Why doesn’t evidence win the day in policy and policymaking?

cairney-southampton-evidence-win-the-dayPolitics has a profound influence on the use of evidence in policy, but we need to look ‘beyond the headlines’ for a sense of perspective on its impact.

It is tempting for scientists to identify the pathological effect of politics on policymaking, particularly after high profile events such as the ‘Brexit’ vote in the UK and the election of Donald Trump as US President. We have allegedly entered an era of ‘post-truth politics’ in which ideology and emotion trumps evidence and expertise (a story told many times at events like this), particularly when issues are salient.

Yet, most policy is processed out of this public spotlight, because the flip side of high attention to one issue is minimal attention to most others. Science has a crucial role in this more humdrum day-to-day business of policymaking which is far more important than visible. Indeed, this lack of public visibility can help many actors secure a privileged position in the policy process (and further exclude citizens).

In some cases, experts are consulted routinely. There is often a ‘logic’ of consultation with the ‘usual suspects’, including the actors most able to provide evidence-informed advice. In others, scientific evidence is often so taken for granted that it is part of the language in which policymakers identify problems and solutions.

In that context, we need better explanations of an ‘evidence-policy’ gap than the pathologies of politics and egregious biases of politicians.

To understand this process, and appearance of contradiction between excluded versus privileged experts, consider the role of evidence in politics and policymaking from three different perspectives.

The perspective of scientists involved primarily in the supply of evidence

Scientists produce high quality evidence only for politicians often ignore it or, even worse, distort its message to support their ideologically-driven policies. If they expect ‘evidence-based policymaking’ they soon become disenchanted and conclude that ‘policy-based evidence’ is more likely. This perspective has long been expressed in scientific journals and commentaries, but has taken on new significance following ‘Brexit’ and Trump.

The perspective of elected politicians

Elected politicians are involved primarily in managing government and maximising public and organisational support for policies. So, scientific evidence is one piece of a large puzzle. They may begin with a manifesto for government and, if elected, feel an obligation to carry it out. Evidence may play a part in that process but the search for evidence on policy solutions is not necessarily prompted by evidence of policy problems.

Further, ‘evidence based policy’ is one of many governance principles that politicians should feel the need to juggle. For example, in Westminster systems, ministers may try to delegate policymaking to foster ‘localism’ and/ or pragmatic policymaking, but also intervene to appear to be in control of policy, to foster a sense of accountability built on an electoral imperative. The likely mix of delegation and intervention seems almost impossible to predict, and this dynamic has a knock-on effect for evidence-informed policy. In some cases, central governments roll out the same basic policy intervention and limit local discretion; in others, it identifies broad outcomes and invites other bodies to gather evidence on how best to meet them. These differences in approach can have profound consequences on the models of evidence-informed policy available to us (see the example of Scottish policymaking).

Political science and policy studies provide a third perspective

Policy theories help us identify the relationship between evidence and policy by showing that a modern focus on ‘evidence-based policymaking’ (EBPM) is one of many versions of the same fairy tale – about ‘rational’ policymaking – that have developed in the post-war period. We talk about ‘bounded rationality’ to identify key ways in which policymakers or organisations could not achieve ‘comprehensive rationality’:

  1. They cannot separate values and facts.
  2. They have multiple, often unclear, objectives which are difficult to rank in any meaningful way.
  3. They have to use major shortcuts to gather a limited amount of information in a limited time.
  4. They can’t make policy from the ‘top down’ in a cycle of ordered and linear stages.

Limits to ‘rational’ policymaking: two shortcuts to make decisions

We can sum up the first three bullet points with one statement: policymakers have to try to evaluate and solve many problems without the ability to understand what they are, how they feel about them as a whole, and what effect their actions will have.

To do so, they use two shortcuts: ‘rational’, by pursuing clear goals and prioritizing certain kinds and sources of information, and ‘irrational’, by drawing on emotions, gut feelings, deeply held beliefs, habits, and the familiar to make decisions quickly.

Consequently, the focus of policy theories is on the links between evidence, persuasion, and framing issues to produce or reinforce a dominant way to define policy problems. Successful actors combine evidence and emotional appeals or simple stories to capture policymaker attention, and/ or help policymakers interpret information through the lens of their strongly-held beliefs.

Scientific evidence plays its part, but scientists often make the mistake of trying to bombard policymakers with evidence when they should be trying to (a) understand how policymakers understand problems, so that they can anticipate their demand for evidence, and (b) frame their evidence according to the cognitive biases of their audience.

Policymaking in ‘complex systems’ or multi-level policymaking environments

Policymaking takes place in less ordered, less hierarchical, and less predictable environment than suggested by the image of the policy cycle. Such environments are made up of:

  1. a wide range of actors (individuals and organisations) influencing policy at many levels of government
  2. a proliferation of rules and norms followed by different levels or types of government
  3. close relationships (‘networks’) between policymakers and powerful actors
  4. a tendency for certain beliefs or ‘paradigms’ to dominate discussion
  5. shifting policy conditions and events that can prompt policymaker attention to lurch at short notice.

These five properties – plus a ‘model of the individual’ built on a discussion of ‘bounded rationality’ – make up the building blocks of policy theories (many of which I summarise in 1000 Word posts). I say this partly to aid interdisciplinary conversation: of course, each theory has its own literature and jargon, and it is difficult to compare and combine their insights, but if you are trained in a different discipline it’s unfair to ask you devote years of your life to studying policy theory to end up at this point.

To show that policy theories have a lot to offer, I have been trying to distil their collective insights into a handy guide – using this same basic format – that you can apply to a variety of different situations, from explaining painfully slow policy change in some areas but dramatic change in others, to highlighting ways in which you can respond effectively.

We can use this approach to help answer many kinds of questions. With my Southampton gig in mind, let’s use some examples from public health and prevention.

Why doesn’t evidence win the day in tobacco policy?

My colleagues and I try to explain why it takes so long for the evidence on smoking and health to have a proportionate impact on policy. Usually, at the back of my mind, is a public health professional audience trying to work out why policymakers don’t act quickly or effectively enough when presented with unequivocal scientific evidence. More recently, they wonder why there is such uneven implementation of a global agreement – the WHO Framework Convention on Tobacco Control – that almost every country in the world has signed.

We identify three conditions under which evidence will ‘win the day’:

  1. Actors are able to use scientific evidence to persuade policymakers to pay attention to, and shift their understanding of, policy problems. In leading countries, it took decades to command attention to the health effects of smoking, reframe tobacco primarily as a public health epidemic (not an economic good), and generate support for the most effective evidence-based solutions.
  2. The policy environment becomes conducive to policy change. A new and dominant frame helps give health departments (often in multiple venues) a greater role; health departments foster networks with public health and medical groups at the expense of the tobacco industry; and, they emphasise the socioeconomic conditions – reductions in smoking prevalence, opposition to tobacco control, and economic benefits to tobacco – supportive of tobacco control.
  3. Actors exploit ‘windows of opportunity’ successfully. A supportive frame and policy environment maximises the chances of high attention to a public health epidemic and provides the motive and opportunity of policymakers to select relatively restrictive policy instruments.

So, scientific evidence is a necessary but insufficient condition for major policy change. Key actors do not simply respond to new evidence: they use it as a resource to further their aims, to frame policy problems in ways that will generate policymaker attention, and underpin technically and politically feasible solutions that policymakers will have the motive and opportunity to select. This remains true even when the evidence seems unequivocal and when countries have signed up to an international agreement which commits them to major policy change. Such commitments can only be fulfilled over the long term, when actors help change the policy environment in which these decisions are made and implemented. So far, this change has not occurred in most countries (or, in other aspects of public health in the UK, such as alcohol policy).

Why doesn’t evidence win the day in prevention and early intervention policy?

UK and devolved governments draw on health and economic evidence to make a strong and highly visible commitment to preventive policymaking, in which the aim is to intervene earlier in people’s lives to improve wellbeing and reduce socioeconomic inequalities and/ or public sector costs. This agenda has existed in one form or another for decades without the same signs of progress we now associate with areas like tobacco control. Indeed, the comparison is instructive, since prevention policy rarely meets the three conditions outlined above:

  1. Prevention is a highly ambiguous term and many actors make sense of it in many different ways. There is no equivalent to a major shift in problem definition for prevention policy as a whole, and little agreement on how to determine the most effective or cost-effective solutions.
  2. A supportive policy environment is far harder to identify. Prevention policy cross-cuts many policymaking venues at many levels of government, with little evidence of ‘ownership’ by key venues. Consequently, there are many overlapping rules on how and from whom to seek evidence. Networks are diffuse and hard to manage. There is no dominant way of thinking across government (although the Treasury’s ‘value for money’ focus is key currency across departments). There are many socioeconomic indicators of policy problems but little agreement on how to measure or which measures to privilege (particularly when predicting future outcomes).
  3. The ‘window of opportunity’ was to adopt a vague solution to an ambiguous policy problem, providing a limited sense of policy direction. There have been several ‘windows’ for more specific initiatives, but their links to an overarching policy agenda are unclear.

These limitations help explain slow progress in key areas. The absence of an unequivocal frame, backed strongly by key actors, leaves policy change vulnerable to successful opposition, especially in areas where early intervention has major implications for redistribution (taking from existing services to invest in others) and personal freedom (encouraging or obliging behavioural change). The vagueness and long term nature of policy aims – to solve problems that often seem intractable – makes them uncompetitive, and often undermined by more specific short term aims with a measurable pay-off (as when, for example, funding for public health loses out to funding to shore up hospital management). It is too easy to reframe existing policy solutions as preventive if the definition of prevention remains slippery, and too difficult to demonstrate the population-wide success of measures generally applied to high risk groups.

What happens when attitudes to two key principles – evidence based policy and localism – play out at the same time?

A lot of discussion of the politics of EBPM assumes that there is something akin to a scientific consensus on which policymakers do not act proportionately. Yet, in many areas – such as social policy and social work – there is great disagreement on how to generate and evaluate the best evidence. Broadly speaking, a hierarchy of evidence built on ‘evidence based medicine’ – which has randomised control trials and their systematic review at the top, and practitioner knowledge and service user feedback at the bottom – may be completely subverted by other academics and practitioners. This disagreement helps produce a spectrum of ways in which we might roll-out evidence based interventions, from an RCT-driven roll-out of the same basic intervention to a storytelling driven pursuit of tailored responses built primarily on governance principles (such as to co-produce policy with users).

At the same time, governments may be wrestling with their own governance principles, including EBPM but also regarding the most appropriate balance between centralism and localism.

If you put both concerns together, you have a variety of possible outcomes (and a temptation to ‘let a thousand flowers bloom’) and a set of competing options (outlined in table 1), all under the banner of ‘evidence based’ policymaking.

Table 1 Three ideal types EBBP

What happens when a small amount of evidence goes a very long way?

So, even if you imagine a perfectly sincere policymaker committed to EBPM, you’d still not be quite sure what they took it to mean in practice. If you assume this commitment is a bit less sincere, and you add in the need to act quickly to use the available evidence and satisfy your electoral audience, you get all sorts of responses based in some part on a reference to evidence.

One fascinating case is of the UK Government’s ‘troubled families’ programme which combined bits and pieces of evidence with ideology and a Westminster-style-accountability imperative, to produce:

  • The argument that the London riots were caused by family breakdown and bad parenting.
  • The use of proxy measures to identify the most troubled families
  • The use of superficial performance management to justify notionally extra expenditure for local authorities
  • The use of evidence in a problematic way, from exaggerating the success of existing ‘family intervention projects’ to sensationalising neuroscientific images related to brain development in deprived children …

normal brain

…but also

In other words, some governments feel the need to dress up their evidence-informed policies in a language appropriate to Westminster politics. Unless we understand this language, and the incentives for elected policymakers to use it, we will fail to understand how to act effectively to influence those policymakers.

What can you do to maximise the use of evidence?

When you ask the generic question you can generate a set of transferable strategies to engage in policymaking:

how-to-be-heard

ebpm-5-things-to-do

Yet, as these case studies of public health and social policy suggest, the question lacks sufficient meaning when applied to real world settings. Would you expect the advice that I give to (primarily) natural scientists (primarily in the US) to be identical to advice for social scientists in specific fields (in, say, the UK)?

No, you’d expect me to end with a call for more research! See for example this special issue in which many scholars from many disciplines suggest insights on how to maximise the use of evidence in policy.

Palgrave C special

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The Science of Evidence-based Policymaking: How to Be Heard

I was interviewed in Science, on the topic of evidence-based policymaking, and we discussed some top tips for people seeking to maximise the use of evidence in a complex policy process (or, perhaps, feel less dispirited about the lack of EBPM in many cases). If it sparks your interest, I have some other work on this topic:

I am editing a series of forthcoming articles on maximising the use of scientific evidence in policy, and the idea is that health and environmental scientists can learn from many other disciplines about how to, for example, anticipate policymaker psychology, find the right policymaking venue, understand its rules and ‘currency’ (the language people use, to reflect dominant ways of thinking about problems), and tell effective stories to the right people.

Palgrave C special

I have also completed a book, some journal articles (PAR, E&P), and some blog posts on the ‘politics of evidence-based policymaking’.

Pivot cover

Two posts appear in the Guardian political science blog (me, me and Kathryn Oliver).

One post, for practitioners, has ‘5 things you need to know’, and it links to presentations on the same theme to different audiences (Scotland, US, EU).

ebpm-5-things-to-do

In this post, I’m trying to think through in more detail what we do with such insights.

The insights I describe come from policy theory, and I have produced 25 posts which introduce each of them in 1000 words (or, if you are super busy, 500 words). For example, the Science interview mentions a spirograph of many cycles, which is a reference to the idea of a policy cycle. Also look out for the 1000-word posts on framing and narrative and think about how they relate to the use of storytelling in policy.

If you like what you see, and want to see more, have a look at my general list of offerings (home page) or list of books and articles with links to theirs PDFs (CV).

how-to-be-heard

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Combine Good Evidence and Emotional Stories to Change the World

total-exposure

This is my 2-page pitch for the Political Studies Association’s Total Exposure 2017 event on Thursday:

People are too quick to criticise the negative role of ideology, emotion, and manipulation in politics, especially after ‘Brexit’ and the rise of Donald Trump. Yet, a good positive and emotional story with a hero or convincing theme is just as important as ‘the evidence’ to social and policy change. This programme gives examples, shows you how to do it, and identifies what stories work. Through first person narrative, it describes the experiences of people telling their own stories, or of their heroes, to generate political attention and support for their cause. It provides additional narrative by experts on storytelling as a craft, and on the science of storytelling effectiveness, to connect powerful stories with the evidence on their role in politics. The end result is a programme which is entertaining, socially relevant, and informative. It will be backed up by further (accessible) reading for people inspired by its message and keen to learn and act accordingly.

Background: telling positive stories for political change

The Brexit vote, and the election of Donald Trump US President, really knocked the stuffing out of people who believe in the primacy of science. Many scientists seem shocked by what they perceive to be ‘post-truth politics’ in which ideology beats evidence.

This post-truth theme has begun to dominate academic discussions on social media and academic conferences. It is a timely issue in which a clear theme has emerged among scientific circles. Its message is dangerous, with the potential to further alienate scientists from politicians and members of the public. It could undermine the prospect of pragmatic debates, in which there is meaningful conversation between people with different points of view, and instead reinforce a tendency for people to speak only with the people whose beliefs they already share.

Too much ‘post-truth politics’ discussion is self-indulgent. Too many academics are quick to demonise the cynical world of politics and politicians and to romanticise their own causes or objectivity. They need to acknowledge that ideological and emotional thinking is a natural part of life, and a part of life to which they are not immune. ‘Experts’ are storytellers for their own cause, and they tell each other the same story about post-truth politics. What separates them from their competitors is that the latter are better at telling effective stories which manipulate the beliefs and emotions of their audience.

So, what can they do about it? Tell good, positive stories, combining scientific evidence with emotional hooks, to help people understand and care about important political issues.

Tell Good Stories to Get What You Want in Politics

So, this programme portrays storytelling in a more positive light, demonstrating how to tell a story with political impact. Its main themes will be ‘hope’ and ‘fear’, to contrast two strategies:

  1. Examples like Brexit and Donald Trump’s campaign are associated with fear, to identify villains (such as immigrants and terrorists) and describe political or policy change as a way to punish them. As short term strategies they are difficult to counter with reference to ‘the evidence’. Some opponents of Brexit and Trump are coming to terms with this strategic problem, but often do not have the knowledge or skills on which to base an effective response.
  2. Examples from other fields are associated with hope, often to identify heroes as symbols of positive political change, or to identify the broad political themes that these heroes represent. The programme can draw on a long list of well-established and promising stories – in fields such as sex work, LGBT rights, immigrant rights, HIV, mental health, criminal justice, disaster relief, and climate change – in which there are skilled advocates for major social and political change.

The discussions would be interspersed with expert commentary, on how to tell stories well and on the evidence of storytelling effectiveness, to provide key ‘take home’ messages on what makes an emotionally engaging story that people talk about and act on.

The Project’s Incredible Timeliness

The project is timely as a political issue. It is also timely in organisational terms. I have been discussing with Brett Davidson of Open Society Foundations (New York) this theme of storytelling, and how it relates to ‘evidence based policymaking’ (as part of a special collection of academic articles on evidence and policy). Davidson is an experienced radio journalist and convenor of a recent 2-day workshop on storytelling. My confidence in the theme of storytelling, and of identifying key stories and commentary, resulted from attending that workshop and hearing their stories and evidence.

The Large International Market

Brexit and Trump provide UK and US hooks that receive high global attention. The stories on which we can draw include personal experiences from people in South-East Asia, South Africa, the US, Latin America, and Eastern Europe (and indirect experiences in places like Syria and Palestine). As a whole, they provide global appeal and a range of salient topics. The immediate market for our academic work is academic, but the themes are wider and should appeal to audiences of radio shows/ podcasts like This American Life. Indeed, given the theme of the programme, it would be useful to follow a similar storytelling format. It could find, for example, a BBC Radio 4 audience but also be marketed as a podcast with international appeal.

The Major Long Term Impact: producing a new generation of storytelling scientists

My ‘high bar’ aim is to prompt a process in this order:

  1. We produce a programme which captures the attention of (the public and) academics and scientists.
  2. They listen to the show and recognise the impact of stories on them: their piqued interest is followed by their emotional engagement.
  3. They recognise the role that storytelling might have in their own research.
  4. We address their initial scepticism by providing some detail on the evidence of the impact of good stories on social and policy change.
  5. Many get in touch with us, and work with us to help them become scientist storytellers.

Bullet 5 is the main legacy. I have begun to work with Jerome Deroy, CEO of Narativ: The Listening and Storytelling Company, to explore the idea of training scientists to be effective storytellers. It could provide a follow-up show in which scientists explain the relevance of their evidence to pressing social and political problems.

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Who are the most deserving and entitled to government benefits?

desrving-and-entitled-book-cover

Schneider and Ingram’s work on Social Construction and Policy Design identifies the populations deemed by policymakers to deserve the benefits or punishments of government policy.

The most concerted attempt to use this theoretical framework empirically is in Schneider and Ingram’s (2005b) edited book Deserving and Entitled, which focuses primarily on the social construction of particular target populations and its largely degenerative effect on US policy design (introduction here).

In this post, I summarise their insights in about 3000 words, splitting their five parts into seven main insights (that way, I can provide a far shorter summary in a journal article, and refer to this page for more discussion).

Insight 1: Policy designs that we take for granted now were built on social constructions of selective deservingness in the (often very distant) past, with key choices setting a precedent for policy design expansion.

Selective group entitlement to state benefits can be traced to the rules created in 1818, initially for very specific ‘veterans of the American Revolution’, providing benefits if they were: men who had travelled extensively to fight for at least nine months and were now ‘poor or unable to work’ (Jensen, 2005: 37). This excluded women, people who were otherwise poor, and veteran militia who fought locally. Officers were paid $20 per month but soldiers $8 (2005: 57). By 1832, pension entitlement extended to all who served for two years, and in 1836 it was expanded to their dependents if they died from war injuries. In 1871, Congress approved a non-means tested pension for those who served in the War of 1812 (and their widows) if they had demonstrated their patriotism by remaining ‘loyal to the United Stated during the Civil War’ and swearing an ‘oath to support the Constitution’, which excluded ‘aged southerners’ (2005: 58). Each expansion encouraged veteran participation: sending a signal about the entitlements that they would receive, or could campaign for if they didn’t.

Selective group exclusion from the ‘universal’ electoral franchise can be traced to a similar time, when many politicians equated popular participation with ‘mob rule’ and sought to limit inclusion. Schriner (2005: 66-7; 73; 76) identifies attempts to exclude ‘idiots’ and the ‘insane’ as the ‘antithesis of the democratic citizen’. For many politicians, they lacked the ‘intellectual competence necessary for political participation’ and/or were mistrusted by the politicians who equated incompetence with deviance, ‘moral degeneracy, dependency, and crime’ (2005: 76). These exclusions only came under serious challenge when social reformers had some success in shifting wider social constructions on mental capacity, highlighting the cruelty of asylums and challenging the link between intellectual incompetence and moral deviance (2005: 76).

Insight 2: Successful challenges to the social construction of target populations are possible but seem exceptional (and, can be at the expense of other minority groups).

Dialto (2005: 81) suggests that the image of Japanese-Americans shifted profoundly between 1941-61, from the hostility and fear of immigrant aliens underpinning WW2 relocation and interment (preceded by late 19th and early 20th century legal rulings which excluded naturalisation and the ability to buy land) to the tag of ‘model minority’ and good citizen. Strategies to change this image did not challenge discrimination directly: finding legal loopholes on land ownership through American-born children; internalising ‘their negative social construction’ and focusing on earning US citizenship (both before WW2); and, crucially, forming a Japanese-American US Army unit which earned war hero status (2005: 90-8). These efforts were reinforced by shifting contexts: internally, Japanese Americans were seen as less of an economic threat (internment left them ‘economically devastated’), and externally, Japan shifted from a threat to a common force against communism and new source of trade (2005: 98).

Court cases in the 1950s helped shift the rules of naturalisation and land ownership. Media coverage in the 1960s used positive portrayals of Japanese Americans, as working hard to overcome hardship, to contrast them with negative portrayals of others and ‘keep other minorities, such as blacks and Chicanos, in their place’ (2005: 99). The US President effectively apologised for internment in 1976, and Congress approved one-off compensation for internment survivors in 1988, and key federal court cases in the late 1980s challenged the War Department’s basis for discriminatory behaviour and convictions (2005: 100). Still, the ‘model minority’ tag has profound drawbacks, in which Japanese Americans perceive the need to live up to a stereotype to gain acceptance, while still facing social discrimination and violence (2005: 100). In other words, the shifting social construction of a social group does not necessarily indicate its growing power.

Insight 3: Advocates have used national policymaking institutions as a source of major change in policy design, but often with limited effects on delivery and/ or profound unintended consequences.

Although often contributing to degenerative policy design, Congress has proved a key organisation to challenging negative social constructions based on race. However, advocates of housing reform to reduce desegregation addressed major opposition (including public, congressional, and business) by assigning deserving/ undeserving status within racial minorities. The narrative underpinning legislative change on fair housing in 1968 was that only some black people deserved to benefit from policy: advocates told individual stories of the black middle class rejecting the life of the black rioter, who ‘deserved to escape the ghettos’, which helped create a race-based underclass (Sidney, 2005: 114-5). Further, this strategy secured very limited policy and social change, partly because few black people could afford the market price of homes in white areas (2005: 118). As predicted by Schneider and Ingram, the ‘benefits to weak groups’ are ‘undersubscribed and conferred at levels insufficient to change behaviour to an extent that it would remediate the problem’ (2005: 119). Policy changes in the late 70s and 80s were based on a ‘diluted’ message on race, focusing for example on the negative role of financial institutions, wider sources (such as class and age) of potential discrimination in housing, or on specific regions (not populations) that might benefit from community investment: the long term benefits of policy to reduce racial desegregation ‘remain fragile and open to dilution or contestation’ (2005: 137).

Congress also acted positively on immigration in 1965, making it ‘no longer acceptable’ for policies to ‘single out groups for exclusion on the base of race or national origin’. In 1986, it gave amnesty to illegal immigrants working in the US for five years, and punished employers not individuals for illegal immigration (Netwon, 2005: 139; 143). Yet, there remain fluctuations in social constructions of which target populations are willing and able to assimilate to achieve legitimate American citizenship, measured according to: legal citizenship, positive values regarding ‘hard work and self sufficiency’, and negative connotations of foreigners committing crimes, procreating excessively, claiming welfare and, during times of economic uncertainty, taking ‘scarce jobs from Americans’ (2005: 139-40; 142).

These negative constructions informed legislation from 1996 which increased southern border patrol staff, equipment, barriers, and detention facilities, made it easier to deport, raised the bar for employers to demonstrate continuously and adequately paid jobs, and reduced entitlement to social security, housing, and higher education subsidies to ‘remove the lure of public benefits’ for ‘problem’ immigrants (2005: 145-6; 151). In congressional debate, ways to define ‘unworthy’ immigrants related to arguments such as: they are freeloaders not paying taxes, but their children get access to free schools; if they break the law to get here, they’ll break the law while here; immigrants are causing a ‘lawless border’ that local law enforcement can’t control; and, an ineffective federal government is hindering border enforcement and blaming employers rather than the criminals (2005: 151-7). Further, rather than challenging such positions with positive counter narratives, opponents used a ‘cure worse than disease’ argument which pointed to the major unintended consequences of policy (for example, removing school entitlement will worsen crime) (2005: 163). Overall, congressional debates signal ‘who matters’ and which people (primarily Mexican) are the ‘wrong kinds of immigrants’ (2005: 166).

Insight 4: public and non-governmental bodies have some discretion to make policy when they deliver. The evidence is mixed on the extent to which those actors use that chance to reframe target populations more positively.

The social and welfare organisations funded to help target populations are often the bodies identifying many as undeserving. For example, Jurik and Cowgill (2005: 173) describe the difference between a potentially positive rationale and negative experience of ‘microenterprise development programs’. MDPs are often initially designed to reduce poverty by helping low-income people of colour with ‘business loans and training’, avoid the stigmatising and unintended consequences of ‘welfare schemes’, and providing programmes to encourage ‘women’s entrepreneurship’ and challenge male conceptions of business strategy and success (2005: 175). However, as philanthropic funding reduces and bodies become more reliant on government and other highly-conditional funding, MDP bodies feel they must demonstrate high performance and distinguish their work from ‘welfare programmes’, and staff become more risk averse to reduce financial losses (2005: 185). They make value judgements based on ‘white, middle-class, male centred standards of business’ to ‘evaluate client worthiness and attempt to resocialize them as well as shape access to further services’ (2005: 174). Worthiness is linked to likely success, and bodies engage in ‘creaming’ (focusing on the easiest, cheapest cases), use implicit moral assessments of character to identify a good attitude and reject ‘entitlement seekers’ and ‘dreamers’, with assessments often ‘class-laden, gendered, and racialized’ (2005: 177; 183). Consequently, people with the lowest incomes and levels of education are less likely to receive significant loans, and most likely to continue to be viewed as ‘helpless deviants … scorned by policymakers’ when they fail to “’lift’ themselves out of poverty” (2005: 196).

Camou (2005: 197-8) identifies a more positive story based on an unusual mix, in small ‘neighborhood organizations’ (non-profit, advocacy, and resident organizations), of constructing often-marginalised groups positively but to ‘resocialize them into an acceptable way of life’ containing the “‘correct’ ‘norms and values”. Most of the studied programs combine a focus on the ‘deficits’ of target populations (such as drug addiction, and low employability and education) and belief that they can’t ‘take control of their lives without interventions’ with the hope that they ‘can reject street values in favour of mainstream ones, including employment, nonviolence, family cohesion, delayed gratification, and respect for property’ (2005: 203). They combine direct interventions, such as programs to enhance employability, with indirect strategies based on some individuals leading by example and encouraging new rules (2005: 204-5). There is minimal emphasis on welfare and structural/ environmental factors such as housing supply, or on challenging a small number of deviants ruining the neighbourhood while helping the upwardly mobile or middle class population (2005: 206-13). Programs ‘tend not to “cream”’, particularly when staff live or recently lived in the same area: their focus is on challenging highly visible and vivid examples of ‘street values’ rather than encouraging the less visible and already positive behaviour (2005: 213-5). Camou (2005: 215) identifies a commitment to a form of ‘tough love’ that ‘would assume a different connotation if pursued by outsiders’; it might punish ‘deviants’ but it also ‘rewards the successful’ users of programs designed to help disadvantaged target populations.

Insight 5: only a small proportion of the many potentially demonised groups receive sustained negative policymaker attention, aided by the ‘moral entrepreneurs’, policy analysts, and ‘policy champions’ who translate specific social constructions into policy design.

Policymakers, the media, and public can only pay attention to a tiny proportion of the issues that could be described as policy problems. So, sustained public anxiety and political attention to a target population requires three conditions (Nicholson-Crotty and Meier, 2005: 224). First, a group is already perceived negatively by many, perhaps with the additional sense that their behaviour is ‘out of control’. Second, a ‘moral entrepreneur’ draws attention to the group successfully: the public, or powerful sections or institutions within it, perceive the entrepreneur as an expert on the social value and group’s deviance; and, those powerful actors perceive a threat that extends from the deviant group to ‘the rest of society’ (2005: 225-7). Moral entrepreneurs use ‘typification’, using the behaviour visible in certain individuals to represent behaviour of a larger group, to identify a ‘dangerous class’ that can be blamed for many more social problems than linked to initial behaviour (2005: 227). Third, there must be ‘sufficient political profit’ to entice a ‘policy champion’ to set the agenda and pursue policy change (2005: 227).

For example, moral entrepreneurs such as Jacob Riis turned broad and widespread suspicion of Chinese immigrants, in the mid to late 19th century, into a specific concern about the spillover effects of their opium smoking: opium addiction spreading to the white population, with the danger of Chinese men using ‘cruel cunning’ to encourage young female ‘promiscuity’ in ‘opium dens’ (2005: 230). Policy champions, such as State Department Secretary Root, proposed legislation to prohibit the import of opium for smoking, thus restricting its effect largely to the Chinese population without prompting opposition from, for example, doctors using opiates for therapeutic purposes (2005: 233).

By the 1980s, a rapid increase in public fear of crime became linked closely to racially-charged fears of social change (2005: 235). Moral entrepreneurs such as James Q Wilson encouraged then used such concerns to generate support for a major shift in policy rationale, from a focus on the structural causes of crime (such as poverty), to a focus on individual responsibility or out of control gangs. Policy champions such as President Reagan and Representative Dan Lundgren pursued legislation (the Comprehensive Crime Act 1984) on the back of ‘organised crime’, ‘the drug racketeers who are poisoning our young people’, and testimony of victims (2005: 239). The effect of such policies is to identify approximately five million people as members of a ‘dangerous class’ (2005: 242).

Insight 6: well-intentioned but problematic social constructions produce unintended consequences if policy designs fail to address major socio-economic inequalities.

Bensonsmith (2005: 244-5) describes the ‘War on Poverty’ programs fostered by President Johnson from 1965, describing key actors such as Daniel Moynihan – author of The Negro Family (‘Moynihan Report’) – as moral entrepreneur and policy champion. Moynihan was part of a ‘new breed of public servants’ with social scientific training and seeking to define as well as solve policy problems (2005: 246). His report identified lower poverty in white and higher in black populations, arguing that the main cause was the ‘disintegration of the African-American family’, in which racism undermined the role of black men as breadwinners, contributing to family breakdown and deviant behaviour (2005: 246). Bensonsmith (2005: 247) argues that the report contributes to black stereotypes that endured from times of slavery, including the ‘shiftless black male’ and the ‘overly fertile and lazy welfare mother’, and that such stereotypes contributed to the idea that welfare dependency helped cause ‘pathological behavior’: ‘broken homes’ have a ‘matriarchal structure’ (aided by female social workers) with no ‘strong father figure’, and a key solution for black men is the ‘masculine world’ of military service (2005: 251). This social construction informed key welfare policies in two main steps. First, black mothers were often initially excluded from social security measures designed for the widows and their dependent children: the state would take on the male role if he died, not if he chose to leave. Second, as entitlement became defined more widely, it became more closely associated with the often-incorrect idea that a disproportionate number of black families received welfare benefits. The association between welfare and race, along with a greater focus on individual responsibility for a culture of dependency, helps cause victim blaming and program retrenchment (2005: 255-6).

Schram (2005: 261) provides an often-different interpretation, arguing that the failure to recognise major ‘racial disparities in the US economy’ helps ‘whitewash’ them rather than asking the ‘hard questions’ in the pursuit of ‘racial justice’. Going too far, to argue that welfare is used more by white than black families – as argued by the Welfare Law Centre’s Welfare Myths in 1996 – can be misleading (from 1985, only the absolute figures on first time use, but not more regular use, and not proportionate calculations, support its position). It is also counterproductive because ‘racial minorities’ were ‘more likely to be living in poverty and in need of public assistance at higher rates’ (2005: 267-70). Similarly, it is tempting for advocacy groups to generate support for welfare rights by associating them with white, middle class and recently divorced mothers as ‘job ready’ and in transition from welfare to work, but problematic because it helps produce insufficient public support for other groups (2005: 281). Programs become ‘bifurcated’, with the predominantly-white male ‘breadwinner’ able to benefit from social insurance based on their previous employment, and others reliant on less generous ‘public assistance’ (2005: 282).

Insight 7: social constructions of (a) deservedness and entitlement create ‘positive identities and participation’ in politics, (b) unworthiness create ‘alienation, resignation, and failure to participate politically’ (Ingram and Schneider, 2005c: 289).

Soss (2005: 291) examines the signals that a bifurcated US social welfare system sends to specific target populations, and how they feel and respond. He examines the idea that US welfare programs have become influenced by ‘new paternalism’, focusing on the ways in which programs are designed ostensibly to encourage good citizenship. In paternalist regimes, they may be associated with ‘civility, self-restraint, and compliance with social expectations’, reflecting the pursuit of ‘social order over social justice and civic compliance over political engagement’ (2005: 292). Different programs also provide profoundly different signals about citizenship, and the signal that a person gets from one key public organization affects their views of government as a whole (2005: 309).

The ‘superior tier’ consists of depersonalised federal ‘social security’ programs, primarily for the ‘elderly or disabled’, pegged to inflation and previous earnings, and producing a positive signal to ‘rights bearing’ recipients (2005: 294-5). The rules are stringent but recipients are encouraged and rewarded, to ‘come away feeling that their claims are welcome’ (2005: 297). Recipients often receive the financial security that allows them to participate in public life as much as the general population, a signal from government that their participation efforts would have a tangible effect, and do not generate feelings of stigma that undermine collective action (2005: 308).

The ‘lower tier’ consists of less generous public assistance ‘that disproportionately serve disadvantaged groups such as people of color, women, and people who have lived in poverty’ (2005: 295). They send negative signals, with recipients attached to state or local case workers and following convoluted and dispiriting rules to establish limited entitlement. Recipients become ‘clients’, vulnerable to bureaucratic rules, entitled to very little privacy (following invasive questions, fingerprinting, and/ or drug testing in some cases), made to attend in person despite limited access to transport, and subject to ‘unpleasant procedures’ in unwelcoming offices (‘authoritarian’ in design and appearance). Many are left vulnerable, with the feeling that ‘they are not valued and their claims unwanted’ and some ‘feeling exposed and humiliated’, powerless, or ‘like cattle’ (2005: 296-9). Recipients are living in poverty and/or fleeing abusive relationships, with minimal choice but to accept these rules without complaint, left with the felling that their feedback would not alter government staff behaviour, and feeling the stigma and lack of self-worth that undermines collective action (2005: 306-7; 310).

Yet, these perceptions are not inevitable. Rather, the key example of Head Start, in which parents participate in collective decisions about the running of local services for their children, ‘provide citizens with evidence that participation can be effective and fulfilling’ (2005: 305), and expose other programs for the minimal extent to which they encourage civic engagement (2005: 321).

If you want to read part two, here it is: scpd-more-empirical-insights-section-31-12-16

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Social Construction and Policy Design

This is an updated and expanded discussion of Policy Concepts in 1000 Words: the Social Construction of Target Populations . It’s the theoretical summary for a paper I’m writing with Jonathan Pierce on the (hopefully positive) future for this approach. I’ll add a post on empirical applications soon.

Policymakers articulate value judgements which underpin fundamental choices about which social groups should be treated positively or negatively by government bodies. When addressing highly politicised issues, they seek to reward ‘good’ groups with government support and punish ‘bad’ groups with sanctions (Schneider et al, 2014). This judgement is often described as ‘moral reasoning’ (Haidt, 2001) or ‘fast thinking’ (Kahneman, 2012: 20). Policymakers make quick, biased, emotional judgements, then back up their actions with selective facts to pursue their understanding of a policy problem and its solution:

Likes and dislikes are not the result of individual or collective reason and deliberation but mainly the product of emotion and heuristics … judgments begin with emotional reactions … and reason is used mainly to justify initial emotion responses (Schneider et al, 2014, drawing on Kahneman, 2012 and Haidt, 2001; 2012).

Yet, social constructions can also be based on conscious bias. Policies reflect the goal-driven use of constructions, ‘strategically manipulated for political gain … to create political opportunities and avoid political risks’ or, at least, an anxiety by politicians ‘not to be caught in opposition to prevailing values’ if it affects their performance in election (Schneider and Ingram, 1997: 6; 192). They aim to receive support from the populations they describe as ‘deserving’, as well as a wider public satisfied with describing others as ‘undeserving’ (1997: 6).

These judgements can have an enduring ‘feed-forward’ effect (Ingram et al, 2007: 112). Choices based on values are reproduced in ‘policy designs’, as the ‘content or substance of public policy’:

Policy designs are observable phenomena found in statutes, administrative guidelines, court decrees, programs, and even the practices and procedures of street level bureaucrats … [they] contain specific observable elements such as target populations (the recipients of policy benefits or burdens), goals or problems to be solved (the values to be distributed), rules (that guide or constrain action), rationales (that explain or legitimate the policy), and assumptions (logical connections that tie the other elements together) (Schneider and Ingram, 1997: 2).

Examples of feed-forward effects include policy designs: signaling that ‘elderly citizens are worthy of respect and deserving of the funds they receive’, prompting ‘a level of political participation rivaled by no other group’; introducing convoluted rules to diminish participation in areas such as housing entitlement; signaling to welfare recipients that they have themselves to blame and deserve minimal support; and, restricting voting rights directly (Schneider and Sidney, 2009: 110-11)

Policy designs based on moral choices often become routine and questioned rarely in government because they are ‘automatic rather than thought through’. Emotional assignments of ‘deservingness’ act as important ‘decision heuristics’ because this process is ‘easy to use and recall and hard to change’ (Schneider et al, 2014). They are difficult to overcome, because a sequence of previous policies, based on a particular framing of target populations, helps produce ‘hegemony’: the public, media and/ or policymakers take this set of values for granted, as normal or natural, and rarely question them when engaging in politics (Pierce et al, 2014; see also Gramsci, 1971; Bachrach and Baratz, 1970; Lukes, 2005).

This signal of limited deservingness impacts on citizens and groups, who participate more or less according to how they are characterised by government (Schneider and Ingram, 1993: 334). Only some groups have the resources to mobilise and challenge or reinforce the way they are perceived by policymakers (Schneider and Ingram, 1997: 21-4; 2005: 444; Pierce et al, 2014), or to mobilise to persuade the public, media and/ or government that there is a reason to make policy on their behalf. Some groups can be categorized differently over time, but this seems to be a non-routine outcome, at least in the absence of long term change in social attitudes, even though social constructions are – in theory – ‘inherently unstable’ (Ingram and Schneider, 2005: 10). For example, it can follow a major external event such as an economic crisis or game-changing election, exploited by ‘entrepreneurs’ to change the way that policymakers view particular groups (Ingram and Schneider, 2005: 10-11). Or, it can be prompted by policy design which, for example, is modified to suit powerful populations with spillover effects for the powerless (such as when drug treatment develops as an alternative to incarceration) (Schneider and Ingram, 2005: 639).

Ingram et al (2007: 102) depict this dynamic with a table in which there are two spectrums – one describes the positive or negative ways in which groups are portrayed by policymakers, the other describes the resources available to groups to challenge or reinforce that image – producing four categories of target population: advantaged, contenders, dependents, and deviants. The powerful and positively constructed are ‘advantaged’; the powerful and negatively constructed are ‘contenders’; the powerless and positively constructed are ‘dependents’; the powerless and negatively constructed are ‘deviants’ (Ingram et al, 2007: 102)

Schneider and Ingram (1997: 3) argue that, although the (US) political system may ‘meet some standard of fairness or openness’, the policies they produce may not be ‘conducive to democracy’. US public policies have failed to solve major problems – including inequality, poverty, crime, racism, sexism, and effective universal healthcare and education – and such policy failure contributes to the sense that the political process serves special interests at the expense of the general public (1997: 4-7). Policy designs ‘are strongly implicated in the current crisis of democracy’ because they have failed and they discourage many target populations (the ‘undeserving’, ‘deviant’, or ‘demons’) from public participation: ‘These designs send messages, teach lessons, and allocate values that exacerbate injustice, trivialize citizenship, fail to solve problems, and undermine institutional cultures that might be more supportive of democratic designs’ (1997: 5-6; 192).

Of course, although there is the unpredictable potential for issues to be politicised, many are not. Yet, low salience can exacerbate these problems of citizen exclusion. Policies dominated by bureaucratic interests often alienate citizens receiving services (1997: 79). Or, experts dominate policies (and many government agencies) when there is high scientific agreement and wider acceptance that the ‘public interest’ is served largely through the production and use of evidence. The process does not include ordinary citizens routinely. Rather, ‘experts with scientific credentials aid and abet the disappearance of the public sphere’, and this is a problem when issues ‘with important social value implications’ transform into ‘a matter of elite scientific and professional concern’ (such as when official calculations of economic activity override personal experiences) (1997: 153; 167).

Overall, they describe a political system with major potential to diminish democracy, with politicians faced with the choice of politicising issues to reward or punish populations or depoliticise issues with reference to science and objectivity, and policy designs uninformed by routine citizen participation. They describe an increasingly individualistic US system with declining rates of collective political participation (at least in elections), a tendency for actors to seek benefits for their own populations, and often ‘degenerative’ policy which produces major inequalities along sex, race, and ethnicity lines (Ingram and Schneider, 2005: 22-6).

Although SCPD began as a study of US politics, many of its concepts and insights are ‘universal’. In other words, they identify ‘policymaking issues that can arise in any time or place’ (Cairney and Jones, 2016: 38):

  1. The psychology of social construction: people make quick and emotional judgements about the populations of which they are a part, and other populations.
  2. Policymakers seek to exploit the ‘national mood’, or other indicators of social preferences, for political reward.
  3. These judgements inform policy design.
  4. Policy designs help send signals to citizens which can diminish their incentive to engage in politics.
  5. Low salience issues are often dominated by bureaucratic politics and scientific language, at a similar expense to citizen participation.

The time and place-specific nature of SCPD refers to specific social attitudes, the social construction of specific target populations (from a large list of potential constructions), and specific policy designs associated with each government.

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The Scottish Government’s holistic education policy: a story of profound success or failure?

The Scottish Government experience of education can give us all a profound lesson, but I’m not yet sure what that lesson will be. The positive lesson might be that you can have a holistic approach to education provision, which has a strategy for childcare, early years, and schools that support further and higher education policy effectively. In particular, its key aim is to address inequality in attainment from a very early age, to solve one driver of unequal access to higher education. More people have a chance of a place at University and higher education remains free.

The negative lesson might be that if you don’t solve the problem at an early stage, your other policies look regressive and reinforce inequalities. Instead of seeing a government committed in a meaningful way to reducing educational inequalities throughout a life course, we see government hubris in one area supporting a vote-chasing and damaging policy in another. Free University education remains a benefit for the higher attainers, and inequalities are reinforced by the lack of financial support for low income students.

In a party political context, we can decide very quickly what lesson to take: for the SNP and its supporters, we are on course for a game changing education policy at all levels. Free tuition fees will become the symbol of its overall success. For their critics, policy is failing at almost every stage and the SNP is saved only by our fixation on the constitution as the beacon for our attention and source of policy obstacles. Every pound spent on free tuition fees for the middle classes is a pound not spent on tackling the worrying levels of attainment inequalities in schools (a point that the Scottish Government often seems to support, with reference to the ‘Heckman curve’ on the greater benefits of spending on high quality education at an early age).

As usual, the truth is likely to be in the middle but, because superficial partisan positions are often so extreme, the middle is a very large space. Without more honesty about what we can generally expect from government policies, and what we can reasonably expect from specific current and future initiatives, this debate will remain a source of poor entertainment, not enlightenment.

What can a government do to reduce educational inequality? What will it do?

The main focus of our ‘game-changer versus hubris’ debate comes from a striking speech by First Minister Nicola Sturgeon on the SNP Government’s aim to abolish inequalities in education attainment. Note how starkly Sturgeon expressed this aim in August 2015:

‘My aim – to put it bluntly – is to close the attainment gap completely. It will not be done overnight – I accept that. But it must be done. After all, its existence is more than just an economic and social challenge for us all. It is a moral challenge. Indeed, I would argue that it goes to the very heart of who we are and how we see ourselves as a nation’.

Sturgeon’s uncompromising language suggests that Scottish governments can and will produce a profound level of influence on socio-economic outcomes.

UK government ministers have abandoned such language partly because they frame the problem increasingly as an individual, not structural, problem. They have no stated ambition to go to the ‘root cause’ of the problem to reduce the socio-economic inequalities driving many attainment inequalities through a far more redistributive tax and benefits system.

It is therefore striking that the SNP-led Scottish Government also has no plans (and a limited ability) to take a ‘root cause’, majorly redistributive fiscal, approach. Instead, we see the use of public services to mitigate the effects of socioeconomic inequalities. This strategy relies heavily on ‘prevention’ policies to intervene as early as possible in people’s lives – through parenting programmes and childcare provision – to improve their chances.

Further, I have not seen another speech like it. Instead, the SNP manifesto in 2016 restated its commitment to free tuition and presented far more modest language on making: ‘significant progress in closing the attainment gap within the lifetime of the next parliament and substantially eliminating it within a decade’.

What can we realistically say about their likely effects?

In that more realistic context, you get the sense that these attainment-reducing initiatives will have limited effect. They include £100m fund to encourage new initiatives and learn from success stories such as the London Challenge, the partial return of testing pupils at key stages in schools, as part of a National Improvement Framework for Scottish education, to ‘ensure that we are making progress in closing the gap in attainment between those in our most and least deprived areas’, and possible reforms to local and regional governance to encourage learning between schools. These school-based measures come on top of substantial plans to increase or maintain childcare entitlement for 3-4 year olds, and for 2 year olds whose guardians meet income-based criteria.

In terms of the effect of attainment strategies on future University entry, we can say that the Scottish Government expects substantial results from schools in 10 years and from its expanded childcare provision (to vulnerable 2 year olds) in 15 years. As described, this does not seem like a holistic or joined up policy anymore, because it involves a gap, between the effect of one policy on another, so large that it seems unreasonable to link the two together.

An early years and attainment strategy this long-term provides almost no cover to its HE policy. Instead, we have free tuition fees in Universities which, in the absence of redistributive fiscal policy, and the long term presence of an attainment gap, reinforces inequalities in education in several ways: a reduced likelihood of University attendance in school leavers from a deprived background; a tendency for HE policy to benefit the middle classes disproportionately, since the debt burden is higher on poorer HE students, and University funding seems to come at the expense of the college places more likely to be filled by students from lower income backgrounds; and a failure to take the Heckman curve seriously enough to prompt a major shift in funding from Universities and schools to early years.

Overall, I expect that we will look back on that one speech – on the ‘moral challenge’ to ‘close the attainment gap completely’ – as an outlier. It is an aim that sounds impressive as a rhetorical device, but it is not backed up by a coherent set of public policies designed to fulfil that end, and – even with the best will in the world – it is not a policy designed to remove the regressive effects of free HE tuition.

 

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What do you do when 20% of the population causes 80% of its problems? Possibly nothing.

caspi-et-al-abstract

Avshalom Caspi and colleagues have used the 45-year ‘Dunedin’ study in New Zealand to identify the ‘large economic burden’ associated with ‘a small segment of the population’. They don’t quite achieve the 20%-causes-80% mark, but suggest that 22% of the population account disproportionately for the problems that most policymakers would like to solve, including unhealthy, economically inactive, and criminal behaviour. Most importantly, they discuss some success in predicting such outcomes from a 45-minute diagnostic test of 3 year olds.

Of course, any such publication will prompt major debates about how we report, interpret, and deal with such information, and these debates tend to get away from the original authors as soon as they publish and others report (follow the tweet thread):

This is true even though the authors have gone to unusual lengths to show the many ways in which you could interpret their figures. Theirs is a politically aware report, using some of the language of elected politicians but challenging simple responses. You can see this in their discussion which has a lengthy list of points about the study’s limitations.

The ambiguity dilemma: more evidence does not produce more agreement

‘The most costly adults in our cohort started the race of life from a starting block somewhere behind the rest, and while carrying a heavy handicap in brain health’.

The first limitation is that evidence does not help us adjudicate between competing attempts to define the problem. For some, it reinforces the idea of an ‘underclass’ or small collection of problem/ troubled families that should be blamed for society’s ills (it’s the fault of families and individuals). For others, it reinforces the idea that socio-economic inequalities harm the life chances of people as soon as they are born (it is out of the control of individuals).

The intervention dilemma: we know more about the problem than its solution

The second limitation is that this study tells us a lot about a problem but not its solution. Perhaps there is some common ground on the need to act, and to invest in similar interventions, but:

  1. The evidence on the effectiveness of solutions is not as strong or systematic as this new evidence on the problem.
  2. There are major dilemmas involved in ‘scaling up’ such solutions and transferring them from one area to another.
  3. The overall ‘tone’ of debate still matters to policy delivery, to determine for example if any intervention should be punitive and compulsory (you will cause the problem, so you have to engage with the solution) or supportive and voluntary (you face disadvantages, so we’ll try to help you if you let us).

The moral dilemma: we may only pay attention to the problem if there is a feasible solution

Prevention and early intervention policy agendas often seem to fail because the issues they raise seem too difficult to solve. Governments make the commitment to ‘prevention’ in the abstract but ‘do not know what it means or appreciate scale of their task’.

A classic policymaker heuristic described by Kingdon is that policymakers only pay attention to problems they think they can solve. So, they might initially show enthusiasm, only to lose interest when problems seem intractable or there is high opposition to specific solutions.

This may be true of most policies, but prevention and early intervention also seem to magnify the big moral question that can stop policy in its tracks: to what extent is it appropriate to intervene in people’s lives to change their behaviour?

Some may vocally oppose interventions based on their concern about the controlling nature of the state, particularly when it intervenes to prevent (say, criminal) behaviour that will not necessarily occur. It may be easier to make the case for intervening to help children, but difficult to look like you are not second guessing their parents.

Others may quietly oppose interventions based on an unresolved economic question: does it really save money to intervene early? Put bluntly, a key ‘economic burden’ relates to population longevity; the ‘20%’ may cause economic problems in their working years but die far earlier than the 80%. Put less bluntly by the authors:

This is an important question because the health-care burden of developed societies concentrates in older age groups. To the extent that factors such as smoking, excess weight and health problems during midlife foretell health-care burden and social dependency, findings here should extend to later life (keeping in mind that midlife smoking, weight problems and health problems also forecast premature mortality)’.

So, policymakers find initially that ‘early intervention’ a valence issue only in the abstract – who wouldn’t want to intervene as early as possible in a child’s life to protect them or improve their life chances? – but not when they try to deliver concrete policies.

The evidence-based policymaking dilemma

Overall, we are left with the sense that even the best available evidence of a problem may not help us solve it. Choosing to do nothing may be just as ‘evidence based’ as choosing a solution with minimal effects. Choosing to do something requires us to use far more limited evidence of solution effectiveness and to act in the face of high uncertainty. Add into the mix that prevention policy does not seem to be particularly popular and you might wonder why any policymaker would want to do anything with the best evidence of a profound societal problem.

 

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