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- [00:10]
A
Hello and welcome to an unbelievably special Crib Sheet edition of Slate Money, normally your guide to the business and finance news of the week. But we are zooming back and out and up this week because the most special guest is in the studio with us. I am Felix Hammond of Axios. Emily Peck of the Huffington Post is here. Anna Shymansky is also here, but most excitingly, Emily Oster is here. Emily, welcome.
- [00:42]
B
Thank you.
- [00:43]
A
We are gonna talk about both of your books this week because they're both amazing, but tell us what they both are.
- [00:49]
B
The first one's called Expecting why the conventional pregnancy wisdom is wrong and what you really need to know. It's about pregnancy and data. And the new book is called Crib Sheet A deded guide to better, more relaxed parenting from birth to preschool.
- [01:03]
A
You really love the long subtitles.
- [01:05]
B
I do, I do. I like the short first title and the long and the long subtitles. I don't have any control over the titles. They just were given to me.
- [01:13]
A
You get given the subtitle and then you write a whole book off it.
- [01:15]
B
Exactly.
- [01:16]
A
We're going to be talking about breastfeeding, lots of breastfeeding, and vaccination, of course, and co sleeping and parental intuition and birth rates and all manner of stuff. It's going to be an amazing show.
- [01:29]
B
And.
- [01:30]
A
And we also have a really kind of awesome Slate plus segment about women in the economics profession. So you're gonna love this episode. Stay tuned for this week's edition of Slate Money. So this is the first book, right? It's basically most people get too stressed about most aspects of pregnancy. If I had to boil it down to like one sentence.
- [01:52]
C
Yeah.
- [01:53]
B
Both of my books are kind of like that. Yeah. I mean, I think with the pregnancy one, it's sort of like when the. You get so much conflicting advice. And that this is, I think, for a lot of us, like the kind of the first time you're like, interacting with the medical system and there's a lot of decisions and there's a lot of stuff you don't expect. And it's sometimes it'll sort of happen in the moment and then you're supposed to make some choice or it's like, oh, by the way, we're gonna do this thing and it's happening right this minute and you're like, whoa, whoa, wait, I didn't know about that. And then it's like sort of too late and you haven't had time to think about it. And so I think that's kind of the Space that I was in when I wrote the first one.
- [02:25]
C
You say in the book, like, your economist brain and training is sort of in opposition to the way physicians essentially work is. Whereas, like, all the decision making has already been done and they just tell you what to do. Whereas, like, in your world, you look at all the evidence, you. You can explain this better, and then you make the decision informed.
- [02:43]
B
Yeah, I think that I. That economists are very accustomed to the idea that there's costs and benefits and we're going to weigh them and combine them with preferences. And that, that's sort of that idea that preferences might differ. And that data, we're going to evaluate data and combine it. That's. That's something that kind of economists do. I think more than, in some ways, more than physicians. I also think in this medical space, there kind of tends to be like, okay, somebody has read all this literature and they've, like, decided what the rule is, and they've decided it based on, I don't know, some average person or sometimes just kind of not really on any particular person. And then it's just like, okay, this is the rule. And I think that I'm. Economists are not comfortable with. And I was not comfortable with the idea that there was like, a rule that a way that everybody had to behave.
- [03:24]
A
Do you think that there's a revealed preference, to use one of my favorite economics terms about doctors in the medical profession, from what rules they come up with and how they communicate them?
- [03:36]
B
I'm not sure I would use the phrase revealed preference for that. But I mean, I do think that there's in a lot of these sort of medical spaces, and I've talked to doctors about this. They're like, you know, we don't have a lot of time to go through all this kind of nuance, but, like, we see our patients for, you know, I'm seeing 30 patients a day for six minutes. And so I don't have time to, like, kind of. There just isn't. There isn't time to sort of really get into this. And so it's very helpful to have rules and guidelines because then we kind of know what to recommend. And I think there, there is value for that. I think for, for the patient or for some kinds of patients, that interaction is frustrating. Part of what is valuable, maybe about a book like this is to be able to say, okay, if you know what's coming, then you can make use of that six minutes in, like, a much more efficient manner, rather than trying to get them to explain, like, all the Options, if you sort of know what they are, you can do a little better.
- [04:23]
D
And I think this is significant just because I think historically the relationship between women and the medical establishment has often been this idea of kind of women going in and a male doctor telling them what to do with this idea that what a woman wants herself is not of much value. It's just there is one right decision, one wrong decision. There's no, you know, marginal utility. It's just black and white.
- [04:44]
C
That's the perfect segue into drinking while pregnant and also co sleeping to an extent, because in both cases a woman is told, don't drink when you're pregnant, hard stop. Or don't co. Sleep with your baby, hard stop. But you looked into both of those things and found a different way.
- [04:59]
B
Yeah. So I mean, I think with the drinking in pregnancy, there's a sort of piece of it where you can really see where this recommendation comes from, which is that drinking a lot when you're pregnant or binge drinking even a few times can be really damaging. And there, that is sort of very clear. We should recommend against that. I think where, where the evidence sort of flips a little bit is in the question of like, what about having an occasional drink? What about having, you know, one at a time, like a few times a week, which is something that has, has sort of historically been much more acceptable, is much more acceptable in many other places. And when I looked at the evidence on that, you can see why it's been more acceptable that there is sort of no evidence that drinking in that occasional way has negative consequences on kids. And there's actually a bunch of evidence like that. And we can sort of. Do I talk a little bit in the book about the pieces of evidence there that are sort of better and why I trust some of them. I think that the sort of blanket, like prohibition that has come up here is sometimes hard for people to think through because you sort of get into a place where it's like, well, if I have one, like, I might as well just have like a bunch of them, you know, and maybe people don't actually react like that. But I do think that we, we are too eager to sort of say, don't do, don't do, don't do, don't do, don't do, do on everything, as opposed to saying, you know, here are some things you should really not do, and here are some, like, you know, the evidence is, is more mixed or maybe sort of more reassuring.
- [06:18]
D
And the doctors may also not be considering the fact that putting all of these limitations and the stress of that can have its own negative consequences. When you have women who are pregnant who are constantly worried that they're doing something wrong, I imagine that that's probably not ideal.
- [06:32]
B
Yeah. And I think and affects. I mean, this comes up in the parenting space also. I think the sort of feeling like, I'm constantly messing this up. And like, you know, I feel terrible about this all the time. People who are like, I was told not to have my kids sleep in the swing. It was the only way to get them to sleep.
- [06:45]
D
I.
- [06:45]
B
So I did it, but I felt horrible about it all the time. And I was constantly, like, feeling bad. I mean, as you said, like, that can't. That's like, a nice way.
- [06:53]
A
Give me a quick, like, history lesson here. Because I feel that, you know, in the 70s, this idea that all we should care about is maximizing our kids well being and making whatever sacrifices necessary to do so wasn't that common? And somewhere it became just, like, generally accepted. And do you understand how and when that happened?
- [07:11]
B
Yeah, I don't have a great sense of that. I mean, I have the same feeling that you did that, like, sort of 40 years ago. People were not, like, spending every moment being like, okay, if something is even a little bit good for my kid, even if it's, like, infinitely costly for me, I have to do it because that's how I'm going to prove that I'm, like, optimizing my parenting. And so I think that is somewhat new. You know, I'm not. I'm not quite sure why. I think part of it is that sort of demographic shift in when people are having kids and what, you know, in some socioeconomic groups sort of, you've, like, achieved a bunch. You know, you went to college, you graduated from college, you got a job, you made partner, whatever it is. And then it's like, this is like, another thing to achieve and, like, do right. Like, another way to do it good. And I'm not sure that that was as true when people were having kids at 22 and kind of thinking about it differently.
- [07:53]
D
I also wonder if part of it has to do with the fact that for a lot of women, because obviously a lot. A lot of women now who have children are also working outside the home. And I feel like. I mean, I know women I've spoken with recently, friends of mine who have kids, and they said they feel like they feel so guilty in every way, but they feel like, well, but at least if I'm breastfeeding, I know I'M like, I'm doing the right thing. There's a sense of guilt from being like a working mother. So thus it's like it creates then all these other anxieties. So like, maybe that's why there's more of a focus on making sure you're doing everything right for your child in other ways because there is this guilt that totally.
- [08:25]
B
That seems good.
- [08:26]
A
Yeah. And that the rise of the child optimized parenting technique also coincides with the rise of women in the workforce. I mean, I guess it does, right?
- [08:36]
C
Yeah. No, I think that's a really good explanation. And then we've solved the problem.
- [08:40]
A
Congratulations.
- [08:41]
D
Credit to my friend Elaine.
- [08:43]
B
Thank you, Elaine.
- [08:44]
C
And you mentioned breastfeeding, which I feel like you totally take the wind out of, like, I'm better than you because I breastfeed argument in your book. It was like, after I read it, I was like, huh, Did I even need to do that?
- [08:56]
B
I think the book tries to sort of like walk a little bit of a middle ground on breastfeeding. So I think on the one hand there definitely are some benefits. So if you said sort of like, is breast best? I think basically the answer is yes. Like, for moms it is best. It's good for moms, particularly good for moms, but, you know, it has some benefits for kids and like, sort of better digestion, some early life benefits. So like this sort of idea that it's best, like, yes, it's best. Okay. But I think when we say breast is best, we seem to imply that it's best by like a huge margin. And then you get told these things like that if you don't do this, like, your kid is going to be stupid and they're going to be overweight and they're going to be sick all the time. And like, you know, and that's not just immediately, it's like forever, you know, like when they don't, you know, get then 1580 on the SATs, like that's because of you. That's like on you. That was your lazy mom points. And, and you know that the data just doesn't support those, those things. And, and you know, there's kind of, I think we have a good understanding of why it sort of shows up in correlations, but those are probably not causal.
- [09:53]
D
I also wonder when it comes to kind of breast as best, what it's always so not necessarily considering is that there are downsides for women who really have a hard time breastfeeding or just don't like to do it. I mean, I have. So I have three sisters and two of them have kids, and one of them, breastfeeding has been great. It's been a great experience. But my other sister hated it. It, like, it made her miserable. She had a hard time in a lot of ways, actually connecting, I think with her, with her son initially because of that. And then once she stopped breastfeeding, it was great and it worked out really well. And I think for her mental and I think also physical health, it was better not to breastfeed. So then I feel like when we talk about breastfeeding, we don't sometimes think of those sides.
- [10:29]
B
Yes. And I think that, you know, I hear from a lot of people who are like, you know, this didn't work for me. And I was really depressed and. And I was like, sort of teetering on, like, postpartum depression. Cause all I could think about was like, how I had failed my kid on the, like, first thing that I was supposed to do for them was, you know, do this thing. And like, everyone was just telling me, I have to do this, I have to do this. And then like, you know, and I think for those people knowing, like, yeah, like, you know, so maybe your kid's gonna, like, have a little extra diarrhea, maybe like one more ear infection. It's like, okay, yeah, that's too, like, that's too bad, but like, that's a little different than, you know, the, like, their lifelong success is.
- [11:00]
C
In fact, I want like every person to read it because one of the other things, even if you don't feel guilty, the choice not to breastfeed like everyone else that sees you, like, whip out the bottle and feed your 2 month old with the, you know, the Similac bottle or something is like giving you side eye on the playground. I think, like Hannah Rosen wrote a piece, like, defending her use of formula years ago, and she was like, the hate mail was fast and furious. Like, people get very upset about it. And there's just so much judgment against mothers and mothers have and women have for each other that your book sort of serves to kind of like chill that out a bit. There's no need for this judgment. Like, here's the real information.
- [11:42]
A
So I want to talk about that question of judgment because more with the first book, but with both, you have run into criticism from the medical profession. Did you expect that? And what is the main point of contention?
- [11:57]
B
So I think this came up much more in the first book than the second book. And I think it was all around the alcohol stuff and, you know, I think that there was. I got sort of a few pieces of pushback. I would say the most pushback I got there was just the view that, like, you know, we. We can never know whether a tiny amount of alcohol is bad. And so, you know, this is the, like, you know, maybe cautionary thing. It's like a precautionary thing. I think related to that is the view that, like, look, as a policy, you know, it is good to tell people, don't do this at all, because, like, we know that if everyone did that, that would be safe. And I think there is something in the space of sort of, like, there's a difference between what you would say in a book like this and what you would make as, like, CDC policy. And. And those are issues I don't take up in the book, but I can kind of see where people would come from on wanting to have policy statements which are different from. Different from this. I think that's complicated. But I. I did find that a little surprising, which is perhaps somewhat naive, partly because I actually, when you sort of, like, look at survey data about what doctors tell their patients, something like, you know, 40% of them say in surveys that, like, they tell the women it's fine to have a little bit of alcohol. So there's a sense in which there's like, a disconnect between sort of like, what does ACOG say and what are the. Which is the American College of Obstetricians and Gynecologists. Like, there's a disconnect between what they say in their policies and what a lot of. How a lot of doctors are practicing. And I thought that that would mean that people were less mad, but that was not right. This book has not gotten. I think I am much more aligned with the American Academy of Pediatrics on a lot of things. So I think it's like, a much more like, there. There are fewer things like that. But I think also a lot of the sort of central tension in parenting is kind of not with your doctor. It's more like with these other people. You know, the people on the playground. Like, you know, a lot of. I think most pediatricians, like, if you come say, I'm, like, really struggling with this. I can't. You know, I'm like, really? Most pediatricians are like, yeah, you know, use some formula. Like, that's totally. Like, that's totally fine. Like, that's right for you. So they're not the guys giving you the. The side eye. The side A is the other people. And so I think that means when you read this book, the tone is sort of not. I mean, among other things, we had amazing pediatricians and there was like many stories in the book about how great our pediatricians were. And so I think that's been a little less. I did get a little pushback on some of the breastfeeding stuff from the AAP in like one case where they felt I should have said more about ulcerative colitis. And you know, I, I did look into that literature, but I, and they.
- [14:17]
C
Were okay with your co sleeping advice because I felt that, no, that felt a little controversial.
- [14:21]
B
They don't. I would say I've gotten a little bit of pushback on that, but I think that, you know, ultimate, ultimately that, that when. So what I say about co sleeping is like, you know, it is a little bit risky, even done as safely as possible. Although if you do it as safely as possible, the risks are very small. And I think that, yeah, there is a little bit of feeling sometimes of like that kind of message could normalize the experience of co sleeping and that, you know, we don't want people to think that it's okay to, to co sleep. So we should just tell them like, never do this under any circumstances. I think what's hard there is for, for like some, for some people, like that's the only way your kid will sleep. So like what, what do you see as the alternative for people? And sometimes you've seen people be like, well, just like get through it.
- [14:56]
D
Right? It's easier said.
- [14:57]
B
Yeah, like that's, that's great. Like I can say as a parent of a four year old, I'm like, well, so what's the big deal? You know, just get through it. It's like. But I, I remember when he was like literally there, like he would only sleep if you were holding him. No, and it was like, what, what should I do?
- [15:09]
C
And you say like, the couch is far more dangerous and so you try not to sleep in the bed with your baby. So you sit upright on the couch and then you wind up falling asleep with the baby on the couch. And that's like, I forget the number. Multiple risk. Yes.
- [15:21]
B
The sofa. Sofa sleeping with your kid is extremely dangerous. And actually, I mean, it's not just that. So like I wrote recently and somebody posted something on Twitter that was like, yes, when I. We tried not to co sleep and I fell asleep nursing my son and I dropped him and I woke up to catch him right before he hit his head like that. Like that's a lot worse than Co sleeping. Like dropping your kid out of a chair.
- [15:42]
A
Yeah, like walking around in a complete sleep deprived days cannot be good for your kid.
- [15:48]
B
Right. Or you or other people driving where you're driving.
- [15:52]
A
Yeah, people. People worry about the risk of like, you know, something happening in the bed, whereas they. Yeah, exactly. The risk of just driving down the street having not got any sleep the night before is probably orders of magnitude greater.
- [16:03]
D
But I think this whole process though, in terms of like the idea of, you know, you putting out books where you're, you know, critiquing the. A lot of the literature and, or just investigating a lot of literature and then having people come back and ask questions. I mean, I think that's the whole point of like what makes looking at parenting through an economic lens so different than looking at it through the kind of medical lens of just right and wrong. Like this is the whole point is that there's lots of literature like that says different things and people can have different opinions and come from different places. And the point is you're supposed to kind of look at all of it and figure out like what makes more sense or more sense for an individual.
- [16:34]
A
Right? Well, I mean, no one is supposed to look at all of it. You'd need to be a crazy economist like Emily Austin. All of it. No, I mean, I'm serious, because at some point, especially if you're a mom, like, no one has the time to look at even a tiny part of it. And so you. We all look for heuristics, right? And then in a sense, like this is where all of these judgments come from is everything just gets boiled down to very oversimplified heuristics. And then people are like, well, if you don't follow my oversimplified heuristic, then you're doing it wrong.
- [17:05]
D
I also think that some of the judgment comes from the fact that it becomes very tied to identity. So it's seen as like, I am the type of person who does this. Like, I'm the type of person who breastfeeds or doesn't. So if I see someone who's not doing that, I view that as a judgment on my choice.
- [17:16]
B
Yeah, I think that is so much of it is that basically like these choices are so important. I want my choices not just to be right for me, but to be right for everybody. And I think you're thinking that.
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D
Right.
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B
And so when I see you making a different choice, I know you must think my choice is wrong. And I think some of the message of this book was like, hey, like, other people could make different choices not because they think your choice is wrong, but because, like, that's what works for their family. You know, Like, I'm like, the book is pretty. Is sort of like pretty positive, I guess, relative to mothers and co sleeping. But I would never have co slept with my kids. Like, that was like, totally. Like, my kids were in their own room on like they four. My daughter was on her own room, like day two. I mean, it was just. That was just like, not something that worked for us. But it doesn't mean that I think that like, co sleeping makes you like a bad parent. It just. It just was like, not for me.
- [18:00]
C
The other thing that I thought was really interesting about you and your book is your parents were economists, your husband's an economist. Like so many can you like. And at one point in the book, you mentioned that you and your husband use software to communicate.
- [18:15]
B
Asana.
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C
Asana. Yes. And I was just like, I need to hear more about what it's like just growing up with and now living with economists.
- [18:24]
A
And are your kids gonna be economists?
- [18:27]
B
Oh, my gosh, I hope not. I think we have like, it's like, enough. My. My nephew, who's like 10, is like obsessed with economics. Like, we brought him to my book party, which had a lot of professional economists, and he was like, this is amazing. Like, it's a me like Jim Perturba. I mean, I love. I love Jim Perturba, but I was like, I was like, oh, oh boy, we are in trouble. But my kids are not as into. As into economics.
- [18:57]
A
No, but I feel like that's the trick, right? It's all you always need to be like the nephew of an economist, and then you're inevitably going to become.
- [19:03]
B
Right. That's like, that's the key. Yeah, exactly. It's like, yeah.
- [19:06]
C
And we see how it affects the way you think about parenting. And I saw your husband's like, instructions on how to take out the garbage. And I was like, what.
- [19:15]
A
What are these instructions?
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C
They were just really detailed. They were like. It was like. It was like step one, two, three. And it was in two sections.
- [19:22]
B
Yeah.
- [19:23]
C
And it was. Well, it was like, at least I feel like eight different numbers.
- [19:27]
B
Instructions. Second section is quite long. Yeah.
- [19:30]
C
There was like a word I had to look up that I now don't remember. And then I was just thinking, I bet there are so many other things, like, what is it like to food shop? Like, how are you making decision decisions about your milk? Like, I just had. I feel like you could become Paralyzed. Looking at all the data and making decision trees. And I wonder how your training kind of impacts your everyday life.
- [19:47]
B
Yeah, I think we do have a kind of slightly weird over analytic approach to some of these systems. Like our family's very into systems. Like we like to have. You know, I have a system. I have like an, like an app, like a menu planning app. And then like, you know, on, on Thursday, like I like decide what we're going to have, you know, for some like. And then I have this, this, this app. And you like enter it into the app and then we have a grocery list.
- [20:10]
C
The app generates the grocery list?
- [20:11]
B
No, the app doesn't generate the gr. The app can generate the grocery list. But it's a little complicated. I haven't quite like gotten to the, to the point of using it for that, you know, and we've tried like various. When the kids were littleer and we had like even less sort of like emotional bandwidth, we had like a even more elaborate system where it was like there was a list of like staples and the nanny who was doing the grocery shopping would have to like check the staples list against the like stuff that we had. I mean it was like a sort of whole complicated system.
- [20:37]
D
Yes.
- [20:37]
C
I knew this would be like this.
- [20:38]
D
You know, I wonder if this could actually be very, very useful for a lot of like young parents because it's such a difficult time and it's a period where they always say like people's happiness goes down and their marriage suffers because you don't have systems. And so like as humans, we always think that we're doing more than the other person.
- [20:53]
B
Yes.
- [20:54]
D
Like that is how our brains work. And so I feel like if you can have like just a very detailed sense of like this is done here. This. You do this. I do this. It is like written down.
- [21:02]
B
I don't know.
- [21:02]
D
I feel like that could be useful.
- [21:03]
B
Yeah, I mean, this is what I like about it, the asana stuff. Because asana is like a task and you like assign people tasks and you kind of like see what tasks people are doing and then you can see when maybe you're doing more tasks.
- [21:12]
A
So I need to ask like, what is the optimal age to get your kid onto asana?
- [21:18]
B
Oh, I don't know. My kids are not on asana yet, but maybe like nine.
- [21:21]
A
Yeah, there you go. They'll be getting, they'll be getting a task. You get your ipod touch. But like the only thing which you're allowed to use is asana.
- [21:29]
B
Like a good idea, actually. Take off your Tasks. Yeah, I mean I do. I think in general, like we, partly because we sort of have the same job, we like use the tools from our job. It's like easy to sort of port the tools from your job into your life. But I think people should do that because like, you know, you spend like you go to work and think a lot about like how to organize your work life and you come home and just sort of like do stuff.
- [21:48]
A
An economist. Do economists use Asana?
- [21:51]
B
Yeah, sure. At work I use Jira and Asana. Wow. Two different task management systems. Which is like totally not. People use. Jesse uses GitHub. We haven't moved the family to GitHub because we don't do a lot of family coding.
- [22:03]
D
Not yet.
- [22:04]
B
Not yet. Not yet. Kids are a little small for family coding.
- [22:08]
D
Parenting and you know, raising children is such an enormous part of human life and yet it has just not been well covered historically by economists. I mean it just seems like an area that there hasn't been maybe quite as much study or maybe I'm totally wrong.
- [22:21]
B
Gary Becker is like seminal work on quantity quality trade offs in children. I don't know. I think economists have been.
- [22:27]
A
Well, so what's the conclusion? What did he conclude about?
- [22:32]
B
So there's a conclusion that there is a quantity quality trade off and that.
- [22:35]
A
In terms of how many children.
- [22:36]
B
Yeah, that like as people have more kids and that you can sort of invest less in them and so you.
- [22:39]
C
Kind of debunk that. Debunk it?
- [22:41]
B
Well, no, I mean, I think he was talking about like what if you have like, you know, having, if you have 10 kids. Like this sort of distinction, like this is about like the fertility transition. So like sort of the move from having like 10 kids to having like three kids. And sort of the idea that, you know, as people get richer you might want to have fewer kids so you can like invest more in them. I do talk about the question of like whether your kids are going to do worse if you have like three kids or two. Like do only kids, Are they weird? And it just turns out like that, like it's okay, whatever.
- [23:07]
A
I mean, so if you only have one, you shouldn't feel guilty.
- [23:09]
B
No, you shouldn't feel guilty. You only have one.
- [23:11]
A
Is there anything. So I mean, I feel like this is the general, you know, Emily Austin message is just don't feel guilty. If something feels right for you, don't feel guilty. Is there, are there exceptions to this rule? That's something I should feel guilty about.
- [23:22]
B
Vaccinations. Vaccinations are A big exception to this rule. I mean, I think part of the, like, in some ways the book is like, most of the things you're gonna do is fine, but you should vaccinate your kids and you should introduce them to peanuts when they're very smart.
- [23:35]
C
That was really interesting. I had the same with my kids. They were like, no peanuts.
- [23:39]
B
No peanuts. Yeah, that's what I got until one. Yeah, that's what I got with Penelope.
- [23:43]
C
That's so interesting that that's.
- [23:44]
B
And then it turned out that was like the opposite of. That's like, awful, awful advice. That is an advice that gave a lot of people peanut allergies.
- [23:51]
D
But I think that's also like, public service health advice in general is just that, like, it's true until it's proven that it's not true.
- [23:56]
B
But this is why it's so hard for people to trust us. And I think that's like, the challenge with this stuff. It's sort of like, well, I had one kid and then they were like, don't give her any peanuts. And then another kid, they were like, give him peanuts. Rub it on him. He's out of the womb. And then it was like, you know, of course, like, I understand, like, why those two pieces of advice are different and what changed about. And like, why these randomized trial was so helpful and so on. Like, I get that. But, like, if you. If you were not like, a person who spent your whole day, like, reading parenting studies and being an economist, like, it just. It sort of seems like you people tell me a different thing, like, every week. So now, like, what if next week, like, vaccines are bad? And so I think. I mean, I think we have to do a better job explaining to people why we come up with these recommendations, because otherwise, like, why would they trust the ones that are right?
- [24:36]
A
Although that's the really tough bit, right? I mean, there's been quite a lot of work on this question of what's the best way to communicate the fact that vaccines are a wonderful thing and perfectly safe and everyone should do it. And it seems to be unbelievably inconclusive. And basically no one's come up with anything that works.
- [24:57]
B
Yeah, that's right. I will say I can see a little bit why that's so hard in some of the interactions that I have had. So I've had a little bit of interaction with, like, the anti vaccination space around the book. And, you know, people have, like, kind of questions that I can't even sort of think about the answer to. Like, you know. Yes, I saw that, you know, enormous study from Denmark that showed that there was absolutely no link between autism and vaccines. But in Denmark, they give the first vaccines at three months, and here we give them a two months. So I don't really feel like that's applicable. And it's like, well, like, I don't even know. Like, there's like. There's just, like, no reaction. Like, I don't know what you would say in response to that.
- [25:30]
A
Like, you just say, like, honestly, they're just like, peanuts. Peanuts for vaccines. You vaccinate your kid against peanut allergies by rubbing peanuts on them.
- [25:37]
D
Yeah, well, because, like, it does seem like this is part of the problem where we talk about everything in the exact same way. We talk about the risk of, you know, whether or not you breastfeed for, you know, a year versus as though, like, that's the same thing about whether or not you vaccinate your child. Like, we don't speak in probabilities or like, maybe economists do, but most normal people don't. So I think that that's part of the problem is that people think of, like, oh, well, if this, as you said, like, if this one issue changed, then that means that this other one is exactly the same. And it's. It's challenging to figure out, like, well, how do you differentiate between these. Like, how do you differentiate between these risks?
- [26:09]
B
How can I rank your recommendations from, like, things I should definitely do to things where, like, you know, maybe that's a good idea, but, like, it isn't that big a deal if it doesn't happen.
- [26:17]
C
Yeah, we actually, we sort of talked about this a few weeks ago when we talked about YouTube and how they sort of moderate content and the difference between bright line rules and principles. And I feel like with your book, it's like, with vaccine, it's a bright line rule. Do the vaccines. And with a lot of other stuff, it's principles. It's like, well, if it works for you, then do it. If it doesn't work for you, like, it depends on your personal principle. Or take.
- [26:42]
D
It's just.
- [26:42]
C
It's like that.
- [26:43]
B
It is like that.
- [26:45]
A
So the peanut thing made me remember that you are quite famous in the world of economists and economics for being the economist who changed your mind on. It was like, happy.
- [26:59]
B
Yeah.
- [27:01]
A
Which you would think would be a more common thing, but it's like, there are lots of, like, probably human reasons why it doesn't happen that often. So tell me a little bit about that and then tell me, like, what, in terms of the parenting thing like, is, do you think, something you might conceivably change your mind on if there was, like, new evidence?
- [27:20]
B
So the sort of short version of this hepatitis B story is that when I was in graduate school, I wrote a paper which argued that some of the, like, excess number of boys in some Asian countries was because mothers who had hepatitis B were more likely to have boy children, and that rather than being due to, like, infanticide or something. And that was based on. And some data analysis I had done and some sort of existing evidence on this, like, link between maternal hepatitis B and child gender. And then that just turned out to be not right. And so there was, like, some other people who had some evidence that it wasn't right. And then I actually went and, like, collected a bunch of additional data and then showed that it also was, like, definitely not right. For sure, not right. And I published a second paper that was like, that this is not right. And it was, like, obviously a humbling and awful experience, but I survived.
- [28:06]
A
Was it bad? Because I feel like when I. When. Okay, because I. I have this feeling when I get things wrong on the Internet. I mean, I. My job is to get things wrong on the Internet, so maybe it's easier for me. But there is this, like, one period where you go, oh, no, I got that wrong. And then you write this thing saying, I was completely wrong about that. And then once you've, like, disburdened yourself of, I was completely wrong about this, and now I've completely changed my mind, I always feel quite good.
- [28:32]
B
I think it was. It was okay once it, like, once it sort of ended like that, like, that was a sort of better. And then especially since people were like, oh, that was like, a good thing to have done. But, you know, I was like, a junior faculty member, and this was like, one of. You know, it's not like I have a billion publications. Like, this was, like, one of my publications, and it was, like, totally wrong. And it was, like, the most visible publication I had. And a lot of people still. A lot of people are like, you know, you're like, liar. And like, you know, you're like, so this is not, you know, I wouldn't say this has ended in some ways, although, you know, most people now are like, I don't know, things have. They've moved on.
- [29:04]
D
So. Yeah.
- [29:04]
B
And so I think part of that experience sort of, like, made me want to be, I don't know, more. More careful or like, to sort of. I mean, I had had probably many different Implications for my behavior. I think in this, in this space of parenting, when I sort of look at the, at the stuff in the books, like, what are the things that are sort of most. Where like we're most likely to learn new things? I think it's partly that the places where we don't have as much data, so, you know, there are some things like breastfeeding, like, you know, we're gonna learn more things about breastfeeding over time, I'm sure, but the like, marginal knowledge is gonna be small because we, we really have a lot of studies of this already. A place where I think we're likely to learn a lot more are things like screens, where things like iPads, iPhones, impacts on kids. It's something where the data like, is not very good. Like, and in part it's not very good because, like, the kids, you know, who are using screens now, like, if you wanted to know, like, what's the impact of having access to iPads when you're two on high school graduation? Well, those kids haven't got high school yet, so we can't know. And so that feels like a place where we are going to learn more about that over time. And so I'm not sure so much I would change my mind because I think most of what I say on that is just like, like we don't have enough evidence on this.
- [30:10]
A
What's your general feeling about, like just the natural intuition of the parent about what's good and what's bad? Like, can, is it. Can you more or less trust your intuitions or is it it dangerous?
- [30:26]
B
I think in many cases your intuition is probably fine. So on things like screens, I think, like, I'm not sure I would say so much intuition, but like judgment, you know, so it's sort of like, okay, my guess is for most parents are judging me. Like, if your kid is watching like nine hours of screen time on their iPad a day, like, that's not good. And if you're using it for like, you know, a half an hour, 45 minutes, you know, three times a week, so you can like take a shower. That's like, almost certainly that's totally fine. And you know, where is the line in there? Like, that's more of a complicated judgment thing. But I think that's a place where like, you kind of, a lot of people's instincts will probably be okay. But then I think there are other places where like, I don't know, sleep training comes to mind where, like, it's pretty hard to sleep train your kid but actually it does have some benefits. And I think that, that, you know, sometimes people's intuitions, there may be a little, maybe you need to push a little bit into sort of reassuring yourself with the data before you decide to do it. I really sleep trained your kids.
- [31:20]
C
I. And I still look at it as literally best thing I ever did as a parent. Even after 10 to 11 years. We had an amazing doctor, Dr. Gold Woo. She was like on our, it was like our 10 week visit or something, I don't remember.
- [31:35]
B
And she's like in Tribeca Pediatrics.
- [31:37]
C
Yeah, Tribeca Pediatrics. Tribeca Pediatrics, yeah.
- [31:40]
B
Michelle.
- [31:41]
C
She was like, this is what you do. You put him in the crib, you kiss him, you close the door and you come back the next morning. And we were like, what? And it was really harrowing. The first night. I remember my husband got really upset and I was really upset just to hear him cry. And he cried a lot. My son, my daughter, when we did it, she didn't cry as much. But then that third night when everyone goes to sleep and you just, that's amazing. You, the parent sleeps through the night because that's what we really care about. We just want, I just wanted to sleep through the night. Please God, let me sleep through the night. And it was thrilling. It was just so thrilling to just wake up at seven in the morning.
- [32:14]
B
We had, our pediatrics practice was the Weiss Bluth practice, like the healthy, sleep happy child who's like one of the sleep training guys. And we didn't actually see him, but we like, like their practice was sort of into this and we had kind of a similar. At some point she was like, you know, you gotta just like do it.
- [32:26]
C
You just gotta do it. And then when you mentioned I knew about the Romanian orphanage. So like people say crying it out is bad because in Romania they let the babies cry and like the babies grew up and they were just, it was bad. They all were. They didn't develop, blah, blah, blah. And as you explain, like they were left alone for like years in their cribs.
- [32:45]
D
And they were Romanian orphans.
- [32:47]
B
Yeah, they were like. There was all kinds of other. I mean, it was like a terrible episode. It's like really not comparable not to this situation. And I think what, I mean, I think what people miss there, which you sort of alluded to, is like, it's sort of like, well, you know, you're just like doing this for yourself. It's like, well, parental happiness is like important. And you know, this actually has big effects on like maternal Depression and marital satisfaction, things which actually like also your baby is benefiting for, even if it was like putting you aside, like your baby is going to be benefiting from a non depressed parent. Also, older kids are probably rested, like these things are.
- [33:20]
C
And the baby's better too, because the baby gets to sleep more uninterrupted longer term.
- [33:26]
D
And I think this is also an example of why the thing that is like quote unquote natural is not always the best thing or at least not always the best choice for everyone.
- [33:33]
B
Because it's always the only choice.
- [33:34]
D
Right.
- [33:35]
A
You know, I mean, and of course, exhibit A being vaccines, right?
- [33:38]
D
Exactly.
- [33:39]
B
Yes. Yes.
- [33:41]
A
This is gonna be my favorite numbers round. Emily Oster, did you bring a number for the numbers round?
- [33:46]
D
I did.
- [33:46]
B
I brought 276, which is the number of the California bill about vaccine exemptions that Jessica Biel opposes.
- [33:55]
C
Jessica Biel really stepped in it.
- [33:57]
D
She did.
- [33:58]
C
And she deserved to be.
- [33:59]
A
Absolutely.
- [34:00]
D
Yeah.
- [34:00]
C
She's been criticized.
- [34:01]
A
Here's my question about anti vax, which is, you know, obviously we're in the middle of a measles epidemic right now, especially in New York State, and it's very much in the news. It seems to me that there was not to overgeneralize too much a kind of big lower middle class, Jenny McCarthy, Oprah, anti vaxx thing a few years ago, which didn't turn into a measles epidemic. And then at some point it spreads into an upper middle class Marin county sort of Jessica Biel demographic. And now it's, you know, Montessori school kind of. Now it's much more Waldorf school, much more prevalent. And it. I'm one of the things which I wonder about is why is it more dangerous among better educated parents?
- [34:51]
B
I think it's just that we like hit a point of concentration. I mean, measles is like super. It's like super contagious. But if, you know, there's like pockets of unvaccinated people, that's kind of okay. It's that we like got some of these concentrations of unvaccinated people and then you were like in trouble. So I think we just sort of hit. But I think something you said I find super interesting is we have very few health behaviors like this which are sort of clustered in like such different demographic groups. Right. So like almost everything else about health, it's like you get more education, you get better health. And like, this is like one thing where that's not true. And we have sort of these two pieces of like these kind of like High educated parents and then sort of like people with less education, both doings. And I think it's the question of.
- [35:31]
A
And then in New York State, there's, it's, there's the Jewish thing, the Jewish thing, which is Orthodox, which is just bizarre. Again, it came out of nowhere. It's not like, oh, yeah, Orthodox Jews don't vaccinate their kids. No one ever thought that way. And then suddenly it turned out that was true.
- [35:46]
D
What?
- [35:47]
C
Yeah. Emily, My number is also measles related.
- [35:50]
A
Oh, okay.
- [35:51]
C
So it's 1,022.
- [35:53]
B
I thought about using that number. That was my second choice.
- [35:56]
A
Is that the number of measles cases?
- [35:57]
C
Yes. In the first six months of this year, it's a record greatest number since 1992, which was before measles were technically eradicated in the United States. And New York State is like, I think the worst state right now. And yesterday they just. New York just passed a law getting rid of religious exemptions for vaccination. So hopefully we'll get this under control.
- [36:17]
A
Do you think?
- [36:19]
C
Yeah, I think so. I mean, I feel like there's been a lot of. We have a story solution which is a vaccine. Turns out for that it's worked before. And this is. The crisis isn't as bad as it was before the, the first time. And there has been a lot of media coverage. The Today show tweeted something that was like, jessica Biel talks about the controversy around vaccines. And like, you know, Twitter just exploded with, like, what? This is so irresponsible. This is the worst thing. Oh, my God. The Today show should be like, taken out back and shot for this. And like, in like 20 minutes, they were like, we're so sorry. You know, they put out a statement like, I think everyone's watching this right now and everyone understands how important. A lot of people understand how important it is. Jessica Biel, maybe not Jessica Biela Shymansky.
- [37:04]
D
Yes. My number is $28 trillion. And that's the amount that McKinsey has said would be added to GDP, global GDP, by 2025 if women were in the labor force at the same rate as men. Which I thought was an interesting statistic for a few reasons. Like, one, because it does indicate that, like, female friendly and just family friendly labor policies are actually extremely important. But I also thought it was kind of interesting because it brings up that whole concept, GDP being a slightly imperfect measurement, because it's like, it's not like the women who aren't. It's not like they're doing nothing.
- [37:35]
B
Yes. Yeah. No, it's somehow when you leave the. Like when you leave the home and you hire someone to work as your nanny, like, that's like great for gdp, Right. But when you're not quite. So there's sort of something a little odd in those metrics.
- [37:49]
A
My number is 0.6%, which is the population growth rate of China, which fascinates me because we are now 40 years after the one child policy first went into effect. Everyone knows that there's this magical 2.1 total fertility rate number. And if women have less than 2.1 babies, then the population shrinks. And the fact is that women have been having less than 2.1 babies in China for decades now, and yet the population is still growing. That it doesn't happen immediately that there's this sort of demographic lag. If you look at the sort of chart of which countries have a fertility rate below 2.1, that's half the countries in the world have a fertility rate below 2.1, but the overwhelming majority of them still have growing populations. And it's just like, I think there are like 17, mostly in Eastern Europe, which have actually falling populations. And I think we haven't really realized what the effects of low fertility are going to be because we have been sort of coasting along on this demographic momentum of growing populations anyway.
- [39:02]
B
Yeah. And the way that these populations are now growing is basically in a. To sort of have a population that's old people. Like survival rates have gone up.
- [39:09]
A
Exactly.
- [39:10]
B
And so we're now going to have like, very few kids and very many old people, which is sort of a totally different structure of the demographics than we had before.
- [39:17]
C
And that's where the US is headed. Right. And if we keep.
- [39:20]
B
Although our fertility is pretty good, pretty.
- [39:22]
C
High.
- [39:24]
A
It'S 1.7 now. So it's, it's, it's below 2.1, but it's a lot higher than most of like Western Europe. But, you know, there's a very simple answer to all demographic problems, which is immigration.
- [39:36]
C
Yeah, I was going to say that's the question mark.
- [39:38]
B
Of course it's not a global. We're not. A certain point. The planet is, you know, the planet still has a.
- [39:44]
A
The planet still has a growing population and all we need to do is find all of those, you know, Ethiopians and Nigerians and get them over to Europe and America and problem solved.
- [39:55]
B
So, yeah, really easy.
- [39:56]
D
Great.
- [39:57]
C
Good job. Good job, everyone.
- [39:58]
B
Good job.
- [39:59]
A
So that's it for the special crib sheet edition of Slate Money. Thanks very much for listening. Thank you Emily Oster for coming in. It's been amazing having you here. Do keep the emails coming on slatemoney@slate.com. many thanks to Jessamine Molly for producing this week and we will talk to you next week on Slate Money.