Economics books: Casting light on the dismal science

December 21, 2007

An economics columnist for the New York Times, David Leonhardt, opened the discussions on the best economics books of the year in his column.

His nominee? A book about medical care: Overtreated: Why too much medicine is making us sicker and poorer, by Shannon Brownlee.

Here’s the hook to the story, retold from Brownlee by Leonhardt, and the reason I think economics is so interesting when done well:

In 1967, Jack Wennberg, a young medical researcher at Johns Hopkins, moved his family to a farmhouse in northern Vermont.

Dr. Wennberg had been chosen to run a new center based at the University of Vermont that would examine medical care in the state. With a colleague, he traveled around Vermont, visiting its 16 hospitals and collecting data on how often they did various procedures.

The results turned out to be quite odd. Vermont has one of the most homogenous populations in the country — overwhelmingly white (especially in 1967), with relatively similar levels of poverty and education statewide. Yet medical practice across the state varied enormously, for all kinds of care. In Middlebury, for instance, only 7 percent of children had their tonsils removed. In Morrisville, 70 percent did.

Dr. Wennberg and some colleagues then did a survey, interviewing 4,000 people around the state, to see whether different patterns of illness could explain the variations in medical care. They couldn’t. The children of Morrisville weren’t suffering from an epidemic of tonsillitis. Instead, they happened to live in a place where a small group of doctors — just five of them — had decided to be aggressive about removing tonsils.

But here was the stunner: Vermonters who lived in towns with more aggressive care weren’t healthier. They were just getting more health care.

A good economics book has a story at its heart, making the economics easier to illustrate and much more memorable for students of economics — this story should echo every time a person enters a physician’s office or stops by a hospital for any reason.

Health care is often a clash between good science and economic policies expounded by hard-core fanatics of one hypothesis or another who don’t understand the science; of course, neither do the scientists speak the economics language. And so our health care crises continue, deepen, drain our pockets, defy efforts to solve them and threaten to ruin the nation.

Put this book on the list of every policy maker you buy for, eh?

(No, I haven’t read the book.)

Read the rest of this entry »

3 Comments | Books, Economics, Health care, Politics | Tagged: , , , , , | Permalink
Posted by Ed Darrell

Breastfeeding still recommended, despite DDT contamination

September 23, 2007

Despite DDT’s being affiliated with reduced cognitive ability in infants after intrauterine exposure, and despite indications that DDT may retard fetal development, a team of Spanish researchers urges mothers to breastfeed anyway. Their study shows that breastfed kids develop better despite after birth even when exposed to DDT in utero, despite any dangers of exposure to DDT and other chemicals in breast milk.

No, the study does not say DDT is harmless.

From the American Journal of Epidemiology, abstracts of the study have been released in advance of publication in the October 2007 edition.

Beneficial Effects of Breastfeeding on Cognition Regardless of DDT Concentrations at Birth

Núria Ribas-Fitó1, Jordi Júlvez1, Maties Torrent2, Joan O. Grimalt3 and Jordi Sunyer1,4 1 Centre de Recerca en Epidemiologia Ambiental, Institut Municipal Investigació Mèdica, Barcelona, Spain
2 Àrea de Salut de Menorca, Servei de Salut de les Illes Balears, Menorca, Spain
3 Departament de Química Ambiental, Institut d’Investigacions Químiques i Ambientals de Barcelona–Centre Superior d’Investigacions Científiques, Barcelona, Spain
4 Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain

Correspondence to Dr. Núria Ribas-Fitó, Centre de Recerca en Epidemiologia Ambiental, Institut Municipal Investigació Mèdica, C. Doctor Aiguader 88, 08003 Barcelona, Catalonia, Spain (e-mail: nribas@imim.es)

Received for publication March 19, 2007. Accepted for publication June 13, 2007.

The authors previously reported that intrauterine exposure to background concentrations of p,p’-dichlorodiphenyltrichloroethane (DDT) reduces cognitive performance among preschoolers. Breastfeeding has been associated with both increased exposure to certain pollutants during infancy and better performance on cognitive tests. Thus, the authors examined the role of breastfeeding in cognitive function among preschoolers, taking prenatal DDT exposure into account. Two birth cohorts in Spain (Ribera d’Ebre and Menorca) were recruited between 1997 and 1999 (n = 391). Infants were assessed at age 4 years using the McCarthy Scales of Children’s Abilities. Levels of organochlorine compounds were measured in umbilical cord serum. Information on type and duration of breastfeeding was obtained by questionnaire when the children were 1 year of age. Children who were breastfed for more than 20 weeks had better cognitive performance regardless of their in utero exposure to DDT. A linear dose response between breastfeeding and cognition was observed in all DDT groups (for children highly exposed to DDT, adjusted ß = 0.30 (standard error, 0.12) per week breastfed). Despite the possibility of harm from environmental contaminants in breast milk, breastfeeding for long periods should still be recommended as the best infant feeding method.

breast feeding; child; child development; child, preschool; cognition; DDT; infant; intelligence

Abbreviations: DDE, p,p’-dichlorodiphenyldichloroethylene; DDT, p,p’-dichlorodiphenyltrichloroethane; IQ, intelligence quotient

Some of the members of this research team have also tied DDT’s daughter product, DDE, to increased asthma in children, in research published in Environmental Health Perspectives in December 2005.

Leave a Comment » | DDT, Health care, Public health, Research, Science and faith | Tagged: , , , | Permalink
Posted by Ed Darrell

Using snake oil to lubricate jaws

September 15, 2007

Oooh, I missed this one; Instapundit said:

August 20, 2007

SOME KIND WORDS FOR DDT — in the New York Times, no less. “Today, indoor DDT spraying to control malaria in Africa is supported by the World Health Organization; the Global Fund to Fight AIDS, Tuberculosis and Malaria; and the United States Agency for International Development. . . . Even those mosquitoes already resistant to poisoning by DDT are repelled by it.”

The debate over DDT is over. There’s scientific consensus. Anyone who disagrees is a DDT denialist and a mouthpiece for Big Mosquito.

posted at 10:18 AM by Glenn Reynolds

The debate should be over.  There is scientific consensus that DDT is dangerous and the ban on broadcast use was wise, fair, and still necessary.  Reynolds is one of the denialist brigade who keeps trying to paint environmentalists wrong for working for the ban.

Reynolds claim is deceptive in at least three ways:

  1. Omission, failing to note history:  Reynolds fails to note that without the ban on broadcast use of DDT (like crop spraying, or spraying of swamps and rivers), DDT would by now be completely ineffective against mosquitoes.  The ban on crop spraying (broadcast use) has been instrumental in preserving the effectiveness of DDT against malaria.  The debate is over, Reynolds lost, and its time he quit denying it (speaking of denialism).  The ban on DDT spraying in the U.S., following similar bans in Europe, and with similar following bans in other nations, has been a key factor in our current victories against malaria — a key factor for the anti-malaria forces.
  2. Omission, not understanding the science:  Reynolds may not know that DDT was cast against other  pesticides that are known to have very low repellent characteristics.  There are other, much more effective and less toxic, and less expensive, ways to repel mosquitoes.
  3. Failure to state the whole case:  Reynolds, the DDT-advocate in the New York Times,  and the study cited, fail to note that DDT is inadequate to more than a very short-term, partial campaign against malaria-carrying mosquitoes.  Other studies recently published note powerful, long-term reduction in malaria infections by use of mosquito netting; these declines do not require multiple, expensive and logistically difficult sprayings of poison in homes every year.  Perhaps more critically, research now shows that mosquito nets produce malaria reductions in the absence of DDT spraying, and the reductions stick; DDT spraying alone cannot produce either a long-term reduction in malaria (say, longer than a year), nor will the reductions stick, nor will the reductions be as great.  Nets work without DDT; DDT does not work without nets.

Other than that, Reynolds is right:  The debate is over.  Reynolds’ “spray DDT on everything — it works better than snake-oil” argument lost.  It’s time Reynolds stops denying the facts.

1 Comment | Accuracy, DDT, Environmental protection, Health care, Junk science, Malaria, Public health, Rachel Carson, Science, War on Science | Permalink
Posted by Ed Darrell

Unstrange maps: Security, health, economics

September 3, 2007

Strange Maps features odd maps, often fictional. I like the site, especially for the inherent humor in some of the maps — and since it’s such a popular site among the more than 1 million WordPress weblogs, it’s clear others share my enthusiasm.

Global map of energy security risk - Maplecroft Maps

There are a lot of unstrange and beautiful maps based on reality, too, used to give a quick, graphic image to the brains of people working on serious problems. Maps guide policy makers, and illustrate geographical range of problems, and sometimes geographical causes and vulnerabilities.

Here’s a source of interactive maps that every economics, government, history, and health teacher should bookmark: Maplecroft Maps.

Maps at this site cover a nearly complete range of issues that worry leaders of businesses and nations. I found the site looking for information about malaria.

Of special note is the wealth of information available from the interactive features. Clicking on nations or on symbols on the map provides details of issues the map covers; three tabs with the maps take the viewer of most of the maps to an extensive list of resources on the issue, and case studies, and analysis. These sources seem tailor made to help students doing geography projects.

Issue maps include disasters, malaria, child labor, climate change, poverty, land mine risk, political risk and a wide variety of others. You’ll need Macromedia Flash on your computer; there does not appear to be any way to download the maps, so you’ll need a live internet link to use these in class.

Information from these maps will be more current than any geography, history or economics book. Go see.

Maplecroft is a network of academic and business consultants. These maps are made to help their clients; Maplecroft’s description of the series is below the fold.

Read the rest of this entry »

3 Comments | Disasters, Geography - Economic, Geography - Physical, Geography - Political, Health care, Natural resources, Public health | Permalink
Posted by Ed Darrell

Nightmare at 1600 Pennsylvania Ave: Socialized medicine! (it works well)

August 16, 2007

Rep. Ron Paul, who wants to be president, made a speech recently on the floor of the House of Representatives where he suggested that Americans are mad at their government because the government tries to do stuff for them that they’d rather do themselves. Having recently spent two nights in the medical brig, I immediately thought that Paul is completely out of his mind — who in their right mind would want to do their own health care?

(Old joke: You know what they told the guy who wanted to do his own appendectomy? His doctor said, “Whatever! Suture self!”)

It seems to me people are upset because they can’t get health care at reasonable cost, and the government is doing absolutely nothing to fix most of those problems.

Then I read somewhere that Karl Rove urged his clients to bring up the bogey word “socialized” to describe programs their opponents advocate, since everybody hates anything that is socialized? Oh, yeah? You mean like people hate socialized roads, socialized water delivery systems, socialized sewer systems, and socialized airports?

So I was ready when Jim Wallis’s e-mail hit my in box this morning. His story about his experience with “socialized medicine” in London — a horror story that George Bush will use in his next State of the Union?

It’s a nightmare for sure — for the critics of “socialized medicine.” Read it for yourself, below the fold.

Here’s the usual, Republican view of “socialized medicine” (click on thumbnail for a larger view:

Government Optical

Pretty funny, eh? It’s totally groundless. Think about the government’s program of eye care for soldiers. Pilots and sharpshooters need great eye care. They get the best. They also get stylish glasses. And, though budgeted, you can get some style on Medicare and Medicaid, too — lots of styles, not just one. Our government operated eye care is socialized almost not at all in the classic, socialism definition of its being a planned output and planned outcomes system. Neither output nor outcomes are planned.

Socialized medicine really works. It’s a nightmare for the crowd that thinks bad health care or no health care is cheap, and the socialized medicine can’t work. Read Jim Wallis’s story, below the fold:

Read the rest of this entry »

17 Comments | Economics, Government, Health care, Politics, Socialism | Permalink
Posted by Ed Darrell

Next Entries »