All of JamesSnowden's Comments + Replies

Implicitly, yes. Though don’t use that exact formulation. money vs daly comparison is based on reported preference not swb. Daly vs swb comparison implicitly writes off time spent asleep where I assumed 1 daly = difference between 40->100 on swb scale.

If didn’t exclude sleep in botec, would make alcohol look worse as happiness bump from alcohol would be for lower % of time. (Set row 21 to 24)

>Another thought - you measure the effects of alcohol on subjective wellbeing as a fraction of someone's waking hours. This seems right from a subjective wellbeing perspective. But is that also the way you think about the value lost by a death? By consistency, you would also need to implicitly downweight the disvalue a death by a third for the time people spend asleep. Or do you already do that in your moral weights?

Oh that's interesting. It's been a while now since I did this, but I think I was implicitly doing that with this calc

>I'm not sure I follow the claim that if you assume that alcohol taxation merely shifts the tax burden, there aren't strong reasons to think the deadweight loss will be greater from alcohol taxation vs other forms of taxation. The subjective wellbeing study found that drinking increases people's wellbeing by almost as much as spending time with friends. It seems unlikely to me that if the tax were instead eg on income that the benefits of the income would be as large as this. Intuitively, this seems off.

Interesting. That doesn't seem off to me. If... (read more)

Hi Nick, thanks for your thoughts.

I agree air quality is meaningfully different from the other areas we highlight in terms of domestic salience (at least in India). But it’s not clear to me whether the existence of nascent government funding (and the consequent opportunity to improve the allocation of that funding) make philanthropic opportunities better or worse.

Efforts like the NCAP framework and 15th Finance Commission budget allocations in India are fairly new, and there aren’t well-developed playbooks for prioritizing and addressing sources of air pol... (read more)

Thanks Barry, 

At GiveWell (where I was working when we started the suicide prevention work), we discounted the impact to account for people who would otherwise die by suicide potentially living somewhat worse lives than a typical person in their context. Given the empirical and moral uncertainty, that estimate was based on a deliberative process and preference aggregation of different staff views rather than a single bottom-up model. Open Phil hasn't yet decided whether to incorporate a similar discount.

An overview of how GiveWell thought about it is ... (read more)

Thanks for the thoughts Kartik!

(Speaking for myself; the 10% estimate comes from work I did at GiveWell but others at Open Phil and GiveWell may disagree with me)

I agree we shouldn’t dismiss consumer surplus entirely, and in retrospect would soften some of the wording in that doc – I think the irrationality point is important but not totalizing. The Nielsen idea is interesting and I’d like to think about it more. I think internalities are less bimodally distributed between people than your model, which muddies the waters, but I wonder if an analysis like t... (read more)

Thanks for pulling this together! It's great to see more funders in the space

Thanks for editing Michael. Fwiw I am broadly on board with swb being a useful framework to answer some questions. But I don’t think I’ve shifted my opinion on that much so “coming round to it” didn’t resonate

>Since then, all the major actors in effective altruism’s global health and wellbeing space seem to have come around to it (e.g., see these comments by GiveWell, Founders Pledge, Charity Entrepreneurship, GWWC, James Snowden).

I don't think this is an accurate representation of the post linked to under my name, which was largely critical.

Thanks Jason, mostly agree with paras 4-5, and think para 2 is a good point as well. 

Do you think the neutral point and basic philosophical perspective (e.g., deprivationism vs. epicureanism) are empirical questions, or are they matters on which the donor has to exercise their own moral and philosophical judgment (after considering what the somewhat limited survey data have to say on the topic)? 

I think the basic philosophical perspective is a moral/philosophical judgement. But the neutral point combines that moral judgement with empirical models... (read more)

Sure, happy to elaborate.

Here's figure 4 for reference:

I think each part of this chart has some assumptions I don't think are defensible.

1. I don't think a neutral point higher than 2 is defensible. 

You cite three studies in this report.^[1] My read on what to conclude about the neutral point from those is:

i) IDinsight 2019 (n=70; representative of GW recipients): you highlight the average answer of 0.56, but this is excluding the 1/3 of people who say it's not possible to have a life worse than death.^[2] I think including those as 0 mor... (read more)

Thanks Jason, makes sense.

I think I’m more skeptical than you that reasonable alternative assumptions make StrongMinds look more cost effective than AMF. But I agree that StrongMinds seems like it could be a good fit for some donors.

FWIW I don't think GiveDirectly should be "the bar" for being considered one of the most effective organizations in the global health and development space.

I think both 5x and 10x differences are big and meaningful in this domain, and I think there are likely billions of dollars in funding gaps between GiveWell's bar (~10x) and GiveDirectly. I think donors motivated by EA principles would be making a mistake, and leaving a lot of value on the table by donating to GiveDirectly or StrongMinds over GiveWell's recommendations (I say this as someone who's donat... (read more)

I felt happy reading the nice things your colleagues are saying about you Max, all of which ring true to me. I admire your humility, thoughtfulness and level-headedness, and I'm looking forward to seeing what you get up to next!

Thanks, this looks like a helpful report!

It looks like this estimate comes from the proportion of countries the Bloomberg consortium and World Bank worked in that passed various policies over a decade without adjusting for the counterfactual chance of policy changes without their work.

I’m curious if CE had any luck trying to estimate the counterfactual (Eg by looking at other countries, trends before BB, or diving deep on individual case studies)?

Fwiw when I looked at this a few years ago (at GiveWell, not OP) I couldn’t find any evidence of a difference i... (read more)

Interesting thoughts Joel. Is the analysis in (9) public / could you point me towards it?

(I work at open phil but only made a tiny contribution to this report; I’m just curious)

(I work at Open Phil on Effective Altruism Community Building: Global Health and Wellbeing)

Our understanding is that only a small proportion of FTXFF’s grantees would be properly classified as global health or animal welfare. Among that subset, there are some grantees who we think might be a good fit for our current focus areas and strategies. We’ve reached out individually to grantees we know of who fit that description

That being said, it’s possible we’ve missed potential grantees, or work that might contribute across multiple cause areas. If you think that might apply to your project, you can apply through the same form.

Very helpful summary, thanks

On (1)

>people inflate their self-reports scores generally when they are being given treatment?

Yup, that's what I meant.

>Is there one or more studies you can point me to so I can read up on this, or is this a hypothetical concern?

I'm afraid I don't know this literature on blinding very well but a couple of pointers:

(i) StrongMinds notes "social desirability bias" as a major limitation of their Phase Two impact evaluation, and suggest collecting objective measures to supplement their analysis:

"Develop the means to negate ... (read more)

Excited to see your work progressing Michael!

I thought it might be useful to highlight a couple of questions I personally find interesting and didn't see on your research agenda. I don't think these are the most important questions, but I haven't seen them discussed before and they seem relevant to your work.

Writing this quickly so sorry if any of it's unclear. Not necessarily expecting an answer in the short term; just wanted to flag the questions.

(1) How should self-reporting bias affect our best guess of the effect size of therapy-ba... (read more)

I would deprioritise looking at BasicNeeds (in favour of StrongMinds). They use a franchised model and aren't able to provide financials for all their franchisees. This makes it very difficult to estimate cost-effectiveness for the organisation as a whole.

The GWWC research page is out of date (it was written before StrongMinds' internal RCT was released) and I would now recommend StrongMinds above BasicNeeds on the basis of greater levels of transparency, and focus on cost-effectiveness.

Thanks Holden. This seems reasonable.

A high impact foundation recently (and helpfully) sent me their grant writeups, which are a treasure trove of useful information. I asked them if I could post them here and was (perhaps naively) surprised that they declined.

They made many of the same points as you re: the limited usefulness of broad feedback, potential reputation damage, and (given their small staff size) cost of responding. Instead, they share their writeups with a select group of likeminded foundations.

I still think it would be much better if they mad... (read more)

I agree this seems relevant.

One slight complication is that donors to GWWC might expect a small proportion of people to renege on the pledge.

It seems like you're assuming that the GiveDirectly money would have gone only to the M-Pesa-access side of the (natural) experiment, but they categorized areas based on whether they had M-Pesa access in 2008-2010, not 2012-2014 when access was much higher.

Ah yes - that kind of invalidates what I was trying to do here.

I didn't notice that GiveWell had an estimate for this, and checking now I still don't see it. Where's this estimate from?

It came from the old GiveWell cost-effectiveness analysis excel sheet (2015). "Medians - cell V14". Act... (read more)

Thanks for this Jeff - a very informative post.

The study doesn't appear to control for cash transfers received through access to M-Pesa. I was thinking about how much of the 0.012 increase in ln(consumption) was due to GiveDirectly cash transfers.

Back of the envelope:

• M-Pesa access raises ln(consumption) by 0.012 for 45% of population (c.20m people).

• 0.012 * 20m = 234,000 unit increases in ln(consumption)

• GiveDirectly gave c.$9.5m in cash transfers between 2012-14 to people with access to M-Pesa. [1]

• GiveWell estimate each $ to GiveDirectly raises ln(c

I agree. Although some forms of personal insurance are also rational. Eg health insurance in the US because the downside of not having it is so bad. But don't insure your toaster.

I agree that dmu over crop yields is perfectly rational. I mean a slightly different thing. Risk aversion over utilities. Which is why people fail the Allais pradadox. Rational choice theory is dominated by expected utility theory (exceptions Buchak, McClennen) which suggests risk aversion over utilities is irrational. Risk aversion over utilities seems pertinent here because most moral views don't have dmu of people's lives.

In normative decision theory, risk aversion means a very specific thing. It means using a different aggregating function from expected utility maximisation to combine the value of disjunctive states.

Rather than multiplying the realised utility in each state by the probability of that state occurring, these models apply a non-linear weighting to each of the states which depends on the global properties of the lottery, not just what happens in that state.

Most philosophers and economists agree risk aversion over utilities is irrational because it violates the... (read more)

We wanted to differentiate the website slightly from the eaglobal site while maintaining brand coherency so went for a slightly different shade of blue which feels a bit 'calmer'.

Not wedded to it though and may change back. Which do you prefer?

Thanks Michael - fixed now

Thanks Ian - agreed it doesn't look fantastic at the moment. We embedded it on the website at the last moment and it screwed with the formatting. We'll be working to improve how it looks over the next couple of weeks.

Thanks Austen. This is really helpful feedback.

1. Yes I agree. This is important but very hard to quantify. Of course the causal relationship goes both ways (poor physical health poor mental health) but it's probable that mental health disorders have worse downstream effects than most physical health problems (economic productivity, stigma, impact on carers, physical health). We tried to capture these qualitatively at the beginning of the report but could have been clearer that they weren't included in the cost-effectiveness calculations.

2. Thanks - this is

Eric - this is so great! Coincidentally, CEA has also been working on a very similar report which was completed last week. It's here: https://drive.google.com/open?id=0B551Ijx9v_RoZWlUUFVTYWZ6aTVCUDRDLTViVHVyQVpPWVNn

I've shot you an email. We should definitely discuss our conclusions.

1) Ah yes - thanks for pointing out. Probably has limited external validity for the strongminds model though (which is psychosocial treatment alone for most patients delivered by community health workers, with only the most serious cases referred to clinics for medication). The numbers come from the Chisholm (2015) WHO-CHOICE model. http://www.bmj.com/content/344/bmj.e609

2) Analysis is here https://docs.google.com/spreadsheets/d/1-lCC1zQHVZlJS8f9OfqhzcZTetHMxuMkW7nT75QDGhk/edit#gid=960072536

[This is quick and dirty but gives a rough indication of cost-effe... (read more)

Just to add to this. Acute schizophrenia is one of the worst health conditions on GBD13 DALY weightings (c.0.8). Severe depression is also one of the worst (c.0.65).

See http://www.thelancet.com/action/showFullTableImage?tableId=tbl2&pii=S2214109X15000698

So Michael - I agree it's very possible that mental health disorders are underweighted by DALY weightings because of the focusing illusion. But they are actually weighted quite highly at the moment. 10 years with severe depression is worth approximately 3.5 years of healthy life.

Hi Michael! As I said before, congrats on an interesting paper.

A few points on this comment:

1) DCP3 didn't have any cost-effectiveness figures for the StrongMinds intervention (interpersonal group therapy). Is the $1,000/DALY figure you mention related to primary care advice on alcohol use?

2) I'm currently writing a piece on mental health for a HNW donor and tried to model c-e of StrongMinds. I got c.$650/DALY reducing to $400/DALY as intervention scales. The biggest uncertainty in this estimate is the long term effects of psychosocial treatment as hardly ... (read more)

Thank you all for some great responses and apologies for my VERY late reply. This post was intended to 'test an idea/provoke a response' and there's some really good discussion here.

Bernadette,

Thank you for your very informative response. I must admit that my knowledge of EBM is much more limited than yours and is primarily Wikipedia-based.

The lines which particularly led me to believe that EBM favoured formal approaches rather than doctors' intuitions were:

"Although all medicine based on science has some degree of empirical support, EBM goes further, classifying evidence by its epistemologic strength and requiring that only the strongest types (coming from meta-analyses, systematic reviews, and randomized controlled trials) can ... (read more)

Thanks both for thoughtful replies and links.

I agree that it may be counterproductive to divide people who are answering the same questions into different camps and, on re-reading, that is how my post may come across. My more limited intention was to provide a (crude) framework through which we might be able to understand the disagreement.

I guess I had always interpreted (perhaps falsely) EA as making a stronger claim than 'we should be more reasonable when deciding how to do good'. In particular I feel that there used to be more of a focus on 'hard' rathe... (read more)