Making Health a Shared Value

Springfield, Massachusetts is a mid-sized city with a large community of color population experiencing socioeconomic and health inequities. Historically there has been little infrastructure in Springfield to support active transportation and recreational walking and biking, so in 2015, Springfield City Council adopted a city-wide “Complete Streets” resolution.

The U.S. is one of three industrialized countries without universal access to paid sick leave. Thirty-five percent of all full-time employees lack this coverage. Among low-income and part-time employees, uninsurance rates exceed 80 percent. In addition to concerns about inequality, worker well-being, and productivity, a lack of paid sick leave also contributes to the spread of disease, when ill workers are forced to choose between their health and their job.

Starting January 1, 2018, New York State’s Paid Family Leave Act—a new state law mandating that employers provide paid family leave benefits through an employee-paid insurance policy—will be effective. This study will evaluate the impact of this law, focusing on three questions:

High-quality, early childhood education (ECE) boosts early-life skills in disadvantaged individuals. These skills translate into better outcomes later in life, in areas like employment, education, income, and criminal activity. But ECE is also costly, and as such, it is important to have a complete picture of the social returns throughout life. In particular, it is not known whether ECE can improve health over the course of a lifetime.

Does enrollment in the Supplemental Nutrition Assistance Program (SNAP) encourage families to purchase healthier foods and thereby increase the nutrition of those families enrolled in the program?

To answer this central question, this study will use an event-study design coupled with new, high-scale commercial transaction data from a grocery retailer to provide precise evidence on the effect of SNAP receipt on the amount and composition of food purchases. The study will generate evidence on the effects of SNAP enrollment from early childhood through adulthood.

The U.S. lags far behind other countries in public policies that support parents in the crucial first days, weeks, and months of a child's life. Most notably, the U.S. is the only developed country that does not guarantee a period of paid and job-protected leave for new parents. As a result, paid family leave coverage is both limited and highly unequal. This situation, however, is beginning to change, as California, New Jersey, New York, and Rhode Island and a handful of U.S. cities now have paid family leave (PFL) programs.

Children who grow up in poverty are exposed to many risk factors that adversely impact their health trajectories, resulting in poorer health into and throughout adulthood. This project will use a simulation approach to test the long-term impact of early childhood income supplements on health and educational attainment. Income supplement policies (e.g., child benefits, guaranteed minimum income, earned income tax credit, or welfare) may provide parents the opportunity to make healthier choices for their children.

Due to budget shortfalls, many states and school districts are implementing pay-to-play policies that allow collection of fees for participation in extracurricular activities such as school sports. The number of school districts with these policies has grown over the last decade, with some states reporting a two-fold increase. Although the extent of these policies and the amount of the fees for participation vary greatly, it seems likely that the overall effects of pay-to-pay policies may disproportionally affect low-income students.

In April 2016, the U.S. Department of Agriculture (USDA) issued updated standards governing the meal pattern requirements for the Child and Adult Care Food Programs (CACFP), effective October 1, 2017. The updated standards will require participating providers to serve more whole grains, a greater variety of fruits and vegetables, and reduce the amount of solid fats and added sugars (SOFAS) in meals.