Alcohol abuse still a public health problem in Ohio

In 2020, early in the pandemic, Gov. Mike DeWine was the talk of the country, earning national praise for his public health efforts to slow the spread of coronavirus.

At the same time that the DeWine administration was effectively shutting down a third of the economy to slow the spread of the virus, it counterintuitively relaxed one public health policy. Through executive order, DeWine allowed restaurants to sell to-go alcohol to customers.

This order was ostensibly to give people more reason to stay at home and to create a new revenue stream for struggling businesses. Later that year, the order became law as the Ohio General Assembly made the policy permanent.

The CDC estimates that over 5,700 Ohioans die from excessive alcohol use per year, defined as binge drinking or heavy drinking throughout a week. The leading causes of death related to alcohol stem from poisonings, heart disease, liver disease, suicide, motor vehicle crashes, and homicide. In this way, alcohol harms people’s physiology, but also their psychology, loosening them up to unintentionally or intentionally harm themselves and others.

An interesting wrinkle with alcohol consumption is that its effects run opposite demographically to many other health trends. According to CDC survey data, college-educated Ohioans are 21% more likely to abuse alcohol than those without a college degree. Ohioans making more than $75,000 are 78% more likely to abuse alcohol than those making $25,000 or less.

White, male, and young Ohioans are more likely to drink excessively than their black, female, and older counterparts. White Ohioans are 18% more likely to drink excessively than Black Ohioans. Men in Ohio are 47% more likely to drink excessively than women. And Ohioans age 18-44 are 200% more likely to drink excessively than those age 65 and up.

While many worry about the impact of alcohol in the wake of the pandemic, self-reported excessive alcohol use decreased in Ohio from 2019 to 2020 by nearly a percentage point. A survey by an organization that provides resources on substance abuse suggested excessive alcohol consumption also fell in 2021.

Despite this progress, alcohol is still killing more people in Ohio than opioids are. So what options do we have for curbing excessive alcohol use?

A simple option is taxation. The U.S. Community Preventive Services Task Force reviewed 72 studies looking at the relationship between taxes, prices, and excessive alcohol consumption, and found that a 10% increase in price of alcohol leads to 5% lower consumption of beer, 6.4% lower consumption of wine, and 7.9% lower consumption of spirits. A can of Budweiser in 2010 cost one-fifth its price in 1950, and cheap liquor in 2010 cost one-fifteenth its price in 1950. Higher prices could reduce consumption and abuse.

A more light touch intervention to reduce excessive alcohol consumption is screening for alcohol abuse, known as “screening and brief intervention.” Instituting this in medical and other settings can help identify people who need help with reduction of excessive drinking behaviors and deliver information to them to curb such behaviors.

Alcohol abuse has been slowly waning in Ohio, but it still kills more people than opioid overdoses in Ohio. Having an intentional public health approach to alcohol abuse will help curb the social ills of excessive alcohol abuse and save lives.

This commentary first appeared in the Ohio Capital Journal.

Ohio economic experts disagree on electric vehicle policy

In a survey published by Scioto Analysis this morning, economists in Ohio were split on questions of progressivity of electric vehicles and cost-effectiveness of electric vehicle investments.

Nine of nineteen economists agreed with the statement that the current $200 annual fee for registering electric vehicles in Ohio is progressive. Among those who agreed, some said this was because higher-income people tend to purchase electric vehicles. Among the 11 economists who were uncertain or who disagreed, one said the fee is currently progressive but will become more regressive as more low-income people purchase electric vehicles and another pointed to the regressivity of flat fees.

Ten of nineteen economists agreed public expenditure on infrastructure to support electric vehicles is likely to be more cost-effective than providing equivalent amounts as tax credits/purchase rebates for buyers. Some who agreed commented that “range anxiety” is likely holding back electric vehicle purchases and that infrastructure will help grow the industry. Those who were uncertain wanted more data on the current state of electric vehicles and clarity on the specifics of policy implementation.

The Ohio Economic Experts Panel is a panel of over 40 Ohio Economists from over 30 Ohio higher educational institutions conducted by Scioto Analysis. The goal of the Ohio Economic Experts Panel is to promote better policy outcomes by providing policymakers, policy influencers, and the public with the informed opinions of Ohio’s leading economists.

Introducing Michael Hartnett, Policy Analyst

Hello! My name is Michael Hartnett, and this week I joined the Scioto Analysis team as a policy analyst. 

I attended Bates College for my undergraduate degree where I studied economics. My main area of interest was using applied microeconomic methods to study policy impacts. Specifically, I focused on the economics of the criminal justice system and rates of recidivism in Maine.

Now, my area of expertise is in statistics as I recently completed my Master’s degree from the University of Minnesota. My goal is to use that knowledge to help make Scioto’s research even more robust. Better models lead to better information, and better information can inform better policy decisions. 

I believe that as data becomes increasingly available, policymakers need to rely on accurate and unbiased analyses in order to achieve the most efficient and equitable outcomes. As a policy analyst, my goal is to use the best data possible to answer pressing questions in a way that is fair and honest.

I am super excited to have this opportunity, and I am looking forward to all of the challenges and responsibilities that come with it. If you have any questions for me, please feel free to email me at michael@sciotoanalysis.com.

Clean energy is about more than just climate change

Imagine for a moment that climate change wasn’t happening. That the Intergovernmental Panel on Climate Change hadn’t determined major inevitable and irreversible climate changes are likely on the horizon due to release of greenhouse gases. Would our transition past coal to a new energy economy still make sense?

According to a new working paper by researchers out of Arizona State University, the University of California, Santa Barbara, and the University of North Carolina, it probably would. This is because, even in the absence of climate change, coal fire plants expose people to dangerous pollutants.

In particular, this new working paper focused on the pollutant PM2.5, which are basically tiny inhalable particles that can end up in people’s lungs and sometimes even bloodstreams. These particles can cause coughing, difficulty breathing, aggravated asthma, irregular heartbeat, heart attacks, and even death for people who inhale them. In addition, particulate matter can make lakes and streams more acidic, change nutrient balances in river basins, deplete nutrients in soil, damage forests and farm crops, kill animals and plants, and create acid rain.

This new working paper argues that people are exposed to significantly less particulate matter now than they were 20 years ago. Among a wide range of socioeconomic groups, particulate matter exposure was down 86-90% in 2018 compared to 2000 exposure levels.

The researchers also found that the racial gap between Black and white exposure to particulate matter has decreased over the past two decades. While in 2000, Black exposure to particulate matter was 30% higher than white exposure (3.22 micrograms per cubic meter per person vs 2.47 micrograms per cubic meter per person), that gap had shrunk to 14% by 2018 (0.32 micrograms per cubic meter per person vs 0.28 micrograms per cubic meter per person).

The researchers estimate that more than half the particulate emission reductions during the period of study are attributable to a shift from coal-based to natural gas-based electricity production, while most of the remainder was due to reduced emission intensity, potentially driven by air pollution policies like the Clean Air Act.

Over the period from 2000 to 2018, Ohio saw a 58% decrease in energy production with coal. Meanwhile, natural gas production ballooned over that time period by a factor of 24 (a 2,418% increase). Natural gas, which was only producing 14% as much energy as coal in Ohio in 2012, surpassed coal energy production in 2014 and hasn’t looked back. In 2020, natural gas produced 30 times (2,956%) as much energy as coal.

Natural gas isn’t completely clean, it too produces particulate matter. Transition to alternative sources of power such as solar and wind will further reduce particulate matter pollution in Ohio. This will lead to less individual exposure to particulate matter, thus reducing morbidity and mortality associated with exposure to particulate matter. It will also curb the environmental impacts of particulate matter. 

Climate change on its own is a reason to want to transition Ohio’s energy economy. But clean energy will also help Ohioans breathe easier, our riverbeds and soil be cleaner, and our forest and wildlife be more healthy right now and for years into the future. This gives us another reason to want to move into the next phase of Ohio’s energy economy.

This commentary first appeared in the Ohio Capital Journal.

Ohio economists mixed on impact of inequality on economic growth

In a survey published by Scioto Analysis this morning, Ohio economists reported a mixed response to the claim that rising inequality in Ohio is slowing state economic growth.

While a slim majority of economists (14 of 26 respondents) agreed that rising inequality in Ohio is hampering economic growth, a substantial minority (8 of 26) were uncertain about the claim while four others flat-out disagreed with the claim. Those who agreed with the statement pointed to research literature suggesting inequality has an impact on economic growth through health impacts and impacts on consumer spending.

Among economists who were uncertain about the claim, some suspected inequality was reducing economic growth but were hesitant to make the claim without more evidence it is doing so. Some of these economists also were not sure how to define economic growth in this context.

The Ohio Economic Experts Panel is a panel of over 40 Ohio Economists from over 30 Ohio higher educational institutions conducted by Scioto Analysis. The goal of the Ohio Economic Experts Panel is to promote better policy outcomes by providing policymakers, policy influencers, and the public with the informed opinions of Ohio’s leading economists.

What can Ohio do to fight PTSD?

If you are interested in the world of public health, you may have heard the growing conversation around adverse childhood experiences (ACEs)—traumatic events in childhood that have health and economic impacts that ripple into adulthood.

According to the Health Policy Institute of Ohio nearly two-thirds of Ohio adults reported exposure to ACEs in 2015. This included over half the population reporting emotional abuse, 41% reporting substance abuse in their household as a child, and over a third reporting experiencing divorce.

Ideally, we can work to prevent adverse childhood experiences from happening. But even going as far as to half these numbers would still leave millions of Ohioans dealing with the traumatic effects of abuse and other problems stemming from childhood. 

On top of the human cost to these individuals, this means higher costs for health care to treat health problems stemming from this trauma and lower labor market earnings due to the effects of trauma on productivity. Trauma is bad for well-being, health, and the economy.

Luckily, we have a tool for ameliorating the impacts of trauma for people experiencing it that has decades of experimental validation: cognitive behavioral therapy (CBT). CBT is a form of psychological treatment that attempts to change thinking patterns through strategies like facing fears, roleplaying to prepare for difficult interactions, and learning to calm the mind and relax the body.

Cognitive behavioral therapy is not only thoroughly supported by experimental research, it also has been found to have large economic benefits.

The Washington Institute for Public Policy (WSIPP) estimates that for every dollar spent on cognitive behavioral therapy for adults experiencing post-traumatic stress disorder, $89 are generated in public benefit in the form of higher labor market earnings, lower health care costs, and reduced chance of death associated with depression. $49 of those $89 are recouped by taxpayers, mainly through new taxes generated from higher labor market earnings.

So what can we do to encourage the use of CBT by people who need it? Some good examples of what states can do come from Richard Reeves of the Brookings Institution.

One suggestion by Reeves is to increase mental health screenings to help identify individual need for cognitive behavioral therapy. This is a recommendation from the U.S. Preventative Services Task Force and has been shown to be effective at improving take-up of treatment. Reeves suggests universal screenings in schools, colleges, and clinical settings.

Another suggestion from Reeves is to make CBT free for patients. WSIPP estimates that a dollar invested in CBT leads to $49 in savings for taxpayers and $89 in total social benefits, making the economic case for covering CBT for patients strong. Reeves suggests CBT can be provided for free in public schools and college and for people serving in civilian or military services corps. He also suggests allowing for Medicare and Medicaid to cover CBT first, accommodating for teletherapy, and expanding community health centers.

A lot has been said about a growing mental health crisis, especially in industrial states like Ohio that have become the center of the conversation around deaths of despair. Encouraging use of one of the best tools we have to fight trauma would improve lives, health, and the state’s economy.

This commentary first appeared in the Ohio Capital Journal.

Ohio economists split on windfall tax for oil and gas companies

In a survey published by Scioto Analysis this morning, 15 of 26 Ohio economists agreed a windfall tax on the excess profits of large oil and gas companies – with the revenue rebated to households – would be an efficient way to provide temporary relief for the average household in Ohio from rising energy costs.

Of those who agreed with the statement said that the tax would reduce consumption of petroleum in favor of other goods and that this approach was more efficient than other forms of taxation. Others pointed to alternatives such as elimination of oil subsidies and reduction of market power of producers.

Of those who were uncertain, disagreed, or had no opinion, some economists argued a windfall tax would make energy more expensive. Others argued it would be difficult to determine what constitutes excess profits. Still others worried that a tax in times of excess profits would imply a subsidy for a time of low profits, which could cause problems for other reasons.

The Ohio Economic Experts Panel is a panel of over 40 Ohio Economists from over 30 Ohio higher educational institutions conducted by Scioto Analysis. The goal of the Ohio Economic Experts Panel is to promote better policy outcomes by providing policymakers, policy influencers, and the public with the informed opinions of Ohio’s leading economists.

Scioto climate change cost study comes before U.S. Senate

On Thursday, August 4, Power a Clean Future Ohio Executive Director Joe Flarida delivered expert testimony to the United States Senate Committee on Banking, Housing, and Urban Affairs during its hearing, “Borrowed Time: The Economic Costs of Climate Change.”

US Senator and Committee Chairman Sherrod Brown invited Flarida to present the findings from a first-of-its-kind report released by the Ohio Environmental Council, Power A Clean Future Ohio, and Scioto Analysis. The Bill is Coming Due: Calculating the Financial Cost of Climate Change to Ohio’s Local Governments provides a conservative estimate of the additional costs that municipalities can expect to incur due to climate change. According to the analysis, local governments across Ohio will need to increase municipal spending by as much as $5.9 billion annually by midcentury to adapt to the challenges of a worsening climate crisis.

“Local governments are burdened with the most challenging public problems we face. They are the eyes that see these problems first, the voices that raise the alarm when we reach a tipping point, and the hands that are asked to implement the solutions we identify,” testified Flarida. “Today, I am here to lift up those Ohio elected leaders and the tireless staff in cities and counties across Ohio that are raising the alarm on the financial costs of climate change that they see coming.”

The climate damages considered in the report are projected to only intensify in approaching decades, generating new costs associated with climate-driven disaster recovery and adaptation, and creating a major strain on already overstretched taxpayers and cash-strapped local governments.

“Climate change is here. The country knows it,” said Senator Sherrod Brown (D-OH), Committee Chairman, as he called the hearing to order. “Ask mayors, ask school superintendents, ask county commissioners about the increasing costs they deal with already because of climate change — costs we know will only get worse — and we know who will be forced to pay for these costs. It’s not the oil companies making record profits… it’s the local taxpayers. The likely impact of climate change could cost people in my state $6 billion a year.”

For more information on the report, click here.

To watch the hearing, click here.

Landmark federal climate bill could change Ohio’s energy landscape

On Sunday, the U.S. Senate passed the Inflation Reduction Act of 2022, a bill that will reduce spending while at the same time offering nearly $370 billion is new initiatives to fight climate change.

While Ohio has many options for mandating clean power and pricing carbon that will reduce carbon emissions, the Inflation Reduction Act takes a different approach, providing a mix of rebates, credits, and grants to reduce carbon emissions and bring the United States closer to the goals set out in the Paris Accords.

Analysis by researchers at Princeton finds the Inflation Reduction Act will push greenhouse gas emissions to less 50% of 2005 levels by 2034, much lower than the projection of the status quo at 73% of 2005 levels but short of the 40% levels needed to reach a “net-zero” emissions goal.

That being said, this is some of the most monumental climate legislation passed in congressional history and large amounts of it are going to go to farmers, manufacturers, and governments in communities across the country, including Ohio, to support the transition to a new energy economy.

Below are some of the provisions in the bill that could bring new clean energy investment into Ohio.

The bill will offer an estimated $30 billion in production tax credits to accelerate U.S. manufacturing of solar panels, wind turbines, batteries, and critical minerals processing. This could lead to more domestic manufacturing in the state of Ohio.

The bill provides $30 billion targeted grant and loan programs for states and electric utilities to accelerate the transition to clean electricity. These could help with purchase of capital and modernization of Ohio’s utilities and state and local governments.

The bill will invest $27 billion in clean energy technology acceleration, which could help deploy technologies to reduce emissions in disadvantaged communities in Ohio.

The bill invests $20 billion in climate-smart agricultural practices. Ohio’s $9 billion agricultural industry could get a substantial boost from investment like this.

The bill allocates up to $20 billion in loans to build new clean vehicle manufacturing facilities across the country. This could help jump start the manufacture of clean vehicles in the state.

It also sets aside $10 billion in investment tax credits to build clean technology manufacturing facilities. These could be used for companies to build new factories in Ohio that make electric vehicles, wind turbines, solar panels, or other new energy economy components.

The bill requires over $9 billion of federal procurement of domestically-manufactured clean technologies to create a stable market for clean products. This could provide a market for manufacturers looking to produce clean tech in Ohio.

It will also provide $9 billion in consumer home energy rebate programs, focused on low-income consumers, to electrify home appliances and for energy-efficient retrofits. This will help low-income people adapt to the new energy economy by reducing the use of energy.

These are just a few provisions of the new bill that could have a big impact on Ohio’s energy sector. Let us hope that if this bill passes the House and is signed by the president, state and local government in Ohio will take advantage of the opportunity to use these resources instead of resist them for petty partisan reasons.

This commentary first appeared in the Ohio Capital Journal.

How to confront tradeoffs in policy analysis

In public policy analysis, there is a concept called “dominance”—when one policy is better than all others and the status quo on the dimensions of effectiveness, efficiency, equity, and other relevant criteria. Unfortunately, dominance rarely occurs. 

This is why Eugene Bardach lists “confront the trade-offs” as his sixth step in his “eightfold path” of public policy analysis. 

What guidance does Bardach give an analyst for confronting tradeoffs? Analysts have a few tools they can use to help sort out seemingly incommensurable tradeoffs inherent in policymaking. 

Analysts must confront trade-offs by having a focus on outcomes, not on alternatives. It is not enough to say “we have a trade-off between establishing a carbon tax or putting a cap-and-trade program in place.” The policy analyst must focus on outcomes (such as carbon tons abated, dollars of economic impact, jobs created or lost) that give policymakers direction when crafting policy.

Ultimately, in order for a policy analyst to help a policymaker confront trade-offs, she needs to establish commensurability. This can be done by monetizing outcomes, which can utilize break-even analysis when the value of one outcome is unknown. The policymaker should be trying to reduce discrepancies, this means framing trade-offs “crisply”: trying to establish magnitudes of tradeoffs so policymakers understand what they are trading off against with one policy versus another.

A way to think about trade-offs in a way that helps a policymaker is to remember that trade-offs are about increments. This means understanding that if two criteria are quantified, that one can be put in terms of another. For instance, if a given policy option will abate 10,000 metric tons of carbon and cost 100 jobs and another policy option will abate 12,000 metric tons of carbon and cost 150 jobs, the former policy is better if you are looking for the most “efficient” policy in terms of job loss but the latter is more “effective” at reducing carbon emissions. The relative value of carbon abatement versus job retention would drive the policy choice for the policymaker.

This process can be made easier with an outcomes matrix. By allowing a policymaker to look at a table that shows what the different outcomes of a policy are across different dimensions, giving the policymaker a tool for conceptualizing tradeoffs inherent in making a given policy decision.

In a case in which outcomes are difficult to quantify, sometimes it is better to put them in terms of the better and the worse. This means ranking policy options rather than rating them. This can be a useful exercise when the budget constraint is uncertain and gives policymakers a general idea of which policy is better than the other.

Tradeoffs are inherent in public policymaking. Policymaking forces policymakers to confront tradeoffs between economic growth, equity, effectiveness, administrative capability, legal feasibility, and political feasibility. The policymaker can only illuminate so much of this policymaking process for the policymaker, but ultimately she has the tools to make the process of confronting trade-offs easier for a policymaker.