In the first of our blogs exploring ideas on economics and infection, Dr Flavio Toxvaerd discusses how economic models can apply to disease control and asks – ‘what can epidemiologists learn from the dismal science?’
Although I trained as an economist and I consider myself an economist through and through, I have spent a good part of the past decade thinking hard about biology, medical interventions and infectious diseases. I have read as much in Nature and Science as I have in the flagship journals of my profession and have attended and given seminars in departments as diverse as plant sciences, veterinary sciences, physics, mathematics and schools of public health. Yet, it has all tied in with one of my main topics of research, the economic study of infectious diseases, also known as economic epidemiology.
Economic epidemiology, you say? The name alone may conjure up images of economic ideas spreading into other disciplines like an unwanted infection, as described by Edward Lazear in this paper on Economic Imperialism. Lazear described how ideas from economics have slowly permeated the walls into otherwise separate disciplines such as geography, sociology and political science and how these ideas often create resentment.
Economic epidemiology has a bit of this flavour, being in essence the study of the propagation and control of infectious diseases in human populations by using the economist’s toolbox. The field considers a wide variety of topics, ranging from game theoretic analyses of individuals’ protective behaviours and how these interact with those of other individuals, to analyses relying on sophisticated dynamic optimisation techniques to characterise the optimal allocation of public funds. In development contexts, it considers large scale randomised controlled trials to tease out the effectiveness of different interventions to alleviate poverty and disease burden.
Why, then, should epidemiologists listen to economists? Surely, with no specialist understanding of the biology of diseases nor any deep knowledge of the medical sciences behind vaccinations or therapeutics, there is little of value that economists can teach epidemiologists working on issues of public health? While these observations are of course true, they are also beside the point. The fact is that many epidemiologists and public health researchers are in fact engaged in economic thinking without appreciating that they are doing so. Anyone engaged in the management of disease outbreaks or in the study of communicable disease dynamics in humans, are unwittingly asking and answering exactly the kind of questions that economists routinely do in other contexts. But if one is in fact doing economics (broadly defined), why then not avail oneself of the experience and insights of economists? In a nutshell, what economists can contribute to disease control and research in public health is to help strengthening the economic analysis and ensure that these vitally important topics benefit from all the knowledge and insights that we economists have gained in other contexts.
But do not take my word for it. Daniel Bernoulli (1700-1782), considered the father of mathematical epidemiology, had this to say about his reasons for modelling infectious diseases:
“I simply wish that, in a matter which so closely concerns the well-being of mankind, no decision shall be made without all the knowledge which a little analysis and calculation can provide”.
Similarly, Daley and Gani (1999), a standard reference on mathematical epidemiology, explicitly identify policy making as a raison d’etre of the formal study of infectious diseases. In their view:
“One of the purposes of modelling epidemics is to provide a rational basis for policies designed to control the spread of a disease.”
As these quotes make clear, the idea of using careful analysis and calculation are not foreign to the field of disease control and much serious and path-breaking research in the biological sciences has improved our ability to combat and prepare for epidemic outbreaks. But economists can contribute in important ways to this effort, exactly because they have made it their business to think clearly about how to best allocate scarce resources and to better understand human decision making and how individuals’ actions may interact in complicated ways.
Bernoulli, D. (1766): Essai d’une nouvelle analyse de la mortalite causee par la petite verole, Mem. Math. Phys. Acad. Roy. Sci., Paris, 1.
Daley, D. J. and J. Gani (1999): Epidemic Modelling: An Introduction, Cambridge University Press.
Lazear, E. P. (2000): Economic Imperialism, Quarterly Journal of Economics, 115(1), 99-146.