Current Social Science Research Report--Health #96, January 21, 2009.

CSSRR-Social is a weekly email report produced by the Data and Information Services Center at the University of Wisconsin-Madison. It seeks to help social science researchers keep up to date with the latest developments in the field. This report will contain selected listings of new: reports, articles, bibliographies, working papers, tables of contents, conferences, data, and websites. For more information, including an archive of back issues and subscription information see:


CSSRR-Social is compiled and edited by Jack Solock and Charlie Fiss.


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Index to this issue:


















1. Census Bureau News Release: "Medicaid Tops Funding for Nursing and Residential Care Facilities," (CB09-09. Jan. 15, 2009). The news release links to tabulations from the "2007 Service Annual Survey: Health Care and Social Assistance" (tables in .pdf and Microsoft Excel format).

2. Department of Health and Human Services, Office of the Inspector General Report: "The Food and Drug Administration's Oversight of Clinical Investigators' Financial Information" (OEI-05-07-00730, January 2009, .pdf format, 44p.).


We found that clinical investigators may not be disclosing all financial interests. Further, we found that FDA's oversight of clinical investigators' financial interest information is lacking.

Clinical investigators may not be disclosing all financial interests: one percent of clinical investigators disclosed a financial interest; FDA cannot determine whether sponsors have submitted financial interest information for all clinical investigators.

FDA's oversight of clinical investigators' financial interest information is lacking: almost half of marketing applications were missing financial interest information; in almost one-third of marketing applications, FDA reviewers did not document a review of financial interest information; in 22 percent of marketing applications with a disclosed financial interest, neither FDA nor sponsors took action to minimize potential bias.

We recommend that FDA ensure that sponsors submit complete financial information for all clinical investigators. Also, to ensure that FDA reviewers consistently review financial information and take action in response to disclosed financial interests, we recommend that FDA use a review template and provide guidance and training to reviewers. Lastly, we recommend that FDA require that sponsors submit financial information as part of the pretrial application process.

FDA generally agreed with our recommendations. However, FDA did not agree with our final recommendation that FDA require sponsors to submit financial information for clinical investigators during the pretrial application process. We continue to believe that collecting financial information before starting clinical trials will better assist FDA in identifying and managing potential conflicts to ensure that human subjects are protected and data are reliable.

3. National Institutes of Health News Release: "Researchers Identify New Regulatory Circuit Controlling Immune Cell Production in Mice" (Jan. 11, 2009).

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US States:


Department of Health and Human Services Report: "Nebraska Outpatient Surgical Procedures Annual Report 2006" (January 2009, .pdf format, 17p.).

New Jersey:

Department of Health and Senior Services Report: "Reported Induced Terminations Of Pregnancy By Selected Characteristics New Jersey Occurrences, 2006" (January 2009).


Department of Health Report: "2007 Vermont Adult Tobacco Survey Report" (May 2008, .pdf format, 110p.).

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NGO and Other Countries:

United Nations:

1. Children's Fund Report: "Children and AIDS: Third Stocktaking Report, 2008," (December 2008, .pdf format, 44p.).

2. Pan American Health Organization Report: "Health Situation in the Americas: Basic Indicators 2008" (2008, .pdf format, 12p.).

3. World Health Organization Regional Office for the Western Pacific Report: "Injection Safety - Facts and Figures (2004)" (January 2009, .pdf format, 2p.).


European Community

Canadian Institute for Health Information/Institut Canadien d'Information sur la Sante Report: "Alternate Level of Care in Canada," (January 2009, .pdf format, 20p.).



Statistics Netherlands: SN has updated its Web Magazine, Economic Monitor, and Press Releases from Jan. 14, 2008-Jan. 21, 2009).



Statistics Norway News Releases: SN has updated its news releases from Jan. 14-21, 2009).

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Kaiser Family Foundation, Various

A. "The Public's Health Care Agenda for the New President and Congress" (January 2009, .pdf format, Chartpack, 15p., toplines, 22p.).

B. "Cost Sharing for Health Care: France, Germany, and Switzerland" (Issue Brief, January 2009, .pdf format, 23p.).

C. "Turning to Medicaid and SCHIP in an Economic Recession: Conversations with Recent Applicants and Enrollees" (January 2009, .pdf format, 15p.).

D. "Pulling it Together". The latest "Pulling it Together," "Window of Opportunity?" by Drew Altman, is available.

E. "Medicaid Home and Community-Based Service Programs: Data Update," by Terence Ng and Charlene Harrington (January 2009, .pdf format, 34p.).

F. "New Reports Examine Impact of Economic Turmoil on Health Coverage and State Medicaid Programs." (January 2009, .pdf format). "As economic conditions worsen across the country, the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured has issued several new reports and other resources examining the impact of the recession on ordinary Americans, their health coverage and state budgets and Medicaid programs.

The materials, released in concert with a briefing on Medicaid and the economy co-sponsored by the Alliance for Health Reform, include the following (all .pdf format): "Rising Unemployment, Medicaid and the Uninsured"; "Medicaid in a Crunch: A Mid-FY 2009 Update on State Medicaid Issues in a Recession"; "The Role of Medicaid in State Economies: A Look at the Research"; and "State Fiscal Conditions and Medicaid." Briefing video webcast "Medicaid and the Economy Alliance for Health Reform and Kaiser Family Foundation, Jan. 9, 2009, running time: 1 hour, 45 minutes, 20 seconds, transcript, .pdf format, 64p.).


Urban Institute Report, Brief:

A. "Providing Maternity Care to the Underserved: A Comparative Case Study of Three Maternity Care Models Serving Women in Washington, D.C.," by Louise Palmer, Allison Cook, and Brigette Courtot (January 2009, .pdf format, 83p.).

B. "Massachusetts Health Reform: Solving the Long-Run Cost Problem," by John Holahan and Linda J. Blumberg (January 2009, .pdf format, 11p.).


Newsweek Article: "Obama’s Unhealthy Choices: He can't control long-term entitlement spending unless he curbs health care, which accounts for a quarter of the federal budget," by Robert J. Samuelson (Jan. 19, 2009).


Proceedings of the National Academy of Sciences Article Abstract: "Forecasting United States mortality using cohort smoking histories," by Haidong Wang and Samuel H. Preston (Vol. 106, No. 2, January 14, 2009, .pdf and HTML format, p. 393-398). Note: PNAS is providing free access to the full-text of this article.


Journal of the American Medical Association Various:

A. "Treating Drug Abuse and Addiction in the Criminal Justice System: Improving Public Health and Safety," by Redonna K. Chandler, Bennett W. Fletcher, and Nora D. Volkow (Special Communication Extract, Vol. 301, No. 2, Jan. 14, 2009, p. 183-190).

B. "Improving the Quality of Health Care: Who Is Responsible for What?" by J. Frank Wharam and Daniel Sulmasy (Commentary Extract, Vol. 301, No. 2, Jan. 14, 2009, p. 215-217).

C. Health Inequality: Morality and Measurement, by Yukiko Asada, reviewed by Timothy Ferris and Sarah Johnson (Book Review Extract, Vol. 301, No. 2, Jan. 14, 2009, p. 222-224).


New England Journal of Medicine Article, Perspective Abstracts:

A. "Cumulative Live-Birth Rates after In Vitro Fertilization," by Beth A. Malizia, Michele R. Hacker, and Alan S. Penzias (Vol. 360, No. 3, January 15, 2009, p. 236-243).

B. "Visions for Change in U.S. Health Care - The Players and the Possibilities," by John K. Iglehart (Vol. 360, No. 3, January 15, 2009, p. 205-207). This article is available free of charge.

C. "Health Care Reform - Why So Much Talk and So Little Action?" by Victor R. Fuchs (Vol. 360, No. 3, January 15, 2009, p. 208-209). This article is available free of charge.


British Medical Journal Various:

A. "Effect of fish oil on arrhythmias and mortality: systematic review," by Hernando Leon, Marcelo C Shibata, Soori Sivakumaran, Marlene Dorgan, Trish Chatterley, and Ross T. Tsuyuki (Article abstract, BMJ 2008;337:a2931, Dec. 23, 2008, Research).

B. "What can we learn from drug marketing efficiency?" by David P. Kao (Analysis extract, BMJ 2008;337:a2591, Dec. 2, 2008, .

C. "Commentary: The balance between marketing and safety," by Keith Beard (Commentary extract, BMJ 2008;337:a2996, Dec. 24, 2008,.

D. "Changing behaviour through state intervention," by Theresa M. Marteau, Adam Oliver, and Richard E. Ashcroft (Editorial extract, BMJ 2008;337:a2543, Dec. 15, 2008).


Lancet Article Abstract: "Medicine prices, availability, and affordability in 36 developing and middle-income countries: a secondary analysis," by A. Cameron, M. Ewen, D. Ross-Degnan, D. Ball, and R. Laing (Vol. 373, No. 9659, January 17, 2009, .pdf and HTML format, p. 240-249). Note: Lancet is making the full-text available for free (free registration if required).

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California Center for Population Research [University of California-Los Angeles]: "Lessons from Empirical Network Analyses on Matters of Life and Death in East Africa," by Jere R. Behrman, Hans-Peter Kohler, and Susan Watkins (PWP-CCPR-2008-059, December 2008, .pdf format, 24p.).


Network-based strategies and competencies are probably even more important in poor societies with limited means of communication and less effective formal structures than in developed economies. And they often deal with life and death matters. This paper presents lessons from and insights about the nature of and the impacts of informal social networks in reducing fertility and coping with HIV/AIDS in Kenya and Malawi based on analyses of quantitative longitudinal data and qualitative data that the authors and their collaborators have been collecting and analyzing for over a decade. Specific lessons include the relevance of social networks and informal interactions for many different domains related to health - and thus life and death - in developing countries, the importance of accounting for the endogeneity of network partners in analyzing network effects, that networks are important even with control for endogeneity, that network effects may be nonlinear, that there may be multiple equilibria, that which networks may either reinforce the status quo or help diffuse new options and behaviors, that both the context (e.g., the degree of market development) and the density of networks matter (possibly interactively), and that multiple approaches, including both qualitative and quantitative analyses, can be informative in providing more in-depth understanding of what networks do and how they function.


National Bureau of Economic Research:

A. "The Effects of Pharmaceutical Marketing and Promotion on Adverse Drug Events and Regulation," by Guy David, Sara Markowitz, and Seth Richards (w14634, January 2009,.pdf format, 53p.).


This paper analyzes the relationship between postmarketing promotional activity and reporting of adverse drug events by modeling the interaction between a welfare maximizing regulator (the FDA) and a profit maximizing firm. In our analysis demand is sensitive to both promotion and regulatory interventions. Promotion-driven market expansions enhance profitability yet may involve the risk that the drug would be prescribed inappropriately, leading to adverse regulatory actions against the firm. The model exposes the effects of the current regulatory system on consumer and producer welfare. Particularly, the emphasis on safety over benefits distorts the market allocation of drugs away from some of the most appropriate users. We then empirically test the relationship between drug promotion and reporting of adverse reactions using an innovative combination of commercial data on pharmaceutical promotion and FDA data on regulatory interventions and adverse drug reactions. We provide some evidence that increased levels of promotion and advertising lead to increased reporting of adverse medical events for certain conditions.

B. "Life (evaluation), HIV/AIDS, and Death in Africa," by Angus Deaton, Jane Fortson, and Robert Tortora (w14637, January 2009, .pdf format, 46p.).


We use data from the Gallup World Poll and from the Demographic and Health Surveys to investigate how subjective wellbeing (SWB) is affected by mortality in sub-Saharan Africa, including mortality from HIV/AIDS. The Gallup data provide direct evidence on Africans' own emotional and evaluative responses to high levels of infection and of mortality. By comparing the effect of mortality on SWB with the effect of income on SWB, we can attach monetary values to mortality to illuminate the often controversial question of how to value life in Africa. Large fractions of the respondents in the World Poll report the mortality of an immediate family member in the last twelve months, with malaria typically more important than AIDS, and deaths of women in childbirth more important than deaths from AIDS in many countries. A life evaluation measure (Cantril's ladder of life) is relatively insensitive to the deaths of immediate family, which suggests a low value of life. There are much larger effects on experiential measures, such as sadness and depression, which suggest much larger values of life. It is not clear whether either of these results is correct, yet our results demonstrate that experiential and evaluative measures are not the same thing, and that they cannot be used interchangeably as measures of "happiness" in welfare economics.


US Federal Trade Commission, Bureau of Economics:

A. "The Effect of Hospital Mergers on Inpatient Prices: A Case Study of the New Hanover-Cape Fear Transaction," by Aileen Thompson (No. 295, January 2009, .pdf format, 20p.).

The Federal Trade Commission initiated a Hospital Merger Retrospective Project in 2002 to analyze the effects of consummated mergers. One of the mergers studied was the 1998 acquisition by New Hanover Regional Medical Center ("New Hanover") of Columbia Cape Fear Memorial Hospital ("Cape Fear") in Wilmington, North Carolina. In this paper, we employ patient-level claims data from four different insurers to estimate the effects of this merger on inpatient prices. Our results provide mixed evidence. Two of the insurers experienced substantial post-merger price increases relative to the control group of hospitals. The post-merger price changes for another insurer, however, were comparable to those for the control group, while the fourth insurer actually experienced a significant price decrease following the merger. Thus, it is difficult to draw conclusions about the impact of this merger on inpatient pricing.

B. "Two Hospital Mergers on Chicago’s North Shore: A Retrospective Study," by Deborah Haas-Wilson and Christopher Garmon (Working Paper No. 294, January 2009, .pdf format, 27p.).


We provide an in-depth analysis of the price effects of two hospital mergers that occurred in the north shore suburbs of Chicago in early 2000: Evanston Northwestern Healthcare’s (ENH) purchase of Highland Park Hospital (HPH) and the merger of St. Therese Medical Center (STMC) and Victory Memorial Hospital (VMH). Using standard difference-in-differences methods with data from multiple sources, including health insurance data with actual transactions prices, we find that the ENH/HPH merger led to a large and statistically significant post-merger price increase. We find no evidence of a price increase after the STMC/VMH merger. These results are robust across data sources, control groups, and case mix adjustment methods.

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JOURNAL TABLES OF CONTENTS (check your library for availability):

Clinical Infectious Diseases (Vol. 48, No. 4, February 2009). Note: Full electronic text of this journal is available in the ProQuest Research Library and the EBSCO Host Academic Search Elite Database. Check your library for the availability of this database and this issue.

Global Public Health (Vol. 4, No. 1, 2009).

Health Economics, Policy and Law (Vol. 4, No. 1, January 2009).

International Journal for Quality in Health Care (Vol. 21, No. 1, January 2009). Note: Full electronic text of this journal is available in the ProQuest Research Library. Check your library for the availability of this database and this issue.

Journal of Biosocial Science (Vol. 41, No. 2, March 2009).

Occupational and Environmental Medicine (Vol. 66, No. 2, February 2009).

Toxicological Sciences (Vol. 107, No. 2, February 2009).

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International Society for Infectious Diseases: ISID's Newsletter (Vol. 10, No. 2, January 2009, features an announcement on the upcoming International Meeting on Emerging Diseases and Surveillance, to be held in Vienna, Austria, Feb. 13-16, 2009. On p. 9-10 of the newsletter, there are several other relevant conference announcements.

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American Statistical Association: ASA has updated its employment page with listings through Jan. 21, 2009.


Chronicle of Higher Education:

Health positions has been updated through Jan. 21, 2009.

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US Senate Committee on Health, Education, Labor, and Pensions Hearing Testimony: "Investing in Health IT: A Stimulus for a Healthier America," a hearing held January 15, 2009 (.pdf format).

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US National Center for Health Statistics: National Health and Nutrition Examination Survey Updates. NCES has announced data and publication updates for NHANES for December 2008. Data is available in SAS Transport (.xpt) format, with documentation available in .pdf format).

See under "December 2008" listing.


Inter-University Consortium for Political and Social Research: ICPSR at the University of Michigan released several new datasets on Jan. 19, 2008 which may be of interest to Health researchers. Note: Some ICPSR studies are available only to ICPSR member institutions. To find out whether your organization is a member, and whether or not it supports ICPSR Direct downloading, see:

New and updated data:

All new and updated data in the last 90 days can be found at:


UK Data Archive (Essex University, Colchester, UK): The UK Data Archive has recently added the following datasets to its holdings. Note: There maybe charges or licensing requirements on holdings of the UK Data Archive. For more information see:

For new data or new editions of new data in the last month:

and pick "1 month" for either.

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Kaiser Family Foundation Updates: has recently added the following tutorial and companion issue module:

"America's Health Care Safety Net," by Andrew B. Bindman (January 2009, 22 slides, slideshow (Microsoft PowerPoint format) can be downloaded, running time of web based audio enhanced slideshow: 16 minutes, 20 seconds).

Companion Issue Module:

An updated Reproductive Health Policy tutorial: "Reproductive Health Care for Women: Coverage, Access, and Financing," by Usha Ranji (January 2009 Update, 18 slides, slideshow (Microsoft PowerPoint format) can be downloaded, running time of web based audio enhanced slideshow: 16 minutes, 44 seconds).

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