Stanford University

Health and Medicine

FSI’s researchers assess health and medicine through the lenses of economics, nutrition and politics. They’re studying and influencing public health policies of local and national governments and the roles that corporations and nongovernmental organizations play in providing health care around the world. Scholars look at how governance affects citizens’ health, how children’s health care access affects the aging process and how to improve children’s health in Guatemala and rural China. They want to know what it will take for people to cook more safely and breathe more easily in developing countries.

FSI professors investigate how lifestyles affect health. What good does gardening do for older Americans? What are the benefits of eating organic food or growing genetically modified rice in China? They study cost-effectiveness by examining programs like those aimed at preventing the spread of tuberculosis in Russian prisons. Policies that impact obesity and undernutrition are examined; as are the public health implications of limiting salt in processed foods and the role of smoking among men who work in Chinese factories. FSI health research looks at sweeping domestic policies like the Affordable Care Act and the role of foreign aid in affecting the price of HIV drugs in Africa.

Partitioning the Curve — Interstate Travel Restrictions During the Covid-19 Pandemic

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Since the onset of the Covid-19 crisis in the United States, government action taken to “flatten” the curve of disease transmission has varied dramatically among states, counties, and cities. The early epicenters — New York City, Washington State, and the San Francisco Bay Area — implemented aggressive measures in mid-March, many of which remain in place. Other states and localities opted for milder restrictions, acted much later, or barely intervened at all. Many states began unwinding restrictions weeks ago, although surging case numbers are prompting some to change course. The patchwork nature of the response helps explain the current situation: Covid-19’s spread now has many different trajectories, which partly track jurisdictional boundaries. In the third week of July, for example, Covid-19 incidence was 10 times as high in some states as in others.

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Publication Type
Journal Articles
Publication Date
Journal Publisher
New England Journal of Medicine
Authors
David Studdert
Michelle Mello
Number
2020
External URL

Coronavirus Could Make America’s Gun Problem Even Deadlier

Authors
David Studdert
News Type
Commentary
Date
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Millions of Americans have experienced the coronavirus pandemic directly, as they or their loved ones suffered through infection. But for most of us, the experience is defined by weeks and months on end stuck at home. The shut-ins are testing the safety of our home environments. Stress and isolation combined with another feature of American life — easy access to firearms — could form a deadly brew.

Last week we released results of a new study — the largest ever on the connection between suicide and handgun ownership — in The New England Journal of Medicine revealing that gun owners were nearly four times as likely to die by suicide than people without guns, even when controlling for gender, age, race and neighborhood.

In this New York Times OpEd piece by myself, Matthew Miller and Garen Wintemute, we write that suicide attempts are often impulsive, prompted by fleeting crises. A vast majority of people who attempt suicide survive and do not go on to die in a future suicide. But whether attempters get that second chance at life depends a lot on the method they use, which in turn depends on what is readily at hand. Firearms afford few second chances. In sum, methods matter.

Our study compiled information on 26 million Americans over 12 years. We tracked handgun acquisitions in a large sample of California residents and then compared the frequency of death among those who did and didn’t own them.

The elevated suicide rates among handgun owners were driven by their higher rates of suicide by firearm — eight times higher for men and 35 times higher for women, compared with non-owners of the same gender. By contrast, handgun owners did not have higher rates of suicide from other methods or higher rates of death by other causes. These results are consistent with those from every serious study that has examined the relationship between gun access and suicide in the United States. If anything, we find a stronger connection than most others have.

Read the Editorial

David Studdert

David Studdert, LLB, ScD, MPH

Professor of Medicine and Law
David M. Studdert is a leading expert in health law.
David Studdert

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News

Owning Handgun Associated With Dramatically Higher Risk of Suicide

Men who own handguns are eight times more likely to die of suicide by handgun than men who don’t have one — and women who own handguns are 35 times more likely than women who don’t, according to startling new research led by SHP's David Studdert.
Owning Handgun Associated With Dramatically Higher Risk of Suicide
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Commentary

Covid-19 Crisis: Is a Showdown Between Public Health Imperatives and Civil Liberties Inevitable?

David Studdert addresses the tradeoff between basic liberties and societal health in the current coronavirus pandemic in a New England Journal of Medicine perspective.
Covid-19 Crisis: Is a Showdown Between Public Health Imperatives and Civil Liberties Inevitable?
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Commentary

The Ethics and Law Behind So-Called Immunity Passports

David Studdert writes in this JAMA Viewpoint that, ideally, a clear scientific understanding and careful deliberation would precede any public or private policy that selectively relaxes restrictions based on positive tests for COVID-19 antibodies. But a measured, evidence-based approach to policymaking is likely to be overrun by hopes and demands for antibody testing.
The Ethics and Law Behind So-Called Immunity Passports
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Subtitle

Several myths cloud public understanding of the connection between guns and suicide. Perhaps the most pernicious is the idea that people who really want to end their lives will find a way to do it, making the presence or absence of a gun somewhat irrelevant. Decades of research on suicide tell a different story.

Samuel Thomas

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Samuel was born and raised in Salt Lake City, UT.  After serving an LDS mission in Russia for 2 years, he pursued a love for science and the humanities and earned undergraduate degrees in Chemistry, Russian and International Studies from the University of Utah.  He then returned to the University of Utah for medical school where he was given a scholarship to add an additional year to his education to earn a Masters in Bioengineering with an emphasis on medical technology innovation through the BioInnovate Program.  He has been involved in numerous NSF and NIH funded research and innovation projects within the University of Utah Health Sciences, Lassonde Entrepreneur Institute, and the Center for Medical Innovation.  He is the co-founder of multiple startups focusing on digital health, minimally invasive surgery, and smart technology. During medical school he was the President of the AMA for the Utah medical student chapter, was a voting member of the Board of Trustee for the UMA (Utah Medical Association), and co-founded two medical-student driven outreach clinics for the homeless and refugee populations.

He recently graduated from the Internal Medicine residency program at the University of Utah where he was able to continue much of his research and innovation projects. During his training he gained a new perspective on systemic challenges within health care delivery and implementation. His current interests involve improving outcomes, reducing costs, and increasing patient and provider satisfaction via a multidisciplinary effort that brings together advanced analytics, implementation science, system and process modeling, smart technology, and patient-centered design to enable the medical community with the information and tools they need for the management of patients throughout the health care system.  

Samuel enjoys spending time with his wife and two boys, snow skiing, biking and working on his 1970 Ford Bronco.

MD, MS, Health Policy

Preventing and Managing Hospital-Based Infections During Coronavirus

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News
Date
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During the severe acute respiratory syndrome (SARS) outbreak in 2003, Taiwan reported 346 confirmed cases and 73 deaths. Of all known infections, 94% were transmitted inside hospitals. Nine major hospitals were fully or partially shut down, and many doctors and nurses quit for fear of becoming infected. The Taipei Municipal Ho-Ping Hospital was most severely affected. Its index patient, a 42-year-old undocumented hospital laundry worker who interacted with staff and patients for 6 days before being hospitalized, became a superspreader, infecting at least 20 other patients and 10 staff members. The entire 450-bed hospital was ordered to shut down, and all 930 staff and 240 patients were quarantined within the hospital. The central government appointed the previous Minister of Health as head of the Anti-SARS Taskforce. Ultimately the hospital was evacuated; the outbreak resulted in 26 deaths. Events surrounding the hospital’s evacuation offer important lessons for hospitals struggling to cope with the COVID-19 pandemic, which has been caused by spread of a similar coronavirus.

Read the Full Study in the Journal of Hospital Medicine

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SHP's Jason Wang and colleagues provide five key steps to managing infections in hospitals during the COVID-19 pandemic in this Journal of Hospital Medicine study, drawing on lessons from previous hospital-based coronavirus infections.

Jasmin Moshfegh

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PhD Student Alumni, Health Policy
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Jasmin Moshfegh is a PhD candidate in Health Economics. She studies how and why innovations in healthcare diffuse, how they shape healthcare provision, and how they affect health inequality. Her dissertation work is supported by the Agency for Healthcare Research and Quality (R36 award).

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Jonathan Lee

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PhD Student Alumni, Health Policy
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Dr. Jonathan Lee, MD, MBA is a Health Policy (Health Economics) PhD candidate and Political Science MA student. In addition, he is a Clinical Assistant Professor of Psychiatry and Behavioral Sciences. Dr. Lee's research focuses on the causes and consequences of, as well as solutions to, rising distrust in sources of expert information (e.g., science, health). This includes studying phenomena such as the politicization of science and health, political polarization, filter bubbles/echo chambers, the emerging post-truth world, and information warfare. It also includes seeking heteorgeneity in the findings across particular demographics at high socioeconomic and health risk. He draws on theories and methods from his uniquely interdisciplinary set of educational, research, and professional experiences, including those from experimental and behavioral economics, political science, psychology, and machine learning. He is currently using machine learning-based text analytics to explore how trust/distrust in sources of expert information is discussed on traditional and social media -- followed by the use of online randomized controlled survey experiments to test the causal effects of particular persuasion strategies on perceptions of trust/distrust, as well as other important behavioral outcomes of interest. In addition, Dr. Lee works on designing and evaluating novel survey experimental research methods aiming to address common, problematic survey biases (e.g., hypothetical bias, social desirability bias, confirmation bias) which may lead to less accurate and precise self-reports from survey participants.

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Suhani Jalota

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PhD Student Alumni, Health Policy
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Suhani Jalota is a PhD Candidate in Health Economics at Stanford University and holds an MBA from the Stanford Graduate School of Business (GSB.) Her areas of interest are development and labor economics, with a particular focus on gender in poor households. She uses field experiments to study the interplay between women's economic power, dignity, and health — as well as the role of technology in amplifying their agency. 

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Harris Carmichael

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Harris Carmichael attended Medical College of Georgia for his MD, graduating Alpha Omega Alpha.  Harris and his wife Chelsea moved to Salt Lake City for his residency in Internal Medicine at the University of Utah.  After completing residency, he stayed in Salt Lake City to serve as a Chief Medical Resident.  It was at the University of Utah where he first gained interest in best practice utilization and methods for education in Evidenced Based Clinical Practice.  He plans to continue research in Implementation and Care Delivery Science while stdying the individual and institutional barriers to best practice utilization.

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