Wednesday, April 9, 2008

Flawed Flawed Flawed

This piece was on NPR's Marketplace Report yesterday. Some professor did a study of health during economic downturns and found that on a macro level, the health of the area in economic turmoil was better than average. I couldn't help but think of the many huge (and I mean enormous) flaws in this research while listening to the piece.

My comments are in bold/italic.

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Kai Ryssdal: $3.60 a gallon's gonna be the magic number this summer. The Department of Energy said today that's where gas prices should top out.

Which, if you really think about it, might turn out to be good news, because chances are paying that much will make most of us think twice before we take to the open road. Which'll mean less traffic, less stress, and probably less pollution, too.

In fact, economist Chris Ruhm at the University of North Carolina Greensboro's been studying exactly that phenomenon.


Ryssdal: Thanks for being with us.

Chris Ruhm: Thanks. My pleasure

Ryssdal: You know, you'd think that bad economic times would do bad things to your health and to society's general well-being. You're telling me that's not true?

Ruhm: Well, what I'm telling you is that bad economic times are actually good for your health. Now, I'm not saying they're good for society, but they do turn out to be good for your physical health?

Ryssdal: How so?

Ruhm: What we find is mortality rates of all kinds fall when the economy weakens, so total mortality, vehicle mortality, deaths from heart attacks, various health conditions like back problems become less prevalent and then people behave in a healthier manner, that is they smoke less, they drink less, they're less likely to be obese.

First of all--mortality is not the only part to health. There is this little thing called "life" that people must go through and if they're unfortunate enough not to be 100% healthy, that's not really fun.

Second of all--just because "various conditions...become less prevalent" in the statistics doesn't mean they don't exist. Perhaps (and this is a pretty good and solid assumption), people don't report these problems as much in poor economic times because they don't have health insurance. Just a thought.

Third--you all know how I feel about the word "obese".

Ryssdal: Now is that generally just less stress because you don't have to deal with all the craziness at work?

Yeah, Kai--because worrying about finding a job and paying your bills and feeding your kids ain't stressful.

Ruhm: That may be part what's going on. There's also environmental risks like reductions in pollution levels and people have more time, so they might have more time to exercise. Part of it might be an income story too. If you don't have as much money, you don't go out to eat as much. When you go out to eat, you tend to eat fatty meals, maybe you drink and smoke, so it could be a combination of factors

Ryssdal: What about everyday things like traffic loads? I mean, if it takes me 15 minutes to get in because people have been laid off, generally a good thing, right?

Ruhm: That's right, and people drive less. Driving is a risky activity

Ryssdal: Do you have any data on mental health as opposed to physical issues?

Ruhm: A little bit. Mental health is harder to measure and the evidence is much less clear and in fact, it's quite possible that in bad times, people's mental health actually worsens. So, for example, we find that suicides increase when times are bad.

Oh, and mental health isn't at all related to physical health, is it? Oh wait...

Ryssdal: Probably ought to take a step back here and make sure everybody understands we're not talking about individual episodes of good or bad health. It's more on a macro scale.

Well, that may be true, but you've been talking about it like it was individual results and then you try and tell me it's on a macro scale. Make up your mind.

Ruhm: That's right. This is looking at population-wide averages. Essentially what I was doing is using each state as an experiment, so I was comparing what was happening in one state, say in Massachusetts or Texas, relative to what was going on in other states, so if the Texas economy was weakening at a time when other states' economies were strengthening, how were, say, mortality rates in Texas changing relative to other states and the result was just very robust, the result that health got better during bad economic times.

Ryssdal: It's kind of counterintuitive though.

And kind of wrong.

Ruhm: It is to most people and certainly it was not what I initially expected, but there are a number of plausible mechanisms. I might also add there was research over a half a century ago where people looked at mortality rates and found results that were consistent with this and actually couldn't figure out what was going on and after a number of years just sort of ignored their own results, but actually, there's been evidence on this for a long time.

Ryssdal: Chris Ruhm is professor of economics at the University of North Carolina Greensboro. Professor, thanks a lot.

Ruhm: Thank you.

SG: No thank you.

4 Comments:

Meggan said...

Got to say, I don't think this is as flawed as you do. I notice that the prof who did the study is an econ guy, and not a bio or health guy. But, he's right - there are a lot of reasons why this could happen. People tend to eat out less, and tend to eat less pre-packaged processed foods, because it's more expensive than to cook it yourself (which tends to be a healthier option). People walk or bike to work, which is healthier. I think that some things are underreported, because people don't have health insurance, but if you're having a heart attack, or stroke, or you have cancer - you're going to get the help you need, whether you're insured or not. Or you'll die - them's your options. I haven't seen the study, but I'd bet he's got solid statistics to back up what he's saying, or else NPR wouldn't have him on to talk about it.

The Honorable Samantha Grace said...

I agree with the less eating out and the more walking thing. But, I think his study fails to take into account the impact of poor mental health on overall health and the fact that the mental health problems during slow economic times can lead to physical health problems long after the period being studied is over.

And sure, you'll get immediate help if you have a heart attack or a stroke (though I know people who have not gotten help for cancer because of money and insurance issues), but there are smaller problems that creep up when you're out of work or underemployed that lead to big problems later. So I think this was a very basic big-picture study which doesn't have much value to the everyday person.

I was kind of surprised to hear this kind of weird overview of it on NPR. Usually they have more statistics and more of an explanation. Maybe if I saw the study itself.

The Honorable Samantha Grace said...

though to be honest i will defer to you as the expert in studies of this nature. maybe it was just the tone of the conversation that rubbed me the wrong way

Meggan said...

haha - I wouldn't call myself an expert by any means...I think it's just a little easier for me to see where this guy is coming from. He did a large-scale meta-analysis of overall health, and found some differences. Yeah, I agree - not much help to the average joe. But, that's also why he had to do a meta-analysis: different people respond to stress in different ways. There's a woman in my sewing class who was laid off from her job, and was miserable for a few weeks, but then she realized that she had more time with her kids, and more time with her husband, and less stress, and now she's talking about not even trying to find a new job once her unemployment runs out. Not everyone can get to that place, but some do. And that's where the mental health issue enters the picture. Studies on mental health and its ties to physical health are difficult to do, even for trained psychologists, so I guess maybe it's better that this Econ prof left that alone :) I agree that it's very broad, and that he didn't take a lot into account. I guess all I was trying to say is that it's very likely that he did get the results he's reporting, even though no one may have a good idea why.

 

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