Category: Medicine
Collective Action Kills Innovation
Oregon has just passed a law that gives gas stations in rural counties the option of allowing self-pumping (in some rural counties this is allowed only between 6 p.m. and 6 a.m.!) As you have probably heard, this incomplete lifting of an absurd restriction has some Oregonians upset and afraid.
“I don’t even know HOW to pump gas and I am 62, native Oregonian . . . I say NO THANKS! I don’t like to smell like gasoline!” one woman wrote.
“No! Disabled, seniors, people with young children in the car need help. Not to mention getting out of your car with transients around and not feeling safe. This is a very bad idea. Grrr,” another woman wrote.
“I’ve lived in this state all my life and I REFUSE to pump my own gas . . . This [is] a service only qualified people should perform. I will literally park at the pump and wait until someone pumps my gas.”
Most of the rest of the America–where people pump their own gas everyday without a second thought–is having a good laugh at Oregon’s expense. But I am not here to laugh because in every state but one where you can pump your own gas you can’t open a barbershop without a license. A license to cut hair! Ridiculous. I hope people in Alabama are laughing at the rest of America. Or how about a license to be a manicurist? Go ahead Connecticut, laugh at the other states while you get your nails done. Buy contact lens without a prescription? You have the right to smirk British Columbia!
All of the Oregonian complaints about non-professionals pumping gas–“only qualified people should perform this service”, “it’s dangerous” and “what about the jobs”–are familiar from every other state, only applied to different services.
Once we got familiar with self-pumping it didn’t seem like a problem, but it’s surprising we ever got self-pumping as it would have been easy to scare people into voting no. After all, the case for trained gas pumpers is far stronger than for licensed barbers. Perhaps we were less risk averse and complacent in the past. I don’t think we could build the Hoover Dam today either.
It’s easier to scare than to inform and we fear losses more than we desire gains so collective decision-making defaults toward stasis.
We have innovations like Uber and Airbnb and many others only because entrepreneurs didn’t have to ask for permission. Had we put these ideas to the vote they would have been defeated. Allow almost anyone with a car to drive customers around town? Stranger danger! Let any house be turned into a hotel? Not in my neighborhood! Once the innovations were brought into existence, the masses saw the benefits but they would not have seen those benefits if the idea had been put to a vote. Demonstration is more powerful than imagination.
More and more, however, the sphere of individual action shrinks and that of collective action grows. Thus, I do not laugh at the Oregonians and their fear of gas pumping freedom. We are all Oregonians in one form or another.
*The Elephant in the Brain: Hidden Motives in Everyday Life*
The authors are Kevin Simler and Robin Hanson, and now it is out!
Robin reports:
On press coverage, back in July Publishers Weekly had a paragraph on it, the Boston Globe did an interview of me back then that they just released, Vice interviewed me recently so I expect that out soon, and I’m told that a Wall Street Journal review is forthcoming. Amazon now has 5 reviews, Goodreads has 7, and 2 reviews have appeared on blogs.
I am pleased to be doing a Conversation with Robin about the book, and other matters too. But don’t forget — conversations aren’t about talking!
Canada facts of the day
The estimate comes from Canada’s bureau of statistics, which studied marijuana consumption between 1960 and 2015.
The government has promised to research the drug’s affect on the economy and society as it ramps up its plans to legalise cannabis next summer.
The report also found that use has gone up over the years as it has become more popular with adults.
In the 1960s and 1970s cannabis was primarily consumed by young people, according to Statistics Canada.
But in 2015, only 6% of 15-17 year olds smoked cannabis recreationally, compared to two thirds of adults over 25.
Here is the story, via Mark Thorson.
Uber as an ambulance substitute
Using an ambulance to travel to the hospital in an emergency can cost upwards of $1,000 USD. Now research demonstrates that a significant number of people are instead choosing Uber to perform the same service.
The paper – currently being peer reviewed – examines the effect on ambulance usage as Uber was introduced to 766 cities across 43 states. According its findings, even the most conservative estimate shows a seven percent reduction in people traveling via ambulance where the service is available.
Here is the full story, via Jeffrey Deutsch. File under “Even with surge pricing, bending the cost curve.”
Were U.S. nuclear tests more harmful than we had thought?
So says Keith A. Meyers, job candidate from University of Arizona. I found this to be a startling result, taken from his secondary paper:
During the Cold War the United States detonated hundreds of atomic weapons at the Nevada Test Site. Many of these nuclear tests were conducted above ground and released tremendous amounts of radioactive pollution into the environment. This paper combines a novel dataset measuring annual county level fallout patterns for the continental U.S. with vital statistics records. I find that fallout from nuclear testing led to persistent and substantial increases in overall mortality for large portions of the country. The cumulative number of excess deaths attributable to these tests is comparable to the bombings of Hiroshima and Nagasaki.
Basically he combines mortality estimates with measures of Iodine-131 concentrations in locally produced milk, “to provide a more precise estimate of human exposure to fallout than previous studies.” The most significant effects are in the Great Plains and Central Northwest of America, and “Back-of-the-envelope estimates suggest that fallout from nuclear testing contributed between 340,000 to 460,000 excess deaths from 1951 to 1973.”
His primary job market paper is on damage to agriculture from nuclear testing.
Political Incorrect Paper of the Day: Food Deserts
Here is the abstract to The Geography of Poverty and Nutrition: Food Deserts and Food Choices Across the United States (free version) by Allcott, Diamond, and Dubé:
We study the causes of “nutritional inequality”: why the wealthy tend to eat more healthfully than the poor in the U.S. Using two event study designs exploiting entry of new supermarkets and households’ moves to healthier neighborhoods, we reject that neighborhood environments have economically meaningful effects on healthy eating. Using a structural demand model, we find that exposing low-income households to the same food availability and prices experienced by high-income households would reduce nutritional inequality by only 9%, while the remaining 91% is driven by differences in demand. In turn, these income-related demand differences are partially explained by education, nutrition knowledge, and regional preferences. These findings contrast with discussions of nutritional inequality that emphasize supply-side issues such as food deserts.
This is a good paper with a credible research design and impressive data from some 35,000 supermarkets covering 40% of the United States. Moreover, because of the widespread attention given to “food deserts” this paper probably had to be written. But color me un-surprised. The results are obvious.
Indeed, I feel that in recent years I am reading a lot of papers that aim massive firepower on weak hypotheses. As an explanation for obesity and poor eating habits, the idea of “food deserts” was absurd. The reasons are manifold. Even in food deserts it’s actually not that difficult to get healthy food and, contrary to popular belief, healthy food is not especially expensive. Try an Asian supermarket for plenty of cheap produce. Indeed, in any part of the United States you can find plenty of poor-people eating healthy foods and plenty of rich people eating unhealthy foods.
The food deserts idea was especially implausible for America because Americans spend less of their income on food consumed at home (6%) than any other nation. The Dutch, for example, spend (12%) of their income on food, the Italians and Japanese (14%), the Vietnamese (35%). There is plenty of room in the American food budget for healthy eating. Finally, Allcott, Diamond, and Dubé show that relative to unhealthy food, healthy food is actually a bit cheaper in low-income areas.
More importantly, just open your eyes. Walk into a fast food joint in a food desert and ask yourself, do the customers really want brussel sprouts but are reluctantly settling for Chips Ahoy? The idea is ridiculous and not a bit insulting in denying agency to the people who live in low-income areas. If what people living in food deserts wanted was brussel sprouts, they would get them.
The Whole Foods class think their kale and kombucha are so obviously superior to what the poor eat that the only possible explanation for poor eating is that poor people are denied choice. Yet put an inexpensive but colorful produce stand next to a McDonald’s and you can be sure that the customers will differ by class. Why the poor choose to eat differently than the rich is an interesting and important question but one more amenable to answers focusing on culture, education and history than price and income. The idea applies widely.
Why Sex? And why only in Pairs?
Understanding the purpose of sex is a fundamental unresolved problem in evolutionary biology. The difficulty is not that there are too few theories of sex, the difficulty is that there are too many and none stand out. To distinguish between theories, we ask: Why are there no triparental species with offspring composed of the genetic material of three individuals? A successful theory should confer an advantage to biparental sex over asexual reproduction without conferring an even greater advantage to triparental sex. Of two leading theories (red queen and mutational), we show that only one is successful in this sense.
That is a new Economic Journal paper by Motty Perry, Philip J. Reny, and Arthur J. Robson. Of course the core question is a classic example of thinking at the margin. The core conclusion is that mutations continue to rise with the number of sex-participating partners, but in simple Red Queen models the limiting features of the genotypes is the same whether there are two, three, or more partners. The argument on pp.2739-2741 is not readily blog-summarizable, and I do not grasp it fully, but at the moment I have the following intuition. If a parasite attack comes, the species needs only move away from the targeted genome to continue reproducing, due to some all-or-nothing assumptions about the nature of the attack. This differs from the mutational game, where there is always some marginal (expected value) gain from moving yet further away from the initial nature of the species. Playing a game against an identified opponent brings a better-specified and more stable and less varying response strategy than playing a game against an as-yet-unidentified opponent. That isn’t how the authors put things, but…
Since we don’t observe much three-party reproduction (hardly any in fact), that suggests the Red Queen model is more likely to apply.
For the pointer I thank TEKL.
A simple theory of gene-culture coevolution, with reference to immigration
Are there genetic vulnerabilities for depression across cultures?
Genetic vulnerability differs substantially from country to country. East Asian contexts, for example, show a high prevalence of genes associated with depression. Yet, despite these vulnerabilities, they develop fewer cases of the disorder. One hypothesis is that genetic vulnerabilities have co-evolved with culture, creating extra protective factors (in this case, extra interdependence). However, when these people leave their cultural contexts, they have a higher risk of developing depression.
That is an interview with Yulia Chentsova-Dutton, associate professor of psychology at Georgetown, and a researcher in this area. You can imagine further applications of this mechanism. The interview has other interesting points, for instance:
What is the role of emotion regulation?
Emotion regulation is increasingly becoming understood as a core factor in all affective disorders. In western societies, we don’t see enough adaptive strategies like reappraisal: learning to tell yourself a different story that would eventually lead to different emotions. There is also not enough social regulation of emotion, which occurs by sharing our emotions with others. Research shows that cultures can facilitate functional regulation strategies. For example, Igor Grossmann’s work shows that Russians make rumination (generally considered a dysfunctional strategy) more functional by encouraging people to ruminate about the self from another person’s perspective, making rumination almost reappraisal-like in its quality.
Do read the whole thing.
New Zealand to Compensate Organ Donors for Lost Earnings
NZ Ministry of Health: People who donate a kidney or part of their liver can now do so knowing they can be fully compensated for lost earnings as a result of their donation surgery.
The Ministry of Health will be implementing compensation for live organ donors from 5 December. People who donate a live organ will be fully recompensed for lost earnings for up to 12 weeks while they recover. This will be paid weekly following the donation surgery. In the past donors received some assistance in the form of a benefit for this.
Former GMU student, Eric Crampton, now Senior Fellow at University of Canterbury had a role in the design.
Hat tip: Frank McCormick.
The Power of Abortion Policy
That is by by Caitlin Knowles Myers, and the full title is “The Power of Abortion Policy: Reexamining the Effects of Young Women’s Access to Reproductive Control.” It is published in the most recent JPE, here is the abstract:
I provide new evidence on the relative “powers” of contraception and abortion policy in effecting the dramatic social transformations of the 1960s and 1970s. Trends in sexual behavior suggest that young women’s increased access to the birth control pill fueled the sexual revolution, but neither these trends nor difference-in-difference estimates support the view that this also led to substantial changes in family formation. Rather, the estimates robustly suggest that it was liberalized access to abortion that allowed large numbers of women to delay marriage and motherhood.
In other words, the pill was less influential than you might think. And from the paper proper:
…policy environments in which abortion has legal and readily accessible by young women are estimated to have caused a 34 percent reduction in first births, a 19 percent reduction in first marriages, and a 63 percent reduction in “shotgun marriages” prior to age 19.
And:
Between the 1950 and 1955 birth cohorts, the fraction of women having sex prior to age 18 increased from 34 to 47 percent.
And:
…cohorts that experienced the most rapid changes in sexual behavior exhibited little change in fertility.
And:
Lahey (2014)…finds that the introduction of abortion restrictions in the nineteenth century increased birthrates by 4-12 percent…
I thought this was one of the most interesting papers I have read all year. Here is an earlier, ungated copy.
The Good Wife
Steffanie Strathdee, [is] the associate dean of global health science at the University of California, San Diego. In 2016, she helped revive her husband from a coma with a combination of phage therapy and antibiotics after he’d come back from Egypt with an untreatable bacterial infection, and she’s since become a kind of phage activist, helping others, like the Smiths, coordinate their own phage hunts.
That’s just a sidenote in an article on phages, viruses that kill bacteria. Seems like there’s a movie there.
Phages were long used in the Soviet Union to treat bacterial infections but are only now being studied in the West as bacteria evolve resistance to antibiotics.
Addendum: Dallas Weaver makes excellent points in the comments.
The North Korean defector
Lee said he had never seen such an extreme case of parasitic infection. The soldier had worms not seen in South Korea since the 1970s, but they appeared to be somewhat common north of the border. In a 2014 study, South Korean doctors sampled 17 females who escaped North Korea and found that seven of them were infected with parasitic worms, according to the BBC. They also had higher rates of diseases such as hepatitis B and tuberculosis.
What was just as curious were the raw corn kernels found in Oh’s [the defector’s] stomach, which shocked many South Koreas. North Korean soldiers typically have a higher ranking on the food-rationing list, so it was alarming that the soldier had been eating uncooked corn.
Some reports claim that North Korean soldiers have been ordered to steal corn from farmers to fend off hunger.
Here is further information.
American health equality is rising
Recent research shows increasing inequality in mortality among middle-aged and older adults. But this is only part of the story. Inequality in mortality among young people has fallen dramatically in the United States converging to almost Canadian rates. Increases in public health insurance for U.S. children, beginning in the late 1980s, are likely to have contributed.
Here is the full article, by Janet M. Currie, via the excellent Kevin Lewis.
Understanding differences in life expectancy inequality
The life expectancy gap at age 40 between high income and low income individuals is substantial. I explore how medical expenditures and unhealthy behaviors account for the life expectancy gap. The data reveals the following. First, low income individuals tend to spend more on healthcare than high income individuals at all ages. Moreover, health disparities by income is salient due to differences in unhealthy behaviors such as heavy smoking. To answer how much dierences in access to medical services and unhealthy behaviors can explain in light of these stylized facts, I construct a life cycle model. The distinctive features of the model are that it flexibly incorporates unobserved, potentially correlated initial human and health capital stocks and embed unhealthy behaviors. Furthermore, the model includes two health systems: private health insurance and Medicare. The main findings are i) differences in access to medical care driven by income inequality potentially accounts for 12.5% of the life expectancy gap, ii) health insurance increases longevity for low income individuals, but modestly, iii) the health condition when young shapes the trend in average medical expenditures by income groups and iv) the impact of differences in unhealthy behaviors is predominant in understanding the life expectancy gap.
That is from Tomoaki Kotera, a job candidate from the University of Wisconsin, here is the paper itself.
There is no great lung stagnation
In 2013, the Post-Polio Health International (PPHI) organizations estimated that there were six to eight iron lung users in the United States. Now, PPHI executive director Brian Tiburzi says he doesn’t know anyone alive still using the negative-pressure ventilators. This fall, I met three polio survivors who depend on iron lungs. They are among the last few, possibly the last three.”
…In the 1940s and 1950s, hospitals across the country were filled with rows of iron lungs that kept victims alive. Lillard recalls being in rooms packed with metal tubes—especially when there were storms and all the men, women, adults, and children would be moved to the same room so nurses could manually operate the iron lungs if the power went out. “The period of time that it took the nurse to get out of the chair, it seemed like forever because you weren’t breathing,” Lillard said. “You just laid there and you could feel your heart beating and it was just terrifying. The only noise that you can make when you can’t breathe is clicking your tongue. And that whole dark room just sounded like a big room full of chickens just cluck-cluck-clucking. All the nurses were saying, ‘Just a second, you’ll be breathing in just a second.’”
…Mia Farrow only had to spend eight months in an iron lung when she was nine, before going on to become a famous actress and polio advocate.
Here is the full story, via the excellent Samir Varma.