Advancing the Power of Economic Evidence to Inform Investments in Children, Youth, and Families (2016) / Chapter Skim
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1 Introduction
1 Introduction
Pages 19-38
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From page 19... ...
Economic evidence -- information derived from economic principles and methods -- can help meet this need.2 Economic evidence can be used to determine not just what works, but what works within budget constraints. Economic evaluation is a particular means of producing economic evidence that can be used to calculate and compare the costs and outcomes of an intervention.
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A more recent legislative effort advocating the use of evidence in general in investment decisions is the Evidence-Based Policymaking Commission Act of 2015, first introduced in 2014 by U.S. Senator Patty Murray (D-WA)
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Given the potential for economic evaluations to influence better investments for children, youth, and families, this report outlines promising strategies for strengthening the evaluations themselves and better incorporating the evidence they produce into the processes used by decision makers. STUDY CHARGE In fall 2014, with support from the MacArthur Foundation, the Robert Wood Johnson Foundation, the Jacobs Foundation, the Institute of Medi
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Other National Academies efforts related to the study charge are highlighted in Box 1-2. BOX 1-1 Statement of Task An ad hoc committee under the auspices of the Institute of Medicine (IOM)
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STUDY APPROACH To address the study charge, the National Academies appointed a committee whose membership included experts in a variety of disciplines and fields, including public policy, public health, education, social welfare, economics, sociology, developmental psychology, prevention science, program evaluation, and decision science. Members also included practitioners with experience (e.g., legislative, agency)
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The committee used this evidence to formulate conclusions and actionable recommendations to inform the research, practice, and policy decisions of prevention researchers, economic researchers, implementation researchers, evaluation scientists, implementers, and budgetary decision makers. The committee's search efforts revealed areas of weakness in economic evaluations, such as gaps in guidance related to cost analysis and other economic evaluation methods.
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and current efforts related to introducing equity issues and outcomes into economic evaluations of social-sector interventions related to children, youth, and families. • Donald Moynihan (University of Wisconsin)
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and the expertise of its appointed members, however, the committee focused on a particular class of methods for producing economic evidence. These methods formally fall under the rubric of cost and outcome evaluation or economic evaluation methods but are better known in terms of several specific types of analysis: cost analysis (CA)
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From page 27... ...
Break-even analysis -- a method of economic evaluation that can be used when the outcomes of an intervention are unknown; can be used to complement cost analysis as a way of anticipating potential economic returns. Budgetary impact analysis -- a special case of cost-savings analysis that exam ines the impact, year-by-year, of a health-related intervention on the government budget for aggregate or specific agencies.
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Return-on-investment analysis -- a method of economic evaluation used in spe cial cases in which benefit-cost analysis is conducted for a specific stakeholder group. Shadow price -- the estimated true value or cost of the results of a particular decision, as calculated when no market price is available or when market prices do not reflect the true value.
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Since there never will be enough evidence to ensure that every dollar or other incremental resource could not be better spent or used elsewhere, the very framework of economic evaluation maintains a balanced focus by calling on those producing or using evidence to look at costs, not just benefits; at margins, not just averages; at every margin, not just one. For instance, a simple evidence framework might reveal that a certain effort succeeds at a certain task, but the economic evidence framework asks additionally whether there might be some better use of the last $100 spent on that effort.
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The corresponding notion that an investment produces a rate of return is incorporated explicitly into economic evaluations by the way in which they sum and compare costs and benefits over time. A classic case is education, which entails a return tomorrow for investments made today.
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General Youth Development School- or community-based programs that serve adolescents to promote positive youth development (e.g., mentoring, sports) Child Welfare Home- or community-based programs designed to prevent abuse or neglect or to intervene with children and families in the child welfare system Health Promotion or Prevention School- or community-based programs for parents or children designed to promote general physical and mental health or to prevent specific health problems, including disease Safety Promotion and Injury Home-, school-, or community-based programs designed Prevention to promote safety or prevent injury Wellness Home-, school-, or community-based programs for children and families focused specifically on nutrition and physical activity Mental Health School- or community-based programs for parents, youth, and children designed to diagnose and treat mental health or substance use conditions Teen Pregnancy Prevention School- and community-based programs for children and youth designed to promote sexual health and prevent teenage childbearing Crime/Violence Prevention School- and community-based programs for children and youth designed to prevent delinquency, crime, and violence Homelessness Prevention and Programs providing housing support to prevent Supports homelessness or providing supportive services for those that are homeless Employment, Training, and Training, employment, and income or in-kind assistance Welfare programs for families with children SOURCE: Adapted from http://www.rand.org/content/dam/rand/pubs/technical_reports/2008/ RAND_TR643.pdf [March 2016]
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Likewise, interventions designed as general youth development programs may also be considered substance abuse prevention programs or teen pregnancy prevention programs if those are domains of behavior in which they have impacts. In general, the committee classifies interventions based on the primary outcomes they are designed to effect, even when there is overlap with other domains.
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Physical Health Physical health, reproductive health (e.g., teen pregnancy, contraceptive use) , health care utilization Antisocial/Risky Behavior Delinquency, crime, substance abuse, sexual activity, bullying Adult Outcome Areas Family Functioning Parent-child relationships, child abuse and neglect, healthy relationships Education Postsecondary education outcomes Economic Labor market outcomes, use of social welfare programs Health Physical health, mental health, reproductive health (e.g., childbearing, contraceptive use)
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Researchers generally produce or provide economic evaluations, although those who gather the data used in such studies often determine what studies can be performed and what costs and benefits can be assessed. Both government entities (legislative and executive branches at the local, state, and federal levels)
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Failure to address quality issues weakens not just individual reports but also the acceptance of evidence more broadly by decision makers. In turn, context always matters: failure by researchers conducting economic evaluations to address the values and concerns of decision makers practically ensures that the resulting evidence will be weakly used, if at all.
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It also provides recommendations, including best practices, for the production and reporting of the results of high-quality economic evaluations of interventions for children, youth, and families, while also describing some related emerging issues. Chapter 4 acknowledges the vital importance of context in considering how quality economic evidence can best be used, highlights the broader influential factors that affect investment decisions, and offers related recommendations.
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. Social Experimentation, Program Evaluation, and Public Policy (Vol.
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Key Terms
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