Health Care | John Barrdear

Archive for the 'Health Care' Category

Enquiring minds want to know …

Are obese people more likely to break their bones when they fall over because of their extra weight?

I can imagine that their bones are stronger than healthy-weighted people, but are they sufficiently stronger to make up for the extra pressure in a fall (as opposed to just walking around)?

Fat = lower wages on average?

Via Steven Levitt, here’s an interesting paper by Roy Wada and Erdal Tekin:  “Body Composition and Wages

This paper examines the effect of body composition on wages. We develop measures of body composition - body fat (BF) and fat-free mass (FFM) - using data on bioelectrical impedance analysis (BIA) that are available in the National Health and Nutrition Examination Survey III and estimate wage models for respondents in the National Longitudinal Survey of Youth 1979. Our results indicate that increased body fat is unambiguously associated with decreased wages for both males and females. This result is in contrast to the mixed and sometimes inconsistent results from the previous research using body mass index (BMI). We also find new evidence indicating that a higher level of fat-free body mass is consistently associated with increased hourly wages. We present further evidence that these results are not the artifacts of unobserved heterogeneity. Our findings are robust to numerous specification checks and to a large number of alternative BIA prediction equations from which the body composition measures are derived.

Our work addresses an important limitation of the current literature on the economics of obesity. Previous research relied on body weight or BMI for measuring obesity despite the growing agreement in the medical literature that they represent misleading measures of obesity because of their inability to distinguish between body fat and fat-free body mass. Body composition measures used in this paper represent significant improvements over the previously used measures because they allow for the effects of fat and fat free components of body composition to be separately identified. Our work also contributes to the growing literature on the role of non-cognitive characteristics on wage determination.

Looking very briefly through the paper, they don’t seem to be looking at what I would have thought an important factor:  relative obesity.  Wada and Tekin don’t seem to postulate a mechanism for how body fat leads to lower wages on average.  While I’m happy to accept that it may come about because of lower productivity, it also seems reasonable to ask if it’s also partially because of a selection bias by employers.  On that basis, looking at how much fat a person is carrying relative to their community average would seem to be important.

Update:  I’m obviously assuming both causality and direction of causality here, but my comment still holds.  A strong result on my suggested extra regressor would, to me, seem to provide evidence of that causality.

I swear I’m not a junkie

My wife is American.  This has various benefits for me, but one of the best is the opportunity, at this time of year, to gorge myself stupid.  Last Thursday was Thanksgiving in the U.S., but we decided to have our little shovel-food-down-your-throat-athon on Sunday night with some of my wife’s friends from university.  The turkey was bought on Friday, the giblets removed and discarded (sorry, I just can’t handle them) and we were ready to get started with marinading it.

My wife wanted to follow in her mother’s footsteps by injecting the turkey with red wine.  I’d never heard of this technique before, but a good roast is worth a lot in my book and a turkey is famously difficult to keep moist, so I was keen to try it.  I raided our travel first-aid kit to look for our syringe, but to no avail.  Okay, no worries, it’s off to the chemist we go to get another one.  The coversation, at a Boots, as it happens, went like this:

Us:  Hi.  Do you have any needles?  Syringes?

Them:  Ummm … maybe.  Is it for travelling?

Us:  No.  It’s for a turkey.  We’re going to inject it with wine.

Them:  Ahhh, no.

Us:  Okay, then.  It is for travelling. [Yes, yes, I know.  This wasn't the most subtle of ploys]

Them:  We’ll need to order them in.  It’ll take two weeks.

Yeah, right.  The implication was pretty clear - hovering in the air, as it were.  They weren’t going to take the slightest risk of selling needles to drug users.  To really slam home the fact that they were looking out for their jobs in a big corporate chain, the conversation finished with:

 Us:  Well, do you know where we might be able to find one?

Them:  Perhaps at an independent pharmacy.

… which is exactly what we did.  There’s a wonderful chemist on England’s Lane that just looks Italian (next time you go to Italy, pay attention to the chemists - they’re fantastically unique).  It’s certainly run by an Italian lady and she was fascinated by the idea of injecting wine directly into the meat.  She insisted on my wife spelling out all the recipe details as she promptly sold us a pack of 10 1ml syringes for £2.90.  It was simple, it was easy, it was friendly and it was helpful.  She’ll keep our business from now on.

I got really quite angry from the whole affair.  My wife and I don’t look particularly shabby (I hope).  We were clearly entering the Boots as a couple.  We weren’t shifting around on our feet or trying to speak quietly to avoid undue attention.  None of these seem consistent with how I imagine a drug abuser would present.  It seems perfectly reasonable - to me - to have believed that we were genuine in our request.

But even if we weren’t, I still would have been upset with them.  Yes, the UK operates a needle exchange programme, but any kind of restriction on the sale of needles simply raises their implicit price, which can only encourage drug users to share needles.  If a chain of Chemists can’t be sold on the idea of harm minimisation, we’re in real trouble.

The turkey turned out great, by the way.  We used a Malbec to inject it with, stuffed it with chopped-up apple, prunes and garlic (the bread-based stuffing was being brought by someone else) to sweaten the meat a little, sprinkled quite a lot of rosemary over the skin, roasted it with tin-foil over the top for the first two hours and without the tin-foil for the last hour.  Beautiful.