Public Health Response Assessment and Evaluation (Volume 4)
Volume 4
Autism Tsunami: The Impact of Rising Prevalence on the Societal Cost of Autism in the United States
Mark Blaxill1, Toby Rogers2, Cynthia Nevison3
Correspondence:
1 Holland Center, Minnetonka, MN, USA; mblaxill [at] hollandcenter.com
2 Fellow, Brownstone Institute for Social and Economic Research, Pasadena, CA, USA.
3 Boulder, CO, USA.
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Abstract
As the rates of diagnosed autism spectrum disorders (ASD) reach unprecedented levels, numerous analyses have attempted to model, quantify, and forecast the societal cost of ASD at the country level. These forecast models focus on costs by category and over the lifespan, but place far less emphasis on the effect of rising ASD rates on societal costs over time. Most models make the unsupported assumption that rates have remained constant. As a result, these models obscure understanding and suppress awareness of the most urgent societal issues that surround rising ASD prevalence. Furthermore, they overstate the current costs incurred for the population of adults with ASD, while simultaneously and dramatically underestimating the magnitude of future costs as the ASD population increases. The cost of ASD in the U.S. is estimated here using a forecast model that for the first time accounts for the true historical increase in ASD. Model inputs include ASD prevalence, census population projections, six cost categories, ten age brackets, inflation projections, and three future prevalence scenarios. Current ASD costs are somewhat lower and projected future costs are much higher than other societal cost of autism models. In this model, total base-case costs of $223 (175–271) billion/year are estimated in 2020; $589 billion/year in 2030, $1.36 trillion/year in 2040, and $5.54 (4.29–6.78) trillion/year by 2060, with substantial potential savings through ASD prevention via identifying and better regulating environmental factors that increase autism risk. This tsunami of rapidly increasing costs raises pressing policy questions. Rising prevalence, the shift from child to adult-dominated costs, the transfer of costs from parents onto government, and the soaring total costs demand an urgent focus on prevention strategies.
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Cite As: Blaxill, M, T. Rogers, and C. Nevison. 2023. Autism Tsunami: The Impact of Rising Prevalence on the Societal Cost of Autism in the United States. Science, Public Health Policy & the Law 4:227-256. PEER-REVIEWED.
Reviewing Editor: James Lyons-Weiler, PhD, Editor-in-Chief
Access to Hydroxychloroquine Is Associated with Reduced COVID-19 Mortality: A Cross-Country Analysis
Hideki Toya & Mark Skidmore
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Dedication: This article is dedicated to my longtime friend, collaborator, and coauthor, Professor Hideki Toya. Professor Toya passed away unexpectedly in 2023. Professor Toya was an insightful and creative researcher. It was a joy to work with him and to count him as a dear friend and colleague.
Correspondence: mskidmor [at] msu.edu, 517-353-9172
Michigan State University, Agricultural, Food and Resource Economics, East Lansing, MI, USA.
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Abstract
Over the last two and a half years the world experienced the severe acute respiratory syndrome coronavirus 2 (COVID-19) pandemic coupled with unprecedented policy responses. In this article we examine the determinants of COVID-19 infections and fatalities in a cross-country analysis. While our primary objective is to evaluate the role of hydroxychloroquine (HCQ), we also control for other factors that determine vulnerability. We find that countries that are more obese, less urban, older, have fewer hospital beds, less sunshine, and greater freedom experienced greater fatalities. Generally, policies such as lockdowns, travel restrictions, or mask requirements are unassociated with fatalities. Polymerase chain reaction (PCR) testing is positively associated with reported infections but is unassociated with fatalities. Controlling for a variety of other determinants of COVID-19 fatalities, we find a robust negative relationship between access to HCQ and fatalities. Estimates indicates that if all countries where HCQ access was restricted had made HCQ available, COVID-19 fatalities would have been reduced by about 520,000.
Cite As: Toya, H. and M. Skidmore. Access to Hydroxychloroquine Is Associated with Reduced COVID-19 Mortality: A Cross-Country Analysis Sci Publ Health Pol & Law (4):196-207 (Peer-Reviewed)
Reviewing Editor: James Lyons-Weiler, PhD
COVID-19 Illness and Vaccination Experiences in Social Circles Affect COVID-19 Vaccination Decisions
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Mark Skidmore
Correspondence: mskidmor [at] msu.edu, 517-353-9172
Michigan State University, Agricultural, Food and Resource Economics, East Lansing, MI, USA.
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Abstract
Policymakers have communicated that COVID-19 vaccination programs need to be accepted by a large proportion of the population to allow life to return to normal. However, according to the Center for Disease Control and Prevention, about 31% of the United States population had not completed the primary vaccination series as of November 2022 and since that time booster uptake has declined. The primary aim of this work is to identify factors associated by American citizens with the decision to be vaccinated against COVID-19. The proportion of fatal events from COVID-19 vaccinations was also estimated and compared with potential fatalities reported in the Vaccine Adverse Events Reporting System. An online survey of COVID-19 health experiences was conducted to collect information regarding reasons for and against COVID-19 inoculations, including experiences with COVID-19 illness and COVID-19 inoculations by survey respondents and their social circles. The survey was completed by 2,840 participants between December 18 and 23, 2021. Logit regression analyses were carried out to identify factors influencing the likelihood of being vaccinated. Those who knew someone who experienced a health problem from COVID-19 were more likely to be vaccinated (OR: 1.309, 95% CI: 1.094-1.566), while those who knew someone who experienced a health problem following vaccination were less likely to be vaccinated (OR: 0.567, 95% CI: 0.461-0.698). Thirty-four percent (959 of 2,840) reported that they knew at least one person who experienced a significant health problem due to the COVID-19 illness. Similarly, 22% (612 of 2,840) indicated that they knew at least one person who experienced a health problem following COVID-19 vaccination. With these survey data, the total number of fatalities due to COVID-19 inoculation may be as high as 289,789 (95% CI: 229,319 – 344,319). The large difference in the possible number of fatalities due to COVID-19 vaccination that emerges from this survey and the available governmental data should be further investigated.
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Cite As: Skidmore, M. 2023. COVID-19 Illness and Vaccination Experiences in Social Circles Affect COVID-19 Vaccination Decisions. Science, Public Health Policy & the Law 4:208-226. (Peer-reviewed)
Reviewing Editor: James Lyons-Weiler, PhD
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