Sunday, July 17, 2016

Babies with no Fathers or How to Spin the Facts

Here's a quote from Greg Hunter's Weekly News Wrap-Up, week ending 15 July 2016:  "Seventy percent of African American kids are born with only a mother" (Hunter, 2016, min. 16:20).  Really?    To me, this comment implies that these children have no father.  (Note to Mr. Hunter:  kids are baby goats.)  Mr. Hunter, who promotes himself as one who presents only unbiased factsin contrast to his nemesis the Mainstream Media (MSM)is nevertheless remarkably skilled at spinning empirical evidence.  In this case, his fact is correct.  According to the US National Vital Statistics System, in 2015 70.4% of US births (415,029 infants) were delivered from women who identify themselves as Non-Hispanic black and unmarried (Hamilton, B. E., Martin, J. A., & Osterman, M. J., p. 10).  Mr. Hunter, please also note, the US National Center for Health Statistics uses the following terminology to label women who are not married when they give birth to human infants:  births to unmarried mothers.  "Infants born to unmarried mothers" is not equivalent to "kids with only mothers."  Treating the two phrases as if they were conceptually equivalent is called spin.  
It seems like the point Mr. Hunter intends to make is probably one about which many people would agree, regardless of race or ethnicity.  Yet sadly, the way he phrases his comments comes across as judgmental and divisive.  What I think he means is that African Americans are enduring continuing conditions of rampant inequality, even under the Obama administration, which was supposed to bring change for them along with the entire population of our country.  But, using an accurate statistic out of context laced with a nearly subliminally delivered value judgement creates and perpetuates stigma that in turn reinforces horrendous and probably untrue beliefs about a socially designated sub-population of the US.  While it's true that 70.4% of babies born to Non-Hispanic black mothers are delivered from unmarried women, it is also true that 29.2% of babies born to Non-Hispanic white mothers, 52.9% of babies born to Hispanic mothers, and 40.2% of all births, regardless of race and ethnicity, are delivered from unmarried women.  Everyone has high numbers if our ideology forces a goal of zero births to unmarried women.

His words become increasingly less factual and more moralistic when he suggests that the remaining 30% of African American children born in 2015 are born into homes with "a mommy and a daddy" and are probably not the ones being arrested indiscriminately and committing rapes, murders, and other crimes.  The implied conclusion here is that nuclear families with one male and one female adult produce children who are productive, desirable US citizens.  I'm not sure there is conclusive empirical evidence anywhere that's been peer reviewed to suggest that African American children born to unmarried women are significantly more likely to become criminals compared with those who are born to women who are married.  Mr. Hunter has wandered decidedly afar from unbiased reporting into the realm of dogma.  He has made a very strong causal claim based solely on a slanted interpretation of one single statistic generated from indicator data with which he has surreptitiously intertwined his personal belief system.  These claims amount to no more than pontification and only serve to abuse his viewers' trust that he is providing an unbiased news program.  Behavior like this is called using a news program as a pulpit.

His words are divisive and destructive.  His tactics are no better than the MSM he despises.  He is fueling the racial divide in this country by perpetuating myths and unnecessarily creating sub-categories of humanssome of whom he judges to be more productive and valuable than others.  Using a single statistic taken out of context can be a powerful weapon, capable of wielding unthinkable destruction.  His human being categorization function weakens our nation by dividing it, at a time when it is supremely critical for us to focus on equality for all, and find platforms of commonality among individual people who are all equally valuable members of the human race and our societies.  His unexamined train of thought illustrates US white male Judeo-Christian hubris and hegemony.  

Greg Hunter needs to be scolded for his ignorance and arrogance.  And I'm here to do it.  It's because I like him and I believe that what he thinks he is doing is offering a factual alternative to the lame information we are fed by the MSM.  His objective is the same as mine.  To discover and convey truth for the welfare of humanity.  He is, in some odd way, a humanitarian.  I also believe that he has a good heart and means to do well by his countrymen.  Still, his thoughts are steeped in ignorance and reveal that he hasn't spent sufficient time looking inward to articulate what he truly believes.

Also, I must thank Mr. Hunter for providing a springboard for me to comment on one of my favorite cultural fallacies.  That is, that the demographic category of married or unmarried measures nothing more than legal status.  It is a binary metric (amusingly, also known as a dummy variable to economists) that provides almost no information about the strength or character of a conventional marriage and hence its effect on any children it produces.  It's even more absurd to use marital status as a dependable signal for assessing the character of a nuclear family.  More accurately, marriage is a socially ascribed legal status for filing tax returns and a handy, automatic asset distribution mechanism for settling financial matters upon the death of one spouse or the other.  That's it.  Regardless, marital and child support obligations are very cumbersome and complicated to enforce legally.  So, what our laws reflect about the values we believe marriage ought to protect, often differs from the reality of life events.  Furthermore, whether a woman is married or not when she gives birth to a human infant or infants is probably not a valid or reliable indicator of the child's immediate or future welfare.  Just because two people are married doesn't mean they live together, sleep in the same bed, or even speak to one another.  Speaking of marital quality, worse yet, maybe the spouses live together but speak to one another using hostile or dismissive tones and attitudes.  Alternatively, when a mother is unmarried it does not necessarily mean that the father is uninvolved.  A father and mother may live together but choose not to marry.  Particularly in low-income, less fortunate sub-populations, it's more likely that state and federal policies provide perverse incentives for parents to remain unmarried or even live apart.  There are many factors that combine and interact to effect major life outcomes for an infant born on this planet.  The real point is, married or not is a weak, egregiously over-celebrated indicator of family structure, unity and quality of life.


Hamilton, B. E., Martin, J. A., & Osterman, M. J. (2016). Births: Preliminary Data for 2015. National vital statistics reports: from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System, 65(3), 1.

Hunter, G.  [Greg Hunter].  (2016, July 15).  Weekly News Wrap-Up 7.15.16 [Video file].  Retrieved from

Friday, July 8, 2016

Making policy is so 20th Century

The board for the coop building where I live has issued a memo introducing the idea of making our collective residence a non smoking building.  Evidently, they were spurred into action by a passionate discussion about non smokers' rights during the recent monthly public meeting.  They write:  "owner-expressed concerns about second hand smoke as well as prevailing standards and practices related to smoking informed the discussion."  While the memo neglected to define non smoking building, it asked owners for a yea or nay vote about whether we should "transition" to a non-smoking building.  A better question might have been:  do we need a policy to solve the second hand smoke problem?

There are too many problems with the board's approach to enumerate here.  Initially, the word bungled comes to mind.  They are handling this matter as if they themselves are members of the US Congress or Council of the European Union.  That means chaotic, short-sighted, out of touch with reality, truly uninformed, and motivated by power and hegemony.  Their memo illustrates:  how to stir up angst and competition among neighbors who otherwise live together peacefully.  

The board's actions also illustrate the reckless practice of using policy as an intervention when it's unnecessary and furthermore, without considering how it may cause more harm than good.  In this case, addressing the problem of second hand smoke with a blanket no smoking anywhere policy is like using a cannonball to kill a flea.  Policy implementation is not a panacea for public problems, and in many situations policy effects may be more undesirable than living with the perceived problem.  The field of biomedicine provides a useful example.  Policies that fund and promote vaccine and antibiotic use save lives.  Upon discovery, they revolutionized advances in ability to produce optimal public health.  They reduce human morbidity and mortality, and unquestionably improve quality of life and life expectancy.  However, using them in an unrestrained manner is rendering them ineffective at best and iatrogenic at worst due to sequelae such as, antibiotic resistant bacteria, vaccine side effects, and populations with overall weakened immune responses.

It's worth noting that conventionally recognized strategies for solving public problems are limited to two intervention options:  (1) regulation through public policy or (2) privatization using economic markets.  Alternatively however, Elinor Ostrom reminds us that there are multiple remedies for any public problem and a limitless range of potential solutions for equitable allocation of public resources, referenced by economists as the commons.  Mostly, these approaches can be characterized as self-governing.

In this youtube video, The Role of Culture in Solving Social Dilemmas, Dr. Elinor Ostrom speaks about how local and regional farmers in Africa self-govern to manage access to water, a precious, limited, commons resource that is not owned by any individual or corporation, or regulated by any government.  Interestingly, her comments include exceptional attention to effectiveness and productivity resulting from these interventions.  It's also worth noting that Dr. Ostrom was trained as an anthropologist, not an economist.  Ponder that fact for a minute.  

Another example of self-governing is set in Manhattan.  From the New York TImes, At Strawberry Fields, Feuding Musicians Give Peace a Chance is a story about a group of street musicians who have organized themselves to allocate benefits derived from a famous, magical, coveted park bench.  The musicians rely on access to the bench, a commons resource, to produce income from performing.  By self-governing, they no longer need to call the police to settle disputes or risk being shunned by would-be patrons, who choose to avoid public obscenity and risk of becoming collateral damage from a full blown public brawl, rather than listen to music in Central Park.  The musicians have made a beautiful discovery.  Behaving cooperatively to achieve a common solution to a public problem protects the commons and ultimately their livelihood.

As for the second hand smoke problem at the coop, I'm wondering how to introduce self-governing concepts to my neighbors and the board, without sounding too weird.  It seems to me it's possible to solve the problem of exposure to second hand smoke without:  (1) dividing the community into yea or nay camps, (2) working tirelessly on developing a policy that will never satisfy everyone, and (3) monitoring and enforcing compliance once they implement yet another regulation.  What's irritating me and diminishing my quality of life are my neighbors' car alarms that spontaneously ignite just outside my window at 2 am or any other time for that matter.  These car owners make up the subpopulation I'll call other-side-of-the-building-residents who are oblivious to the noise from unattended auto noise that pollutes my-side-of-the-building environment.  I think the coop may have just opened a Pandora's Box.        

Monday, October 13, 2014

Unfortunate disconnect between the facts and policymaking

The New York Times published an op-ed by U.S. Congressman Andy Harris (R-MD 1st District) in which he proposes a policy solution for the problem of, not enough innovative thinking to optimize the value of dollars spent on biomedical research.  Harris presents a fairly disparaging picture of the National Institutes of Health (NIH) and its poor ability to administer the money that Congress appropriates each year.  Whether this claim is true or not, one of his criticisms in particular is that NIH is funding the wrong people, investigators who, “though well-regarded in their fields,” are too old to make particularly valuable contributions to science. 
One of Congressman Harris’s more clearly defined solutions is based on an over-simplified problem definition, which presumes an inverse relationship between an investigator’s age and her propensity to produce innovative discoveries.  According to this framework, his proposed policy solution is to increase the value of dollars Congress allocates for biomedical research by lowering the average age of NIH investigators.  The sole basis for this solution rests on the results of a single study published by the National Bureau of Economic Research (NBER) entitled, Age and Great Invention (Jones, 2005).   It is strikingly noteworthy that The Review of Economics and Statistics published a peer-reviewed version of this study (Jones, 2010) and concluded--in the abstract--that, "innovators have become especially unproductive at younger ages.”  Furthermore, the Harris solution to increasing scientific productivity subtly and erroneously presumes that the relationship between age and productivity is causal.  In other words, young age causes productivity.  The NBER study does not seem to provide any empirical evidence to support that claim.  A more accurate interpretation suggests that the average age of “great innovation has trended upwards by approximately 6 years over the course of the 20th Century” (Jones, 2005, p. 17), and reasonably so, because the demand for increasing time requirements of education and knowledge acquisition functions as an opportunity cost of preparing aspiring great achievers to produce.  Given a more accurate interpretation of empirical observations, alternative funding policies would have a greater probability of producing desired results by incorporating evidence of the trade-off between training investment and age at time of great achievements.

Too often, policy formulation is based on belief, custom, and a need to do something rather than an in-depth understanding about the true nature of the problem.  In the matter of how to promote and ensure innovative productivity in biomedical research, a truly wise and potentially more effective solution would be to invest increased resources in and attribute greater value to policy research and evaluation efforts designed to determine which factors and circumstances predict production of research discoveries that lead to marketable discoveries that are capable of improving public health.  Congressman Harris’s statements illustrate the inherent disconnect between policy research and how its results get haphazardly translated into quick-fix policy solutions with little promise for influencing desirable outputs.  It also points out the importance of defining a public problem succinctly and rationally, using empirical evidence as a guide. 

Here's another point worth noting:  Andy Harris will be sitting on the Labor Subcommittee of the House Appropriations Committee this fall.  There's a god chance that his proposed policy will become a reality, or at the very least, a total nightmare for those bureaucrats charged with preparing talking points for the upcoming budget hearings.

Tuesday, May 27, 2014

Data collection for health outcomes research: twenty-first century options

Here is an interesting article outlining an effort supported by the government of India to compile vital statistics for determining the leading causes of death in its country between 2001 and 2014 (New York Times, Door by Door, India Strives to Know More About Death, May 22, 2014).  While the sentiment is admirable, the approach seems byzantine and early 20th century.  Government registry officials visit the homes of deceased citizens using autopsy forms as a guide to verbal information gathering about circumstances surrounding cause of death for those individuals who died at home without medical supervision.  Good old fashioned epidemiology.  Of course collecting data this way provides huge opportunity for bias due to errors affecting its reliability, including those introduced by language barriers, human recall, and lack of respondents' willingness to disclose intimate family details to a stranger representing the national government.  Not to mention time-consuming:  results will not be final for at least five years.  With great insight, the article's author notes a more modernistic objection to building data sets of this type, that might not have been considered even 20 years ago:  "A great reservoir of information will be valuable to public health specialists, but will probably bring little to the families who were its subjects."

Contrast conventional vital statistics data collection methods with crowdsourcing approaches.  The crowdsourcing concept is characterized by collecting volumes of data, in a systematic manner, at no or very low cost to any single entity.  Millions of ordinary people, fueled by passion for the cause, each contributes information about an observation made during the course of their normal activities, at but a micro-cost to themselves.  Individual contributions are turned into digital data and amassed into a single, gigantic data set so the statisticians can do their magic.  In terms an economist would understand, using crowdsourcing to create a useful data set is like harnessing the antithesis of forces that lead to the tragedy of the commons.

An interesting article also published by the New York Times (Crowdsourcing, for the Birds, August 19, 2013) provides an illustration of two variations of crowdsourcing used by wildlife biologists to monitor bird populations.  It provides an articulate description of both efforts, each of which harness the power of crowdsourcing techniques to produce data for bird epidemiology research:  (1) the Breeding Bird Survey coordinated by the United States Geological Survey (USGS) and (2) the eBird project, a non-profit, global ornithological network of high tech data collectors.  The app-driven eBird project seems more productive, efficient, and appealing, despite criticisms lobbed against it by more conventional Bird Survey proponents, including the usual generic validity and reliability snarks.  But the Bird Survey is adept at organizing and training volunteer bird-watchers to count birds in a systematic, quasi-controlled manner, and transfer observations by hand to a paper survey form.  It requires conventional data processing methods to key in and compile data points to produce a final data set.  Still, final data set products from both projects are freely available to the public so that anyone can use the data for their own analysis.  Open data!  A highlight of the data gathering process for the eBird project is that it provides the ability to produce a real-time view of bird populations around the world using heat maps, a visually appealing, intuitively easy to understand depiction of bird species population density, location, and migration over time.  Imagine being able to track human health epidemics, diseases, conditions, and health outcomes in response to various interventions using similar methods.

My favorite quote from the article is, "Birds are notoriously hard to count."  This observation, as if birds are harder to count than any other species?  Scientists who count birds must not have any cross-training in the epidemiology of human health.  How is it that birds are any harder to count than babies?  Adults?  People with heart disease?  People living in poverty or substandard living conditions?  My mind almost short-circuited with thoughts about how crowdsourcing might be applied to compiling data sets for the study of human health and the effects of public policy and other interventions on health outcomes.  Crowdsourcing:  an untapped resource for producing data that could answer crucial questions in medical care research, particularly useful for very large, heterogeneous populations that were heretofore impossible to study because of the impracticalities of producing requisite data for a nominal cost.

Twenty-five hundred grams

Twenty-five hundred grams (2,500 g) is the upper cut-off point for classifying infant birth weight as undesirably low.  A customary public health metric, low birth weight is defined as an infant weight of less than 2,500 g (equivalent to 5 pounds, 8 ounces), measured within one hour of birth.  As it relates to infant health at birth, as infant size declines, risk for early death and acute and chronic morbidity increases.  Low birth weight is a noteworthy public health concern because:  (1) it is a major risk factor for infant mortality; (2) it consumes a disproportionately high level of health care resources; and (3) its prevalence continues to rise despite investment of public resources aimed toward improving birth outcomes.      

Infant birth weight is one of the primary measures of infant health at birth, making it a central target of much public health policy in both the U.S. and globally.  It is a well documented predictor of neonatal health, infant survival, and future health and productivity (Currie, 2011, p.12; Martin et al., 2011; Almond, Chay, & Lee, 2005).  Public health entities and policy makers traditionally view infant birth weight as an indicator of overall health at the population level because poor birth weight outcomes reflect maternal undernutrition, chronic ill health, excessive physical exertion or stress, and poor health care during pregnancy (The World Health Organization [WHO], n.d.; Stevens-Simon & Orleans, M., 1999).  The WHO and others also note its importance as an indicator of a country or region's health care system's effectiveness in delivering life-saving, life enhancing interventions to its citizens (Almond et al., 2005; WHO, 2000).

Federal and state governments are heavily invested in financing medical care for childbirth associated maternal and infant health outcomes.  In the U.S., public funding sources finance the cost of health insurance coverage for a substantial number of infant deliveries and subsequent medical care.  The Federal-State Medical Assistance Program, better known as Medicaid, is the primary source of insurance for publicly financed infant deliveries.  Federal and state governments share the cost of providing pubic insurance for low-income residents who meet certain eligibility criteria, and states administer their respective programs.

In 2010, the U.S. recorded 3,854,224 million births.  Of those, Medicaid provided insurance coverage for 45% (1.75 million) of associated deliveries and just under half (48% or 1.86 million) were billed to private payers; those that made up the remaining portion (3% or 131,205) were either uninsured or covered by other miscellaneous government programs (Source:  Agency for Healthcare Research and Quality [AHRQ], Nationwide Inpatient Sample [NIS], n.d.).  AHRQ indicator data that tracks sources of insurance coverage for all U.S. hospital deliveries illustrate a steadily rising trend in public insurance financing for infant deliveries under current eligibility criteria.  And as federal health care reform progresses toward full implementation, eligibility criteria are likely to expand, at least in many states.


Sunday, May 4, 2014

Sex & Econometrics

You think it's impossible that these two topics are related?  Not so.  Imagine my delight when I came upon the following quote, embedded in a dry old journal article published in 1983, by The Journal of Economic Review.

"Methodology, like sex, is better demonstrated than discussed, though often better anticipated than experienced" (Leamer, 1983, p. 41).

I think it's poetic. 

Although Lerner wrote this paper in 1983 (based on a public lecture presented at the University of Toronto in 1982), it is crammed full of wisdom relative to current events in applied health research.  Take, for one example, the presumed belief in the relative power of experimental over nonexperimental data to produce credible inferences.  Customary assumptions rely on the belief that the randomized controlled trial (RCT) is the gold standard in medical care research.  Maintaining control over randomization automatically equates to "a rigorous study."  However, Lerner addresses this question directly when he asks, "Is Randomization Essential" (p. 31)?  The answer is:  "the randomized experiment and the nonrandomized experiment are exactly the same" (p. 32), at least in terms of drawing credible inferences.

Randomization is customarily the linchpin for determining the value of research today, but really it might better be viewed as one consideration among many others within the context of overall study design.  Here is a perspective that levels the playing field between the value of research produced by RCTs and econometric methods as far as their potential to generate valid inferences.  Regardless, any applied research is dependent on measurement whether using experimental or nonexperimental data.

My third favorite point:  "The job of a researcher is then to report economically and informatively the mapping from assumptions into inferences" (p. 38).  Sensitivity analyses ameliorate doubt about the reality of some assumptions, but others are not objective nor are they value free.  When this is the case, changes in assumptions can change inferences.

In conclusion, most facts are really opinions, and many opinions are based on conventions rather than truth.  So it seems that, just as there are similarities between sex and econometrics, questioning assumptions about econometric modeling conventions might be a process that is similar to how we determine the truths by which we live our lives.

Monday, February 24, 2014

Minimum Wage Outcomes

While it seems like raising the minimum wage is the right thing to do, it is probably a woefully inadequate intervention for improving the living standards of the population many believe it will benefit.  A recent CBO analysis projects the effects for two levels of a minimum wage hike to either $9.00 or $10.10 (it's $7.25 now).  Here are some bullets from the $10.10 scenario:  
  • Many low-wage workers would see an increase in their earnings.
  • Some of the people earning slightly more than $10.10 would also have higher earnings.
  • Increased earnings for low-wage workers would not go only to low-income families, because many low-wage workers are not members of low-income families. Just 19 percent would accrue to families with earnings below the poverty threshold, whereas 29 percent would accrue to families earning more than three times the poverty threshold.
  • Some people will became jobless because of the minimum-wage increase.
  • Business owners and consumers will face higher prices.
Analyzing policies based on economic realities complicates simple realities.  And it may be one explanation for the prevailing prejudice liberals have about economists -- that they're all Republicans.  At $10.10 per hour, assuming that the number of hours in a typical work year is 2080, a minimum wage worker could expect to earn an annual income of $21,008, that's before taxes and don't forget health insurance premiums.   I can't see how anyone could manage a decent standard of living on such a salary without subsidies from somewhere and forget it if they're responsible for any dependents.