HW week 7
· Identify a policy that is not usually intended to be a health policy but that you think may have important health implications.
There are so many! I think an interesting one is vouchers to rent houses in chosen neighborhoods. These are often called “housing choice vouchers” and need to be implemented along with other policy changes that allow this to be actualized, including Federal, state, and local agencies can make four sets of interrelated policy changes to help families in the HCV program live in better locations:
- Create strong incentives for state and local housing agencies to achieve better location outcomes;
- Modify policies that discourage families from living in lower-poverty communities;
- Minimize jurisdictional barriers to families’ ability to live in high-opportunity communities; and
- Assist families in using vouchers to rent in high-opportunity areas.
· Describe why an evaluation of that policy is informative (e.g., determining effects of the policy, or primarily a test of hypothesized mediators).
I would want to determine the effects of the policy because it is such a big change that it would be difficult to track all the mediators between housing and neighborhood and health outcomes.
· Specify the outcomes and populations you think most affected or least affected by the policy.
The populations that would be most affected would be low-income households.
· Propose a study design to evaluate the policy.
A longitudinal study which look at long-term health outcomes for people (and their children) who were assigned to section 8 vs another neighborhood.
· Describe biggest challenge to implementing and drawing inferences about the impact of the policy on health.
A longitudinal study would be the best for looking at this but incredibly expensive. I remember reading about the early education program for families that looked at two generations of data and showed higher IQ, gross income, and the basis for the data that support free early education, but that took at least 50 years to produce! In addition, there is the problem of innumerable confounders. But, for an issue so fundamental as housing and neighborhood, I think it would show improved health outcomes for people living in wealthier neighborhoods. Also, one would have to look at if health improved in all sorts of situations—neighborhoods that were more or less diverse in terms of race/ethnicity and in terms of wealth.