1.19.2007
Economics and AIDS
On the front page of the University of Chicago's website (my alma mater), there is a link to a New York Times about Emily Oster, a fellow at the University working on HIV in Africa. Intrigued about such a prominent Emily working on HIV at Chicago, I read further. Apparently, Ms. Oster is an economist, and according to the news article, her work has established that poor people in Africa;
...had less of an incentive to practice safe sex...because many of them could not expect to reach old age, whether or not they contracted H.I.V. Any attack on AIDS should therefore include an attack on poverty.
Oh really? Phillip Setel, in his ethnography of changing sexual relationships in Northern Tanzania talked to women who were not using condoms. They told him that they understood the risk of AIDS, that they thought it very possible that their husbands had extramarital relationships, and they knew that using condoms would protect them, but that they had no way to communicate about safe sex with their husbands. He found that teenagers in the region had received many messages about safe sex, but had a highly specific set of relationships and didn't see the messages as applying to all of these relationships. In some countries, a history of biomedical abuses by the government has caused HIV messages to be viewed as politically motivated and therefore ignored. And anyone who has been to a place where AIDS has hit hardest knows that people understand the unique nature of the threat, and would not choose to die a painful and prolonged death.
Granted, the article provides a basic summary of her work, but it's exactly the type of thing that drives me crazy about economists, and particularly those that economics is the best way to explain absolutely everything. Economics can't usefully describe power structures or traditions or history or human terror. Reducing complicated human actions down to the equation of a cost-benefit analysis is not illuminating and is usually offensive. Ms. Oster's work both assumes and implies that people view their low life-expectancies in value-neutral terms, but that's not true. If you ask them, the poor say that their misery is excessive, the result of structural injustice. From defining their behavior as a simple logical responses to a given situation, Ms. Oster resolves to fight poverty as a technical response. A better analysis asks why these people live in poverty, and asks them what their constraints on behavior are to inform a community-based response. Poor people are people, not thought-experiment decision machines.
...had less of an incentive to practice safe sex...because many of them could not expect to reach old age, whether or not they contracted H.I.V. Any attack on AIDS should therefore include an attack on poverty.
Oh really? Phillip Setel, in his ethnography of changing sexual relationships in Northern Tanzania talked to women who were not using condoms. They told him that they understood the risk of AIDS, that they thought it very possible that their husbands had extramarital relationships, and they knew that using condoms would protect them, but that they had no way to communicate about safe sex with their husbands. He found that teenagers in the region had received many messages about safe sex, but had a highly specific set of relationships and didn't see the messages as applying to all of these relationships. In some countries, a history of biomedical abuses by the government has caused HIV messages to be viewed as politically motivated and therefore ignored. And anyone who has been to a place where AIDS has hit hardest knows that people understand the unique nature of the threat, and would not choose to die a painful and prolonged death.
Granted, the article provides a basic summary of her work, but it's exactly the type of thing that drives me crazy about economists, and particularly those that economics is the best way to explain absolutely everything. Economics can't usefully describe power structures or traditions or history or human terror. Reducing complicated human actions down to the equation of a cost-benefit analysis is not illuminating and is usually offensive. Ms. Oster's work both assumes and implies that people view their low life-expectancies in value-neutral terms, but that's not true. If you ask them, the poor say that their misery is excessive, the result of structural injustice. From defining their behavior as a simple logical responses to a given situation, Ms. Oster resolves to fight poverty as a technical response. A better analysis asks why these people live in poverty, and asks them what their constraints on behavior are to inform a community-based response. Poor people are people, not thought-experiment decision machines.
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