CREATIVE DESTRUCTION: Don Boudreaux: Uber vs. Piketty.

Problems galore fill Piketty’s book – including his failure to recognize that market-driven innovation and competition are incessantly creating new capital while reducing or even destroying the value of older capital, all in ways that move new flesh-and-blood people into the central ranks of the ‘capitalists’ while moving others onto the periphery of those ranks. (Twelve years ago Mark Zuckerberg, the son of a dentist, was no one’s idea of a capitalist. He’s now worth close to $40 billion.)

While working together earlier this week on a business trip to California, my Mercatus Center colleague Ashley Schiller and I were chatting about Uber and the assaults that governments are now launching on this amazing innovation. Ashley had a brilliant insight, which I share here with her kind permission: Uber (and other ‘sharing economy’ innovations, such as Airbnb) allow ordinary people to turn their consumption goods into capital goods.

Uber enables someone who would otherwise drive his or her car only for personal use to drive his or her car for paying customers – that is, to drive his or her car in an income-earning (and, hence, wealth-enhancing) manner. Uber enables a consumption good to easily become a capital good for however long the car owner chooses to operate as an Uber driver. For whatever number of hours car owners use their personal cars as Uber (or Lyft) cars, part of value of those cars becomes part of the value of an economy’s capital stock even if formal statistics do not yet register it as such.

Uber and other sharing-economy innovations create more productive capital and create more capitalists.

Ah. That explains why lefties hate them so much. It all makes sense now.

When I was a kid, my parents had strict television rules: no more than an hour a day, and the content must be educational. This meant a lot of PBS. I did briefly convince my mother that the secret-agent show “MacGyver” was about science, but that boondoggle ended when she watched an episode with me. These restrictions seemed severe at the time, but my parents were just following the orders of the American Academy of Pediatrics (AAP): Children and teens should have no more than one to two hours of screen time per day, with children under 2 having no screen time at all. Those orders remain the same today.

Relative to my childhood, limits on screen time have become increasingly restrictive and confusing. The iPad (and Kindle, and various other tablets) has opened up a world of “educational” screen time. If my 4-year-old is doing a workbook on the iPad, does that mean she learns less than if we used a physical workbook? The AAP advocates for newspapers and physical books over iPads, computers and other screen options.

The AAP statement on media seems opposed to screens per se (quote: “young children learn best when they interact with people, not screens”) without really differentiating among various uses and types of screens. But, not surprisingly, when you look at the research, the screen matters less than what you do with it.

Of all the possibilities for screen time, television watching clearly gets the most negative attention. It’s not hard to see why. Unlike educational games on a tablet, which at least can be argued to have some interactive value, television and movie watching are largely passive. Those who oppose TV for children worry about many downsides, but chief among them are declines in test scores (or other cognitive ability) and increases in obesity.

Let’s consider a few examples. This paper relates television viewing among preschoolers to measures of “executive function” — basically, whether a kid can focus and accomplish a goal — and finds that more television exposure is associated with lower executive function. This one looks at a large sample of children and associates television viewing at younger than 3 years with lower test scores at ages 6 and 7. And this one relates television watching to obesity among children.

These are a small number of the many, many studies that show associations between time spent watching television and health and development outcomes. But all these studies have an obvious problem: the amount of TV children watch is not randomly assigned. In the general population, kids who watch a lot of TV — especially at young ages — tend to be poorer, are more likely to be members of minority groups and are more likely to have parents with less education. All these factors independently correlate with outcomes such as executive function, test scores and obesity, making it difficult to draw strong conclusions about the effects of television from this research.

There are a few studies with better designs, and these have mixed results. There does seem to be some evidence to suggest that lowering media consumption, including television, can help combat obesity in children (see here and here for examples).

The impacts of TV on IQ and test scores have not been subjected to large randomized trial evaluation. Perhaps the best causal evidence on this question comes from a 2008 paper by two media economists.¹ The researchers take advantage of the fact that television was introduced to different areas of the United States at different times. This variation meant that, when television was first introduced in the 1940s and 1950s, some kids had access to TV when they were children and some did not. The researchers could then see how having TV access as a young child — what the AAP is most worried about — related to test scores when kids were in school at slightly older ages.

The researchers find no evidence that more exposure to television at an early age negatively affected later test scores. The contemporary applicability of this research is subject to various concerns — television in the 1940s and ’50s differs from the TV of today, for example — but it does suggest that such concerns about test scores may be overblown.

A second set of concerns with television — and these extend to all other screen time — is that there is something inherently bad about exposure to a screen per se. There really isn’t anything in the research to make us think this is a concern. Even the AAP, the ultimate screen time naysayer, focuses in its warnings on attention and learning difficulties, obesity and risky behaviors resulting from screen time.

Some parents worry about eye strain from looking at screens, but, again, there is simply no evidence for this. Looking for “iPad and vision” (or “tablet and vision”) in the medical literature results primarily in papers about using iPads to help people with poor vision read better. If you’d rather read your kid a book on the Kindle than on paper, there should be nothing to give you pause.

Based on my read of the evidence, I’d say there’s absolutely no reason to think there’s anything worse about using a screen to do activities you would otherwise do on paper. When it comes to passive screen time — TV and movies — it seems that, on average, watching more TV has limited (if any) impacts on test scores, but maybe has some small impacts on obesity among children. However, the key phrase here is “on average,” and fleshing this out makes clear why the effect of television is such a difficult issue to study.

To judge what impact TV has on children, we have to think about tradeoffs — what would kids be doing with their time if they weren’t watching television? There are 24 hours in a day. If your kid watches one less hour of TV, she does one hour more of something else. The AAP guidelines imply that this alternative activity is something more enriching: reading books with dad, running on the track, discussing current events with grandma, etc.

But a lot of kids and families may not use an additional hour in these ways. An hour of TV may be replaced by an hour of sitting around doing nothing, whining about being bored. Or, worse, being yelled at by an overtired parent who is trying to get dinner ready on a tight time frame. If letting your kids watch an hour of TV means you are better able to have a relaxed conversation at the dinner table, this could mean TV isn’t that bad for cognitive development.

With this insight, it’s easy to see why less television is likely to decrease obesity. The process of weight gain and loss is pretty simple: if you burn more calories than you take in, you’ll lose weight. Watching television is mostly done sitting. And most other activities involve at least some moving around. So pretty much no matter what else they do, watching less TV is likely to be associated with kids burning more calories and losing weight.

Similarly, it is easy to see why TV might not affect test scores. If the alternative use of an hour for most families is not in highly enriching parent engagement, television may be just fine.

In the run-up to my son’s birth a couple of months ago, I spent a lot of time sitting in my midwife’s office staring aimlessly at the posters on the wall. My favorite one depicted two scoops of ice cream with cherries on top, strategically set to look like breasts. The caption underneath suggested that exclusive breastfeeding for six months would lower a child’s risk of obesity. Presumably the implication was that if you chose to breastfeed, your child could later eat ice cream with impunity.

It was a great visual, and given the current rate of obesity in the United States, a compelling argument. The only trouble is that there is no good reason to think it is correct. The one high-quality randomized controlled trial of breast-feeding did not show any impacts on childhood obesity.

Of course, it’s not just childhood obesity. The purported benefits of nursing (here is one list from the California Department of Public Health) extend to better mother-infant bonding, lower infant mortality, fewer infections in infancy, higher IQ, higher wages in adulthood, less cancer and on and on. If one takes the claims seriously, it is not difficult to conclude that breastfed babies are all thin, rich geniuses who love their mothers and are never sick a day in their lives while formula-fed babies become overweight, low-IQ adults who hate their parents and spend most of their lives in the hospital.

It shouldn’t come as a surprise, then, that many women who struggle to breastfeed (or just find it annoying and want to quit) feel ashamed and sad that they are not giving their children the “best” start in life. It wouldn’t be great to make women feel this way even if all the purported benefits of breastfeeding were real. It’s even worse because the truth is that the vast majority of these claims are way overblown.

This is not to say that there aren’t some benefits to breastfeeding. In poor countries where water quality is very poor, these benefits may be very large since the alternative is to use formula made with contaminated water. In developed countries — the main focus of the discussion here — this isn’t an issue. Even in developed countries, there are a few health benefits of breastfeeding for children in the first year of life (more on this below).

In addition, many women enjoy nursing, so that’s a benefit regardless of any long-term impacts. And if you are planning to be home with your baby for an extended period of time, breastfeeding can be convenient and inexpensive (if you are planning to return to work, this is largely not the case, given the time and costs of pumping). But the vast majority of the claimed benefits of nursing simply do not hold up when we look at the best data.

It is not that the claims about benefits are completely made up. They are mostly based on some data. The trouble is that the evidence they are based on is often seriously biased by the fact that women who breastfeed are typically different from those who do not. Breastfeeding rates differ dramatically across income, education and race.

In the U.S. (and most developed countries), white, wealthy women with a lot of education are much, much more likely to nurse their babies than the rest of the population. But these demographic characteristics are also linked to better outcomes for infants even independent of breastfeeding. This makes it very difficult to infer the actual causal effect of breastfeeding. Sure, there is a correlation between nursing and various good outcomes — but that doesn’t mean that for an individual woman, nursing her baby would improve the child’s life.

To give a concrete example, take this study (conducted in the late 1980s) of 345 Scandinavian children that compared IQ scores at age 5 for children who were breastfed for less than three months versus more than six months. The authors find that the children who nursed for longer had higher IQ scores — about a 7 point difference. But the mothers who breastfed longer were also richer, had more education and had higher IQ scores themselves. Once the authors adjusted for these variables, the effects of nursing were much smaller.

The authors of this and other studies claim to find effects of breastfeeding because even once they adjust for the differences they see across women, the effects persist. But this assumes that the adjustments they do are able to remove all of the differences across women. This is extremely unlikely to be the case.

Think about it this way: Even holding constant maternal education levels, mothers with higher IQ scores are more likely to nurse their babies. Maternal IQ is also linked directly with child IQ. So even if researchers are able to adjust for a mother’s education, they are still left with a situation in which breastfeeding behavior is associated with other characteristics (in this example, maternal IQ) that may drive infant and child outcomes.

I would argue that in the case of breastfeeding, this issue is impossible to ignore and therefore any study that simply compares breastfed to formula-fed infants is deeply flawed. That doesn’t mean the results from such studies are necessarily wrong, just that we can’t learn much from them.

You might wonder: If this is correct, why all the mania about breastfeeding? Why all the policy focus? Why put out a poster trumpeting the value of breastfeeding against obesity if it is wrong? The simplest reason is that people (including policymakers) may not stop to think about which research they should believe — and, as I’ve noted, there are plenty of (flawed) papers that would point to all kinds of breastfeeding benefits. It often takes time for good research to trump bad — many people still think a low-fat diet is a good idea even though randomized trial data has not supported that belief.

It’s also the case that when it comes to our kids, we all want to believe that what we are doing is the best thing for them. Ensuring that your child gets exclusively breast milk for six months or a year can be very challenging, and it may be that we want to believe the sacrifice has some benefits. And it does. Just not nearly as many as we might think.

To actually learn about the impacts of breastfeeding, we need to rely on studies in which breastfeeding is assigned randomly (the best option) or, in the absence of that experiment design, studies that somehow fully adjust for differences across women.

This leaves us with a small but informative set of studies. In the first camp — the randomized trial camp — we have one very large-scale study from Belarus. Known as the PROBIT trial, trial, it was run in the 1990s and continued to follow up as the children aged.¹ The study randomized women into two groups, one in which breastfeeding was encouraged and another in which it wasn’t, and found that the encouragement treatment increased breastfeeding rates. The trial has studied all sorts of outcomes, including infant and child health and cognitive development.

Given how much interest there is in this topic, it is perhaps surprising that we have only this one large randomized trial of breastfeeding. It’s not clear to me why this is the case. People may be so convinced of the benefits of breastfeeding that they see no need for further testing. Or it may be that a large enough study is too daunting and expensive to run. Whatever the reason, the randomized evidence is limited to this single case.

The other group of helpful studies are those of siblings — that is, studies that compare a sibling who has been breastfed with one who has not. These aren’t as good as randomized trials, since there must be some reason why one child was nursed and one was not, but they do get around the issue of mothers who breastfeed being different from those who don’t.

When people cite the benefits of breastfeeding, those benefits typically fall in one of three groups: early life health, later life health and IQ. So, what does the data say?

Breastfeeding and infant health

Among the most straightforward benefits claimed for breastfeeding are improvements in infant health. The randomized trial in Belarus evaluated a very large number of infant health outcomes. The results are decidedly mixed.

Infants in the treatment group — who, remember, were more likely to be breastfed — had fewer gastrointestinal infections (read: less diarrhea) and were less likely to experience eczema and other rashes. However, there were no significant differences in any of the other outcomes considered. These include: respiratory infections, ear infections, croup, wheezing and infant mortality.

In other words, the evidence suggests that breastfeeding may slightly decrease your infant’s chance of diarrhea and eczema but will not change the rate at which he gets colds or ear infections and will not prevent death.

Breastfeeding and child health and behavior

Many sources (for example, that poster in my midwife’s office) go further and claim that breastfeeding has health benefits for the child in the long term — lower obesity risk, better blood pressure and so on. And on top of this, there are the claimed benefits on behaviors — less hyperactivity, fewer behavior problems, more maternal attachment, etc.

Here, the evidence is not mixed. It rejects these claims across the board.

The PROBIT randomized trial is again the best source. The researchers analyzed the impacts of breastfeeding on allergies and asthma; on cavities; and on height, blood pressure, weight and various measures of obesity. They found no evidence of nursing’s impacts on any of these outcomes. They also found no evidence of impacts on child behavior issues, emotional problems, peer issues, hyperactivity or maternal-child connection.

These non-results are also present when we look at sibling data. This study, published last year in the journal Social Science & Medicine, compares siblings who were and were not breastfed on various health and behavior outcomes — obesity, asthma, hyperactivity, parental attachment, compliant behavior. They find no impact of breastfeeding on any outcome.

These sibling results also provide a sense of why less effective research methods would have shown impacts. The researchers demonstrate that if you simply compare breastfed to formula-fed infants, there are significant differences on virtually all outcomes. However, once you compare siblings — where differences among mothers are fully adjusted for — you no longer see any positive impacts of breastfeeding.

Breastfeeding and IQ

The final area in which the benefits of breastfeeding are often proclaimed is children’s cognitive development. All those fatty acids in breast milk are supposed to raise your child’s IQ. Perhaps more than any other benefit, this possible IQ effect is what drives the shaming of women who choose to bottle feed (at least in certain social circles).

The randomized trial in Belarus did evaluate IQ. Its results are mixed and a little confusing.

First, researchers looked at all the kids in the study. For this sample, the evaluation of IQ was done by evaluators who knew whether or not a child was in the breastfeeding-encouraged treatment group. There were no significant effects of breastfeeding on overall IQ. In addition, breastfeeding had no effect on teachers’ evaluation of the children’s school performance. But the researchers observed large effects of breastfeeding on verbal IQ.

Because the researchers were concerned about evaluator bias, they also had a subset of children evaluated by independent evaluators who did not know which children were breastfed. The differences in verbal IQ disappeared. This, in combination with the teacher evaluations, makes it seem likely that the overall effect was driven by the evaluators, not by true differences among children because of breastfeeding.

This explanation seems especially likely since the effects observed in the full sample are too large to be plausible. Taking into account the impact of the program on breastfeeding rates, the results suggest that nursing increases child IQ by about 24 IQ points, which is far outside of what any other study — even one seriously biased by differences across mothers — would suggest. Overall, as others have noted, this study doesn’t provide especially strong support for the claim that breastfeeding increases IQ.

Comparisons among siblings (i.e., this and this) also show no IQ impacts. Again, these studies make clear that if you ignore differences across mothers, you can find large impacts of breastfeeding on IQ. It is only when you compare within the same family that you reveal the fact that it really doesn’t seem to matter.

The bottom line

Many women find breastfeeding to be an enjoyable way to bond with their babies. There is certainly no evidence that breastfeeding is any worse for a baby than formula. And maybe there are some early-life benefits in terms of digestion and rashes, which you may or may not think are important. But what the evidence says is that the popular perception that breast milk is some kind of magical substance that will lead your child to be healthy and brilliant is simply not correct.

That ice cream poster is wrong. If you want to help your child avoid becoming obese, breastfeed or not as you please. The key is to hold off on the ice cream.

My sons were at thirty-two weeks gestation when the doctor said, “looks like it’s time for their two month vaccinations.”

I recoiled in surprise–they were technically two months old, but they were micro preemies. If they had been term babies, they wouldn’t have been born for another two months and they were so small.

Don’t get me wrong. I am strongly in support of vaccination. But, Jesus, my kids weren’t even supposed to be born yet. They were tiny and medically fragile. There had to be a mistake.

They were barely 3 pounds. They were hooked to wires and tubes, and being treated for multiple life-threatening conditions. Doctors had put off procedures and surgeries until they would be healthier and larger.

I asked why we weren’t waiting until they were two months old corrected (five months actual), and the doctor explained that they needed their vaccines on time for all the reasons that caused my hesitation.

Because they were medically fragile, diseases other children might survive would kill them. Because the diseases of childhood wouldn’t wait until they were five months old or hit a certain size. Because, no matter how much we tried to protect them over the next few years, they would come in contact with unvaccinated people, and getting them on a vaccine schedule gave them the best chance possible.

my 2 month old baby with a preemie pacifier (pic by deek, all rights reserved)

I was afraid. If anyone was going to have a reaction to vaccines, it would be the smallest sickest babies. But, the attending physician had never seen an adverse vaccine reaction. Other doctors and nurses echoed his sentiment: no one had personally seen a NICU baby struggle due to vaccinations, nor did they know anyone who had, and they had data to back their assertion that on time vaccination is best even for NICU babies.

I looked for reputable, peer reviewed studies and articles suggesting that vaccinating preemies was a mistake. But I found none–only the hyperbole and fear-mongering of the anti-vaccination movement. (This NIH article was helpful, though)

So, my tiny 3 pound babies got their first vaccinations on time despite being too sick to undergo surgery, too weak to breathe or eat on their own, and too young to have been born.

And they did just fine.

I have no patience for the “too small for vaccinations” excuse.

All of this is to say that I have no patience for the argument that healthy, full term, two-month-old babies are too small or too fragile to get a vaccination that could save their lives. Especially given that the average two month old child in the United States weighs 10 lbs, more than three times what mine weighed when they got their shot.

Small, early term preemies are safely vaccinated every day because there is no room for unfounded unscientific claims when making medical decisions for babies who live so close to the line between life and death.

I have zero patience for the casual trivialization of serious illnesses.

child infected with haemophilus Influenzae virus from the ASP website

It blows my mind that someone fortunate enough to have a child who has never spent time in an intensive care unit would skip doing the one simple thing that would keep their baby healthy and hospital free. These parents have never had to watch their child struggle to breathe, or see a line running from their baby’s head because the staff ran out of accessible veins, had to sit beside them hopelessly, or listen to the alarms ring as their child’s heart slows or stops.

Yet they repeatedly make the deliberate choice to avoid a proven safeguard against that dark future.

So, although by nature my babies’ vaccine story is not scientific, and should carry no greater weight in decision making than any other piece of anecdotal evidence, I share it often in the hope that it sets new parents’ minds at ease as they take their 10lb infant in for vaccinations, or at provides a counter to the horror stories on anti-vaccination sites.

But often, conversations with anti-vaxxers take crazy turns into logical quagmires. I walk away frustrated beyond the ability to speak because, there’s no way to make some people see the bizarreness of their choice from the perspective of someone who has had a critically ill child.

Seriously. When you are fortunate enough to hold a healthy baby in your arms, why would you let debunked research, fear-mongering, and friend of a friend stories be the deciding factors in putting that child’s health and life at risk instead of the overwhelming sea of scientific research?

Why would you take their health so much for granted? I have no patience for this.

Featured image by Christine Szeto can be found on flickr. All meme images are commonly shared, but credit was given where possible.

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When I was pregnant with my daughter, family and friends began encouraging me to buy organic produce. I was always a critical thinker, and I doubted the touted benefits of organic food. Still, to appease family, my husband and I started purchasing organic apples, strawberries, and some of the other others fruits and vegetables from the Environmental Working Group’s “Dirty Dozen” list. Never mind that in my estimation, organic apples in our area are at least 50% more expensive than conventional.

Dirty Dozen? Nah, it’s fine

Long story short, I’m glad I know better now. I’m not a fan of getting bamboozled. I have no qualms about saying that the EWG “Dirty Dozen” list is unsubstantiated. There is no compelling reason to buy organic, yes, even the Dirty Dozen. The Farmer’s Daughter USA does an excellent job explaining why the scientific methodology behind the EWG list is flawed.

I will unabashedly say that “organic” food is the scam of the decade. We already know that organic food is no more nutritious than its conventional counterparts. You may be thinking, “Well, I buy organic to avoid toxic pesticides.” Alas, the idea that organic farming doesn’t use pesticides is brilliantly pervasive, and has likely helped the massive growth of the 63 billion dollar organic industry. In fact, organic farmers often have to use more so-called “natural” pesticides to achieve the same effect of synthetic pesticides. Just like conventional produce, organic produce shows pesticide residue in laboratory tests.

Isn’t boycotting a little extreme?

I didn’t used to go as far boycotting organic, but I can no longer handle the pesky cognitive dissonance. Even after I learned that there is no reason to buy organic, I’d purchase organic bananas if the conventional fruit was too green. I’d pick out a box of organic cookies if it was on sale. Quoth the Kavin, nevermore. Not only is there no tangible reason to buy organic, but it contributes to the sad weakness of America’s critical-thinking skills. The organic industry perpetuates the “natural is better” fallacy. Supporting this industry with my family’s money is like personally hindering scientific progress.

I’ve never set foot in a Whole Foods, and never will

If you shop at Whole Foods and care whatsoever what I think, don’t fret. I’ve heard from lots of people that it’s a really nice store with fancy cheeses, amazing bakery items, and a wide selection of ready-to-eat vegetarian options. That’s fine my friends, go nuts (do they have really good nuts, too?) In my opinion, Whole Foods helps promote the pretentious, judgmental false dichotomy that non-GMO and organic foods are somehow healthy and wholesome, while regular old food is junk. This company that grossed nearly 13 billion dollars in 2013 devotes an entire section of its website to how “Values Matter.” It is such an extensive section that I won’t give you a synopsis for now, but here’s a 60-second video. Gag me with an organic carrot:

Spare me the value judgement, Whole Foods. This type of value judgement emanates not just from Whole Foods, but from the larger organic movement over all. The Big Organic Behemoth’s rhetoric creates a deceptively discordant image of people who care about their health versus those buying conventional food. The tacit message is that those neglecting to buy organic are lazy, parsimonious, poor, or gluttonous. Perhaps the mom choosing conventional produce is selfish, and doesn’t care about her child’s well-being. This mom-shaming is far more ubiquitous than I ever believed.

An image shared by March Against Monsanto. First of all, organic food is way more expensive. Second, it’s my prerogative to have nice things. Credit

These so-called “values” are completely ideological. Worse, Whole Foods is a leader in promoting the fallacy that GMOs should be avoided. As I’ve discussed extensively, the overwhelming scientific consensus agrees that GMOs are safe. Genetic modification has the potential to feed and nourish the world’s growing population in the most sustainable manner possible.  I personally will no longer buy into the organic scam. The idea that moms like me don’t care about our kids is ludicrous. In fact, I WANT BETTER for my children. I want them to grow up knowing how to spend their money wisely. I want them to be able to smell a scam from a mile away. I want them to grow up in a more scientifically savvy country than America is today, and I’m doing my best to make that happen. My children love fruits and vegetables, but there is no way on this green, genetically dynamic earth that I’ll buy an organic fruit again. Except on the rarest of occasions like the other day when I bought organic apple juice by mistake. I’m a busy, sometimes frazzled woman.