The 'cultural inflation of morbidity' during the English mortality decline: a new look.

This article contributes to the debate about using insurance records to reconstruct historical experiences of sickness during the Western mortality transition. Critics regard these sources as problematic as they measure morbidity indirectly through absences from work; these might be determined not by timeless biological criteria but by more contingent factors, notably shifting norms surrounding the sick role and responses to economic incentives (for which we adopt the generic term 'cultural inflation of morbidity'). We review historical demographers' contributions to this literature and discuss the concepts of moral hazard and the principal/agent problem as developed by health economists. This leads us to frame three empirical tests for 'cultural inflation' which allow us to assess the validity of insurance records for deriving morbidity trends: was there an increasing frequency of claims for complaints of diminishing severity; were unduly prolonged claims noticeable, particularly by older people for whom sickness benefit may have compensated for income insecurity; and did the insurer satisfactorily manage the agency problem to ensure reliable physician gatekeeping? We analyse records of the Hampshire Friendly Society, an exceptionally well-documented fund operational in Southern England, 1825-1989. Findings are based on a dataset of individual sickness histories of a sample of 5552 men and on qualitative documentary analysis of administrative records. On each count our results fail to demonstrate a cultural inflation of morbidity, except perhaps for those aged over 65. However, occasional discussion in the administrative records of economic incentives encouraging unnecessary prolongation of claims means we cannot rule it out entirely.

Diabetes: an investor's perspective.

Total health care expenditure in 2006 was $2.1 trillion. This figure is estimated to double within the next few years as the cost of treating diabetes and other chronic conditions continues to rise. Moreover, the baby boomer demographic is anticipated to place an enormous burden on the health care system and employer-based health insurance premiums were increased at rates as high as 10% per year in 2006.The quest to address these challenges has also created opportunities for investment, particularly in the fields of telemedicine, health care information technology, and medical technology.The author shares his business perspective, informed by years of experience as a physician and astronaut at NASA, and describes new applications of exciting technologies that deliver effective and efficient health care to diabetes patients, no matter where they may be.

Mathematical methods in combatting terrorism.

This document is a preliminary report on the role that mathematical and statistical methods might play in the defense against terrorist attacks. In no way does this replace the efforts of law enforcement agencies or intelligence activities. The hope is that mathematical techniques can make their efforts more efficient. The ideas enumerated here utilize the notion of probabilistic risk analysis, which was developed for the purpose of assessing the safety of nuclear reactors, as well as randomization and game theory. More extensive work in these directions is contemplated for the future. The author is planning workshops to evaluate the ideas presented here and to elicit additional methodologies that may prove useful in this endeavor.