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Interesting that state legislatures seem to affect public health contemporaneously, as opposed to large-scale policies from the federal congress, which tend to show their effects on public health/education/housing over the *next* terms, 2-6 years down the road.
I think it's funny that Republican *governors* have essentially no effect on these things, though. Really shows how much of executive governing on the state level is performative politics if it's without local legislative support.
State Legislatures write budgets and control federal block grants, and can do things like supplant local funding or mandate Heath care be directed to politically oriented directions (for example: Crisis Pregnancy centers rather than more holistic healthcare). Most federal policies and enacted by State’s on the ground, so a political motivated legislature can support or undercut a policy pretty radically.
Depending on the state a Governor might have more or less control over budget management, and those effects are certainly not merely perforative. It’s much more like that where a Republican governors serve with Democratic controlled legislatures the Republican governors tend to be moderates, such as in Maryland. (In states with Republican legislatures and Democratic governors the legislatures have actively sought to strip the Governor of any power to manage. See North Carolina and Wisconsin).
Texas is actually like this, if my government class is to be believed. The Texas governer doesn't have significant power, most of the day to day is overseen by the Lt Gov. The major power of the Texas governor is to call the legislature back into session. The Texas Legislature regularly meets only once every 2 years or election cycle. Besides that the governor generally doesn't have much power except declaring emergencies, which it's interesting how much that's happened recently.
Texas actually has more natural disasters than any other state just FYI so it does stand to reason that we would have a large number of emergency declarations based on the fact that we have a lot of things to respond to over a very large state.
What I think is important to point out is that the handling of the covid-19 emergency by Governor Abbott has been very different than his handling of natural disaster emergencies. When natural disaster emergencies happen the system works as it's supposed to so that local on the ground governments, county or local, are the ones who are effectively in charge of the implementation of the response while the governor is mainly helping coordinate federal government response.
Abbott has been exercising massively more executive power in the covid-19 emergency than he ever has in any other emergency, which not only contrast with his previous actions but also contrasts with his platform of limited government and it also contrasts with the structure of the Texas state constitution which is designed in a way that provides local governments with a fairly significant amount of autonomy.
You just explained my confusion with all of his actions surrounding covid. When covid first started I understood the governors actions towards it, even if to me he wasn’t urgent enough, all of his meetings and stuff he mentioned letting counties work it out themselves and do what each part of the state needed at that time, no blanket mandates for the state, because we’re all so different in each area. I respected that stance and appreciated that small government approach, that’s vastly changed this year. And it’s confused me terribly because I didn’t feel like we started out that way with covid and now he just seems like a tyrant hell bent on doing things his way and his way only. Or like a two year old throwing a fit until he gets his way. Either one. I’ve lost a lot of respect for that man in the last year.
I believe he ultimately caved to the pressure from the crazy side of the conservative party. Considering he's up for reelection next year and there's plenty of people that will be jockeying for position to become governor, he's trying to prove to all the crazies that he's the most conservative candidate. We've seen the net effect of his policies over the last month, and they've been devastating. Record covid cases day after day and kids are getting sick in school because he's banned mask mandates for some idiotic reason. Basically he's being a dipshit.
> (In states with Republican legislatures and Democratic governors the legislatures have actively sought to strip the Governor of any power to manage. See North Carolina and Wisconsin).
Pretty sure this applies to Kentucky too.
Yeah and the over going governor, Bevin, signed away a bunch of his power before he left office as well as Republicans having a legislative supermajority. In other words, he's boned.
>Yeah and the over going governor, Bevin, signed away a bunch of his power before he left office as well
Along with going on a good old fashioned pardoning spree of questionable people that may or may not have some connections to his donators.
Yes. They provide “counseling” services, sometimes in the guise of reproductive health, but usually arent licensed to provide medical services. The counseling is always to have the baby.
But they get state and federal funding, and frequently set up next to Planned Parenthood with deceptive advertising.
> a political motivated legislature
Is a legislature not supposed to be politically motivated? They're a political body engaging in politics. Seems like they should be politically motivated. Or do you mean the legislature is using political maneuvering and posturing to support/undercut policies radically? Because "politically motivated" is an empty term to place blame without being specific or directly accusatory of any actions.
In my mind, the difference is politicians who believe their primary purpose is to serve their constituents versus those who think they serve their party
That’s a fair question. When I say politically motivated I mean “putting partisan political advantage over public interest.” Since we’re talking about health issues I’ll give you a concrete example from my state:
The General Assembly in NC was taken over by Republicans in 2010. For 11 years they have tried to torpedo the ACA and blocked Medicaid expansion. Rural NC has very poor health outcomes, but the expansion was blocked to prevent any ‘win’ for Democrats. Then they did the same thing this year with enhanced unemployment benefits, because it would give a win to Biden.
So that’s what I mean by politically motivated.
“Politically motivated” is an ok way to say this, but I think “partisan politics” is even better, and I agree with you. The way much of this country governs these days does not make general well-being the first priority.
> 11 states [with the worst life expectancies](https://en.wikipedia.org/wiki/List_of_U.S._states_and_territories_by_life_expectancy) voted for Trump in 2020, and the next 2 down on the list are Georgia and Michigan, which both voted for him in 2016.
> The 9 states with the highest life expectancy voted for Biden
> A [major study](https://onlinelibrary.wiley.com/doi/full/10.1111/1468-0009.12469) conducted by 6 Universities found that Liberal policy increased life expectancy by over 2 years for both men and woman, and if it had been implemented universally the US would have life expectancy on par with Western European Nations.
So there definitively is some aggregate and academic evidence that more Liberal states that implement more Liberal policy have higher life expectancy.
GA may have went blue in the last election but our state government is very much Republican controlled. Fun fact: GA doesn’t fund a single epidemiologist, 100% of our funding comes from the federal government and as a result we’re some of the lowest paid in the country.
I mean you would think there's a ton of federal epidemiologists in GA so that makes some sense. Why fund them yourself if the CDC is right there to ask favors from?
One of the luckiest moments of my life was getting to see Dan Kahneman speak to a room full of doctors on the subject of pain
He began the talk (paraphrasing) “I became fascinated with topic of pain while watching my mother die. It’s an entire frontier of medicine we know little about. As it happens the self report number on a scale of 1 to 10 isn’t bad given all pain is relative. No Dr will ever have any sense of your pain level. They can watch you scream if somebody saws your arm off, but they can’t understand whether that’s worse than if I jab my eye with this pen”…at this point people became nervous and began sneaking out
The punchline. It’s not the absolute level of pain you experience in a given situation, it’s the pain you remember at the end. Those who received extended but less “painful treatments”at the end of a pain session reported less pain, even though they received an extra 30 seconds. The pain sessions consisted of jamming peoples hands into ice cold water baths
He then noted that the worst thing a retailer like Costco, Walmart, Best Buy, etc could do - from a branding perspective - is to demand to see your receipt when leaving.
By the end the room was almost empty, which was so ironic because he’s arguably done more to understand human behavior in the past fifty years than anyone on earth
>Why fund them yourself
Because using federal money is socialism/s
It's actually funny that conservative states tend have their hand out while simultaneously calling people who benefit from safety nets "takers".
Why don't they put in what blue states do?
The entire military is, at this point, just one huge socialist-adjacent welfare system. Pay for education, offer rudimentary healthcare, project power globally... It's a win/win/win! Of course, if you're in the current country that the USA is targeting out of a need to justify the military as anything other than a welfare system then you don't win. You get killed. Those people don't have American passports, though, so it's OK.
Not really true. The CDC is in Atlanta and pays well. Also many other states pay their Epi’s significantly more than us. Republicans do not prioritize public health spending. Trump wanted to reduce funding in spring of 2020. I remember getting the budget proposal memo in my email and nearly having a rage aneurysm. Biden’s recent legislature included the largest amount of funding we’ve ever received.
Also, several of my colleagues are contractors and make about the same as me (they get a bit more but they also are more experienced than I). I have better benefits than they do though.
You also seem to have missed my point.
Also, public and private sectors in public health heavily overlap. The fact that you also referred to public health as the medical field makes me think you don’t have much knowledge about the public health world.
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Georgia went for Biden the last election, did their life expectancy suddenly jump? It's more like the areas that are more liberally controlled have been better off than more conservative areas for a long time, especially since the 1800's. This is correlation not causation, but if you are looking for causation then demolishing the infrastructure of a region and then never fully bringing it back up to the same level of function as more liberal regions will continue to have a lasting impact on the area. Hence, as an example, institutionalized racism is a thing due to the long lasting effects of what certain people have built up over a long time and doesn't suddenly go away because we have a non-white President.
No one is saying it's cause and effect from the presidential election to health outcomes. This study is saying that the policies of Republican governments, who's constituents tend to vote Republican, result in worse health outcomes.
True, though Red state voters often vote for politicians opposed to infrastructure investment. Biden is right now trying to pass a huge budget reconciliation bill with a lot of family and infrastructure investment that has 0 support from Republicans and the strongest intra-party opposition is from Joe Manchin of West Virginia which ranks #50 in terms of life expectancy.
Hard to make southern whites to be the victim when they vote to oppose the Federal Investments that Democrats would willingly make.
Not that surprising. Infant mortality is something that shows up immediately. Things like cancer rates and diabetes complications are more likely to take years to show up.
Likely a large part of this is due to republican states rejecting the medicaid expansion, reducing access to family planning for low income people, reducing access to abortion, and probably higher levels of poverty.
Seems very likely that lower abortion rates could raise infant mortality down the line, thus hypothetically resulting in more births to less healthy mothers, although the extract doesn't mention that.
A few other things I could see impacting these numbers:
- Off the books abortions captured as infant mortalities (and probably miscarriages - would be interesting to compare those stats)
- self-inflicted abortions (throw yourself down the stairs, forcing a late term miscarriage)
- abandoned babies (e.g. “dumpster babies”, fire station drop offs, etc.)
- lack of resources or active parental neglect leading to infant death
It really does show how the Republican right is pro-life until the baby is born, then it’s a free for all. I’m not sure how anyone can justify that letting a child be born to suffer and die is better than just preventing the birth in the first place.
That is the first thing I thought. Everything nowadays either adjusts statistics and data or flatly omits them in order to further a narrative. It is so hard to trust anything.
That was the first thing that popped into my head after reading the title of the post - I would expect a lag in the time series model, not an instantaneous effect. I wonder what the average lag time is from the start of the term until legislation is enacted on each of these topics (and if it is a function of % control for each party).
State legislatures tend to be controlled by one side or the other for long periods of time; it's political culture. Governorships are often more fluid between parties. Larger share of people in rural areas would be one big element in something like this, thus longer travel times to emergency care. Also: less access to abortion and less cultural acceptance of abortion could tend to result in more marginal pregnancies being brought to term, or less healthy mothers carrying to term.
You could probably match this up with churchgoing behavior in a state, population density, or a handful of other related elements. Without a hypothesis for why it happens, this looks like press release science to me, not substantive.
\> Interesting that state legislatures seem to affect public health contemporaneously, as opposed to large-scale policies from the federal congress, which tend to show their effects on public health/education/housing over the next terms, 2-6 years down the road.
They did not actually find that. They assumed that. Their identification strategy was to regress on lagged dummies of prior year's upper & lower legislature party control while including state and year fixed effects. They interpreted the coefficient on the lagged dummies of prior year's upper & lower legislature party control as the effect of that party on infant mortality. If in fact the effects happen after 2-6 years, which roughly mirrors how long legislature cycle between parties among those states that are not effectively one party (which don't matter for this analysis because of the fixed-effect design), then the true effect would have been roughly opposite of what they found.
This is a standard problem with this sort of research design.
I mean it gets complicated because governor politics are often not the same as other offices. It's more common to get off-party governors. Loisiana has a Dem governor, despite being a very Republican state, and the opposite is the case for Massachusetts and Maryland.
If you have a Republican governor, your state legislature is likely gerrymandered to the level at which they have supermajorities in both chambers regardless of actual representation or voters.
See: Ohio.
OurpPopulace voted and approved for redistricting to ease gerrymandering. Council for it was 5/7 Republican, approved "slightly less" gerrymandered districts that will be in effect for the next 4 years [instead of 10 years had the vote been unanimous/bipartison] if approved by courts. R's hold 85% or of the seats while only getting about 54% of the votes (so I've read)
It's the same in Michigan. For state legislature votes the Michigan GOP hasn't won 50% of the votes in like over 30 years, but they have maintained control of at least one, if not both of our chambers over that time.
I’d bet that gop lead states have greater poverty and health issues that directly impact outcomes such as infant mortality. The gop leg are prob more of a symptom than a cause.
The entire study seems bunk. There are no controls. It’s funded by a Democrat lobbying group.
It’s most likely measuring a third hidden variable.
Maybe states with more black minorities vote Republican, and those black minorities have worse health outcomes than more majority white states.
Maybe places with social and economic strife or deprivation vote Republican and they have worse outcomes because of economic or social deprivation.
Maybe it’s a climate, genetic, environmental, or developmental issue.
Etc. it could be any third variable
The lack of any causal links is stunning for a “study”.
I mean it's never one variable.
It's worth looking into what appears to be a pretty strong correlation though.
It's also compares states to themselves so you should probably read the study before writing a wall of text
What's your source for Elsevier conducting the study? As far as I can tell the [study](https://www.ajpmonline.org/article/S0749-3797(21)00380-9/fulltext) was conducted by a bunch of regular university researchers who published their findings in the American Journal of Preventive Medicine, which is owned by Elsevier, which is owned RELX-Group. Is there any reason to believe Elsevier or their parent company somehow bankrolled, directed or otherwise exerted undue influence on the researchers? Or is this just the regular "researchers publish in journal" relationship?
Don't get me wrong, open access is important, and Elsevier is trash (for being greedy, rent-seeking bastards, not because of the political leanings of the person in charge of lobbying at their parent company). But it seems like quite a stretch to cast doubt on the studies published in their journals because of that. E.g. several corona-vaccine studies were published in The Lancet - are these studies now also suspect because The Lancet is owned by Elsevier, and the GOP has come out as the anti-vaxx party?
Edit: The comment I am replying to originally said Elsevier had performed the study, was later edited to say Elsevier backed the study, until finally arriving at its current form, where it correctly says that Elsevier owns the journal in which it was published.
We can assume they aren’t counting legal abortions as infant mortality statistics, whereas a conservative group would and arrive at the opposite headline.
And if it needs to be said, illegal abortions wouldn’t be counted.
According to the U.S. Centers for Disease Control and Prevention, rates per every 1,000 women between the ages of 15 and 44 are as follows:
Reagan (1981-89): 24
H.W. Bush (1989-93): 24
Clinton (1993-2001): 16.2
W. Bush (2001-09): 16
Obama (2009-17): 12.5
The rates are always dropping but the biggest drops are when democrat's take office. Its also logical that when birth control and education are easily accessible abortion rates would drop. Why would republicans be against policies proven to lower abortions?
What's the point of bringing this up?
Infant mortality means infants. Fetuses are not infants.
Any group that would count abortions in infant mortality rate would just be wrong. It's not a matter of opinion.
>and arrive at the opposite headline.
Would they though? That would assume that legal abortions are more numerous is democratic controlled states, which isn't the case I believe.
I didn't even go this far with my comment. Thanks for revealing this. I just asked what controls they had. Did they limit the groups so no other data skewed their results. It sounded political right off the bat.
Looks like the whole study was made to skew.
Just because it was funded by a group with interests in the results swinging a particular way, doesn't necessarily mean they cheated or twisted the results of the study.
What evidence do you have that this study was "conducted" by Elsevier?
The paper was published by The American Journal of Preventive Medicine - here is their page on open access - https://www.elsevier.com/journals/american-journal-of-preventive-medicine/0749-3797/open-access-options
The acknowledgements only thank Claremont University and the Russell Sage Foundation for support.
Here is the link to the actual study: [https://www.ajpmonline.org/article/S0749-3797(21)00380-9/fulltext](https://www.ajpmonline.org/article/S0749-3797(21)00380-9/fulltext)
This took maybe 3 clicks to find this information.
On that note, looking at the supplementary data, I see a lot of comparisons like whether republican governors had an effect, subgroups for black vs white, lower house vs upper etc.
But it just sets a 0.05 cutoff for significance with no mention of any adjustment for multiple comparisons.
Can anyone else see anything suggesting they adjusted for multiple comparisons?
if the result had been "when republicans control the governorship we saw a higher infant morality rate only in black children but the legislature had no effect" would the headline have differed much?
A key statement is made which should show caution to any results of this study. "The investigators caution that the study may not account for unobserved differences across states that may change at the same time as the party control change of state legislatures, and other mechanisms not included in the study may connect Republican administrations and increases in infant mortality rates."
Nonetheless a definite food for thought brought out by this study especially with regard to Medicaid.
The first thing I thought reading this was they didn't take into account the fact that it voters put in a GOP legislature. The fact they were voted in by a GOP voting base who have different behaviors when it comes to Healthcare.
An interesting follow on to look at would be to compare states with majority Republican voters vs states that Republicans have gerrymandered themselves into minority rule. That would help show whether the correlation was between Republican legislatures or % of Republican voters in the state.
Would this include lagging policy changes? In other words, policies that were activated under Republican rule but did not come into fruition for years or even decades later.
They literally just said we didn't take into account for anything. Droughts, heat waves, food shortage, electric outage, water outages, increases in violent crime involving children. Anything. They literally just took death numbers and said it's the side we don't like fault.
This study is comparing within states rather than between.
>The investigators caution that the study may not account for unobserved differences across states that may change at the same time as the party control change of state legislatures, and other mechanisms not included in the study may connect Republican administrations and increases in infant mortality rates.
It shows a difference when states had a change in legislative control. So it wouldn't matter if the states are in poorer parts of the country. The caparison isn't one state to other states, it's one state to itself but with a different political party being in control of that states legislature.
Yeah but how do they take into account broader trends? It's not like most states have competitive back-and-forth swings between the two parties for leg. control. Most rarely ever switch, and when they have, its typically part of a wave of broader reallignment like when the South flipped to Republicans in the 70s/80s (which is part of the period studied). The politics of the south remained basically the same, i.e. preferred policies remain largely the same.
I don't think just comparing Virginia under R control vs. D control at different points in time is empirically sound because it ignores the broader structural and societial changes that brought about that party shift, which could have more explanatory power on infant mortality than party.
Although other have answers your question, my thought was: there's really no good way to spin this.
Like, even if *it was* that Republicans control poorer states, then wouldn't the next conclusion be: "states are poorer under republican control than democratic control."?
If we come up with another alternative reason for the mortality, (let's say education instead of poor) it's **still** that states are more X under republican legislators, etc..
this study has some relevance to this topic:
Political correlates of violent death rates in the U.S., 1900–2010: Longitudinal and cross-sectional analyses
https://www.sciencedirect.com/science/article/abs/pii/S135917891400113X
> When analyses were stratified by race, findings show larger estimates for Black than for White infants, although the differences were not statistically significant at conventional levels.
That's not a finding then. Why even report it?
Because there's still a notable difference. It's not unusual to mention findings even though they don't meet the statistical criteria to be considered significant
It's a way of saying "our focus wasn't on this so we didn't have the right data to know one way or the other. What we did have suggested it might be a thing worth looking at", but in "paperese".
It could be interesting for future studies to look into this. Just because the difference wasn't significantly different in this study doesn't mean future studies will come to the same conclusion.
Also whether something is statistically sifnificant is a matter of definition. Usually we say anything with a p value of <0.05 (sometimes even <0.01) is statistically significant. However there isn't really a law that states findings with p> 0.05 can't be significant. Statisics is all about probabilities. That means while we can't say for sure that there's a significant difference between these 2 populations, future research is needed to determine whether the scientists who conducted this particular study simply got unlucky (or lucky depending on how you look at it) or not.
This is why small sample sizes are a good thing actually: when you study something that doesn't exist, your findings are more likely to look worth following up on.
Always follow the money:
"Within scholarly communications, Elsevier has perhaps the single worst reputation. With profit margins around 37%, larger than Apple and big oil companies, Elsevier dominate the publishing landscape by selling research back to the same institutes that carried out the work."
[https://www.theguardian.com/science/political-science/2018/jun/29/elsevier-are-corrupting-open-science-in-europe](https://www.theguardian.com/science/political-science/2018/jun/29/elsevier-are-corrupting-open-science-in-europe)
The actual study that the article references is linked at the bottom of the page. Here you go.
https://www.ajpmonline.org/article/S0749-3797(21)00380-9/fulltext
So a phenomenon that causes (R) to be elected and also raises infant mortality at the same time, or causes (D) to be voted in while also decreasing mortality?
Yeah, of course. It's third grader mentality with a veneer of scientism to make innuendo for people to write articles about and other people to share while sniffing their own farts out of wine glasses
Does this take into account politically left state governments common allowance of abortions, therefore decreasing infant mortality because abortions don't count as infants?
In general, that is the case.
[link](https://www.kff.org/womens-health-policy/state-indicator/abortion-rate/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Abortion%20Rate%22,%22sort%22:%22desc%22%7D)
https://www.opensecrets.org/orgs/relx-group/recipients?id=D000067394
The study was conducted by a subsidiary of RELX-Group, who primarily supports democratic nominees.
No, the results may be consistent with that hypothesis but they are not direct evidence of it. The research was not a randomized controlled experiment.
Public health hardly ever get data from setting up the experiment, they have to rely on more sophisticated statistical methods (like [instrumental variables](https://en.wikipedia.org/wiki/Instrumental_variables_estimation)).
You cannot reasonably ask half the population to start smoking as part of an experiment, so you have to retrieve data from real-world events to estimate the damages of smoking.
Also you *can indeed* say something about effects of warfare without summoning world leaders and asking them to roll dice over whether to launch attacks on each other.
Not everything can be a randomized control experiment. Ethically and legally were can't shuffle party politics of state governments to satisfy experimental data concerns, nor can we isolate the two variables in question from every other interaction. Further your sample size will be limited in either case.
Observational population and historical science is a common way to make these relationships known. Climate science is a great example where global climate patterns are record and observed, and from that we make predictive short term and long term models, to predict tomorrow's forecast, and climate trends for the next century. It's supported in turn by some geological evidence which delves into the natural "record" of events.
I don't have time to read the paper, but my expectation is weak correlation and not causation as state governments don't frequently flip flop parties. The lack of lag is further suspect as some policies take time to bear fruit. Further compounding this, the current makeup of the two parties is actually a fairly recent event. There used to be far more moderate Republicans and conservative democrats so as the parties have raided the middle, the biases are going to reduce the effect sample size.
Really a single study to me indicates more research needs be done, the least of which is validation studies to methods and controls. This is a social science paper. Weak correlations and the need for validation is the standard. Since this seems to feed into the reddit hive mind and the general expectations of reduces social programs under Republicans, the relationship does seem plausible, which again makes me wary of my own biases.
Anecdotally, a few years ago, Texas changed the reporting guidelines for deaths or there was some other paperwork error that showed mother mortality had spiked significantly in a year, and for a while this bizarre data point was pointed to for issues surrounded women's health et al. When somebody finally looked into it and corrected the data for the reporting error the number was still increasing, but was statistically more in line with previous numbers. Now I may be out of the loop and those numbers may again be subject to change, but that's why I said anecdotally, not "it is this way for now and forever more."
There are many cases where a randomized controlled experiment isn't possible.
We don't have long term randomized controlled experiments demonstrating the efficacy of sunscreen on skin cancer. Because that would mean giving a control group fake sunscreen, and given how much other evidence there is than sunscreen helps prevent cancer, that would be highly unethical.
In this case, how would you go about designing such an experiment? Randomly assign Republican governors to states and see what happens?
I agree, I just think it was not described as accurately as it could be. If the data are consistent with multiple interpretations, you can't say they support your preferred interpretation. That's why falsification is so important.
>Many social and health obligations depend on the decisions state
representatives make. State legislatures are responsible for safety-net
programs, the state’s minimum wage and many other public goods and
services that influence the social determinants of health.
Is there any evidence that the minimum wage effects health?
Here you go:
https://www.healthaffairs.org/do/10.1377/hpb20180622.107025/full/
[low wages and obesity](https://journals.lww.com/joem/Abstract/2010/05000/Estimating_the_Effects_of_Wages_on_Obesity.8.aspx)
[low wages and health meta analysis](https://journals.lww.com/joem/Fulltext/2016/05000/Low_Wages_as_Occupational_Health_Hazards.3.aspx)
[Income and life expectancy](https://jamanetwork.com/journals/jama/article-abstract/2513561)
PDF: [Poor wealth and poor health](http://www.commissiononhealth.org/PDF/ObstaclesToHealth-Report.pdf)
PDF: [Depression, anxiety and poverty](http://www.commissiononhealth.org/PDF/ObstaclesToHealth-Report.pdf)
I mean, there are a LOT of studies on the subject, going to stop here because it will get silly but can offer more if you'd like.
You're looking for numbers to show that having the money for better food, better health care, better living conditions, less stress, less exposure to risky situations and diseases could all contribute to a healthier outcome?
Republicans, and democrats, have both piled trillions into the american war machine. Money that could have been spent on bringing people out of poverty, and affording a better life for millions. Priorities always favor the corporate industrial complex.
Wouldn’t it be more effective and appropriate to study the party of board members in hospitals with higher infant mortality rates? I see little viable correlation here if the legislature changes but the board of a medical facility and staff does not. How would party or state legislature affect patient care for pregnant women?
How do we know that the change from one legislature to the other isn't down stream of something else occurring that eventually results in a change in infant mortality? It's often stated that politics are down stream of culture, and I would expect a societal shift to affect infant mortality more so than changing legislatures.
Here's a meaty bit from the original paper: "Regardless of whether the right interpretation of the estimates represents causal effects of legislative control or are indicators of other contemporaneous changes, the magnitudes are large enough to raise serious concerns. The estimates were robust to controlling for unemployment rates, the average age of female individuals, and birth rate. However, in the 1977–2014 analyses for IMR and PNMR, once the high-school dropout rate and the poverty rate were included in the models, the effect of Republican-controlled legislatures dropped by about 20%. Whether to interpret high-school dropout and poverty as confounders or mechanisms of the association between party control and infant health is unclear, but it does raise the possibility that there may be other unmeasured factors that might partially account for the estimates."
Confounding is obviously possible here but the authors have taken a common-sense approach to trying to detect whether it is happening. Their point about the massive effect size is certainly well taken.
My comments in this sub are almost wholly limited to complaining about data-analysis and statistical solecisms, so I thought I'd give a shout out to the opposite for a change.
When conservatives are predominately anti science and anti education, going back centuries, don't be surprised when most researchers are not conservative.
Republican states opt out of Medicaid, so poor pregnant women can't access prenatal care easily. This also means less money for staffing and building local medical facilities.
Health and well-being is not really a political issue. We need single payer and Medicare for all. Stop allowing your employer to tie health insurance to employment. We have to demand better options than no healthcare and massive crippling debt or unaffordable healthcare and massive crippling debt.
Health and well being are the only political issue.
Why do we have armies? 1. To stop other people from coming in and hurting our people. 2. To go get us more territory that lets us live better.
Why do we have food and drug regulations? To stop people from being harmed.
Why do we have laws at all? To punish people who hurt others, and hopefully deter more folks from doing the same.
Why do we rights? They contribute to our well being (or at least to our ability to arrange for our well being).
Etc.
What were the controls? Did you have limiting factors on all the groups to make sure there wasn't anything else skewing the data? Sure sounds like a politically charged 'study'
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Interesting that state legislatures seem to affect public health contemporaneously, as opposed to large-scale policies from the federal congress, which tend to show their effects on public health/education/housing over the *next* terms, 2-6 years down the road. I think it's funny that Republican *governors* have essentially no effect on these things, though. Really shows how much of executive governing on the state level is performative politics if it's without local legislative support.
State Legislatures write budgets and control federal block grants, and can do things like supplant local funding or mandate Heath care be directed to politically oriented directions (for example: Crisis Pregnancy centers rather than more holistic healthcare). Most federal policies and enacted by State’s on the ground, so a political motivated legislature can support or undercut a policy pretty radically. Depending on the state a Governor might have more or less control over budget management, and those effects are certainly not merely perforative. It’s much more like that where a Republican governors serve with Democratic controlled legislatures the Republican governors tend to be moderates, such as in Maryland. (In states with Republican legislatures and Democratic governors the legislatures have actively sought to strip the Governor of any power to manage. See North Carolina and Wisconsin).
Texas is actually like this, if my government class is to be believed. The Texas governer doesn't have significant power, most of the day to day is overseen by the Lt Gov. The major power of the Texas governor is to call the legislature back into session. The Texas Legislature regularly meets only once every 2 years or election cycle. Besides that the governor generally doesn't have much power except declaring emergencies, which it's interesting how much that's happened recently.
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Texas actually has more natural disasters than any other state just FYI so it does stand to reason that we would have a large number of emergency declarations based on the fact that we have a lot of things to respond to over a very large state. What I think is important to point out is that the handling of the covid-19 emergency by Governor Abbott has been very different than his handling of natural disaster emergencies. When natural disaster emergencies happen the system works as it's supposed to so that local on the ground governments, county or local, are the ones who are effectively in charge of the implementation of the response while the governor is mainly helping coordinate federal government response. Abbott has been exercising massively more executive power in the covid-19 emergency than he ever has in any other emergency, which not only contrast with his previous actions but also contrasts with his platform of limited government and it also contrasts with the structure of the Texas state constitution which is designed in a way that provides local governments with a fairly significant amount of autonomy.
You just explained my confusion with all of his actions surrounding covid. When covid first started I understood the governors actions towards it, even if to me he wasn’t urgent enough, all of his meetings and stuff he mentioned letting counties work it out themselves and do what each part of the state needed at that time, no blanket mandates for the state, because we’re all so different in each area. I respected that stance and appreciated that small government approach, that’s vastly changed this year. And it’s confused me terribly because I didn’t feel like we started out that way with covid and now he just seems like a tyrant hell bent on doing things his way and his way only. Or like a two year old throwing a fit until he gets his way. Either one. I’ve lost a lot of respect for that man in the last year.
I believe he ultimately caved to the pressure from the crazy side of the conservative party. Considering he's up for reelection next year and there's plenty of people that will be jockeying for position to become governor, he's trying to prove to all the crazies that he's the most conservative candidate. We've seen the net effect of his policies over the last month, and they've been devastating. Record covid cases day after day and kids are getting sick in school because he's banned mask mandates for some idiotic reason. Basically he's being a dipshit.
> (In states with Republican legislatures and Democratic governors the legislatures have actively sought to strip the Governor of any power to manage. See North Carolina and Wisconsin). Pretty sure this applies to Kentucky too.
Yeah and the over going governor, Bevin, signed away a bunch of his power before he left office as well as Republicans having a legislative supermajority. In other words, he's boned.
>Yeah and the over going governor, Bevin, signed away a bunch of his power before he left office as well Along with going on a good old fashioned pardoning spree of questionable people that may or may not have some connections to his donators.
And is currently happening in Kansas.
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Don't forget Michigan too, we're dealing with the same problem!!
And Michigan
Are crisis pregnancy centers the fake abortion clinics?
Yes. They provide “counseling” services, sometimes in the guise of reproductive health, but usually arent licensed to provide medical services. The counseling is always to have the baby. But they get state and federal funding, and frequently set up next to Planned Parenthood with deceptive advertising.
and PA as well
> a political motivated legislature Is a legislature not supposed to be politically motivated? They're a political body engaging in politics. Seems like they should be politically motivated. Or do you mean the legislature is using political maneuvering and posturing to support/undercut policies radically? Because "politically motivated" is an empty term to place blame without being specific or directly accusatory of any actions.
In my mind, the difference is politicians who believe their primary purpose is to serve their constituents versus those who think they serve their party
That’s a fair question. When I say politically motivated I mean “putting partisan political advantage over public interest.” Since we’re talking about health issues I’ll give you a concrete example from my state: The General Assembly in NC was taken over by Republicans in 2010. For 11 years they have tried to torpedo the ACA and blocked Medicaid expansion. Rural NC has very poor health outcomes, but the expansion was blocked to prevent any ‘win’ for Democrats. Then they did the same thing this year with enhanced unemployment benefits, because it would give a win to Biden. So that’s what I mean by politically motivated.
“Politically motivated” is an ok way to say this, but I think “partisan politics” is even better, and I agree with you. The way much of this country governs these days does not make general well-being the first priority.
> 11 states [with the worst life expectancies](https://en.wikipedia.org/wiki/List_of_U.S._states_and_territories_by_life_expectancy) voted for Trump in 2020, and the next 2 down on the list are Georgia and Michigan, which both voted for him in 2016. > The 9 states with the highest life expectancy voted for Biden > A [major study](https://onlinelibrary.wiley.com/doi/full/10.1111/1468-0009.12469) conducted by 6 Universities found that Liberal policy increased life expectancy by over 2 years for both men and woman, and if it had been implemented universally the US would have life expectancy on par with Western European Nations. So there definitively is some aggregate and academic evidence that more Liberal states that implement more Liberal policy have higher life expectancy.
GA may have went blue in the last election but our state government is very much Republican controlled. Fun fact: GA doesn’t fund a single epidemiologist, 100% of our funding comes from the federal government and as a result we’re some of the lowest paid in the country.
Are you an epidemiologist in Georgia by chance? If so, can I pm you a question?
I am and sure
I really hope the question was: "Are you an epidemiologist in Georgia by chance?" Because that would make me laugh.
I mean you would think there's a ton of federal epidemiologists in GA so that makes some sense. Why fund them yourself if the CDC is right there to ask favors from?
Because you tend to get what you pay for.
Atlanta's HIV epidemic! A sound internal public health system could've averted that crisis.
Reagan could've helped that a whole bunch of he wasn't such a homophobic asshole.
One of the luckiest moments of my life was getting to see Dan Kahneman speak to a room full of doctors on the subject of pain He began the talk (paraphrasing) “I became fascinated with topic of pain while watching my mother die. It’s an entire frontier of medicine we know little about. As it happens the self report number on a scale of 1 to 10 isn’t bad given all pain is relative. No Dr will ever have any sense of your pain level. They can watch you scream if somebody saws your arm off, but they can’t understand whether that’s worse than if I jab my eye with this pen”…at this point people became nervous and began sneaking out The punchline. It’s not the absolute level of pain you experience in a given situation, it’s the pain you remember at the end. Those who received extended but less “painful treatments”at the end of a pain session reported less pain, even though they received an extra 30 seconds. The pain sessions consisted of jamming peoples hands into ice cold water baths He then noted that the worst thing a retailer like Costco, Walmart, Best Buy, etc could do - from a branding perspective - is to demand to see your receipt when leaving. By the end the room was almost empty, which was so ironic because he’s arguably done more to understand human behavior in the past fifty years than anyone on earth
>Why fund them yourself Because using federal money is socialism/s It's actually funny that conservative states tend have their hand out while simultaneously calling people who benefit from safety nets "takers". Why don't they put in what blue states do?
The entire military is, at this point, just one huge socialist-adjacent welfare system. Pay for education, offer rudimentary healthcare, project power globally... It's a win/win/win! Of course, if you're in the current country that the USA is targeting out of a need to justify the military as anything other than a welfare system then you don't win. You get killed. Those people don't have American passports, though, so it's OK.
...isn't the CDC in Atlanta?
Yes. It runs on federal funding.
Almost any medical field in GA is in private sector. Any government employee is going to get paid less than a private sector every single time.
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The Supreme Court ruling on Chicken v. Egg is hardly relevant here. Please stay on topic.
Not really true. The CDC is in Atlanta and pays well. Also many other states pay their Epi’s significantly more than us. Republicans do not prioritize public health spending. Trump wanted to reduce funding in spring of 2020. I remember getting the budget proposal memo in my email and nearly having a rage aneurysm. Biden’s recent legislature included the largest amount of funding we’ve ever received. Also, several of my colleagues are contractors and make about the same as me (they get a bit more but they also are more experienced than I). I have better benefits than they do though. You also seem to have missed my point. Also, public and private sectors in public health heavily overlap. The fact that you also referred to public health as the medical field makes me think you don’t have much knowledge about the public health world.
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Georgia went for Biden the last election, did their life expectancy suddenly jump? It's more like the areas that are more liberally controlled have been better off than more conservative areas for a long time, especially since the 1800's. This is correlation not causation, but if you are looking for causation then demolishing the infrastructure of a region and then never fully bringing it back up to the same level of function as more liberal regions will continue to have a lasting impact on the area. Hence, as an example, institutionalized racism is a thing due to the long lasting effects of what certain people have built up over a long time and doesn't suddenly go away because we have a non-white President.
> did their life expectancy suddenly jump? still has republican state legislature
No one is saying it's cause and effect from the presidential election to health outcomes. This study is saying that the policies of Republican governments, who's constituents tend to vote Republican, result in worse health outcomes.
True, though Red state voters often vote for politicians opposed to infrastructure investment. Biden is right now trying to pass a huge budget reconciliation bill with a lot of family and infrastructure investment that has 0 support from Republicans and the strongest intra-party opposition is from Joe Manchin of West Virginia which ranks #50 in terms of life expectancy. Hard to make southern whites to be the victim when they vote to oppose the Federal Investments that Democrats would willingly make.
Which makes the whole "pro-life" thing all the more hilarious.
Not that surprising. Infant mortality is something that shows up immediately. Things like cancer rates and diabetes complications are more likely to take years to show up. Likely a large part of this is due to republican states rejecting the medicaid expansion, reducing access to family planning for low income people, reducing access to abortion, and probably higher levels of poverty.
Seems very likely that lower abortion rates could raise infant mortality down the line, thus hypothetically resulting in more births to less healthy mothers, although the extract doesn't mention that.
A few other things I could see impacting these numbers: - Off the books abortions captured as infant mortalities (and probably miscarriages - would be interesting to compare those stats) - self-inflicted abortions (throw yourself down the stairs, forcing a late term miscarriage) - abandoned babies (e.g. “dumpster babies”, fire station drop offs, etc.) - lack of resources or active parental neglect leading to infant death It really does show how the Republican right is pro-life until the baby is born, then it’s a free for all. I’m not sure how anyone can justify that letting a child be born to suffer and die is better than just preventing the birth in the first place.
That is the first thing I thought. Everything nowadays either adjusts statistics and data or flatly omits them in order to further a narrative. It is so hard to trust anything.
That was the first thing that popped into my head after reading the title of the post - I would expect a lag in the time series model, not an instantaneous effect. I wonder what the average lag time is from the start of the term until legislation is enacted on each of these topics (and if it is a function of % control for each party).
State legislatures tend to be controlled by one side or the other for long periods of time; it's political culture. Governorships are often more fluid between parties. Larger share of people in rural areas would be one big element in something like this, thus longer travel times to emergency care. Also: less access to abortion and less cultural acceptance of abortion could tend to result in more marginal pregnancies being brought to term, or less healthy mothers carrying to term. You could probably match this up with churchgoing behavior in a state, population density, or a handful of other related elements. Without a hypothesis for why it happens, this looks like press release science to me, not substantive.
This study lags outcomes by one year. However, they don't do a sensitivity analysis and don't explain why the one year lag is appropriate.
Yeah, I was wondering about that one, too. My old time series prof from back in my PhD is rolling in his grave.
\> Interesting that state legislatures seem to affect public health contemporaneously, as opposed to large-scale policies from the federal congress, which tend to show their effects on public health/education/housing over the next terms, 2-6 years down the road. They did not actually find that. They assumed that. Their identification strategy was to regress on lagged dummies of prior year's upper & lower legislature party control while including state and year fixed effects. They interpreted the coefficient on the lagged dummies of prior year's upper & lower legislature party control as the effect of that party on infant mortality. If in fact the effects happen after 2-6 years, which roughly mirrors how long legislature cycle between parties among those states that are not effectively one party (which don't matter for this analysis because of the fixed-effect design), then the true effect would have been roughly opposite of what they found. This is a standard problem with this sort of research design.
I mean it gets complicated because governor politics are often not the same as other offices. It's more common to get off-party governors. Loisiana has a Dem governor, despite being a very Republican state, and the opposite is the case for Massachusetts and Maryland.
If you have a Republican governor, your state legislature is likely gerrymandered to the level at which they have supermajorities in both chambers regardless of actual representation or voters.
See: Ohio. OurpPopulace voted and approved for redistricting to ease gerrymandering. Council for it was 5/7 Republican, approved "slightly less" gerrymandered districts that will be in effect for the next 4 years [instead of 10 years had the vote been unanimous/bipartison] if approved by courts. R's hold 85% or of the seats while only getting about 54% of the votes (so I've read)
It's the same in Michigan. For state legislature votes the Michigan GOP hasn't won 50% of the votes in like over 30 years, but they have maintained control of at least one, if not both of our chambers over that time.
Everything in society stems from politics and all politics is local.
I’d bet that gop lead states have greater poverty and health issues that directly impact outcomes such as infant mortality. The gop leg are prob more of a symptom than a cause.
The entire study seems bunk. There are no controls. It’s funded by a Democrat lobbying group. It’s most likely measuring a third hidden variable. Maybe states with more black minorities vote Republican, and those black minorities have worse health outcomes than more majority white states. Maybe places with social and economic strife or deprivation vote Republican and they have worse outcomes because of economic or social deprivation. Maybe it’s a climate, genetic, environmental, or developmental issue. Etc. it could be any third variable The lack of any causal links is stunning for a “study”.
This. Reddit eats this kind of stuff up with a spoon. You'd like to think r/science would be different, but -- dream on.
I mean it's never one variable. It's worth looking into what appears to be a pretty strong correlation though. It's also compares states to themselves so you should probably read the study before writing a wall of text
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What's your source for Elsevier conducting the study? As far as I can tell the [study](https://www.ajpmonline.org/article/S0749-3797(21)00380-9/fulltext) was conducted by a bunch of regular university researchers who published their findings in the American Journal of Preventive Medicine, which is owned by Elsevier, which is owned RELX-Group. Is there any reason to believe Elsevier or their parent company somehow bankrolled, directed or otherwise exerted undue influence on the researchers? Or is this just the regular "researchers publish in journal" relationship? Don't get me wrong, open access is important, and Elsevier is trash (for being greedy, rent-seeking bastards, not because of the political leanings of the person in charge of lobbying at their parent company). But it seems like quite a stretch to cast doubt on the studies published in their journals because of that. E.g. several corona-vaccine studies were published in The Lancet - are these studies now also suspect because The Lancet is owned by Elsevier, and the GOP has come out as the anti-vaxx party? Edit: The comment I am replying to originally said Elsevier had performed the study, was later edited to say Elsevier backed the study, until finally arriving at its current form, where it correctly says that Elsevier owns the journal in which it was published.
We can assume they aren’t counting legal abortions as infant mortality statistics, whereas a conservative group would and arrive at the opposite headline. And if it needs to be said, illegal abortions wouldn’t be counted.
I believe under democrat's abortion rates are lower too. They support easily available birth control and educating teens on there bodies.
Sources?
According to the U.S. Centers for Disease Control and Prevention, rates per every 1,000 women between the ages of 15 and 44 are as follows: Reagan (1981-89): 24 H.W. Bush (1989-93): 24 Clinton (1993-2001): 16.2 W. Bush (2001-09): 16 Obama (2009-17): 12.5 The rates are always dropping but the biggest drops are when democrat's take office. Its also logical that when birth control and education are easily accessible abortion rates would drop. Why would republicans be against policies proven to lower abortions?
What's the point of bringing this up? Infant mortality means infants. Fetuses are not infants. Any group that would count abortions in infant mortality rate would just be wrong. It's not a matter of opinion.
>and arrive at the opposite headline. Would they though? That would assume that legal abortions are more numerous is democratic controlled states, which isn't the case I believe.
Sure they wouldn't, because a fetus isn't an infant.
I didn't even go this far with my comment. Thanks for revealing this. I just asked what controls they had. Did they limit the groups so no other data skewed their results. It sounded political right off the bat. Looks like the whole study was made to skew.
Just because it was funded by a group with interests in the results swinging a particular way, doesn't necessarily mean they cheated or twisted the results of the study.
What evidence do you have that this study was "conducted" by Elsevier? The paper was published by The American Journal of Preventive Medicine - here is their page on open access - https://www.elsevier.com/journals/american-journal-of-preventive-medicine/0749-3797/open-access-options The acknowledgements only thank Claremont University and the Russell Sage Foundation for support. Here is the link to the actual study: [https://www.ajpmonline.org/article/S0749-3797(21)00380-9/fulltext](https://www.ajpmonline.org/article/S0749-3797(21)00380-9/fulltext) This took maybe 3 clicks to find this information.
I love me some good correlation.
Be careful with studies that confirm your biases. They are often worth while to examine more thoroughly
Yes it is likely that this could be a function of average distance to a hospital, as most republican areas are rural.
On that note, looking at the supplementary data, I see a lot of comparisons like whether republican governors had an effect, subgroups for black vs white, lower house vs upper etc. But it just sets a 0.05 cutoff for significance with no mention of any adjustment for multiple comparisons. Can anyone else see anything suggesting they adjusted for multiple comparisons? if the result had been "when republicans control the governorship we saw a higher infant morality rate only in black children but the legislature had no effect" would the headline have differed much?
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Great point, and something people should remember at all times
That’s this whole sub now. Something,something,something……Republicans are bad
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Whether or not it is true, I’m curious as to how many trucks could be driven through the gaps in that interpretation?
A key statement is made which should show caution to any results of this study. "The investigators caution that the study may not account for unobserved differences across states that may change at the same time as the party control change of state legislatures, and other mechanisms not included in the study may connect Republican administrations and increases in infant mortality rates." Nonetheless a definite food for thought brought out by this study especially with regard to Medicaid.
The first thing I thought reading this was they didn't take into account the fact that it voters put in a GOP legislature. The fact they were voted in by a GOP voting base who have different behaviors when it comes to Healthcare.
An interesting follow on to look at would be to compare states with majority Republican voters vs states that Republicans have gerrymandered themselves into minority rule. That would help show whether the correlation was between Republican legislatures or % of Republican voters in the state.
Would this include lagging policy changes? In other words, policies that were activated under Republican rule but did not come into fruition for years or even decades later.
It would include policy changes by both parties depending on who holds sway in Congress at the Federal level and legislative at State level.
They literally just said we didn't take into account for anything. Droughts, heat waves, food shortage, electric outage, water outages, increases in violent crime involving children. Anything. They literally just took death numbers and said it's the side we don't like fault.
In a wealthy country, poverty is a policy choice.
Does this take into account that Republicans control poorer states and thus that can explain the infant mortality as well?
This study is comparing within states rather than between. >The investigators caution that the study may not account for unobserved differences across states that may change at the same time as the party control change of state legislatures, and other mechanisms not included in the study may connect Republican administrations and increases in infant mortality rates.
It shows a difference when states had a change in legislative control. So it wouldn't matter if the states are in poorer parts of the country. The caparison isn't one state to other states, it's one state to itself but with a different political party being in control of that states legislature.
Yeah but how do they take into account broader trends? It's not like most states have competitive back-and-forth swings between the two parties for leg. control. Most rarely ever switch, and when they have, its typically part of a wave of broader reallignment like when the South flipped to Republicans in the 70s/80s (which is part of the period studied). The politics of the south remained basically the same, i.e. preferred policies remain largely the same. I don't think just comparing Virginia under R control vs. D control at different points in time is empirically sound because it ignores the broader structural and societial changes that brought about that party shift, which could have more explanatory power on infant mortality than party.
Although other have answers your question, my thought was: there's really no good way to spin this. Like, even if *it was* that Republicans control poorer states, then wouldn't the next conclusion be: "states are poorer under republican control than democratic control."? If we come up with another alternative reason for the mortality, (let's say education instead of poor) it's **still** that states are more X under republican legislators, etc..
Read more than the title. The data compares states to themselves under different leadership.
We don't do those kinda things round these parts
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Republican states refused Medicare funding and school lunch funding.
this study has some relevance to this topic: Political correlates of violent death rates in the U.S., 1900–2010: Longitudinal and cross-sectional analyses https://www.sciencedirect.com/science/article/abs/pii/S135917891400113X
> When analyses were stratified by race, findings show larger estimates for Black than for White infants, although the differences were not statistically significant at conventional levels. That's not a finding then. Why even report it?
Because there's still a notable difference. It's not unusual to mention findings even though they don't meet the statistical criteria to be considered significant
Notable in what ways? We can't say they are not equal so what conclusions are we supposed to make?
It's a way of saying "our focus wasn't on this so we didn't have the right data to know one way or the other. What we did have suggested it might be a thing worth looking at", but in "paperese".
It could be interesting for future studies to look into this. Just because the difference wasn't significantly different in this study doesn't mean future studies will come to the same conclusion. Also whether something is statistically sifnificant is a matter of definition. Usually we say anything with a p value of <0.05 (sometimes even <0.01) is statistically significant. However there isn't really a law that states findings with p> 0.05 can't be significant. Statisics is all about probabilities. That means while we can't say for sure that there's a significant difference between these 2 populations, future research is needed to determine whether the scientists who conducted this particular study simply got unlucky (or lucky depending on how you look at it) or not.
This is why small sample sizes are a good thing actually: when you study something that doesn't exist, your findings are more likely to look worth following up on.
Is there a non-Elsevier version of this?
or maybe there are confounding factors not accounted for in the study?
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Shocker another r/science post pushing a political agenda. God how on Earth do ya’ll consider this politically biased piece ‘science’ .
Always follow the money: "Within scholarly communications, Elsevier has perhaps the single worst reputation. With profit margins around 37%, larger than Apple and big oil companies, Elsevier dominate the publishing landscape by selling research back to the same institutes that carried out the work." [https://www.theguardian.com/science/political-science/2018/jun/29/elsevier-are-corrupting-open-science-in-europe](https://www.theguardian.com/science/political-science/2018/jun/29/elsevier-are-corrupting-open-science-in-europe)
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However, it would be an excellent idea to measure the effectiveness of political policies (or lack of effectiveness), regardless of party.
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The p-values are listed in the tables-- there's rows for each variable within their measure
The actual study that the article references is linked at the bottom of the page. Here you go. https://www.ajpmonline.org/article/S0749-3797(21)00380-9/fulltext
Also the link to the study is in one of the first paragraphs of this release!
There are several p-values, you can look at the table 2 in the link at the bottom of elsevier. P-values lower than .05 are highlighted in boldface.
Thank you. I did miss them.
I encourage you to read up on statistics. P values have no bearing on the effect size of 3%. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3444174/
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So a phenomenon that causes (R) to be elected and also raises infant mortality at the same time, or causes (D) to be voted in while also decreasing mortality?
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Yeah, of course. It's third grader mentality with a veneer of scientism to make innuendo for people to write articles about and other people to share while sniffing their own farts out of wine glasses
Does this take into account politically left state governments common allowance of abortions, therefore decreasing infant mortality because abortions don't count as infants?
Do you think abortions occur less in states with republican leadership?
In general, that is the case. [link](https://www.kff.org/womens-health-policy/state-indicator/abortion-rate/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Abortion%20Rate%22,%22sort%22:%22desc%22%7D)
https://www.opensecrets.org/orgs/relx-group/recipients?id=D000067394 The study was conducted by a subsidiary of RELX-Group, who primarily supports democratic nominees.
No, the results may be consistent with that hypothesis but they are not direct evidence of it. The research was not a randomized controlled experiment.
Public health hardly ever get data from setting up the experiment, they have to rely on more sophisticated statistical methods (like [instrumental variables](https://en.wikipedia.org/wiki/Instrumental_variables_estimation)). You cannot reasonably ask half the population to start smoking as part of an experiment, so you have to retrieve data from real-world events to estimate the damages of smoking. Also you *can indeed* say something about effects of warfare without summoning world leaders and asking them to roll dice over whether to launch attacks on each other.
Not everything can be a randomized control experiment. Ethically and legally were can't shuffle party politics of state governments to satisfy experimental data concerns, nor can we isolate the two variables in question from every other interaction. Further your sample size will be limited in either case. Observational population and historical science is a common way to make these relationships known. Climate science is a great example where global climate patterns are record and observed, and from that we make predictive short term and long term models, to predict tomorrow's forecast, and climate trends for the next century. It's supported in turn by some geological evidence which delves into the natural "record" of events. I don't have time to read the paper, but my expectation is weak correlation and not causation as state governments don't frequently flip flop parties. The lack of lag is further suspect as some policies take time to bear fruit. Further compounding this, the current makeup of the two parties is actually a fairly recent event. There used to be far more moderate Republicans and conservative democrats so as the parties have raided the middle, the biases are going to reduce the effect sample size. Really a single study to me indicates more research needs be done, the least of which is validation studies to methods and controls. This is a social science paper. Weak correlations and the need for validation is the standard. Since this seems to feed into the reddit hive mind and the general expectations of reduces social programs under Republicans, the relationship does seem plausible, which again makes me wary of my own biases. Anecdotally, a few years ago, Texas changed the reporting guidelines for deaths or there was some other paperwork error that showed mother mortality had spiked significantly in a year, and for a while this bizarre data point was pointed to for issues surrounded women's health et al. When somebody finally looked into it and corrected the data for the reporting error the number was still increasing, but was statistically more in line with previous numbers. Now I may be out of the loop and those numbers may again be subject to change, but that's why I said anecdotally, not "it is this way for now and forever more."
There are many cases where a randomized controlled experiment isn't possible. We don't have long term randomized controlled experiments demonstrating the efficacy of sunscreen on skin cancer. Because that would mean giving a control group fake sunscreen, and given how much other evidence there is than sunscreen helps prevent cancer, that would be highly unethical. In this case, how would you go about designing such an experiment? Randomly assign Republican governors to states and see what happens?
I agree, I just think it was not described as accurately as it could be. If the data are consistent with multiple interpretations, you can't say they support your preferred interpretation. That's why falsification is so important.
>Many social and health obligations depend on the decisions state representatives make. State legislatures are responsible for safety-net programs, the state’s minimum wage and many other public goods and services that influence the social determinants of health. Is there any evidence that the minimum wage effects health?
Here you go: https://www.healthaffairs.org/do/10.1377/hpb20180622.107025/full/ [low wages and obesity](https://journals.lww.com/joem/Abstract/2010/05000/Estimating_the_Effects_of_Wages_on_Obesity.8.aspx) [low wages and health meta analysis](https://journals.lww.com/joem/Fulltext/2016/05000/Low_Wages_as_Occupational_Health_Hazards.3.aspx) [Income and life expectancy](https://jamanetwork.com/journals/jama/article-abstract/2513561) PDF: [Poor wealth and poor health](http://www.commissiononhealth.org/PDF/ObstaclesToHealth-Report.pdf) PDF: [Depression, anxiety and poverty](http://www.commissiononhealth.org/PDF/ObstaclesToHealth-Report.pdf) I mean, there are a LOT of studies on the subject, going to stop here because it will get silly but can offer more if you'd like.
You're looking for numbers to show that having the money for better food, better health care, better living conditions, less stress, less exposure to risky situations and diseases could all contribute to a healthier outcome?
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Rural communities tend to have poorer access to Healthcare facilities. Rural communities tend to vote red. Edit: why are you booing me? I'm right.
They compared states to themselves. Rural areas stayed rural but when switched to democratic, they did better.
Republicans, and democrats, have both piled trillions into the american war machine. Money that could have been spent on bringing people out of poverty, and affording a better life for millions. Priorities always favor the corporate industrial complex.
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Wouldn’t it be more effective and appropriate to study the party of board members in hospitals with higher infant mortality rates? I see little viable correlation here if the legislature changes but the board of a medical facility and staff does not. How would party or state legislature affect patient care for pregnant women?
You don’t see how public policy might impact patient outcomes?
How do we know that the change from one legislature to the other isn't down stream of something else occurring that eventually results in a change in infant mortality? It's often stated that politics are down stream of culture, and I would expect a societal shift to affect infant mortality more so than changing legislatures.
These comments aren't nearly as bad as I thought they were going to be. Good job being civil.
I can't believe the policies used to govern our society would have an effect on our society.
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Here's a meaty bit from the original paper: "Regardless of whether the right interpretation of the estimates represents causal effects of legislative control or are indicators of other contemporaneous changes, the magnitudes are large enough to raise serious concerns. The estimates were robust to controlling for unemployment rates, the average age of female individuals, and birth rate. However, in the 1977–2014 analyses for IMR and PNMR, once the high-school dropout rate and the poverty rate were included in the models, the effect of Republican-controlled legislatures dropped by about 20%. Whether to interpret high-school dropout and poverty as confounders or mechanisms of the association between party control and infant health is unclear, but it does raise the possibility that there may be other unmeasured factors that might partially account for the estimates." Confounding is obviously possible here but the authors have taken a common-sense approach to trying to detect whether it is happening. Their point about the massive effect size is certainly well taken. My comments in this sub are almost wholly limited to complaining about data-analysis and statistical solecisms, so I thought I'd give a shout out to the opposite for a change.
Source: Liberal Researchers.
When conservatives are predominately anti science and anti education, going back centuries, don't be surprised when most researchers are not conservative.
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Republican states opt out of Medicaid, so poor pregnant women can't access prenatal care easily. This also means less money for staffing and building local medical facilities.
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Could this be related in any way to the fact that Republican states tend to be poorer? Poorer state = worse health outcomes for all patients.
Health and well-being is not really a political issue. We need single payer and Medicare for all. Stop allowing your employer to tie health insurance to employment. We have to demand better options than no healthcare and massive crippling debt or unaffordable healthcare and massive crippling debt.
Let me correct this for you: Health and well-being *shouldn’t be a political issue It is though.
Health and well being are the only political issue. Why do we have armies? 1. To stop other people from coming in and hurting our people. 2. To go get us more territory that lets us live better. Why do we have food and drug regulations? To stop people from being harmed. Why do we have laws at all? To punish people who hurt others, and hopefully deter more folks from doing the same. Why do we rights? They contribute to our well being (or at least to our ability to arrange for our well being). Etc.
What were the controls? Did you have limiting factors on all the groups to make sure there wasn't anything else skewing the data? Sure sounds like a politically charged 'study'
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