A Conversation with Emily Oster: The Economics of Pregnancy, Parenting and the Pandemic

Himalaya.
Hey, justin you know what, I think it's time for
us to learn a few lessons in parenting.
I've often felt that way that my co parent would
tell me that's a little more direct than I expected,
But you're right.
You know it turns out economics has a lot to
teach us about parenting.
And today on Think Like an Economist, we have one
of the world's experts, not just on economics, but on parenting,
and so I'm super excited that today we're going to
welcome Emily Asta to the show.
She's one of the most interesting economists I know, and
I was really excited that she agreed to come on
Think Like an Economist because she has written three great
books that help parents use the tools of economics to
make better parenting decisions.
And it's not just directly important. It's a great way
of flectioning as economic muscles and seeing that the principles
we've learned and through this podcast.
Can be used in your daily life as a parent.
And in just about any other role you play as well.
Emily Austar is a full professor of economics at Brown University.
As one of the most interesting and diverse portfolios of
any economist on the planet. I'm thrilled she's here to
talk with me. Betsy Stevenson and I'm Justin Wolfis on
today's episode of Think Like an Economist. Emily. It's my
pleasure to welcome you to Think Like an Economist. Thanks
for joining us today.
Thanks for having me, Emily.
I remember talking to you when I was first expecting
and talking about how I was really having a hard
time navigating the advice I was getting. I'm guessing that
was your experience too.
Yeah, it was.
I think that the experience a lot of us have
that you are used to having a tremendous amount of
autonomy and decision making and time to take to sort
of think about the advice you're getting, and pregnancy felt
a lot like being bossed around and relatively little like
I was being asked to make decisions on my own,
even though they felt like decisions that both were very
important and also that I could engage with with some
of the tools of data and statistics and economics that
I was used to using at my job.
So can you give me an example of a decision
that you think you were better able to make using
your tools as an economist than what you were told
or advised to do by medical professionals.
Yeah, so I think for me, the place that really
started was in decisions about prenatal testing.
So when I got pregnant, there were.
A set of what I viewed as sort of very
arbitrary guidelines around prenail testing, which said that women over
the age of thirty five should have one procedure and
women under the age of thirty five should have another procedure.
And generally, as economists, we would not think that a
good decision making would be so bifurcated like that around
something like age, which is pretty continuous. And so I
spent a lot of time thinking about that and turned
out there's kind of two things that were missing from
that calculus. One was the data underlying the risks of
these procedures was very old and very poorly understood, and
so some of what I was doing with my economics
training is digging into the data piece of it. But
then there was the other side, which is that in
economics to spend a huge amount of time trading off
costs of benefits and thinking about through the role of
preferences along with data, and in this particular example, the
guideline of over thirty five hundred thirty five was based
on effectively assuming everybody had exactly the same preferences about
the sort of relative risk for these things, which seemed
very unrealistic. So for both of those reasons, that decision
was much better approached, at least in my view, by
using some decision theory and some data analysis rather than
just taking this arbitrary age cutoff as gospel.
It sounds like you're talking bit the decision about whether
to get an amniosynthesis.
Yeah, so it it's more than that. So there was
a set of decisions about whether to get an amnios andthesis,
whether to get a CBS test, which is a different thing,
or whether to get some other kinds of screening which
provides some information but less good information. So it's actually
a sort of a suite of things that one chooses between.
One of the things that really struck me with that
is that there all of those procedures have a risk
associated with them. Yet no one really asked you, what
would you conceive the benefit of being as you said,
They thought about that your age, But what would you
do with the information? How would it make things different
for you? Which would surely inform the benefit, which would
help you figure out how to trade off the risk,
and I found that completely absent as well.
Yeah, I sort of started with that because in some
ways that was the most surprising to me, because it
felt so much like, Okay, a huge, hugely important part
of this decision is how valuable is this information. If
I'm not interested in the information, if it wouldn't be
at all decision relevant, I don't know why I would
get it at any risk. Whereas for some people, and
I was in this camp, that information was really valuable
that I would have changed a lot of things that
I was going to do as a result of having
different information and knowing which camp you're in, how much
this information matters, how much it would change your decision
seems like almost the first thing and certainly not something
that should be completely ignored.
And so for our listeners, the superpower it sounds like
you were using is what we call the cost benefit principle.
And your argument seems to be that that's a more
central principle to economics than it is to medicine.
I think that's right.
I mean, I think that there is a cost benefit
principle that underlies a lot of things in medicine.
But there are also many places.
Where we have kind of gotten to some kind of
rule of thumb which maybe is based on a cost
benefit principle, but it's based on a kind of average
cost benefitrate off or like a cost you know, cost
benefit trada.
For the average person.
And since there could be heterogenating across people, so not
obvious that would make the right decision for every person.
So I think it is also certainly the case that
we spend a lot more time on cost benefit trade
offs and economics than you do in medicine, at least
in terms of the training.
So ultimately you gave birth not just to a beautiful baby,
but also a beautiful book, and your book Expecting Better
is the first thing that Betsy and I as fellow economists,
give any of our friends when they get pregnant, because
we want them to be able to think about these
decisions using ideas like risk and uncertainty, costs and benefits
and the like. How was the book received? Not by
your fellow economists. We're a pretty easy sell. There are
a fair few people who might think that economics doesn't
really or shouldn't really have much to say about women
and children's health.
It's interesting you say that.
So I actually think, if I think about the reception
of the book, I would say that that, at least initially,
probably the worst reception was from economists, because I think
it was at complicated to be a person who was
trying to be a professional economist and also writing this
book which is sort of written for a lay audience
about pregnancy, you know, and I think from pregnant women, much.
Of the reaction was very good.
I think there was some, you know, some demand for
this idea of thinking of pregnant women as people who
can make their own decisions and who can actually engage
with the data. But certainly early on especially, I did
get some pushback from doctors in the kind of space
of like, who are you? You're not a doctor, Like
you're just some economist, what are you bringing to this.
I think over time I've managed to convert some of
those people, but I don't know, it's been a while.
Emily.
I wanted to start at the very beginning of your career,
and in fact, I'm going to start the beginning of
your career all the way back to in utero, because
you're the child of two economists and you yourself as
a child, were the focus of academic study. And I'm
wondering how you think all of that shaped who you
became as an adult and who you are. You know,
your path in economics.
Part of what I gained from having parents who are
economists is that I knew what economics was that was valuable,
and I think that, you know, not everybody does, and
so I think I knew this.
You know, I knew this was a job. And I
always really liked data.
So the fact that I become an economist who's kind
of primarily data focused, I think isn't too surprising, because
that was something I loved you even as a relatively
young kid, and I've always sort of liked doing research.
So I think all of those pieces, how much were
they influenced by my parents?
And how much are they? Are they genetic?
It's always hard to sort of pull things together like that.
I guess one thing I will say is that my
mother is a really gifted teacher and a person who's
understanding of basic economic concepts is really really very deep,
and that let her convey many of those concepts to
us while we were in our sort of the course
of our regular life. And so I think part of
what has made me good at using those economic tools
to help people make decisions in their life is that
I kind of grew up with somebody doing that all
the time.
One of the reasons it's important to me that we
talk about this with you is because you know, a
lot of economists, but not all economists, really do use
the tools of economics to make decisions in their daily life,
and it had struck me that that was sort of
how you were raised. So, you know, raised to make
decisions like an economist. But I also you know, your
questions from the very beginning of your research career have
always been much broader than the questions economists typically ask.
What's driven? How you figure out what question you want
to ask in your research.
You know, I think I've always just asked questions that
I found interesting and been sort of pretty agnostic about
unstrategic agnostic I'm not sure what the word is reoting
for there, about whether they sort of fit into the
stuff that I was that I was doing. And so
I think that's been really freeing and it's part of
why I love doing research. I think part of what's
hard about sometimes hard about being an academic is that
it is very self driven. You really need to love
doing it because you fail a lot, and people tell
your work is garbage and the referee to is the worst.
And it has to be the case that you love
the activity of doing it. And the thing that helps me,
that has made me love the activity of doing it
is that I get to work on this stuff that
I think is interesting, even if that's.
All kind of occasionally a little bit all over the place.
Let's fast forward to more recently, because you really plunged
yourself into trying to understand the risks to kids of
COVID and how parents could really think about costs and
benefits when they were making decisions about how to navigate
the pandemic and the risks of COVID for their kids.
I got involved in this initially because I had started
doing some writing through a newsletter of all things for parents,
and the intention was to really write about the things
that I write about my books, so really, you know,
parenting and pregnancy. But I happened to start of the
news around the time that the COVID pandemic started, and
I then sort of pivoted a little bit to really
responding to a lot of the questions I was getting
from parents, which were about how to navigate decision making
in the world of COVID, So how to think about
questions like should I send my kid back to childcare
when it's available, should I see my grandparents? How should
I think about the risk to my kids, the risk
to older people? And like a huge amount of that
early on work that I was doing in the pandemic
was really about kind of decision tools and helping people
think about how to trade off cost and benefits, because
I think it's often one thing to tell people, oh,
trade the cost and benefits, like, think about the cost
and benefits, but it is easier to do that if
you have more scaffolding around well what does that actually mean?
What are those costs and benefits? But also how can
I put them together? And how can I kind of
have a structure to make good decisions. And then I
part of the sets of things people really wanted to
understand was like, Okay, great, I want to trade the
cost and benefits, but I don't know the disease risks.
I don't actually understand the data around these questions, So
how can I think about whether it's send my kid
back to school if I have no idea, if school
is a place where a lot of people are going
to get COVID, And that pivoted me into doing some
actual data collection around COVID and schools, which wasn't really
being done by others, and ultimately I think playing somewhat
more of an advocacy role around the idea that we
should have opened schools more and that we should continue
to keep them open.
Emily, you just said we collected some data. I fear
you're being a little modest, So tell us a little
more about the data that you collected.
In the skylee of the effort, we started in a
way that I thought was very simple, which was to
try to get as much information as we could from
schools and school districts in the US about their reopening plans,
how many students teachers they had back in the classroom,
and this was back in the ball of twenty twenty,
and then to track their COVID cases over time and
sort through a combination of our efforts the sort of
individual schools and districts we were working with and working
with states to get the data that they were in
some cases collecting systematically. We were able to build this
public facing dashboard which we kept updated over the whole
school year, and by the end was reporting out data
on twelve million enrolled students, which is something like, I
don't know, like a little more than twenty percent of
the whole US population in that group.
So it ended up being a reasonably large data effort.
And you described yourself in a moment ago as you
said you went from doing research to advocacy around these issues.
It seems like a very complicated line. I was surprised
you use that description. Where does analysis end an advocacy begin.
I grappled with this a lot over the last year, because,
you know, if you sort of started me at the
being of a pandemic and you said, your goal in
this pandemic is to write sort of a definitive research
on how much COVID is spread in schools. Doing that
would require a particular approach where you probably take a
relatively small sample of schools and you would study them
really intensively and try to look at how, you know,
when there was a case in the school, do really
careful contact tracing, and try to kind of really dig
into who is spreading to who and how much spread
is there and so on, And there actually were researchers
that did that, but it took months and months and
months and months to get that data. And what we
were trying to do, I was not thinking about it
explicitly as research. It was really about sort of public
service data collection, where we were getting information from schools
about how many COVID cases they had, but not following
up in this sort of super detailed way. But I
thought at the time and I continue to think, that
there was something incredibly valuable about having any information, because
at the moment we were starting doing this, there was
no information, and it was a time in which schools
had to decide about whether they should be open, and
there were real consequences of not being open. So it
felt very different than some of the time skills that
we do our research on, much more like, we need
the answer to this question, now, let's do what we
can to get a good answer to this as quickly
as possible, or the best answer we can get in
the timeframe that we have available.
And so that felt valuable in many ways to me.
But it's also really different than doing research, even though
it has many of the same tools so sort of
a complicated it's based in advocate.
I want to take you where this research went, which is,
ultimately it led you to believe that we should be
more aggressive about reopening schools. That's a reasonable summary.
Absolutely, that's correct.
And so that was a conclusion you weren't shy about,
and it put you very much in the public eye.
And I've been involved in a fair number of economic
debates in my time, but I don't think I've ever
seen another economist receive as much vitriol as I saw
you endure it through that period. I just want to know, like,
what does it feel like to be in the eye
of the storm? How did you deal with it? How
do you maintain your bearings at a time like that.
When people gall at you, it feels as terrible, And
I think even the people with the sort of the
thigkest skins still feel bad.
I don't.
I think I have a figger skin than I did
eighteen months ago. But it's it's not that big in
those moments. Really, most of what you can say is like, boy,
I'm really glad that I have a spouse and kids
that I like. I mean, it's true, like because I
think that we see this in research on sort of
how kids deal with bullying and how what makes you
a kid who was resilient to bullying, And the answer
is sort of in part like having a place to go,
having a family that is kind of there to scaffold you.
And so I think when you spend the entire day
having people send you emails that so if someone sent
the an emails of the president of my university and
the provost and my department chair and me saying you know,
you're the university should now have a department of genocide studies,
which should be headed by this person, right, And so
when you have that day, it's actually like the sort
of the only thing you can do is go home
and have your kids be like, yeah, I had a
good day and you know I got it, did well
my test and this person was nice to me.
And you know, have your spouse be like, well, I'm
not on Twitter and doesn't sound great, but like I
like you. So I mean, I do think that was
sort of all.
It was a very hard time, and I think I
really relied on the kind of family being totally separate
from it.
I think, just to be clear, justin described you as
having a position. I think throughout the whole thing which
you were trying to do is take the tools of economics,
which is, how do we break things down on the
margin and think about marginal benefits at marginal costs. How
do we then figure out what those costs are, including
opportunity costs, and you know, put it all together in
a way that parents might have come to different decisions.
But it was clear that the risk of kids in
school was lower than a lot of people were thinking.
I think the problem was people who came to it
with a preconceived idea that their kids needed to stay home,
and then they were angry at you for giving them
a way of thinking about it which maybe they would
come to a different conclusion, and they didn't know how
to process that.
Yeah, I think that was I that was a piece
of it.
And the other way I ended up processing a lot
of it was it was a lot of fear among
both parents and school staff, and it was very hard
almost to accept the idea that like, Okay, we stayed
at home all this time, and like now I'm going
to go into this classroom and we know that kids
give each other illnesses, Like that's one of the things
you know about being a parent is when your kid
first goes to childcare, they come home with a cold.
And it's actually, I think been very hard for people
still to kind of shift to really understanding like the
sort of age pattern of COVID is just not like
the age pattern of the flow or these other or
these other things for reasons that.
I don't think are super well understood.
And so the result is that schools were way less
sources of spread than actually even I had I had
been pretty optimistic, but it was actually the sort of
circumstances in the fall of twenty twenty were better than
I had expected them to be. One of the more
striking conversations I had during the last year was sometime
in maybe November, I talked to a superintendent in North Dakota,
which at the time had, you know, an enormously bad outbreak.
It was like, by far the worst place in the US.
And you know, his schools.
Had been open full time in person for the entire fall,
and I said, you know, are you going to close?
And he said, well, you know, we haven't really seen
any spread in school even though the keys rates are
incredibly high.
We're just not seeing it.
In school, and so we're just going to stay open
basically until we have to close for staffing reasons. And eventually,
you know, they had to close for a couple of weeks.
But I think as a result of like spread that
happened at family gatherings over Thanksgiving, and so that was
striking to me because it felt like, boy, this is
a place where if you're going to pick somewhere to say,
you know, there's like full non distance, like fully dense
in person learning in the high school in North Dakota
in the middle of the biggest outbreak. If that guy's saying,
we're really not seeing a lot of spread in schools,
that was telling.
So, like you, both Betsy and I were somewhat active
during the pandemic and trying to give policy advice. One
of my great fears was that I was giving the
advice that I wanted to hear rather than the advice
that was analytically justified. Did you have a similar fear
and if so, how did you deal with it?
Definitely? I mean I particularly had that fear in the
summer of twenty twenty because of course I wanted my
kids to go back to school, and so in some sense.
It was good that by the time we got the data,
my kids were already at school, so it was a
little like, okay, well, I like already accomplished you know,
that piece of it. But I think it is impossible
not to grapple with that and feel like, Okay, how
am I going to be to sort of be be
honest here when, unlike in almost all of my other research, actually,
you know, something that could affect the functioning of my
family or could affect my kids is sort of riding
on some of the research. I will say, there's a
sort of flip side of that, which is that I
think some of what made me so willing to put
up with some of this vitriol and sort of keep
collecting this data and put all this time into this
was that I saw what happened with my kids in
the spring of twenty twenty, and you know, we are
a family with a tremendous amount of resources and people
who could work from home and childcare help, and still
the sort of being home in the spring of twenty
twenty was really, really, really hard on my kids. And
there's a moment of realizing, if that's true for my kids, like,
imagine what this is like for all kids who do
not have these advantages. And I think that sort of
thinking about that pushed a lot of this, like, you know,
we need to figure out how we can if it
is possible to do this safely, and you know, how
we can how we can do it Emily.
One of the things that I worry a lot about
is that economists, pretty economists who work on education, we've
spent a lot of time trying to say, well, we
can evaluate schools by measuring how kids do on certain
tests and looking at test scores, and so now we're
going to see what was the effect of the pandemic
on kids by looking at what happened to their test scores.
But when you talk to parents about the effect of
the pandemic on their kids, the learning and test scores
is not usually the first thing they want to talk about.
It's the isolation, the anxiety, the developmental, social emotional, developmental
issues that seem to be at the forefront. And I
guess I'm wondering if you've thought about that, if you
agree with that, and then also how do you think
economists would go about trying to assess.
That is exactly right?
I think the chess course, stuff is easier to measure,
and I think we will see data on that pretty
soon or at least at some point. But I also
think all of these other things are much more front
of mind. I think there are things that we can measure,
at least in some sort of extreme senses. Right, So
things like depression and anxiety and sort of mental health
diagnoses and prescriptions for medications to deal with those issues.
Those are all things that we can, you know, a principle,
see in the data, and I think we will see
people start analyzing that. I think it will be extremely
important to try to continue these sort of follow ups
over time and to try to understand, you know, is
this a short term impact? Are these longer term impacts?
You know, how we say the kids are resilient. I
believe the kids are resilient, but you know, are they
going to need more scaffolding? Not just for three months
or six months, but you know, maybe for a longer
period than that.
Emily, one of the things I had that the listeners
of Think like an Economist get is not just an
understanding of economics, but the ability and will willingness to
use those tools in what have a leadership reals they
play in their own communities. That's exactly what you've been doing.
So would you mind just sort of stepping back and
do you have advice for our listeners on how they
can use the economic tools that you and I love
to show this sort of leadership in the communities.
Some piece of it is about kind of making sure
that you have good data and that you're sort of
thinking about how to translate that data in a way
that is understandable. I think in some sense, if I
think about what I bring to the table and a
lot of the work that I do, it is really
a translation rule. So there's a lot of kind of
it's not enough to just have the data. You actually
need people to engage and understand what you are showing them.
And that's different from like lying with statistics. But there's
a piece of you know, just showing people your raw
data is actually not so helpful, and sort of if
you are a person who is in a position to
engage with the data with the independent research, how can
you take that and then kind of make sure that
it is as useful as possible for people for whom
the like engagement with the raw data is maybe less fascial.
I want to dive a little bit again into the personal.
It's no secret that economics is a male dominated field,
and I was hoping you could reflect a little on
what it's like to be an economist, well female.
I think when you when you are in an environment
in which there are mental being a woman in a
male dominated environment like this, you you kind of get
used to some things. And there are occasionally moments when
I when I was sort of reflect I'm like, oh, actually,
like that probably wasn't okay, but sort of in the
in the moment, it didn't. You know, it doesn't seem
like too big a deal. And I think, you know,
part of it is I've been very lucky and I
haven't had any particularly terrible gender type experiences in the profession,
at least not very direct ones. But you know, I
think there are opportunities that we have to try to
make this better for the next generation.
I guess that's that's a lot of what I what
I think about.
So, you know, people say a lot of you know,
sexist stuff, and I sometimes not just economists, just you
know people in general, And I think sometimes about, you know,
what are the circumstances in which I want to publicly
respond as opposed to just kind of ignore it because
you know, I'm very lucky and I feel like I've succeeded,
and I actually don't need to respond all of those things.
And I have found that the places that I respond
are when there is someone more junior who will see
that response, because I want the women who are more
junior to me to understand that, like, that kind of
behavior is not okay, even if there are times in
which individually, I'd rather just let it go than kind
of engage with it.
I hear you so deeply on that, because you know
and trying to figure out where your responsibilities lie, and
you know, making sure things are better for the next generation.
And I have to say I've watched, like, you know,
young female economists in their twenties PhD students who are
just much more aggressive about calling things out and demanding better.
Do you feel I mean, maybe you don't feel this.
I feel in some ways I feel little a shamed that,
like I just maybe I should have been doing more
of that.
Yeah, I know that's how I feel, Like, Oh, why
didn't I.
Just maybe that wasn't okay when they said those things?
You know I should have said I should have said something, right.
I know that it's that my own fear of the consequences,
you know, absolutely.
I know it's not it's partly just not, you know,
not having wanted to be brave and just want to
say like, okay, I'll just let it go and like
we you know, later once I like, i'll fit in
and you know, once I've made it all, I'll do
these things. But then they're doing it now, and I think, oh,
I guess maybe that was an option.
Right, But you've done some super brave things in your career,
and I have to say when you wrote Expecting Better,
I thought that was a very brave thing to do,
not just because it was a popular book, which was
super brave to do at that stage of your career,
but because it was a very gender and popular book.
Right. If it had been a book about golf, I could.
Yeah, everyone be like, oh yeah, book about.
Golf, super interesting.
Yeah yeah, But.
It's a bug about Bajaina's gat for you.
Emily Austa, I could talk economics with you all day,
and you've been so generous with your time. Let's have
one question. Our listeners are here to learn how to
think like an economist. We don't all have the twenty
years to study the field that you and I have had,
So what advice have you got for them?
Always think carefully about framing your question before you think
about the cost and benefits. That when you want to
think like an economist, the cost benefit principle is really important.
But you want to make sure you understand what you're
trading off between so you can do the cost benefits right.
That's a brilliant answer.
It's a great answer.
There you go, you have framed things perfectly for us. Emily.
Let me just say thank you for your time.
Thank you guys for having me.
It was great talking with you today. Thank you, Emily,