which means language skills, and that’s going to be more important. So if I was advocating, I’d be leaning toward resourcing harder in those areas.

COWEN: Now, of course, your father was a general. You come from a military family. Why is it that military recruitment, right now, is so well predicted by having had a parent in the armed forces? What’s driving that? And how can we take advantage of that to recruit additional people?

MCCHRYSTAL: Well, we’ve taken advantage of it to the point where it may be counterproductive now. When I would travel the battlefields and go to small bases, invariably, the sergeant or lieutenant in charge was the son or daughter of a friend of mine. In one way, it’s comforting because you know people have entered the service with open eyes and clear expectations, and they make good soldiers, but you don’t want a soldier class in America.

Definitely recommended, there is also a segment about disabled veterans and their rights.  And again here is Stan’s new book Risk: A User’s Guide, co-authored with Anna Butrico.

Wednesday assorted links

1. “It is said that bosses of the ‘Ndrangheta – godfathers and clan leaders – make their most important decisions in front of a plate of dormice…”

2. “A British bakery has been forced to pull its top-selling cookies from the market, after regulators informed the owner that the sprinkles are illegal. The U.S.-made sprinkles contain a coloring that’s legal for some uses — but not for sprinkling.”  Link here.

3. “We propose that people exhibit an insight bias, such that they undervalue persistence and overvalue insight in the creative process.

4. Vaccines in rural Kentucky.

5. No British newborn boys named “Nigel” in 2020.

6. Davis Kedrosky on the Great Coinage Debate.

Causal Inference at Twitter

Twitter engineering had a nice tweet thread on how they use econometrics and causal inference:

 You may have heard about this year’s Economics Nobel Prize winners – David Card, Josh Angrist (@metrics52) & Guido Imbens.

Their publicly available work has helped us solve tough problems @Twitter, and we’re excited to celebrate by sharing how their findings have inspired us. Understanding causal relationships is core to our work on identifying growth opportunities and measuring impact.

This year’s winners laid the foundation for cutting-edge techniques we use to understand where Twitter can improve and how changes affect our platform experience.
To share a few exciting causal inference applications at Twitter:

While online experimentation is helpful to understand the impact of a product change, it may not be the most efficient way to measure long-term impact. We built a causal estimation framework on the idea of statistical ‘surrogacy’ (Athey et al 2016) – when we can’t wait to observe long-run outcomes, we create a model based on intermediate data.

Estimating Treatment Effects using Multiple Surrogates: The Role of the Surrogate Score and the Surrogate Index

Estimating the long-term effects of treatments is of interest in many fields. A common challenge in estimating such treatment effects is that long-term outcomes are unobserved in the time frame needed. We combine this framework with our online experimentation platform to form a feedback/validation loop and to help accurately infer product success. One of the challenges we face is understanding the impact of different actions at Twitter (likes, Retweets etc.) Engagement actions often occur sequentially and at different surface areas. How to disentangle the effect of multiple actions presents many challenges.
We use Double Machine Learning to understand the causal impact of engagement actions.

Our work leverages research by Chernozhukov et al. (2018), and is influenced by Imbens & Rubin (2015).

Causal Inference for Statistics, Social, and Biomedical Sciences
This framework helps the team to interpret search experiments and make Twitter a better place to serve the public conversation. These applications promote a better understanding of tradeoffs among competing signals, helping our engineering team to iterate fast under more principled measurement and decision frameworks, making Twitter a better platform to create and share ideas and information.

We’re grateful for the role that academic research plays in driving innovation across society. We couldn’t do this work without the methodological foundation of the winners’ work and contributions across academia. Work like this inspires product innovation and engineering ideas alike, and we look forward to all that is yet to come.

More details on Twitter Data Science work will be introduced in our upcoming Engineering Blog posts.

Long soccer Covid

This paper estimates the workplace productivity effects of COVID-19 by studying performance of soccer players after an
infection. We construct a dataset that encompasses all traceable infections in the elite leagues of Germany and Italy. Relying on a staggered difference-in-differences design, we identify negative short- and longer-run performance effects. Relative to their preinfection outcomes, infected players’ performance temporarily drops by more than 6%.Over half a year later, it is still around 5% lower.

Here is the full paper, by Kai Fischer, J. James Reade, and W. Benedikt Schmal, via Florian Ederer.  How about chess?

Medicaid coverage doesn’t seem to help for diabetes and asthma

…we use Oregon’s 2008 Medicaid lottery to assess the management of diabetes and asthma, as well as several markers of physical health. This analysis complements several prior studies by introducing new data elements and by analyzing chronically ill subpopulations. While we had previously found that having insurance increases the diagnosis and use of medication for diabetes, we show here that it does not significantly increase the likelihood of diabetic patients receiving recommended care such as eye exams and regular blood sugar monitoring, nor does it improve the management of patients with asthma. We also find no effect on measures of physical health including pulse, obesity, or blood markers of chronic inflammation. Effects of Medicaid on health care utilization appear similar for those with and without pre-lottery diagnoses of chronic physical health conditions. Thus, while Medicaid is an important determinant of access to care overall, it does not appear that Medicaid alone has detectable effects on the management of several chronic physical health conditions, at least over the first two years in this setting. However, sample limitations highlight the value of additional research.

That is from a new NBER working paper by Heidi Allen and Katherine Baicker.  To be clear, my intuition here is to blame “medicine,” and also the patients, not Medicaid per se.

What is going on in this Malaysian-Chinese libertarian video of the year?

Blocked on Weibo, by the way.  One major figure in the video is the Malaysian-Chinese rapper Namewee, also Kimberly Chen.  I put up this post, among other reasons, to show just how much there is in the way of cultural codes to crack.  How much of it do you understand?  Do you get the references to this Thai-Chinese internet controversy?  What else?  Here is further excellent commentary from Sabina Knight.  #20 on the YouTube music charts.

Via Stu.

Tuesday assorted links

1. Ted Gioia 12 predictions for the future of music.

2. How and what should a ghost maximize?

3. Agarwal and Budish survey chapter on market design.

4. Can robotic textiles improve your breathing?

5. Colombia’s antimachismo hotline (NYT, a good thing to be clear!).  Encapsulates the broader trend.

6. Puerto Rico now the most vaccinated place in the United States.

7. Janos Kornai, RIP.

Make TeleMedicine Permanent

One of the silver linings of the pandemic was the ability to see a doctor and be prescribed medicine online. I used telemedicine multiple times during the pandemic and it was great–telemedicine saved me at least an hour each visit and I think my medical care was as good as if I had been in person. I already knew I had poison ivy! No need for the doctor to get it also.

Telemedicine has been possible for a long time. What allowed it to take off during the pandemic wasn’t new technology but deregulation. HIPAA rules, for example, were waived for good faith use of standard communication technologies such as Zoom and Facetime even though these would ordinarily have been prohibited.

The Federal Ryan Haight Act was lifted which let physicians prescribe controlled substances (narcotics, depressants, stimulants, hallucinogens, and anabolic steroids) in a telemedicine appointment–prior to COVID an in-person appointment was required.

Prior to COVID Medicaid and Medicare wouldn’t pay for many services delivered over the internet. But during the pandemic the list of telemedicine approved services was expanded. Tennessee, for example, allowed speech therapists to bill for an online session. Alaska allowed mental health and counseling services and West Virginia allowed psychological testing to be delivered via telemedicine. Wisconsin allowed durable medical equipment such as prosthetics and orthotics to be prescribed without a face-to-face meeting.

Another very important lifting of regulation was allowing cross-state licensing which let out-of-state physicians have appointments with in-state patients (so long, of course, as the physicians were licensed in their state of residence.)

The kicker is that almost all of these changes are temporary. Regulatory burdens that were lifted for COVID will all be reinstated once the Public Health Emergency (PHE) expires. The PHE has been repeatedly extended but that will only push off the crux of the issue which is whether many of the innovations that we were forced to adopt during the pandemic shouldn’t be made permanent.

Working from home has worked better and been much more popular than anyone anticipated. Not everyone who was forced to work at home because of COVID wants to continue to work at home but many businesses are finding that allowing some work from home as an option is a valuable benefit they can offer their workers without a loss in productivity.

In the same way, many telemedicine innovations pioneered during the pandemic should remain as options. No one doubts that some medical services are better performed in-person nor that requiring in-person visits limits some types of fraud and abuse. Nevertheless, the goal should be to ensure quality by regulating the provider of medical services not regulating how they perform their services. Communications technology is improving at a record pace. We have moved from telephones to Facetime and soon will have even more sophisticated virtual presence technology that can be integrated with next generation Apple watches and Fitbits that gather medical information. We want medical care to build on the progress in other industries and not be bound to 19th and 20th century technology.

The growth of telemedicine is one of the few benefits of the pandemic. As the pandemic ends, let’s make this silver lining permanent.

Worrying Sentence(s) of the Day

NYTimes: An examination of hundreds of health departments around the country shows that the nation may be less prepared for the next pandemic than it was for the current one.

…State and local public health departments across the country have endured not only the public’s fury, but widespread staff defections, burnout, firings, unpredictable funding and a significant erosion in their authority to impose the health orders that were critical to America’s early response to the pandemic.

People have had it. Let’s hope we aren’t tested again soon.

My podcast with philosopher Jimmy Alfonso Licon

Somewhat less than an hour, here is his summary of our chat:

Prof. Cowen and I had a wide ranging interview on topics ranging from whether economic growth is a moral imperative, UFOs are extraterrestrials, rent seeking is a drain on the economy, things like Plato, pumpkin spice, and the Founding Fathers are overrated, why we should (or shouldn’t) care about chess, and how to think about failure, among other topics.

I am pleased to have Jimmy visiting at George Mason this year.  Here is Jimmy’s home page and publications, note he is on the job market this year.

Average is over

Thirteen-year-olds saw unprecedented declines in both reading and math between 2012 and 2020, according to scores released this morning from the National Assessment of Educational Progress (NAEP). Consistent with several years of previous data, the results point to a clear and widening cleavage between America’s highest- and lowest-performing students and raise urgent questions about how to reverse prolonged academic stagnation.

The scores offer more discouraging evidence from NAEP, often referred to as “the Nation’s Report Card.” Various iterations of the exam, each tracking different subjects and age groups over several years, have now shown flat or falling numbers…

both reading and math results for nine-year-olds have made no headway; scores were flat for every ethnic and gender subgroup of younger children — with the exception of nine-year-old girls, who scored five points worse on math than they had in 2012. Their dip in performance produced a gender gap for the age group that did not exist on the test’s last iteration.

More ominous were the results for 13-year-olds, who experienced statistically significant drops of three and five points in reading and math, respectively. Compared with math performance in 2012, boys overall lost five points, and girls overall lost six points. Black students dropped eight points and Hispanic students four points; both decreases widened their score gap with white students, whose scores were statistically unchanged from 2012.

In keeping with previous NAEP releases, the scores also showed significant drops in performance among low-performing test-takers. Most disturbing: Declines among 13-year-olds scoring at the 10th percentile of reading mean that the group’s literacy performance is not significantly improved compared with 1971, when the test was first administered. In all other age/subject configurations, students placing at all levels of the achievement spectrum have gained ground over the last half-century.

Here is the full story, please note these are pre-Covid test scores, arguably now the problem could be worse.  Via Luke, a concerned human.

FDA relents on mix and match for third dose

Here is the NYT account, they sound both confused and confusing.  How about “if you have had J&J, it is fine and probably preferable to get a further dose of Moderna or Pfizer”?  Yet suddenly it is fine.

And it is the usual story — people have been doing this for months, and the FDA would not say it is terrible.  Because they knew it wasn’t.  But they wouldn’t say so.  And now the status quo has shifted, and so everyone will treat it as fine, as if the supposed fears of yesterday never ever existed.

Maybe I should insult people more often?

Some of them are frauds

The panel also seemed intrigued by preliminary data suggesting that Johnson & Johnson recipients may be better off with a booster shot from Moderna or Pfizer. Although no vote was taken, Dr. Peter Marks, who oversees the F.D.A.’s vaccine division, said regulatory action to allow boosters with a different vaccine was “possible.”

While some experts emphasized that the data was based on small groups of volunteers and short-term findings, others urged the F.D.A. to move quickly with what has fast become known as a mix-and-match approach, especially for recipients of Johnson & Johnson’s vaccine, which is much less widely available.

“I’m sold already,” said Dr. Mark Sawyer, an infectious disease specialist with the University of California San Diego School of Medicine. “We need flexibility and to improve access to everyone.”

Others said they worried that the public would end up bewildered if the government kept broadening the categories of people eligible for boosters and which vaccine could be used for extra shots.

“I hope we can do this in a way that doesn’t look like we’re changing rules all the time,” said Dr. Stanley Perlman, a professor of immunology at the University of Iowa.

Health officials and committee members suggested on Friday that the single-shot Johnson & Johnson vaccine had long been less protective. In a particularly biting critique, Dr. Amanda Cohn, a high-ranking C.D.C. medical officer, said a single dose of Johnson & Johnson’s vaccine offered less protection than two doses of the mRNA vaccines made by Pfizer or Moderna — a gap that would only grow if it remained a one-shot regimen while the other two-shot vaccines were followed by a booster…

The experts generally agreed that the protection conferred by a single dose was inadequate, but at least some were unconvinced that the second dose would bolster that protection significantly.

The smart people I know who started with J&J took this matter into their own hands some time ago, typically opting for an mRNA supplement.  They are just “people,” yet they had “skin in the game” and they are miles ahead of the FDA and CDC as formal institutions.  Here is a research paper on the question.  Here is another.  And here is a Paul Sax tweet and Op-Ed: “Don’t know anyone who disagrees with this, and the data have been highly suggestive for months.”  And this is after the authorities insisted for months that all vaccines will be treated the same.

Again, I will repeat the perennial question: do our public health agencies wish to maximize their own status and control and feeling of “having done everything properly as they were trained,” or do they wish to maximize the expected value of actual outcomes for the citizenry?  If it is not the latter, and too often it is not, I say they are oppressive frauds.  (And please don’t try to tell me this kind of craperoo is boosting their credibility — in fact they have lost massive credibility with America’s public intellectual class, both left wing and right wing and for that matter centrist.)

I really do not have much sympathy for Kyrie Irving and Bradley Beal and their ilk, but in fact their views are more understandable than you might think from reading MSM.  Their generalized mistrust is not so crazy, even though they are quite wrong in this particular instance.  By the way, don’t take those aspirin any more!

Here is the full NYT article, cringeworthy throughout, and I thank Jordan for the pointer.