In addition to the most pressing issues of the day, scholars at the Freeman Spogli Institute for International Studies focus their research on many regions of the world, from Beijing to Brazil.
Research Spotlight
The Ripple Effects of China’s College Expansion on American Universities
Researchers at SCCEI trace how China’s unprecedented expansion of higher education has impacted U.S. graduate education and local economies surrounding college towns.
While Nayib Bukele's style of authoritarianism may have some successes on paper, Beatriz Magaloni and Alberto Diaz-Cayeros argue that the regime is headed for a reckoning.
Time for Iran to Make a No-enrichment Nuclear Deal
The time has come for Iran’s leaders to reconsider their past intransigent, deceptive posture and instead pursue a nuclear power program that will benefit the Iranian people, write Abbas Milani and Siegfried Hecker.
During the COVID-19 pandemic, courts have limited the federal government’s ability to impose vaccination mandates; some judges have also questioned whether states must grant religious exemptions to vaccination mandates. The Supreme Court’s June 2023 decision in Groff v DeJoy2 concerning Title VII of the Civil Rights Act of 1964 raises new questions about the ability of private employers—including health care organizations—to enforce vaccination requirements for employees who have religious objections.
Objective To test the feasibility and effectiveness of a mindfulness-based intervention in rural-to-urban migrant Chinese children using trained community volunteers.
Method Migrant students ages 9 to 16 from 5 schools in Shanghai (N = 653) were randomly assigned to a mindfulness only group (n = 167), a mindfulness plus life skills group (n = 118), or a waitlist control group (n = 368). The first 2 groups received an 8-week mindfulness intervention delivered 1 hour weekly by trained community volunteers. The mindfulness plus life skills group received 8 additional hours of skills-based mentorship. Measurements on mindfulness, resilience, and anxiety and depression symptoms were collected before and after intervention. Multivariable regression analyses compared the intervention vs control groups.
Results Before intervention, there were no significant demographic or outcome measure differences between groups except that students in the intervention groups were slightly older. Students had relatively low levels of mindfulness and prosociality difficulties and similar degrees of depression and anxiety symptoms compared with prior studies. After intervention, no statistically significant differences were found in mean scores for mindfulness, resilience, anxiety, or depression in the intervention vs control groups.
Conclusion A volunteer-led mindfulness intervention did not significantly benefit migrant Chinese children after 8 weeks. More implementation research is needed for low-cost, scalable, and contextually effective mental health prevention programs.
Low- to moderate-intensity statins were associated with a greater reduction in LDL-C levels in older persons than younger persons and may be more appealing as initial treatment in older adults who are at increased risk for adverse events.
The authority of states and localities to require vaccination is a bedrock principle of public health law. Since 1905, when the US Supreme Court upheld compulsory smallpox inoculations, there has been sustained judicial consensus that the Constitution “does not import an absolute right to be…wholly freed from restraint.” Otherwise, “organized society could not exist with safety to its members.” Until recently, objections to mandatory vaccinations were confined to a small minority of US residents. However, civic values eroded during the COVID-19 pandemic, creating a groundswell of resistance. With state legislatures now sharply limiting public health authority and a bevy of legal challenges mounted vaccination mandates—an old and highly effective public health tool—face legal uncertainty that only a few years ago seemed inconceivable.
Society for Medical Decision Making,
July 18, 2023
Under the current US kidney allocation system, older candidates receive a disproportionately small share of deceased donor kidneys despite a reserve of potentially usable kidneys that could shorten their wait times. To consider potential health gains from increasing access to kidneys for these candidates, we developed and calibrated a microsimulation model of the transplantation process and long-term outcomes for older deceased donor kidney transplant candidates.
Introduction: The high incidences of both the developmental delay among young children and the mental health problems of their caregivers are major threats to public health in low-income and middle-income countries. Parental training interventions during early childhood have been shown to benefit early development, yet evidence on strategies to promote caregiver mental health remains limited. In addition, evidence on the optimal design of scalable interventions that integrate early child development and maternal mental health components is scarce.
Methods and analysis: We design a single-blind, factorial, cluster-randomised controlled, superiority trial that will be delivered and supervised by local agents of the All China Women’s Federation (ACWF), the nationwide, government-sponsored social protection organization that aims to safeguard the rights and interests of women and children. We randomise 125 villages in rural China into four arms: (1) a parenting stimulation arm; (2) a caregiver mental health arm; (3) a combined parenting stimulation and caregiver mental health arm and (4) a pure control arm. Caregivers and their children (aged 6–24 months at the time of baseline data collection) are selected and invited to participate in the 12-month-long study. The parenting stimulation intervention consists of weekly, one-on-one training sessions that follow a loose adaptation of the Reach Up and Learn curriculum. The caregiver mental health intervention is comprised of fortnightly group activities based on an adaptation of the Thinking Healthy curriculum from the WHO. Primary outcomes include measures of child development and caregiver mental health. Secondary outcomes include a comprehensive set of physical, psychological and behavioural outcomes. This protocol describes the design and evaluation plan for this programme.
Ethics and dissemination: This study received approval from the Institutional Review Board of Stanford University (IRB Protocol #63680) and the Institutional Review Board of the Southwestern University of Finance and Economics in Chengdu, Sichuan, China. Informed oral consent will be obtained from all caregivers for their own and their child’s participation in the study. The full protocol will be publicly available in an open-access format. The study findings will be published in economics, medical and public health journals, as well as Chinese or English policy briefs.
China's higher education system has undergone a rapid expansion over the last two decades. By drawing on hand-collected data, we explore students' experiences in college and in the labor market post-graduation in the wake of this expansion. According to our data, the largest employer of college graduates in the labor market was the state sector, followed by the domestic private sector. To explain the returns to college education in China, we explore three mechanisms: human capital, social networks, and signaling. We find that human capital measures, apart from a student's college English test scores, cannot explain the college wage premium, whereas both social networks (for example, membership of the Communist Party) and signaling matter significantly. This seems to indicate that in China, connections are crucial for student success in the labor market, whereas the higher education system itself is more a system for selecting talented individuals than it is for educating them. Finally, students allocate their time accordingly, for example, by spending more time studying English in college than any other subject.
Is government guiding the invisible hand at the top of the labor market? We use new administrative data to measure physicians' earnings and estimate the influence of healthcare policies on these earnings, physicians' labor supply, and allocation of talent. Combining the administrative registry of U.S. physicians with tax data, Medicare billing records, and survey responses, we find that physicians' annual earnings average $350,000 and comprise 8.6% of national healthcare spending. The age-earnings profile is steep; business income comprises one quarter of earnings and is systematically underreported in survey data. There are major differences in earnings across specialties, regions, and firm sizes, with an unusual geographic pattern compared with other workers. We show that health policy has a major impact on the margin: 25% of physician fee revenue driven by Medicare reimbursements accrues to physicians personally. Physicians earn 6% of public money spent on insurance expansions. We find that these policies in turn affect the type and quantity of medical care physicians supply in the short run; retirement timing in the medium run; and earnings affect specialty choice in the long run.
Radioactive Cs-rich microparticles (CsMPs) released from the Fukushima Daiichi Nuclear Power Plant (FDNPP) are a potential health risk through inhalation.
A collaboration between the Stanford Internet Observatory and Thorn looks at the risks of sexual abuse material produced using machine learning image generators.
One out of every three children under the age of 5 in developing countries lives in an environment that impedes human capital development. Children growing up in resource-poor settings are at an increased risk of early developmental delay due to risk factors such as being in environments that lack cognitive stimulation, nutrition, or care in the home environment. Given that early developmental deficits are difficult to reverse later in life, such deficits are key drivers of inequality and impediments for intergenerational mobility. This policy brief reviews this problem and then proposes a design of cost-effective, scalable, and sustainable parental training programs (focusing on psychosocial stimulation for young children) as a global strategy to improve the developmental opportunities of children before they reach the age of 5 in developing countries, to remediate social inequalities, and to boost long-term economic development. We present concrete policy recommendations for the implementation of such programs at scale.
Report prepared by the Deliberative Democracy Lab at Stanford University, housed within the Center on Democracy, Development and the Rule of Law at the Freeman Spogli Institute for International Studies
One-time CKD screening at age 55 years had an ICER of $86 300 per QALY gained by increasing costs from $249 800 to $259 000 and increasing QALYs from 12.61 to 12.72; this was accompanied by a decrease in the incidence of kidney failure requiring dialysis or kidney transplant of 0.29 percentage points and an increase in life expectancy from 17.29 to 17.45 years. Other options were also cost-effective. During ages 35 to 75 years, screening once prevented dialysis or transplant in 398 000 people and screening every 10 years until age 75 years cost less than $100 000 per QALY gained.
Proceedings of the National Academy of Sciences (PNAS),
June 12, 2023
Significance One fundamental issue in economic, psychological, and social sciences is whether and how much income truly brings happiness. This paper draws on twins data to examine whether income indeed affects happiness and estimates the size of such an effect. We control for unobserved genetic factors that may impact both income and happiness using identical twins, address measurement error bias, and conduct a series of robustness checks. Income has a much larger effect than previous estimates: doubling income boosts the four-scale happiness value by 0.26 scales or 0.37 SDs. Heterogeneity analyses suggest that income matters most for males and the middle-aged. Our findings emphasize the importance of income maintenance for individuals’ well-being.
Abstract We estimate the causal effect of income on happiness using a unique dataset of Chinese twins. This allows us to address omitted variable bias and measurement errors. Our findings show that individual income has a large positive effect on happiness, with a doubling of income resulting in an increase of 0.26 scales or 0.37 SDs in the four-scale happiness measure. We also find that income matters most for males and the middle-aged. Our results highlight the importance of accounting for various biases when studying the relationship between socioeconomic status and subjective well-being.
On June 6th 2023, Steven C. Hazy lecturer Rose Gottemoeller spoke at a roundtable organized by the National Nuclear Security Administration and the National Defense University. Find her full speech below.
