Creating Healthier, More Equitable Communities

As shoppers prepare for the holidays with trips to the mall, supermarket, and big box stores, many workers who stock the shelves and work the registers are scrambling to piece together child care to match their unpredictable work schedules.

A unique partnership in Minnesota is linking data about health, human services, housing, and criminal justice to increase our understanding of risk factors and protective factors for children entering foster care. But how do we ensure we tailor our research approach to fit the complicated lives of real parents, caregivers, and children?

The U.S. housing system has created a chronic affordability gap and persistently inequitable and unhealthy living conditions. Law plays an important role in shaping that system, but there is too much unknown about the impact of housing laws and policies on health and health equity. This report series by the P4A Research Hub at the Center for Public Health Law Research at Temple University’s Beasley School of Law aims to highlight these gaps, and to suggest areas for research and action needed to produce healthier communities.

Housing in the United States is in bad shape. There are not enough units, and where there are units, they are often not affordable, and not in the right places. These problems are a result of the U.S. housing system, which is a complex set of people, organizations, laws, and conditions that interact to produce our current housing arrangements. This system has created a chronic shortage and affordability gap and persistently inequitable, segregated, and unhealthy living conditions for millions of Americans.

Low-income working parents often face routine uncertainty in their schedules because of “just-in-time” scheduling practices that offer workers little notice of when they will be expected to work. In a new working paper, Kristen Harknett, Daniel Schneider, and Sigrid Luhr of P4A’s Research Hub at University of California, Berkeley, examine the consequences of unstable and unpredictable work schedules on child care arrangements.

What could we gain if we committed to increasing diversity in research? P4A National Advisory Committee member Jewel Mullen, the associate dean for health equity at the Dell Medical School of the University of Texas at Austin, helps us explore this question.

At this time, little is known about the health consequences of growing up in gentrifying neighborhoods. Many observers worry that gentrification could heighten stress and undermine children’s health, but it may also bring changes to low-income areas that enhance health. Kacie Dragan, Ingrid Ellen, and Sherry A. Glied, representing P4A’s NYU Wagner Research Hub, explore these issues in a new paper, focusing on children’s physical and mental health.

In fall 2018, we launched a new Policies for Action Research Hub at Vanderbilt to examine barriers to the healthy development and success of low-income children in Tennessee. We knew that building a strong, policy-focused research agenda would require open communication and a cooperative spirit among our state agencies and community health and education organizations.

While Earned Income Tax Credit expansions are typically associated with improvements in maternal mental health, little is known about the mechanisms through which the program affects this outcome. Anuj Gangopadhyaya, Fredric Blavin, Jason Gates, and Breno Braga of the Urban Institute assess the impact of more than two decades of federal expansions in EITC credits and the implementation of state-specific EITC programs on maternal mental health in a new working paper.

In June 2018, Arkansas became the first state to implement work requirements in Medicaid. Benjamin D. Sommers, Anna L. Goldman, Robert J. Blendon, E. John Orav, and Arnold M. Epstein of Harvard University provide the first independent assessment of early changes in beneficiary coverage and employment after the work requirements went into effect.

Researchers at Brown University released a working paper analyzing the effects of the Supplemental Nutrition Assistance Program (SNAP) on nutritional quality of purchased foods. Examining seven years of transaction records at a large U.S. grocery chain, the team found that SNAP participation had only a small effect on the nutritional quality of purchased foods.

How does the current housing affordability crisis widen health inequities across race and income? What are the wide-ranging effects of housing subsidies on children’s well-being or on positive aging for low-income seniors? Policies for Action is trying to answer some of these questions, and create actionable evidence for those shaping housing policies at the local, state, and federal levels.