Is the incidence of depression higher where a high proportion of the population are 'suffering'?

Before being willing to guess the answer to that question I expect most readers would want to know how I define suffering. For the purposes of this exercise, I am using the definition of suffering adopted by the Gallup World Poll. Gallup classifies respondents as "thriving," "struggling," or "suffering," according to how they rate their current and future lives on a ladder scale, based on the Cantril Self-Anchoring Striving Scale, where the bottom rating is ‘the worst possible life’ and the top rating is ‘the best possible life’. Respondents are classified as suffering if they have poor ratings of their current life situation (4/10 and below) and negative views of the next five years (4/10 and below). They are more likely to report lacking the basics of food and shelter, more likely to have physical pain, a lot of stress, worry, sadness, and anger. They have less access to health insurance and care, and more than double the disease burden, in comparison to "thriving" respondents.


So, do you think the incidence of depression is likely to be higher in countries where a high proportion of people are suffering? By now, you are probably thinking that must be a trick question. Given the way Gallup defines suffering, surely it must be reasonable to expect the incidence of depression to be higher in countries with relatively high levels of suffering.

However, that doesn’t seem to be so when the Gallup data are compared with the results of a recent study of the incidence of depression in 18 countries. The study, by Evelyn Bromet (and 21 co-authors) recently published in BMC Medicine involved face to face interviews of over 89,000 adults using the WHO’s Composite International Diagnostic Interview. I don’t know what that means exactly, but it sounds impressive. This looks like a reliable study.

The authors report that the incidence of major depressive episodes (MDE) was greater on average in the higher income countries than in the low-to- middle income countries included in their study. That is what attracted my attention initially and the reason why I thought it might be interesting to plot the incidence of MDE against Gallup estimates of the percentage of populations who are suffering, as shown below.

The chart doesn’t seem to show any evidence of a positive relationship between prevalence of MDE in the last 12 months and the percentage suffering. Similarly, a graph plotting lifetime prevalence of MDE against the percentage suffering showed no obvious positive relationship.

The data depicted in the chart suggest there is no simple relationship between income levels and prevalence of MDE. For example, the prevalence of MDE seems to be relatively high in the United States and relatively low in Japan, Germany and Italy.

The findings of the study reveal several things about depression that I was not previously aware of. The incidence of MDE among women is, on average, about twice that for men. The average age of onset is the mid-20’s. The strongest demographic correlate in high-income countries was being separated from a partner, whereas in low-to-middle income countries it was being divorced or widowed.

Depression is obviously related to emotional well-being, but the links seem to be complex. For example, I don’t know how to relate data suggesting that only 2 percent of the population in Brazil are suffering with data suggesting that about 10 percent had a major depressive episode in the last 12 months. Over the last few years I have gained some understanding of correlates of well-being, but that doesn't seem to help much in understanding the incidence of depression.

Postscript 1
Cameron Lau of International Business Times talks about the depression study here. However, seems to have his facts twisted when he claims that depression rates in rich countries far outpace those in poor countries.

Postscript 2
I have just remembered a recent study by John Helliwell and Shun Wang that sheds considerable light on the incidence of depression in different countries. These authors have been able to explain 58% of the variance of 117 average suicide rates drawn from different years in 50 countries around the world using only four key variables: social trust, membership in community organizations, strength of religious belief, and the divorce rate. They comment: ‘The first three variables act to reduce suicide, while higher divorce rates are associated with higher suicide rates. The effects of social trust are large and statistically significant. Moving 10% of the population from generally untrusting to generally trusting, a shift of … less than one standard deviation for the sample data, would be predicted to lead to a … drop in the suicide rate, more than 10% of its average value’ (‘Trust and Wellbeing’, IJW, 2011, p. 50).

Data from World Values Surveys for 2005-6 indicate that the percentage of the population who think that most people try to take advantage of them (ratings of 1 to 4 on a ten point scale) is much higher in Brazil and the Ukraine (shown to have a high incidence of depression in the above chart) than in Japan, Germany and Italy (which have a relatively low incidence of depression).

However, lack of trust does not seem to explain the relatively high incidence of depression in the United States, where the percentage of the population who think that most people try to take advantage of them is about the same as in Japan, Italy and Germany.

Do Australian political leaders lack vision?

I ended my last post asking why the major political parties in Australia seem to be finding it more difficult to promote sensible policies. One possible explanation I hear quite frequently is that our political leaders lack vision. The argument seems to be that the policies of the major parties are too easily blown around by powerful interest groups because the leaders are no longer anchored to a set of values that their parties stand for.


The argument is expressed most often about the prime minister. I often hear people ask: Who is the true Julia? What does she really believe in? What does stand for? (A recent example is in the remarks by Paul Gardner here.)

I am not about to become an apologist for the prime minister, but it seems to me that those questions are unfair. Julia Gillard tells an authentic story about her origins, the use she made of the educational opportunities available to her and the values she holds relating to opportunity and responsibility. Why can’t more people accept that she means what she says when she argues that ‘Labor's modern mission’ is ‘to spread opportunity with a matching sense of responsibility’?

One of Gillard’s problems is that her espousal of opportunity and responsibility seems vague and out of kilter with the leftist views she is known to have held in the past. Some people might feel that she is using the language of opportunity and security as a cover for statism and wealth redistribution.

The leader of the opposition, Tony Abbott, has a somewhat different problem stemming from his background. Abbott makes no secret of the fact that in his youth he was strongly influenced by Bob Santamaria, a catholic political ideologue, who was a particularly divisive figure in Australian politics. The problem that poses for Abbott is that some people think the values he has espoused are a cover for paternalistic conservatism.

So, what values has Abbott espoused? In his book, ‘Battlelines’, Abbott poses the question: “How can Australians, individually and collectively come closer to being their ‘best selves’ and what can the Liberal Party do to bring this about?” (p79). That question seems to me to imply a strong set of values relating to individual aspirations. The doubts that some people have about Abbott stem from the possibility that he may be inclined to impose a social conservative’s view of what it means to be ‘one’s best self’ rather than respecting the rights of every individual to live according to their own views of what it means to be ‘one’s best self’.

It seems to me that the claim that our political leaders lack vision is garbage. The values that Gillard and Abbott currently espouse deserve to be recognized and considered on their merits, even if there are be grounds for suspicion that both are still influenced by their respective ideological histories.

There should be more focus on the similarities and differences between the values that Gillard and Abbott espouse . It seems to me that Gillard’s ‘opportunity and responsibility’ is closely allied to allowing and helping people to come closer to being their ‘best selves’. The difference is that Gillard puts more emphasis on spreading opportunity while Abbott would probably put more emphasis on encouraging greater productivity and individual excellence. There is still potential for the major parties to compete for votes on the basis of their emphasis of different values even though the old political divide based on attitudes toward the role of the state have greatly diminished.

So, if lack of vision is not the problem, what is? The prime minister has failed to ensure that ‘opportunity and responsibility’ are reflected in policy development outside of education and social welfare. For example, the national broadband network seems to be as much about reducing opportunity for people in the big cities, by restricting competition, as it is about expanding opportunities for people in regional areas. Health policy seems to be more about attempting to reduce risk factors through greater government regulation, rather than encouraging individuals to take greater responsibility for their own health.

The leader of the opposition has adopted a small target strategy. Rather than promoting new policies to encourage greater productivity, he continues to recite the mantra he took to the last election about ending the waste, repaying debt, stopping the new taxes and stopping the boats.

What are the incentives for politicians to adopt small target strategies? What role does the media play in this? Why don’t journalists do more to hold political leaders to account for lack of consistency between their high ideals and the policies they adopt? Is there anything that ordinary people can do to raise the level of political debate in this country?

Postscript:
Jim Belshaw - an historian, economist, management consultant and blogger - has suggested in a comment below that there is a lack of good policy ideas and that people like me (and himself) have something to answer for in that regard. Jim has also posted a more extensive comment on his blog.

Should politicians be required to meet competency standards?

‘Until philosophers are kings, or the kings and princes of this world have the spirit and power of philosophy, and political greatness and wisdom meet in one, and those commoner natures who pursue either to the exclusion of the other are compelled to stand aside, cities will never have rest from their evils’ – Plato, ‘The Republic’.

Plato proposed that the philosophers and warriors who are guardians of his ideal state should live in poverty. I can see some merit in that idea. I find it difficult, however, to see much merit in the breeding program that Plato suggested for producing guardians. Plato suggested that individuals should be deceived into thinking that they were participating in a lottery for the selection of their partners, but the lottery would be rigged by a breeding committee in an attempt to produce the best offspring.

If those are the serious proposals of a great philosopher, then it seems to me we might have reason to be concerned about the quality of public policy that philosopher kings might seek to implement. The great philosopher sets out to devise a system that would ensure that we are not governed by numpties and ends up, unwittingly, demonstrating what life might be like if we were governed by numpties. (I am indebted to Shona for introducing me to the word, ‘numpty’. According to one online dictionary, a numpty is a person ‘who, sometimes unwittingly, by speech or action demonstrates a lack of knowledge or misconception of a particular subject or situation to the amusement of others’. Others dictionaries that are less inclined to mince words suggest that a ‘numpty’ is a fool. Either way, it is probably a good idea for Australians to know what a numpty is before visiting the UK.)

There seems to me to be a lot more merit in the suggestion that politicians should be required to meet minimum competency standards than in the idea of breeding philosopher kings. This suggestion has arisen as a result of a discussion I have been having with Shona about political institutions. (Our discussion of politics began in a recent post.)

As a discussion starter, Shona suggests that politicians should be required to have a Master of Politics – something like an MBA for politicians. The degree would include practical work and be politically unbiased. It would cover a range of topics including political science, debating and language skills, law, economics and presentation. Shona noted that there could be a problem in ensuring that all politicians earn their MP degrees from reputable academic institutions. It would be necessary to find a way to stop some of them from just purchasing a degree on the internet.

When asked why she included presentation in her proposed course, Shona explained as follows:

‘Interestingly, I have just read and reviewed a large number of technical reports as part of my work. What infuriates me in doing so is the poor presentation, continual mistakes and many inconsistencies. Remind you of anything? I get angry with myself as a woman, looking at Julia Gillard and being distracted by a jacket too tight, poor make-up or dodgy hair, as opposed to focusing on what she has to say. When men do this it makes me very very angry. But I also notice the nose hairs, bad mannerisms and appalling body language of her male counterparts – so I’m not just judging the women. Presentation matters. Bad presentation distracts the reader/listener from the content/message. People would be more inclined to listen to what politicians have to say if they shine their shoes and clip their nose hair.’

In order to provide an example of how Australian politicians could present themselves in order to distract people from what they are saying it seems appropriate at this point to link to an interview of Sir Les Patterson.

The concern I have with the development of some kind of formal qualification for politicians is that it might tend to reinforce problems stemming from the similar backgrounds of many politicians. These days many seem to come from political families, study law at university and become party apparatchiks before standing for election. Mark Latham raised a related question in a recent article: ‘how can the Labor Party, having professionalised its ranks in the 1980s now look so unprofessional in office?’(‘A party without a point’, AFR, 30 June).

By coincidence, I am currently reading Vernon Smith’s book, ‘Rationality in Economics’, which has a useful discussion about wisdom of crowds and the characteristics of groups that enable good information aggregation. Smith (citing Suroweicki) suggests that four characteristics of groups enable good information aggregation outcomes: diversity, independence, decentralization and an aggregation principle to process private knowledge and yield group outcomes.

Does that mean that candidates for election should all do different work placements for a year – for example, as police, teachers, child care workers, hospital staff or garbage collectors? I am not confident that would produce better outcomes.

Mark Latham suggests, in the article mentioned above, that the Labor Party’s problems stem from a collapse of its policy-making culture. A particular problem for Labor has been the narrowing of the political divide following the end of the Cold War. Another contributing factor he mentions – the recent tendency for reformist ideas to be seen as an electoral liability – has inflicted both sides of politics.

So, that leaves me wondering whether competency of politicians is a fundamental problem in Australia. The basics of the system seem to me to be OK. Voters choose on the basis of criteria that are important to them. Political parties have strong incentives to find candidates who are acceptable to voters. The system should be able to weed out politicians who do not meet minimum competency standards.

Yet it would be hard to claim that in our political system everything is for the best in the best of all possible worlds. What is the problem with Australian politics? Why are the major parties finding it more difficult to promote sensible policies?

Postscript:
The web page I have linked to claims that the interviewer of Sir Les Patterson was Clive James. The interviewer was certainly not Clive James, whose web page can be found here.
Shona tells me that the interviewer was Clive Anderson. He is indentified as Clive Anderson in the description of the relevant video here.

Is the 'great big new carbon tax' a good idea?

I am using that emotive description of the new tax because I have previously suggested on this blog that a great big new carbon tax might not be a bad idea if it replaced other taxes that are having adverse effects on economic incentives. So, how good is the carbon tax package announced by the prime minister yesterday?


The first point that needs to be recognized in assessing the package is that it only makes sense if it is viewed as a signalling exercise. By itself this package will have a small impact on carbon dioxide emissions in Australia, a tiny impact on the world-wide emissions and an almost negligible impact on the stock of global emissions and global climate. Its impact depends almost entirely on the extent to which it may help to encourage people in other countries to take similar action to reduce their carbon dioxide emissions. If there is sufficient action by other countries more investors may come to expect that development of more efficient alternative technologies is likely to become a profitable venture.

The incentives that the tax provides for development of more efficient alternative technologies are the critical factor in whole exercise. If the world community ever gets serious about making substantial reductions in global emissions, the economic cost will be massive unless low-cost technologies are developed for energy generation and/ or removal of carbon dioxide from the atmosphere. Unfortunately, the proposed tax is unlikely to induce many people to rush into investing in development of new technology.

The tax cannot credibly be claimed to be anything other than a modest step by a small country. The longer term promises about the extent of reductions in emissions that are aimed for have little credibility. At best, the proposed carbon tax provides a weak signal of Australia’s willingness to participate in global action to reduce greenhouse gas emissions. The signal would be stronger if there was bipartisan support for the tax – but even if it is introduced and remains in place it will not amount to much in a global context.

Why don’t we hear the government arguing that ordinary people should be prepared suffer some pain in order to save the world from a climate disaster? The government is not talking about pain. It seems to have reasoned that since it will be obvious to almost everyone that the contribution of the tax to saving the world will be extremely modest and contingent on similar action by other countries, the tax can only be justified to Labor’s traditional voters if they suffer no pain. The package is being sold to the government’s traditional supporters as a redistribution measure that will actually improve their lot at the expense of the big polluters. And it is all being done in the name of ‘tax reform’!

Could anyone object to a new tax being used to fund reforms that will make the overall tax system more efficient? I imagine that such a proposal would have widespread support. The question that must be asked, however, is whether the proposed increase in the tax-free threshold should be viewed as a reform.

My concern is that the proposed tax relief will do very little to improve the work incentives faced by people with low incomes because it will leave effective marginal tax rates largely unchanged. The government has missed an opportunity to undertake some meaningful tax reform that might raise productivity. If this carbon tax package can be sold as economic reform, then the meaning of economic reform has changed beyond recognition and new words will have to be found to describe policy actions that will raise productivity.

Postscript:
In proposing to raise the tax threshold the government can claim to have followed a recommendation of the Henry review.
However, there is a strong case that greater tapering of welfare benefits would be a better way to tackle poverty traps.The relative merits of increases in the tax free threshold and greater tapering of welfare benefits as means of reducing poverty traps was discussed by David Ingles in a paper for the Australia Institute last year. Ingles suggested:  'In general, the recommendations of the Henry Tax Review are a slight improvement on the current situation but they do not address really fundamental issues and lack a coherent underlying rationale'.
In my view, Ingless goes too far in suggesting that the recommendations of the Henry review lack a coherent underlying rationale, but I can't see a coherent rationale in the way the government is cherry picking the recommendations of that review.