So I dropped my laptop 2 weeks ago and the internet connection has been off and on, dying completely yesterday. Until I either fix it or get a new one, posts will be limited to what I can type on my phone without getting aggravated.

This week I came across a post by Random Critical Analysis analyzing the fairly famous “US spends more on healthcare and has lower life expectancy” graphs. As part of this analysis, he graphs life expectancy vs obesity and shows that the US is very well in line with other developed countries given our above average obesity rate.

To further the point, he breaks down the states individually and shows that this holds within our countries as well:

In other words, low obesity Colorado has a life expectancy in with the other developed countries, while higher obesity states are much lower. He also redid the analysis by splitting other countries up in to regions, and found this pattern holds for other countries as well. The post then goes on to build the causal chain, and it’s pretty fascinating. It even throws in maternal mortality, and shows that if we adjust for BMI, we’re right on par there as well.

I obviously suggest reading the whole post, but it’s a good reminder that this factor has been under discussed in the conversation about healthcare. We often say “other countries have figured out how to deliver healthcare more effectively than we have”, but no country has figured out how to do that with a population as obese as ours. In other words, it seems that unless we really start finding some good ways of preventing obesity or facilitating weight loss, it may be hard to ever reduce our costs. Sobering thought.

The Assistant Village Idiot has re-posted one of my favorite anecdotes of his. For those not familiar with him, he has 40+ years experience in a state mental hospital. It’s short, so I’ll repost it in its entirety here (source):

A paranoid patient of ours had taken the book 1984 out of the patient library.  His particular paranoia is very much concerned with thought reading and thought broadcasting. He is not a person one might expect to have good general knowledge of literature and political culture, and he did not have much preconceived notion what it might be about.  He had heard somewhere it was an important book.  We were a little concerned what he might take away from the book, but we don’t get much involved in people’s selections.

He found it sad.  This guy had a girlfriend, but he lost her.

He didn’t really notice the paranoia-inducing parts of the book.  Those were just normal background to him

I think about that a lot, most often when I see a poll question asking people how they feel about current events or to compare previous years to this one. Getting people’s impressions without knowing their baseline can be highly misleading.

There was a great article in the Atlantic this past week called “What Joe Biden Can’t Bring Himself to Say“.  The article focused on his (and the authors) struggle with stuttering, and contained a lot of fascinating information about stuttering that I never knew. Regardless of your political orientation and/or feelings about Joe Biden, it’s a very worthwhile read.

One of the interesting stats it contained was that stuttering was twice in common in boys than in girls, and that girls have a higher recovery rate. I was interested in this, because aside from a vague “girls have better verbal skills earlier, so I guess that makes sense” train of thought, there doesn’t seem to be a clear reason for this. I Googled a bit and found that no one is really clear on the reason for the discrepancy, though there is a thought that girls may tend to get earlier help because people expect them to be more verbal. This discussion got me interested in other similar disorders. We’re not surprised to hear that issues like prostate cancer or breast cancer are more common in one sex than the other, but some things feel like they should be more gender neutral.

I decided to look up a few other examples, though I excluded mental health type disorders since some of the sex differences there can be a bit controversial, and excluded diseases or disorders that seem to be linked to differences in behavior (such as lung cancer):

• Migraines: This one is near and dear to my heart, and women are 3 times more likely to get migraines than men. There are theories that some female specific hormones may increase susceptibility or that some male hormones may be protective, but no one is quite sure about this one either.
• Multiple Sclerosis: MS is another disorder that is two-three times higher in women than men. There has been at least one sex linked brain difference that has been implicated in the discrepancy, but nothing definitive.
• Skin cancer: Okay, this one is partially behavior, but I’m including it because it’s a subtle behavioral thing. Apparently men are far more likely to get skin cancer on their ears and scalp than women are. This is almost certainly because men are more likely to have short hair than women, offering less protection from sun exposure.
• ALS (Lou Gehrig’s disease): While Lou Gehrig was unfortunate enough to end up with a terrible disease named after him, it’s not totally surprising the public face of this disease was a man instead of a woman. Men are hit by ALS more often than women by a margin of about 2 to 1. No one’s clear exactly why, though some theories are a greater likelihood of exposure to toxic chemicals or differences in the nervous system.

I wasn’t intending to write about student debt this week, but oddly enough I had two different people ask me about it on the same day. The first was a younger coworker, who had heard Elizabeth Warren say that student loan debt disproportionately affected African Americans and was curious if that was true. He also wanted to where “average student loan debt” numbers came from. The second was the AVIs wife, who sent me a new report looking at the return on investment from different types of colleges, and wanted to know if family income was taken in to account.

Okay, so let’s take this one thing at a time. First, Warren’s comments came from a Tweet where she also shared this article. For clarity, I want to note that this article ISN’T by Warren, but her Tweet would seem to indicate some agreement. The article started with the stat that the average student loan debt was $37,102. My colleague (a fairly recent grad) thought that sounded low.

The average student loan debt number comes from this Chamber of Commerce report. Now this report was interesting because it is looking only at those people who graduated in 2017. When my colleague had first mentioned this to me, I had wondered if the “average” number was including those further from graduation, but it doesn’t. It did however, point out that student loan debt varies wildly based on the region of the country you live in:

New England is one of the highest average levels, so those of us living here will tend to see higher loan totals among our peers. Additionally, borrowers owing 6 figures are the fastest growing group of borrowers,  with about 2 million people owing over $100,000. While much of that is due to graduate school debt, one would suspect those folks would be concentrated in the same areas as the higher levels of debt.

So what about the disproportionate impact claim? Well, that also came from the Chamber of Commerce report. More black students take out loans to pay for their education (77% vs a national average of 60%), they take out higher amounts ($29,000 vs $25,000) and are more likely to default on their loans within 12 years of graduation (50% vs 36% of Hispanic students and 21% of white students). However, it’s important to note that this is comparing graduating students to other graduating students….it excludes those who didn’t go to college or didn’t graduate. Those groups are also disproportionately comprised of minorities. Inside Higher Ed has a good graph of the outcomes by race 6 years after people matriculate:

I think this is striking because it’s something I always wonder about when we talk about student loan forgiveness. Some people choose not to go to college or start in community colleges because of the expense of college. Forgiveness of debt may really help some people, but in many cases big choices have already been made. If there is inequality in those initial choices, then loan forgiveness will not solve those inequalities. We know that white 18 to 24 year olds are more likely to enroll in college than black or Hispanic students, so while the loans taken out by black students may be higher, the proportion of people taking them out is lower. It may still be true, but I think it should be clearer that we’re only talking about students here.

I think this is an important point because if we’re talking fairness, then we have to consider the poorest among us may be among the least likely to take out student loans to begin with. Indeed, an analysis of Warren’s plan showed only 10% of the benefits of this plan would go to the bottom 20% of households. By contrast, the top 20% of qualifying households would get 18% of the benefits. This may even out as the other parts of her plan were implemented (reduction in college cost going forward), but it’s something to consider.  (Note: I will fully admit I haven’t spent much time studying Warren’s proposal, so I may be missing something. Let me know in the comments if I’ve misstated something and I’ll update. I’m using her plan as an example to discuss the broader point about who currently carries student loan debt, not to knock her proposal over others. I really appreciate that she was willing to publicly release her plan for discussion like this.)

Alright so now to the last point….what’s the return on investment for college students? Well according to this calculation in the short run (10 years) it’s better to have gone to a public school than a private one, but by the 40 year mark it’s better to have gone to a private school. For example, my alma mater is Boston University. At the 10 year mark, it’s the 3,318th best ROI in the country. By year 20 post grad, it jumps to 464. By year 30, it’s at 142, and by 40 years it’s almost one of the top 100 best values at 116. The calculator is fun to play around with because you note some interesting patterns. Small schools in the Boston area do better than small schools in New Hampshire, which I will guarantee is a function of the graduates staying near cities. There’s no cost of living adjustment in alumni salary calculations. Some of the Protestant colleges my friends and family went to don’t fare well, but I’d suspect an inordinate number of graduates go in to things like social work, teaching or other ministry positions. In fact a good number of the “worst” ROI schools are actually Rabbincal colleges.

So are these institutions cherry picking rich students and then taking credit for their earnings? Possibly. Nothing in the calculations takes your family’s wealth in to consideration, so a kid who inherits the family business gets counted the same way as a kid who comes from nothing. Additionally, it’s interesting to note that some specialty schools do really well (pharmacy) and some really poorly (art). Schools who don’t have a lot of different types of graduates are very tied to how the professions associated with them are doing.

Additionally, families with money probably tend to send their kids to private schools to begin with. For example, Stephanie and Shane McMahon (children of Vince and Linda McMahon, owners of the WWE) both went to Boston University and then promptly went to work for the family business. I don’t know for sure, but I suspect they never looked at UCONN when they were applying. Now this wasn’t every kid at BU, but having even a handful of the already wealthy can be enough to boost your lifetime earnings scores. In other words, we don’t know if BU is a better deal for a kid from a middle class household who wants to be a high school teacher, or if UMASS would be equal in those circumstances. We only know that overall, BU grads do better 40 years out.

So overall we don’t really know what we don’t know here, but we do know that many college stats leave out some confounders (who didn’t go to college, who was going to have money handed to them regardless of college status). Overall I think they are good for getting a general sense of things, but up close they have some issues. Like a Monet painting or something.