Jim: Thank you for taking the time to do this interview and letting ASHEcon members get to know a little more about you! You have been a prolific researcher in health economics for over two decades. Can you talk a little bit about what drew you to becoming a health economist in the first place?
John: When I first started the Econ Ph.D. program at the University of Chicago, I had no awareness of the field of health economics. I came in thinking I might want to study economic history, because I really enjoyed each of those two subjects separately. However, when taking Price Theory from Gary Becker, I got interested in his Theory of Rational Addiction. I started looking for a new empirical application of the model and thought of eating and body weight. At first I considered looking at anorexia nervosa (which was heavily covered by the media in the 1980s) but when I looked at the data on measured prevalence I was surprised by what a small percentage of the population was underweight. I was also surprised to see that the prevalence of obesity was substantial and had recently been rising. At that point, the most recent data on measured weight were from NHANES III phase 1 (1988-91), so there wasn’t widespread awareness that we were in the middle of an obesity epidemic. But seeing those prevalence data was enough to inspire me to start researching obesity and the economics of diet and physical activity. Gary Becker kindly agreed to be the chair of my dissertation committee, and he was a fantastic advisor and mentor. I began by studying the relationship between body weight and labor market outcomes such as employment, wages, and disability. That was about 30 years ago and I’ve expanded to study all sorts of economic causes of obesity, consequences of obesity, and interventions to prevent and reduce obesity as well as promote healthy diets and physical activity.
Jim: Much of your work has centered on risky health behaviors. Can you talk a little about what makes this topic so interesting to you?
John: Risky health behaviors like poor diet and physical inactivity, but also alcohol abuse and drug abuse, involve a lot of interesting and important economic concepts. Risky health behaviors tend to involve a tradeoff between immediate gratification and long-run health consequences, so the rate of time discount and myopia are relevant. Risky health behaviors tend to be addictive, in the sense that the stock of past consumption may raise marginal utility of consumption. There may also be peer effects. There are also numerous market failures: there may be external costs of consumption (such as cancer from second-hand smoke, fatalities from drunk driving, and fiscal externalities through health insurance) and imperfect information (for example, about health risks). Behavioral economics concepts are relevant, because people may alternate between cold rational states in which they are able to maximize their own utility, and hot impulsive states in which they over-consume. These are markets with a history of substantial government intervention, ranging from outright prohibition (alcohol, narcotics), high taxes (cigarettes, alcohol), restrictions on access (minimum legal drinking age, prescription requirements for pain killers), and requirements of information disclosure (labels of calories and nutrition). There have also been dramatic changes in prevalence in recent decades: obesity and fatal drug overdoses have risen considerably, but smoking and teen pregnancy have substantially declined. There have also been major changes in public policy, such as taxes on sugar-sweetened beverages and legalization of cannabis and assisted suicide. All of this makes it a rich research area for economists, as well as a great set of applications for teaching economics.
Jim: What made you decide that you wanted to take on the role of President of ASHEcon?
John: I’m honored to serve in the role. ASHEcon has been the most important professional economics organization for me since it was founded. From the beginning, it’s been an organization in which senior people are supportive and encouraging of early-career researchers (ECRs). This is manifested in the organized mentorship sessions (hat tip to Melinda Pitts and Kosali Simon) and professional development sessions like Meet the Editors, but also in the helpful and constructive way that senior people engage with ECRs in the sessions and social events. It’s been a conference that even senior faculty feel is valuable for getting important feedback on their research, so you see a large percentage of the field and can learn what is cutting-edge. Importantly, people don’t just attend their own session – they also tend to visit others of interest and are available to chat. The founding of the American Journal of Health Economics has been a wonderful thing for the field. I’m happy to have an opportunity to help continue to grow and strengthen the organization.
Jim: What are you most excited about for your new role?
John: The annual conference is a key function of the organization, and the President-Elect has the opportunity to organize the opening plenary and shape it in other ways (such as tweaking the program areas and suggesting candidates for vacant program chairs). We’re fortunate to have an extremely capable Executive Director and stellar Board, and I’m looking forward to working with all of them.
Jim: What would you say are your top two to four priorities for ASHEcon over the course of your term?
John: The top priority is ensuring the highest quality of research at the annual conference and in the association journal (AJHE). Both are in good shape but we can’t lose sight that the primary mission of the organization is the promotion of health economics research and teaching. An increasingly critical part of that involves protecting and promoting academic freedom and the freedom of scientific inquiry. A second priority is to strengthen the finances of the organization, by seeking external grants and donations. Third is to promote the professional development of early-career researchers.
Jim: You are known for your guide to the economics job market. Do you have any advice for current Ph.D. candidates who are preparing for their first market?
John: The last two years have been tough, in that there have been fewer jobs available for essentially the same number of new job candidates. While that’s unfortunate, I don’t want to overstate it – there are still lots of jobs, and the employment rate of respondents to our AEA surveys of job candidates has been at or close to 100% (of course, that could be biased if people with good outcomes are more likely to respond). This coming year will likely be tougher still, given that many U.S. academic institutions have hiring freezes, and the government is unlikely to hire as much as in the past. The perennial advice still applies: be honest with yourself about your preferences and comparative advantages, and share that information with your advisors. Show your advisors the list of places you’re planning to apply, and ask if they could write a better letter if you dropped some jobs from your list. Also ask if they’d be willing to email people at any of those institutions to recommend they interview you. For the jobs that are your highest priority, carefully tailor the cover letter to explain why you are a good match for their position, and vice-versa. Exhaustively practice your elevator pitch (3-to-5-minute description of your job market paper) and your full job talk. Be sure to send your two “signals of special interest” through the AEA. Keep in mind that there are smart and talented people everywhere.
Jim: Is there anything else you would like to add?
John: Just a piece of advice for graduate students and ECRs: it can be socially challenging at first to go to research conferences because you don’t know many people yet, and it can be intimidating to approach and chat with new people. But doing this early on pays off because you get to know more people each time, and it’s really nice when you get to the point that you know many of the people who work in your area and you have friends to catch up with at each conference. So don’t be shy to chat with presenters about their work after the session, or to approach people at the conference’s social events. ASHEcon in particular is a good place to meet people, because health economists are very friendly and supportive.
Jim: Favorite book?
John: Midnight in the Garden of Good and Evil
Jim: Favorite movie?
John: The Godfather
Jim: Favorite sport/team?
John: Red Sox in baseball and the Celtics in basketball.
Jim: Works in economics that had a big influence on you?
John: Reading The Worldly Philosophers and Free to Choose during high school made a big impression on me, and definitely made me interested to study economics in college. Becker and Murphy’s “Theory of Rational Addiction” put me on the path to being a health economist.