Public health departments that have been accredited by the U.S. Public Health Accreditation Board are more likely to have capacity and support for evidence-based decision making, according to a new paper from the Brown School at Washington University in St. Louis.
In a survey of 350 local health departments, staff were asked about six factors of their organization’s support for evidence-based decision making (EBDM). About one-third of the departments were accredited, another third were preparing for accreditation and the remainder were neither accredited nor preparing.
Accredited health departments were more likely to report higher capacity and resource availability for EBDM than health departments that reported not yet preparing for accreditation.
The U.S. national movement for voluntary public health department accreditation by the Public Health Accreditation Board has gained momentum since it began in 2011. Standards include evidence-based practice. As of March 2019, 79% of the U.S. population resided in areas served by accredited health departments.
“Survey findings support the premise that the national voluntary accreditation movement is linked with improved health department performance,” wrote the study’s lead author, Dr. Peg Allen, Research Assistant Professor at the Brown School. “Accreditation standards may help motivate organizational supports for evidence-based decision making.”
The study was published Dec. 17 in Frontiers in Public Health.
On Wednesday, January 22, 2020, Missouri became the newest state to take up legislation for a statewide Child Development Account (CDA) policy.
Filed by Rep. Jonathan Patterson, the bill creating the Missouri Children’s Savings Account Program would automatically open a Show-Me Child Savings Account with a $100 seed deposit for every resident born on or after January 1, 2021.
Patterson’s filing represents the culmination of considerable work, much of it done by State Treasurer Scott Fitzpatrick and Margaret Clancy, policy director with the Center for Social Development (CSD) in the Brown School at Washington University, along with the Missouri Child Development Account Coalition, which includes Brown School Associate Professor Jason Purnell.
The proposal draws upon research on the CDA policy modeled in SEED for Oklahoma Kids (SEED OK), a randomized, statewide CDA experiment conducted by the Brown School’s Center for Social Development (CSD) since 2007. The findings have shaped state policies elsewhere.
“Seven states have adopted automatic statewide CDA policies,” said Margaret Clancy, a member of the coalition’s leadership committee and CSD’s policy director. Clancy advised policymakers on the development of all statewide CDAs and this policy proposal in Missouri. Nebraska, Illinois and California enacted CDA legislation in 2019, and Pennsylvania did so in 2018.
“The level of commitment that we’ve seen across this region has really been quite remarkable,” said Jason Purnell, co-chair of the coalition’s leadership committee, as well as director of Health Equity Works and faculty director with CSD. “We all share a commitment to the brightest possible futures for our children,” Purnell added. “This is just an approach that makes sense for investing in the future of our children, in the future of our state, and our families and communities.”
“We want every baby born in Missouri to have this,” Purnell said.
“A big key to our success so far was turning interest from State Treasurer Fitzpatrick into a full-on commitment to support and to champion this,” said Kaycee Nail, director of client and legislative affairs with the Penman Group. “It was really helpful for him to see the fact that Nebraska passed this legislation unanimously.”
Child Development Accounts
A CDA is a long-term investment account opened with a seed deposit when a child is born. That seed grows with market appreciation and supplemental deposits until he or she is ready to use the assets for higher education. The policy is designed to be universal and automatic, and assets may be used only for postsecondary education. The effects of the accounts extend beyond the assets they hold.
“The concept is that, by providing assets very early, CDAs can lead to financial planning for college and greater financial capability, a college-bound identity, educational preparation and later, college success,” said Clancy.
The benefits of CDAs are widely documented in publications from SEED OK. Findings show that the accounts expand assets for children’s education but that they also shape family behavior, boosting children’s social-emotional development, parents’ educational expectations for their children, and positive parenting practices, while reducing depressive symptoms among mothers.
Clancy added, “These findings matter because other studies have shown that these positive outcomes, particularly the higher education expectations, affect later educational success.”
Some of the benefits are greater for disadvantaged families. “Financially vulnerable families face numerous challenges that can negatively affect children’s development,” Clancy said. “For maternal depressive symptoms and positive parenting practices, the CDA effects were greater for families who participated in TANF and Head Start than for families who did not.”
Ray Boshara, a member of the coalition’s leadership committee and director of the Center for Household Financial Stability with the Federal Reserve Bank of St. Louis, noted the potential effects of a CDA policy on the gap between the wealth of black and white households. Citing estimates from a 2016 study, he said that a universal CDA program established in 1979 could have eliminated 23% of the gap between black and white households for young adults.
Leadership committee member David Dwight added, “CDAs are a powerful starting point for chipping away at those disparities.” Dwight is the executive director and lead strategy catalyst of Forward Through Ferguson.
The Proposal for Missouri
When a child is born in Missouri, the state’s Department of Health and Senior Services collects vital records information. The bill directs the department to transmit some of that (names, address, and date of birth) to the state treasurer’s office, which would contact the child’s family about the program and automatically enroll the infant unless parents opt out. The treasurer’s office also would communicate how families can access account balances and details online.
Enrolled children would receive a Show-Me Child Savings Account with a $100 “scholarship.” With additional deposits and market appreciation, assets would grow in these long-term investment accounts until accessed for trade school, community college or university. Like all statewide policies, the Missouri program would manage its CDAs through the state 529 college savings plan. Boshara added that the state’s plan offers “the best platform for inclusive asset building and wealth building.”
Additional details:
- Children adopted by Missouri residents also would be eligible for accounts.
- Funds in the accounts would be exempt from the tests used to determine eligibility for public assistance.
- When a beneficiary reaches age 30, any unused assets in the account would go back to the program fund.
- The Missouri CDA Coalition estimates that approximately 75,000 Missouri newborns would receive accounts each year.
As the legislature began its work on the bill, Clancy expressed optimism. “This bill has the support of legislators from both sides of the aisle.”
Forward Through Ferguson’s Dwight shared his hopes for the bill : This is where we can start: universal at-birth investment in Missouri’s children and families for their opportunity, their health, and their well-being for the future.” He added, “When Missouri babies grow up and take their first steps into the state, what future will they find? And what future will we leave them?”
To learn more about the Center for Social Development’s work with Child Development Accounts, please visit their website.
Including the insights of more than 30 leading social work scholars from the Brown School at Washington University in St. Louis and beyond, a new book grapples with 13 key areas in the profession in an effort to identify innovative solutions toward achieving a “livable life — a life in which individuals are able to thrive and reach their full potential.”
“Given the challenges facing us in the 21st century, the field of social work has become increasingly relevant and important,” said Mark Rank, the Herbert S. Hadley Professor of Social Welfare and editor of “Toward a Livable Life: A 21st Century Agenda for Social Work,” published Jan. 2 by Oxford University Press.
“This book represents a historic point in the profession’s development,” Rank said. “It brings together for the first time the world class expertise of the Brown School faculty in order to tackle the key social, economic and environmental challenges in the future.”
Thirty-three faculty members from the Brown School contributed to the work, writing on topics including child abuse, substance abuse, health, gender, poverty and big data.
“The faculty at the Brown School represent the cutting edge of knowledge with regard to many of society’s most pressing issues,” Rank said. “They come from a wide array of disciplines and are trained in a variety of methodologies and frameworks that address issues such as poverty, inequality, health, child maltreatment, environmental justice, discrimination and aging. As such, they are uniquely positioned to help guide the direction of the field in the decades to come.”
The goal of the profession of social work in the future, Rank said, will be to ensure that everyone is able to live a livable life.
“This refers to the idea that an individual is able to thrive and develop in a healthy manner across their lifetime in order to reach their full potential,” he said. “Unfortunately, many Americans, as well as people around the globe, have been unable to achieve such a life as a result of numerous obstacles and barriers.
“This book seeks to understand and suggest ways in which social policy can confront and alleviate these barriers,” Rank said. “It argues that by doing so, the overarching goal of a livable life for every child born today can become a reality in the future.”
In addition to Rank, the Brown School faculty who contributed are:
Wendy F. Auslander, Ana A. Baumann, Derek S. Brown, F. Brett Drake, Amy Eyler, Vanessa Fabbre, Patrick J. Fowler, Eleni Gaveras, Janelle Gibson, Michal Grinstein-Weiss, Jenine K. Harris, Darrell Hudson, Kim J. Johnson, Melissa Jonson-Reid, Shanti K. Khinduka, Patricia L. Kohl, Matthew W. Kreuter, Edward F. Lawlor, Carolyn Lesorogol, Gena Gunn McClenden, Mary M. McKay, Molly Metzger, Nancy Morrow-Howell, Sojung Park, David Patterson Silver Wolf, Rodrigo Reis, Stephen Roll, Barry Rosenberg, Anna Shabsin, Joseph Steensma, Rachel G. Tabak, and Vetta Sanders Thompson.
The Brown School community will take part in more than 60 presentations during the Social Work and Social Policy annual conference, January 15-19, 2020. Held at Washington D.C.’s Marriot Marquis, the theme this year’s meeting is “Reducing Racial and Economic Inequality.”
In addition to presentations, there are several additional conference events of interest to the Brown School community:
- Mark Rank, Herbert H. Hadley Professor of Social Welfare, will host a book signing for “Toward a Livable Life: A 21st Century Agenda for Social Work” at the Oxford University Press Booth from 1:30 – 2:30 p.m. on Friday, January 17. Rank, who edited the volume, will be joined by two of the more than 30 Brown School contributors: Mary McKay, Neidorff Family and Centene Corporation Dean of the Brown School, and Edward Lawlor, William E. Gordon Distinguished Professor Emeritus and Special Assistant to the Provost. The first 100 attendees will receive a free copy of the book.
- Research Professor Margaret Sherraden will be inducted into the American Academy of Social Work and Social Welfare on January 17 at 7:00 p.m. AASWSW is an honorific society of distinguished scholars and practitioners dedicated to achieving excellence in the field of social work and social welfare. The ceremony will take place in Independence Salons D&E, with a reception immediately following the event.
- The Brown School will honor the National Institute of Mental Health’s Denise Juliano-Bult with a Champion of Social Work Research Award during this year’s Aaron Rosen Lecture on Saturday, January 18 at 11:30 a.m. She is being recognized for her commitment to scientific excellence and steadfast support of social work scholarship, research, development and training.
- The Brown School sponsors the Aaron Rosen lecture on January 18, and this year’s speaker is University of Washington Professor Karina Walters, who focuses on the historical, social and cultural determinants of health among American Indian and Alaska Native populations as well as chronic disease prevention research.
Please see the list of Brown School presentations below; presenting authors are noted by an asterisk where applicable.
Thursday, January 16
Friday, January 17
Saturday, January 18
Sunday, January 19
For families trying to find affordable housing, options can be scarce. But recently enacted policies may offer relief in the St. Louis region.
By a 4 to 3 vote, the St. Louis County Council approved legislation to create an Affordable Housing Trust Fund with proceeds from the sale of medical marijuana.
The county executive voted in favor of the measure and is expected to sign it.
The fund would prioritize the needs of single-parent families with children, households earning less than $35,000, older adults, and households experiencing homelessness or at risk of homelessness, especially households with children.
“Stable homes are a necessary component of healthy communities. This is an issue that affects all of us, whether or not we are directly experiencing a housing crisis,” said Molly Metzger, faculty director of Inclusive Housing with the Center for Social Development in the Brown School at Washington University.
A local expert on affordable housing and co-editor of “Facing Segregation: Housing Policy Solutions for a Stronger Society,” Metzger testified on the trust fund bill, citing her research showing housing instability’s effects on children.
In many schools serving low-income families, “more than half the kids are entering or leaving the school in the middle of the school year,” she stated. “Housing transitions coupled with school transitions are a major challenge for everyone involved. Students in these circumstances aren’t fully able to develop relationships with their teachers and meet their full potential.”
Sponsored by Councilwoman Lisa Clancy and Councilwoman Rochelle Walton Gray, the ordinance draws upon a report from the county’s Affordable Housing Trust Fund Task Force, which released its recommendations in April.
The City of St. Louis created such a fund in 2000. Testifying before the County Council, Gary Newcomer said, “We’ve looked at the trust find in the City of St. Louis and found that it raised $17 for every $1 invested, which is a pretty good return.” Newcomer is director of operations with the Community Builders Network of Metro St. Louis.
Passage of the county bill marks another step in a trend across the St. Louis region.
In August, the City of Clayton amended its Human Rights Code to add “source of income” to “race, color, religion,” and the other groupings in the city’s list of protected classes. The amendments make it illegal to discriminate in the terms of a sale or rental because of income source, to mischaracterize the availability of housing on that basis and to advertise a preference because of a potential occupant’s source of income.
The City of Webster Groves followed suit in October. Like those in Clayton, the measures in Webster Groves make it illegal to refuse to sell or rent housing because of an individual’s source of income. Both municipalities criminalized the use of source-of-income information for block busting. Violating the Webster Groves ordinance could cost landlords their operating licenses. In Clayton, violators face a $500 fine.
In St. Louis County, affordable housing advocates cheered the April 2019 introduction of a similar source-of-income proposal, which built upon a recommendation in the Ferguson Commission’s 2015 report. The sponsor, Councilwoman Clancy, withdrew the bill in August, acknowledging opposition and the need to build a countywide consensus.
“Research shows that people who are aware of the history of structural racism in housing are more likely to support these sorts of measures, so education is a critical piece of the puzzle,” said Metzger, who testified in support of the withdrawn bill and advised policymakers in the development of the measure enacted by Webster Groves.
So-called source-of-income laws have been around since at least the early 1970s but did not come to Missouri until 2003, when the City of St. Louis passed its own measure. In 2015, the city added language to specifically protect people with Section 8 and forms of other rental assistance.
Housing advocates will be watching efforts to implement the region’s new policies. The city’s experience with the policy suggests that awareness and enforcement are key.
Despite explicit prohibitions against rental advertising with messages like “No Section 8,” a 2019 report by the Metropolitan St. Louis Equal Housing and Opportunity Council found that such practices continue. The organization discussed the county source-of-income measure at its 2019 meeting, which CSD sponsored and co-organized.
Despite the St. Louis region’s reputation for high levels of segregation, the new measures suggest momentum in the region’s struggle for inclusive housing and offer hope to families in search of accommodation.