Commentary
Health policy
U.S. mortality, geography, and the anti-social determinants of health
Preventive Medicine
89: 324-326, August 2016.
Drug-related overdoses appear to be a major factor behind an historic
pause or even a reversal in the predominant downward trend over time
in U.S. mortality rates, a departure that is especially evident among
non-Hispanic white females of middle age. The new geography of
accidental poisoning deaths and their covariates suggests that we
should reassess traditional policies and perspectives in order to
combat this threat to public health.
The good, the bad, and the ugly of alcohol
consumption and taxes
Preventive Medicine
55(3): 244-245, September 2012.
The new contribution in these pages by Lhachimi et al. (2012) tallies
up the net effects on mortality from internal and external causes that
are likely to derive from changes in alcohol taxes in 11 countries
within the European Union. Health economists prefer the efficiency of
taxes to quotas or outright prohibition, but there are costs as well
as benefits associated with any tax, because it drives a wedge between
demanders and suppliers and thus reduces welfare. To guide public
policy in this area, researchers should measure costs and benefits
broadly defined, and Lhachimi et al. provide a useful first step.
Sugar-sweetened beverage taxes raise demand for substitutes and could
even raise caloric intake
Preventive Medicine
54(3-4): 284-285, March-April 2012.
If the goal is to reduce obesity, taxes on sugar-sweetened beverages
(SSBs) may not work because consumers can and do shift demand to
cheaper calories. Adam Smith identified sugar, alcohol, and tobacco as
appropriate commodities for taxation because they were luxury goods in
his day. He would never have supported differential rates of taxation
across close substitutes, as implied by a tax on SSBs rather than on
calories.
Soda taxes, obesity, and the
shifty behavior of consumers
Preventive Medicine
52(6): 417-418, June 2011.
Rising obesity is a threat to public health, and taxing
sugar-sweetened beverages (SSBs) in order to reduce consumption and
thus caloric intake could be a viable policy response. But raising the
price of SSB calories will raise the quantity demanded of relatively
cheaper calories, and net effect on obesity is unclear. I review the
evidence on shifting calorie demand and discuss the viability of soda
taxes to achieve improvements in public health.
Veterans
Health, Aging, and the Post-Service Life Cycles of U.S. Veterans
with Alair MacLean
in Jomana Amara and Ann Hendricks, eds., Military Medical Care: From
Pre-Deployment to Post-Separation, Abingdon: Routledge, 2013.
For the majority of U.S. veterans, the period of military service is a
relatively brief but potentially important segment of the life
course. Service can entail shocks to mental and physical health
through exposure to combat and other risks, inspire healthy or
unhealthy behaviors in response to stress, affect future earnings and
wealth, subsidize and increase educational attainment, and it can
affect family formation and quality. Many of these influences have
lasting effects on health and well-being throughout the life
cycle. But isolating the effects of military service per se on
post-service health and other outcomes is a challenging task, one that
is complicated by selection governing the composition of the current
all-volunteer force. In this review, we summarize and discuss the
existing evidence regarding the health of aging cohorts of veterans
over their life cycles and the relationship between military service
and later-life health and well-being. We identify the open questions
in this subfield of life-course research and suggest avenues for
future inquiry.
Still in the Nation's Service: What Military Retirees' Educational
Histories Reveal About Health
AMRA News
36(4): 22-23, Fall 2010.
What makes us healthy? Good genes, good living, or just good luck?
Doctors and health researchers have a variety of answers to this
question, but specific medical advice can vary significantly across
decades, and even year-to-year. While not an excuse to ignore your
doctor, the ephemeral nature of dietary and behavioral advice raises
the obvious question of which determinants of good health are more
stable over time, are more fundamental, and arguably most important,
which are subject to intervention. It turns out that the life
histories of U.S. military retirees offer new and important insights
into these research and policy questions.
Macroeconomics
Population aging, the dependency burden, and challenges facing
preventive medicine
Preventive Medicine
55(6): 533-534, December 2012.
Population aging will significantly raise the burdens on individuals
at working ages of caring for retirees in advanced economies because
of the modern system of age-related government transfers. Ensuring
that future generations of workers remain healthy and productive will
be an increasingly salient goal of preventive medicine.
Post-9/11 War Spending, Debt, and the Macroeconomy
paper prepared for the Costs of
War Project, Eisenhower Research Project, Watson Institute
for International Studies, Brown University,
June 2011.
Military activities in Iraq and Afghanistan have entered their ninth
and tenth years respectively and have produced $1.1 trillion in direct
costs through 2010. The federal budget has been in deficit since 2001,
and by the end of 2010, debt held by the public had risen by more than
$5.7 trillion, to a level exceeding 60% of GDP. A large part of this
rapid increase was due to the recession of 2008 and the unprecedented
fiscal policy response to the financial crisis. But the consequences
of deficit spending to finance war activities have been
considerable. Thus far, post-9/11 war spending has increased
indebtedness by $1.3 trillion or around $4,000 per person, raised the
ratio of public debt to GDP by 9-10 percentage points, roughly a third
of the total increase since 2001, and probably raised long-term
interest rates by 30-35 basis points. It also has likely boosted
annual GDP by perhaps 0.5% on net, but that effect will dwindle as
impacts of borrowing on the nation's capital stock emerge, and it is
small relative to the effect on debt. If forecasts of war spending
over the next ten years prove accurate, the associated war debt may
increase the debt-to-GDP ratio by up to 20 percentage points, and
interest rates may rise by 70 basis points.
Related: Statement to
Reuters on June 20, 2011.
Work, Well-Being, and a New Calling for Countercyclical Policy
International Journal of Epidemiology
34(6):1222-1225, December 2005.
The new paper by Jose A Tapia Granados, "Increasing Mortality During
the Expansions of the US Economy, 1900-1996," like others in the
important and increasingly vibrant subfield of interdisciplinary
research on economic fluctuations and health, gives macroeconomists
much to think about. The basic finding of the paper is that mortality,
a fundamental measure of the inverse of human well-being, rises
significantly during periods of economic expansion and falls
significantly during recessions. In a very real sense, this result
turns both neoclassical and traditional Keynesian perspectives on
their heads.
Demography
(Book Review of) Demographic Forecasting
Journal of the American Statistical Association
104(488): 1718-1719, 2009.
With their new book, Girosi and King contribute a new Bayesian
methodology of fore- casting mortality when time series are noisy and
sparse. The method is strongly evocative of seemingly unrelated
regression; another parallel is that
the book's title is almost seemingly unrelated to the method's much
broader applicability. This is not to understate the authors' valuable
contributions to the particular field of mortality forecasting, as
evidenced by extensive and repeated application of the methods. But it
is not until the last section of the introductory chapter that we
catch a glimpse of the wider relevance of the methods, during a
discussion of their applicability to, and perhaps their partial
genesis in a seemingly unrelated field: comparative political
science.