Week of 02/08

Week of 02/08

by Brianna Michelle Singleton -
•Identify a policy that is not usually intended to be a health policy but that you think may have important health implications.
I think the "Banning the Box" would be a non-health (but really) health policy. Banning the box is an initiative that would require that job applications no longer ask if people have a criminal record. Some proponents advocate that it should be extended to government housing, food stamps, higher education and other social services.
 
•Describe why an evaluation of that policy is informative (primarily about the policy, or primarily a test of hypothesized mediators?)
This is a major policy that would have a profound implication on poverty, crime, childcare, education and health. It is posited that if men and women could have a fair chance of getting a job they would commit less crime. They would have more financial resources to pay for the services that they need. They would be able to contribute to the household (allowing for greater family wealth) and they can help pay for daycare and school supplies. In short, they can reap all of the benefits of being gainfully employed.
 
A qualitative and quantitative evaluation would be imperative because there are so many direct and indirect benefits that I'm sure that many people haven't even conceived of. 
 
Specify the outcomes and populations you think most affected or least affected by the policy. Propose a study design to evaluate the policy
  • The population that would most benefit from this policy would be poor, black and brown communities. I think the least affected population would be white collar criminals who have connections and resources that would allow them to bypass known housing and employment barriers.
  • I would do a prospective cohort study that would look at employment direct and indirect outcomes
  1. Ability to get and maintain employment for the 5 years after being released
  2. Recidivism rates for 5 years after being released
  3. Where they live and who is in their home 5 years after being released
  4. Utilization of social and community services for the first 5 years after being released   
 

–Describe biggest challenge to implementing and drawing inferences about the impact of the policy on health

The biggest challenge about implementing a policy like this is people's perception about ex-offenders, crime and punishment, and fairness. Also, this policy would greatly impact black and brown individuals and communities in a positive way. Unfortunately, there are a lot of companies that profit off of incarcerated people and the nearly slave labor that they provide society. There would be a lot of push back from organizations that have money and don't want to end mass incarceration.

Re: Week of 02/08

by Maria Glymour -

Brianna

Very interesting example!  I agree about the importance of qualitative approaches given the current inadequate understanding of the ways this might affect people's health. 

But let's focus on the quantitative piece: how could you evaluate the effects on any outcome, let's say for example re-arrest rates?  Who will you try to enroll in your cohort? How could you access this population?  Is there a setting where Ban the Box has been implemented and a comparison community where the Box stands?  If so, where and how could you enroll people from both (or multiple such) communities?  Are the places w Box vs Banned Box otherwise comparable, or might there be other features of such places that influence the outcomes of formerly incarcerated individuals?  

I think it is actually hard to know the consequences of this policy, and so it is important to evaluate it.  Are there potential adverse consequences you would want to evaluate?

Maria