#100wordreview – Harry’s Last Stand (Harry Leslie Smith) [Book]

An emotive defence of the society denied to us by neoliberalism. Tales from Harry’s 91 years are woven into a fact-of-the-matter narrative of today’s status quo. From upsetting accounts of a hungry childhood in the Great Depression to triumphs of love against the odds. Parallels are drawn between our brutal past and today’s social malaise, with striking effect. Harry’s angry and disturbed, but most of all he’s worried. Is society so inflicted by the wilful myopia and amnesia of government that Britain’s post-war progress will be completely undone? Harry’s seen this before, and we should listen.

Amazon / Google Books / Icon Books

Harry’s Last Stand: How the World My Generation Built is Falling Down, and What We Can Do to Save it

Hardback, 224 pages, ISBN: 9781848317369, published 5 June 2014

Marathon done!

It’s 48 hours since we lined up to start the Brighton Marathon… and about 43 since we finished it! Results here for those interested. It was both much harder and way more fun than expected.Marathon finishers


There are lots of people we need to thank. Thanks to everyone who sponsored us by donating through our JustGiving page. So far we’ve got £1,617.20 in the kitty, which is pretty exciting! If you’ve donated then you really should feel great for supporting the valuable work done by CRY. Thanks to everyone who offered me advice during training and in the run-up to the big day. Thanks to all our friends and family and all the volunteers, celebs and the strangers who came out to support us on Sunday. It’s amazing how a cheer and a few words of encouragement can keep your legs going at mile 21.

Tips for first-timers

This was my first marathon, and first race of more than 10k. If you’re considering doing a marathon you really should go for it. I don’t really have any particular words of wisdom to pass on, but here are a few things that were important for me on the day and might help you:

  • Run with a friend and stick together.
  • Your race time really doesn’t matter. Save that for your second marathon.
  • Keep running.
  • … but it’s ok to stop for a wee.
  • Thank the crowds – you’ll need them.
  • Vaseline. Everywhere.
  • Eat.
  • Follow a training plan, but don’t worry too much about it.
  • This book was useful (despite the New Age mumbo jumbo).


In two months’ time I’ll be running the Brighton Marathon in memory of Arabella. I’m raising money for Cardiac Risk in the Young (CRY), so for those who’d like to donate I’ve added a link in the sidebar→→→→→

Please do consider donating, or at least read the rest of this blog post before you decide you don’t want to.

I’m no runner. Or at least, I wasn’t until I signed up for the marathon. I was always one of the group walking at the back in ‘cross-country’ at school. Until recently I was running in a pair of £9 trainers bought from Sports Direct in 2011. I’m getting the hang of it though. If you’re the running/cycling type yourself, you can see my progress on my Strava profile.


Selfie pro

Arabella was (my partner) Rosie’s cousin, but much more like a sister. She died in May from a cardiac arrest, just 16 years old. The three of us spent a lot of time together, along with Arabella’s mum Clare and the rest of the family. I can only be thankful that we spent her last day together.

According to CRY, 12 young people in the UK die each week from undiagnosed heart conditions; a handful of these completely unexplainable, as in the case of Arabella. The randomness of the event makes it all the more devastating for the families of people who die in this way. This short video gives an accurate representation:

CRY are a great charity. They were quick to offer support after Arabella died and continue to do so. If you decide to make a donation, your money will be spent on CRY’s services such as bereavement support, as well as clinical research and their screening programme. Hopefully the work supported by CRY will someday reveal the mysteries of sudden adult deaths like Arabella’s.

I’m not the only one doing things to raise money. For starters I will be running the marathon with Rosie’s sister, Amy. Amy’s husband Peter will be walking 100km from London to Brighton in May. Rosie did a bake sale, and her brother Richard sang carols in Borough Market. Arabella would have turned 17 on February 21st. I’ve set up a Thunderclap on this day, which is where lots of people sign-up to send out a simultaneous tweet or Facebook post. Please do so by clicking here – it won’t cost you anything.

Arabella is missed so much by so many people. Please help us raise as much money as possible for CRY.

Economics: the death of a discipline

John Kay recently wrote an article titled “Economists: there is no such thing as the ‘economic approach’“. If Kay is right, and there is no ‘economic approach’, then to what extent is there a discipline of economics? To what extent is there economics at all? Here are my thoughts on the issue*.

In my field, a distinction has been made between economics as a ‘topic’ and economics as a ‘discipline’ (e.g. here and here). While the latter is (if it ever existed) doomed, the former might be salvageable.

The discipline

Most of us will agree that although there are overlaps between economics and other disciplines, the lines of analytical demarkation are sufficiently clear for us not to be in much doubt about the differences between the disciplines.

Culyer (1981)

While this may have just about held true 30 years ago, I do not believe it to be true today. For me, the economics of suicide (to which Kay refers) represents the suicide of economics. Gary Becker’s The Economic Approach to Human Behavior was an important milestone. One can look at Becker’s 1992 Nobel Memorial Prize as something of a watershed; though he is preceded largely by ‘proper’ economists studying explicitly market-based phenomena, he is succeeded by individuals who have achieved breakthroughs in mathematics, statistics, psychology, moral philosophy and history.

Do not get me wrong, this is a very good thing. It represents the success of interdisciplinary research and in particular the application of the scientific method to all aspects of life, and we are all the better for it. Outside economics, this conflation of science and social science is leading to painful lessons about the impossibility of quantification in certain aspects of human nature and social interaction (here is one recent example), but economics is the most vulnerable.

The discipline of economics is in a strange state of simultaneous ascendency and yielding. It is ascendant in its influence over any policy analysis and its application to all aspects of life. The reason for this occurring is clear; every action – human, animal, governmental, societal – relates in some way to the allocation of scarce resources. The Wiktionary definition of economics reads: “(social sciences) The study of resource allocation, distribution and consumption; of capital and investment; and of management of the factors of production.” And herein lies the problem; as we approach the lowest common denominators of knowledge, these issues are increasingly explained by other better-defined and time-tested disciplines. I am left wondering, over what does the discipline of economics have a monopoly?

The topic

Economics could survive in our lexicon as a topic. This topic is macro. The topic of microeconomics, it seems to me, can be entirely subsumed by other topics. Microeconomics is largely about agents. Humans are agents. The behaviour of these agents is primarily studied by psychologists, sociologists, ethicists, anthropologists, geographers and others, depending on scale. Firms are also agents. Firm-specific topics can reside in the realm of business studies – a far more modest subject than economics. Though an economist’s toolkit is undoubtedly of value to each of these disciplines, it is unclear which tools are exclusively those of the economist.

Inflation, unemployment, trade, growth. Economics may be saved by these topics – they will at least remain under the economics banner until its final day. But they are not safe. Each can be explained by their microfoundations in some combination with political science, philosophy and meteorology. Furthermore, marketisation and the spread of free markets means that society and the economy are now one in the same. One cannot be a quantitative social scientist without straying into the topic of economics. As such, it becomes unclear which topics are exclusively those of economics.

The choice

In my opinion, the primary value of economics today is its multidisciplinarity. But we already have a word for that. The inability of economics to restrain and contain itself is what will lead to its demise. Through its application to everything it will come to mean nothing. To my mind, economics has a choice. Either it can continue to expand itself into obscurity, or it can choose to restrict itself to the study of the economy and engage in the difficult task of differentiating (pun intended) the economy from society more generally.

No matter what, I suspect that economics has much the same destiny as natural philosophy. How long will it be before Economics degrees evaporate and we instead read Social Science? To be what was once termed an economist, one need simply sign-up for the BSc stream.

* This blog post is intentionally provocative, in the hope that people might engage with its content!

Priorities in academic publishing: quality vs quantity

A recent Twitter exchange got me thinking about academic publishing again. It seems to me that much of the current debate about peer review, publication bias and open access boils down to a conflict between quantity and quality, and I have a favourite: quantity.

Quality (the problem)

This is why we have peer review, to ensure that only the good stuff gets published. Clearly this doesn’t work, but I do still feel there is a place for peer review; not in the selection of the ‘best’ papers, but in the filtering-out of erroneous work. In the UK, the REF, and by extension universities, encourage quality over quantity. I have often heard school heads and research group leads trumpet the need for fewer, higher-quality papers. No wonder, if that’s what brings in the money.

Quality is important, for sure (even if our ways of defining quality are weak). However, in my opinion, these incentives are totally unnecessary for ensuring quality. The reason an economist might give half their right thumb to publish in American Economic Review over any other journal is not simply because of quantifiable career benefits and employability. No doubt the prestige gained (or the envy induced) is a sufficient incentive.

Quantity (the solution)

Isn’t this what current campaigns are striving for? We want to reduce publication bias through the publication of uninteresting or negative results. We want datasets and detailed methodologies made available. Yet academics are encouraged not to waste their time on these things and instead strive for that publication in AER/Science/Nature/NEJM. We want academics to stop prioritising prestigious journals with unscalable paywalls, yet this is exactly what they are currently incentivised to do.

Incentives for quantity should be appended to my previous suggested solution to the problems of academic publishing. The REF should reward quantity instead of quality, for example. Some research suggests that academics face a quality/quantity trade-off, while others suggest that the two may go hand-in-hand; no doubt this depends on the field of research. Nevertheless, a re-alignment of incentives towards quantity and away from (self-sustaining, immeasurable) quality would surely be better for academia as a whole.

Reddit for academics

I’ve finally figured out reddit, and it’s a great tool for academics. You should really give it a try.

Over the past few years I’ve dabbled in reddit, failing to really ‘get it’. I thought it was just a place for silly GIFs and celebrity AMAs (Ask Me Anything), but I was wrong. It’s a place to share links to interesting internet stuff, but more importantly it’s a place where these links can be discussed. So if like me you’ve tried it before and failed to grasp it, or if you fancy giving it a go, here’s my suggested route in.

  1. Read this.
  2. Sign-up. Choose a username. You can remain anonymous if you wish.
  3. Go to reddit.com/subreddits and unsubscribe from any stupid subreddits to which you’ve been automatically subscribed.
  4. Go and find some subreddits to join. For academics I suggest academicpublishing, DepthHub and Scholar. And if you’re a fellow health economist, try academiceconomics, Economics, healthcare and HealthEconomics.
  5. Have a look at your homepage. By this stage it should be full of articles that interest you. Follow the links. Vote-up the ones you like. Join the discussion by commenting on them.
  6. Take a look at your preferences. They can alter the experience somewhat.
  7. Head over to metareddit.com to find more subreddits you might like.
  8. If you use Chrome, download the reddit companion.
  9. Start submitting your own links and comments to subreddits and watch the discussion unfold. You can submit links to academic papers, blogs, silly pictures… whatever you like!

A word of warning. DO NOT use reddit exclusively as a means of self-promotion. You will be Shadow Banned, as I have been. Stick to the rule of thumb of no more than 1 in 10 of your link submissions being some way self-promotional. The number of links you can submit is, in some secretive way, defined by your ‘karma’. You get karma by posting links and comments that other people like. Just be helpful and nice and you won’t fall foul of the reddiquette police.

New working paper – ‘The relationship between individual risk and cost-effectiveness in screening interventions’

I’ve just released a new working paper, along with my co-authors Profs Marilyn James and David Whynes. You can access it through RePEc here. The paper discusses the (somewhat obvious) relationship between a person’s risk of developing a disease and the cost-effectiveness of screening them. This is important because publicly-funded screening interventions will, in the future, I suspect, have to discriminate based on risk.

Here’s the abstract:

Advancements in our understanding of the causes and correlates of disease mean that we are now able to estimate an individual’s level of risk. This, and the ever-increasing need for healthcare interventions to be cost-effective, has led to calls for the introduction of risk-based screening. Risk-based screening would involve the use of information about an individual’s risk factors to decide whether or not they should be eligible for screening, or the frequency with which they should be invited to attend screening. Evidence is emerging that targeted screening, towards those at higher risk, can increase the cost-effectiveness of a screening programme. The relationship between individual risk and the cost-effectiveness of screening an individual is implicitly recognised in current population screening programmes in the UK. However, the nature of this relationship, and its implications for cost-effectiveness analysis, has not been presented in the academic literature. In this study we propose that an individual’s risk of developing a disease has a consistent and quantifiable relationship with the cost-effectiveness of screening them. We suggest a simple modification to standard methods of cost-effectiveness analysis that enables the incorporation of individual risk. Using numerical examples we demonstrate the nature of the relationship between risk and cost-effectiveness and suggest means of optimising a screening intervention. This can be done either by defining a minimum level of risk for eligibility or by defining the optimal recall period for screening. We suggest that methods of decision modelling could enable such an analysis to be carried out, and that information on individual risk could be used to optimise the cost-effectiveness of population screening programmes.

I’d really appreciate any comments you might have on this paper. Feel free to post below or alternatively please send me an email.