On the Evidence

Latest Episodes:

81 | Addressing the Health Risks Posed by Extreme Heat Oct 20, 2022

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On this episode of On the Evidence, Don Berwick of the National Academy of Medicine’s Climate Collaborative, Tom DiLiberto of the National Oceanic and Atmospheric Administration, and Aparna Keshaviah of Mathematica explore the risks that climate change and extreme heat pose to human health and how data can help inform solutions. A full transcript of the episode is available here: https://www.mathematica.org/blogs/addressing-the-harmful-effects-of-climate-change-on-extreme-heat-and-human-health Learn more about ClimaWATCH, an interactive online tool that can support communities seeking to understand and adapt to the local effects of heat waves on their residents’ health: https://mathematica.org/publications/climawatch-tool Learn more about Mathematica’s interdisciplinary climate change practice: https://mathematica.org/sp/climate-change/climate-action Learn more about the National Oceanic and Atmospheric Administration’s work over the past five years with more than 65 communities to map urban heat islands and use data-driven insights to mitigate the harmful and inequitable effects of extreme heat: https://www.noaa.gov/news-release/noaa-and-communities-to-map-heat-inequities-in-14-us-cities-and-counties Learn more about the National Academy of Medicine’s Action Collaborative on Decarbonizing the U.S. Health Sector: https://nam.edu/programs/climate-change-and-human-health/action-collaborative-on-decarbonizing-the-u-s-health-sector/

80 | Lessons from Contact Tracing During the Pandemic Oct 05, 2022

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This episode of On the Evidence explores lessons from contact tracing for COVID-19 that should inform current and future efforts to rebuild the public health field, particularly its workforce, after the public health emergency ends. This episode features the following guests: • Elinor Higgins, a policy associate at the National Academy for State Health Policy • Shelley Fiscus, a pediatrician and senior policy consultant at the National Academy for State Health Policy • Rachel Brash, a strategist in the Mayor’s Office of Employment Development who helped oversee the Baltimore Health Corps Initiative • Shan-Tia Danielle, who worked as a contact tracer and led a team of contact tracers for the Washington State COVID-19 Contact-Tracing Partnership • Candace Miller, a principal researcher at Mathematica who directed the Washington State COVID-19 Contact-Tracing Partnership • Shaun Stevenson, an advisory services analyst at Mathematica who supported the Baltimore Health Corps Initiative Episode transcript: https://www.mathematica.org/blogs/charting-a-course-for-public-health-based-on-lessons-from-contact-tracing-during-the-pandemic Learn more about the Washington State COVID-19 Contact-Tracing Partnership between the Washington State Department of Health, Mathematica, Comagine Health, and Allegis: https://mathematica.org/news/mathematica-partners-with-comagine-health-allegis-and-washington-state-on-contact-tracing Read Mathematica’s interim (https://mathematica.org/publications/baltimore-health-corps-initiative-a-transitional-jobs-program-to-improve-public-health) and final issue briefs about lessons from Mathematica’s coaching of career navigators who supported more than 300 community health workers under the Baltimore Health Corps Initiative: https://mathematica.org/publications/lessons-learned-from-the-baltimore-health-corps-initiative-a-transitional-jobs-program-to-improve Read an independent evaluation of the Baltimore Health Corps Initiative, prepared by Abt Associates: https://moed.baltimorecity.gov/news/press-releases/2022-08-19-evaluation-baltimore-health-corps-pilot-economic-and-public-health Explore a dashboard developed by Mathematica and the Public Health Foundation to present key demographic characteristics of (1) contact tracing trainees who received training through the TRAIN Learning Network and (2) the communities they serve: https://www.mathematica.org/dataviz/building-community-based-contact-tracing Read a blog explaining the purpose behind the contact-tracing dashboard developed by Mathematica and the Public Health Foundation: https://mathematica.org/blogs/insights-for-building-a-community-based-contact-tracing-workforce Explore an interactive map and table developed by Mathematica and the National Academy for State Health Policy that tracks state approaches to contact tracing for COVID-19: https://www.nashp.org/state-approaches-to-contact-tracing-covid-19/ Explore a Mathematica data visualization showing the importance of demographics and other community characteristics in informing approaches to contact tracing: https://www.mathematica.org/dataviz/grounding-state-contact-tracing-efforts-in-context Listen to an episode of On the Evidence about the variation in state approaches to contact tracing: https://www.mathematica.org/blogs/understanding-the-variation-in-states-covid-19-contact-tracing-approaches Listen to an episode of On the Evidence about the importance of building a community-based contact-tracing workforce: https://www.mathematica.org/blogs/contact-tracing-workforce-driving-equitable-sustained-risk-mitigation-in-a-post-pandemic-world Listen to an episode of On the Evidence about the importance of equity in implementing effective contact tracing: https://www.mathematica.org/blogs/early-lessons-for-effective-and-equitable-contact-tracing

79 | Using Data Transparency to Control Hospital Costs Sep 21, 2022

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On this episode of On the Evidence, guests Gloria Sachdev of the Employers’ Forum of Indiana, Maureen Hensley-Quinn of the National Academy for State Health Policy, and Evelyn Li and Guru Rasukonda of Mathematica discuss the value of new online tools for making sense of large sets of hospital cost and pricing data being made available in response to new federal regulations. A full transcript of the episode is available here: https://www.mathematica.org/blogs/using-data-transparency-to-control-hospital-costs Explore Sage Transparency, a free online tool developed by the Employers’ Forum of Indiana and Mathematica. The tool draws on data from the RAND 4.0 Hospital Price Transparency Study, Centers for Medicare & Medicaid Services, and other health databases to show the real prices that employers pay for health care across the country: https://employerptp.org/sage-transparency/ Explore the Hospital Cost Tool, a dashboard designed by the National Academy for State Health Policy and Mathematica, which helps bridge the information gaps on costs and pricing: http://d3g6lgu1zfs2l4.cloudfront.net/

78 | Addressing the Cash Cliff in Safety Net Programs: Lessons from a National Demonstration Jun 29, 2022

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Across many safety net programs, workers with low income and their families face the threat of a sudden and unexpected loss of benefits if their earnings increase too much, sometimes resulting in a net decrease in overall income. Policymakers have long worried that the phenomenon, often described as the cash or benefits cliff, discourages work and reinforces dependence on public assistance. Over the past decade, the Social Security Administration has launched two national demonstrations intended to mitigate this so-called cash cliff effect in the Social Security Disability Insurance (SSDI) program. The latest episode of On the Evidence explores the results of those demonstrations and what they mean for future efforts to address program cliffs in the SSDI program and many other safety net programs. Our guests for this episode are John Jones, David Wittenburg, and Diane Beaver. Jones is an economist at the Social Security Administration in the Office of Research, Demonstration, and Employment Support who has overseen several large-scale randomized controlled trials testing potential changes to the SSDI program, including two discussed on this episode: the Promoting Opportunity Demonstration (POD) and the Benefit Offset National Demonstration (BOND). Wittenburg is a senior fellow at Mathematica whose research on interventions to promote employment for people with disabilities includes evaluations of POD and BOND. Beaver is an advisory services analyst at Mathematica who spent more than a decade at a community nonprofit counseling people on how work and other entitlements would affect their Social Security benefits. In that role, she played a part in implementing POD and has firsthand knowledge of what beneficiaries experience as they navigate the patchwork of program rules that govern the amount of government aid people can receive for housing, food, child care, health care, and other needs as their work status changes. Find a full transcript of the episode here: mathematica.org/blogs/why-a-national-demonstration-to-mitigate-the-cash-cliff-in-one-safety-net-program-didnt-increase Read the final evaluation report on POD: https://www.ssa.gov/disabilityresearch/documents/POD_Final_Evaluation_Report.pdf Read the final evaluation report on BOND: https://www.ssa.gov/disabilityresearch/documents/BOND%20Deliv%2024e2%20FER%20Vol%201%2020181018.pdf Find a summary of lessons learned from several decades of demonstrations by the Social Security Administration to test policy ideas in the Social Security Disability Insurance and Supplemental Security Income programs: https://www.ssa.gov/disabilityresearch/demonstrations/lessons.htm Learn more about the Ultimate Demonstration referenced at the tail end of the episode: https://www.ssa.gov/disabilityresearch/documents/Simplification_Demo_TEP_Final_Report_Final%20Remediated.pdf Watch a recorded discussion between Pamela Herd and Sebastian Jilke, professors at the McCourt School of Public Policy at Georgetown University, about administrative burden in the Social Security Disability Insurance program: https://www.ssab.gov/announcements/ssab-to-host-experts-on-researching-and-evaluating-equitable-access-to-social-security-programs/

77 | Addressing a Primary Care Workforce Crisis Jun 08, 2022

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The latest episode of On the Evidence, the Mathematica podcast, explores the primary care workforce crisis, a complex and long-standing problem that was exacerbated by the COVID-19 pandemic. Guests Sue Lin, Luci Leykum, Julie Schilz, and Diane Rittenhouse discuss recent research on the nature of the problem as well as evidence-based solutions for strengthening primary care. Lin is the deputy office director of the Office of Quality Improvement within the Bureau of Primary Health Care at the Health Resources and Services Administration. Leykum is a professor in the Department of Internal Medicine at the Dell Medical School at the University of Texas at Austin who was involved in the creation of a report last year from the National Academies of Sciences, Engineering, and Medicine that looked ways to rebuild primary care. Schilz is a senior director on the Clinical and Quality Partners team at the Primary Care Development Corporation, which recently published a data brief on investing in primary care to achieve better health and equity in the United States. Rittenhouse is a family physician by training and a senior fellow at Mathematica, where she co-authored a report for the California Health Care Foundation that reviewed evidence that could inform health policies aimed at increasing the size and diversity of the primary care workforce in California. A full transcript of the episode is available here: mathematica.org/blogs/addressing-a-workforce-crisis-in-primary-care-made-more-severe-by-the-covid-19-pandemic Have questions for our podcast guests? Julie Schilz and Diane Rittenhouse will be participating in a Twitter chat co-hosted by Mathematica on June 23 from 2 to 3 p.m. ET on challenges and opportunities for the primary care workforce. Use the hashtag #PrimaryCarePolicyChat to find the chat on Twitter. Read the 2021 report from the National Academies of Sciences, Engineering, and Medicine on implementing high quality primary care: https://nap.nationalacademies.org/catalog/25983/implementing-high-quality-primary-care-rebuilding-the-foundation-of-health Read Mathematica’s 2021 review of evidence-based strategies for increasing the size and diversity of the primary care workforce in California: https://www.mathematica.org/publications/health-workforce-strategies-for-california-a-review-of-the-evidence Read the Primary Care Development Corporation’s May 2022 data brief on investing in primary care to improve health and equity: https://www.pcdc.org/resources/investing-in-primary-care-the-pathway-to-better-health-and-equity-in-the-united-states/

76 | The Costs of Untreated Maternal Mental Health Conditions May 04, 2022

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In honor of Maternal Mental Health Awareness Week, Mathematica’s podcast, On the Evidence, explores recent research on the societal costs of perinatal mood and anxiety disorders. These disorders—which can include depression, suicidal thoughts, and panic attacks—affect women and birthing people during pregnancy and the postpartum period. Although these disorders are common, they often go undiagnosed and untreated, which can negatively affect the long-term physical, emotional, and developmental health of the birthing parent and child. On this episode, Mathematica’s Kara Zivin, The Commonwealth Fund’s Laurie Zephyrin, and Texans Care for Children’s Adriana Kohler discuss the societal costs of maternal mental health conditions and how fresh evidence on those costs informed a policy change to improve the well-being of birthing people and their children in one state. Find a full transcript of the episode here: mathematica.org/blogs/the-costs-of-untreated-maternal-mental-health-conditions Additional resources: Read the 2021 issue brief from Mathematica and the St. David’s Foundation that estimated the societal costs of untreated maternal mental health conditions in Texas: https://mathematica.org/publications/untreated-maternal-mental-health-conditions-in-texas-costs-to-society-and-to-medicaid Read the 2021 issue brief from Mathematica and The Commonwealth Fund on the high costs of maternal morbidity: https://www.commonwealthfund.org/publications/issue-briefs/2021/nov/high-costs-maternal-morbidity-need-investment-maternal-health Read the 2019 issue brief from Mathematica, the California Health Care Foundation, the ZOMA Foundation, and the Perigee Fund on the societal costs of untreated perinatal mood and anxiety disorders in the United States: https://mathematica.org/publications/societal-costs-of-untreated-perinatal-mood-and-anxiety-disorders-in-the-united-states State-level estimates, which Mathematica produced as part of the same research, are also available: California: https://mathematica.org/publications/societal-costs-of-untreated-perinatal-mood-and-anxiety-disorders-in-california Colorado: https://mathematica.org/publications/societal-costs-of-untreated-perinatal-mood-and-anxiety-disorders-in-colorado Washington State: https://mathematica.org/publications/societal-costs-of-untreated-perinatal-mood-and-anxiety-disorders-in-washington Read an op-ed in STAT by Zivin, Zephyrin, and Mathematica’s So O’Neil about the toll of complications related to pregnancy and childbirth: https://www.statnews.com/2021/11/23/staggering-toll-pregnancy-childbirth-related-complications/ Read an op-ed in STAT by Zivin about how her personal experience with suicidal thoughts during pregnancy drove her to conduct research on access to health care for women with mental health and substance use conditions during pregnancy and postpartum: https://www.statnews.com/2021/03/11/meghan-markle-gave-voice-to-the-despair-i-once-felt-during-pregnancy/

75 | Human Services Adapted During the Pandemic. What Will Stick? Apr 27, 2022

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The COVID-19 pandemic prompted human services agencies to rethink how they engage with clients and how they address persistent stress and trauma experienced by their own staff. On this episode of On the Evidence, Mathematica’s J.B. Wogan and Diana McCallum discuss how human services agencies have adapted during the pandemic. The episode also includes insights from Kataney Couamin and Andrea Barnum, who work at local agencies providing workforce services, as well as Mathematica’s Jonathan McCay and The Adjacent Possible’s Michelle Derr, who have provided research and evaluation technical assistance to state, tribal, and local agencies that administer the Temporary Assistance for Needy Families program. Find a full transcript of the episode here: mathematica.org/blogs/pandemic-era-adaptations-in-human-services-could-fill-a-need-even-outside-a-public-health-emergency Read the issue brief about supporting mental wellness for TANF program staff and participants: https://www.acf.hhs.gov/opre/report/supporting-mental-wellness-program-staff-and-participants-strategies-temporary Read the issue brief about pandemic-era innovations for the future of Temporary Assistance for Needy Families programs: https://www.acf.hhs.gov/opre/report/brief-pandemic-era-innovations-future-temporary-assistance-needy-families-programs Read the issue brief about lessons from delivering remote services to job seekers with low incomes during the COVID-19 pandemic: https://pathwaystowork.acf.hhs.gov/pathways_publications/lessons-learned-delivering-remote-services-job-seekers-low-incomes-during Read the issue brief about what works to help job seekers with low incomes during economic recessions and recoveries: https://mathematica.org/publications/what-works-during-economic-recessions-and-recoveries-evidence-from-the-pathways-clearinghouse Read the issue brief about providing coaching and navigation services virtually to promote economic mobility during the pandemic: https://www.mathematica.org/publications/using-coaching-and-navigation-to-promote-economic-mobility-how-might-programs-provide-these-services Read a program snapshot about a nonprofit in South Carolina that used virtual services to continue supporting fathers during the pandemic: https://www.mathematica.org/publications/engaging-fathers-during-the-covid-19-pandemic-and-beyond-program-snapshot

74 | Globalizing Evidence-Based Solutions for an Interdependent World Mar 16, 2022

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As the COVID-19 pandemic and climate change demonstrate, in an increasingly interdependent world, communities across the globe face shared challenges and need shared solutions. In the latest episode of On the Evidence, Adam Coyne, Chris Boyd, and Respichius Deogratias Mitti discuss the changing role of data and evidence in supporting decisions to improve well-being in a more interconnected world. Coyne oversaw international research at Mathematica for most of the past two years and currently serves as the company’s chief growth officer. Boyd is the managing director of EDI Global, a data collection and research organization focused on East Africa that became a subsidiary of Mathematica in 2018. Mitti is a country director for EDI Global who lives and works in Tanzania. A transcript of the episode is available at mathematica.org/blogs/the-globalization-of-evidence-informed-decision-making-in-a-more-interdependent-world Learn more about Chris Boyd, the managing director of EDI Global, in a recent Q&A for Mathematica’s blog: https://www.mathematica.org/blogs/a-conversation-with-chris-boyd Learn more about Mathematica’s international research in more than 50 countries across Africa, Asia, and Latin America: https://mathematica.org/focus-areas/international-research Learn more about Mathematica’s ground-breaking work on studying negative income tax experiments in the United States, which has informed pilot projects in other countries as well as in the U.S. to test the impacts of monthly guaranteed income payments: https://mathematica.org/blogs/idea-that-launched-a-policy-research-revolution

73 | Ensuring Equity as Wastewater Testing for COVID-19 Matures in the United States Mar 02, 2022

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Sewage has proven to be a valuable source of real-time SARS-CoV-2 data during the COVID-19 pandemic, giving public officials insights into the health of their community without relying on individuals getting tested. But as wastewater monitoring expands, local officials and their research partners are increasingly interested in how wastewater testing might also advance or hinder equity. On this episode of On the Evidence, guests Dr. Na’Taki Osborne Jelks, Dr. Otakuye Conroy-Ben, and Aparna Keshaviah discuss the challenges of and opportunities for ensuring an equitable approach to wastewater monitoring and the importance of representation from historic Black neighborhoods, Indigenous communities, and rural communities. Jelks, Conroy-Ben, and Keshaviah are involved with the Wastewater Action Group, a national initiative founded and supported by the Rockefeller Foundation’s Pandemic Prevention Institute that seeks to transform wastewater data into public health action. The group includes five grantees that serve tribal nations and four cities: Atlanta, Houston, Louisville, and Tulsa. • Jelks, an assistant professor in environmental and health sciences at Spelman College, is an expert on health equity and community-engaged research approaches for environmental justice in southwest and northwest Atlanta’s African-American neighborhoods. • Conroy-Ben is an assistant professor of environmental engineering at Arizona State University, a member of the Oglala Lakota Nation, and the principal investigator for research and community outreach projects funded by the National Science Foundation and the National Institutes of Health to support tribal nations in combatting coronavirus and improving local resources. • Keshaviah is an applied biostatistician and principal researcher at Mathematica who is a nationally recognized expert in translational wastewater research, has led wastewater-based research in Montana and North Carolina, and is collaborating with the Rockefeller Foundation to develop robust analytics and tools that boost the capacity of public health personnel to use wastewater data. Find a full transcript of the episode here: https://www.mathematica.org/blogs/ensuring-equity-as-wastewater-testing-matures-in-the-united-states To learn more about the Wastewater Action Group and the Rockefeller Foundation’s broader wastewater activities, contact Megan Diamond, who leads its international wastewater initiatives: mdiamond@rockfound.org Learn more about the Rockefeller Foundation’s efforts to deliver an equitable and sustainable recovery from the COVID-19 pandemic while helping to guard against future pandemics: https://www.rockefellerfoundation.org/covid-19-response/ Learn more about Mathematica’s work harnessing evidence on wastewater testing, vaccines, rapid antigen tests, and contact tracing to guide the COVID-19 pandemic response: https://mathematica.org/focus-areas/health/covid-19

72 | Bayesian Methods Could Provide the Key to Answering Which Policies Work Best for Whom Feb 16, 2022

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On this episode of On the Evidence, Mathematica’s Mariel Finucane and John Deke join Tim Day of the Center for Medicare & Medicaid Innovation to discuss the application of evidence-informed Bayesian methods that not only confirm whether a policy or program works, but for whom. Learn more about Mathematica's work using evidence-based Bayesian methods in applied policy research: https://mathematica.org/features/bayesian-methods Read a brief about using a Bayesian framework for interpreting findings from impact evaluations prepared by Mariel Finucane and John Deke for the Office of Planning, Research and Evaluation at the Administration for Children and Families: mathematica.org/publications/moving-beyond-statistical-significance-the-basie-bayesian-interpretation-of-estimates-framework Read a paper co-authored by Mariel Finucane that compares Bayesian methods with the traditional frequentist approach to estimate the effects of a Centers for Medicare & Medicaid Services demonstration on Medicare spending: mathematica.org/publications/revolutionizing-estimation-and-inference-for-program-evaluation-using-bayesian-methods Read a paper co-authored by Tim Day describing an experiment to provide evidence that would be useful to policymakers and other decision makers through an interactive data visualization dashboard, presenting results from both frequentist and Bayesian analyses: https://www.researchgate.net/publication/335169870_Making_Evidence_Actionable_Interactive_Dashboards_Bayes_and_Health_Care_Innovation Read Emily Oster’s newsletter article about why and how she applies Bayes’s Rule to interpret new evidence in the context of existing evidence, including a recent study (https://emilyoster.substack.com/p/does-pre-k-really-hurt-future-test) about the effects of a preschool program in Tennessee on future student test scores: https://emilyoster.substack.com/p/bayes-rule-is-my-faves-rule

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