Archive for health care
les urgences en PLS [Libé]
Posted in Kids, pictures with tags #ensemblesauvonslhopital, emergency, French hospital, health care, Libé, residency on May 19, 2022 by xi'anput the data aside [SCOTUS v. evidence]
Posted in Statistics with tags abortion, editorial, evidence, health care, legalisation of abortion, maternal mortality, Nature, Planned Parenthood, reproductive rights, Roe v. Wade, SCOTUS, Supreme Court, US Constitution on May 18, 2022 by xi'anReposted from a Nature editorial:
(…) Moving in the opposite direction runs contrary to 50 years of research from around the world showing that abortion access is a crucial component of health care and is important for women’s equal participation in society. After the Supreme Court agreed to hear Mississippi’s case last year, Nature covered some of this evidence, submitted to the court by US scientific societies and more than 800 US researchers in public health, reproductive health, social sciences and economics, to the court in advance of the case’s hearing in December.
Some outcomes of outlawing abortion can be predicted by what’s known. Researchers expect overall infant and maternal health to decline in the United States in the wake of abortion bans, because more unintended pregnancies will be brought to term. Unintended pregnancies are associated with an increased risk of health problems for babies, and often for mothers, for several reasons — including reduced prenatal care.
Maternal health is also expected to decline overall. One straightforward reason is that the risks of dying from pregnancy-related causes are much greater than the risks of dying because of a legal abortion. A predicted rise in maternal mortality among Black women in the United States is particularly distressing, because the rate is already unacceptably high. In one study, sociologist Amanda Stevenson at the University of Colorado Boulder modelled a hypothetical situation in which abortions are banned throughout the United States, and found that the lifetime risk of dying from pregnancy-related causes for non-Hispanic Black women would rise from 1 in 1,300 to 1 in 1,000.
One claim made by abortion opponents in this case is that abortions no longer benefit women and even cause them harm, but dozens of studies contradict this. In just one, health economist Sarah Miller at the University of Michigan in Ann Arbor and her colleagues assessed around 560 women of comparable age and financial standing who sought abortions. They found that, five years after pregnancy, women who were denied the procedure had experienced a substantial increase in debt, bankruptcies, evictions and other dire financial events — whereas the financial standing of women who had received an abortion had remained stable or improved. A primary reason that women give for wanting an abortion is an inability to afford to raise the child, and this study suggests that they understand their own situations.
Abortion bans will extract an unequal toll on society. Some 75% of women who choose to have abortions are in a low income bracket and nearly 60% already have children, according to one court brief submitted ahead of the December hearing and signed by more than 150 economists. Travelling across state lines to receive care will be particularly difficult for people who do not have the funds for flights or the ability to take time off work, or who struggle to find childcare.
Unfortunately, some of the justices seem to be disregarding these data. At the December hearing, Julie Rikelman, a lawyer at the non-profit Center for Reproductive Rights, headquartered in New York City, brought up studies presented in the economists’ brief; Roberts interrupted her and suggested “putting that data aside”. In the leaked draft opinion, Alito also elides a body of research on abortion policy, writing that it’s “hard for anyone — and in particular for a court — to assess” the effect of the right to abortion on women’s lives.
Such an attitude suggests that the justices see research as secondary to the question of whether the US Constitution should protect abortion. But the outcome of this ruling isn’t an academic puzzle. The Supreme Court needs to accept that the consensus of research, knowledge and scholarship — the evidence on which societies must base their laws — shows how real lives hang in the balance. Already, the United States claims the highest rate of maternal and infant mortality among wealthy nations. Should the court overturn Roe v. Wade, these grim statistics will only get worse.
abortion data, France vs. USA
Posted in Kids, Statistics, Travel with tags anti-abortion organisations, Brett Kavanaugh, France, Guttmacher Institute, health care, Le Monde, official statistics, Planning Familial, public health system, reproductive rights, Ruth Bader Ginsburg, USA on October 5, 2020 by xi'anAs Le Monde pointed out at a recent report on 2019 abortions in France from Direction de la recherche, des études, de l’évaluation et des statistiques (Drees), showing an consistent rise in the number of abortions in France since 1995, with a rate of 15.6 abortions for 1000 women and the number around a third of the live births that year, I started wondering at the corresponding figures in the USA, given the much more restrictive conditions there. Judging from this on-line report by the Guttmacher Institute, the overall 2017 figures are not so different in both countries: while the abortion rate fell to 13.5‰, and the abortion/life birth ratio to 22%, the recent spike in abortion restrictions for most US States did not seem to impact considerably the rates, even though this is a nationwide average, hiding state disparities (like a 35% drop in Iowa or Alabama [and a 62% drop in Delaware, despite no change in the number of clinics or in the legislation]). In addition, France did not apparently made conditions more difficult recently (most abortions occur locally and the abortion rate is inversely correlated with income) and French (official) figures include off-clinic drug-induced abortions, while the Guttmacher institute census does not. The incoming (hasty) replacement of Judge Ruth Bader Ginsberg in the US Supreme Court may alas induce a dramatic turn in these figures if a clear anti-abortion majority emerges…
new news about ISBA2020
Posted in pictures, Statistics, Travel with tags China, coronavirus epidemics, health care, ISBA, ISBA 2020, Kunming, travel restrictions on January 29, 2020 by xi'anAs you probably are all aware now that there is a coronavirus epidemic going around in China, impacting most severely Hubei province but all provinces in China have been affected to various extents. Expectedly there are concerns among the community regarding attending the ISBA World Meeting in China in late June.
We are keeping a close eye on the development. While at this point we are cautiously optimistic that the epidemic will not last till June, both as a result of the extraordinary measure that China is taking to contain the spread, and as cold-like coronaviruses generally don’t spread effectively as temperature rises in spring. However, we want to stay cautious and keep options open, and will take the necessary actions to ensure the health and safety of our community.
As of now, after discussing with the ISBA executives and the local organizers, we have decided to
1. Extend the Early Registration Deadline from April 15 to May 15, allowing the prospective participants to have more time to observe the development.
2. Keep the submission for Contributed Posters open till the new Early Registration Deadline May 15.
3. Keep you all updated should there be any changes in the plan of the meeting. In particular, if in the next couple of months the epidemic is not contained, and thus there will be health risk to the community in participating in the meeting, we will consider alternatives such as postponing the World Meeting.
If you were considering submitting a Contributed Talk and/or Travel award application by the deadline Jan 31, please still do so as the Scientific Committee will need sufficient time to evaluate those submissions.
Thank you all again for your support to the meeting and ISBA.
We hope that the epidemic will be contained quickly and we will still be able to see you all in Kunming!
Best Regards,
Li Ma, on behalf of the ISBA2020 Scientific Committee
Statistics and Health Care Fraud & Measuring Crime [ASA book reviews]
Posted in Books, Statistics with tags American Statistical Association, ASA, biases, book review, CHANCE, Chicago, CRC Press, crime, crime statistics, David Spiegelhalter, Edith Abbott, health care, health care fraud, Minority Report, Pau, Rat-Stats, Venezia on May 7, 2019 by xi'an From the recently started ASA books series on statistical reasoning in science and society (of which I already reviewed a sequel to The Lady tasting Tea), a short book, Statistics and Health Care Fraud, I read at the doctor while waiting for my appointment, with no chances of cheating! While making me realise that there is a significant amount of health care fraud in the US, of which I had never though of before (!), with possibly specific statistical features to the problem, besides the use of extreme value theory, I did not find me insight there on the techniques used to detect these frauds, besides the accumulation of Florida and Texas examples. As such this is a very light introduction to the topic, whose intended audience of choice remains unclear to me. It is stopping short of making a case for statistics and modelling against more machine-learning options. And does not seem to mention false positives… That is, the inevitable occurrence of some doctors or hospitals being above the median costs! (A point I remember David Spiegelhalter making a long while ago, during a memorable French statistical meeting in Pau.) The book also illustrates the use of a free auditing software called Rat-stats for multistage sampling, which apparently does not go beyond selecting claims at random according to their amount. Without learning from past data. (I also wonder if the criminals can reduce the chances of being caught by using this software.)
A second book on the “same” topic!, Measuring Crime, I read, not waiting at the police station, but while flying to Venezia. As indicated by the title, this is about measuring crime, with a lot of emphasis on surveys and census and the potential measurement errors at different levels of surveying or censusing… Again very little on statistical methodology, apart from questioning the data, the mode of surveying, crossing different sources, and establishing the impact of the way questions are stated, but also little on bias and the impact of policing and preventing AIs, as discussed in Weapons of Math Destruction and in some of Kristin Lum’s papers.Except for the almost obligatory reference to Minority Report. The book also concludes on an history chapter centred at Edith Abbott setting the bases for serious crime data collection in the 1920’s.
[And the usual disclaimer applies, namely that this bicephalic review is likely to appear later in CHANCE, in my book reviews column.]