This year, we decided to try something a little different when it comes to our December E4A Methods Blog post. We crowdsourced innovative and/or transformative studies published in 2021 - innovative referring to approaches or methods that are novel or applied in new ways; and transformative reflecting studies that made meaningful contributions to decision- and policy-making to effect change.
The year has been shaped largely by COVID-19, with the pandemic impacting the research questions and topics being studied, the approaches taken to gathering primary data and interacting with participants, the types of policies being formed or reevaluated, and the personal lives of us all. So, as you might imagine, many of the “nominations” focused on COVID-19 related research - either public health prevention strategies like masking and vaccination policies or economic and social supports like financial stimulus efforts.
We didn’t provide any topical bounds, though, and studies focused on a few other issues arose as well, including tobacco control policies and maternal health. Read on for the round-up of research highlighted through our crowdsourcing effort.
We’d love to hear if you have any thoughts about the articles below or if there are other studies you'd add to the list.
In addition to driving research in new directions, the pandemic has also served to highlight existing inequities and encourage us to consider how we might do things differently moving forward to achieve more equitable outcomes.
Perpetuating Inequities During the COVID Response
Geographically targeted COVID-19 vaccination is more equitable and averts more deaths than age-based thresholds alone
Wrigley-Field, et al. Science Advances, 29 Sep 2021, Vol 7: Issue 40
- Why it's transformative: This study highlighted that age-based vaccine prioritization resulted in an unintended consequence of exacerbating racial and ethnic disparities in COVID-19 deaths. Geographic targeting was identified as a more equitable approach.
COVID-19 Public Health Policies & Recommendations
Impact of community masking on COVID-19: A cluster-randomized trial in Bangladesh
Abaluck et al. Science, Epub ahead of print.
- Why it’s innovative: The study demonstrates that trials can be done in a variety of settings and for topics where it might not have initially been thought possible. It also highlights how rapid iteration of multiple versions of an intervention can be simultaneously tested to produce timely and actionable information.
- Why it’s transformative: The findings make it abundantly clear that masks work to slow COVID-19 transmission.
Mask Mandates Save Lives
Hansen, N-J.H., & Mano, R.C. International Monetary Fund, August 2021.
- Why it’s transformative: The authors of this study quantified the impact of mask mandates on lives saved (87,000 through December 2020; with an estimated additional 58,000 lives saved if a national mandate had been implemented in April 2020). The paper contributed insights to inform more nuanced masking policies.
The impact of keeping indoor dining closed on COVID-19 rates among large US cities: a quasi-experimental design
Schnake-Mahl, et al. Epidemiology (Cambridge, Mass.). 2021 Nov 12.
- Why it’s transformative: This study provided strong evidence to support controversial indoor dining closures, demonstrating that policies to keep indoor dining closed were effective in reducing COVID-19 cases by approximately 61%, averting up to 142 daily cases in the average city.
- Why it’s innovative: As E4A postdoc, Ellicott Matthay, explained to me, the creative approach to identifying proxy control sights used for this study about indoor dining policies was very clever. In policy studies the outcomes in places that didn't adopt a policy are often used as proxies for what would have happened in places that did adopt the policy, had they not actually adopted the policy. One thing that's challenging is that sometimes these proxies aren't very good - all of the places that did adopt the policy are pretty different from the places that didn't, and probably some of the places without the policy never would have adopted the policy at all. In this study, the authors identified cities that did want to adopt a policy, but were then pre-empted from doing so by state law. This makes their outcomes pretty convincing proxies for cities that were in fact able to implement the law under study. As Ellicott told me, “I hadn't seen that done before, and I think it's a very useful tool for deriving causal inferences in policy studies.”
Cash Supports Prior to and During the Pandemic
Guaranteed Income Reduces Income Volatility, Improves Health, Leads to More Full Time Employment, and More
West, S., Castro Baker, A., Samra, S., & Coltrera, E. Stockton Economic Empowerment Demonstration (SEED): Preliminary Analysis: SEED’s First Year. Issue Brief, 2021.
- Why it’s transformative: Initial findings from the SEED evaluation catalyzed a national movement of cities and local governments to start their own guaranteed income programs (Mayors for Guaranteed Income) and a corresponding coordinated approach to evaluating them (Penn Center for Guaranteed Income Research). Despite a relatively small sample size (125 people in the treatment group), findings were statistically significant, demonstrating how impactful guaranteed income is for participating individuals/families.
Direct Cash Transfers for Patients with Covid-19 Served by New York City’s Safety-Net Health System
Kumar, S.L., Calvo-Friedman, A., Clapp, J., Brookover, C., & Davis, N.J. NEJM Catalyst: Innovations in Care Delivery, June 2021.
- Why it’s transformative: Low-income recipients with COVID-19 used unconditional cash transfers of $1,000 to pay rent and utilities and buy food. In some cases recipients also used funds to pay for home-use supplemental oxygen, demonstrating that cash transfers can have positive effects on recipients, beyond what may have originally been foreseen.
Benefits of Building Back Equitably from COVID-19
The Economic Gains from Equity
Shelby R. Buckman, Laura Y. Choi, Mary C. Daly, and Lily M. Seitelman, Sept. 2021, Brookings.
- Why it’s transformative: The authors found that if opportunities and outcomes were more equitably distributed by race and ethnicity the U.S. economy would be up $22.9 trillion over the 30 year period they examined. Information from this study has proven itself to be instrumental in helping advocates and other stakeholders argue for more equitable COVID-19 recovery policies and programs.
Unions and Inequality over the Twentieth Century: New Evidence from Survey Data
Farber, H.S., Herbst, D., Kuziemko, I., Naidu, S. The Quarterly Journal of Economics, Volume 136, Issue 3, August 2021, Pages 1325–1385.
- Why it’s innovative: The authors developed a “new source of microdata” extending back into the 1930s. Using this data, they were able to analyze the impacts of unionization on income inequality and discovered that unions act to reduce inequality.
- Why it’s transformative: The data and findings fill in a lot of holes in economic history, as well as the history of labor and unions. There is quite a lot of potential for this work to be transformative for efforts in which groups are attempting to unionize and as advocates and others work to reduce income inequality.
Variation in guideline-based prenatal care in commercially insured population
Gourevitch, R.A., Natwick, T., Chaisson, C.E., Weiseth, A., & Shah, N.T. American Journal of Obstetrics and Gynecology. October 2021.
Associated STAT News article (opinion piece)
- Why it’s transformative: The study highlighted that using the number of prenatal visits - versus the type of care received - is not an adequate proxy for quality of care. Many pregnant people were not receiving the most basic health care services, despite following the recommended regimen of visits. This was particularly true for patients living in rural communities, younger patients, lower income patients, patients with low educational attainment, and in locations that had a higher proportion of minoritized groups. Findings can inform updates to practices and guidelines around caring for pregnant people, as well as other instances in which care depends on regular timing and number of visits, such as well-child visits.
Geographical distribution and social determinants of Tobacco 21 policy adoption and retail inspections in the United States, 2015–2019 (and related studies)
Dai, H., Tamrakar, N., Rathnayake, N., & Samson, K. Tobacco Induced Diseases. 2021;19(September):71.
- Why it’s innovative: Authors used a novel approach combining big data analytics with community engagement, participation, and agency.
- Why it’s transformative: Findings have the potential to improve health equity through better implementation and enforcement of T21 policies at the local level. As Summer Woolsey, one of the research team members mentions, “the goal of this study is to use the voices of stakeholders from around the nation to strengthen T21 policy to reduce youth tobacco use while also looking at how to close potential health disparities the law may exacerbate.”
Thanks to everyone who shared studies they found innovative and/or transformative with us! This is only a small subset of the amazing studies published in 2021 - let us know the studies you’d add to the list by emailing email@example.com.