Aid blogger Tom Murphy is hosting the (third?) annual Aid Blogger's Best Awards (ABBAs). My series of posts on "Machine Gun Preacher" Sam Childers is up for the "Best Series" ABBA. If you missed my writing on Mr Childers the first time around there's a shorter version at Foreign Policy, a longer version here, and the latest updates on the whole sad story here.
Vote for that and the other awards at Tom's blog, a View From the Cave.
I've been remiss in blogging lately, but my excuses are excellent for once. Princeton has an odd academic schedule with finals after the winter / Christmas holidays. So after spending a couple weeks in Arkansas visiting family it was back to cold (but not as cold as usual) New Jersey to study for finals, write papers, and take exams, all in the middle of January. For normal students -- i.e., those who are used to finishing final exams before Christmas and actually having a mental break over the holidays -- this schedule is unpleasant. But it has one upside: last week was intersession, a one-week break where the fall semester is completely done and the spring semester and its obligations have yet to begin, and Woodrow Wilson students (in the vernacular, "Woos") traditionally plan group vacations.
One group went to Colombia for the week, another to the Dominican Republic, and various individuals and small groups jaunted off to exotic locales like Paris and Florida. I opted for the low-cost, low-energy Puerto Rico group. Sixteen of us rented a condo and this house (which I highly recommended) in Luquillo Beach and enjoyed this for a week:
Needless to say the stress of finals was washed away and we Woos are both more tanned and less loathe to start the spring semester. Today was our first day of classes so I'm still figuring out which classes I'll be taking, but this seems like a good moment to pause and celebrate:
I'm officially halfway through grad school! 1.5 years down, 1.5 to go. So far I've done:
Still to go:
I'm happy with my course of study so far, and have largely concentrated on the comparative advantage of each school and program: epidemiology, infectious disease, and other public health courses at Hopkins and economics and more general public policy courses at Princeton. For more details on the two programs (for instance, if you're considering programs like these) click below the fold...
I don't typically blog much about my classes because a) it is difficult and awkward to comment on a class in progress, and b) you might be quite bored since one of several reasons formal education exists is to force students to learn subjects more systematically and in-depth then we might otherwise care to pursue in the course of regular pleasure reading. So I avoid writing about the minutiae of classes -- but am happy to talk if you're considering either of the programs I'm in. One major difference I've mentioned before is that Hopkins is on the quarter system (four terms between August and May) whereas Princeton does semesters (two terms between August and May).
Now that I've finished a semester at Princeton I can say that by comparison the quarter classes aren't exactly a whole semester's worth of material crammed into half the time, but they're definitely more than half. I'd say on average (a very rough approximation!) I learned about two-thirds as much material in a quarter-length class as in a semester one.
As for what classes I've taken, I think they're fairly illustrative of the focus of both programs. As my interests continue to solidify around the implementation and evaluation of large-ish health programs, I think I'll end up using a lot of tools and knowledge from both programs. My course load has also been fairly typical for both programs:
Hopkins MSPH (Global Disease Epidemiology and Control)
I took 16 quarter-length classes for credit, five seminars for credit, and was a teaching assistant in one course:
Princeton Woodrow Wilson School MPA (Economics and Public Policy track):
Students typically take 4-5 classes per semester, but as a dual degree student I'll do three semesters instead of four. Classes I've completed or must take because they're required:
Others I might take this spring or next spring (my final semester) to complete requirements:
Footnotes: * - these core courses, along with a first-semester stats course, are offered at varying levels for students with different math backgrounds ** - most students take an introductory statistics/quantitative course followed by econometrics, while some students opt in to the linear models course instead.
Last week a classmate of mine at the Woodrow Wilson School shared this story, which I in turn share with permission.
Today G and I were doing our impossible econ problem set in Schultz Café. It was about consumer surplus so there were some nice geometric properties, and it was fun finding the areas of the triangles and trapezoids. I said out loud, "I don't how to do it the econ way, G. I only know how to do it the 9th-grade-math way."Guess who was sitting right behind us?
For background, search this article for the paragraph on Sims and the SAT. Maybe this is why economics folks might think we public policy students aren't so great at math? Related: how to fight impostor syndrome.
Imagine there's a pandemic flu virus on the loose, and a vaccine has just been introduced. Then come reports of dozens of cases of Guillain-Barré syndrome (GBS), a rare type of paralysis. Did the new vaccine cause it? How would you even begin to know? One first step (though certainly not the only one) is to think about the background rate of disease:
Inappropriate assessment of vaccine safety data could severely undermine the eff ectiveness of mass campaigns against pandemic H1N1 2009 influenza. Guillain-Barré syndrome is a good example to consider. Since the 1976–77 swine influenza vaccination campaign was associated with an increased number of cases of Guillain-Barré syndrome, assessment of such cases after vaccination will be a high priority. Therefore, it is important to know the background rates of this syndrome and how this rate might vary with regard to population demographics. The background rate of the syndrome in the USA is about 1–2 cases per 1 million person-months of observation. During a pandemic H1N1 vaccine campaign in the USA, 100 million individuals could be vaccinated. For a 6-week follow-up period for each dose, this corresponds to 150 million person-months of observation time during which a predicted 200 or more new cases of Guillain-Barré syndrome would occur as background coincident cases. The reporting of even a fraction of such a large number of cases as adverse events after immunisation, with attendant media coverage, would probably give rise to intense public concern, even though the occurrence of such cases was completely predictable and would have happened in the absence of a mass campaign.
That's from a paper by Steven Black et al. in 2009, "Importance of background rates of disease in assessment of vaccine safety during mass immunisation with pandemic H1N1 infl uenza vaccines". They also calculate background rates for spontaneous abortion, preterm delivery, and spontaneous death among other things.
One of my classmates drove from Los Angeles to Princeton and set up his camera to take photos along the way. He edited the results into this video:
In his words: "California to Jersey, 5,000+ photos, 2,800+ miles, 45 hours of driving, 0 speeding tickets, 1 driving hero." And yes, they stopped to sleep (though maybe not enough).
Things to watch for include the moon, the palms trees at the beginning, the changes in lighting (including sunrise around 1:40), and how many tractor-trailers they pass. But what strikes me the most is the uniformity of the road system -- the two-lane interstate highway, the road markings, the signs, the road-side stops. As outdated as our transportation system is, it's still a phenomenal public good when you compare it to what came before. It took Lewis and Clark a lot longer and they didn't even go as far.
The lectures are over, the problem sets are submitted -- all that's left for the fall semester are finals in a couple weeks. One of the courses I'm taking is Germán Rodríguez's "Generalized Linear Statistical Models" and it occurred to me that I should highlight the course website for blog readers. Princeton does not have a school of public health (nor a medical school, business school, or law school, amongst other things) but it does have a program in demography and population research, and Professor Rodríguez teaches in that program.
The course website includes Stata logs, exams, datasets, and problem sets based on those data sets. The lectures have closely followed the lecture notes on the website, covering the following models: linear models (continuous data), logit models (binary data), Poisson models (count data), overdispersed count data, log-linear models (contingency tables), multinomial responses, survival analysis, and panel data, along with some appendices on likelihood and GLM theory. Enjoy.
The late Joshua Lederberg, a Nobel-winning molecular biologist (at the age of 33!), wrote an essay on the history of our fight against microbes titled "Infectious History." It's readable and covers a lot of ground fairly succinctly, and there's a non-paywalled version here. (The formatting isn't great, so it's a great excuse to install the Readability plugin if you haven't already.) One of my favorite excerpts:
Bacteriology's slow acceptance was partly due to the minuscule dimensions of microbes. The microscopes of the 19th and early 20th centuries could not resolve internal microbial anatomy with any detail. Only with the advent of electron microscopy in the 1930s did these structures (nucleoids, ribosomes, cell walls and membranes, flagella) become discernible. Prior to that instrumental breakthrough, most biologists had little, if anything, to do with bacteria and viruses. When they did, they viewed such organisms as mysteriously precellular. It was still an audacious leap for René Dubos to entitle his famous 1945 monograph "The Bacterial Cell."
And on diminishing returns on extending life expectancy (at least in industrialized countries) since 1950:
Other statistics reveal that the decline in mortality ascribable to infectious disease accounted for almost all of the improvement in longevity up to 1950, when life expectancy had reached 68. The additional decade of life expectancy for babies born today took the rest of the century to gain. Further improvements now appear to be on an asymptotic trajectory: Each new gain is ever harder to come by, at least pending unpredictable breakthroughs in the biology of aging.
Read the rest. I came across Lederberg's article in a footnote to Adel Mahmoud's article "A global road map is needed for vaccine research, development, and deployment."
In short, no, liberals are just more likely to select themselves into grad school attendance (PDF). The abstract:
This paper analyzes longitudinal data to evaluate three claims that are key to a recently developed theory of professorial politics. The theory explains the liberalism of the American professoriate as a function of reputation-based self-selection: because academia has a reputation for liberalism, liberals are more likely to pursue graduate degrees and academic careers. We examine whether in fact young Americans who identify as liberal are more likely to enroll in graduate programs with the intention of completing a doctorate; the proposition that such a tendency cannot be explained away by variables unrelated to occupational reputation; and the claim, also made by the theory, that exposure to many years of higher education is not a major cause of the liberalism of graduate students. We find support for all three claims, with ambiguity only on the question of whether the greater propensity of those on the left to attend graduate school results from personality differences.
Within the particular fields I'm studying this is even more true. For public policy -- speaking very broadly -- if you're conservative and mostly want to cut government then why study how to do government better? Why not study business or law instead? And public health has traditionally been a field that favors a lot of government intervention too.
Cesar Victora, Bob Black, Ties Boerma, and Jennifer Bryce (three of the four are with the Hopkins Department of International Health and I took a course with Prof Bryce) wrote this article in The Lancet in January 2011: "Measuring impact in the Millennium Development Goal era and beyond: a new approach to large-scale effectiveness evaluations." The abstract:
Evaluation of large-scale programmes and initiatives aimed at improvement of health in countries of low and middle income needs a new approach. Traditional designs, which compare areas with and without a given programme, are no longer relevant at a time when many programmes are being scaled up in virtually every district in the world. We propose an evolution in evaluation design, a national platform approach that: uses the district as the unit of design and analysis; is based on continuous monitoring of different levels of indicators; gathers additional data before, during, and after the period to be assessed by multiple methods; uses several analytical techniques to deal with various data gaps and biases; and includes interim and summative evaluation analyses. This new approach will promote country ownership, transparency, and donor coordination while providing a rigorous comparison of the cost-effectiveness of different scale-up approaches.
Charles Mann wrote the wonderful book 1491, a summary of research on the Americas before Columbus, as well as 1493 (which I haven't read yet), a sequel of sorts that takes on the post-Columbus exchange of ideas, tools, plants, and germs. He's also written an article titled "How the Potato Changed the World" (which I imagine covers some of the same material as 1493) in the latest Smithsonian. One of the most arresting sections of the potato article is actually about a forgotten commodity. Today we take nitrogen fixation for granted, but its industrial perfection enabled a massive increase in world agricultural output, and more darkly the use of chemical weapons during the First World War. But prior to all that one of the best source of nitrogen was guano, or bat and bird dung:
In 1840, the organic chemist Justus von Liebig published a pioneering treatise that explained how plants depend on nitrogen. Along the way, he extolled guano as an excellent source of it. Sophisticated farmers, many of them big landowners, raced to buy the stuff. Their yields doubled, even tripled. Fertility in a bag! Prosperity that could be bought in a store!
Guano mania took hold. In 40 years, Peru exported about 13 million tons of it, the great majority dug under ghastly working conditions by slaves from China. Journalists decried the exploitation, but the public’s outrage instead was largely focused on Peru’s guano monopoly. The British Farmer’s Magazine laid out the problem in 1854: “We do not get anything like the quantity we require; we want a great deal more; but at the same time, we want it at a lower price.” If Peru insisted on getting a lot of money for a valuable product, the only solution was invasion. Seize the guano islands! Spurred by public fury, the U.S. Congress passed the Guano Islands Act in 1856, authorizing Americans to seize any guano deposits they discovered. Over the next half-century, U.S. merchants claimed 94 islands, cays, coral heads and atolls.
Read the rest of the Mann potato history article here. A related academic paper is Nathan Nunn and Nancy Qian's "The Columbian Exchange: A History of Disease, Food, and Ideas" (ungated PDF).
And while the idea of this blog post was simmering in my head I came across another piece by Charles Mann in Vanity Fair, this time on air travel security and how so much of it is theater to reassure the public. It's called "Smoke Screening":
Remember the fake boarding pass that was in Schneier’s hand? Actually, it was mine. I had flown to meet [TSA critic] Schneier at Reagan National Airport because I wanted to view the security there through his eyes. He landed on a Delta flight in the next terminal over. To reach him, I would have to pass through security. The day before, I had downloaded an image of a boarding pass from the Delta Web site, copied and pasted the letters with Photoshop, and printed the results with a laser printer. I am not a photo-doctoring expert, so the work took me nearly an hour. The T.S.A. agent waved me through without a word. A few minutes later, Schneier deplaned,compact and lithe, in a purple shirt and with a floppy cap drooping over a graying ponytail.
The boarding-pass problem is hardly the only problem with the checkpoints. Taking off your shoes is next to useless. “It’s like saying, Last time the terrorists wore red shirts, so now we’re going to ban red shirts,” Schneier says. If the T.S.A. focuses on shoes, terrorists will put their explosives elsewhere. “Focusing on specific threats like shoe bombs or snow-globe bombs simply induces the bad guys to do something else. You end up spending a lot on the screening and you haven’t reduced the total threat.”
My Solar System is a browser-based gravity simulation that lets you choose from several pre-built solar systems or create your own. Endless fun for the nerdy:
(There are several other simulation programs at the PHET website.)
It is ironic that modern capitalist societies engage in public campaigns to urge individuals to be more attentive to their health, while fostering an economic ecosystem that seduces many consumers into an extremely unhealthy diet. According to the United States Centers for Disease Control, 34% of Americans are obese. Clearly, conventionally measured economic growth – which implies higher consumption – cannot be an end in itself.
That's economist Ken Rogoff, asking "Is Modern Capitalism Sustainable?". And of course it goes beyond ironic; it's tragic. Changes in policy that address that "economic ecosystem" itself are usually considered outside the realm of public health, which is exactly why public health folks have to (and do) engage on broader policy issues.
bleg: (Internet slang) An entry in a blog requesting information or contributions. (from Wiktionary)
This entry was prompted by an interesting post on religion and human rights by Kate Cronin-Furman over at Wronging Rights. My question here has little to do with the contents of that particular post other than having been prompted by it in my impossibly tangential brain, but I think it's a great post that you should all read regardless. Now on to my question:
I'm not sure I believe in human rights. Don't get me wrong; I'm not a monster, and I'm really more agnostic on them than a certain skeptic. I also happen to value very highly pretty much all the widely-believed human rights and most everything to which the title of a human right has been expanded. I'm not convinced that my personal normative valuation or preference is the same as actually believing in human rights (their existence and universality), or whether the rights framework is the most true or helpful one. The work I want to do overlaps a lot with rights practitioners and language -- again with the valuation of those ends. I've also read quite a few things written by human rights activists, but mostly on the level of "we were trying to document or stop this atrocity" or otherwise using the language of rights towards an end which I support, but usually assuming from the beginning that the reader believed in human rights. It also seems that a lot of things that just seem good to many people, independent of a rights-based framework, are touted in that language because it is simply what is done. I also get the impression that there are a fair number of people working within the 'human rights establishment' who see the construct as more useful than true (or don't distinguish between the two) but I have no way to verify that.
None of these hesitations are final, of course -- this may simply be a shortcoming in my education that I need to rectify. I grew up very religious and went to a very conservative college that only employs professors who belong to a particular conservative evangelical denomination. I missed out on formal coursework or guided readings in secular philosophy or ethics, or at least any presentation of that material by people who actually believed it. Some of what I learned was heavily filtered through that strain of fundamentalist thought that looks at everything that is not itself and decries it as an un-moored, baseless fantasy. (Amongst others, blame Francis Schaeffer -- one his books recounts the truly atrocious evangelistic technique of trying to convince a confused young person that there are only two intellectually honest ways to reconcile hopelessness resulting from the perceived failure of secular philosophy to find meaning; believe in God or commit suicide.)
There were certainly others who were more gentle in approach but the underlying thought was always there, that there can be no absolute statements -- whether about morality or rights -- without theistic belief. However, in college I took a skeptical turn and eventually came to disbelieve my theist roots altogether. My graduate work has been more technically-focused (which is what I wanted), for example considering how to achieve improvements in health rather than deep thinking about the foundational assumption that there is a right to health. Many of my peers who attended liberal arts schools or research universities have obviously focused on the study of human rights to a much greater extent, whereas my education bypassed it altogether. To some extent I want to believe in human rights because it seems to be the dominant framework and language and things would just be simpler if I did. But wanting to believe something because it's helpful is not enough to me. It seems like it would be easier to believe in human rights if one did believe in a higher power, which may be one reason why liberal religious groups seem well-represented in human rights circles.
So finally, my bleg: what should I read? Is there a single primer on or defense of the foundations of human rights that you would recommend to a secular/skeptical person like me? This could be a book, an essay, a journal article -- whatever you think might be the most convincing case. I think this line of thinking deserves more than a simple read of a Wikipedia page; I'm hoping that you can distill the arguments that you've found most useful in thinking about rights into a few recommendations. Likewise, if you're in the doubter camp or think there is a better secular alternative out there I'd be happy to hear counter-suggestions as well.
I enjoyed this piece by Dani Rodrik at Project Syndicate:
Indeed, though you may be excused for skepticism if you have not immersed yourself in years of advanced study in economics, coursework in a typical economics doctoral program produces a bewildering variety of policy prescriptions depending on the specific context. Some of the frameworks economists use to analyze the world favor free markets, while others don’t. In fact, much economic research is devoted to understanding how government intervention can improve economic performance. And non-economic motives and socially cooperative behavior are increasingly part of what economists study.As the late great international economist Carlos Diaz-Alejandro once put it, “by now any bright graduate student, by choosing his assumptions….carefully, can produce a consistent model yielding just about any policy recommendation he favored at the start.” And that was in the 1970’s! An apprentice economist no longer needs to be particularly bright to produce unorthodox policy conclusions.
Nevertheless, economists get stuck with the charge of being narrowly ideological, because they are their own worst enemy when it comes to applying their theories to the real world. Instead of communicating the full panoply of perspectives that their discipline offers, they display excessive confidence in particular remedies – often those that best accord with their own personal ideologies.
Is it that bad? Well, statistician Kaiser Fung of the blog Numbers Rule Your World) says that it's actually much worse and that Rodrik doesn't go far enough as he compares Rodrik's point with a critique of economic modeling in Emanuel Derman's new book Models Behaving Badly (which I haven't read yet):
My own view, informed by years of building statistical models for businesses, is more sympathetic with Derman than Rodrik. There is no way that economic (by extension, social science) models can ever be similar to physics models. Derman draws the comparison in order to disparage economics models. I prefer to avoid the comparison entirely.
The insurmountable challenge of social science models, which constrains their effectiveness, is that the real drivers of human behavior are not measurable. What causes people to purchase goods, or vote for a particular candidate, or become obese, or trade stocks is some combination of desire, impulse, guilt, greed, gullibility, inattention, curiosity, etc. We can't measure any of those quantities accurately.
The students at the Woodrow Wilson School have a group blog on public policy called 14 Points. I've been helping promote the blog for a while but just got around to writing my first submission this week. It's titled "Testing Treatments: Building a culture of evidence in public policy". Here's an excerpt:
Similar lessons can be gleaned from the history of surgical response to breast cancer. In The Emperor of All Maladies (2010), a new history of cancer, oncologist Siddhartha Mukherjee chronicles the history of such failed interventions as the radical mastectomy. Over a period of decades this brutal procedure – removing the breasts, lymph nodes, and much of the chest muscles – became the tool of choice for surgeons treating breast cancer. In the 1970s rigorous trials comparing radical mastectomy to more limited procedures showed that this terribly disfiguring procedure did not in fact help patients live longer at all. Some surgeons refused to believe the evidence – to believe it would have required them to acknowledge the harm they had done. But eventually the radical mastectomy fell from favor; today it is quite rare. Many similar stories are included in a free e-book titled Testing Treatments (2011).As a society we’ve come to accept that medical devices should be tested by the most rigorous and neutral means possible, because the stakes are life and death for all of us. Thousands of people faced with deadly illnesses volunteer for clinical trials every year. Some of them survive while others do not, but as a society we are better off when we know what actually works. For every downside, like the delay of a promising treatment until evidence is gathered properly, there is an upside – something we otherwise would have thought is a good idea is revealed not to be helpful at all.
Under normal circumstances most new drugs are weeded out as they face a gauntlet of tests for safety and efficacy required before FDA licensure. The stories of the humanitarian-exemption stent and the radical mastectomy are different because these procedures became more widely used before there was rigorous evidence that they helped, though in both cases there were plenty of anecdotes, case studies, and small or non-controlled studies that made it look like they did. This haphazard, post-hoc testing is analogous to how policy in many other fields, from welfare to education, is developed. Many public policy decisions have considerable impacts on our livelihoods, education, and health. Why are we not similarly outraged by poor standards of evidence that leads to poor outcomes in other fields?
Read the rest at 14 Points, and check out the posts by my classmates.
As a follow-up to my last post on values and humility in economics, I thought the following video (which Mankiw shared on his blog) of Steve Marglin talking about heterodox economics is great:
Marglin gives two reasons to study mainstream economics in his talk. One of them resonates strongly with me because it is part of why I'm studying economics right now; it is the language of power. While I'm more interested in morbidity and mortality than I am in interest rates, much of health policy, aid policy, and development policy is done by -- or strongly influenced by -- those who speak the language of economics. For the other reason Marglin gives (and of course, there are many others) you'll have to watch the talk (it's good).
