Traffic Congestion and Infant Health: Evidence from E-ZPass [pdf]
economics.yale.edu
economics.yale.edu
There's a recently built 9 storey building at one of the busiest intersections in the city. If you look at the rental ads, it's all luxury finish, shiny appliances, modern kitchens with marble this and oak that. Personally, I'd much rather live in a dated or even run down apartment in a quiet street than in this "luxury" where I can't open the windows and can hear traffic even with them closed.
Side 1 - The busiest Firefighting station of the town on a road named the most dangerous road of the town by a local news source
Side 2 - Qdoba & Chinese food restaurants, followed closely by the busiest artery of the town
Side 3 - Shopping Plaza parking lot with at least 500 car capacity
Side 4 - our office building & post office
I struggled to imagine the kind of person who willingly decides to live in a place surrounded by car traffic, (thus air pollution and noise) at least 12 hours a day.
The complex didn't even have any kind of greenery around it, except for a few shrubs. Also, if you lived on the bottom 2 floors, you had a view of the concrete car garage of the complex and nothing else (garage was immediately adjacent to the shopping plaza)
If we were getting a commensurate or greater decrease in pollution deaths, this number would be negative, so I think we can pretty confidently dismiss this hypothesis.
By contrast, COVID can kill within weeks.
My expectation is that we'll probably see a bit more flexibility for office jobs overall going forward. But it's not going to be the sea change that some expected/hoped for.
I will say that the couple of times I've taken the train or subway over the past six months, they've seemed relatively underutilized compared to pre-pandemic. So there may be some degree of switching to cars from transit options.
To give you an idea of what that looks like, I currently have two options to get healthcare. I can try to get a GP appointment. The only way is to phone, and the phone system of my local surgery is overloaded as soon as it opens at 8am. You have to ring repeatedly until you can even get a place in the phone queue, then you stay on hold until you get through to a very stressed receptionist who will see if there are any appointments left. They run out quick, and if there aren't any, you have to try again tomorrow at 8am when the next batch are released.
The other option is to go to A+E. Calling an ambulance is out of the question, because there's a good chance you'll die before one turns up (if you actually have a life-threatening emergency).
Good job we saved the NHS, eh? Covid won't kill granny, good ol' neglect will.
I was in the hospital (not UK, my own country) for a very dangerous, non-covid, pneumonia in December 2020 during the height of cases. I needed intensive care, but it took 4 days for them to find me a bed and a ventilator.
Why? Because the hospital was full of covid patients. There just wasn't any room for me.
Covid may kill granny, as it almost killed me. Just not the covid in our systems but the covid in the systems of other people. If I died of my PCP pneumonia I would have been a victim of covid, even tho covid never entered my system.
I have a very different opinion. I believe that, like many other aspects of life and culture, our response to Covid ripped open any cracks and accelerated ongoing problems. I think we are currently seeing an accelerated and terminal decline of fully-public healthcare in the UK.
It's hard to call it "saved", when people going into cardiac arrest are literally dying waiting hours for ambulances, and routine care is largely unavailable.
I'm not saying I don't believe you, I want to take everyone at their word... the problem is it seems like you can talk to different people and the experience is like night and day.
You're not the first person to bring up that their healthcare is awful, I see it often. I also see people saying its the best thing since sliced bread since its free and how thankful they are for it.
Its so hard to tell what is the truth because I could see both being true at the same time.
I try not to pry but personally, I do have a friend in Canada that their dad needs a life saving operation but just can't get one. I really don't know what that means. They say the appointment is too far out and it costs too much to get it done in the US or that they can't get approved or something. To me that just seems insane to the point where I must not be understanding correctly... but on the flip side, I see the same thing.
For instance, I had a European tell me they were thankful their general check up didn't cost $1k "like it does in the US" and for whatever reason they were adamant that a routine checkup costs $1k. It's just not true at all. I feel we all may just be extrapolating headlines lol.
Here's something to help you understand the state of Canadian healthcare: Right now, it is impossible—let me repeat, impossible—for people in Atlantic Canada (the easternmost four provinces) without a family doctor to get one. <https://atlantic.ctvnews.ca/nova-scotia-still-struggling-to-...> The waitlist has been years long for years. This is not something occurring only in rural areas; this is true in big cities like Halifax.
I am hearing that the same is true in Vancouver.
That makes a lot of sense...
Not gonna take a political stance other than pointing out that conservatives are not known for bolstering social services.
Actually my only real political stance in general is that any party being in power for too long is a bad thing regardless of their politics. Tories have been in power for 12 years now, which is very unusual in general since discontent with current government tends to grow with how long they've been in office.
Indeed. I live in Wales, which has only ever been led by Welsh Labour. Since having our own devolved parliament in the late 90's, it's been Labour in charge.
As we've been talking about the state of healthcare, conditions here in Wales are much worse than the UK as a whole. This also happens to be true of practically every other form of governmental function.
The only thing that seems to actually work is switching between them often enough that you get mostly the initial improvement, with some regression that is corrected by switching sides, and then rinse and repeat. A lot this applies to things like taxes and financial regulation too, I've found.
The general idea is that representative democracy can be seen as a sort of evolutionary algorithm, evolving a set of laws and regulations.
Think of elections as your fitness test. Whatever things feed into the election results, like debates and media storms can be seen as selective pressures.
For a democracy to function you need a healthy multi-party system, healthy independent media, political parties with strong grassroots control internally, a reasonably educated populace, and minimal corruption. All of these make the total selective pressures more aligned with what's best for everyone. If one party gets power for too long, we're essentially overprioritising selective pressures from one subset of society, causing an effective power imbalance that starts to cause more and more problems.
I might blog about it since it's a bit complicated to explain years of private, abstract thought like this, but hopefully that was an interesting read anyway.
Routine cardiac, cancer, and other diagnostic screenings do not exhibit the same resource conflict and yet were also stopped or sharply curtailed in many places.
Whether it was actually overloaded from March 2020 onwards is another question - the publicly-available patient data shows that the total patient occupancy was at about 70% of normal levels during the Covid years. It was also found (and relatively quickly) that Covid patients didn't need complex care - bed rest and low-flow oxygen was the best treatment, for those who didn't need forced ventilation (and there's a whole lot of discussion about how much damage that may to do a Covid patient anyway).
The argument that follows is that "we couldn't treat other conditions because that would have caused Covid to spread more widely", with the assumption that it's better to have this many untreated patients than for Covid to have spread more rapidly.
Time will tell, but I strongly believe that it will show that, like many other aspects of our response to Covid, the cure will be much worse than the disease.
Many hospitals in the US closed wards during COVID because they didn't have the staff, not because they physically lacked space.
I don't know enough about the UK response to make a well-reasoned reply, except it sounds like a very strange decision to me.
I suppose it could have been a form of pre-emptive triage to avoid hospital overload?
It's always been my view that lockdown was the only response sufficiently effective to actually stop the spread in its tracks, and that's been proven in countries that locked down earlier, like Norway(at least in the first wave). The problem is that stopping the pandemic globally would more or less require a globally coordinated lockdown, which was never going to happen because we're just not at that level of internation cooperation in general, and it only takes one reckless government like Trump's or Bolsonaro's so ruin it for everyone. And it would probably be untenable for economic reasons as well.
Yes, it is very strange. In March 2020, we were promised a global pandemic the like of which had never been seen before, with the young and old alike dropping dead in the street. Despite it very quickly becoming apparent that this was not the case, the general response, public messaging, and state of mind for many continues as if that were true.
>would more or less require a globally coordinated lockdown
It would also require borders to be sealed shut to allcomers, which is not something that most Western countries are used to enforcing.
Instead, they increase:
educational gaps
domestic abuse
unemployment
alcohol & drug abuse
suicides & self-harm
depression & anxiety
cardiac & cancer deaths
And bullshit there's no evidence. You're clearly just not interested in considering it. Which is why you make hyperbolic statements like "there is no single scientific evidence". Give me break.
Here's some. It's a report commissioned by the government where I live, on the school attendance rates post-Covid. Even allowing for direct Covid-related absences, attendance rates continue to fall. Take a look at Table 3 in the report - attendance among disadvantaged groups has dropped in the medium double digit range.
The spell of universal school attendance has been broken. Many kids and families will be permanently left behind - this lines up with what teacher friends have told me.
https://gov.wales/sites/default/files/publications/2022-04/a...
I'm not sure it could be seen as intrinsic to lockdown though, but could be more of an issue with the implementation of it. Closing schools and online teaching was a a controversial topic in the discourse here in Norway.
This study[1] from Norway surveyed teachers about the attendance of students with pre-existing School Attendance Problems(SAP) during online homeschooling:
>Teachers rated their experiences of their students’ participation in homeschooling compared to regular school attendance. The findings indicate that teachers very slightly perceived better/much better participation during homeschooling (35 percent) than worse/much worse participation (31 percent) (Table 5). There were no significant gender differences; however, teachers reported that more boys than girls participated better/much better during homeschooling (42 percent boys and 27 percent girls).
So in this case there was a slight overall improvement, it seems.
[0]: https://www.frontiersin.org/articles/10.3389/feduc.2021.7200...
"A total of 79.8 percent of the students participated during homeschooling, while 20.2 percent (50 students) did not. The number of students not participating in homeschooling increased gradually from 5th to 10th grade (0.4 percent in 5th grade and 7.3 percent in 10th grade). Regarding the number of students in each grade level, 8 percent did not participate in 5th grade, 13 percent in 6th grade, 13 percent in 7th grade, 17 percent in 8th grade, 23 percent in 9th grade and 29 percent in 10th grade."
Tables 6 and 7 also have some interesting results, showing that teachers felt that students' quality of life was worse under these circumstances.
All of this paints a pretty clear picture - the general response to Covid had huge side-effects, and the already disadvantaged will feel them harder.
Sometimes I wonder why I bother. As a member of the priviledged (relatively) elite, my life is doing pretty darn good right now. Maybe I should embrace this new dismissal of the disadvantaged.
Edit: You talk about "implementation problems" - well the implementation of School Covid policies was set here in Wales by our ever-benevolent Welsh Labour party. Think how much worse it would be under the Tories, eh?
However, we did also try to leave schools open while having everyone else WFH during subsequent waves, and that led to a host of other problems. Preventative measure were constantly being micromanaged, leading to student and teacher confusion, teacher and student abscence due to Covid skyrocketed and students were stuck with increasingly poor substitute teachers, etc. I'm not aware of any detailed comission on the tradeoffs between the two approaches yet, but both seem to have had severe problems.
Of course there was also the giant elephant in the room: the assumption that letting school children be massively infected couldn't have any long term health effects. There was no evidence that it could at the time, but also that evidence wouldn't have had time to exist yet, and so it's essentially just a gamble. Time will tell I suppose, fingers crossed...
I don't think it's controversial any more to say that Covid was a lab-generated virus. I have a personal theory that it was supposed to be much worse than it turned out to be, and even then it quickly mutated to more mild strains. If certain cultures are not allowed to admit a loss of face, it would explain why one country in particular is still acting like Covid is the worst....
I'm all for science, but are you implying China's strict COVID lockdown strategy didn't save any lives?
Whether extremely strict lockdowns like those seen in China and Singapore save lives or not is completely irrelevant as they are wrong, at the most basic level. Whether other countries went too far or didn't go far enough can be debated, but having police lock people inside their own homes isn't really something you can argue that good government does.
There is no single scientific evidence
It's going to take decades, if not longer, for many of these effects to play out. Both the positive and negative ones.
The most optimistic take I saw here was somebody wondering -- certainly not claiming, but wondering -- if the positive benefits such as pollution might outweigh the negative effects in the long run.
Sweden had different approaches mostly in terms of no mask mandates, they did not close down schools, and early in the pandemic there were not as strong border lockdowns (not that it mattered much when all the neighboring countries locked their borders). In term of traffic congestion there seems to have been similar reductions during covid as in other countries, through by default Swedish roads are not as congested more populated countries.
Assuming they were making mention of Swedens recommendations only approach, it’s still not a good argument because there are plenty of countries that tried similar methods and failed miserably (e.g. Brazil).
There are a lot of confounding factors not controlled for or properly studied.
Edit: I want to add something here. Had they replied to my sarcasm with a more cogent reply, I would thank them for it and reply accordingly. I may have a bit of a temper and impulsivity at times, leading to snark. But if you look at most of my comments I'm here to share interesting ideas and conversations with people, and I try my best to discuss in good faith and to be humble when I make mistakes. But at some point arguing like that with someone who is never gonna reciprocate is just being a doormat, and a waste of time.
Although, we can probably also agree it would have been best to ignore that "Sweden" comment entirely since such comments tend to be downvoted swiftly.
Now, you may be wondering: do I reliably follow my own advice and avoid responding to trollish replies like that? No. No I do not.
These hunches are usually not proven or disproven until much later when the initial dust-up has settled and more excess mortality data is available.
1. let’s make families safer
2. 3+ HOV lanes to select for families
3. Single parents of one don’t apply
But no, no one designed carpools to make families safer.
I’m more speaking to the above good-faith idea.
* You can apply to get a green licence plate if your car meets certain emissions standards.
This paper is from 2011 and appeared in the journal Applied Economics, but that is behind a paywall.
In the DELMARVA area in particular there are now "express lanes" on I-95 that you can pay a little extra to use the lane, the tolls seem to be variable too (presumably depending on traffic).
I imagine they have a few ways of checking if there's actually 3+ ppl but not sure if there's an "official" answer.
The fact that motorists expect to get free roads while public transit users have to pay is an affront to the entire point of publicly-funded infrastructure.
There has been other research that shows a correlation between certain health outcomes and proximity to highways, but there may be confounding factors in that type of study, whereas this is almost more like an interventional study even though the change obviously wasn't actually made for the purposes of the study.
This is very strong evidence that many of the negative health effects that have been shown to be correlated with proximity to highways are indeed caused by car emissions.
edit: Correcting myself here, it's EZ-Pass-only at certain times of day: http://66expresslanes.org/e-zpass/default.asp which I find even more confusing.
Colorado isn't even in the EZ Pass network.
I thought it should maybe read "reduced infant
mortality to numbers in cities/countries without
toll booths"
Check the paper; it's very readable. Alternatively, know the following:
The reason they chose their approach was because it gives them a "natural experiment" - by comparing the exact same area before and after EZPass, you get a fairly valid experiment with only a minimal number of variables to wrangle.
I've got a nice bridge to sell the author...