Identify a policy that is not usually intended to be a health policy but that you think may have important health implications.
The case below is from a highly recommended episode of the investigative reporting podcast Reveal, called Redlining.
Policy: In 1989, the modern from of "credit scores" became the standardized way to evaluate applicants for home mortgage loans. The standardization using an objective number was supposed to reduce lenders' discrimination practices based on race and other factors. However, the credit score formula is skewed to favor those who already own homes and to propel home owners into better credit scores while keeping it difficult for renters to improve their credit scores. It works like this: credit score goes up for each on-time mortgage payment and goes down for each late mortgage payment, but credit score does NOT got up for each on-time rent payment--it does go down with late rent payments. This gives renters less opportunity to increase their credit score to be able to get home mortgage loans. As a consequence of this and outright discriminatory practices, African Americans in the US have far less home ownership compared to Whites, and this results in substantially less annual expendable income for African American households to spend on health and wellness.
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 how credit scores are affecting mortgage loan acquisition and home ownership would be informative in identifying discriminatory practices that affect household expendable income and "upward mobility."
Specify the outcomes and populations you think most affected or least affected by the policy.
Propose a study design to evaluate the policy.
Select a population of home owners and renters whose credit scores are calculated with on-time rent payment increasing credit similarly to on-time mortgage payment. Follow these households for 2-3 decades and then compare their annual expendable household incomes, and certain health outcomes, to each other and to "control" households whose credit scores were calculated as status quo.
Describe biggest challenge to implementing and drawing inferences about the impact of the policy on health.