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 ADVANCING THE POWER OF
Economic Evidence
to Inform Investments in
Children, Youth, and Families

Committee on the Use of Economic Evidence to

Inform Investments in Children, Youth, and Families

Eugene Steuerle and Leigh Miles Jackson, Editors

Board on Children, Youth, and Families

Division of Behavioral and Social Sciences and Education

THE NATIONAL ACADEMIES PRESS

Washington, DC
www.nap.edu
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW
Washington, DC 20001

This activity was supported by Contract No. 10002411 from the

Jacobs Foundation, Contract No. 10002006 from the MacArthur
Foundation, and Contract No. 10002289 from the Robert Wood
Johnson Foundation. Any opinions, findings, conclusions, or
recommendations expressed in this publication do not necessarily
reflect the views of any organization or agency that provided support
for the project.

International Standard Book Number-13: 978-0-309-44059-2

International Standard Book Number-10: 0-309-44059-9
Digital Object Identifier: 10.17226/23481
Epub ISBN: 978-0-309-44062-2

Additional copies of this report are available for sale from the
National Academies Press, 500 Fifth Street, NW, Keck 360,
Washington, DC 20001; (800) 624-6242 or (202) 334-3313;
http://www.nap.edu.

Copyright 2016 by the National Academy of Sciences. All rights

reserved.

Printed in the United States of America

Cover credit: Jay Christian Design, LLC.

Suggested citation: National Academies of Sciences, Engineering,

and Medicine. (2016). Advancing the Power of Economic Evidence to
Inform Investments in Children, Youth, and Families. Washington,
DC: The National Academies Press. doi: 10.17226/23481.
The National Academy of Sciences was established in 1863 by
an Act of Congress, signed by President Lincoln, as a private,
nongovernmental institution to advise the nation on issues related to
science and technology. Members are elected by their peers for
outstanding contributions to research. Dr. Ralph J. Cicerone is
president.

The National Academy of Engineering was established in 1964

under the charter of the National Academy of Sciences to bring the
practices of engineering to advising the nation. Members are elected
by their peers for extraordinary contributions to engineering. Dr. C.
D. Mote, Jr., is president.

The National Academy of Medicine (formerly the Institute of

Medicine) was established in 1970 under the charter of the National
Academy of Sciences to advise the nation on medical and health
issues. Members are elected by their peers for distinguished
contributions to medicine and health. Dr. Victor J. Dzau is president.

The three Academies work together as the National Academies of

Sciences, Engineering, and Medicine to provide independent,
objective analysis and advice to the nation and conduct other
activities to solve complex problems and inform public policy
decisions. The Academies also encourage education and research,
recognize outstanding contributions to knowledge, and increase
public understanding in matters of science, engineering, and
medicine.

Learn more about the National Academies of Sciences, Engineering,

and Medicine at www.national-academies.org.
 COMMITTEE ON THE USE OF ECONOMIC
EVIDENCE TO INFORM INVESTMENTS IN
CHILDREN, YOUTH, AND FAMILIES
EUGENE STEUERLE (Chair), Urban Institute, Washington, DC
RICARDO BASURTO-DAVILA, Office of Health Assessment and
Epidemiology, Los Angeles County Department of Public Health,
CA
JENNIFER BROOKS, Early Learning, U.S. Program, Bill & Melinda
Gates Foundation, Seattle, WA
JEANNE BROOKS-GUNN, Teachers College and the College of
Physicians and Surgeons, Columbia University, New York City, NY
BARBARA CHOW, Education Program, William and Flora Hewlett
Foundation, Menlo Park, CA
PHAEDRA CORSO, Department of Health Policy and Management,
University of Georgia, Athens
DANIEL MAX CROWLEY, College of Health and Human
Development, Pennsylvania State University, University Park
JODY L. FITZPATRICK, School of Public Affairs (retired),
University of Colorado, Denver
LYNN A. KAROLY, Pardee RAND Graduate School, RAND
Corporation, Philadelphia, PA
MARGARET KUKLINSKI, Social Development Research Group,
School of Social Work, University of Washington, Seattle
RACHEL NUGENT, Chronic Noncommunicable Diseases Global
Initiative, RTI International, Seattle, WA
OLGA ACOSTA PRICE, Center for Health and Health Care in
Schools, George Washington University, Washington, DC
TED MILLER, Public Services Research Institute, Pacific Institute for
Research and Evaluation, Calverton, MD
ANNE SHERIDAN, Sheridan & Associates, Potomac, MD

LEIGH MILES JACKSON, Study Director

BRIDGET KELLY, Senior Program Officer
TARA MAINERO, Associate Program Officer
NOAM KEREN, Research Associate
STACEY SMIT, Senior Program Assistant
PAMELLA ATAYI, Administrative Assistant
ALIA SANI, Intern
BOARD ON CHILDREN, YOUTH, AND FAMILIES
ANGELA DIAZ (Chair), Departments of Pediatrics and Preventive
Medicine, Icahn School of Medicine at Mount Sinai
SHARI BARKIN, Monroe Carell Jr. Children’s Hospital, Vanderbilt
University
THOMAS F. BOAT, College of Medicine, University of Cincinnati
W. THOMAS BOYCE, Faculty of Medicine, University of British
Columbia
DAVID A. BRENT, Western Psychiatric Institute and University of
Pittsburgh School of Medicine
DAVID V.B. BRITT, Sesame Workshop (retired)
DEBBIE I. CHANG, Nemours Health and Prevention Services
PATRICK H. DELEON, F. Edward Hebert School of Medicine and
the Graduate School of Nursing Uniformed Services University of
the Health Sciences
ELENA FUENTES-AFFLICK, University of California, San Francisco,
and San Francisco General Hospital
EUGENE E. GARCIA, Mary Lou Fulton Teachers College, Arizona
State University
J. DAVID HAWKINS, School of Social Work, University of
Washington
JEFFREY W. HUTCHINSON, Uniformed Services University of the
Health Sciences
JACQUELINE JONES, Foundation for Child Development
ANN S. MASTEN, Institute of Child Development, University of
Minnesota
VELMA McBRIDE MURRY, Peabody College, Vanderbilt University
BRUCE S. McEWEN, The Rockefeller University
MARTIN J. SEPULVEDA, IBM Corporation
TAHA E. TAHA, Johns Hopkins University, Bloomberg School of
Public Health

NATACHA BLAIN, Director(beginning December 2015)

KIMBER BOGARD, Director (through July 2015)
BRIDGET KELLY, Acting Director (July-December 2015)
 Preface

Almost nothing drives the development of society more than

investments in the nation’s children. Accordingly, public and private
policy makers, funders, and others have in recent years called for
and sponsored the production and use of economic evidence to
inform decision making on how to make such investments. The
rationale for these efforts appears straightforward: better evidence
should enable higher returns from such investments. Yet to date, the
use of such evidence has been limited. Why? Many reasons might be
ventured: politics, special interests, power of the status quo, the
limits on which evidence can be quantified, and the relative
adolescence of the field. Some of these reasons can be interesting
from an historical viewpoint, but the more compelling question for
future investments is how to improve the development of economic
evidence so it can better inform those investments.
Two answers to this latter question stand out and serve as the two
principles around which this report is organized: quality counts and
context matters. The better the quality of the research, the better it
is received, and the more likely it is to generate demand for future
economic evidence even on unrelated investments. At the same
time, if high-quality evidence is to be used well, it must be suited to
the context in which decisions are made. It must be timely and
relevant to the decisions at hand and account for many other needs
of the consumer. It was in teasing out the many ramifications of
these two principles that the committee convened to conduct this
study responded to a 2014 charge from its sponsors—the Jacobs
Foundation, the MacArthur Foundation, and the Robert Wood
Johnson Foundation—to study how to improve the use of economic
evidence to inform investments in children, youth, and families.
The committee focused its attention on economic evaluation, a
type of economic analysis that is commonly performed to provide
economic information related to investments in children, youth, and
families. Economic evaluation encompasses cost analysis, cost-
effectiveness analysis, benefit-cost analysis, and related methods
used in an effort to quantify program costs and outcomes and
potentially to make comparisons among programs. These methods
are commonly employed in randomized controlled trials, but by no
means does the committee discount the value of other approaches—
ranging from theory to qualitative analysis to other forms of
statistical analysis—and indeed, it encourages researchers reporting
on economic evaluation to acknowledge what might be learned
through such other means.
Perhaps not surprising, the committee identified many instances in
which the quality of economic evidence was low, such as failure to
account for many types of costs, or was reported in ways that could
mislead by failing to acknowledge limitations of the analysis, often
forced by restricted budgets. Accordingly, a major goal of this study
was to recommend a number of ways in which current practices in
the production of economic evidence could be improved. Likewise,
this report suggests that producers and consumers of economic
evidence can gain by giving considerable attention before, during,
and after economic evaluations are performed to the context or
broader system within which investment decisions are made. Setting
and organizational capacity matter—as do politics and values, culture
and management practices, and budget. This report includes a
roadmap outlining a multipronged strategy for fostering multi-
stakeholder partnerships to address these issues and for improving
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