Health and Medicine

FSI’s researchers assess health and medicine through the lenses of economics, nutrition and politics. They’re studying and influencing public health policies of local and national governments and the roles that corporations and nongovernmental organizations play in providing health care around the world. Scholars look at how governance affects citizens’ health, how children’s health care access affects the aging process and how to improve children’s health in Guatemala and rural China. They want to know what it will take for people to cook more safely and breathe more easily in developing countries.

FSI professors investigate how lifestyles affect health. What good does gardening do for older Americans? What are the benefits of eating organic food or growing genetically modified rice in China? They study cost-effectiveness by examining programs like those aimed at preventing the spread of tuberculosis in Russian prisons. Policies that impact obesity and undernutrition are examined; as are the public health implications of limiting salt in processed foods and the role of smoking among men who work in Chinese factories. FSI health research looks at sweeping domestic policies like the Affordable Care Act and the role of foreign aid in affecting the price of HIV drugs in Africa.

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Covid-19 has exposed major weaknesses in the United States’ federalist system of public health governance, which divides powers among the federal, state, and local governments. SARS-CoV-2 is exactly the type of infectious disease for which federal public health powers and emergencies were conceived: it is highly transmissible, crosses borders efficiently, and threatens our national infrastructure and economy. Its prevalence varies around the country, with states such as Washington, California, and New York hit particularly hard, but cases are mounting nationwide with appalling velocity. Strong, decisive national action is therefore imperative.

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Publication Type
Journal Articles
Publication Date
Journal Publisher
New England Journal of Medicine
Authors
Michelle Mello
Number
2020
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“We believe health professionals have a moral duty to practice `upstanding’ — intervening as bystanders — in response to sexual harassment and general bias and that this obligation should be described in codes of medical professional ethics and supported within institutional training,” the authors write. While many medical professional societies now mention sexual harassment in their ethical codes, these guidelines fall short in that they do not encourage professionals to respond to the behaviors and intervene when they become aware of discrimination or harassment. The only large specialty society whose guidelines contain “aspirational advice” to stop sexual harassment in its tracks is the American Association of Orthopaedic Surgeons.

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Publication Type
Commentary
Publication Date
Journal Publisher
New England Journal of Medicine
Authors
Michelle Mello
Number
2020
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Urgent responses to the Covid-19 pandemic have halted movement and work and dramatically changed daily routines for much of the world’s population. In the United States, many states and localities have ordered or urged residents to stay home when able and to practice physical distancing when not. Meanwhile, unemployment is surging, schools are closed, and businesses have been shuttered. Resistance to drastic disease-control measures is already evident. Rising infection rates and mortality, coupled with scientific uncertainty about Covid-19, should keep resentment at bay — for a while. But the status quo isn’t sustainable for months on end; public unrest will eventually become too great.

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Publication Type
Journal Articles
Publication Date
Journal Publisher
New England Journal of Medicine
Authors
David Studdert
Number
2020
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BACKGROUND

Research has consistently identified firearm availability as a risk factor for suicide. However, existing studies are relatively small in scale, estimates vary widely, and no study appears to have tracked risks from commencement of firearm ownership.

METHODS

We identified handgun acquisitions and deaths in a cohort of 26.3 million male and female residents of California, 21 years old or older, who had not previously acquired handguns. Cohort members were followed for up to 12 years 2 months (from October 18, 2004, to December 31, 2016). We used survival analysis to estimate the relationship between handgun ownership and both all-cause mortality and suicide (by firearm and by other methods) among men and women. The analysis allowed the baseline hazard to vary according to neighborhood and was adjusted for age, race and ethnic group, and ownership of long guns (i.e., rifles or shotguns).

RESULTS

A total of 676,425 cohort members acquired one or more handguns, and 1,457,981 died; 17,894 died by suicide, of which 6691 were suicides by firearm. Rates of suicide by any method were higher among handgun owners, with an adjusted hazard ratio of 3.34 for all male owners as compared with male nonowners (95% confidence interval [CI], 3.13 to 3.56) and 7.16 for female owners as compared with female nonowners (95% CI, 6.22 to 8.24). These rates were driven by much higher rates of suicide by firearm among both male and female handgun owners, with a hazard ratio of 7.82 for men (95% CI, 7.26 to 8.43) and 35.15 for women (95% CI, 29.56 to 41.79). Handgun owners did not have higher rates of suicide by other methods or higher all-cause mortality. The risk of suicide by firearm among handgun owners peaked immediately after the first acquisition, but 52% of all suicides by firearm among handgun owners occurred more than 1 year after acquisition.

CONCLUSIONS

Handgun ownership is associated with a greatly elevated and enduring risk of suicide by firearm. (Funded by the Fund for a Safer Future and others.)

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Publication Type
Journal Articles
Publication Date
Journal Publisher
New England Journal of Medicine
Authors
David Studdert
Jonathan Rodden
Number
2020
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Since the onset of the Covid-19 crisis in the United States, government action taken to “flatten” the curve of disease transmission has varied dramatically among states, counties, and cities. The early epicenters — New York City, Washington State, and the San Francisco Bay Area — implemented aggressive measures in mid-March, many of which remain in place. Other states and localities opted for milder restrictions, acted much later, or barely intervened at all. Many states began unwinding restrictions weeks ago, although surging case numbers are prompting some to change course. The patchwork nature of the response helps explain the current situation: Covid-19’s spread now has many different trajectories, which partly track jurisdictional boundaries. In the third week of July, for example, Covid-19 incidence was 10 times as high in some states as in others.

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Publication Type
Journal Articles
Publication Date
Journal Publisher
New England Journal of Medicine
Authors
David Studdert
Michelle Mello
Number
2020
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**Please note all CDDRL events are scheduled using the Pacific Time Zone

About the Event:

On November 3, in the midst of a pandemic, America elects its next President. CDDRL scholars will discuss the election results (or election challenges), Trump and Biden, key Congressional races, and what to expect between November and Inauguration Day. Join Bruce Cain, Nate Persily, Hakeem Jefferson, and Didi Kuo.

About the Speakers:

Bruce E. Cain is a Professor of Political Science at Stanford University and Director of the Bill Lane Center for the American West. He received a BA from Bowdoin College (1970), a B Phil. from Oxford University (1972) as a Rhodes Scholar, and a Ph D from Harvard University (1976). He taught at Caltech (1976-89) and UC Berkeley (1989-2012) before coming to Stanford. Professor Cain was Director of the Institute of Governmental Studies at UC Berkeley from 1990-2007 and Executive Director of the UC Washington Center from 2005-2012. His areas of expertise include political regulation, applied democratic theory, representation and state politics.

Nathaniel Persily is the James B. McClatchy Professor of Law at Stanford Law School, with appointments in the departments of Political Science, Communication and FSI.  Prior to joining Stanford, Professor Persily taught at Columbia and the University of Pennsylvania Law School, and as a visiting professor at Harvard, NYU, Princeton, the University of Amsterdam, and the University of Melbourne. Professor Persily’s scholarship and legal practice focus on American election law or what is sometimes called the “law of democracy,” which addresses issues such as voting rights, political parties, campaign finance, redistricting, and election administration. He has served as a special master or court-appointed expert to craft congressional or legislative districting plans for Georgia, Maryland, Connecticut, and New York, and as the Senior Research Director for the Presidential Commission on Election Administration. In addition to dozens of articles (many of which have been cited by the Supreme Court) on the legal regulation of political parties, issues surrounding the census and redistricting process, voting rights, and campaign finance reform.

Hakeem Jefferson is an Assistant Professor of Political Science at Stanford University. His research interests move at the intersection of American politics and social psychology. In particular, his current work examines the conditions under which members of stigmatized groups punish group members who transgress social norms. Moving beyond a study of identity that centers largely on the attitudes and predilections of dominant social groups, his work explores the psychological and instrumental considerations stigmatized individuals bring to bear in response to “bad” (negatively stereotyped) behavior from within their own group. Using African-Americans as the test case, this work builds on scholarship about the politics of respectability and in-group policing to inform conversations about Blacks’ attitudes toward punitive social policies.

Didi Kuo is the Associate Director for Research and Senior Research Scholar at the Center on Democracy, Development, and the Rule of Law at Stanford University. She is a scholar of comparative politics, with a focus on democratization, corruption and clientelism, political parties and institutions, and political reform. Her recent work examines changes to party organization, and the impact these changes have on the ability of governments to address challenges posed by global capitalism. She is the author of Clientelism, Capitalism, and Democracy: the rise of programmatic politics in the United States and Britain (Cambridge University Press, 2018), which examines the role of business against clientelism and the development of modern political parties in the nineteenth-century.

Online, via Zoom: REGISTER

Bruce Cain Professor of Political Science at Stanford University
Stanford Law School Neukom Building, Room N230 Stanford, CA 94305
650-725-9875
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James B. McClatchy Professor of Law at Stanford Law School
Senior Fellow, Freeman Spogli Institute
Professor, by courtesy, Political Science
Professor, by courtesy, Communication
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Nathaniel Persily is the James B. McClatchy Professor of Law at Stanford Law School, with appointments in the departments of Political Science, Communication, and FSI.  Prior to joining Stanford, Professor Persily taught at Columbia and the University of Pennsylvania Law School, and as a visiting professor at Harvard, NYU, Princeton, the University of Amsterdam, and the University of Melbourne. Professor Persily’s scholarship and legal practice focus on American election law or what is sometimes called the “law of democracy,” which addresses issues such as voting rights, political parties, campaign finance, redistricting, and election administration. He has served as a special master or court-appointed expert to craft congressional or legislative districting plans for Georgia, Maryland, Connecticut, New York, North Carolina, and Pennsylvania.  He also served as the Senior Research Director for the Presidential Commission on Election Administration. In addition to dozens of articles (many of which have been cited by the Supreme Court) on the legal regulation of political parties, issues surrounding the census and redistricting process, voting rights, and campaign finance reform, Professor Persily is coauthor of the leading election law casebook, The Law of Democracy (Foundation Press, 5th ed., 2016), with Samuel Issacharoff, Pamela Karlan, and Richard Pildes. His current work, for which he has been honored as a Guggenheim Fellow, Andrew Carnegie Fellow, and a Fellow at the Center for Advanced Study in the Behavioral Sciences, examines the impact of changing technology on political communication, campaigns, and election administration.  He is codirector of the Stanford Program on Democracy and the Internet, and Social Science One, a project to make available to the world’s research community privacy-protected Facebook data to study the impact of social media on democracy.  He is also a member of the American Academy of Arts and Sciences, and a commissioner on the Kofi Annan Commission on Elections and Democracy in the Digital Age.  Along with Professor Charles Stewart III, he recently founded HealthyElections.Org (the Stanford-MIT Healthy Elections Project) which aims to support local election officials in taking the necessary steps during the COVID-19 pandemic to provide safe voting options for the 2020 election. He received a B.A. and M.A. in political science from Yale (1992); a J.D. from Stanford (1998) where he was President of the Stanford Law Review, and a Ph.D. in political science from U.C. Berkeley in 2002.   

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Date Label
James B. McClatchy Professor of Law at Stanford Law School
Hakeem Jefferson Assistant Professor of Political Science at Stanford University

Encina Hall, C150
616 Jane Stanford Way
Stanford, CA 94305

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Center Fellow, Freeman Spogli Institute for International Studies
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Didi Kuo is a Center Fellow at the Freeman Spogli Institute for International Studies (FSI) at Stanford University. She is a scholar of comparative politics with a focus on democratization, corruption and clientelism, political parties and institutions, and political reform. She is the author of The Great Retreat: How Political Parties Should Behave and Why They Don’t (Oxford University Press) and Clientelism, Capitalism, and Democracy: the rise of programmatic politics in the United States and Britain (Cambridge University Press, 2018).

She has been at Stanford since 2013 as the manager of the Program on American Democracy in Comparative Perspective and is co-director of the Fisher Family Honors Program at CDDRL. She was an Eric and Wendy Schmidt Fellow at New America and is a non-resident fellow with the Carnegie Endowment for International Peace. She received a PhD in political science from Harvard University, an MSc in Economic and Social History from Oxford University, where she studied as a Marshall Scholar, and a BA from Emory University.

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Associate Director for Research and Senior Research Scholar at the Center on Democracy, Development, and the Rule of Law at Stanford University.
Seminars
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Avi Tuschman, Adam Berinsky, David Rand

Please join the Cyber Policy Center for Exploring Potential “Solutions” to Online Disinformation​, hosted by Cyber Policy Center's Kelly Born, with guests Adam Berinsky, Mitsui Professor of Political Science at MIT and Director of the MIT Political Experiments Research Lab (PERL) at MIT, David Rand, Erwin H. Schell Professor and an Associate Professor of Management Science and Brain and Cognitive Sciences, and Director of the Human Cooperation Laboratory and the Applied Cooperation Team at MIT, and Avi Tuschman, Founder & CIO, Pinpoint Predictive. The session is open but registraton is required.

Adam Berinsky is the Mitsui Professor of Political Science at MIT and serves as the director of the MIT Political Experiments Research Lab (PERL). He is also a Faculty Affiliate at the Institute for Data, Systems, and Society (IDSS). Berinsky received his PhD from the University of Michigan in 2000. He is the author of "In Time of War: Understanding American Public Opinion from World War II to Iraq" (University of Chicago Press, 2009). He is also the author of "Silent Voices: Public Opinion and Political Participation in America" (Princeton University Press, 2004) and has published articles in many journals. He is currently the co-editor of the Chicago Studies in American Politics book series at the University of Chicago Press. He is also the recipient of multiple grants from the National Science Foundation and was a fellow at the Center for Advanced Study in the Behavioral Sciences.

David Rand is the Erwin H. Schell Professor and an Associate Professor of Management Science and Brain and Cognitive Sciences at MIT Sloan, and the Director of the Human Cooperation Laboratory and the Applied Cooperation Team. Bridging the fields of behavioral economics and psychology, David’s research combines mathematical/computational models with human behavioral experiments and online/field studies to understand human behavior. His work uses a cognitive science perspective grounded in the tension between more intuitive versus deliberative modes of decision-making, and explores topics such as cooperation/prosociality, punishment/condemnation, perceived accuracy of false or misleading news stories, political preferences, and the dynamics of social media platform behavior. 

Avi Tuschman is a Stanford StartX entrepreneur and founder of Pinpoint Predictive, where he currently serves as Chief Innovation Officer and Board Director. He’s spent the past five years developing the first Psychometric AI-powered data-enrichment platform, which ranks 260 million individuals for performance marketing and risk management applications. Tuschman is an expert on the science of heritable psychometric traits. His book and research on human political orientation have been covered in peer-reviewed and mainstream media from 25 countries. Previous to his career in tech, he advised current and former heads of state as well as multilateral development banks in the Western Hemisphere. Tuschman completed his undergraduate and doctoral degrees in evolutionary anthropology at Stanford.

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Noa Ronkin
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The world’s population is aging at a faster rate and in larger cohorts than ever before. In countries like Japan that have low fertility rates and high life expectancy, population aging is a risk to social sustainability. Developing policies and healthcare infrastructure to support aging populations is now critical to the social, economic, and developmental wellbeing of all nations. As the COVID-19 pandemic has repeatedly shown, accurate projections of future population health status are crucial for designing sustainable healthcare services and social security systems.

Such projections necessitate models that incorporate the diverse and dynamic associations between health, economic, and social conditions among older people. However, the currently available models – known as multistate transition microsimulation models – require high-quality panel data for calibration and meaningful estimates. Now a group of researchers, including APARC Deputy Director and Asia Health Policy Program Director Karen Eggleston, has developed an alternative method that relaxes this data requirement.

In a newly published paper in Health Economics, Eggleston and her colleagues describe their study that proposes a novel approach using more readily-available data in many countries, thus promising more accurate projections of the future health and functional status of elderly and aging populations. This alternative method uses cross‐sectional representative surveys to estimate multistate‐transition contingency tables applied to Japan's population. When combined with estimated comorbidity prevalence and death record information, this method can determine the transition probabilities of health statuses among aging cohorts.

In comparing the results of their projections against a control, Eggleston and her colleagues show that traditional static models do not always accurately forecast the prevalence of some comorbid conditions such as cancer, heart disease, and stroke. While the sample sets used to test the new methodology originate in Japan, the proposed multistate transition contingency table method has important applications for aging societies worldwide. As rapid population aging becomes a global trend, the ability to produce robust forecasts of population health and functional status to guide policy is a universal need.

Read the full paper in Health Economics.

Learn more about Eggleston’s research projects >>

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A communications robot named Pepper by Softbank
Q&As

Robots May Be the Right Prescription for Struggling Nursing Homes

Karen Eggleston and Yong Suk Lee speak to the Oliver Wyman Forum on how robotics and advancing technologies are helping staff in Japanese nursing homes provide better and safer care to their patients.
Robots May Be the Right Prescription for Struggling Nursing Homes
Portrait of Young Kyung Do, Winner of the 2020 Rothman Epidemiology Prize
News

Asia Health Policy Program Alum Wins Rothman Epidemiology Prize

Dr. Young Kyung Do, an expert in health policy and management at the Seoul National University College of Healthy Policy and the inaugural postdoctoral fellow in Asia health policy at APARC, has been awarded the 2020 prize for his outstanding publication in the journal Epidemiology last year.
Asia Health Policy Program Alum Wins Rothman Epidemiology Prize
Cover image of the book "Healthy Aging in Asia", showing a smiling elderly Chinese woman with a cane standing in a small village.
News

New Book Highlights Policy Initiatives and Economic Research on Healthy Longevity Across Asia

Asia health policy expert Karen Eggleston’s new volume, ‘Healthy Aging in Asia,’ examines how diverse Asian economies – from Singapore and Hong Kong to Japan, India, and China – are preparing for older population age structures and transforming health systems to support patients who will live with chronic disease for decades.
New Book Highlights Policy Initiatives and Economic Research on Healthy Longevity Across Asia
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An elderly individual travels in a cart up a street.
An elderly individual travels in a cart up a street.
Galen Crout, Unsplash
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Asia Health Policy Director Karen Eggleston and her colleagues unveil a multistate transition microsimulation model that produces rigorous projections of the health and functional status of older people from widely available datasets.

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George G.C. Parker Professor of Finance and Economics, Stanford Graduate School of Business
Director of the Corporations and Society Initiative, Stanford Graduate School of Business
Director of the Program on Capitalism and Democracy, Center on Democracy, Development and the Rule of Law
Senior Fellow, Stanford Institute for Economic Policy Research
Senior Fellow (by courtesy), Freeman Spogli Institute for International Studies
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Anat R. Admati is the George G.C. Parker Professor of Finance and Economics at Stanford University Graduate School of Business (GSB), a Faculty Director of the GSB Corporations and Society Initiative, and a senior fellow at Stanford Institute for Economic Policy Research. She has written extensively on information dissemination in financial markets, portfolio management, financial contracting, corporate governance and banking. Admati’s current research, teaching and advocacy focus on the complex interactions between business, law, and policy with focus on governance and accountability.

Since 2010, Admati has been active in the policy debate on financial regulations. She is the co-author, with Martin Hellwig, of the award-winning and highly acclaimed book The Bankers’ New Clothes: What’s Wrong with Banking and What to Do about It (Princeton University Press, 2013; bankersnewclothes.com). In 2014, she was named by Time Magazine as one of the 100 most influential people in the world and by Foreign Policy Magazine as among 100 global thinkers.

Admati holds BSc from the Hebrew University, MA, MPhil and PhD from Yale University, and an honorary doctorate from University of Zurich. She is a fellow of the Econometric Society, the recipient of multiple fellowships, research grants, and paper recognition, and is a past board member of the American Finance Association. She has served on a number of editorial boards and is a member of the FDIC’s Systemic Resolution Advisory Committee, a former member of the CFTC’s Market Risk Advisory Committee, and a former visiting scholar at the International Monetary Fund.

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In collaboration with TeachAids, Stanford Medicine, and the University of California, San Francisco, SPICE is helping to develop the CoviDB Speaker Series, which seeks to provide free online videos to educate the general public about the ongoing COVID-19 pandemic. SPICE’s work is focused on the development of teacher guides for the Series. Leading the Series is Dr. Piya Sorcar, CEO & Founder, TeachAids. The first three speakers and their topics are Dr. Anurag Mairal, Director of Global Outreach, Stanford Biodesign, “COVID-19 and Global Health: Facts and Myths”; Shuman Ghosemajumder, Global Head of AI at F5, “Cybersecurity and Privacy in the Era of COVID-19”; and Anne Firth Murray, Founding President, Global Fund for Women, “Violence Against Women.”

Read a recent article from The Stanford Daily about this here.


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CoviDB Speaker Series; photo courtesy, TeachAids
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In collaboration with TeachAids, Stanford Medicine, and the University of California, San Francisco, SPICE is helping to develop the CoviDB Speaker Series, which seeks to provide free online videos to educate the general public about the ongoing COVID-19 pandemic.

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