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Mr Epidemiology

No, I'm not a skin doctor

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Time trends

2017: What can we expect?

Following up from the end of last year, I thought it would be fun to predict what I think the next 12 months will have in store for us. So lets get to it!

1. Repeal of the Affordable Care Act

President Trump has already made it clear that this is one of his first priorities when he assumes office. The groundwork was already laid with the combination of the Senate passing a budget measure that was supported by Congress, and this week Trump issued an executive order to start rolling back the ACA. Now, the ACA is not without fault as we’ve discussed before; premiums have increased for many users, and the lack of true, universal coverage means many who don’t need coverage would rather pay the penalty than enrol. But repealing it without a replacement could be a disaster for many Americans. The Washington Post estimates that the repeal will kill more than 43,000 annually (based on this study in the NEJM). The impacts will be felt beyond the healthcare system though, with evidence from California suggesting that such a move could affect everyone involved with the health industry ranging from hospitals, food, and transportation services that all work together to provide patient care. Estimates from this study suggest up to 209,000 people would lose their jobs, and it would cost California over $20 billion dollars. It remains to be seen what replacement is offered, but the transition between the two is one that needs to navigated delicately.

 

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How can one person completely change the results of a survey?

In public health, we rely heavily on samples, as measuring everyone you are interested is often impractical. However, this requires a lot of thought and development in order to avoid unintentionally biasing your sample, as was the case for the USC Dornslife/LA Times Daybreak poll.

Last week, a story came out about how one 19-year old black man in Illinois was single-handedly changing the standings of the US Presidential election. This was based on the results from the USC Dornsife/Los Angeles Times Daybreak, a survey of voter attitudes on “a wide range of political, policy, social and cultural issues.” In this survey, Donald Trump has generally held the lead, until last week, when Hillary Clinton came out in front. Interestingly, this is markedly different than most other national polls, that have shown Clinton is generally ahead, or a much closer contest than that poll would have you believe. So what happened?

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