Childho o d, E duc a tio n a nd We lfa re : Re se a rc h a nd Po - PowerPoint PPT Presentation

Childho o d, E duc a tio n a nd We lfa re : Re se a rc h a nd Po lic y I nsig hts Wo rksho p Pre se nta tio n Ba rb a ra Wo lfe , Ric ha rd A. E a ste rlin Pro fe sso r o f He a lth E c o no mic s, Unive rsity o f Wisc o nsin-Ma diso n a nd Unive rsity o f Me lb o urne – F a c ulty o f Busine ss a nd E c o no mic s E mine nt Re se a rc h Sc ho la r 2017

Go a l o f my ta lk  Bro a d q ue stio n: Ho w c a n re se a rc he rs a nd po lic y ma ke rs wo rk to g e the r to impro ve c hildho o d e duc a tio n, he a lth a nd o ve ra ll we ll-b e ing ?  Are re se a rc he rs wo rking o n the “rig ht re se a rc h”? Ho w do we impro ve the c o nve rsa tio n b e twe e n “us”?  Are po lic y ma ke rs “liste ning ” to wha t re se a rc he rs ha ve le a rne d?  My a ppro a c h this mo rning :  Se t o ut so me q ue stio ns whic h I ho pe a re use ful to g uide disc ussio ns o f the wo rksho p  Sha re a fe w e xpe rie nc e s fro m the U.S. with yo u

Bro a d Que stio ns fo r to da y  Ho w do we e nc o ura g e pro duc tive disc ussio n b e twe e n re se a rc he rs a nd po lic y ma ke rs?  Ho w do re se a rc he rs a nd a c a de mic s c o mmunic a te so tha t re le va nt re se a rc h is use d in the po lic y a re na ? Ho w c o nfide nt do re se a rc he rs ne e d to b e to c o nve y “a nswe rs fro m re se a rc h” to po lic y ma ke rs?  Wha t type o f e vide nc e / pre se nta tio n do po lic y ma ke rs find c o nvinc ing ?  Wha t a re future c ha lle ng e s – ma jo r issue s tha t de se rve a tte ntio n fro m the re se a rc h c o mmunity? Ho w to ide ntify future “g ra nd c ha lle ng e s? ”  Do we fo c us o n whe the r pa rtic ula r inte rve ntio ns o r po lic ie s wo rk suc h a s a pa rtic ula r mo de l fo r pre sc ho o l? Or is the re a dditio na l pa yo ff to sta rting with de fine d g o a ls fo r c hildre n a nd the n a sking ho w b e st do we a c hie ve the m?

E xpe rie nc e s tha t she d so me lig ht o n the se q ue stio ns.  1. Cha ir o f Na tio na l Ac a de my Wo rksho p o n Stre ng the ning Be ne fit-Co st Ana lysis fo r E a rly Childho o d I nte rve ntio ns  Wha t is the Na tio na l Ac a de my?  Na ture o f Wo rksho p a nd its o utput  Cha lle ng e s ide ntifie d  2. Me a ns te ste d he a lth insura nc e a nd re duc e d wo rk e ffo rt. Stro ng e mpiric a l wo rk he lpe d le a d to po lic y c ha ng e whic h re mo ve d e lig ib ility fo r me a ns te ste d he a lth insura nc e fro m pa rtic ipa tio n in c a sh suppo rt  3. Gro wing a tte ntio n to ”sc ie nc e ” e vide nc e o f influe nc e o f po ve rty o n the b ra in.

T he Na tio na l Ac a de mie s  T he Na tio na l Ac a de my o f Sc ie nc e s is a priva te , no npro fit, se lf-pe rpe tua ting so c ie ty o f disting uishe d sc ho la rs e ng a g e d in sc ie ntific a nd e ng ine e ring re se a rc h, de dic a te d to the furthe ra nc e o f sc ie nc e a nd te c hno lo g y a nd to the ir use fo r the g e ne ra l we lfa re .  Upo n the a utho rity o f the c ha rte r g ra nte d to it b y the Co ng re ss in 1863, the Ac a de my ha s a ma nda te tha t re q uire s it to a dvise the fe de ra l g o ve rnme nt o n sc ie ntific a nd te c hnic a l ma tte rs  T he Na tio na l Ac a de my o f Me dic ine (o ne c o mpo ne nt o f the Na tio na l Ac a de mie s)wa s e sta b lishe d in 1970 b y the Na tio na l Ac a de my o f Sc ie nc e s to se c ure the se rvic e s o f e mine nt me mb e rs o f a ppro pria te pro fe ssio ns in the e xa mina tio n o f po lic y ma tte rs pe rta ining to the he a lth o f the pub lic .

Ho w do e s a po lic y ma ke r de c ide whic h c hildho o d inte rve ntio ns a re the b e st inve stme nt? A wo rksho p o n Stre ng the ning the use fulne ss o f Be ne fit c o st a na lysis fo r c hildho o d inte rve ntio ns  Go a l: ide ntify suc c e ssful c hildho o d inte rve ntio ns.  Ma jo r I SSUE S :  Sa mple se le c tio n.  Sa mple se le c tio n, o n the pa rt o f the pro g ra m de sig ne r o r the pa rtic ipa nts, in e ithe r the initia l re c ruiting pro c e ss o r the sub se q ue nt b a se line e va lua tio n, o r b o th  Attritio n  L e ng th o f fo llo w-up pe rio ds Ma ny o f the e c o no mic re turns to c hildho o d inte rve ntio ns a nd, e spe c ia lly, e a rly c hildho o d inte rve ntio ns o c c ur re la tive ly fa r into the future .  Size a nd c o mpo sitio n o f Sa mple s studie d. Ge ne ra liza b ility  Re plic a b ility

Pa rtic ula r c ha lle ng e fo r pro g ra ms ta rg e te d a t c hildre n, e spe c ia lly yo ung c hildre n  Asse ssing lo ng -te rm o utc o me s  A c ha lle ng e tha t c uts a c ro ss studie s a nd do ma ins is ide ntifying a nd me a suring o utc o me s tha t pe rsist o r sho w up lo ng a fte r the inte rve ntio n is c o mple te d  L o ng itudina l da ta a re e xpe nsive to c o lle c t, a ttritio n o f pa rtic ipa nts o ve r the ye a rs c a n b e a se rio us pro b le m, a nd, b y de finitio n, the da ta pro duc e a nswe rs o nly ye a rs a fte r the inte rve ntio n b e g ins.  Appro a c he s to ma ke b e tte r use o f e xisting da ta : (1) po sing ne w q ue stio ns tha t c a n b e a nswe re d using e xisting da ta , (2) me rg ing ne w info rma tio n into e xisting da ta se ts, a nd (3) me rg ing se ve ra l e xisting da ta se ts.

Curre nt Co mmitte e o f Na tio na l Ac a de my  T he c o nundrum we fa c e is this: vo lume s o f re se a rc h studie s a re b e ing pro duc e d. So me studie s a ddre ss spe c ific po lic y q ue stio ns a nd o the rs pro vide va lua b le b a c kg ro und o n the myria d o f so c ie ta l c ha lle ng e s tha t c o nfro nt a nd c o nfo und po lic yma ke rs. Ye t a g a p e xists (so me sa y a c ha sm) b e twe e n the pro duc tio n o f re se a rc h a nd its utiliza tio n b y po lic yma ke rs.  An impo rtant ac tivity o f an o rg anizatio n like the Me lb o urne I nstitute o r the I nstitute fo r Re se arc h o n Po ve rty (b o th unive rsity b ase d) o r the Natio nal Ac ade mie s are to c lo se this g ap. But ho w?

Cha lle ng e s I de ntifie d: An e xa mple o f a n e ffe c tive g ro up tha t b ridg e s the re se a rc h c o mmunity a nd po lic y ma ke rs: Wa shing to n Sta te I nstitute fo r Pub lic Po lic y  Se t up to to pro vide a na lysis o f po lic y o ptio ns fo r la wma ke rs. T he institute ha s b e c o me a va lua b le re so urc e fo r sta te le g isla to rs,  loc a lly ba se d a nd c lo se ly tie d to the c o mmunity a nd the la wma king pro c e ss.  sta ff ha s c lo se working re la tionships with the la wma ke rs,  the y kno w e xa c tly whic h o ne s to a ppro a c h o n a g ive n issue .  I nc lude info rma tio n fro m ma ny so urc e s, o fte n c o nduc t o wn me ta a na lyse s, distill a nswe rs to the pre c ise q ue stio ns tha t a re c urre nt in the sta te .  Pre se nt the ir info rma tio n in c o nsiste nt wa ys (the y use a Co nsume r Re po rts –type fo rma t) so it is e a sy fo r b usy le g isla to rs to find wha t the y ne e d a nd unde rsta nd the b a sis fo r the c o nc lusio ns.  Nonpar tisan ; b e ne fit-c o st a na lysis the mo st use ful to o l fo r he lping De mo c ra ts a nd Re pub lic a ns to ide ntify a n a ppro a c h the y c a n a g re e o n, re g a rdle ss o f the pro b le m. Be c a use the institute ha s b e e n willing to re c o mme nd c utting pro g ra ms whe n e vide nc e e me rg e s tha t the y do no t wo rk, the y ha ve b uilt trust in the e vide nc e -b a se d a ppro a c h

E xa mple 2: Re se a rc h tha t is time ly, like ly to impro ve we ll-b e ing AND sa ve do lla rs  “T he E ffe c t o f the Me dic a id Pro g ra m o n We lfa re Pa rtic ipa tio n a nd L a b o r Supply” b y Ro b e rt Mo ffitt a nd Ba rb a ra Wo lfe in T he Re vie w o f E c o no mic s and Statistic s and “ Me dic a id, We lfa re De pe nde nc y, a nd Wo rk: I s T he re a Ca usa l L ink? ” in He alth Care F inanc ing Re vie w .  Use d Surve y o f I nc o me and Pro g ram partic ipatio n to e stimate the e ffe c t o f Me dic aid (me ans te ste d he alth insuranc e tie d to re c e ipt o f c ash assistanc e ) and private he alth insuranc e o n partic ipatio n in c ash assistanc e and e mplo yme nt fo r fe male he ads o f ho use ho lds.  F o und 1) inc re ase s in value o f Me dic aid le ad to inc re ase d take up o f c ash assistanc e and Me dic aid and de c re ase d e mplo yme nt 2) inc re ase d availab ility o f private insuranc e at the wo rkplac e inc re ase d e mplo yme nt and de c re ase d c ash assistanc e and Me dic aid take -up.  Simulatio n fo und that if private c o ve rag e similar to Me dic aid o ffe re d wo uld de c re ase tho se o n c ash assistanc e b y 25% and inc re ase e mplo yme nt b y 18%