Unions, Right-to-Work, and Occupational Deaths

Happily, my paper “Does ‘right to work’ imperil the right to health? The effect of labour unions on workplace fatalities” is attracting a lot of attention, which makes me feel good as an academic who cares at least a little about producing things that others find valuable (we will see how the sheriff stuff is received, once it’s finally done, though it seems like there’s something both quaint and gripping about them!). Although I wrote that short article in August 2017 — and had really no sense of the Janus case at that time — it’s really seemed to have caught the moment. It helps that there’s yet a non-trivial, vested constituency in organized labor that finds something useful, or reassuring, in these results. Anyway, in response to a journalist query about, essentially, what “14.1%” (the coefficient of the reduced form regression of the RTW variable) means exactly,  I wrote something like this:

predicted_annualfatalities_rtw

There were 138,736 total deaths on the job in the 50 states over 1992-2016 recorded in the Census of Fatal Occupational Injuries. Using a negative binomial regression (with the same predictors as the “reduced form” regression in the paper, but with the number of workers as an offset variable and the state/annual count of workplace deaths as the dependent variable) to model the incidence of occupational deaths,  the expected count of occupational deaths in a state during this time-period is about 118.7 in a right to work state and about 104.9 in an otherwise similar state without RTW (figure above; Stata margins command with coefplot for figure). Reassuringly, this 13.1% increase in RTW states in the negative binomial model is essentially the same result as in the “reduced form” model in the paper (about a 14% increase in RTW states relative to others). The Incident Rate Ratio on the right-to-work coefficient is also  1.1314 — which makes sense, as that is the ratio of the predicted values!

Over this same 1992-2016 period, 529 state-year dyads had right to work legislation (721 did not). Therefore, the model-implied count of occupational fatalities attributable to RTW  (assuming no confounders) is (118.7-104.9)*529 or about 7,300.That is, if no states had RTW over these years, the model implied counterfactual is that about 131,436 occupational deaths would have occurred instead of the observed 138,736 occupational deaths.

Semi-related: Using the original (non-logged) rate of fatalities, here’s a predicted effects plot of occupational fatality rate at different levels of unionization; I shared this on Twitter previously. This was used with an OLS model containing all the parameters of model 3 in the paper (or replication code), but with the non-logged dv (in the replication code labeled “robustness check using original unscaled variable”). This shows how the actual, observed decreases in unionization rates we’ve seen in states like Wisconsin in recent years may translate into meaningful increases in occupational mortality.

marginaleffects_origdv

Suicide is not inevitable (Vanderbilt Hustler re-post)

I wrote several articles for Vanderbilt’s campus newspaper, but all of these were lost from the Vanderbilt Hustler website (along with all historic website content) sometime in the summer of 2016. I’m going to try to upload these articles here while I can still find scanned PDFs of the print issues that existed at the time. Unfortunately, the articles’ original links to sources are lost. 

Suicide is not inevitable
A look at how small changes can make all the difference 

(published October 23, 2013)

The decision to commit suicide may be the most important choice a person could ever make. Suicide is unrivaled in its finality, permanence and, of course, tragedy. Death is forever, unknown and unknowable, surely a state a person would want to think about carefully before embracing. And to kill oneself may be the only decision one cannot take back. As a result, it is commonly understood that suicide is a deliberate act, the capstone of years of unrelenting suffering.

But this characterization of suicide is almost always wrong. In the spring 2013 edition of its seasonal magazine, the Harvard School of Public Health called the notion that suicides are “long-planned deeds” the “biggest fallacy” about the act. The magazine reports: While “people who attempt suicide often face a cascade of problems,” empirical studies suggest that “they act in a moment of brief but heightened vulnerability.” In 2001, epidemiologists at the Centers for Disease Control and Prevention interviewed 151 people who nearly died while attempting suicide. Shockingly, a quarter of interviewees reported that less than five minutes elapsed between the decision to commit suicide and the attempt itself. Half said less than 20 minutes had passed. Seventy percent said less than one hour, and 86 percent said less than eight hours. Suicide thus tends to be an impulsive reaction to a crisis. Many people kill themselves, for example, on the days they get fired, get divorced or fail a test, and the availability of suicidal means is often the trigger for suicide.

The suicides on the Golden Gate Bridge demonstrate this fact. As described in a recent Slate article, the bridge’s “mythic beauty, easy access, and promise of near-certain death” beckons many to suicide. To jump off the bridge, one need only surmount a 4-foot barrier; suicide notes left on the bridge often ask, “Why did you make it so easy?” More than 2,000 people have leapt off the bridge to their deaths since it opened in 1937. Nevertheless, efforts to erect a barrier on the bridge have not gained traction, largely because of the belief that it wouldn’t prevent suicide. But there is good reason to believe that stopping a person from attempting suicide very often saves his or her life. A famous 1978 study at the University of California Berkeley tracked down 500 people who were restrained just before they leapt off the Golden Gate Bridge between 1937 and 1971. At the time of the study, 94 percent were alive or had died of natural causes.

Furthermore, there is ample evidence that even simple measures can stop suicides. A meta-analysis of the effect of bridge barriers at suicide hotspots around the world found that, on average, they reduce suicides on that bridge by 85 percent; though in some cases suicides shifted to nearby bridges, barriers still decreased the number of local suicides by 30 percent. Gun-owning households in the U.S. are at least three times more likely to be the site of a suicide, but simply using gunlocks or securing ammunition can reduce the risk of suicide by two-thirds. As the Harvard School of Public Health reports, whether those who attempt suicide survive “depends in large part on the ready availability of highly lethal means, especially firearms.” (More than half of the 40,000 Americans who kill themselves each year do so with guns.) In the U.K., a 1998 law restricting the pack size of acetaminophen (the active ingredient in Tylenol) reduced the number of suicides by 200 in the first three years alone.

Hence, restricting access to suicidal means is an effective way to prevent suicide. Heeding this fact, as Cornell University did, can save lives. Between 1990 and 2010, 27 people committed suicide by jumping off one of the five bridges on Cornell University’s campus. In 2010, responding to three student suicides in a month, Cornell installed safety nets on campus bridges.

Moreover, the Golden Gate Bridge example shows that suicidal thoughts, even when acted on, are often fleeting. Only 30 people have survived a jump off the Golden Gate Bridge; of those, 27 lived out the rest of their lives without killing themselves, according to the Bridge Rail Foundation. In interviews with The New Yorker, many survivors of attempted suicide reported that they felt regret the moment they jumped. Ken Baldwin, a survivor who later found his calling as a high school teacher, recalled: “I instantly realized that everything in my life that I’d thought was unfixable was totally fixable — except for having just jumped.” Perhaps many of the thousands who did not survive felt the same way.

These findings echo nationwide studies, which suggest that 90 percent of people who attempt suicide and survive ultimately do not kill themselves. Nevertheless, many people cling to the erroneous idea that suicide is inevitable, an opinion commonly held even by psychiatrists, the people trusted with caring for the mentally ill. How many people must die on the altar of fatalism before that belief fades?