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Crémieux

Jun 1, 2023 • 8 tweets • 4 min read • Read on X

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American military veterans have a suicide problem.

Some have theorized the reason is deployment-related trauma.

Leveraging the random assignment of new soldiers to units with different deployment cycles, Bruhn et al. found that was wrong.

Deployment did not increase suicides.

Looking only at violent deployments (ones with peer casualties), there aren't noncombat mortality effects either.

What explains veteran suicide rates?

The reason seems to be that the proposition is wrong: veterans do not have increased suicide risk.

This may seem surprising, but it's not. Their suicide rates are elevated over the general population because most of them are young White men. That group has a suicide issue.

There are good and bad parts to this observation.

On the one hand, it means that there is not selection of suicidal people into the military.

On the other, demographic selection makes this problem into one that agencies like the VA will probably not be able to fix on their own

because it's not a soldier problem, it's a young White male problem.

I don't know how this can be fixed, but presumably tackling opiate use would help.

Soliman (2022) found that DEA crackdowns on overprescribing pharmacies resulted in fewer local suicide deaths.

Soliman also found that sanctioning specific doctors affected opioid-related mortality more generally without impacting suicide rates. Effects were generally larger for males than females and they were larger for people aged 30-49 than those aged 15-29 or 85+. No race data.

Kennedy-Hendricks et al. found that Florida's pill mill crackdown reduced opioid overdose mortality considerably.

Their supplement contained details on the characteristics of the people who died from opioid overdoses, but I wasn't able to access it.

Regardless, this problem can

probably be helped to some degree.

Sources:

nber.org/papers/w30622

fivethirtyeight.com/features/suici…

papers.ssrn.com/sol3/papers.cf…

ajph.aphapublications.org/doi/full/10.21…

More:

bfi.uchicago.edu/insight/resear…

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Crémieux

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Mar 12

Manhattan is arguably America's most iconic city, and more arguably, its only 'real' city.

But its own laws have made the buildings that make it so iconic illegal to build more of🧵

Many of the existing buildings in Manhattan that you couldn't make today are too tall by current standards.

Many of the existing buildings in Manhattan that you couldn't make today have too many apartments by current standards.

Read 9 tweets

Crémieux

@cremieuxrecueil

Mar 11

President Trump just sent a hugely important memo to all agency heads.

It instructs them to inform courts filing injunctions against them that, per the law, plaintiffs have to post a security equal to the potential costs of the injunction to the Federal Government.

So, if you, a plaintiff demand the government make good on a payment of $2 billion that they were going to cancel, you must post $2 billion, just in case it's later found that the injunction was wrongful.

This means the injunctions will stop.

Activists groups are trying to get injunctions against the government to force massive payments to continue.

They will lose many of these battles, but now the battles probably won't even take place in most cases, because these securities are enormous and they won't make them.

Read 5 tweets

Crémieux

@cremieuxrecueil

Mar 11

Proposed DOGE target:

In 1992, Congress told the FDA to approve generic drugs within 180 days of submitting Abbreviated New Drug Applications (ANDAs).

Since 2006, they've failed, and generic drug approvals lag badly. Getting back to 180 days would save hundreds of billions.

There really is no good excuse here for doing this slowly, because

1. Generic drugs are drugs that are already in use. We know they're OK to approve!

2. Generic drugs make it possible for the healthcare system to save so much money that fast approval can pay for itself.

Chart via: sciencedirect.com/science/articl…

Read 5 tweets

Crémieux

@cremieuxrecueil

Mar 10

On the left, you can see child autism diagnoses.

On the right, you can see states with policies that give schools more money when their students are diagnosed with autism.

When these policies pass, autism diagnoses increase by almost 25%!

Incentives really do matter for autism diagnoses.

For example, people on SSI receive larger payouts if they're diagnosed with autism.

After the economic downturn in 2008, the most heavily impacted age group started getting diagnosed with autism at an incredible rate:

Similarly, because laws in many places mandate providing more resources to autistic children, parents have sought to get their mentally retarded children diagnosed as autistic.

Using California as an example, more than a quarter of the rise 1992-2005 was due to this:

Read 12 tweets

Crémieux

@cremieuxrecueil

Mar 10

The U.S. reports a higher maternal mortality rate than many peer nations like Canada, the United Kingdom, and France.

But the key word there is "reports".

How America classifies maternal mortality varies from peer nations, and this matters🧵

If you go based on the official reports, America's maternal mortality has actually increased since about 1999.

Rising maternal mortality is a disgrace and a tragedy.

But that's if it's really rising. America's rise has more to do with this checkbox on death certificates.

The U.S. used to code maternal deaths as any deaths during childbirth or the immediate postpartum period, under the old ICD-9 classification.

When they switched to ICD-10, the classification expanded to any deaths during pregnancy, childbirth, or 42 days of the end of pregnancy.

Read 22 tweets

Crémieux

@cremieuxrecueil

Mar 5

During Bernie's second set of questions in today's Senate confirmation hearing, @DrJBhattacharya came very close to describing the U.K.'s RECOVERY trial and arguing that the U.S. should emulate that sort of pragmatic clinical trial.

Bernie cut him off, but he shouldn't have🧵

The RECOVERY Trial was the in-patient equivalent to the community-level PRINCIPLE Trial.

Both were trials run in the U.K. to figure out what works for keeping people off of serious treatments like ventilators and out of the morgue after they've been infected with COVID-19.

RECOVERY was an amazing success, but it can't be done in the U.S., because America's healthcare resources are not aligned like they are in the U.K.

In Britain, the NHS and the country's death index (how deaths are tracked) enable people to be easily signed up and tracked.

Read 11 tweets

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