Financing prevention: opportunities for economic analysis across the translational research cycle

Abstract

Prevention advocates often make the case that preventive intervention not only improves public health and welfare but also can save public resources. Increasingly, evidence-based policy efforts considering prevention are focusing on how programs can save taxpayer resources from reduced burden on health, criminal justice, and social service systems. Evidence of prevention's return has begun to draw substantial investments from the public and private sector. Yet, translating prevention effectiveness into economic impact requires specific economic analyses to be employed across the stages of translational research. This work discusses the role of economic analysis in prevention science and presents key translational research opportunities to meet growing demand for estimates of prevention's economic and fiscal impact.

Translating Prevention Research for Evidence-Based Policymaking: Results from the Research-to-Policy Collaboration Pilot

“…For instance, policymakers have increasingly used tiered evidence initiatives that predicate public spending for different social programs on attaining certain thresholds of empirical evidence (e.g., impacts found within randomized controlled trials, replication, large-scale studies; Haskins & Margolis, 2015). Despite early successes, many opportunities to incorporate prevention science into policy have yet to be realized (Crowley & Jones, 2015; Fishbein, Ridenour, Stahl, & Sussman, 2016; National Academies of Sciences, Engineering, and Medicine, 2016). This is particularly concerning considering the growing evidence that social and behavioral prevention strategies can improve health and save public resources (National Academies of Sciences, Engineering, and Medicine, 2016; O’Connell, Boat, & Warner, 2009).…”

A Framework for Valuing Investments in a Nurturing Society: Opportunities for Prevention Research

“…Strategies to enhance investments in a nurturing society are distinct from tertiary efforts that only address problems (or the symptoms of problems) after major and potentially irreversible outcomes occur (e.g., treatment of preventable chronic illness, mass incarceration, permanent removal of children from their families). Instead, such strategies tend to be preventive in nature—seeking to promote skills and abilities characterized by ‘upstream’ deployment of resources to avert the consumption of an even greater amount of public spending in the future (i.e., downstream; Crowley & Jones, 2015; National Academies of Medicine, 2015). …”

“…Many preventive interventions offer the ability to orient spending within these systems toward upstream investments that negate the need for downstream costs (Crowley & Jones, 2015; National Academies of Medicine, 2015). These could be programs embedded within a specific system (e.g., Drug Courts) that avoid future spending within that system (e.g., corrections spending from incarceration).…”

“…If trial participants can be linked to administrative records within each system, it may be feasible to conduct high-quality cross-system analyses (Crowley, 2015; Garnier & Poertner, 2000). In many cases administrative data will not be available and researchers will need to employ survey methods to assess impact on systems (Guyll, Spoth, & Crowley, 2011; Kuklinski et al, 2012).…”

“…This work described here offers a framework for such research. The growing need to value efforts to nurture children and families requires an understanding of how public resources are spent and how the success of those individuals in turn support future public investment (i.e., priorities, resources, tax revenue; Crowley & Jones, 2015; National Academies of Medicine, 2014). In particular there is an imperative need to reduce approaches that exacerbate exposure to coercion and conflict and augment and increase support for prosocial behavior (see Biglan, 2015) There are multiple public systems used to invest in children and families that should be considered (Currie, 2006; Issacs, Edelstein, Hahn, Toran, & Steurle, 2013).…”