Category Archives: global health

Network Theory in Health Metrics

The heavy-tailed/small-worlds crowd had a big impact in health research recently, and now it’s drawing criticism from the theorists. Slate covered the story well a couple weeks ago, and interviewed Russ Lyons at length about the methodological shortcomings of the evidence that obesity, smoking, and loneliness are socially contagious. The Slate article even links to Russ’s preprint on the matter, which is some pretty technical stuff to point a general audience towards. Go Slate!

When I passed on some of Russ’s concerns to my experienced health metrics colleagues, one replied that the idea of social contagion is important enough that it doesn’t matter if the methods are wrong. Interesting perspective. It reminds me of Gian Carlo Rota’s ordering of mathematical results: most important are definitions, less important that that are theorems, and much, much less important than that are the proofs.

I’ve been in meetings for almost 3 weeks now, and meanwhile more good papers on networks for health are pouring out. Christakis and Fowler have posted a preprint to arxiv, showing how network thinking improved flu surveillance of Harvard undergrads. So maybe the idea was the important part. Meanwhile, the Cosma Shalizi and Andrew Thomas have an additional critique preprint, to be put in the same category as Russ’s. I asked Russ what he would accept as evidence of social contagion, and I didn’t find out, but the paper by Shalizi and Thomas says maybe nothing can be convincing: Homophily and Contagion Are Generically Confounded in Observational Social Network Studies.

For me, it’s time to get back to that meeting!

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Filed under global health, statistics

Congratulate Me

I’ve got good news to announce, I’m going to be an assistant professor of medicine at UW starting in July. I definitely would not have thought I’d one day be in the school of medicine when I started my graduate studies in Algorithms, Combinatorics, and Optimization, but I love global health research, and this is a good place to sit if I’m going to keep doing it. You’ll still find me here at the Institute for Health Metrics and Evaluation, but soon I’ll get to move offices.

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Filed under global health

Verbal Autopsy Challenge from AI-D

I was down in Palo Alto last week to attend the AAAI session on Artificial Intelligence for Development. The proceedings should be available online soon.

I was there to connect with other theoretical computer science and find out how they have been applying machine learning to “development”. It turned out that development means mostly applications to health, education, and agriculture in this crowd.

I was also there to share a very concrete challenge problem that I’ve been dabbling in here at IHME, which my colleague Sean Green presented our short paper on: the Verbal Autopsy.

Instead of recapping the problem in detail here, I’ll point you to our paper, and try to say just enough to get you interested. Continue reading

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Filed under global health

Inequality vs Stuff

I went to a talk a few weeks ago by Richard Wilkinson and Kate Pickett, global health researchers who have written a book called The Spirit Level.  They were quick to explain that, while the name makes perfect sense in British English, it has been a source of continuing confusion in American English.  What is a “spirit level”?  It’s a building tool, a type of ruler with little bubbles in it to show when it is parallel to the ground.  Maybe it’s called a carpenter level in the states, or just a level when the context is clear.

I would have called it “Inequality vs Stuff”, or at least that’s my description of the talk:  a vast array of scatterplots showing the relationship between income inequality and different measurements of population health.  Here is one that is typical for their case:

When they told the story, they started with a composite health index scattered against inequality, since that has much less noise, and then use the noisy plots like this one as supporting evidence when they show that the relationship holds for everything.

The slide that stuck with me the most is one that diverged from their story a little:

Not population health this time, but still interesting.  Something to share with your entrepreneur friends.

These plots seem like enough fun that I made my own, based on a question from the question and answer portion of the talk.  I’ve forgotten who, but someone in the audience asked “How is inequality related to total fertility rate?” and the answer from Wilkinson and Pickett was along the lines of “We never thought to check, how do you think it might be related?”

Since I had the data lying around from my attempts to learn about model selection last summer, I made myself the plot.  Turns out there is not much of an association.The only example of a non-association the speakers mentioned was a surprise to them: suicide rates are not correlated with income inequality.

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Filed under global health, Mysteries

haiti.ushihidi by category

What people are saying now: Water shortage, food shortage, medical equiptment needed.  What they are not saying as much anymore: Food, shelter, search and rescue.

(data details in previous post.)

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Filed under combinatorial optimization, global health

OR and Crisis Camp

When the earthquake devastated Haiti, Laura McLay asked if OR is helping with the relief efforts.  I’ve been wondering the same thing, and I went to a “Crisis Camp” this weekend to see if there is anywhere I could plug in.

This Crisis Camp business is hard to describe, and I didn’t really know what I was getting into when I showed up, and it seems like most of the other participants didn’t either.  But we all woke up for a 9 AM meeting on Saturday, and we all wanted to do something good for the people of Haiti.

This isn’t exactly something you can make an impact on in a day, and the only tangible result of my work was fixing a typo on a wiki, but I did learn a little bit about what is going on.  One group of geographers did a quick course on Open Street Maps and was able to start helping in an effort to update the maps of Port-au-Prince, tagging blocked roads, collapsed buildings, etc.

I joined group that connected with an ongoing project to find hospitals outside Port-au-Prince and help them share information about available capacity with people who need medical attention.  Like I said, I didn’t manage to help with this in a day, but I did learn about this Sahana project and their success in finding the lat and long of 100 hospitals in Haiti.

Another impressive data sharing tool that I a look at is Ushahidi, which I had heard about before, but never seen in action.  This is a project that has a free SMS gateway for people in Haiti to use to report emergencies or share information.  They translate messages into english and post them on the web with a CC-BY-SA license.  I started looking at them yesterday, and they can be heartwrenching.  Here is the breakdown by category, as of last night:

Does this inspire any operations research solutions?  It makes me think of vehicle routing, if the earthquake damage tags in Open Street Maps show which roads are closed, that is:

I’m not sure if they do.  (Red is map features with the tag earthquake:damage, but those are mostly IDP camps.)

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Filed under combinatorial optimization, global health

Health Care Reform, Accountability, Disparity

I got some good news for the weekend, an opinion piece that I wrote together with some of the other post-graduate fellows at IHME was published online as a Science e-letter. It is titled U.S. Health Care Reform: The Case for Accountability and it’s about the measuring the outputs, outcomes, and impacts of the reform, whatever shape they end up taking.

The part that I was especially interested in adding to the discussion appears in paragraphs 3 and 4, about what these some of these statistics look like currently:

Disparities in health outcomes in the U.S. are unacceptable. A healthy life expectancy at birth in the U.S. ranks behind 28 other developed countries (1). Sizable groups in the United States have mortality risks resembling those in sub-Saharan Africa (2), including urban blacks between the ages of 15 and 64 living in counties with high homicide rates.

On average, Asian women lived 21 years longer than high-risk urban black males in 2001 (2). Although life expectancy for most American women increased between 1983 and 1999, life expectancy for women in 180 counties in areas such as Appalachia, the Deep South, the southern Midwest, and Texas decreased by 1.3 years (3).

I made some figures to accompany this, which Science didn’t print, so I’ve included them for you here:

Probability of a 45 year-old male dying before age 65, 2001, from Murray et al., Eight Americas: Investigating mortality disparities across races, counties, and race-counties in the United States. PLoS Medicine 2006.

Female life expectancy in US counties, 1961-1999 from Ezzati et al., The reversal of fortunes: Trends in county mortality and cross-county mortality disparities in the United States. PLoS Medicine 2008.

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Filed under global health, science policy

Paper rejected, Cheer Up with Baby Animals

Too bad for me, my first global health paper will have to be revised and resubmitted. In addition to some more substantive objections, the negative reviewer said “It is unclear what software was used to carry out the Bayesian estimation by MCMC. This is not possible in STATA and would be extremely difficult in the scripting language, Python.” It was difficult in Python! I doubt that any software would make it much easier, though.

To cheer myself up, I’ve been looking into the newest fads in pets: robotic hamsters and teacup pigs.

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Filed under global health

Post-doc Ops

Would you like to work with me applying computational algorithms to challenges in global health metrics? Then apply for the IHME post-graduate fellowship. Deadline is Feb 15.

(There is also a “pre-graduate” version, for those who have not started graduate school yet.)

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Filed under education, global health

Conference you should know about

This weekend marks the submission of my first “Global Health” paper. Congratulations to me! And many, many thanks to all the people who have worked with me to make it happen. I’ll go into details sometime in the future, first let me see how things go in the refereeing process.

While I was over-working on that business, I got an interesting Call-for-Papers forwarded from global health/AI researcher Emma Brunskill. The AAAI Spring Symposium on Artificial Intelligence for Development (AI-D) is an effort to build a community of people applying computer science and artificial intelligence in less-developed settings.

TCS people, don’t let the “AI” in their title turn you off. Eric Horvitz says that this is for all of us. Continue reading

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Filed under global health, TCS