Thursday, October 8, 2020

PNAS celebrates Janet Currie

 The National Academy of Sciences celebrates Janet Currie in the current issue of PNAS, with an interview and an inaugural article.

QnAs with Janet Currie, by Tinsley H. Davis, PNAS September 29, 2020 117 (39) 24008-24009;

"Many mental illnesses arise in adolescence, and a study of national insurance claims in the United States finds a large variance in how adolescent patients are treated even within the same zip code. The findings, reported in Janet Currie’s Inaugural Article (IA) (1), reveal that 45% of adolescents receive first-line treatments that are not approved by the US Food and Drug Administration (FDA) (1). Currie, elected to the National Academy of Sciences in 2019, has studied children’s health for three decades. A professor of economics and public affairs at Princeton University, Currie has undertaken pioneering economic analysis of child development, including analysis of the effects of the Head Start program on children (23) and the effects of expansions of the Medicaid program for pregnant women and children (45). In her IA (1), Currie analyzes a large national dataset to reveal disparities in treatment that cannot be attributed to supply-side factors, such as limited availability of treatment providers."

Here's the first question and answer:

"PNAS:What is the link between health and economics?

"Currie: Health can have an impact on how much human capital, like education, people are able to acquire. Moreover, healthcare is a business, and it accounts for almost 20% of US GDP [gross domestic product]. So there are two strands: One is thinking about health as a business, and another is thinking about health as a form of wealth. My work generally focuses more on that second aspect of health as a form of human capital. The Inaugural Article (1) brings those two strands together to a certain extent because mental health problems in children are one of the things that causes them to have less human capital than they might otherwise, and I’m looking at how those children with mental health problems end up getting treated by the healthcare system."


Treatment of mental illness in American adolescents varies widely within and across areas

Emily Cuddy and  Janet CurriePNAS September 29, 2020 117 (39) 24039-24046;

"Abstract: Many mental health disorders first manifest in adolescence, and early treatment may affect the course of the disease. Using a large national database of insurance claims, this study focuses on variations in the type of care that adolescent patients receive when they are treated for an initial episode of mental illness. We found large variations in the probability that children receive follow-up care and in the type of follow-up care received across zip codes. We also found large variations in the probability that children receive drug treatments that raise a red flag when viewed through the lens of treatment guidelines: Overall, in the first 3 mo after their initial claim for mental illness, 44.85% of children who receive drug treatment receive benzodiazepines, tricyclic antidepressants, or a drug that is not Food and Drug Administration-approved for their age. On average, these children are 12 y old. While the supply of mental health professionals impacts treatment choices, little of the overall variation is explained by supply-side variables, and at least half of the variation in treatment outcomes occurs within zip codes. These results suggest that other factors, such as physician practice style, may play an important role in the types of treatment that children receive."

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