The Effects of Financial and Economic Literacy on Individual Policy Preferences

Thesis (Ph.D.)--University of Washington, 2021In a time of growing support for welfare-reducing, protectionist policies, such as those opposing immigration, free trade, and EU integration, my dissertation is among the first studies to explore the role that financial and economic literacy, and its interaction with information, plays in shaping voters' policy preferences. The hypothesis tested in my first essay is that financial literacy affects economic policy preferences. I analyze data from the British Election Study and test my theory on support for free trade in the United Kingdom. Findings suggest that financial literacy does affect economic policy preferences. On average, financially literate individuals are more likely to think that free trade is good for the British economy. Furthermore, this is true regardless of economic self‐interest, as both financially literate winners and losers from globalization are more likely to support free trade than their illiterate counterparts. In my second essay I analyze original survey data collected in Italy and show that financially and economically literate individuals, regardless of their economic self-interest, are more likely to prefer remaining in the Eurozone, to favor free trade, EU immigration, non-EU immigration, and the Fornero pension reform. I provide preliminary evidence that the lack of differential effects between financially and economically literate winners and losers from globalization and pension reform is driven by longer time horizons. Finally, I examine different ways to measure financial and economic literacy and find that there is no evidence of a similar effect when looking at general education, suggesting that financial and economic literacy has distinctive features that more closely capture an individual's ability to evaluate policies. In the third essay I add an important mediator in the relationship between financial and economic literacy and policy preferences: discount rates. The findings from my second essay on Italy suggest that financially and economically literate individuals have significantly lower discount rates, which may explain differential preferences across literacy levels in policy scenarios with intertemporal trade-offs. To further investigate this relationship, in my third essay, I conducted a classroom experiment at the University of Washington, where I found that learning concepts such as interest compounding, the time value of money, and risk in the capitalization process lowers discount rates, and there is not a selection effect into economics and finance. Finally, in my fourth essay, I investigate what type of information economically literate and illiterate individuals rely on to form their preferences. I use a survey experiment on price controls in Italy and show that voters are less likely to rely on party cues and more likely to rely on policy information when they are financially and economically literate, while the opposite is true of financially and economically illiterate individuals. My dissertation has implications for electoral democracies in general, and for the current wave of populism. Most protectionist and populist policies harm social welfare; if most people lack the framework for comprehending the effects that a specific policy has on society, then they are also more likely to be susceptible to appeals by populists to adopt distortionary policies in the name of seemingly beneficial outcomes such as national sovereignty and greater equality. Conversely, if they can recognize the potential for mutual gains, this may get them close enough to welfare enhancing behavior

Identifying American climate change free riders and motivating sustainable behavior.

Funder: Resnick Sustainability Institute for Science, Energy and Sustainability, California Institute of Technology (Resnick Institute); doi: https://doi.org/100007287Free riders, who benefit from collective efforts to mitigate climate change but do not actively contribute, play a key role in shaping behavioral climate action. Using a sample of 2096 registered American voters, we explore the discrepancy between two groups of free riders: cynics, who recognize the significance of environmental issues but do not adopt sustainable behaviors, and doubters, who neither recognize the significance nor engage in such actions. Through statistical analyses, we show these two groups are different. Doubters are predominantly male, younger, with lower income and education, exhibit stronger conspiracy beliefs, lower altruism, and limited environmental knowledge, are more likely to have voted for Trump and lean towards conservative ideology. Cynics are younger, religious, higher in socioeconomic status, environmentally informed, liberal-leaning, and less likely to support Trump. Our research provides insights on who could be most effectively persuaded to make climate-sensitive lifestyle changes and provides recommendations to prompt involvement in individual sustainability behaviors. Our findings suggest that for doubters, incentivizing sustainability through positive incentives, such as financial rewards, may be particularly effective. Conversely, for cynics, we argue that engaging them in more community-driven and social influence initiatives could effectively translate their passive beliefs into active participation

Identifying American climate change free riders and motivating sustainable behavior

Abstract Free riders, who benefit from collective efforts to mitigate climate change but do not actively contribute, play a key role in shaping behavioral climate action. Using a sample of 2096 registered American voters, we explore the discrepancy between two groups of free riders: cynics, who recognize the significance of environmental issues but do not adopt sustainable behaviors, and doubters, who neither recognize the significance nor engage in such actions. Through statistical analyses, we show these two groups are different. Doubters are predominantly male, younger, with lower income and education, exhibit stronger conspiracy beliefs, lower altruism, and limited environmental knowledge, are more likely to have voted for Trump and lean towards conservative ideology. Cynics are younger, religious, higher in socioeconomic status, environmentally informed, liberal-leaning, and less likely to support Trump. Our research provides insights on who could be most effectively persuaded to make climate-sensitive lifestyle changes and provides recommendations to prompt involvement in individual sustainability behaviors. Our findings suggest that for doubters, incentivizing sustainability through positive incentives, such as financial rewards, may be particularly effective. Conversely, for cynics, we argue that engaging them in more community-driven and social influence initiatives could effectively translate their passive beliefs into active participation

Who Can Assert Ownership Over Automation? Workplace Technological Change, Populist and Ethno-nationalist Rhetoric, and Candidate Support

Technological change has dramatically reshaped labour markets, but technology’s distributional implications have to date been less politicized than other economic shocks. However, as technological advances accelerate, political parties may face growing incentive to "claim" the issue. Candidates proposing to protect workers against technological change may appeal directly to workers’ economic concerns, but if technology is perceived similarly to other economic shocks, workers may also be mobilized through populist and ethno-nationalist appeals. This paper asks: compared to other shocks, what kind of messaging around workplace technological change resonates with voters? We examine this question through a ten-country survey experiment that randomizes respondents into reading about a candidate proposing to protect workers against offshoring, automation and AI, or changing consumer demand, using either populist rhetoric, populist and ethno-nationalist rhetoric, or no additional messaging. We find that overall support for protecting workers against technology is lower than for other shocks, but that all types of candidate messaging appeals to workers who feel vulnerable to technology

Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic

Before 2020, mental disorders were leading causes of the global health-related burden, with depressive and anxiety disorders being leading contributors to this burden. The emergence of the COVID-19 pandemic has created an environment where many determinants of poor mental health are exacerbated. The need for up-to-date information on the mental health impacts of COVID-19 in a way that informs health system responses is imperative. In this study, we aimed to quantify the impact of the COVID-19 pandemic on the prevalence and burden of major depressive disorder and anxiety disorders globally in 2020. Through a systematic review of data reporting the prevalence of major depressive disorder and anxiety disorders during the COVID-19 pandemic and published between Jan 1, 2020, and Jan 29, 2021 and using the assembled data in a meta-regression to estimate change in the prevalence of major depressive disorder and anxiety disorders between pre-pandemic and mid-pandemic (using periods as defined by each study) via COVID-19 impact indicators (human mobility, daily SARS-CoV-2 infection rate, and daily excess mortality rate) by age, sex, and location. Final prevalence estimates and disability weights were used to estimate years lived with disability and disability-adjusted life-years (DALYs) for major depressive disorder and anxiety disorders

Estimating global, regional, and national daily and cumulative infections with SARS-CoV-2 through Nov 14, 2021: a statistical analysis

Timely, accurate, and comprehensive estimates of SARS-CoV-2 daily infection rates, cumulative infections, the proportion of the population that has been infected at least once, and the effective reproductive number (Reffective) are essential for understanding the determinants of past infection, current transmission patterns, and a population’s susceptibility to future infection with the same variant. Although several studies have estimated cumulative SARS-CoV-2 infections in select locations at specific points in time, all of these analyses have relied on biased data inputs that were not adequately corrected for. In this study, we aimed to provide a novel approach to estimating past SARS-CoV-2 daily infections, cumulative infections, and the proportion of the population infected, for 190 countries and territories from the start of the pandemic to Nov 14, 2021. This approach combines data from reported cases, reported deaths, excess deaths attributable to COVID-19, hospitalisations, and seroprevalence surveys to produce more robust estimates that minimise constituent biases

Pandemic preparedness and COVID-19: an exploratory analysis of infection and fatality rates, and contextual factors associated with preparedness in 177 countries, from Jan 1, 2020, to Sept 30, 2021

National rates of COVID-19 infection and fatality have varied dramatically since the onset of the pandemic. Understanding the conditions associated with this cross-country variation is essential to guiding investment in more effective preparedness and response for future pandemics. Daily SARS-CoV-2 infections and COVID-19 deaths for 177 countries and territories and 181 subnational locations were extracted from the Institute for Health Metrics and Evaluation's modelling database. Cumulative infection rate and infection-fatality ratio (IFR) were estimated and standardised for environmental, demographic, biological, and economic factors. For infections, we included factors associated with environmental seasonality (measured as the relative risk of pneumonia), population density, gross domestic product (GDP) per capita, proportion of the population living below 100 m, and a proxy for previous exposure to other betacoronaviruses. For IFR, factors were age distribution of the population, mean body-mass index (BMI), exposure to air pollution, smoking rates, the proxy for previous exposure to other betacoronaviruses, population density, age-standardised prevalence of chronic obstructive pulmonary disease and cancer, and GDP per capita. These were standardised using indirect age standardisation and multivariate linear models. Standardised national cumulative infection rates and IFRs were tested for associations with 12 pandemic preparedness indices, seven health-care capacity indicators, and ten other demographic, social, and political conditions using linear regression. To investigate pathways by which important factors might affect infections with SARS-CoV-2, we also assessed the relationship between interpersonal and governmental trust and corruption and changes in mobility patterns and COVID-19 vaccination rates. The factors that explained the most variation in cumulative rates of SARS-CoV-2 infection between Jan 1, 2020, and Sept 30, 2021, included the proportion of the population living below 100 m (5·4% [4·0–7·9] of variation), GDP per capita (4·2% [1·8–6·6] of variation), and the proportion of infections attributable to seasonality (2·1% [95% uncertainty interval 1·7–2·7] of variation). Most cross-country variation in cumulative infection rates could not be explained. The factors that explained the most variation in COVID-19 IFR over the same period were the age profile of the country (46·7% [18·4–67·6] of variation), GDP per capita (3·1% [0·3–8·6] of variation), and national mean BMI (1·1% [0·2–2·6] of variation). 44·4% (29·2–61·7) of cross-national variation in IFR could not be explained. Pandemic-preparedness indices, which aim to measure health security capacity, were not meaningfully associated with standardised infection rates or IFRs. Measures of trust in the government and interpersonal trust, as well as less government corruption, had larger, statistically significant associations with lower standardised infection rates. High levels of government and interpersonal trust, as well as less government corruption, were also associated with higher COVID-19 vaccine coverage among middle-income and high-income countries where vaccine availability was more widespread, and lower corruption was associated with greater reductions in mobility. If these modelled associations were to be causal, an increase in trust of governments such that all countries had societies that attained at least the amount of trust in government or interpersonal trust measured in Denmark, which is in the 75th percentile across these spectrums, might have reduced global infections by 12·9% (5·7–17·8) for government trust and 40·3% (24·3–51·4) for interpersonal trust. Similarly, if all countries had a national BMI equal to or less than that of the 25th percentile, our analysis suggests global standardised IFR would be reduced by 11·1%. Efforts to improve pandemic preparedness and response for the next pandemic might benefit from greater investment in risk communication and community engagement strategies to boost the confidence that individuals have in public health guidance. Our results suggest that increasing health promotion for key modifiable risks is associated with a reduction of fatalities in such a scenario

Predicting Functional Recovery and Quality of Life in Older Patients Undergoing Colorectal Cancer Surgery: Real-World Data From the International GOSAFE Study

PURPOSE The GOSAFE study evaluates risk factors for failing to achieve good quality of life (QoL) and functional recovery (FR) in older patients undergoing surgery for colon and rectal cancer.METHODS Patients age 70 years and older undergoing major elective colorectal surgery were prospectively enrolled. Frailty assessment was performed and outcomes, including QoL (EQ-5D-3L) recorded (3/6 months postoperatively). Postoperative FR was defined as a combination of Activity of Daily Living >= 5 + Timed Up & Go test <20 seconds + MiniCog >2.RESULTS Prospective complete data were available for 625/646 consecutive patients (96.9%; 435 colon and 190 rectal cancer), 52.6% men, and median age was 79.0 years (IQR, 74.6-82.9 years). Surgery was minimally invasive in 73% of patients (321/435 colon; 135/190 rectum). At 3-6 months, 68.9%-70.3% patients experienced equal/better QoL (72.8%-72.9% colon, 60.1%-63.9% rectal cancer). At logistic regression analysis, preoperative Flemish Triage Risk Screening Tool >= 2 (3-month odds ratio [OR], 1.68; 95% CI, 1.04 to 2.73; P = .034, 6-month OR, 1.71; 95% CI, 1.06 to 2.75; P = .027) and postoperative complications (3-month OR, 2.03; 95% CI, 1.20 to 3.42; P = .008, 6-month OR, 2.56; 95% CI, 1.15 to 5.68; P = .02) are associated with decreased QoL after colectomy. Eastern Collaborative Oncology Group performance status (ECOG PS) >= 2 is a strong predictor of postoperative QoL decline in the rectal cancer subgroup (OR, 3.81; 95% CI, 1.45 to 9.92; P = .006). FR was reported by 254/323 (78.6%) patients with colon and 94/133 (70.6%) with rectal cancer. Charlson Age Comorbidity Index >= 7 (OR, 2.59; 95% CI, 1.26 to 5.32; P = .009), ECOG >= 2 (OR, 3.12; 95% CI, 1.36 to 7.20; P = .007 colon; OR, 4.61; 95% CI, 1.45 to 14.63; P = .009 rectal surgery), severe complications (OR, 17.33; 95% CI, 7.30 to 40.8; P < .001), fTRST >= 2 (OR, 2.71; 95% CI, 1.40 to 5.25; P = .003), and palliative surgery (OR, 4.11; 95% CI, 1.29 to 13.07; P = .017) are risk factors for not achieving FR.CONCLUSION The majority of older patients experience good QoL and stay independent after colorectal cancer surgery. Predictors for failing to achieve these essential outcomes are now defined to guide patients' and families' preoperative counseling

Estimating excess mortality due to the COVID-19 pandemic: a systematic analysis of COVID-19-related mortality, 2020???21

The full impact of the pandemic has been much greater than what is indicated by reported deaths due to COVID-19 alone. Strengthening death registration systems around the world, long understood to be crucial to global public health strategy, is necessary for improved monitoring of this pandemic and future pandemics. In addition, further research is warranted to help distinguish the proportion of excess mortality that was directly caused by SARS-CoV-2 infection and the changes in causes of death as an indirect consequence of the pandemic

Quality of life in older adults after major cancer surgery: the GOSAFE international study

Abstract Background Accurate quality of life (QoL) data and functional results after cancer surgery are lacking for older patients. The international, multicenter Geriatric Oncology Surgical Assessment and Functional rEcovery after Surgery (GOSAFE) Study compares QoL before and after surgery and identifies predictors of decline in QoL. Methods GOSAFE prospectively collected data before and after major elective cancer surgery on older adults (≥70 years). Frailty assessment was performed and postoperative outcomes recorded (30, 90, and 180 days postoperatively) together with QoL data by means of the three-level version of the EuroQol five-dimensional questionnaire (EQ-5D-3L), including 2 components: an index (range = 0-1) generated by 5 domains (mobility, self-care, ability to perform the usual activities, pain or discomfort, anxiety or depression) and a visual analog scale. Results Data from 26 centers were collected (February 2017-March 2019). Complete data were available for 942/1005 consecutive patients (94.0%): 492 male (52.2%), median age 78 years (range = 70-95 years), and primary tumor was colorectal in 67.8%. A total 61.2% of all surgeries were via a minimally invasive approach. The 30-, 90-, and 180-day mortality was 3.7%, 6.3%, and 9%, respectively. At 30 and 180 days, postoperative morbidity was 39.2% and 52.4%, respectively, and Clavien-Dindo III-IV complications were 13.5% and 18.7%, respectively. The mean EQ-5D-3L index was similar before vs 3 months but improved at 6 months (0.79 vs 0.82; P < .001). Domains showing improvement were pain and anxiety or depression. A Flemish Triage Risk Screening Tool score greater than or equal to 2 (odds ratio [OR] = 1.58, 95% confidence interval [CI] = 1.13 to 2.21, P = .007), palliative surgery (OR = 2.14, 95% CI = 1.01 to 4.52, P = .046), postoperative complications (OR = 1.95, 95% CI = 1.19 to 3.18, P = .007) correlated with worsening QoL. Conclusions GOSAFE shows that older adults’ preoperative QoL is preserved 3 months after cancer surgery, independent of their age. Frailty screening tools, patient-reported outcomes, and goals-of-care discussions can guide decisions to pursue surgery and direct patients’ expectations