Pandemics, economic freedom, and institutional trade-offs.

We argue that institutions are bundles that involve trade-offs in the government's ability to provide public goods that affect public health. We hypothesize that the institutions underlying economic freedom affect the mix of diseases by reducing diseases of poverty relative to diseases of commerce (those associated with free movement of people, such as smallpox or COVID-19). We focus on smallpox and typhoid fever in the late nineteenth century and early twentieth century in order to build on recent work that make arguments similar to ours, especially the framework Werner Troesken sets forth in The Pox of Liberty. Our evidence shows that economic freedom, in multiple periods of time and settings prior to the eradication of smallpox in the second half of the twentieth century, reduced typhoid mortality but had no effect on smallpox deaths. The implication for COVID-19 is that the trade-off between fighting the pandemic and preserving economic freedom may not be too severe in the short run. However, in the long run, the wealth benefits from economic freedom are likely to be crucial in reducing vulnerability to diseases of commerce primarily from their impact on comorbidities (such as diabetes and heart disease). Thus, economic freedom is on balance good for public health, which suggests that it, while requiring trade-offs, might be the best institutional bundle for dealing with pandemics. Supplementary Information: The online version contains supplementary material available at 10.1007/s10657-021-09704-7.

Lifestyle and mental health disruptions during COVID-19.

Using a longitudinal dataset linking biometric and survey data from several cohorts of young adults before and during the COVID-19 pandemic ([Formula: see text]), we document large disruptions to physical activity, sleep, time use, and mental health. At the onset of the pandemic, average steps decline from 10,000 to 4,600 steps per day, sleep increases by 25 to 30 min per night, time spent socializing declines by over half to less than 30 min, and screen time more than doubles to over 5 h per day. Over the course of the pandemic from March to July 2020 the proportion of participants at risk for clinical depression ranges from 46% to 61%, up to a 90% increase in depression rates compared to the same population just prior to the pandemic. Our analyses suggest that disruption to physical activity is a leading risk factor for depression during the pandemic. However, restoration of those habits through a short-term intervention does not meaningfully improve mental well-being.

Lifestyle and Mental Health Disruptions During COVID-19

From the Abstract: "COVID-19 [coronavirus disease 2019] has affected daily life in unprecedented ways. Using a longitudinal dataset linking biometric and survey data from several cohorts of young adults before and during the pandemic (N=685), we document large disruptions to physical activity, sleep, time use, and mental health. At the onset of the pandemic, average steps decline from 9,400 to 4,600 steps per day, sleep increases by about 25-30 minutes per night, time spent socializing declines by over half to less than 30 minutes, and screen time more than doubles to over 5 hours per day. The proportion of participants at risk of clinical depression increases to 65%, over twice the rate in the same population prior to the pandemic. Our analyses suggest that disruption to physical activity is a leading risk factor for depression during the pandemic. However, restoration of those habits-either naturally or through policy intervention-has limited impact on restoring mental well-being."