Dataset Information

Geographic Variation in Personality is Associated With Fertility Across the United States.

ABSTRACT: Levels of fertility and the shape of the age-specific fertility schedule vary substantially across U.S. regions with some states having peak fertility relatively early and others relatively late. Structural institutions or economic factors partly explain these heterogeneous patterns, but regional differences in personality might also contribute to regional differences in fertility. Here, we evaluated whether variation in extraversion, agreeableness, conscientiousness, neuroticism, and openness to experience measured at the U.S. state-level was associated with the level, timing, and context of fertility across states above and beyond sociodemographics, voting behavior, and religiosity. Generally, states with higher levels of agreeableness and conscientiousness had more traditional fertility patterns, and states with higher levels of neuroticism and openness had more nontraditional fertility patterns, even after controlling for established correlates of fertility (r ~ |.50|). Personality is an overlooked correlate that can be leveraged to understand the existence and persistence of fertility differentials.

SUBMITTER: Junkins EJ

PROVIDER: S-EPMC11364352 | biostudies-literature | 2021 Jan-Dec

REPOSITORIES: biostudies-literature

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Geographic Variation in Personality is Associated With Fertility Across the United States.

Junkins Eleanor J EJ Potter Joseph E JE Rentfrow Peter J PJ Gosling Samuel D SD Potter Jeff J Harden K Paige KP Tucker-Drob Elliot M EM Derringer Jaime J Briley Daniel A DA

Personality science 20210101

Levels of fertility and the shape of the age-specific fertility schedule vary substantially across U.S. regions with some states having peak fertility relatively early and others relatively late. Structural institutions or economic factors partly explain these heterogeneous patterns, but regional differences in personality might also contribute to regional differences in fertility. Here, we evaluated whether variation in extraversion, agreeableness, conscientiousness, neuroticism, and openness t ...[more]

PMID: 39220375

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Project description:BackgroundDespite numerous studies of geographic variation in healthcare cost and utilization at the local, regional, and state levels across the U.S., a comprehensive characterization of geographic variation in outcomes has not been published. Our objective was to quantify variation in US health outcomes in an all-payer population before and after risk-adjustment.Methods and findingsWe used information from 16 independent data sources, including 22 million all-payer inpatient admissions from the Healthcare Cost and Utilization Project (which covers regions where 50% of the U.S. population lives) to analyze 24 inpatient mortality, inpatient safety, and prevention outcomes. We compared outcome variation at state, hospital referral region, hospital service area, county, and hospital levels. Risk-adjusted outcomes were calculated after adjusting for population factors, co-morbidities, and health system factors. Even after risk-adjustment, there exists large geographical variation in outcomes. The variation in healthcare outcomes exceeds the well publicized variation in US healthcare costs. On average, we observed a 2.1-fold difference in risk-adjusted mortality outcomes between top- and bottom-decile hospitals. For example, we observed a 2.3-fold difference for risk-adjusted acute myocardial infarction inpatient mortality. On average a 10.2-fold difference in risk-adjusted patient safety outcomes exists between top and bottom-decile hospitals, including an 18.3-fold difference for risk-adjusted Central Venous Catheter Bloodstream Infection rates. A 3.0-fold difference in prevention outcomes exists between top- and bottom-decile counties on average; including a 2.2-fold difference for risk-adjusted congestive heart failure admission rates. The population, co-morbidity, and health system factors accounted for a range of R2 between 18-64% of variability in mortality outcomes, 3-39% of variability in patient safety outcomes, and 22-70% of variability in prevention outcomes.ConclusionThe amount of variability in health outcomes in the U.S. is large even after accounting for differences in population, co-morbidities, and health system factors. These findings suggest that: 1) additional examination of regional and local variation in risk-adjusted outcomes should be a priority; 2) assumptions of uniform hospital quality that underpin rationale for policy choices (such as narrow insurance networks or antitrust enforcement) should be challenged; and 3) there exists substantial opportunity for outcomes improvement in the US healthcare system.

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Dataset Information

Geographic Variation in Personality is Associated With Fertility Across the United States.

Publications

Geographic Variation in Personality is Associated With Fertility Across the United States.

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