Standards of Evidence for Conducting and Reporting Economic Evaluations in Prevention Science.

Over a decade ago, the Society for Prevention Research endorsed the first standards of evidence for research in preventive interventions. The growing recognition of the need to use limited resources to make sound investments in prevention led the Board of Directors to charge a new task force to set standards for research in analysis of the economic impact of preventive interventions. This article reports the findings of this group's deliberations, proposes standards for economic analyses, and identifies opportunities for future prevention science. Through examples, policymakers' need and use of economic analysis are described. Standards are proposed for framing economic analysis, estimating costs of prevention programs, estimating benefits of prevention programs, implementing summary metrics, handling uncertainty in estimates, and reporting findings. Topics for research in economic analysis are identified. The SPR Board of Directors endorses the "Standards of Evidence for Conducting and Reporting Economic Evaluations in Prevention Science."

Housing insecurity and sleep among welfare recipients in California.

STUDY OBJECTIVES: To estimate the effect of housing insecurity on sleep duration and sleep quality. METHODS: Using longitudinal data from a sample of 1,046 welfare recipients in the state of California followed from 2015-2016 through 2017-2018, we regressed self-reported measures of sleep duration and sleep quality recorded in 2017-2018 on experiences of housing insecurity in the prior year. We applied propensity score weights to attenuate potential bias from an array of observed covariates, including sleep duration and sleep quality measured prior to experiences with housing insecurity. RESULTS: Sample members who were unable to make their rent/mortgage payments slept on average 22 fewer minutes a night and had lower quality sleep than those who were able to make their rent/mortgage payments. Sample members who were forced to move because of an inability to make rent/mortgage payments slept on average 32 fewer minutes a night and had lower quality sleep than those who were not forced to move. CONCLUSIONS: By compromising sleep health, housing insecurity represents a distinct form of stress in the lives of economically-disadvantaged adults, which could also contribute to other health disparities.

Using matched survey and administrative data to estimate eligibility for the Medicare Part D low-income subsidy program.

This article uses matched survey and administrative data to estimate, as of 2006, the size of the population eligible for the Low-Income Subsidy (LIS), which was designed to provide "extra help" with premiums, deductibles, and copayments for Medicare Part D beneficiaries with low income and limited assets. We employ individual-level data from the Survey of Income and Program Participation and the Health and Retirement Study to cover the potentially LIS-eligible noninstitutionalized and institutionalized populations of all ages. The survey data are matched to Social Security administrative data to improve on potentially error-ridden survey measures of income and program participation. Our baseline estimate, based on the matched data, is that about 12 million individuals were potentially eligible for the LIS as of 2006. A sensitivity analysis indicates that the use of administrative data has a relatively small effect on the estimates, but does suggest that measurement error is important to account for.

Investing Early: Taking Stock of Outcomes and Economic Returns from Early Childhood Programs.

The past two decades have been characterized by a growing body of research from diverse disciplines-child development, psychology, neuroscience, and economics, among others-demonstrating the importance of establishing a strong foundation in the early years of life. The research evidence has served to document the range of early childhood services that can successfully put children and families on the path toward lifelong health and well-being, especially those at greatest risk of poor outcomes. As early childhood interventions have proliferated, researchers have evaluated whether the programs improve children's outcomes and, when they do, whether the improved outcomes generate benefits that can outweigh the program costs. This study examines a set of evaluations that meet criteria for scientific rigor and synthesizes their results to better understand the outcomes, costs, and benefits of early childhood programs. The authors focus on evaluations of 115 early childhood programs serving children or parents of children from the prenatal period to age 5. Although preschool is perhaps the best-known early childhood intervention, the study also reviewed such programs as home visiting, parent education, government transfers providing cash and in-kind benefits, and those that use a combination of approaches. The findings demonstrate that most of the reviewed programs have favorable effects on at least one child outcome and those with an economic evaluation tend to show positive economic returns. With this expanded evidence base, policymakers can be highly confident that well-designed and -implemented early childhood programs can improve the lives of children and their families.

Intended And Unintended Effects Of The War On Poverty: What Research Tells Us And Implications For Policy.

During the mid-1960s, the United States adopted a series of cash and in-kind transfer programs, as well as human capital investment strategies, as part of the War on Poverty. A number of other programs were first proposed as part of this "war" but were not implemented until the mid-1970s. These programs had noble goals: to increase incomes at the bottom of the income distribution, reduce poverty, and improve nutrition, heath, and human capital. However, various features of the programs also had the potential to produce unintended consequences: for example, means-tested programs can discourage work. In this paper, we comprehensively evaluate the main War on Poverty programs that were aimed at the low-income nonelderly population along with several follow-on programs. We focus on both intended and unintended consequences, drawing on the most compelling causal evidence. We conclude with a series of lessons learned and questions that are outstanding.

Early care and education for children in immigrant families.

A substantial and growing share of the population, immigrant children are more likely than children with native-born parents to face a variety of circumstances, such as low family income, low parental education, and language barriers that place them at risk of developmental delay and poor academic performance once they enter school. Lynn Karoly and Gabriella Gonzalez examine the current role of and future potential for early care and education (ECE) programs in promoting healthy development for immigrant children. Participation in center-based care and preschool programs has been shown to have substantial short-term benefits and may also lead to long-term gains as children go through school and enter adulthood. Yet, overall, immigrant children have lower rates of participation in nonparental care of any type, including center-based ECE programs, than their native counterparts. Much of the participation gap can be explained by just a few economic and sociodemographic factors, the authors find. To some extent, the factors that affect disadvantaged immigrant children resemble those of their similarly disadvantaged native counterparts. Affordability, availability, and access to ECE programs are structural barriers for many immigrant families, as they are for disadvantaged families more generally. Language barriers, bureaucratic complexity, and distrust of government programs, especially among undocumented immigrants, are unique challenges that may prevent some immigrant families from taking advantage of ECE programs, even when their children might qualify for subsidies. Cultural preferences for parental care at home can also be a barrier. Thus the authors suggest that policy makers follow a two-pronged approach for improving ECE participation rates among immigrant children. First, they note, federal and state ECE programs that target disadvantaged children in general are likely to benefit disadvantaged immigrant children as well. Making preschool attendance universal is one way to benefit all immigrant children. Second, participation gaps that stem from the unique obstacles facing immigrants, such as language barriers and informational gaps, can be addressed through the way publicly subsidized and private or nonprofit programs are structured.

Employment and self-employment in the wake of Hurricane Katrina.

We use data from the monthly Current Population Survey to examine the short- and longer-term effects of Hurricane Katrina on the labor market outcomes of prime-age individuals in the most affected states--Alabama, Florida, Louisiana, and Mississippi--and for evacuees in any state. We focus on rates of labor force participation, employment, and unemployment, and we extend prior research by also examining rates of self-employment. With the exception of Mississippi, employment and unemployment one year after the hurricane were at similar rates as the end of 2003. This aggregate pattern of labor market shock and recovery has been observed for other disasters but masks important differences among subgroups. Those evacuated from their residences, even temporarily, were a harder-hit group, and evacuees who had yet to return to their pre-Katrina state up to one year later were hit especially hard; these findings hold even after controlling for differences in observable characteristics. We also find evidence of an important role for self-employment as part of post-disaster labor market recovery, especially for evacuees who did not return. This may result from poor job prospects in the wage and salary sector or new opportunities for starting businesses in the wake of Katrina.

Labor-Force Dynamics at Older Ages: Movements Into Self-Employment for Workers and Nonworkers.

Labor-market transitions toward the latter parts of workers' careers can be complex, with movement between jobs and classes of work and in and out of retirement. The authors analyzed factors associated with the labor-market transitions of older workers to self-employment from unemployment or disability, retirement, or wage and salary work using rich panel data from seven waves of the Health and Retirement Study (HRS). They found evidence that (prior) job characteristics and liquidity constraints are important predictors of movements to self-employment for workers and nonworkers, while risk aversion is a significant predictor only for workers.