· Identify a policy that is not usually intended to be a health policy but that you think may have important health implications.
Environmental protection and laws relating to industry (coal, fracking, etc) may not be designed specifically to address (or worsen) public health issues but they clearly have an impact on public health. For example, there have been recent policy changes to loosen regulations and rescind a rule aimed at protecting the environment from the ill effects of fracking. This rule via the Bureau of Land Management sought to mitigate risk to underground water sources and manage the disposal of pollutants resulting from the growing fracking industry.
https://www.washingtonpost.com/news/energy-environment/wp/2017/12/29/to-round-out-a-year-of-rollbacks-the-trump-administration-just-repealed-key-regulations-on-fracking/?utm_term=.de217c1ee43b
· Describe why an evaluation of that policy is informative (e.g., determining effects of the policy, or primarily a test of hypothesized mediators).
The implementation and subsequent removal of the regulations, in a sense, creates a natural experiment where the instrumental variable is the regulation. This data could help describe some of the negative effects of the fracking industry
· Specify the outcomes and populations you think most affected or least affected by the policy.
Fracking primarily occurs in/near rural communities that are often lower SES with access to fewer job opportunities or resources. Some individuals in the community may benefit economically (more jobs in the area) by the influx of industry but all will be affected by increased pollution and other deleterious effects of this industry. See below for more re outcomes.
· Propose a study design to evaluate the policy.
The implementation and subsequent removal of the regulations, in a sense, creates a natural experiment where the instrumental variable is the regulation. Ideally, one would have access to water quality data (or illness rates for diseases considered related to water quality and pollutant exposure) from multiple time points (pre regulation, during regulation, post regulation). Then you could compare the differences in specific chemical levels or specific disease rates during these time periods.
· Describe biggest challenge to implementing and drawing inferences about the impact of the policy on health.
In the case of regulations it may be difficult to assess baseline disease risk secondary to pollutants from the fracking process. High levels of pollutants may already have accumulated in the area so this specific regulation change may not appear to have a large role in worsening health.