Identify a policy that is not usually intended to be a health policy but that you think may have important health implications.
I have chosen to evaluate the Earned Income Tax Credit (EITC) policy for this assignment. I believe that while its primary goal is to generally provide a financial "benefit for working people with low to moderate income," (https://www.irs.gov/credits-deductions/individuals/earned-income-tax-credit) it has important health implications. That's because it affects an important SDH: income. According to the hypothesized "Social Factors and Health" pathway that we look at in class, this means that this policy also affects a person's proximity to toxic/dangerous environments and their proclivity to participate in dangerous behaviors, as well as the psychological experiences they have. This in turn means that this policy affects disease onset, progression, and consequences.
Describe why an evaluation of that policy is informative (e.g., determining effects of the policy, or primarily a test of hypothesized mediators).
An evaluation of this policy will likely be informative if done correctly because it will show policymakers and lawmakers that the pathway between EITC and financially benefitting people with low to moderate incomes is not as simple as that; instead, it will show this group that there are other effects of the policy to consider that are potentially affecting health outcomes. Depending on the results, this evaluation could encourage lawmakers and policymakers to update/change this policy.
Specify the outcomes and populations you think most affected or least affected by the policy.
I hypothesize that this policy is likely most affecting people with low SES (that's the target of this policy, and I have no reason to believe that the policy is affecting people with high SES). Given that EITC directly affects income, I have to think that it also affects where a person lives, how often and from whom they seek medical care, the amount of stress they feel providing for their family, their work schedules (so, how many hours they work in a week), the amount of exercise they get (I think that number of hours worked is likely a mediator on this pathway), etc. It's hard to say exactly what outcomes the policy most affects given that income is related to so many health factors.
In terms of populations affected, I have to think that some of the poorest groups in America (and, particularly, those people who don't pay taxes), are negatively affected by this policy, because it likely exacerbates the financial differences between the most poor and the middle class groups in America. I also say this because in order for a person to claim the EITC benefit, they have to be aware of it and also how to claim it. I assume that the poorest people in America who are eligible to use this resource likely know about this policy LESS frequently than just low or middle class people who use this policy, because it requires some financial literacy and/or maybe even access to an accountant, which the poorest group likely does not have.
Propose a study design to evaluate the policy.
A research question for this policy could be "What is the relationship between EITC and toxicity of living environment?" (The goal would be to see if those who receive EITC live in neighborhoods with less toxicity, compared with those who have the same income but do not receive EITC.) It would be to determine whether or not there is an association between the two measures. Although it would be ideal to do a randomized study to evaluate this health policy, I don't believe that that would actually be feasible here.
Describe biggest challenge to implementing and drawing inferences about the impact of the policy on health.