We document a divergence in the duration of rule for monarchs in Western Europe and the Islamic world beginning in the medieval period. While leadership tenures in the two regions were similar in the 8th century, Christian kings became increasingly long lived compared to Muslim sultans. We argue that forms of executive constraint that emerged under feudal institutions in Western Europe were associated with increased political stability and find empirical support for this argument. While feudal institutions served as the basis for military recruitment by European monarchs, Muslim sultans relied on mamlukism—or the use of military slaves imported from non-Muslim lands. Dependence on mamluk armies limited the bargaining strength of local notables vis-à-vis the sultan, hindering the development of a productively adversarial relationship between ruler and local elites. We argue that Muslim societies’ reliance on mamluks, rather than local elites, as the basis for military leadership, may explain why the Glorious Revolution occurred in England, not Egypt.

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Background As a result of the continuing surge of COVID-19, many patients have delayed or missed routine screening and preventive services. Medical conditions, such as coronary heart disease, mental health issues, and substance use disorder, may be identified later, leading to increases in patient morbidity and mortality. Methods The National Emergency Medical Services Information System (NEMSIS) data were used to assess 911 Emergency Medical Services (EMS) activations during 2018–2020. For specific activation types, the percentage of total activations was calculated per week and joinpoint analysis was used to identify changes over time. Results Since March 2020, the number of 911 emergency medical services (EMS) activations has decreased, while the percentages of on-scene death, cardiac arrest, and opioid use/overdose EMS activations were higher than pre-pandemic levels. During the early pandemic period, percentages of total EMS activations increased for on-scene death (from 1.3% to 2.4% during weeks 11–15), cardiac arrest (from 1.3% to 2.2% during weeks 11–15), and opioid use/overdose (from 0.6% to 1.1% during weeks 8–18); the percentages then declined, but remained above pre-pandemic levels through calendar week 52. Conclusions The COVID-19 pandemic has indirect consequences, such as relative increases in EMS activations for cardiac events and opioid use/overdose, possibly linked to disruptions is healthcare access and health-seeking behaviors. Increasing telehealth visits or other opportunities for patient-provider touch points for chronic disease and substance use disorders that emphasize counseling, preventive care, and expanded access to medications can disrupt delayed care-seeking during the pandemic and potentially prevent premature death.

Will the Arab Spring lead to long-lasting democratic change? To explore this question, I examine the determinants of the Arab world's democratic deficit in 2010. I find that the percentage of a country's landmass that was conquered by Arab armies following the death of the prophet Muhammad statistically accounts for this deficit. Using history as a guide, I hypothesize that this pattern reflects the long-run influence of control structures developed under Islamic empires in the premodern era and find that the available evidence is consistent with this interpretation. I also investigate the determinants of the recent uprisings. Taken in unison, the results cast doubt on claims that the Arab-Israeli conflict or Arab culture or Muslim theology is a systematic obstacle to democratic change in the region and point instead to the legacy of the region's historical institutional framework.

We investigate economic dynamics in the Malthusian era using the 1609 expulsion of Moriscos from Spain. Sharp population declines in former-Morisco districts were accompanied by decreased output and increased per capita output. While these short-run results are consistent with standard Malthusian predictions, Malthusian convergence was delayed up to 1786 in former-Morisco districts. Archival sources and historical accounts suggest extractive institutions and cultural differences may have contributed to delayed convergence in population and output per capita. This historic episode provides an unusually rich setting to examine Malthusian dynamics, highlighting the potential for sustained differences in per capita output in the Malthusian era.For the millennia prior to the demographic transition, models of economic growth focus on capturing 'Malthusian dynamics'. In this Malthusian era, technological growth or population declines are predicted to cause temporary increases in output per capita that dissipate as population grows and the land-to-labour ratio declines.Scholars have generally found empirical support for the traditional Malthusian predictions. In a recent contribution, Ashraf and Galor (2011) show that both land productivity and technology were historically related to population density rather than income per capita. Impacts of the European Black Death are also consistent with this framework (Phelps-Brown and Hopkins, 1981;Hatcher, 1996;Clark, 2005), although population and wages appear to converge slowly following this large population shock.However, the Malthusian era can be more nuanced. Many historical civilisations sustained incomes significantly above subsistence, at least for an elite subset of the population. In addition, recent research has argued that large population shocks could lead to sustained increases in incomes by changing the demographic regime Voth, 2009, 2013a, b). Although such nuance can be reconciled with an augmented Malthusian framework, empirical identification of deviations from the canonical model can be challenging. Such identification issues have often limited empirical analysis in the Malthusian era more generally. For example, efforts to identify the effects of population shocks have generally been hampered by the tendency for disease-driven population shocks to affect entire regions and often