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New policy analysis website will help researchers uncover links between economic policies and health

About 22 percent of children in the United States live below the federal poverty line and 45 percent come from low-income families, increasing their risk for myriad health problems.

In 2012, the federal earned income tax credit lifted 6.5 million people, including 3.3 million children, above the poverty line.

While several organizations have recognized the role that policies and laws can have on health, few studies have rigorously examined the effects of family economic security policies, such as tax credits, minimum wage laws and unemployment compensation, on health and health behaviors. Now, a team from the University of Florida’s Institute for Child Health Policy and Temple University’s Public Health Law Research Program has developed new methods for analyzing policy effects using the Public Health Law Research Program’s national policy surveillance website, LawAtlas.org.

“Many of these policies directly affect children of families who are struggling financially,” said Kelli Komro, Ph.D., a professor in the UF College of Medicine and associate director of the Institute for Child Health Policy. “The importance of those early years for children’s long-term health into adulthood cannot be overstated, which underscores the importance of conducting rigorous analysis to see which social policies are actually improving the health of families.”

The research team — which also includes Alexander C. Wagenaar, Ph.D., an Institute for Child Health Policy faculty member and associate director of Temple’s Public Health Law Research Program, and Scott Burris, J.D., a professor of law at Temple Law School and director of the Public Health Law Research Program — is pioneering new ways to evaluate the effects of various social policies on health. In particular, legal scholars systematically code individual aspects of different policies that are then quantitatively analyzed across time and states, where variations of laws are enacted.

For instance, the researchers examined unemployment compensation laws by coding the maximum weekly benefit, how the benefit amount was calculated, the maximum benefit duration and the base period of eligibility in all 50 states across the past 35 years. This coding facilitates detailed scientific evaluation of how particular provisions within unemployment compensation laws affect health and health behaviors. The team is currently analyzing the data for future publications.

“Our approach is more granular than studies to date, where normally whole policies are analyzed for impacts rather than looking at particular provisions within the laws,” said Burris, who has collaborated with the University of Florida faculty on multiple endeavors as part of Temple University’s Public Health Law Research Program, funded by the Robert Wood Johnson Foundation. “Our team’s methods blend policy analysis with statistical analysis to not only find out whether a law impacts health but also to better understand why and how.”

LawAtlas addresses a major impediment to scientific advancement in the field of social determinants of health, which examines how the broad social and economic conditions in which people live impact their health. The need is for systematic collection, analysis and dissemination of information about policies that can improve health and reduce health disparities in people across various socioeconomic backgrounds. The first paper from this effort, titled “Social Determinants of Child Health: Concepts and Measures for Future Research,” details past research, the new data collection methods and future directions for the field, and was published in the journal Health Behavior & Policy Review in December.

LawAtlas (http://lawatlas.org) will house a growing number of datasets on family economic policies from 1980 to the present in an open-access format for scholars to use. The first dataset, on state-by-state differences in minimum wage laws, is already complete, with analyses of state laws on earned income tax credit, unemployment compensation and temporary assistance to needy families in progress.

“These datasets will allow health scholars to compare various state policies at different times and with different populations — all in an effort to discover which policies improve health and which policies do not,” said Wagenaar. “Knowing what works, at a precise level, is the first step toward systematically putting into place policies that will challenge the status quo and engender lasting improvement in the culture of health in America.”

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