Jean-François Kobiané
Professor of Demography, Higher Institute of Population Sciences, Joseph KI-ZERBO University, Burkina Faso
August 5, 2024
Professor of Demography, Higher Institute of Population Sciences, Joseph KI-ZERBO University, Burkina Faso
Former Associate Vice President
Professor of Sociology, Université Laval, Canada
Countries across Africa that are engaged in the 2020 census round (underway from 2015 through 2024) are grappling with financial, administrative, and other constraints and hoping to take advantage of the wealth of data that a census offers about populations. The 2020 census round has become particularly important for establishing a baseline measurement of indicators required for assessing progress toward countries’ Sustainable Development Goal commitments.
This Population Bulletin provides an overview of the historical trajectory in African nations’ administration of censuses, their use of technological innovations in the 2020 round, and prospects for innovation in using census data for development planning.
The research spotlights in this report are a unique feature that highlights the breadth of activity being undertaken across the continent to ensure census results can be used in policymaking and program planning.
Examples from Ethiopia and Malawi illustrate how technological progress—particularly the increasingly high performance of computers and the development of electronic collection technologies—offers opportunities to share and reduce costs. It also offers the possibility of improved data storage capacity and practices.
While analysis of the enormous mass of census data remains a major challenge for many countries, researchers are using the data to gain a better understanding of demographics and other characteristics, illustrating the value of investing time and expertise in a thorough analysis of census results. Such analyzes are being applied to examine how a range of issues affects a population, such as:
The 2020 census round in African nations offers opportunities for new technologies that support data collection and analysis, which analysts, policymakers, and others can draw on to better understand the past and present and provide more effective public planning and services for the future.
This Population Bulletin was developed by PRB in collaboration with the Union for African Population Studies (UAPS) and is available in English and French.
Les pays d’Afrique engagés dans le cycle 2020 de recensements (en cours de 2015 à 2024) sont aux prises avec des contraintes, entre autres financières et administratives, et espèrent tirer parti de la richesse des données qu’offre un recensement de la population. Le cycle 2020 de recensements est devenu particulièrement important pour établir une mesure de référence des indicateurs requis pour l’évaluation des progrès vers les engagements des pays pour les objectifs de développement durable.
Ce Bulletin de population donne un aperçu de la trajectoire historique de l’administration des recensements des nations africaines, de leur utilisation des innovations technologiques lors du cycle 2020 et des perspectives d’innovation dans l’utilisation des données de recensement pour la planification du développement.
Les points forts de la recherche présentés dans ce rapport mettent en évidence de manière unique l’étendue des activités entreprises à travers le continent pour garantir que les résultats du recensement puissent être utilisés dans l’élaboration des politiques et la planification des programmes.
Les exemples de l’Éthiopie et du Malawi illustrent comment le progrès technologique – en particulier les performances croissante des ordinateurs et le développement des technologies de collecte électronique – offre des opportunités de partager et réduire les coûts. Il offre également la possibilité d’améliorer la capacité et les pratiques de stockage des données.
Alors que l’analyse de l’énorme masse de données de recensement reste un défi majeur pour de nombreux pays, les chercheurs utilisent ces données pour mieux comprendre les données démographiques et d’autres caractéristiques, illustrant ainsi l’intérêt d’investir du temps et de l’expertise dans une analyse approfondie des résultats de recensement. De telles analyses sont appliquées pour examiner comment une série de problèmes affectent une population, tels que :
Le cycle 2020 de recensements dans les pays africains offre des opportunités pour les nouvelles technologies qui soutiennent la collecte et l’analyse de données, sur lesquelles les analystes, les décideurs politiques et autres peuvent s’appuyer pour mieux comprendre le passé et le présent, et fournir une planification et des services publics plus efficaces pour l’avenir.
Ce Bulletin de population a été élaboré par PRB en collaboration avec l’Union pour les études démographiques africaines (UEPS). Il est disponible en anglais et en français.
A conversation with author Jessica Calarco on her new book, Holding It Together
June 27, 2024
On June 27, our first PRB Book Talk focused on Holding It Together: How Women Became America’s Safety Net with author and sociologist Jessica Calarco.
In Holding It Together, Calarco (University of Wisconsin-Madison) draws on five years of research to show how U.S. society and policy disproportionately burden women with caregiving responsibilities. With an expert panel, we discussed Calarco’s key findings and their implications for reproductive health care policy and explore additional research on abortion, contraception, fertility, gender, and motherhood.
Panelists include:
Beth Jarosz, PRB: Welcome, everyone. I’m Beth Jarosz, Senior Program Director at the Population Reference Bureau, and I want to welcome you all to today’s discussion.
As we were preparing for this webinar, I started to write a really formal introduction to this talk. But as I was writing, I kept thinking about my grandmother, Alice. Her story began almost a century before the examples gathered in Dr. Calarco’s research but mirrors many of them so closely: pressure to get married, poverty, violence, and very few resources to teach out there.
It’s been generations. The same patterns still play out today. And it’s not like we don’t know these things. Researchers have been working for years to understand how policies can uplift people or leave them behind. We know that policies in the U.S. have a history of burdening women with caregiving responsibilities and offering them limited protections relative to peers and many other nations.
To be clear, we’re using the word women today in a gender-expansive way that encompasses cis women, trans women, people with a uterus, people who’ve had hysterectomies but identify as women, people who are parents, and those who are child-free. Under that umbrella, we find a group of people who tend to be marginalized by U.S. policy, with marginalization that cuts much deeper for Black women, Indigenous women, Hispanic and Latino women, disabled women, and trans women, to name just a few.
Today, we’re going to unpack some of the ways in which women are asked to hold it together. For the discussion, I’m joined by an all-star cast: Dr. Jessica Calarco of the University of Wisconsin–Madison; Dr. Tiffany Green, also of the University of Wisconsin–Madison; Dr. Karen Benjamin Guzzo of the University of North Carolina at Chapel Hill; and Jocelyn Foye of the Womxn Project. We’ll hear from all four panelists and will round out the hour with Q&A.
If you have questions, please type them into the Q&A box. I’ll ask as many of your questions as we can during that Q&A portion. Without further ado, I’m going to invite Jess to begin.
Jessica Calarco, author of Holding It Together: Thank you so much to the PRB team for inviting me. Thank you all for being here today.
And thank you also to the, uh, you know, um, the panelists who are helping to flesh out this topic with more details and insights from their expertise of Karen and Tiffany and Jocelyn. It’s a pleasure to be here with all of you, and I’m so grateful for your work, um, engaging with this material and being part of this conversation.
Um, and thanks, a note of thanks also to the research team that contributed to the work that I’ll talk about today, which included, um, a very large number of graduate and undergraduate students and staff members who helped me produce the research that I’ll be sharing in my talk today.
So I’ll start off here by alluding to or kind of building on what Beth mentioned, this idea that other countries—other, especially high-income countries—have invested in social safety nets to help people manage risk. They use taxes and regulations, especially on wealthy people and corporations, to protect people from poverty, give them a leg up in reaching economic opportunities, and give them the time and energy and incentive to participate and contribute to a shared project of care.
In the U.S., we have instead tried to DIY society. We’ve kept taxes low, we’ve slashed huge holes in the social safety net that we do have, and we’ve told people that if they just make good choices, they won’t actually need government support at all.
Now, the problem with this model is that you can’t actually DIY society. Essentially forcing people to manage all that risk on their own has left many American families and communities teetering on the edge of collapse. And yet, as I’ll talk about today, we haven’t collapsed in part because we have disproportionately women being the ones who are holding it together, filling in the gaps in our economy and the gaps in our threadbare social safety net.
So to illustrate what I’m getting at here, let me tell you the story of a mom that I’ll call Brooke. Brooke was raised in a conservative, white, working-class family in rural Indiana, and her parents had a volatile relationship when she was growing up, and given that upbringing, Brooke never wanted to have kids of her own. But then, like many young women, she ended up accidentally getting pregnant in college.
Brooke and her boyfriend Brendon initially planned to get an abortion, and Brendon’s parents even offered to pay. But then Brooke’s parents found out, and Brooke’s mom persuaded Brooke to keep the baby, promising that she would help both with raising the baby and also with helping Brooke finish college.
Once Brooke’s son Carter was born, though, Brooke’s parents told her they couldn’t afford to pay or help her pay for both child care and for college, and in the wake of that decision, Brooke ended up dropping out of college, moving herself and Carter into a women’s shelter and enrolling in welfare. And because welfare came with work requirements, Brooke also took the first job that she could find, which was a part-time minimum wage job in retail that she hated. And she eventually found a full-time job at a child-care center, but that job also paid only around minimum wage. That said, it did come with free child care, and so this was appealing because at the time she was paying almost as much for child care as she was for rent.
And so at the same time, even when she got promoted to assistant director of the center a few years later, Brooke’s salary was still only $25,000 a year. And given the precarity of that situation, Brooke thought about trying to go back to college to, to get a nursing degree. But Brooke just couldn’t figure out a way to make it work. She didn’t trust her parents to watch Carter, so night classes weren’t an option, and quitting her job, even with how little it paid, seemed too risky. So Brooke just kept working at the child-care center, and she was still working there five years later and still hadn’t finished her college degree.
So Brooke is one of the hundreds of mothers that my team and I interviewed for this book between 2019 and 2022. We conducted more than 400 hours of in-depth interviews with moms and their partners from across the socioeconomic and racial, ethnic, and political spectrum. Most of those families were initially recruited through prenatal clinics in Indiana, so I also conducted two national surveys, each with more than 2,000 parents of kids under 18 from across the U.S.
And what I find in the data, and what Brooke’s story illustrates, is that women’s unpaid and underpaid labor helps to maintain this illusion of a DIY society. It makes it seem as though we can get by without a sturdy social safety net. Brooke’s story also illustrates a second piece of the equation here, which is that to facilitate this kind of exploitation, the U.S. has tried to trap women in motherhood and leave them with nowhere to turn for support in holding it together for their children and nowhere to hide when others ask them to hold even more.
And I talk in the book about how this system of exploitation is, is particularly damaging for low-income and middle-income women and disproportionately for Black and Latino women and women from other racially marginalized groups. In the absence of a decent social safety net, women in these groups can be easily forced into having or raising children or more children than they planned. And once they’re caught in that kind of motherhood trap, they can be easily forced to fill in the other gaps in our economy and also in our social safety net.
So to that end, to give you another story, I’ll talk about a mom I call Patricia. Before the pandemic, Patricia, who’s a Black mom, was still married to her husband, Rodney, and they had three kids, a toddler and two in elementary school. At that point, Patricia was working full time from home as a customer service rep, and Rodney was working full time in construction, and they were earning less than $30,000 a year combined.
Patricia, unlike Rodney, had some college education and she might have been able to find a higher-paying job, but she’d taken her customer service job, even though she found it repetitive and demoralizing, because it was the best remote work job that she could get before the pandemic. And being able to work remotely meant that Patricia didn’t have to pay for afterschool care or make alternate arrangements if the kids got sick.
When the pandemic hit, though, that arrangement ultimately meant that Patricia and Rodney never even talked about who would care for the kids when, you know, schools and child-care centers closed. That responsibility just fell to Patricia, and Rodney kept leaving the house every day for work.
Now, this kind of pandemic parenting took a huge toll on Patricia. The kids were constantly interrupting during her work time, leaving her frustrated and overwhelmed. She talked about the guilt that she felt, saying, “When it’s time to clock out, I need to not clock out mentally as a mother too.” And given that guilt, Patricia decided in the fall of 2020 to cut back to just four days a week of paid work. She figured it would give her more time and energy to focus on the kids, and she also hoped it would give her more time to rest because she had recently and unexpectedly become pregnant with twins.
What ended up happening, though, was that Patricia’s extended family saw her extra day off as an opening to ask for her help with car rides. Patricia was one of the only people in her extended family who had a reliable vehicle at the time, and she and her family were living in Indianapolis, which has been rated as the worst major city for public transit in the U.S. And so Patricia said yes, even when she explained that, she said, “your whole day that you had to yourself ends up being dedicated to running errands for someone else.” And she told me, she said yes because she had, you know, she knew her family had nowhere else to turn. The buck sort of stopped with her. And she also worried that she might need help herself someday.
And unfortunately, that someday came when Patricia and Rodney ended up divorcing just before the kids, the twins, were born in 2021. At that point, Patricia had to lean on those same people who leaned on her, and after her C-section, for example, she needed someone to drive her to doctor’s appointments, and she was grateful that she hadn’t pushed them away before.
And so Patricia’s story gets at this idea that, you know, our attempts to DIY society have, have decimated families, and particularly families that have been systematically marginalized in our society. And in that context, it’s often impossible for women not to get stuck filling in the gaps in our economy and in our social safety net, because we’ve really left them with nowhere to turn for support and nowhere to hide when others ask them to hold even more.
Now, within this system, it’s important to acknowledge that, that more privileged women have it easier because they can afford to offload some of their responsibility they’ve been handed by dumping it onto others who are more vulnerable than they are.
And in the book, I talk about a couple that I call Holly and Kathleen. They’re a white, same-sex married couple, and when their daughter Willa was born in 2019, they planned to split paid work and care work evenly. But the child-care crisis kept getting in the way. Without family nearby to help and with huge wait lists for care, their best option, child-care wise, was a part-time spot that wouldn’t be available until Willa was 9 months old.
And so to make it work in the meantime, Holly and Kathleen decided Holly would work for pay part time from home, while Kathleen worked for pay full time, in part because Holly’s job as a data analyst didn’t pay as much and was able to be done remotely, while Kathleen’s job in law enforcement, you know, had to be done outside the home and paid a whole lot more.
So that arrangement, though, got increasingly difficult as Willa got older, and Holly couldn’t wait for Willa to start child care. But then almost as soon as that spot opened, COVID closed the center, and they’re just right back where they were before.
And, you know, this caused deep frustration for Holly. And she actually went in and complained to her, tried to go in and complain to the center director. But what she learned in the process was that the center couldn’t afford to recruit and keep staff, as she learned, for example, that, you know, her child’s previous teacher didn’t have health care benefits and was still struggling to pay off medical debt that she had accrued, you know, years before the pandemic started.
And hearing those stories left Holly feeling guilty. She told me, “Kathleen and I just feel really guilty about being complicit in this thing where it’s like we have all these women of color watching our kids, and we’re not really taking good care of them.”
And, you know, that guilt of complicity weighed heavily on Holly, but she also recognized that, that she and Holly needed reliable, affordable care if they were going to be working full time and especially if they wanted to pay for IVF to have another kid. And so she talked about how, you know, “we have more than we need right now, but it could change at any moment without that social safety net. So you’re like, I guess I should just hoard it in a giant pile and sleep on top.”
And so as we see in Holly’s story, some women benefit from this kind of exploitation of women who are more vulnerable because that exploitation makes it possible for them to afford to outsource help with care. And yet, at the same time, and as we also see here, even relatively privileged women are drowning because our DIY model has left all but the wealthiest families with more responsibility than they can manage and because what’s left over disproportionately falls to women, even when men could do more to fill in the gaps.
And on that front, and I’ll quickly tell the story of a mom I’ll call Virginia, who’s a tenure-track professor at a research university who makes $75,000 a year, and her husband is a middle school math teacher who makes $45,000 a year. And despite being the primary breadwinner, Virginia is still the default parent for the kids. She’s also the default caregiver for her aging parents, even though her brother could be stepping up to do more, and it makes it tremendously difficult for Virginia to be able to feel as though she can concentrate enough to do her work, her research. She said, “I do actually have a brain. I love thinking, and I’d love to be able to do that again sometime.”
Um, at the same time, she also balked at the suggestion from her employer that she should just be taking more time for self-care. She said self-care is just a way that institutions have offloaded their responsibility of enacting humane work. Um, and she said that what she really needed was institutional support. She said, “I need the child tax credit back. I need a financial cushion. I need time and reliable care for my kids. I need consistency, I need institutions to step up and be humane.”
And essentially, I mean, Patricia, or Virginia’s lament here makes clear that we already know what the problem is, and we already know the solution. And so the solution is to build the kind of safety net that would actually protect us all.
But we haven’t built it, and I, and I argue in the book that we haven’t built it because, you know, billionaires and big corporations and their cronies, or who I talk about in the book as sort of the engineers and profiteers of our DIY society, have us right where they want us. And because they’ve promoted a series of myths that help to dissuade us, to help, to delude us into believing that we don’t need a social safety net, and to, to divide us by race and class and gender and politics and religion in ways that prevent us from coming together to demand the kind of social safety net that would better protect us all.
So I’ll leave things there for now, just to ensure that we have lots of time for other discussion. But I’m looking forward to the, to the questions and also to the, to the discussion with the whole group. So thank you.
Beth Jarosz: Thank you so much. Um, and I’m going to invite Tiffany now to speak a bit about her research.
Tiffany Green, University of Wisconsin–Madison: Thank you so much for having me here today. Congratulations, Jess, on your new book.
Um, I’m going to talk a little bit today about, um, some work that my team and I have been doing on a policy called birth cost recovery, or the birth tax, and just really thinking about its implications for caregiving. Um, a special thanks to the people that have funded this research, including the Wisconsin Partnership Program, uh, the Wisconsin Department of Children and Families, and the Centennial Scholars Program. So many people on my team to thank, um, including, uh, Klaira Lerma, who’s not pictured here, my research director; Frank Lewis, Obi Anaya, and Mikaela Miller, who are RAs as well; and also the many community partners that have been involved in this work.
So, what is birth cost recovery and what does it have to do with what we’re talking about today? Um, birth cost recovery is a policy primarily practiced in Wisconsin, where states draw upon a certain interpretation of federal Medicaid law that allows them to pursue, um, the Medicaid birthing costs, um, that, that people pursue. So if I have a baby and I’m on Medicaid, uh, the father, um, the non-custodial father would be asked to pay part of that cost.
And, how does this work? Um, basically, a person discovers that they are pregnant. Uh, they may or may not decide to enroll in prenatal Badger Care or Medicaid is what we call it here in the Badger State. Um, a person gives birth. Now, the state cannot withhold, uh, birthing coverage if the father is not declared. However, there is an automatic referral system in the state where if someone has a Medicaid for part of their birth, labor, and delivery costs, it automatically gets referred to child support.
Um, after that, the courts determined, um, one within the context of that child support order, if birth cost recovery or the birth tax should be incurred. Um, and that can be, that can be used to garnish a person’s wages, etc. And this is very much separate from child support, and it does not go towards the maintenance of the child. Um, if the birthing parent refuses to declare who the father is, the state can take away Badger Care or Medicaid after the 60-day period is over and they are otherwise eligible.
And so why does this matter? Well, for someone like me who studies structural inequality, this matters a lot. Because of structural racism, Black people and Indigenous people are far more likely to have their births covered by Medicaid, both in Wisconsin and the rest of the United States.
Um, I first learned about this policy from Rachel Azanleko, who was a former MPH student here who really focused on thinking about the impacts of birth cost recovery on outcomes. And she told me that, and as an economist I got excited, that there was a huge policy change in Wisconsin, which I’ll talk about in a minute.
But this is something that’s also coming up in the context of discussions with communities. This idea, particularly among Black communities, that this is a policy that magnifies financial instability for families. It penalizes birthing parents with health care coverage loss if they don’t declare the father. And it deepens many men’s struggles to financially support their children and strains family dynamics. So, you know, if there are strained family dynamics that that caregiving work almost certainly is going to go towards the birthing parents or mothers.
So in January 2020, Dane County stopped collecting new birth cost recovery funds. And we did some work to think about what the impacts might be on families. We found that there was an increase in child support that went to the birthing parent, and this was particularly true among Black families.
But one thing we found is that we weren’t hearing a lot about the Black families that were actually affected. And so in this, in this work through the Wisconsin Partnership Program, we decided to really try to document the experiences of the team and eventually create a quantitative survey where we could kind of assess how people’s experiences with birth cost recovery were affecting their mental and physical health.
Um, we started with birthing parents, and I’ll talk just a little bit about what we found. Um, and we also will be interviewing fathers as well, or non-birthing parents. Um, how do these birthing parents think that birth cost recovery has affected their lives? It’s dads not having money for necessities or extras. Negative impacts on bonding and, and these inequitable effects, particularly among Black Wisconsinites.
And so what this boils down to, again, is that it makes sure it helps to ensure that fathers are not able to fully participate in their children’s lives because of this extra cost that’s incurred. Um, here’s one quote from some of the qualitative interviewing that we’ve been doing. We interviewed, uh, I think 24, uh, birthing parents at this point.
“Yeah. I mean, that could be challenging for the 5-year-old.” So, so they’re talking specifically about birth cost recovery.
“I can’t give you extra money for school clothing because I got to help pay the birth expenses. Hey, I don’t have—let’s say I was to run into a gym where I needed $25 for gas. The funds is so tight that they’re not even leaving room for the fathers to do anything extra or curriculum activities, because they’re getting this money, taking out of their checks every two weeks or every week for child support.”
A second quote from a respondent: “If men didn’t have this birthing fee right off top, that would make it a better relationship bonding for the mother, the father, the child. Men would be able to do more, provide more, and it’d just be a healthy family overall.” So again, these quotes really embody the fact that this, this particular policy, far from being sort of these individual-level choices, has the capacity to frame what can be offered, fathers are able to offer children, and the stability of family units.
Um, just so you know, there have been some more recent policy changes. I feel like it’s a moving target for us. Um, Milwaukee County has stopped taking fathers to court for birth cost recovery. And Dane County also is, is working on forgiving back pay, as is Milwaukee. So there’s been a lot of change just since we started studying this policy. And we’re working to try to understand how this shapes family dynamics and caregiving within families.
Um, now we are focused on interviewing Black fathers now to understand their perceptions of the policy and understanding how this affects how they see fatherhood and their ability to support, uh, child, child experiences in their growth, and really trying to understand the short- and learn long-term effects of these policy changes on all Wisconsinites, but specifically Black Wisconsinites.
And I’ll end there and kick it over to the next person. Thank you so much.
Beth Jarosz: Thank you. And Karen, I will invite you to share about your research next.
Karen Benjamin Guzzo, University of North Carolina at Chapel Hill: Great, great. Thank you so much, and I’m really pleased to be here. And thank you to PRB for putting this together. Uh, and thank you Jess for writing this book.
And so I’m a demographer, and so I study population-level changes in behavior. And my particular area of research, uh, is childbearing, uh, looking at birth rates and trends over time, differences across different groups, um, the factors that predict whether people have children.
And so what’s important to me and some of my takeaways from this book or that related it back to a larger issue some of you may have heard of, which is that the U.S. is at record low fertility rates. Uh, this has caused considerable alarm and for all sorts of reasons, and maybe we can get into this later. Um, but different groups are alarmed for different reasons.
Uh, and so the question has become, geez, why aren’t women having births? And this is, I get this question a lot from journalists. And really, it’s tightly tied to how we think about women and birthing people. And you know, what we expect from them, how we judge them, and what we do or do not owe them and provide them as a society. And so when we’re talking about birth rates declining, um, to me, this is very much a story of damned if you do, damned if you don’t.
So for years the U.S. has had higher fertility rates than other countries, many of its pure nations. We, so we kind of aim for what’s called replacement level, which is about two births per woman. This allows women basically to replace themselves and their partners, and, uh, absent immigration, this keeps the population stable. And so with the U.S. was above this rate for, for quite a while when many of its pure nations were not.
And, as such, the U.S. was kind of able to ignore the social safety net, the kind of things Jessica talks about in her book: things like affordable care, affordable and accessible child care, lack of paid parental and family leave, um, having a functional health care system that everyone could access regardless of income or employment status.
And so low fertility, low birth rates, was really not on our national radar. Um, any woman can probably tell you it’s certainly on the individual people’s radar. So lots of women were, “So when are we going to start having kids? When are you going to start having kids?” Um, but this wasn’t a national conversation because what we are, the conversation we’re actually having as a country was who shouldn’t be having children.
And so the U.S. has generally had very high teen birth rates and high unintended pregnancy rates relative to our peer nations. Uh, and as it turns out, those teen birth rates and unintended pregnancy rates were actually propping up our overall fertility rate.
And so, since the 1990s, under the Clinton administration, um, we had the emergence of, um, different efforts to reduce teen and unintended pregnancy. Uh, so in 1996, we saw the emergence of the National Campaign to Prevent Teen Pregnancy, um, come out. And then later expanded to include, um, teenage and unintended or unplanned pregnancy. Uh, it since changed its name again.
Um, and so in the 1990s, teen pregnancy rates were at, um, sort of record highs, but only in terms of recent memory. Because if you go back to the 1950s, during the baby boom, teenage birth rates were much, much higher. But they were the right kind of birth. They were births to people who were married, and we weren’t worried about those.
So what happened in the 80s and 90s is that birth rates were increasingly teen birth rates were to low-income women who were unmarried, women from racially minoritized populations. And these were the wrong kinds of births. And so we were very worried about those.
Um, and so, um, we had all sorts of campaign ads to reduce teen and unintended childbearing. So you might remember from just a decade ago, New York City ran these fairly horrific ads, um, targeting teen moms and trying to shame them into not having, um, children.
Um, and then even at the federal government level, we have official policies. Uh, every 10 years, the federal government publishes something called the Healthy People objectives or Healthy People initiatives. And, and these are kind of health, public health goals they’d like to reach over the next decade. And for a long time, those have included, uh, reducing teen and unintended pregnancy rates.
And so I say all this to say, over the past 10 years, basically since the Great Recession, it actually happened. We’ve seen this long-term decline in teen pregnancy rates, but now we’re also seeing a pretty sizable decline in births to unintended births that would be characterized by people themselves as happening maybe later in earlier than they would have wanted. So now that people aren’t having those births, this is essentially good news.
So when reporters ask me, you know, “What’s happening with birth rates? Why aren’t people having kids?” I’m like, this is a success story. This is a story in which young people, those are, those are the people who typically, if they had a birth, would consider it sort of earlier than they would have wanted. This is a good news story that people are able to better control their reproductive lives so that they can have children when they want them, under the context in which they want them, and to have as many children as they feel personally able to have.
Um, and so this is a good news story, but part of this good news story, the background to this is that we have been preaching for years that it is irresponsible for people, but really for women, for young women, to have a child when you’re not ready: you don’t have a good job, you haven’t finished school, you don’t have a good partnership, you know, you can’t afford to live on your own, you live in an unsafe neighborhood.
So we’ve been preaching this for years that you shouldn’t have a child if it’s, if you’re not in the right circumstances. And so the decline in unintended fertility in some way it’s very good. And the decline in birth rate is because of sort of declining teen and unintended birth rates. But we need to think about the other side of the story.
Um, since the Great Recession, our society, and that of other societies, I’ll be honest too, who also have more of a social safety net, um, a lot of these societies are not providing people, young people, a sense of security and optimism for the future. I mean, all for all intents and purposes, having a child is a future-oriented decision. And so people need to look to the future and think, “Okay, I can do this, and I’m going to have a good life, and I can provide my children with things.”
And so to me, it’s, it’s baffling that people are baffled that we’re not having, young people aren’t having kids today, that they are waiting. And because they’re holding up their end of the bargain, the bargain that we’ve been preaching for, you know, 15, 20, 30, 40 years really: don’t have kids, don’t have kids if you do not have, you know, essentially all your proverbial ducks in a row.
But the other half of the bargain is that society needs to create a set of conditions in which you can reasonably predict for the future that you’ll have enough money, you’ll have a good job, you can afford health care, you can afford to find a safe place to live. You can have a good partnership. And so people aren’t having kids because those things don’t look like they’re happening for them in the future. Um, and, of course, without an adequate social safety net otherwise, it’s just simply too risky to have children in some ways.
So most of my research really shows that it’s not that people are saying, “I don’t want kids.” They’re saying “I want kids, but not now. I want kids if—.” And they really are thinking quite rationally about what they want in the future, what they think childbearing for them should look like.
Um, and so if you’re a woman, childbearing is incredibly risky. So it starts in pregnancy. We monitor what you eat, what you drink, how little or how much weight you gain. If you have a substance use disorder, uh, and you’re pregnant, you could go to jail or risk losing your child rather than getting help. Um, if you’re sick during pregnancy, you know, God bless you. Um, because we don’t know what meds might work for you because we actually don’t study, um, women, pregnant women have typically been excluded from medical trials.
If you have a condition that threatens your pregnancy, um, or threatens your life and you live in certain states, uh, again, you might literally be risking death because health care professionals cannot or don’t feel as if they’re allowed to treat you. Um, even before some of these recent changes we’ve seen in abortion law, uh, your chance of dying during pregnancy, during childbirth, or thereafter was much higher in the United States than elsewhere.
And then, of course, if you make it all through that, and you have a child, and you’re on your own to figure out if you can take time off. We do not have paid family leave in the United States. So people go back to work much sooner than they would like. Um, but if you’d like to stay home and recover from childbirth, you know, bond with your baby, you’re going to have to figure out how to do that on your own. You’re going to have to fund that on your own.
If you do go back to work, um, you’re going to have to find someone to care for your child. Um, and we have such a huge problem with child care affordability and accessibility, and this has really been accelerated and magnified during the, um, the pandemic and post-pandemic years, uh, where we’ve seen a real decline in child-care slots.
So you have to go back and try to figure out who’s going to watch your kid for you, and can you afford it? Um, if you do have a financial setback of some sort, you know, you’ll have to navigate our patchwork safety net programs. Um, and those, there’s a lot of sort of administrative burden there, and it often seems like they’re designed to turn you down and humiliate you in the process of getting them.
Um, even for advantaged women, you have these sort of do-it-all norms, uh, and you’re going to be struggling to find child care during summers if your kids are school age or before and after school. Um, you are worried about social mobility, so parents feel like they have to do everything right and get their kids into all the right programs. Um, if you can afford not to work as a mom and you choose to work, you’ll be judged for that, and you’ll face this constant feeling of neither being good enough at work or at home. And these are all just really gendered things.
And so when, when people ask me, “Why aren’t people having kids?” I’m like, well, they’re making really rational choices about what’s available to them. What’s the safety net look like? What does my own future look like? Does it look safe? Secure? And mostly they’re saying no, it doesn’t. It doesn’t look like that right now. And so people are waiting longer and longer to have kids. And sometimes that might mean they end up with fewer kids or not having kids at all.
And so this is not a story of individual women saying, “Oh, I just don’t like kids.” I mean, of course, some people probably say that, but really it’s a story about young people as a whole looking around and saying, “There’s— the conditions in which you’ve told me I’m supposed to have kids don’t exist for me, and I’m not sure they will.” And so this is very much a story about what is our social safety net look like for people and families, but particularly for women who are making these decisions.
So I think I’ll stop there, so we have chances for someone else to weigh in.
Beth Jarosz: Thank you so much, Karen. And last but certainly not least, um, we want to, we’re talking about all of these challenges, the social safety net and sort of policy changes that could be helpful. So we’re going to wrap up with a little bit of discussion about, uh, how policy can change. So Jocelyn, turn it over to you.
Jocelyn Foye, Womxn Project: Thanks. Hi, everyone. How do you do? My name is Jocelyn Foye, she/her.
I am located in, um, Providence, Rhode Island, um, which I relocated from Southern California. But to give any of you a sense who aren’t from these parts, um, Rhode Island is the smallest state in the nation with only 1.1 million people living within our borders at this time. Our census says that we are a 77% white-identifying population, which if anyone studies census work, they’d understand that that’s not the right number for minority spaces. But, um, it’s an important one to name. And then also, we’re the third most Catholic state in the nation, which means we have an incredibly powerful, um, bully pulpit for the, for the bishops here.
And so when I moved here from Southern California, um, what I found really quickly was how restrictive the policy was for a state that people often say is a blue state when you see it on the map. And when we’re looking at presidential elections, it always goes blue. Well, we’re very purple, and it’s important to name that as I talk about this work, because, um, my organization came out of a place of recognizing that with Trump coming in as his first presidency, we had concerns.
A number of us who were doing policy, and I come from a background of being an artist, a spectacle-based artist and a design professor, and we wondered if we could put together policy strategies and inclusive installations that were spectacle based and activating of community to be welcomed into the process of how to do art and activism with us. So these are some images of ways we did the work. Um, and it’s, there’s a lot of pictures on our website. So we, we welcome you to take a look at it.
But the reason I think I was invited here was because the Womxn Project. Um, and I want to say to woman with an X when we originally named ourselves, was to be an inclusive organization to include all folks, of all folks who wanted to get active with us, to join it. Language has recently changed, and so we constantly are in a mutative form of how do we rebrand to be in alignment with inclusive, inclusive work?
Um, so, um, we came on the scene after 24 years of essentially what was the Roe bill in Rhode Island. It was, um, fought for, for 24 years and had no success. And so with our style of activism, what we did is we created this community quilt. And we wondered if by going into different areas across the state, and we had conversations with people about, were they aware of their rights? Were they aware that after, um, if Roe should be overturned—and mind you, we started this in 2017—um, that based on the constitution of our state, we would see that, um, providers would be tried as murderers.
And I went to an event in Washington, D.C., where I sat with some women from Alabama, and they said, you know, “Rhode Island and Alabama aren’t very different, are they?” And I was like, oh, tell me more like, what are you thinking? And what they said was, is that we both are run by the mob, which is true, and we both are, um, are going to have abortion providers tried as murderers based on our states’ constitutions.
So our group was like, okay, how do we bring more people to the table? Let’s look at the way marriage equality was done nationally. And we started doing one-on-one conversations, house parties. We started going into spaces where women were collecting, book clubs, sewing groups, you name it, and we started asking people if they wanted to make a quilt square with us. And the quilt square became essentially their own signature of a petition.
And as a lot of us may know, the history of quilts says a lot about, um, memor— like memorandums or histories of passage of people’s lives. But it also is a, is a, um, history or a path of understanding of where to go.
So what we did is we ended up building this giant quilt, and we had master quilters across the state helping us build these sections that we carabinered onto one another, and we moved around and we would display in our state house. And for anyone who’s a visual interests learner, installation art, this thing kept getting bigger and bigger, and we had security guards really angry that we had this mass thing.
But what happened was a ton of people across the state felt really this was their thing. They all were working on it. It was a very collaborative effort. And what really happened was, is we got to have 2,500 small conversations with people who made those squares with us that were part of those quilts, and that had the networking effect that women do do so well, or small communities that are unique and tight with one another.
So it became an intersectional project in a lot of different ways because of where we were invited. And we intentionally designed it so that different spaces made it their own. People built different methods of this, this style of work together.
And we were able, after three years, to pass the bill, which was turned into, they named it the Reproductive Privacy Act. Um, and we did it because we built community momentum, and we got people to a point where they not only understood what was at risk through conversations and networking, but also they learned about the education of how a bill becomes a law. And they learned that they wanted to get involved and they wanted to see this bill through.
People felt a level of ownership. And so when I talk about us as an organization, the part that’s hard for people to wrap their heads around it is, is that we stemmed from grassroots organizing. We still are. Um, but we also shift policy. And we do that by way of, of basically the people power.
And often when you talk to organizational leaders who say, well, what is your piece? What makes you different here? Um, unfortunately or fortunately, it is the fact that I’ll walk into a room with legislators or the governor, often not comfortably, they’ll see me and they’ll be like, oh no, she’s here, because I bring sort of this level of question of what is the action or the behavior that I’m representing, but also how many people are, are coming with me.
And so what it’s done is, is in this movement, this intersectional movement of “women’s work” or organizational, um, like, uh, patriarchally like suppressed spaces. What we’re doing is, is we’ve pivoted from not just working in the abortion space, but we’ve also been invited and have board members who are identifying in the space of the LGBTQIA space.
So after two years of passing the Reproductive Privacy Act through, excuse me, because of COVID, we passed essentially the Hyde Amendment in Rhode Island to be overturned. And so that meant that Medicaid recipients and state workers then had that included in their insurance policy, which, when we think about it, if you pull back on a lens, um, a lot of people will say abortion is been taken over by white women, second-generation feminists. And I can’t argue against that. But we looked for ways to make it everyone’s work. And with the second bill, it was an equity piece. It was like every, if one person has access to this, then everyone should.
And so now we’ve gone into the same sort of work in a similar way. But we’re not talking about abortion because it’s never really been about abortion. Roe was not about abortion being overturned. It was about taking away our rights. And so, in a medical way, and so we’re now looking at we just passed a bill this year, which is incredible because there’s really no good news in this horizon, but a provider shield bill.
And so we now have we just today, I just came from the signing of our governor where providers who are giving, doing abortions or who are doing gender-affirming care will be protected from any out-of-state attacks that they may receive from states so that those providers can be taken care of, as can the patients, which is not something we always get to talk about. So our work is this like modeling of policy mixed with community action.
And I think that, um, there’s a lot to say further, but I’ll stop. Um, we are, I will say this too, in, in just full disclosure, we’re an organization that started as a C4, not-for-profit, which is unusual. It’s not a C3. A C3 is tax exempt, so it’s not allowed to talk about policy as a lobbying thing. Well, we started as the opposite, which is a lot harder in America. People don’t like to fund this type of work.
But what it allowed us to do was it was tool, we had tools in our toolboxes that were different, so we were able to drive billboard trucks around our state with faces of General Assembly members on it that said, this person doesn’t believe in the right to abortion in your district. Here’s their phone number. Call and ask them why. Because it became an accountability process.
And, um, and we built massive coalitions around this work because people saw the value in it and for their communities as well. And so we’re growing while trying to figure out how to, you know, keep pushing the envelope. So I’ll stop there.
Beth Jarosz: I feel like I, we could continue this conversation for two more hours. Um, but we’ve got, we’ve got about 20 minutes now for questions, and we’ve had a lot of really fantastic questions, um, come in through the chat. So, um, I think I, I had prepared some questions, but I think the one theme that sort of has come across several of the questions that have come in is, what would an improved social safety net look like? And I’m thinking each one of you probably has a perspective on that. And we’ll go kind of in the same order we did. So Jess, Tiffany, Karen, and Jocelyn for that one.
Jessica Calarco: So I mean, I think that’s a great question. And I think the kind of social safety net that we need, in my view, is one that helps to essentially take care out of the for-profit market. That’s one piece of it, in the sense that so much of the unpaid, underpaid labor that women end up doing, women hold almost 70% of the lowest wage jobs in our economy. And often those are jobs where women, especially women of color, especially women from more marginalized groups in our society, are pushed into doing these kinds of low-wage jobs because someone, they’re not, they don’t work within our profit-driven model.
And so ensuring that that taking that work out of the market, whether that’s child care, home health care, the, you know, health care in general, that removing that from the profit pressures can help to then pave the way for the second step, which is about ensuring that the care, the care work is equitable and funded to the level where it can be both equitable and sustainable, essentially taking care of the people who care. And that includes both paid work and unpaid care work in the sense of things like unpaid, or things like paid family leave, things like paid vacation time, things like limits on paid work hours like they have in places like France, to ensure that everyone has the time and energy to contribute to this shared project of care.
So those are sort of, you know, two key components, um, kind of ways to think about the social safety net as opposed to, you know, specific programs. Um, so it’s about sort of, you know, giving people a backstop and also making sure that people have the time and energy to, uh, you know, take care of each other and take care of themselves because we can’t outsource everything, even with a sturdy social safety net.
Beth Jarosz: Tiffany, do you want to add to that? What’s, what would the safety net look for you?
Tiffany Green: I don’t have much else to add. I think high-quality child care is, is a key thing where, where child-care workers are paid well. We know that child-care workers were at the front lines during the ongoing COVID-19 pandemic, and many quit, um, during, during that time. So making sure we have high-quality child care where the people taking care of our kids can actually afford, um, that high-quality child care is really key. Having, um, paid parental leave is really important.
But I would say even within the context of our institutions, many of us are at universities—I’m tenured now, so I will say this—um, a lot of the care work is put on, um, you know, faculty assigned female at birth. Let’s, let’s be really clear. So we have a pervasive, um, um, the thing where we put care work upon women and other people assigned female at birth within all of our institutions. So I think we need a full-sale overhaul, uh, a wholesale overhaul of what that looks like.
And the other thing I would say, I always think about the non-sexy things, and so one of those things is our tax system. I’m not an expert in that. But I’ve, I’ve been very convinced by my colleagues who are experts in the tax system in thinking about how we can use that to, to reduce poverty, because, again, many of the most impoverished households are headed by women. So things like the Child Tax Credit were very effective at, uh, at improving things, making sure we have, um, an equitable system so that people, people that, households that are headed by women, um, will not be as poor, I think is really important, other than, you know, burning down the patriarchy.
Beth Jarosz: Yeah. How about you, Karen? Anything to add?
Karen Benjamin Guzzo: Yeah, so I want to comment on something that I think I showed up in the Q&A a bit, which is that people sometimes say, oh, well, other countries have some of the social safety net things you’re talking about. You know, some of the Scandinavian countries have great leave or great child care, and their birth rates are also falling, or what’s happening, um, in East Asia, where the birth rates are extremely low and they have some generous policies.
Part of the problem, though, is that you need all the things, but you also need social change. Um, and it’s not enough to, especially for some of the East Asian societies, to say they have a generous maternity leave policy, um, if women are actually still expected to come home and do all the work, uh, and their husbands are not doing anything, or you still have a culture in where, um, working all the hours is how you actually get ahead in your job. So it’s not enough to have just any one of these things.
Um, but I would also say even if birth rates don’t go up, they are the right thing to do to have, you know, a strong maternity and parental leave policy, to have adequate child care. Um, it is, I think it’s important to have these things because it does improve the well-being of, of our families. And I think that is really where we all want to end up, where people feel like they can live the kind of meaningful lives without this level of stress.
But going back to the culture thing, and one of the things I find is a sticking point sometimes in conversations I’ve had in research I’ve done, which is that women feel as if they’re doing everything and their husbands are like, “But I’m doing so much more than my dad. I’m doing so much more than the earlier generations did.” And the women that they’re partnered with are saying, “But you’re not doing as much as me.” And so people are sort of talking across each other within relationships, but we don’t recognize this sort of care work and value this.
So there’s been this movement. Um, I think Richard Reeves is sort of the kind of most proponent, biggest proponent of this is, how do we get men, how do we help men out? But one argument he’s making is we’ve got to get men to understand that care work is important and meaningful. Um, and help them make, you know, firm relationships with their children, with their friends so that they can engage in this care work that makes everybody better.
And so we need a social safety net, but we need the cultural change that supports using a social safety net and that a social safety net is an investment and not some sort of extra expense that we’re doing because women aren’t doing their jobs.
Beth Jarosz: Thank you. And I actually think that answers one of the other questions that have come in. So the person who asked the question about how are men being called in, if that’s, if you want to continue on, repost that question in the chat. And then Jocelyn, do you have anything you want to add about the safety net?
Jocelyn Foye: The only, yeah, I mean from my lens as it would make sense then is, is that from a social safety net too, we need to be supporting not-for-profit organizations that are doing a lot of this work. Um, it’s the second largest industry in the United States, which is not-for-profit work, but how, um, those organizations struggle and actually exist within spaces where they’re in competition with each other is really difficult.
Um, and so I would just say for those with the means, it’s not always about money. It’s also sometimes, which we often talk a lot about, what it’s about, um, finding your superpower and what can you contribute to the work. Um, often for people who have the means, yes, money is a really helpful tool. But for people who time is of the essence, you have children, you, there are organizations that invite you to do some of the work with, um, them with your children, and more and more not-for-profits are making that a part of the process. Um, but also organizations are looking for people who can do work in ways that are very creative.
And so I’m just putting out there I think that, again, I come back to I’m not thinking of the folks who were trying to just get by, but I’m thinking of the spaces that are places where people can add a little something. Um, I think it’s important to name, and I, I don’t have a stat that’s as, as recent as I’d like, but Ms. magazine has been putting out research about what kind of not-for-profit funding exists in the United States. And in 2020, it was only 1.6% of not-for-profits were being funded that supported women and girls, specific not-for-profits. And so when we look at how support is existing out there, I think we could all do better. Um, and I think we make assumptions about that.
But I go back to I’m a designer. I always offer my resources as a designer. I can’t offer my resources as a, as someone who makes money. And so I try to fit it in when my kids go to bed before I go to bed, if I can. And I think that that’s a way to think about certain models. Again, a privileged model nonetheless. But if you had the time, what could you offer?
Beth Jarosz: Thank you. Um, and taking it in a slightly different direction and sort of a question that I had prepared, um, but then Tiffany sort of spoke to in the chat just now is that, you know, the underpinning this assumption is the idea that, um, that people should be having more children. Um, and is that really even a, is that really even the right assumption?
I know, um, Karen and I have been chatting about this a little bit too, that, and Karen, maybe you want to kick that off, that, that just that underlying assumption of is that even the right question, like is, is the question how to, how do we increase birth rates? Or is the question about making sure we have a safety net because that’s the right thing whether the birth rates get there or not? But also how do we push back against this idea that like people having kids is the way to solve our economic problems?
Karen Benjamin Guzzo: Sure, sure. So, um, I’ll just sort of lay my, my, my position clear, which is I’m not worried about our fertility rates. Uh, I worry about fertility in the sense of we have people who say they’d like to have kids and feel like they can’t have the kids that they’d like to have under the conditions they would like to have them. That is a societal failure to me that we have people who want to have children and feel like they can’t. That is a problem we need to fix. Um, but birth rates in themselves don’t concern me.
Uh, you know, if we’re worried about, you know, we talk about Social Security or, um, the labor force or something like that, or even worse, you know, nation-states. I can tell you how little I care about nation-states. Um, but, you know, things like Social Security, we have other means. We could, we could, we have other policy-level levers, um, but expecting people to say, oh, I should have children so that, um, future generations can, so that my kids 20 years from now can pay into Social Security to help fund retirees at that point is sort of nonsensical to me when we have levers like, we could raise the Social Security cap, um, you know, we can change our policies in terms of immigration. We, uh, we can, there are things we can do. And as automation changes and jobs change, do we need as many workers?
Um, and so we need to we need a wholesale sort of reimagining. And do I think it’s going to happen? I don’t know about that, but, um, but this idea that birth rates are going to be the thing that save us as a future just does not resonate with me, because it’s not just about birth rates. Let’s be really honest. It’s about the right people having births. Um, it’s not just we don’t want more immigrant births, so we don’t want births from poor people. We want a very specific group of people to have births. Um, and ideally, they should stay at home with their kids and get out of the labor force.
And I mean, it’s, there’s a whole level of things that, you know, probably aren’t worth getting into right now.
Beth Jarosz: And, Tiffany, since you were the one who put that comment in the chat, is there anything you want to add to how we think about the sort of social structures about who’s the right person, or, you know, that it should be going up?
Tiffany Green: Yeah, I mean, I think it’s very much grounded in the eugenics of, of, of earlier and I guess present times that the people that need to be having births are white cisgender women and other people should not be giving birth. Um, so I teach a lot about that in my classes, and I think it’s really important to sort of question our underpinning ideas of why we, we think people should be giving birth.
Like Karen, I don’t care about birth rates. I care about people that, you know, from a reproductive justice standpoint, the right to get pregnant and stay pregnant is really critical. And we know that social structures, uh, are very much against, for example, Black people, uh, getting pregnant, whereas during enslavement, um, the idea was for Black women to get pregnant and to, to perpetuate the institution of slavery. So there is no neutral way of thinking about birth rates, uh, in, in that context.
So in total agreement with Karen and just adding that extra historical context.
Beth Jarosz: Thank you. Um, and then there are, there are so many good questions. Um, and I have to pick, we probably have time for one, maybe two more. So I am going to go with one, um, that, uh, Jess, throughout the book, there’s this theme that good choices aren’t enough to save people, um, that, that there is this sort of social belief that, oh, well, you know, if that person had just done x differently, then y wouldn’t have happened. And you lay out a really clear case that that is not really how things work. Could you expand on that just a little bit?
Jessica Calarco: Sure. I mean, this is basically the idea that correlation is not causation in the sense that certainly there are, um, choices that people can make in our society or some people can make in our society, things like getting married, you know, delaying childbirth, uh, going to college, finishing a college degree. You know, these kinds of choices correlate with better outcomes. You know, more economic stability, lower risks of poverty, better health outcomes.
But that doesn’t necessarily mean that it’s those choices themselves that lead to those better outcomes. And it ignores the role of privilege in facilitating people making those kinds of choices. As Karen was talking about before, we’ve set people up to understand that you should really only be bringing a child into the world, or you won’t be, the only real way to not be judged for doing so is if you’re doing so in the right kind of context.
And the same is very much true for marriage. The same is very much true, I mean, for college. I talk in the book about how just going to college, especially for women given gender pay gaps and given the way that we, you know, differentially value gendered work, it doesn’t necessarily pay off in those kinds of ways.
And so we have to be very careful about that kind of messaging that just tells people to make good choices. And that’s really the whole, um, the basis of this DIY myth that I talk about.
Beth Jarosz: Does anyone else want to speak to that question?
Karen Benjamin Guzzo: I would just chime in to say some of the stuff that was in the book that I’ve seen in other places, which is you make the right choices and something catastrophic goes wrong and there’s no safety net for you. You have a sudden illness, uh, your spouse dies. All your good choices don’t mean anything, you know, because you’re on your own again, because there’s no safety net.
So, again, making these right choices, it’s no guarantee that things will work out. And so the amount of luck people have, um, in their lives is sort of underplayed because the people who’ve done well don’t like to think of themselves as being lucky or fortunate, but they are just one sort of bad mistake or bad, you know, car accident away from something catastrophic happening. But we don’t think about it that way. And we tend to say, oh, you must you must have made bad choices to have ended up this way.
Beth Jarosz: Um, I don’t think we have time to address this one, but I just want to note that a couple of people have mentioned in the Q&A that there’s also, we’ve talked a lot about child care, but similar patterns play out with elder care and with other family caregiving responsibilities. So I think it’s sort of just a resounding acknowledgment that that is true, and that when we talk about these roles that society plays on women, we’re talking about all of those, um, even if we’re focused on the child care piece today.
So the last question I want to leave with, um, is we’ve talked about a lot of what’s wrong. Um, we’ve talked about a lot of the challenges and the holes in the safety net. I want to just ask, is there anything that makes you optimistic about the future? And we’ll, we’ll go in reverse order this time. So we’ll do Jocelyn and wrap up. Jocelyn, what makes you optimistic?
Jocelyn Foye: Sure. Um. So, uh, the Womxn Project lately has been doing a lot of organizing at school board and town council levels, because that is a space where a majority of women are taking in, taking on the roles of those leadership positions, at least in school committees. But typically they get kicked. They decide not to continue in government because, frankly, it beats them down.
Um, what I will tell you is, is, well, we’re fighting against a lot of the hate group organizing ourselves in terms of how it’s impacting bodily autonomy and freedoms. Um, I will tell you that when people in their communities find out, so in Rhode Island, people don’t think it’s as present here. And so I would say that representation of the different states that is here in this panel, that’s a very different type of thing. But for this particular state, when people find out that there is things, there are certain things happening in certain areas close to them, people aren’t shying away from it as much as we expected. They’re actually asking, how can I help?
And so my talks have been very much around maybe it’s not direct because that puts you in direct conflict with people or vulnerable with people who are in your community directly, maybe at the supermarket. But there are different ways to engage. And I’m seeing a lot of innovative thinking and a lot of, of hopeful thinking, and that gives me hope that whatever happens on the other side of this, um, presidential election, that the network we’re building within our state, within these different communities to defend, um, their school boards and town councils that we’ll have a network of people that are working together to do something as simple as, how do you support people if Medicaid goes away?
And so there are different methods of behaviors that people are analyzing and turning to for their community health centers to do that. So again, I think hope is coming in like, who are the heroes? And it’s everyday heroes that we’re seeing, and it is moms, and it’s birthing people who are just like, you know, not, not on my watch. And so I think that that’s an important place to be and to hold on to is hope.
Beth Jarosz: All right. How about you, Karen? What gives you hope?
01:00:18
Karen Benjamin Guzzo: Young people. Um, they are very, they, they’re very clear that they, like, they think about parenthood a lot and what we owe kids. And they’re not willing to, to take it for granted that things will work out okay. They’re like, well, what do I need to do? And so they’re very conscious about, about having kids and about what their futures look like and how what they need to do to make it to, to, to make a better future for themselves and the, and the kids they’d like to have.
And so I’m always impressed by the young people I talk to. And I say, I sound so old when I say that. But, you know, my students in college, like they are really deliberate about thinking about their futures and what they want, and they want to make sure that they have those. So, so it’s not people aren’t taking childbearing too seriously, it’s that they’re taking it very seriously and they’re not willing to do things under, you know, less unsuitable conditions. And I think they’re going to work for those.
Beth Jarosz: Thank you. How about you, Tiffany? What, what gives you hope?
Tiffany Green: You know, um, so prison abolitionist Mariame Kaba always talks about hope being a discipline. And I think that is what I try to do.
You know, I work in reproductive health and equity and justice, and there’s a lot to be depressed about. But I think for me, it’s staying in the work and seeing that no matter how, how, you know, we despair, there have been people that have been working in reproductive justice for a long time. There have been people that have been working to, to expand access to child care for a long time. There have been people that have been fighting for all of the things that we’re talking about, and that progress is never, was never going to be linear.
So I think really for me, it’s staying in the work and working to uplift those people who are doing that work that keeps me hopeful.
Beth Jarosz: Thank you. And last but certainly not least, Jess, what gives you hope?
Jessica Calarco: Yeah, I mean, I think one thing that gives me hope, in addition to what’s already been mentioned, is that we got really close with Build Back Better, and we actually learned some really important lessons from the policies that we put in place during the pandemic: things like the Child Tax Credit, things like universal free lunch, you know, from the Medicaid expansion. We learned from these policies that we can do large-scale social programs in the U.S. despite our size, despite our political variations and all of the other challenges that we’re up against.
And the other thing that gives me hope is that, at least for now, we still live in a democracy, which means that we have the chance to, that we don’t actually need to persuade everyone, that we, if we can convince enough people to reject the kinds of myths that are designed to delude and divide us, then we actually have a shot at electing the kinds of policymakers who have the potential, at least, to fight for a stronger social safety net.
And so I think it’s those are the kinds of pieces that give me hope that we got very close and that this is possible if we just have enough people who are willing to reject some of these ideas that help us stay stuck in the status quo. Thank you.
Beth Jarosz: And thank you all so much. This has been—I don’t know if you can tell from the reactions that are coming in through the chat here with the hearts and the clapping—this has been an absolutely fantastic conversation. And thank you all for your time today. I truly, truly appreciate it, and we will post the recording soon.
Expert data users from PRB, the U.S. Census Bureau, and the Southern California Association of Governments review shortcuts, resources, and tools to help data users maximize their experience analyzing American Community Survey data.
An array of resources and tools can be used with American Community Survey (ACS) data to enhance the efficiency and proficiency of data users. However, given the volume of information available from the U.S. Census Bureau and elsewhere, learning about these resources and tools may be challenging for some users.
In this 90-minute workshop, expert data users from PRB, the Census Bureau, and the Southern California Association of Governments (SCAG) walked through some of their favorite shortcuts, resources, and tools to help data users maximize their experience analyzing ACS data.
Attendees were first introduced to the ACS data users group, an online community that provides help to members seeking to better understand ACS data and methods. The second presentation focused on accessing Census data via the API and MDAT, including basics such as how to create a call for an estimate in the API and access data through the public microdata sets (MDAT) on data.census.gov.
The third panelist provided a high-level overview of how to use R and the tidycensus package to execute commands such as switching between spatial scales, outputting a map, and looping through a query to assemble a longitudinal series from the ACS.
Mark Mather, PRB: Okay, well, I think we should go ahead and get started. Hi, everyone. Thanks for joining today’s webinar on ACS resources, shortcuts, and tools. I’m Mark Mather, and for those who don’t know me, I help manage the ACS Online Community website and other activities in partnership with the U.S. Census Bureau.
I am very excited to introduce the three speakers in today’s webinar. Lillian Kilduff is a Research Analyst at PRB and will provide a brief overview of the ACS Data Users Group and Online Community. Following Lillian, we’ll have Mary McKay, who’s a survey statistician in the American Community Survey Office. Mary is going to show you how to access the ACS through the Census Bureau’s API and microdata extraction tool, also known as the MDAT. And then we have Kevin Kane, who’s a program manager with the Southern California Association of Governments. Kevin is going to describe how he uses R and the tidycensus package to access and output ACS data.
A few housekeeping notes. We’re going to save the Q&A until the end. We do have a large number of participants. We encourage you to use the raise hand feature in Zoom, and then we’ll try to unmute you to ask your question, but you can also feel free to use the question box at the bottom of your panel there, and you can type in your questions at any time during the webinar.
Closed captioning is also available as an option at the bottom of your screen. And in addition to our three panelists, we also have several other Census Bureau staff members on standby to answer your questions today. And finally, this webinar is being recorded, and we will send you a link to the recording after the event. And with that, I’m going to turn it over to Lillian.
Lillian Kilduff, PRB: Thanks, Mark. I’m going to be talking about the ACS Online Community today and also showing the new upgrades. If you haven’t already seen to the look and feel of the website, I’m going to go ahead and share my screen real quick. Right here. Okay. Sorry about that. Okay. Um, so I’m going to provide the brief introduction to the ACS Online Community.
So here’s an overview of the presentation today. First we’re going to do a quick recap of the American Community Survey itself. Then we’re going to talk about the ACS Data Users Group and Online Community. Then we can go over the tabs of the ACS Online Community, and that includes the discussion forum, the ACS resources, webinars, and conferences tabs.
After that, we’re going to talk about the ACS Online Community itself. So behind the scenes, how many members do we have, threads and replies, page views, response rates, and then also talk about the discussion forum topics that often get viewed. We’ll go over the site upgrade if you haven’t already seen the changes and talk about how to join the ACS Online Community.
So just to review, if you’re new to the American Community Survey, people use the American Community Survey to get, uh, data on the demographic characteristics. So that would include social characteristics, economic, housing, and demographic. And you can see some of the examples in those parentheses there. The data products include one-year estimates, one-year supplemental estimates, five-year estimates, and you can access those through many tools including tables, the summary file, and PUMS.
Here is a quick hierarchy of the geographies available. So we have from the nation down to block groups.
When it comes to the ACS Online Community, this is a partnership between us at PRB and the American Community Survey Office at the Census Bureau. The ACS Online Community’s purpose is so that ACS data users can share tips and tricks, questions, materials, and then also we post announcements about things like today, the webinar. Membership is free and open to all ACS data users and new ACS data users. The group is led by our steering committee, and we try to pick a steering committee that represents all different data users, local governments’ data users, geography, geography data users. And we just had a new steering committee this this year.
So I’m going to show you the home page. Okay. This is fine. Here is the home screen of the new ACS Online Community. Here is just what I talked about, the purpose of it. Here’s some quick facts about it. And we also have the most frequently asked questions. That’s based on questions from data user surveys and also from the most viewed and interacted discussion forum post. You can view more FAQs on the FAQs page from there. We also have latest discussions, people who are posting in the ACS Online Community. We have a link to the Census Bureau website.
The discussion forum is the main part of the ACS Online Community. Here is an example of a discussion forum post. So a data user is asking a question, and then we get a reply from another data user. You can upvote replies, and if you become a member of the ACS Online Community, you can do things like uploading, replying, and adding to the discussion forum. Here you can see the views, replies. You can also add tags to new discussion forum posts. And then we have more information over here.
Next is the ACS resources page. Here you can see a lot of different links to ACS resources under these helpful headings. If you aren’t already familiar, the ACS handbooks are a great place to start, and we also have handbooks that are catered to certain data users.
Here is our webinar page. So this is the webinar we’re having today. And then we also have links to past webinars with recordings, information, and even the slide decks.
We hold a biannual conference every year. The latest conference was the 2023 ACS Data Users Conference. We have the agenda from that. That includes the recordings of the presentations and also the slides as well. We have the previous conferences, and those include that information as well.
I’m going to go back to my PowerPoint now.
Again, this is the discussion forum. Here is an example of a notification of a Federal Register Notice. That’s one of the examples of a discussion forum post that’s helpful to ACS data users.
Okay, so behind the scenes we can talk about the membership. We have over 5,600 members as of the end of May. Here you can see the fiscal year 2022 and 2023, and membership can vary over that time. And usually when we, when we have events like conferences or a new series of events called ACS on the road—we just went to the Texas Demographic Conference—we can see an increase in membership.
There’s a lot of discussion forum posts, and they get a lot of replies. Here again we have, uh, the total number of the threads and replies across the two last, last fiscal years.
And here are the number of page views that the ACS Online Community gets. If you’ve ever googled a question about the American Community Survey and its data, a lot of times the first Google result is the ACS Online Community itself. And you can see that overall, uh, with the last fiscal year, the page views and the ACS Online Community have increased.
The great thing about the ACS Online Community is that we do have a great response rate. So you can see that just within one day, if you post a question or an announcement or a comment, you get a pretty good, uh, you know, response rate.
And here are the top 10 discussion topics. We get a lot of questions about calculating margin of error, especially, uh, zip code–level geographic questions.
So onto our site upgrade. This is how the ACS Online Community used to look. You may remember it this way, but now live on the site, we have this new upgrade that’s, uh, more intuitive and more modern in the look and feel. This is how the discussion forum used to look. And now here is the upgraded website.
So finally, how do you get involved with this site? You don’t need to be a member of the ACS Online Community to view the posts, but you do need to be a member to post in the Online Community, comment, uh, and also upvote. You can tailor the email notifications that you get, so, uh, to new threads and comments. And these are all optional. So if you’re hesitant about joining the ACS Online Community because you’re worried about a lot of email notifications, you can cater those. You can also bookmark discussion forum threads so you can reference those whenever you have questions about a certain topic.
And again membership is free and signing up is very simple. First, you click on the sign up button in the top right and then just answer a few questions. We use this information so that we can better cater to different data user groups.
Finally, there is a picture of one of the ACS data users conferences, and please give us your feedback or suggestions.
Thank you so much. Here is my contact information if you ever have any questions. And I can either answer the questions or direct you to someone who will know your, the answer to it.
Mark Mather: Great. Thank you, Lillian. Next up we have Mary.
Mary Ana McKay, American Community Survey Office: Hello? Hello. Okay. All right, I can share my screen once Lillian is done sharing hers.
Lillian Kilduff: Yep. Um. Stop there.
Mary Ana McKay: Perfect. Knock on wood. Awesome.
Okay, so hello, everyone. My name is Mary Ana McKay. I’m a survey statistician with the Census Bureau’s American Community Survey Office. I’m here to highlight two data products and tools that you may be familiar with or you’ve never heard of before. And just a little bit of housekeeping, I’m going to apologize in advance if I speak quickly. I just have a ton of information that I want to share with you all, and I’m very excited to be here. I’m excited that you’re all here.
So without further ado, let me get started. I want to give a broad roadmap of what I’m going to be presenting during this workshop. So to start, I’m going to dive into the ACS Public Use Microdata Sample, or PUMS. This portion is going to cover basics. Then I’m going to run through the Census Bureau’s tool to access these data, and then I’ll wrap up that section with some resources for you as you dive in on your own.
And then immediately following the PUMS, I’m going to jump over and give a very brief introduction to the application programming interface, the API. We won’t go too much into details, but you will learn the basics, so you’re hopefully able to build off what we do today as you go off onto your own data journey. And we’ll go through an example API call, and then I’ll share just a sample of the many, many resources available to you as an API data user before I turn it over to Kevin for the last leg of this workshop.
So before I dive into the PUMS and API, I want to remind everybody about data.census.gov. It’s a really powerful tool for you as you grow your ACS data accessing skills. So many of you here today are probably familiar with data.census.gov, which is the primary way to access data from the American Community Survey, 2020 Census, and more. And I’ll be sprinkling my use of it throughout my two demonstrations, but it’s not the star of the show, so I’m kind of going to run through them a little bit more quickly than I would otherwise. But in an effort to be brief, I will let you know that there are a variety of how-to materials, video tutorials, webinars, and FAQs to help you use data.census.gov.
And I’m going to step aside again and just mention there are links at the bottoms of a lot of my slides. I have a colleague who will be sharing some of them in the chat, but also the PDF version of this presentation is going to have clickable links too.
So the ACS Public Use Microdata Sample can be overwhelming, but we’re going to briefly cover basics to start to get you familiar and hopefully comfortable with this powerful data set.
And I want you to think about these questions: What are your main goals when accessing ACS data? Are you primarily accessing pretabulated estimates? Are you finding that the data you need are not published in these estimates? And what about when you’re looking at cross tabulated estimates? How do you primarily access ACS data? Are you using data.census.gov or a third-party tool such as Social Explorer? What do the data look like on a daily basis? And finally, with the tool or tools you are using, what limitations do you face accessing ACS data?
So these questions might have different answers depending on the day or the data you need. So in some cases, the tool that we are going to explore will be the best option, but other times another method will work better. It’s all about the best way to address your needs. And I always check data.census.gov—I’m going to say this constantly throughout my portion—just to see if there’s pretabulated estimates for the data product and the geography of interest. But in cases that I need something a little bit more specific, I’ll hop over to PUMS.
So, for example, today I’m curious about poverty among veterans by age, and I know I can find tables in data.census.gov that might get close to what I need but not quite exact. And luckily, PUMS is going to be able to step in and get us the table that I want.
So I want to introduce a few PUMS basics before we work on an example. And finally I will share some resources that you can access on our website.
So again, when I say PUMS, I am referring to the Public Use Microdata Sample. ACS data products are released about one year after the data are collected, and the PUMS is a publicly available subsample of ACS records. The one-year PUMS estimates are a subsample of data collected over a calendar year, 12 months, and they constitute approximately 1% of U.S. households. Whereas the five-year PUMS combines data collected over 60 months, or five years, and they constitute approximately 5% of all U.S. households.
Additional restrictions are added to protect data confidentiality, such as including broader categories of data or grouping together extreme values in the form of top and bottom coding. And you’re going to see a couple examples of this top coding in my demonstration.
PUMS files allow data users to calculate their own estimates and margins of errors that may not be available on data.census.gov. Statistical software is recommended when working with PUMS data unless you are working with our microdata access tool on data.census.gov, and this is the tool that I’m going to be demonstrating today.
So here are some examples of why you might want to use the PUMS. These data come in handy when you are looking for cross tabulations that might not be part of the standard table packages released in the ACS. For example, you could be looking for specific poverty thresholds or income levels for veterans at a specific age ranges like I am today. Again, always check data.census.gov and the pretabulated estimates. They may have exactly what you need.
This information is going to be a little bit heavy, but I want to mention it before we continue. So PUMS data provide individual records that data users must aggregate to form estimates. Unlike in data.census.gov, there are no pretabulated data. Weights are included on the PUMS files so that data users may create weighted population estimates. If you are working with housing records, you will use the housing weights. And if you’re working with person records, you’re going to use person weights.
When working with a merged file that includes both housing and person records, person weights should be used to produce estimates for person characteristics. Housing characteristics cannot be tallied from this merged file without taking extra steps to ensure that each housing weight is only counted once per household. In today’s example, I am using all person records.
And then replicate weights, those numbered one through 80 are used for calculating replica estimates needed to calculate standard errors. These standard errors are necessary in order to calculate the associated margins of error or MOEs, and we won’t be going this in-depth for this presentation, but there are guided examples that I can direct you to for more.
The five-year PUMS is the equivalent of five one-year files, so again includes about 5% of all U.S. households. So people often ask, and you may be wondering, what is the benefit of the five-year PUMS? So there’s some nice standardization for the five-year PUMS that you can’t necessarily get by merging five- to one-year files. For example, there are new weights that are produced for these records so that the weighted population matches the latest population estimate. Dollar amounts have an adjustment factor to standardize them to the latest year, so that no one is comparing varying levels of inflation. Other coding schemes are updated, such as ancestry and occupation, so you don’t have to recode those yourself.
I’m going to focus on a limitation data users might experience someone accessing PUMS, and that’s geography. To ensure the confidentiality of ACS respondents, the Census Bureau has to balance geographic detail with detail in the data. There are more than 250 variables on a single PUMS person record. This means that we cannot identify as many small geographies in the PUMS as users might hope. We can put the region, division, and state on the file, but the only other geography is something called a Public Use Microdata Area, a PUMA. PUMS is not designed for statistical analysis of small geographic areas, but the PUMAs can still be used for focus analysis in counties and cities of about 100,000 people or more as well as many metro areas.
So I want to spend a little bit more time here on PUMAs. PUMAs are areas with a population of, again, at least 100,000, which is large enough to meet disclosure avoidance requirements. PUMAs are identified by a five-digit code that is unique within each state. These geographies are redefined after each decennial census and are defined by either the state data center or, in some cases, the Census Bureau’s regional geography staff. For example, the 2020 PUMA definitions were introduced with the 2022 PUMS files.
As with many geographic concepts, seeing PUMAs on a map may help you understand them better. So as you can see, some PUMAs are small and others are large, because, again, PUMAs are built on population and not geography. The smaller PUMAs here on this map are mainly concentrated in the Buffalo and Rochester regions of this map, and some counties in this region that have smaller populations are combined together as part of a multi-county PUMA.
So I use data.census.gov here to visualize geographies. This is a screenshot that shows, um, the PUMAs that make up Marin County, California. So as you can see, there are two that make up the county. So you can combine data from both to approximate estimates for the county. The primary difficulties occur when we get further away from urban centers to counties with smaller populations, which are then again combined with other counties to make PUMAs. And in these cases it becomes less feasible to infer data about the individual county. Furthermore, while I am showing you an example here of PUMAs that adhere to county boundaries, it is not actually a requirement that PUMAs be designed that way, although it is recommended.
And I want to acknowledge really quickly that some of you might know that data.census.gov now has an address lookup option in the search bar. I just want to let you know that right now, PUMA geographies do not pop up when you use that option. I just tried it before, but hopefully someday you’ll be able to put in an address and see what PUMA that falls into.
All right, let’s get our hands dirty with PUMS data. And to start, I’m going to heed my own advice and go directly to data.census.gov. I’m going to first see what tables I might find. And again, I’m going to zip through this because I want to focus more on the microdata access tool. I’m going to use the advanced search feature.
And again, today I’m interested in poverty among veterans by age. I’m going to apply two filters: “veterans” and then I’m going to select “poverty” to see what tables come up. I’m going to click the search bar. And I see here there’s actually a table age by veteran status by poverty status. And it’s a little bit more detailed; it also has disability status. But it does have generally what I’m looking for. So again I said poverty among veterans by age.
But as I’m looking through this table, the age ranges are not quite what I’m looking for, and I’m actually interested at below, at, and above poverty. So this just has two thresholds; I want to add a third. So in any other day but today this table might actually serve the exact purpose I’m looking for, but now I’m going to use the PUMS data to get what I really want.
I’m going to click on the logo to go back to data.census.gov home page, and on the top right, you probably can’t see it, there’s a little button that says apps. I’m going to click on that. And it’s this first option here that says microdata. So this is what you’re going to see. The default data set is the ACS one-year PUMS. And the select vintage is 2022. And perfect, that is exactly what I want. I’ll click next so I can select my variables.
So before I select my variables, I want to search for what they might be called. I know I want poverty, I want veteran status, and I want age. So I like to use the label option here—and I’m going to zoom in, I might have to zoom in and out—I like to use the label here to use keywords to see what pops up. And we also have PUMS documentation with data dictionaries, so you can do the same thing before you get into this tool.
So for the first one I’m going to type in “poverty,” and I see this income-to-poverty ratio recode; I selected this for, uh, today’s demonstration because this is the poverty variable in PUMS, so I want to show people how to use it. It does give me a little bit of a warning here that the variable is continuous, but we’re going to make a custom group with this variable to be able to put on our table, so we don’t have to worry about that quite yet.
And so for my veteran’s variable I’m going to type in “veterans” or “veteran.” And I’m going to open the detail of the three variables that show up. And this isn’t quite what I’m looking for. This veteran period of service is a little bit more detailed. I just want to know if a person has ever served in the military or not.
So now I’m going to try typing another keyword. So I’ll do “military.” And luckily for me I have this military service. Let’s cross our fingers. And yes, okay, this is exactly what we want. We have a value 2 that says “On active duty in the past, but not now.” So that’s how I’m operationalizing veterans. I’m going to select this variable. So now I have two. And my final one is age. So it’s right here at the top. It’s going to give me that same warning that the variable is continuous, but that’s totally fine.
So from here we have our three in the data cart. We’re going to click on View Table and see what we have to start with. So for most situations simply selecting the variables is not going to be the last step for you, for your table, unless by some chance it’s laid out exactly how you want it and the categories are exactly what you want.
So at first glance, there is a lot going on, and I’m going to rename the table just to keep myself organized up here. You can go in and change that title as much as you want, but I’m just going to do “Poverty x Age for Veterans,” so that’s just going to keep it organized in my head as to what we’re doing.
So we see that the default table has military, that military variable on the columns. We have nothing on rows. And then we have two variables here in the values in table cells. Then in this drop-down this is the first thing I’m going to change. I’m going to click on this and select Count. So this is going to give us a value for how many fall in each category.
So I’m going to organize to make variables, and then I’m going to put them so we have our universe limited to just veterans. And then I’m going to create grouped categories for age. And then income-to-poverty ratios on the columns will be three thresholds. Or I’ll make a threshold of three.
So to put in simple terms, our universe is going to be just veterans. My columns are going to be the recode of that income-to-poverty ratio. And then finally the rows are going to be simplified categories of age. And what’s great about this tool is you can organize and flip-flop your rows and columns super easily, so if you don’t like what we have planned, we can change it when we’re done.
So we’re going to start first with making our universe what we want, which is just veterans. So I’m clicking on the variable. I’m going to deselect everything that says Include in Universe. And I’m only interested in Value 2: “On active duty in the past, but not now.” I’m going to select that option, and I like to click into View Table just to see kind of what we’re working with with every change that I make. So now I see my universe is only limited to my definition of veterans.
So now let’s move on and make the age category. So I’m going to click on the Age variable. I’m going to click on Create Custom Group. From here we’re going to use the Auto Group feature. I’m going to change the start age to 17 because that’s generally the cutoff date to join the military. And then for this, this is an example of a top-coded variable, we have 99. So anybody who’s 99 years or older is going to be in this category. And then I want groups of 10 years. It’s not going to be perfect with the values that I have, but for what I need, this is going to be fine. And I’m going to click Auto Group, and you see that it makes those groups for you.
The last thing I’m going to do is there’s a Not Elsewhere Classified category. I’m going to click on Edit Group. These are all the values that aren’t in the groups that I just designated. I’m going to toggle to show off the table. So I’m going to toggle that on, and you have to click Save Group. So now this isn’t going to show in my table. Let’s view the table and see what we have. It doesn’t show up, but we’re just going to click and drag, and to keep myself organized, we have the rows is what we’re going to have for age. So I just clicked it and dragged it over to On Rows. And we’ll see. Now we have account for the people who are veterans in these different age groups.
And the last thing we have is to make the poverty variable. So again I’m clicking on the POVPIT variable. And just to look at this, it is continuous. And I want to explain a little bit more about what the numbers mean before I go in and make my custom group. So for this variable, less than 1 or 100%, because this is a percentage, is below poverty; 1 or 100% is at poverty; and above 1 or 100% is above poverty.
So these are the actually the three categories I’m going to create. But this is an instance where you can really go where your research question or your need takes you. For example, I know that 200% poverty is a threshold a lot of data users need, and there are limited options on data.census.gov. So using PUMS here is, you’re going to be able to get that.
So the calculation for this specific variable is simply to divide income by poverty thresholds, which are determined by number of children, sze of family, and inflation. So for this I’m going to click on Create Custom Group. I am not going to use the Auto Group feature. I’m going to dig in right here where it says Group Label. I’m going to start with Below Poverty. And again you can go in and change these group labels. Um, as you’re going through, if you want to relabel it, you’re able to do that.
So I’m going to click on below 501%. The bottom value I want is zero. And then the top value I want for this one is 99. I’ll click Save Group. So it makes that for me I’m going to click back into Not Elsewhere Classified. Let’s do at poverty. And this is going to be a single value. You can do that. So just when we’re looking at estimates, note that this only has one single value in it. So we have 100 to 100, Save Group.
And then finally we’re going to have above poverty. We’re going to select the remaining of the between 101 and 500. And then since this is another top-coded variable, I want this 500% or more because that’s above poverty. I’ll click Save Group. The last step similar to that Auto Group you’re going to click into, Not Elsewhere Classified. I don’t want this on my table so I’m going to toggle it off, Save Group. And now we’ll view table.
So again right now POVPIT doesn’t show, that Recode doesn’t show. But I’m going to click hold and drag on to columns. I can actually take the military variable off the table because it is my universe. I don’t need to have it on there. It’s included. And here is the example of the table. So now I have the poverty thresholds for different age ranges among veterans.
So I didn’t dive into this. But I want to mention that you can click Change Geography up here at the top. And you see that we have the geographies that we talked about. And the default is going to be the United States. And since PUMAs, the Public Use Microdata Areas, have populations of 100,000 or more, all of them and all of these geographies are going to be included in both the one-year and the five-year PUMS. So from here you can click, download, and share what you’ve made. And remember that you can calculate the error with resources available on the ACS website.
So now I want to go briefly and share some few links with valuable resources for you. So I do my best learning when I am practicing. So if you’re like me, I like to follow along with webinars that have some activities to check, and I put together a list of videos to see step-by-step directions for various aspects of the MDAT tool. So the data gems are going to be shorter, more brief videos, whereas the webinars go into a little bit more detail.
And I’m going to make a plug for the PUMS documentation page. I did mention it, but we didn’t go into it. It has all the resources you’re going to need for every data release. You can explore user guides, data dictionaries, and more. And this is also where you’re going to find directions for calculating variances.
And finally, I think a really great resource that we spent a lot of time perfecting, and Lillian talked about it briefly, are the data users handbooks. We do have one for PUMS users, and I also don’t want to spoil the next part of my presentation too much, but you can find the PUMS on the API.
Um, and with that, that’s the worst segue I’ve ever had, so again, I apologize, but now we’re going to jump immediately into talking about the Census Bureau’s application programming interface. So let’s take a deep breath and move on to the next part of the workshop.
So I want you to think again about the same questions we, we had when we were exploring PUMS data. So what are your main goals when accessing ACS data? Are you primarily accessing pretabulated estimates? Are there a few variables within a single table that you find yourself going to more and more? And what about variables across different geographies or across years? How do you primarily access ACS data? Are you using data.census.gov or third-party tools such as Social Explorer? And what do the data look like on a daily basis? With the tool or tools you are using, what limitations do you face accessing ACS data? Being able to answer these questions can determine if the API is a good option for your needs.
Now on to the basics. When you use the API, imagine that you are in a strawberry field since it is summer. The strawberries are data points you seek, and in order to go get them, you are going to be running calls or going around the field and picking the ripe strawberries. Data.census.gov itself is a fellow strawberry picker. What we are doing today is just a smaller example of what data.census.gov does through its website. We are trying to directly access the data in a very simple way.
So some of you may be creating dashboards on your websites that users will access to get different data to display, given certain criteria. Others might be trying to make data visualizations, and there may be some of you who are using R to run analysis. It’s also okay if you are none of these types of users. The API can still be a very simple process to get the estimates that you want.
As I was just describing what uses the Census API might be for, here are some more specific examples. What if you simply need just one variable, let’s say percent below poverty level for individuals under 18 and nothing else within the table? What if you wanted to grab all the census tracts within a county in Delaware? How about an estimate for an individual below poverty level at the census tract, county, state, and national level? It could just be that you have a data point that you’re trying to easily access year after year. I’m going to show you some ways to simplify that process for you using the API. And I will say this, and I’ve said it several times before using the API, consider checking out data.census.gov.
So with that let’s run through an API call. These are the ACS data tables that you can find on the API. In data.census.gov, the second column here is what the table ID starts with. For our example today we’re going to be using subject tables from the five-year estimates. So we’re going to be using this here. So after you put the beginning of the call, you’re going to put in the variables the tables and the geographies you want, but we’re going to get there in a second.
We’re going to start with data.census.gov, like I’ve said a million times already. And just for the purposes of time, I have screenshots here. So I typed in “poverty” because that’s what I’m interested in for this example. I found Table S1701. And then I limited my geography to Wyoming County, New York. That’s my hometown is there. And this is a smaller county, so it’s going to be the five-year estimates. It has a population of fewer than 65,000 residents, so we’re going to be using the ACS five-year estimates.
Now on this table I see, and I’m sorry if it’s hard to read, we have below poverty levels. So we have the estimate and the margin of error. That’s what I’m interested in. Just those two pieces of the entire table. This table also has percent below poverty level, which is a measure I would prefer, especially if I’m going to be comparing with other counties of varying sizes, but for this example, I’m just going to stick with the estimate and its margin of error.
I’ll mention one cool thing about data.census.gov, there are many, but if you look along the top of your table, there’s actually an API button now that you can click and it’ll create the call for the table that you’re looking at. So this can be really helpful if you’re using the filter options to select geographies, and you might just want that entire table you’re looking at. You can also use it as a starting point to build off. If you want a little bit more detail with your call. And I highly recommend always working off an example when you’re working on calls; it makes it a lot easier than building from the ground up.
So we only want two variables: the estimate and then the margin of error. And what I’m showing here is the entire call. But we’re going to dissect it before running and seeing what happens. I use the slide a few back to figure out what table type I had. And then I did a few additional steps, using some web pages to figure out (1) the variables that I need and (2) the geography.
So to start to break it down, this is the base for all Census API queries. This second set pulls out the data product year, 2022; the program, ACS; the date, the data set, ACS five-year, so this is the 2018–2022 ACS five-year; and then, finally, the table type, which is subject. And again you can refer back a few slides to see the base of all the table types. That slide will get you the portions up until this point. So once we get to this after ?get, that’s where the customization gets started.
So this pulls out, this is where I’m picking the variables. And how did I get here? We’re going to hop over to the website, and just for transparency, I’m using Google Chrome because that’s what I prefer to use when I’m doing API. So I’m going to census.gov/api, the main website, and I’m going to scroll down to latest available available APIs and view all available APIs. From here you see what’s available. I’m going to click on American Community Survey, in theory. And we divide it by the different data products, um, which I find they’re all pretty similar for all of them. So it’s easy once you know how to use one, you can jump around and use the other ones.
So we’re selecting the five-year data. We release this for every data release. So we’re here in 2022. I’m going to scroll down, and I find Subject Tables. So this is again the same for all table types, what I’m doing; you just have to make sure that you’re following along with your table type.
So the first thing I’m going to start with is the second bullet down: the 2022 ACS Subject Table Variables. I’m going to click on the HTML. So for API, Ctrl+F is going to be your best friend, if it’s not already. So I’m going to click Ctrl+F on my keyboard. And we’re going to type in “poverty” because I want to overwhelm you briefly with what shows up.
So as it’s loading, in theory, we’re going to have thousands of options. So it’s loading, um, there’s so many of it that now it doesn’t want to do it. So there’s actually over 3,700 results on this page for poverty. And that’s a lot to go through. So I’m going to show you a little bit of an insider secret, or at least that’s what I like to call it.
Um, I’m back on S1701. I’ve magically loaded it for us here, and I’m going to talk about the different columns. So this is a column set 1. We have the total. And then for this table, there’s a column set 2. Now what does that mean? We’re going to go back to this table, the variable lists. And if I start to scroll down, you hopefully can see that there’s a table ID, then there’s an underscore, and a CO1 that corresponds with column 1. So I can use this as my base to Ctrl+F again. And since I’m looking at S1701, I’m going to type that in. It’s going to jump me to the first time that that shows up. When I do the underscore, it’s going to jump me to the section for this table.
And I know I’m looking for the second set of columns, so I’m just going to write in CO2. And luckily for me it’s this first estimate in column set 2. So we have below poverty level population for whom poverty status is determined. Then the one that ends in E is going to be my estimate, and I want that margin of error, and you should too. That’s going to be the one that just ends in N.
So let’s hop back over to the slides to see what I did here. So I have the two variables that I found and I put them in here. I also put Name here. So to make sure that I get the geography names when I run the call. But this is not a necessary component of your call. I tend to use it just to confirm that I have the right geography, so I can run it with that, confirm I have the right geography, and then you can run it again without if you don’t need it for the larger purposes of your call.
One thing I will note, you separate the variable names with just a comma. if you add a space or an additional character, you are going to get an error when you run your call. So working backwards, if you get an error, double-check your call and make sure that there’s no spaces in between the commas. You can pull up to 50 variables with this method, and if you want more than 50, it’s likely that you just have to pull the entire table and then work from there.
I also want to mention one more thing. You can pull variables from different tables of the same type. Say, for instance, you want to pull all of the same variable in a table series for different race iterations. So we have detailed tables for the different race and ethnicity iterations that end in A through I. You can pull the same variable from those different tables.
I also want to jump back to this name variable and give you a little bit of a warning. So it does cause a shift in Excel, especially if it’s a geography within a geography. And you’re going to see this when we open the file from our example here. And I’m not sure if this happens with every table type, but just keep that in mind that I know for a fact that we do not recommend using it for group calls, particularly with data profiles. So just keep that in mind that it can get a little bit messy. But again, I like to have it as a little check for me.
So before I move on, what happens if you want all variables in the table? What if you want the entire S1701? You can use a group call. So I have that down here. Um, you can also use data.census.gov if you have the geographies you selected already. That API button is going to do exactly what this is going to do for us.
So now we have the last part, which is the geography. And in many instances you will want to limit to a specific geography. And in this example I want one county. And you may be wondering how I got these numbers. And I did not, in fact, memorize every county code for every state to figure this out. I’m going to share another secret, and I think this one’s a little bit more exciting, but who knows? You’ll have to tell me.
So we’re back on the ACS five-year API page, and we’re still in the subject table section. I’m going to click on the fourth bullet down that says Examples. So this breaks it up by geographies. And since I’m looking at state and county, I’m going to look at the example API calls that I have here. And fortunately for me I’ve used this so much that it’s already, um, calling itself out.
There’s one here that has a wild called, wild card or the asterisks for county and state. So if I click on this, it’s going to actually give me, um, and hopefully let’s, that we’ve zoomed in, it’s giving me all counties in all states. It does have a random variable. Um, just to call it out again, as an example, you can leave that in there, or you can delete it with the comma and just have name. So now you have the call to get all of the counties in all of the states.
And again, your best friend, at least for now, is Ctrl+F. You’re going to start to type in your geography of interest. And luckily for me, the first Wyoming on this list is actually Wyoming County. So I can use context clues here and see 36 for all of the New York counties that shows up. So I know that’s my state code. And then the second three digit code, 121, is going to be my county code.
So now we have all the pieces we need. I’m going to jump back. And we have the &for county 121 and &in state is 36. So the nice thing here is that you don’t have to remember the little syntax components, the codes. If you follow an example, you’re going to be able to always have access to what you want, and then you can customize from there.
So much like getting the full table, that group call, you can get full geographies. So what if you wanted all counties within a state? You can use that wildcard in your calls like we just did. For some geographies, as we just did to get our geocodes, you can do the wild cards for both components. It’s really trial and error.
So let’s take this call. I’m going to copy it from my document, and I’m going to run it in the browser. So I copy paste it, and now I’m going to run, and this is what we have. So we are getting the number the estimate of those in Wyoming County in New York who live below poverty with the corresponding margin of error. And we see we have the name here, we have the estimate, the margin of error, and then the state and the county codes.
So I want to just show you back on this slide that your output might look different than what you see here. Sometimes it’s the browser you’re using or the settings. But it’s okay, because when you download it, it’s all the same.
So jumping back over to the browser, if all you needed was the estimate, you can stop here, but you can also download it. And what you’re going to do is you’re going to right click. You’re going to click Save As. You’re going to name your file. And this is important, you’re going to type in the file name .csv. The last step for the Save As type you’re going to select All Files. So you’re going to click Save. And it’s going to download that CSV. And I’ll open it up just to show you what we have.
So like I mentioned briefly, or maybe not briefly, I think briefly, name does cause a shift, especially when you have a geography within a geography. So I had a county within a state. So here it shifted my variables, and all I’m going to do is highlight these. I’m going to cut and paste to move them over. Um, so that is just what you’re going to look like, what it’s going to look like when you download your file.
So hopefully that was not too overwhelming. Um, and that was just a little bit of a breakdown of what the API is. So really quick, I now want to share some resources as you go on your own. But don’t worry, I do have contact information so you can always be connected with our team if you get stuck.
So when you’re on your own, start with checking the example calls to get yourself started. I sound like a broken record when I say that. That’s what we did today. So I want to emphasize how useful they can be and how much time you can save. You can always edit them to fit your needs, but having the base like we walked through can be really helpful.
Unfortunately, some variable names change with every data release, so variables are added and subtracted from tables, so it’s important that you check the variable names if you’re looking at data year after year, to make sure you are extracting the same data variable. It’s super easy when you use that variable list, so I always just open that HTML as soon as I get started, as you saw in the walkthrough. And then the other one is that Examples page. So these are the two that I use when I’m customizing the components of my call.
And one thing I want to mention is keys. Um, some of you may be wondering what or why, and a key is essentially just that: a way to open the door to more calls. Without a key, you are maxed at 500 calls a day, and if it’s just you and your organization running calls here, there, a key isn’t necessary. But if you are creating a dashboard that’s going to get a lot of traffic, you might consider a key. It’s completely free, and it takes mere moments.
Um, and I will mention that if you’re going to use the R package tidycensus, you need a key. And Kevin’s probably going to repeat that as well. Can’t do it without a key.
Um, this is just a start regarding the resources. Again, this PDF is going to be able to be clickable if you can’t get access, um, in the chat to the links. So there’s a lot on here. And if you’re lost I can always connect you. The last two in this webinar list, um, are going to be a good run-through of an example similar to what we did today with a little bit more detail. And I also included some resources for using open-source data and programs, which is really helpful if you’re using the API.
One really unique and valuable tool we have to offer is the Slack channel. There are Census staff that engage on their every day to help with data user questions, especially if you’re accessing data through different ways such as R or Python. And finally, as I mentioned, tidycensus, it’s a great R package to use with the Census API. It is not maintained by us, but it has great resources to guide you.
Um, and I finally want to mention a few final things before turning it over to Kevin to wow us with his expertise with tidycensus. There is a team at Census that has live workshops to go over that MDAT tool and the Census API. I highly recommend you sign up if you’re curious to learn more about either. These are great for both beginners and advanced users. Please consider joining the ACS Data Users Group that Lillian highlighted at the beginning of this workshop if you aren’t members already.
And I know these were very quick demonstrations of the PUMS and API, but you can email our team at acso.users.support@census.gov if you have any questions in the future. Thank you so much. And Kevin, the floor is yours.
Kevin Kane, Southern California Association of Governments: Well, goodness, Mary, thanks for such a thorough and comprehensive, uh, you know, overview of both PUMS and, uh, Census API calls. Hopefully I can build on it. Um, doing these is kind of your job, for the most part, I just kind of, uh, do this as somewhat of a service to a degree.
I’m Kevin Kane. I’m the Program Manager for demographics and growth visioning here at the Southern California Association of Governments. Uh, why do I do this, uh, type of, this type of a webinar? Just, you know, um, I find it extremely useful to kind of have effective workflows, certainly in my field, which is regional planning and demographics. But, uh, I also teach this material to a course at the University of Southern California.
So, um, you know, bottom line, uh, I find, Mary’s API call workflow, uh, to be really useful, but you are a little bit limited in terms of the replicability of it, um, by putting calls into a URL. And, uh, she gives me a hard time every time I follow her after a webinar, um, because of what I’ve titled this, uh, “R tidycensus: Your graceful exit from data.census.gov.” And what I’ll share with you here is basically the workflow that I kind of developed once data.census.gov, um, started a few years back in order to just kind of help, uh, you know, be a little bit more replicable.
Uh, Southern California Association of Governments has 191 cities under its purview across six counties in Southern California. So we’re working with a lot of county-, place-, uh, and tract-level data longitudinally, uh, and kind of that’s buried within either PUMS or other detailed tables. I’m sure that’s the workflow for a lot of folks here.
So, um, I’ll be very brief in terms of, uh, slides here, but, uh, really, what I want to mostly show to you is a demonstration. Um, because frankly, it’s not possible in 20 or so minutes to actually get into R or RStudio or a coding environment. But basically what I’m going to pick up where Mary left off, uh, and wrap that within an R, or a code-based workflow.
So R is an open-source, uh, programming language. RStudio is a freeware wrapper of it that just makes it a little bit easier to use. Um, I’ve included here some very easy installation instructions, uh, for you, uh, like teaching in this because, uh, it’s not a commercial product. You can take it to wherever you work, uh, and not have to worry about a license.
The second thing that I’ll say is I’ve posted a lot of training materials here on this GitHub, uh, website here. I’m not sure who, uh, you know, the level of folks are GitHub users or not. I frankly just use this for file transfer. I am going to have to confess, I’m more of an intermediate-level user of this and frankly of some of the R packages. But like all of us, you know, hey, we’re, we’re doing this to do our jobs better.
Um, so what I’ve done here is included a package which I call the kind of a half-day R introduction. There’s also a video where I did the full webinar for this, uh, if you like the workflow. Um, I would say it probably would take you about a half a day, roughly, to get through it and to actually learn R to a point where you can use the Census API usefully. Um, if you hit this code here, you can download a ZIP file containing all of this. The key file is one that has a dot R at the end of it. And that’s what we’re going to be kind of going through mostly today.
Um, switching back here to kind of all the information you’ll need. Um, Mary already gave you a lot of the Census API information, so I won’t repeat that. Um, uh, there’s a full recording, uh, of, of the webinar that takes you through how to actually get up and running in our studio so that you can get to the point where we’ll start here today. Um, and also the details on Kyle Walker is amazing, tidycensus package, uh, which, although not maintained by the Census Bureau, uh, clearly is good enough to make a make a guest appearance in a Census Bureau closing slide. So, uh, certainly has kind of revolutionized how I interact with American Community Survey material.
So, um, how to get up and running here. Basically, uh, I’m going to open up this particular dot R file for you in our studio. If you’ve gone to the GitHub page that I shared with you before, uh, and I’m sure perhaps, uh, if you do want to follow along, maybe I could task Lillian, who has this slide deck to toss it into the chat for folks. Um, but if you’re, uh, I’ll just go through a couple of ways to, uh, to kind of access and use code here.
But, um, at the, at the bottom bullet here, uh, is what’s in this, Rbootcamp file. I basically have 10 modules here. Module sections 1 through 6 are just basic data usage skills and visualization skills using R. I’m not going to go over those today. I’m going to skip them and start with section 7, which is how to use the Census API. Um, and then I’m going to provide you with section 8, which is basically a replicable code block for doing those API calls. Uh, once you’re, uh, kind of up and running in R, you can use that to basically declare whatever variables you want, geographies, etc., um, and get them in, in a nice tabular format, in Excel format, even a shapefile format, if you like to do that.
Um, and, uh, new since last time we’ve done this, I’ve added a little bit of a code block to get longitudinal ACS data if you want the full series from 2005 or 2009, uh, when when ACS one and five years started respectively until now on the same thing. Uh, and then a new little section here at the end on, um, doing a tract-level map of something in your census place or in your city, uh, as, uh, Lillian shared in one of her earlier slides. I’m going to nab it here, um, you know, a lot of kind of how you interact with this, the API is, as Mary also said, uh, it follows the Census Bureau’s geographic hierarchy. Um, you know, and there’s, there’s a difference whether you’re on kind of this main vertical or if you’re off the main vertical.
Um, you know what I tend to focus on, uh, are counties or, you know, as kind of a reflection of the overall trend or census tracts to kind of be reflective of neighborhood-type dynamics. ACS oftentimes does go down to block group as well, but you tend to get those high margin of errors, which, uh, you know, well, I’ll leave it to you to decide the level of importance of the margin of error for your for your, uh, for your workflow.
But one of the challenges is that, um, cognitively, uh, and electorally and everything like that, places are pretty important census places, uh, which are basically cities, towns, CDPs, etc., are really, uh, you know, how people interact with information. So if you’re looking to get an understanding of how a phenomenon, uh, is dispersed across the neighborhoods of a city, you really need this tract-to-place relationship. So I’ll go into that a little bit, um, as I do the demo.
Um, apologies. I’m not really able to see the chat right now, but, uh, please, please holler if any issues. And thanks, Lillian, uh, for putting those, uh, those links up there.
So I’m going to, uh, go over now to RStudio, where I’ve just opened up Rbootcamp, uh, 2024.R. So really basic two ways, two main ways to enter code. On the righthand side here I’ve got a script file, which is, um, I prepared this, this one for you here. It’s about 500 lines or so and goes through those 10 modules. You can update it, change it, change things, um, and using this nice hashtag here could kind of comment something out. So, for example, line 22 here, um, the command is Print; I’m gonna print something, and then I made myself a little note behind the hashtag here.
On the left side is actually where you’re executing code. It’s got this little triangle called a chevron and a blinking cursive. So if I want to use the Print command to say “hello world,” which is sometimes what folks do when they start a new programming language, it’s going to return to me a line that says “hello world” back, because that’s what I asked it to do. Um, certainly when we get a little bit more sophisticated with our calls and things that we want to put into the console here, uh, typing it is not going to be efficient. So that’s why we have the script file up on the righthand side here.
So long as your cursor is on a line or has highlighted a portion of code, there are a lot of easier ways to run that code. The first one is to go up here to the top right and hit run. It’s going to do the same thing. Or if your cursor is just on it and you hit Ctrl+R if on a PC, Command-R on a Mac, or in some instances it’s Ctrl+Enter. I’m not sure exactly why people’s computers all have slightly different setups. That’s going to be the other way that you can run this line of code.
The second thing that I’ll mention about kind of RStudio in general, um, in terms of this workflow, is to just be really careful what you’re working directory is. What that means is a file path on your computer somewhere where you’re saving data, where you’re saving images, where you’re saving your output, or sometimes reading in data as well.
Um, there are a few ways to do this. Um, you can, uh, if I type “getwd,” it’s going to get my working directory. Goodness. The default is, uh, what appears to be somewhat something of a My Documents on a C drive. Um, I can go up here to Session, Set Working Directory, and choose, uh, where I want to pull information from. Or I can declare it in the code here. I’ve already written it down here is “setwd.” So if I “setwd,” um, something I’d like to do kind of early in the workflow, uh, I’m going to be working with this folder. Um, and you can see it’s in Dropbox, Rbootcamp as, as the folder.
So, um, that’s just the absolute basics again. Um, if you want more information, you know, certainly I would suggest downloading, uh, the package from GitHub, including this dot R file following along yourself or following it along in the video link there. And right now I’m going to scroll down to the fun step to actually the, uh, using Census API here in R, which is, uh, what I have as section 7 here.
So, um, the way that, uh, R is, is useful is that it kind of has a lot of base functionality kind of built into it. And then it’s very customizable. Folks have built, um, tons of different packages in it. And the one that’s really helpful is called tidycensus. I’m also going to be using a few other packages here to be able to work with spatial data and to do some other data manipulation.
Um, when you install it, you have to do two things to use a package in R, first you have to install it, and you just have to do that once. But then every time you open R or RStudio, you do have to kind of invoke the package or activate the package. So you install it with this line here, Install Packages. And I’m not going to run that because it’s installed already on my machine. But I am going to highlight all of these and activate these four packages here by running this line of code. So this is basically telling our studio, hey, add this new functionality to this instance of the program that you’re working on.
Mary already mentioned getting a Census API key, which you will need. Uh, it takes, she said, mere moments to sign up. I think it takes probably like 2.5 seconds perhaps. Uh, and that, that is an alphanumeric code that’s a little bit ugly here, but, um, it allows you to actually use this because you are going to be iterating and pulling a lot of things. Um, it’s nice not to overwhelm the, uh, the, you know, our, our federal government’s, uh, servers, uh, the Census Bureau.
So they’re, uh, the first thing that you’ll have to do is to enter your Census API key here. And tidycensus has a command called, you know, what do you know, Census API key. So you put it in here like this and hit Run. Here’s my Census API key and boom, you’re done. Um, it gives you a new flashing chevron. Uh, so that means it’s taking the line of code, uh, effectively.
So, um, really we’re just working with a couple of key commands here. Um, as Mary had mentioned earlier, there are a lot of things available through the Census API, the Economic Census, the decennial, various other programs that the Bureau has, and ACS being the key one.
In tidycensus, you’ve got decennial and you’ve got ACS. So “get_decennial” is the command here for how to how to get something from the decennial census. And this gets decennial census command takes a few different arguments. And you can see what I’ve set up here in line 405 is, well let’s see, I want state-level geography. So I want state-level data. I want this variable. We’ll get to how you search for variables in a little bit. You know a little bit already.
Um, I want the census summary file, and I want from the year 2000. So I’m going to run this “get_decennial” command. And then what this equal sign does is it puts it in an object or thing or a, you know, something that you can call back called medrent00. I’ve just called it medrent00. I could call it whatever I want. So I’m going to run this line here, and what it’s doing there, uh, for that a quarter second is it’s actually getting the data. And now if I just type that run, oh, um, it’s going to show me the median rent across all the 50 states.
Uh, I can make it a little bit easier by using the view command and view medrent00. What that will do is pop it up into something that looks a little bit more like Excel or tabular data and see that, um, goodness, in Alabama in 2000, rent is probably a heck of a lot less than it is today. Um, quite a bit higher in Alaska. So, you know, this passes the smell test. Always a good check. Uh, when you’re, when you’re doing a new data extraction process.
Um, so that’s useful. Um, you know, you can certainly there’s, there’s commands, right dot CSV commands to save this in Excel. You know, if you really want to, you can just grab and copy or what have you, uh, from here. But R has a lot of really nice visualization capabilities, so it’s nice to be able to take advantage of them.
I’ve left you with a few examples in this code here that you can, you know, certainly, uh, you know, modify the name of the, the variable, the data set you’ve extracted or the variable or change some of the other parameters. But if I run this line here, it’s going to make a nice little bar plot, um, of states by rent. And you can see here. Oh, Hawaii is quite, by quite a bit the highest. And this is alphabetized, um, well, not quite alphabetized by FIPS code, but, you know, thereabouts.
I’m going to close this here, and, and I’ve made a slightly fancier bar plot here with some bells and whistles by sorting the data, adding some color, adding a label, adding some guidelines. And I can highlight all of this and hit Run or Ctrl+R or what have you. And it gives me a really nice little bar plot here of state median rents in the year 2000. Again, seeing how it varies from a high of Hawaii to a low of North Dakota. Um, did not expect that to be lower than in Puerto Rico even, but goodness.
So, uh, here. So that’s, that’s just the way to kind of get a little bit of a visualization. And I haven’t uploaded any data into my program, which you usually have to do. Um, as long as you have the internet and a Census API key and tidycensus, uh, as a package installed, uh, you’re able to just extract it in one clean flow.
Now, in order to find good variables to use, uh, Mary already gave a little bit of a tutorial to that, but, um, you can do that within tidycensus if you want to. So, um, load variables is a, is a command here. And I’ve just asked it to look at 2022, five-year ACS, um, and put it into an object that I’ll call “acsvars” and, um, oh goodness, I have 28,152 entries for, for, uh, you know, explicit ACS variables that are coming in through what I imagine, uh, Mary can correct me if I’m wrong, what I imagine are the detailed tables rather than the summary tables.
Um, in any case, uh, this is a little bit cumbersome, you know, certainly. Um, and Ctrl+F is one of your friends. You can write this to a CSV here as comma-separated values file and, and open it up if you want to. But in the GitHub site I’ve included, um, my little cheat sheet. Um, if it’s useful to you, happy to share. But these are my top one, top most commonly used 125 ACS variables with their code and a somewhat intuitive abbreviation, um, that I’ve, that I’ve, uh, renamed it, “totpop,” for example, or median age. Um, this includes just some of the, the age structure, basics, race, race, ethnicity, commuting, educational attainment, income, and housing. Just to give kind of a smattering. Um, so if you want to start there, um, that’s, that’s not a bad way, at least, at least in my view.
So, um. Right. Uh, so, so now that we’ve found some good census variables to use, and we’ll scroll down just a little bit here and try to assemble, um, some tract-level variables for a county. Um, now this is the kind of the main command here. It’s get underscore ACS and you pass it a lot of information. I want tract-level data. I want the state of California, Orange County, and this variable here, 25035, which is the median age of the housing stock in each tract. You’ll notice that I’ve also added this argument called geometry equals true. This will also extract the data as spatial data so that you can visualize it right here in R. Or you can export it as a shapefile if you’re a GIS user.
So, um, it just takes maybe two or three seconds or so to get all the tracks, uh, in Orange County, California. Um, if I look at what this is, “head” just gives me the first five rows of any given data set. Uh, let’s see, I’ve got a GEOID. This looks like my FIPS code. I’ve got estimate, which is actually the value I’m looking for. So this tracks median housing home year, built year was 1971, 1959. All right. So this passes the smell test. Certainly these are reasonable values especially in the western United States.
Um, so I can do just a little bit of manipulation, renaming it old age. Um, you know, getting rid of the old one. And if I want to see how many rows there are, take a quick look and see that there are 614 tracts in Orange County, California. So now I have a good understanding of, of the rows and columns, which at the end of the day, that’s all data are.
What if you need more than one variable? Um, tidycensus will extract it for you, but it’s a little bit trickier because it does it long. Um, to show you what I mean, I’m going to, um, make a list of three variables: population; housing stock age, which we already did; uh, and median household income. And I can extract those in one single call by, uh, declaring this list that I made as the variables that I want. So I’m going to call this one TR underscore plus. Again, it just took a second.
And if I want to see how many rows are in underscore plus, oh goodness, it’s 1,842. Well I know there are 614 tracts. So, um, I can take a look at it and see that, hmm, this is not stacked in a terribly intuitive way. I’ve got three records for each tract, and each one’s for a different variable. Kind of a pain in the butt when you want to do math, compare it, put things as a rate, uh, put them on a map, uh, or anything like that. So, um, you know, if you really want to use it, you can use something called the match command, which is described in the earlier sections that I totally glossed over. Uh, and, and do a subset of this lengthy file and then and then bind it to your original text file. So now I have 614 entries here and eight total columns. I’ve got one for home age, total population, median income. My apologies to the Bureau for omitting the margins of error here, but you can grab those as well, especially for tracts. Mea culpa.
Um, some of the other nice features within R is that you can actually just plot this as a map using one of the, using what’s called the SF package. So if I hit line 450 here, sorry, um, uh, goodness, I can get a nice little map already of the tracks in Orange County. And again, uh, let’s see, we’ve got 1940s, 1950s here, kind of in the North Side. This is downtown Santa Ana, the older neighborhoods of city of Anaheim. Those look a little bit older, uh, then used to get to the south, to Irvine, to Laguna, Niguel, Coto de Caza. These are the newish developments up in the hills. You can see that reflected in the more curvilinear boundaries but also in the, the newer home ages there.
So, um, neat little trick there. And if you are a GIS user, you can use this “st_write” command here. Um, whoops. To write an entire shapefile. Um, now this is, uh. Let’s see. What did I call it? I called it orange underscore merge. So if I go back to here now, I have four files here I’ve seen if you’re a GIS user, you know, you’ve got somewhere between three and eight files typically together in a shapefile format. But now I can use this in GIS. I have orange underscore merge. All right.
So, uh, racing along right here. Um, hope folks are getting a little bit out of this at least. But what I’ve built here in section 8, um, is a way to group a lot of variables together. Uh, like I said, it’s a little bit clunky to extract variables one by one because they’re stacked long. So you want to make a loop and, uh, loops are, you know, a little bit more advanced coding skill. Uh, but I’ve built this to hopefully make it so that you can just enter your parameters here, um, and, uh, and then run this big block of code in section 8 and then get a good data set.
So I’m going to ask the audience here for somebody to put in the chat a state and a county, like not a tiny county, at least the medium-sized one. You know, five more seconds before I use Tampa. Okay. Sacramento. Let’s do, let’s do Sacramento okay. Thank you.
So Sacramento County, California, my state equals CA. My county equals Sacramento. Let’s see. Let’s I’ll run the first chunk of this. And the first chunk. The way I’ve set this up is it’s just grabbing total population B01001 underscore 001. And then what I’m doing is taking this whole big list of 125 variables that I’ve shared with you earlier in this spreadsheet here. Uh, and then I’m renaming them to something that’s a little bit intuitive. Um, not perfect, of course, but, uh, you know, if you follow a logic, uh, you know, commute, walk, uh, median household income, you know, female aged 5 to 9, etc. Uh, you know, should be logical. Select all of this, even do a little bit of math on the end of it. And it’s really only going to take probably a few seconds to extract this for, um, 125 different variables for, um, the tracts in Sacramento County.
All right. There we go. I can view this. I just called it D to keep it a little bit easier. Uh, and now you can see all the tracts, uh, total households, median age of 29. Goodness, that’s quite a bit under median. So that must be a young area. Um, race ethnicity, variables, etc. Um, how I put them up, I’ve got 135 total columns in this, uh, in this data frame right now. I can write it to a CSV right here. Whoops. I called it Hillsboro, Florida. Sacramento. Don’t get confused now. My Hillsborough file is messed up, but, uh, that was, uh, that was from somebody else. So Sacramento tracts and ACS can just open it up in Excel in a comma-separated values format, um, and, um, manipulate that however you like.
So there you go. You’ve got, um, uh. Uh, you can also write it to a shapefile here. Um, Again, make sure you name it the right thing so you don’t forget that that’s Cook County, Illinois. Um, and, uh, you know, you can do some plotting. Um, here is median median home value in Sacramento County. I’m not super familiar with the urban geography of Sacramento, but I’m assuming this is a little bit more kind of an inner ring neighborhoods in the downtown core and then the fringe, you see some higher income as well. This is all in the SF package. So there are a lot of parameters that you can do here.
Uh, the nice thing is, well, by doing this workflow is that you can just do math right here. So what if I want to know if the the share of commuters who work from home. Uh, a question that we get asked all the time. Uh, so I could just do the, uh, number who work from home divided by the total population of commuters. Do a little math here and then plot that variable. So, okay, the work from home share in Sacramento County is way high out here, fairly high in somewhat of the downtown core, and a little bit mixed. Again, you can do quite a bit of a different analysis here if you’d like.
Um. And then if you want to plot the variable a little bit more neatly, um, I’ve got median home value pulled up here with the Jenks optimization so that it gets some nice natural breaks. You can do a reasonable looking plot just right here in R without having to open up GIS or anything else.
Two more quick tricks here before the getting in under the gun at 12:30, uh, Pacific time. that is, um, is a task we often need is to get longitudinal ACS data. Um, I find this a little bit tricky, um, because you do have to iterate quite a bit. Um, can somebody, let’s see. I’m going to pull, um, Milwaukee County, Wisconsin, from, from the chat here for this example. But basically what I’m doing here, um, is I’m making a sequence of all the ACS years that are available. Um, sending, I use a lot of one-year data because I tend to work in big counties. Um, so it’s a little bit tricky because it didn’t exist for 2020. So you have to make sure to make a list that has that gap in there. Um, five year, that’s not an issue.
But in any case, um, what I’ve kind of given here is a not quite as sleek of a, of a loop as, as earlier, but a mechanism to, uh, go through and enter whatever I’d like to here, Milwaukee County. So, um, this is going to take a couple of seconds, in fact, to run this because it’s pulling, um, well, that’s what I’ve come across. Oh, I don’t think that. I think there we go. So now you can see as this runs here in the red text, it’s 2008, 2009. It’s just looping through, uh, all of the available ACS years to get me, um, two variables here. I put them in. I kind of snuck it in here. One is, it’s what I just showed you earlier, the number of people who work from home versus the total commuters. So, um, and what this can give you right here is total commuters in 2005, the number who work from home, and then a really nice time series of how work from home has evolved since the ACS started collecting data on it, uh, in 2005.
So again, you can write that, you can use it later. Um, I can plot it here, make a little plot and see. Goodness, that’s what happened here during COVID. Uh, and then in the most recent year, a little bit of a dip. I can make a better line graph that I’ve put a few bells and whistles into. Uh, whoops, I forgot to change this to Milwaukee County, Wisconsin. I’ll do that in just a second here. Um, and I can even make a, um, a comparative graph. Change that to Milwaukee, just so I don’t get confused. So an example of how to do a little bit of these edits here.
And what I’m also going to do is I’m going to, I’m going to make a comparative graph here. I’m going to also extract Sangamon County, Illinois, which is Springfield, which is kind of a smallish mid-sized city. Uh, and then, um, and then run through this again. And once I run through this again, I’ll be able to have a graph that compares two different places in their work from home trajectories, which is kind of interesting. And this is probably the slowest part of the Census API, at least the way I built this here.
All right. So now I can see Milwaukee County work from home. Goodness, shot up during COVID and went down, but a much smaller, um, you know, uh, metro area, uh, had not only a lower level overall but didn’t see a kind of a drop in 2022 as a return to office happened. So again, just an example of some of the analysis you might be able to do with this.
I’ll share one final tip and trick in the last couple of minutes that I have with you here. Um, and it’s something that we just, just figured out. Um, my colleague Echo Xiang, who’s also on the call, and I, um, is to do a tract-level map of something in a single city. So while I’m doing this, if somebody can, um, tell me a city and the county it’s in, uh, to make a tract-level map, something that actually has not just a few tracts, something that’s a little bit at least medium size.
And this is going to, um, uh, this is going to require a few new packages: terra, readr, and mapview. All right. Let’s do, uh, let’s do, um, Oklahoma City. Actually, it has city twice. I’m not 100% sure it’s going to work. Um, how about, um, Tempe, Arizona, Maricopa County. Tempe, Arizona.
Um, I’m just going to work with median household income right now to show you this. And, um, you know, also one, one thing that I’ve given you here, um, in the GitHub is a file, that’s a relationship file developed from geo core that I use to relate tracts to census places, because, again, it’s not on that main spine of the census geographic hierarchy. Um, so, you know, it gives you the percentage, you know, tracts don’t necessarily nest within cities or places. And this, this tells you, for example, uh, Autauga County, Alabama, which we always see when we’re doing census work nationwide. Uh, nine, 98.42% is in this tract, and 1.5% is apparently outside of Prattville, Alabama. Um, so just, that’s all to say that you can define a threshold, um, to kind of get rid of some of the superfluous stuff that’s, you know, 99% outside of the city.
So I’m going to declare a place, a variable household income. I’m going to make sure that I asked for Maricopa County, Arizona. Uh, solicit this tract data here. Make sure everything works. Okay. Looks like it all works. And then I’m going to use this neat mapview feature here, see. All right. Some, some issues here. So I’m going to go back to, uh, press the old Riverside County, California. What is this for? Apologies for the work. If you troubleshoot, I’m sure.
All right, here we go. A dynamic map of Riverside County, California, by median household income. Uh, mapview even allows you to hover and see what the household incomes are. You can do a pretty yeoman’s job of exporting the image. And, uh, there you go. There is your analysis.
So anyways, check the GitHub. Um, hope this was a helpful demonstration. A little bit sloppy, albeit, but, um, uh, enjoy. And thanks for participating. I think I’ll turn it back to, uh, Lillian and/or Mark for the kind of the closing.
Mark Mather: Great. Thanks so much, Kevin. Um, we are we, it’s 3:20, it’s 3:29 East Coast time. So I know we’re almost at the end of the time for the webinar, but, um, and this was an incredible amount of information. So just as a reminder, we will be sending out a recording and the slides that have all of the relevant links. I think that, um, flew by in many of these, in many of these presentations.
Um, I think because of the time we are going to officially close the webinar, but the panelists have agreed to, I think that you all agreed to stay for a few more minutes. If anybody wants to stay behind, uh, more informally and ask them some questions, we can, um, unmute you and, um, you know, five or 10 more minutes, I think, and we can, uh, turn off the recording so we can just speak more informally. But, uh, with that, I do want to officially close the webinar. I’ll stop recording. And thank you all for joining.
New data released today by PRB and the Appalachian Regional Commission shows that rates of labor force participation, educational attainment, income, and poverty continue to improve in Appalachia.
The 14th annual update of The Appalachian Region: A Data Overview from the 2018-2022 American Community Survey draws from the latest American Community Survey and comparable 2022 Census Population Estimates. Known as “The Chartbook,” the report contains more than 300,000 data points comparing Appalachia’s regional, subregional, state, and county economic status with the rest of the nation.
Key improvements in the region’s economic indicators are as follows.
Increased income and lower poverty rates
Higher educational attainment and labor force participation
Increased population growth in south
Increase in broadband access
“We celebrate the progress Appalachia has made, including declined poverty rates and increased broadband access. However, we know that there is still much work to be done for our entire region to reach economic parity with the rest of the country,” said ARC Federal Co-Chair Gayle Manchin. “ARC will continue to prioritize the quality of life of Appalachia’s 26 million residents, and remains committed to continued collaboration across federal, state, and local levels to ensure our people have a bright future.”
Despite positive trends, several data points revealed vulnerabilities that emphasize the inequities in Appalachia compared to the rest of the nation:
Overall population decline
Poverty rates for children and families and specific counties
Disability and poverty in older adults
Despite gains in access, digital divides persist
“The data in this year’s Chartbook highlight strides being made in the Appalachian Region, with noteworthy improvements across economic, educational, and health-related measures,” said Sara Srygley, a senior research analyst at PRB. “Yet, these data also emphasize considerable variation throughout the region—particularly the persistent challenges facing rural communities.”
The data show that Appalachia’s rural areas continue to be more vulnerable than its urban areas. Appalachia’s 107 rural counties are also more uniquely challenged, compared to 841 similarly designated rural counties across the rest of the U.S. Though rural Appalachians did have higher health insurance coverage than the rest of rural America, rural Appalachian counties continue to lag behind on educational attainment, labor force participation, broadband access, household income and population growth.
The Appalachian Region: A Data Overview from the 2018-2022 American Community Survey was written by PRB and the Appalachian Regional Commission.
In addition to the written report, ARC offers companion web pages on Appalachia’s population, employment, education, income and poverty, computer and broadband access, and rural Appalachian counties compared to the rest of rural America’s counties. For more information, visit www.arc.gov/chartbook.
The Appalachian Regional Commission is an economic development entity of the federal government and 13 state governments focusing on 423 counties across the Appalachian Region. ARC’s mission is to innovate, partner, and invest to build community capacity and strengthen economic growth in Appalachia to help the region achieve socioeconomic parity with the nation.
What are the barriers to conducting abortion-related research in the United States today?
June 7, 2024
In 2022 the Dobbs v. Jackson Women’s Health Organization decision, which overturned Roe v. Wade, ended the Constitutional right to an abortion and dramatically changed the health care landscape in the United States. Researchers on abortion, fertility, and reproductive health have been working to understand the implications of the Supreme Court decision, including access to care, birth rates, and health outcomes.
In this webinar expert panelists discussed questions including: What are the barriers to conducting abortion-related research today? What have we learned from the data so far? Where are the data gaps and how can we fill them?
Panelists included:
Beth Jarosz, PRB: Hello, everyone. I’m Beth Jarosz, Senior Program Director at the Population Reference Bureau and Vice President of the Association of Public Data Users. And with both of those hats on, I want to welcome you to what will be a very engaging discussion.
As you all know, it’s been nearly two years since the Dobbs v. Jackson Women’s Health Organization decision changed the abortion health care landscape in the United States, and researchers have been working to understand the implications of Dobbs on access to care, birth rates, health, and other outcomes.
In addition to hearing a bit about that research, today we’re going to tackle questions like: What are the barriers to conduct abortion-related research? What have we learned from the data so far? What are the data gaps, and how can we fill them?
To help answer those questions, I’m joined by an all-star cast: Abigail Aiken, Associate Professor of Public Affairs at UT Austin; Jane Seymour, Research Scientist at the University of Wisconsin–Madison, Collaborative for Reproductive Equity; Alison Gemmill, Assistant Professor at Johns Hopkins Bloomberg School of Public Health; and Laura Lindberg, Professor of the Rutgers School of Public Health.
We’ll hear from all four researchers and will round out the hour with a Q&A. If you have questions, please type them into the Q&A box, and I’ll ask as many of your questions as I can during the Q&A session at the end. So without further ado, I’m going to invite Abigail to begin.
Abigail R.A. Aiken, University of Texas at Austin: Thank you very much, Beth. It’s wonderful to be here with everybody today. I’m just going to share my screen so you can see my slides. And then I’m going to give a short, 10-minute overview of some of the work that we’ve been doing trying to measure self-managed abortion and shield law abortion provision in the post-Dobbs landscape.
I want to say that the work I’ll present to you is the result of a lot of people’s work. So everybody here has been involved with Project SANA, that’s our project, the Self-managed Abortion Needs Assessment Project, at some point over the past five years. And so want to, um, say thank you to everybody who’s been involved in trying to get an effort to look at the who, what, and why of self-managed abortion in the U.S. off the ground. When we started this project back in 2018, we knew so very little in the research sense about self-managed abortion, and we really come a long way since then.
So to be clear on terms, I’m mostly going to be talking about self-managed medication abortion this afternoon. And that’s the process of obtaining medication abortion pills. It could be mifepristone and misoprostol or misoprostol alone, and managing your own abortion outside of the formal health care setting, so with no U.S. licensed provider or clinic involved. And, of course, self-managed abortion can also be done via other methods: herbs, botanicals, self-harm. There’s lots of different ways. It’s really a spectrum of things. Most of what I’ll talk about today will focus on medication self-management, but in the Q&A, I’m also happy to talk about some of the other methods as well.
So self-managed abortion is really hard to study. It’s hard to study because by definition, it’s something that’s happening in private settings. It’s usually in people’s homes. It’s not something where there’s an administrative record that you can request or track easily. And so since 2018, we have been thinking hard in Project SANA about how to, uh, count self-managed abortion, how to explore self-managed abortion, how to get a sense of how often this might occur and why it might occur.
And a lot of work has been done since then, and we really have focused a lot of our work on the nonprofit organization Aid Access. And that’s because since 2018, Aid Access has been providing self-managed medication abortion through online telemedicine. Now, the model of Aid Access has changed in recent times, and we’re going to talk about that later in the presentation. But for about five years this was considered self-managed medication abortion because it was happening entirely outside the formal U.S. health care setting.
We formed a collaboration with Aid Access, having worked with their sister organization, Women on Web, in Ireland and Northern Ireland prior to 2018. And so we were able to look at the trends in the number of people that were making requests to Aid Access. We established the safety, effectiveness, and acceptability to the user of this model. Um, please check out our papers if you’re interested in that.
And we also had a look of, at the question of, Would we expect there to be a relationship between abortion bans and self-managed abortion? You can imagine that when states put, um, abortion restrictions in place and people have less access to clinics that they might more often look to self-manage outside of the formal health care setting. And it’s also evident from our research and the work of others that people sometimes also self-manage from a point of view of being their preference. It’s not just an alternative to lack of clinical access; it’s also something people might prefer to do for a variety of reasons.
So the first part of what I’m going to talk about looks at this question of is there a relationship between SMA and abortion bans? Because leading up to Dobbs, we wanted to know, can we use data from Aid Access to find out whether when states ban abortion post-Dobbs, are we going to see an increase in people self-managing? And we had good reason to expect that that would probably be the case based on a number of prior studies that I’m going to talk about super quickly because I’ve only got 10 minutes. But I just want to show you the strength of data behind this relationship.
So this first paper looked at what happened when Texas, back at the beginning of the COVID-19 pandemic, banned abortion essentially for a period of two weeks by saying that abortion was a non-essential medical procedure. And we looked at what happened at, to request to Aid Access during that admittedly short time period. But it was a really quick and evident increase. You’re looking here at a graph of cumulative requests, so you’re seeing the actual data before the ban. They’re in black. Then you see the data after in the orange line, and the model fit, um, compared to what was forecast. And we saw this doubling of requests over the two-week time period after abortion services were shut down in Texas.
Staying in Texas, we saw what happened in September of 2021, when Senate Bill 8, that was essentially the six-week ban, uh, went into effect. And again, we saw that compared to a long baseline of what Aid Access had been doing, requests for self-managed abortion really spiked when people knew what was about to happen. But even out several months afterwards, you were seeing a tripling over the baseline numbers.
Again then after Dobbs, we saw states with total abortion bans. And again, we saw, when you compare to this baseline of what access had been seeing from these states, a doubling or sometimes even a tripling of requests in those banned states, which is more than what was happening in states without bans. So over and over again, and this is really, I think, in keeping with what we’re seeing, we see in the global context, what we’ve seen historically in other places with abortion bans, when you make clinical abortion access harder, you see this increase in people looking to self-manage.
So now what I want to talk about is going beyond requests and trying to actually count, because the question that, you know, people often ask is, okay, but we see that relationship, but how many self-managed abortions do we think are happening in the U.S. post-Dobbs? And that’s a really hard question to answer. Looking here though, this is from WeCount, and people maybe hope are familiar with the effort from Society of Family Planning to count and make a census of abortions provided within the formal health care setting after the Dobbs decision.
And this is early on, right? We’re only looking out here to six months post the Dobbs decision. But initially there was a decrease. There was a decrease in the number of abortions being provided within the formal health care setting, which raises the question of did we see a concurrent rise in people self-managing? Do we know how much of that decrease of approximately 32,000 abortions provided within the formal health care setting might get offset by abortion outside of the formal health care setting?
Now, the post-op landscape really changed what self-managed abortion looked like. That’s another issue for us. We had worked with Aid Access for a long time and continued to do that because they were an online clinic mailing pills. But there was such a response to the Dobbs decision from community support networks. So based on accompaniment models, oftentimes in Mexico or Latin America, and we knew that model’s been so prevalent in South America for so long, coming to the U.S. to try to secure access for people through volunteer networks and then also websites selling pills. So not online, um, telemedicine operations, but simply online vendors that were like, yep, we’ve got misoprostol/mifepristone. You can order it from us, and we’ll send it to your house.
So trying to, first of all, map this is a large effort, right? Trying to figure out how many different providers out there, out there, as particularly with online vendors, they tend to change a lot. And different people may run multiple websites. They may pop up and go away. It’s hard to keep track of all this. So part of the work that we’ve been doing is trying to figure out how many pathways are there, how many providers are there, and then what does each provider provide.
And in an attempt to do that, we published the first kind of findings out of that looking out six months post-Dobbs. Um, you can find this paper also online. We saw this increase in self-managed abortions provided in that six-month period post-Dobbs, when you saw the decrease that was found within the formal health care setting and now this increase in self-managed abortion. And this chart attempts to break it down by the different types of provider, the community networks, the telemedicine org, and the online vendors. So you can see the baseline.
There was, of course, provision beforehand before Dobbs. People were, of course, self-managing then, too, partly as a result of abortion restrictions, partly as a result of preference. But it really changed post-Dobbs in mostly in states that enacted bans. And approximately 26,500 abortions is our estimate for the six-month post-Dobbs that took place outside the formal health care setting. Lots more methodological details on that in the paper that I don’t have time to cover right now.
I wanted to highlight that these different types of organization, um, play a critical role, partly because of cost. Um, from our qualitative work, we know that even the $90 that a service like Aid Access was asking for in donation is too much for a lot of people, and many of the accompaniment networks are able to provide at no cost, which is really important for people.
Secondly, these options are out there. They are, they’re, they’re becoming more known about. But that doesn’t mean that people don’t often look to other ways, too, maybe as part of their journey to getting what they need or as the ultimate end of their journey. And for some people, this could even be something that’s unsafe or harmful to them. So I haven’t talked a lot about that today, but I don’t want to overlook it completely. It comes up in our qualitative work quite a lot.
Then finally we’ve got this shifting post-Dobbs landscape. We’re now looking at numbers coming in from WeCount showing abortion numbers increasing. And we also see from the Guttmacher map project also, um, similar counts in the monthly provision data as well. So there seems to be an increase in access overall.
And what Aid Access are now doing we wouldn’t call self-managed abortion anymore because they’re now providing, um, entirely through U.S.-based clinicians, through shield laws. So getting medication abortion to banned states from providers that are working in states that have shield laws, that allow that to be within their scope of practice. So now we have a different, um, challenge on top of the counting of self-managed abortion, which is this new definition of shield law provision, and trying to count that alongside, um, the self-managed, uh, medication abortions too.
So I like to leave it there because I only have those 10 minutes. Uh, that’s a summary, a very high-level summary of what we’ve been up to and what we’ve been trying to do. Uh, please check out our site to look at our papers. Um, I’m looking forward to your questions in the Q&A as well. Thanks so much for your time.
Beth Jarosz: Thank you so much for setting the stage and for covering a lot of information in a very short time. And I’m going to invite Jane up next.
Jane Seymour, University of Wisconsin–Madison CORE: Wonderful. Thank you all so much. Um, I’m really delighted to be here today to talk about some of the ways that we’re measuring the impact of Dobbs in Wisconsin at the University of Wisconsin Collaborative for Reproductive Equity, or UW CORE. CORE is a research initiative focused on abortion, contraception, and other aspects of reproductive autonomy that’s housed at the University of Wisconsin School of Medicine and Public Health, which is Wisconsin’s largest and only public medical school.
Okay, there we go. So given our focus, one of CORE’s goals both pre- and post-Dobbs is to document the health, well-being, and social consequences to Wisconsinites of barriers to wanted abortion care.
As you may know, post-Dobbs, an 1849 state law here in Wisconsin was interpreted as banning abortion, and as a result, all abortion services in the state were halted, and data from the Society of Family Planning’s WeCount effort, which Abigail referenced, shows here that the, in the year after Dobbs, roughly 7,000 fewer abortions occurred in Wisconsin compared to the prior year.
And while abortion services have resumed in Wisconsin as of last fall, we know that many barriers that predate Dobbs remain in place, and providers are still ramping up services to pre-Dobbs levels. In other words, there are still significant barriers to abortion in Wisconsin.
So naturally, this leads us to ask what happens to Wisconsinites who want abortion services given these bans and restrictions. And we can imagine three scenarios for these folks. First, we can imagine that some likely cross state lines for abortion, as was already the case prior to Dobbs, given Wisconsin’s extreme abortion restrictions. However, data from, excuse me, data from WeCount, um, shows us that the increases in haven states, such as some of the other Midwestern states shown here, don’t make up for the bans in states such as Wisconsin. Um, second, we can imagine that some people self-managed an abortion, obtaining pills from a variety of sources, including places like Aid Access. And finally, we imagine that some Wisconsinites who wanted an abortion did not have one and instead carried their pregnancy to term.
So although we can imagine these scenarios, it’s important to understand the lived experiences and trajectories of abortion seekers in this restrictive environment as well as the impact on their health and well-being.
So to understand these experiences, we must get information from Wisconsinites who considered abortion. As many on this call know, prior to Dobbs our field often recruited for studies from abortion clinics, which may have induced a selection bias, as we failed to include those who face barriers to care such that they never made it to a clinic. Some researchers in our field have made attempts to overcome this limitation by recruiting from prenatal care clinics and/or online via social media or, or Google ads.
Post-Dobbs, especially in states where there were no longer abortion clinics, including Wisconsin for a time, this method, methodological challenge has only been amplified. In other words, we have to search in many different places for research participants to fully answer our questions about barriers to care.
Here at CORE, we’re taking a multi-pronged approach to understanding the impact of Dobbs on abortion seekers, which we call the post-Roe impact research portfolio. In this portfolio, there are three studies shown here, which we refer to as the Turnaway, prenatal, and MAP studies. I’ll briefly note that the Turnaway work is comprised of interviews with those who participate in Dr. Diana Greene Foster’s post-Roe, uh, work.
But today I’m going to focus on our other two studies, which recruit from prenatal care clinics and online, respectively. And both include longitudinal surveys as well as in-depth interviews. Overall, this portfolio builds on Dr. Foster’s original Turnaway Study as well as pre-Dobbs work that sought to recruit those who considered abortion outside of the clinical setting.
Here’s a bit more detail about these two studies. In brief, the prenatal study recruits patients from UW Health prenatal care clinics, after which they complete a baseline survey. Those who report having considered abortion are invited to participate in an in-depth interview two weeks after the baseline survey, as well as for 10- and 18-month follow-up surveys. Additionally, at baseline, we ask all participants to agree to use of their electronic medical record, or EMR. We pull EMR data for all study participants to compare outcomes between those who did and did not consider abortion care.
Oops. Excuse me. Uh, currently, we’re still recruiting, and the first participants have received their 10-month follow-up survey. As you’ve already seen, the MAP Study, or the Midwest Abortion Pathways Study, is a partnership between CORE, Ibis Reproductive Health, and Indiana University and recruits participants via Google and Microsoft internet search engine advertisements. Participants are eligible if they’re pregnant, live in Wisconsin, and report having considered abortion for their current pregnancy. They complete a baseline survey after clicking through the advertisement and then are invited to complete 4-, 10-, and 18-month follow-up surveys, as well as an interview post-4-month survey. Currently, we’re still recruiting in the first. Participants are about to receive the 10-month survey.
Now, typically this is where I would share a few nuggets of our results, but instead I’m going to share some challenges we’ve encountered as those feel particularly relevant to today’s conversation.
First, as is likely no surprise, abortion seekers who were hard to find pre-Dobbs are even harder to find now, likely due in part to concerns about the legality of abortion and related increases in conversations about digital security. Second, the legal and health care delivery context for abortion is extremely dynamic. We’ve had to be very flexible and in some cases act quickly to update our survey instruments to understand the current legal or political context in Wisconsin.
Finally, and perhaps most notably, bad actors and bots abound in this work. We’ve been overwhelmed by the number of fraudulent responses we’ve received and, in turn, the time and effort it takes to parse the good responses from the bad. In the cases of bots that churn out thousands of responses each week, identification is fairly easy, as, for example, their open-ended responses and their email addresses are completely nonsensical. But for those duplicate responses from legitimate participants who are likely trying to obtain additional remuneration and individuals posing as eligible when they’re not, the process is much more art than science.
Through this process we’ve learned a lot about how to proactively prevent fraud and handle it when it slips past our checks. First, the thoughtful, capable data scientists on our team have been an invaluable resource. Their efforts have allowed us to analyze data quickly and again, pretty proactively and quickly, identify appropriate data flags with relative ease and pivot our processes accordingly.
Additionally, having checks in our data collection tools that help identify bad actors and bots has been crucial to our success. I’m happy to talk more about those in detail during the question and answer period, but for now, I’ll highlight to you. Um collecting IP addresses and asking questions for which responses can be compared, both within a single survey and across multiple survey waves has been crucial in helping us catch fraud. With that said, I’ll say that our team remains hopeful in this really is a team effort.
Through the process, we’ve developed even stronger partnerships, and we’ve learned so much. We’re better scientists because of the challenges we’ve encountered. And while our progress may be slower than we hoped in some regards and much more challenging than we expected, our methods are working. We’re finding Wisconsinites who considered abortion and never made it to a clinic and are willing to share their experiences with our team.
So I’ll leave, leave it at that except for two asks. My first is that we continue to fill the gap in finding folks who consider abortion but don’t make it to care. They’re a crucial population within, uh, that should be a focus of our work more often, and I’d ask that we all continue to work collaboratively to build effective anti-fraud strategies that can be applied across contexts. I know there are many folks in the field and in other fields working on this effort, and our collaborative efforts have already been so fruitful, and I welcome more investment.
So with that, thank you very much. And I’ll welcome questions during the question and answer or at this email address at any time.
Beth Jarosz: Thank you so much, Jane. And we will move on to Alison.
Alison Gemmill, Johns Hopkins Bloomberg School of Public Health: Okay. Great. So thank you so much for organizing this. Um, I’m really happy to talk about the, see, it’s working, the data component here. So, um, for those of you who don’t know me, I’m a demographer and a reproductive perinatal epidemiologist, and I am studying the health impacts. And I’m going to talk about some of the challenges of using secondary data sources in this work.
Um, so I wanted to highlight two current projects. Uh, and this is collaborative work with Dr. Suzanne Bell. The first of these is to look at the impact of highly restrictive abortion policies on fertility: so birth rates, uh, severe maternal morbidity and mortality, if possible, and birth outcomes. And then the second project is to look at the impact of these highly restrictive abortion policies on changes in high-risk pregnancy care. And this work is currently funded through the Society of Family Planning.
So what are the data sources that we use? Um, for the first project where we look at birth rates, we obviously use birth certificate data. So we, we rely on vital statistics data a lot. Um, we are also looking at some infant outcomes like infant mortality. So we rely on death certificates as well. The good thing about vital statistics data is that they are virtually complete. So for births, for example, they represent over 99% of all births in the U.S., including home births, and all states participate. So we have good coverage over time and space.
Um, for maternal health outcomes or pregnancy-related outcomes, we can’t really rely on vital statistics for those. And I’ll explain more why shortly. So we’re going to rely on state-level hospitalization data, um, and specifically this is through a database through AHRQ. And what we do is we use ICD 9 or 10 codes for diagnosis and procedure, procedures to identify these types of outcomes.
And then, uh, potential projects in the pipeline might actually be using some of our typical survey data. So, for example, some of you are familiar with the National Survey of Family Growth, or NSFG, and the Pregnancy Risk Assessment Monitoring Survey, or PRAMS, and I’ll talk about those in a bit.
So I wanted to actually highlight some data challenges, uh, because I think it’s really important in this work, and it’s what we’re dealing with. The number one challenge: everybody wants to know what’s happening on the ground right now, but we do not yet know, and that’s because our data are lagged in terms of when they are released. So in the case of vital statistics data here, um, usually final birth and death certificate data are lagged by a year. So we have to play the waiting game. However, uh, I’ll talk about this at the end, uh, there have been changes in that they’re making provisional data more available to researchers. And this has been an amazing change.
Um, in terms of hospitalization data, these take a lot of time to come out as well. So I can’t tell you yet what’s happening to an outcome like severe maternal morbidity. Um, so these are lagged by about two years. So data on 2023 births will not be available until early 2025, for example. Um, in terms of those two surveys I mentioned, CDC’s PRAMS, they interview people who are postpartum, so these are among people who gave birth, data on 2023 births will not be available until 2025. And then for the National Survey of Family Growth, they did resume data collection in 2022. So there is a potentially an opportunity to use these data, but they won’t be released for some time.
The second challenge is about varying data availability, availability across states or limited geographic identifiers, and to conduct the kinds of studies that we want to conduct that have very strong causal inference embedded in them. We need data for states, each state. So the state inpatient databases that I talked about, the hospitalization data, those are great because we can get those at the state level. However, one of the big states that we’re interested in, Texas, does not participate, at least in the HCUP Central Distributor where we access these data typically. And then for the NSFG, they do not include state identifiers, nor do they include month year of important reproductive events. To access those data, you actually have to go to a restricted data center, which is associated with time and cost burdens.
The third challenge I want to note is that there’s varying data quality across states. And this is very, or this is, um, specific to birth certificates here. Um, so not all items on the birth certificate have high validity. And this validity varies by state. So because I have a captive audience, I wanted to highlight one of the papers that we wrote. Um, so what you see down here is a section of the birth certificate where there is something known as the maternal morbidity checkbox. So on the birth certificate we can capture information about some of these common maternal morbidities like maternal transfusion or ruptured uterus. However, we did a validation study where we compared the data on the birth certificate to the hospitalization data, and the estimates do not match up. And what our conclusion was is that the birth certificate data for these specific maternal mortality, morbidity indicators, the validity is quite low. So I recommend not using them.
Another challenge: the data are cost prohibitive. So I mentioned that we’re going to be using these state inpatient databases. These are really expensive. So one year of data for one state can cost anywhere from $200 in the case of Florida to about $1,600 in the case of Mississippi. So for our project where we need data for several states and several years, this is going to be quite costly. Thankfully, we have funding to support this work. Um, but again, this is a big barrier, right? Um, I mentioned the NSFG. You have to go to that restricted data center, and that costs a lot of time and a lot of money.
And then finally, I think a really great data source are Medicaid claims data. However, I will not be using them because they are very expensive to use. And you kind of need an existing data infrastructure. So you need, so you need to be linked to universities that are already kind of using Medicaid data because it’s a big, um, what’s the word, it’s a big barrier to overcome to get started with the Medicaid data, is what my understanding.
And then finally, this is my last data challenge, and it’s more of a statistical challenge. It’s about how do we estimate impacts among subgroups. And we know this is a very important question. However, the numbers can be quite small and this comes with lower statistical power. So, for example, how do we measure fertility rates among smaller or, yes, subgroups in smaller geographies? Or how do we measure events of very rare maternal outcomes that really matter, but they might just be so rare they’re hard to study.
So we need to expand our causal inference toolkit to detect these effects. We don’t want them, we don’t want them to go unnoticed, right? We want to detect some signal. So how do we do that? And that’s where I think a lot of the work needs to be done in terms of population health outcomes.
And then finally I’ll close with some data opportunities. Um, the one that I briefly touched on is that the CD, or the National Center of Health Statistics has made this release of provisional data in terms of birth certificate data and death certificate data. Um, and it’s been a game changer. I think what happened is COVID prompted the release of this data because we needed to know in real time, especially with mortality, what was going on. Um, and as of 2023, provisional birth and death certificate data are now available on CDC Wonder. So if you don’t know about CDC Wonder, this is a great interactive, um, platform that you could use online to download data. It’s an amazing resource.
So one of the first things that we did, um, while we’re still waiting for, uh, to study impacts of Dobbs, is we could study the impact of Texas SB8 policy using that provisional data from NCHS. And so this is a paper that my colleagues and I wrote, um, looking at what happened to fertility after SB8. And we did find a 3% increase in live births.
And I believe this is the last thing I want to say. So I just wanted to know other potential data sources for those of you in the audience that are thinking about doing this work. Uh, one colleague at Hopkins, he’s a current student, has actually used the behavioral risk factor surveillance system, which does have data by state. And he looked at outcomes related to self-reported anxiety and depression and found that those were elevated in respondents in banned states following the Dobbs decision.
I know other people might be looking at changes in the workforce. So there’s potential data, um, from some organizations that might be possible. I know people have looked at Reddit forums. Um, so there’s some rich qualitative there, data there potentially. And then I think we’re just going to be, have to be innovative in terms of other types of digital data that might be used.
So, um, I think that was it. And I look forward to any questions you might have. Thank you so much.
Beth Jarosz: Thank you so much, Alison. And last but certainly not least, I will invite Laura to present.
Laura Lindberg, Rutgers School of Public Health: Okay. Thank you all for having me here today. And, um, Alison really set this up because I want to focus on a subpopulation, which is adolescence. And I want to move my slides. There we go.
So adolescents are experiencing disproportionate legal, financial, logistical, and social barriers to abortion. This policy environment impacts not just adolescents seeking abortion, but all adolescents. And the experience of adolescence itself may have fundamentally changed. Adolescents are thinking differently about many aspects of their lives: their relationships, health, where to go to college, where to live, and what their future might look like.
Adolescents are impacted by new abortion laws aimed at all pregnancy capable people, as well as those such as abortion trafficking laws that specifically target minors’ access to abortion. And abortion access remains difficult for minors, even in states where access is protected, whether it’s because of parental involvement requirements, financial logistical challenges, or forms of abortion stigma.
It’s against this backdrop that I’m going to draw on a new report, Adolescence Post-Dobbs: A Policy-Driven Research Agenda for Minor Adolescence and Abortion. And I’d like to take this opportunity to acknowledge and thank my incredible co-authors, Julie Maslowsky and Emily Mann. While we focus on minors because of their unique standing in the law, our recommended action steps would benefit adolescents of all ages, their families, and their communities. And today, I’m going to focus on the data agenda that we developed in this report.
This report was produced under the auspices of Youth Reproductive Equity, a national multidisciplinary research collaborative composed of both researchers and clinician scientists. We formed in 2021 in anticipation of the Dobbs decision and its disproportionate impact on young people, and we continue to expand our work.
So, we found that minors are systematically underrepresented in research about abortion. Far too often, studies start at age 18, excluding the experiences of younger adolescents. Failing to produce needed research on minor adolescents and abortion is an equity issue, and the large knowledge gap has become a liability as the data gap allows for non-evidence-based policies.
A key call to action of our research agenda is to ensure that research designs and analyses include the experiences of minors. We make a distinction between studying the direct impacts of changing abortion policies on pregnant minors and the indirect impacts of abortion policies on the total population of minors.
So currently we lack the data needed to study the direct impacts of the new restricted abortion policies on minors. For example, it’s well established that federal and state abortion surveillance is incomplete. For example, California doesn’t participate in these systems, and states don’t always collect data by age. Studies of abortion patients, usually based out of clinics, even when they do include minors, are often limited by small numbers, and the new real-time data collection of abortion counts, such as that from Guttmacher or the Society of Family Planning, doesn’t even collect patient age, leaving critical gaps in the surveillance of minors’ receipt of abortion care.
Thus, we recommend expanding data collection to increase and improve the inclusion of minors in clinical studies, as well as state and national surveillance, and this may include a need targeted oversampling of minors.
Further, where there is data, we need to expand again our approach so that we present age-specific data in ways that we can identify minors’ unique experiences and not group them with all adolescents up to age 19 or, worse, with the general population.
In addition to expanding our research, we call for approaches that use tailoring, which is to tailor direct collection to provide an in-depth examination of those experiences that are unique to minors. This allows for focused attention to policies, focus on this age group’s abortion access, experience, access and experiences separate from those of adults. And a key recommendation around tailoring is to field a new longitudinal study of pregnant minors across different policy environments to better understand their pregnancy, abortion, and parenting experiences.
Now, I want to turn to the data needed to examine the indirect effect of abortion policies on minors. And here we propose the need for what we call contextualizing, calling for population representative as well as targeted studies of minors that aren’t so focused on abortion but capture the context of adolescents’ lives as abortion access is changing.
So as we think about contextualizing, we can see many gaps in existing federal, state, and national data collection efforts that limit our, our ability to do needed research. So let me just talk about a few. There’s obviously other data sources out there, but I think these are some major ones that are worthy of discussion.
So the Youth Risk Behavior Survey, or YRBS: these are state surveys of high school students. And they should allow us to compare between different abortion policy environments. But an increasing number of states are choosing not to participate in the YRBS, and this is likely to only get worse over time. Still, there are opportunities here to abortion policies by knowing the state that the student resides in to outcomes such as their mental health, their experience of intimate partner violence, and contraceptive use patterns.
Alison mentioned the National Survey of Family Growth. This is a household survey that starts at age 15 and goes through age 49. However, the sample size of adolescence is relatively small, and especially if you want to do analyses limited to sexually experienced teens. Um, Alison noted that the geographic identifiers in the study are not made publicly available, which I’ll talk about more in a minute. She also mentioned BRFSS, and this is a good resource because it does provide state representative health data that could be of interest, but it only samples adults. And this is an example of the exclusion of minors from research that an expansion of the survey could address and improve.
And finally, we lack a current longitudinal study of adolescent lives. Add Health has been probably the most influential source, source of longitudinal data on teens, but it was started in the 1990s, and those adolescents are now adults. Indeed, it’s the National Institute of Aging that now funds this project, so it doesn’t help us to study today’s teens in today’s post-Dobbs world.
The National Longitudinal Survey of Youth, or NLSY, faces similar aging as the 1997 cohort, which was the most recent cohort, is now in middle age. The Bureau of Labor Statistics is currently designed designing a new NLSY, and this is really an opportunity, I hope, for collaboration to ensure that relevant health and psychosocial and other effects are, and measures are included in addition to the conventional labor force and work and education measures that this survey has usually focused on.
These gaps lead to key recommendations to improve and expand current data collection and start new efforts in the field. So we’re calling for both new cross-sectional and longitudinal survey of the general population of adolescents. These surveys should include not only sexual and reproductive health behavior, but adolescents’ knowledge, attitudes, and behaviors related to changing abortion access. And they should allow for the longitudinal study of the impact of the Dobbs environment of living in this, at this time on their behaviors, their education, their economic and their health, health outcomes into adulthood. Now is the time to design and implement these studies.
And we recognize that part of the context of minors’ lives are the adults in them. Be it parents, health care providers, caseworkers, teachers, even policymakers whose views on adolescence color their approaches. And studies of these adolescents who are influential in minors’ abortion experiences are also needed to understand the context of these experiences.
Finally, I want to remind everyone that in our country right now, your zip code determines your access to abortion care. And to help researchers study the influence of location, we need to make geographic data more readily accessible. This could include strategically collecting state representative data as well as making existing geocodes on surveys more available. So Alan, Alison pointed out the challenges of the difficult to access NSFG geocodes through the research data centers. I’ve lived through that; I call it often the, um, circles of hell, um, and it is not easy. But one approach to facilitating needed research with these geocodes could be to create publicly available aggregated geocodes that group states according to their state policy environment but don’t run these kinds of risk of disclosure, disclosure that the RDC is trying to protect from.
So in conclusion, all adolescents are impacted by the changing abortion policies, even if they aren’t seeking an abortion. And there’s a need, there’s substantial need for more research and data for this population. The historic exclusion or blind eye to minors’ experiences as compared to adults leaves us with inadequate data systems. Excluding and overlooking minors is both an equity and a rigor issue. We need quality science that includes marginalized populations, including those treated differently because of their age. Expanding, tailoring, and contextualizing data collection for minors and improving how researchers can access key data offers us a needed path forward.
I’ve shared here a QR code so you can access, download our entire report. It has not just these data and research needs, but also a deep dive into the changing legal and policy environment. I also invite you to contact us at Youth Repro. We are available for consultation, collaboration, and thought partnership, and my email is up here as well. Thank you.
Beth Jarosz: Thank you so much. All of these presentations have been fantastic, and I want to take a moment to acknowledge all of the great work that you are all doing, and also to suggest that our audience members seem to think so, too, because we have a ton of questions. Um, I will try to get to as many of these as we can, and that’s the 15 minutes that we have left.
And so I want to start with, um, and this is probably for Abigail, but for any of these, any of you can answer, um, and the question is, Is it legal for women in banned states to receive the pill in the mail? And I think maybe talk a little bit about shield laws, which you mentioned in your talk.
Abigail R.A. Aiken: Yes. Thanks for the question. Um, it’s a complicated one because it depends, um, on who we’re talking about being the subject of the laws. Um, it is the case that, um, most states don’t have laws on the books currently that would explicitly criminalize the person using the medications or receiving the medications for a self-managed abortion, although that doesn’t mean that people won’t be surveilled and won’t be subject to investigation or even times prosecution, um, unlawfully. And so, um. That’s one where I would also, if you’re interested in that question, check out the resources of If/When/How: Lawyering for Reproductive Justice because they’re extremely knowledgeable on this issue. So that’s one, um, where it’s, you know, not explicitly criminalized, but doesn’t mean that people couldn’t face, um, legal jeopardy.
For those who are delivering the pills, and I see the question about, um, is it, uh, legal for the person sending them. Now, technically, that would be against the laws of most states who had to have abortion bans or have restrictions on, uh, telemedicine provision of abortion. But the idea of the shield laws is to protect providers in states where they reside and where they practice. So there’s a great article in The New England Journal, uh, written by David Cohen, that lays out shield laws. It’s a really interesting and informative read, and it tells you about some of the protections, uh, that providers residing in states with shield laws would have in terms of protecting their license and protecting them from states that want to enforce their own state laws outside of their state boundaries.
Beth Jarosz: You know, and that kind of leads into, I love someone posted a question that I already had on our list, and I think it dovetails nicely with this. And it’s speaking to privacy and confidentiality. I think that’s one of, it’s sort of the, the elephant in the room when we’re thinking about this, that we need really good, high-quality data for a topic that is sort of legally challenging. Um, and, uh, so can you speak, I know we talked a little bit about that with geography, but I think each of you probably have a perspective on this. Who wants to go first, Abigail, do you want to take us off?
Abigail R.A. Aiken: Yeah. I can kick off there. Yeah. From the self-managed abortion and also the shield law perspective, um, it’s extremely difficult, right. And, you know, we know that, as I said, just because people don’t live in states with state laws that explicitly criminalize them doesn’t mean they won’t be, uh, surveilled and harassed and sometimes even unjustly prosecuted.
And so we really limit our data collection, and we are really limited in terms of what we can collect. So we never collect anything identifying. And even then, we don’t collect a lot of the things that, you know, I appreciated Laura’s call for this more detailed data, and I think we absolutely need that. It’s really hard with self-managed abortion. Um, and so far we have really stuck to the idea of firstly, anyway, counting right, getting information on volumes on prevalence.
Um, before Dobbs, we did quite a lot of qualitative work looking at people’s experiences and their motivations. And I’m not saying we won’t go there again. Um, but it is an even more difficult environment in which to, uh, do this work than it was before. And so, um, right now we’re really very much, when we get data directly from providers, we ask for as little as possible.
Beth Jarosz: Thank you. And I think Alison and Laurie, you both mentioned, um, sort of geographic specificity, which we know is really important in this context. And, Jane, I have a follow-up related to privacy for you, too, but I want to talk a little bit about the challenge of balancing geographic access with confidentiality in these cases. If either of you want to speak to that.
Alison Gemmill: Well, I was actually thinking about some of the rarer outcomes that we’re going to be studying, which you could inadvertently disclose somebody’s identity in a given state, you know, in a given age range. And they have a very rare pregnancy-related outcome. And so one of the challenges we’re going to have is that data are made available to us, and we have a data use agreement where we will make sure that we protect the data at all, at all costs.
But, um, it’s, it might be challenging for us in how we disseminate the information. So we have to make sure that we’re not going to, you know, report only five cases of something. So there’s certain rules. So that’s how I’m thinking about it with the secondary data that I use.
Laura Lindberg: Yeah. And I just want to mention, I mean, there certainly are real risks here. And our role as researchers, we have to take those seriously. But we also need to be educating our IRBs about the reality of the extent of those risks. And what we’re hearing from a lot of research these days is that IRB, IRB members don’t know much about abortion. They’re getting their news from wherever they’re getting it. Um, and they may be concerned in ways that doesn’t reflect the true risk, and their solutions may not be true solutions.
So being the person in your university or in your setting who can work with the IRB to educate them, um, can be helpful. And the Society of Family Planning is in the process of preparing and will be disseminating a series of, um, guidance documents that people can use with their IRBs, both for general sexual and reproductive health research and focused on doing research with minors. So that should be useful to the field.
Beth Jarosz: Wonderful. Thank you. And that’s actually a really nice lead into the question that came in for Jane. And it was thinking of privacy, actually, from the flip side is that, um, you’re finding ways to remove cases that are fraudulent using IP addresses, but does that cause any IRB or confidentiality concerns?
Jane Seymour: Thanks so much for this question. This is something I think about pretty much constantly, it feels like. Um, I think it’s a really, really important conversation, and the tension is really real. So I don’t, I don’t pretend to have any of the answers.
Um, with that said, I really appreciate Laura’s call to, for high-quality data. And we as researchers have a responsibility to ensure that the data that we put out into the world, the results that we put into the world are as real as possible. And in the case where we’re dealing with hundreds and thousands of cases of people who in some cases, like, I think they’re, they’re kind of the two groups I spoke about, there’s like the bots and things that are really, really easy to weed out. You know, when it’s like Abcdefg and a string of 14 letters at mymail.com. That’s pretty easy.
There are some people who have, like, really done their homework and have really convincing stories. And in some cases, we’ve gotten as far as getting them on the phone for an in-depth interview, and it’s become clear that there’s no way that this is a real story that they’re telling. They’re talking about getting pills over the counter in Wisconsin in a time period when, like, pills are not available over the counter, abortion wasn’t available in Wisconsin, you know, just and, and when we probe that, it’s clear that that’s not the case. We’re not talking about issues of stigma where somebody might be changing their story due to abortion stigma.
At any rate, I think it’s incumbent upon us to balance participant safety and security with the rigor and validity of our data. And we feel pretty strongly that IP address is one of those data points we can collect that helps us significantly. We’re really lucky at our institution to work with an IRB that’s very supportive of our work.
One thing I’ll flag here that I didn’t have time to talk about in my presentation was the challenges that we’re working with, um, as it relates to certificates of confidentiality from the National Institutes of Health. There have been changes to that program, and many third-party platforms, including Qualtrics, which I imagine many of us use for data collection, are no longer acceptable, uh, third-party platforms to use under a certificate of confidentiality. So we’re really again struggling with how much does the rigor, how do we balance the rigor with the data protection. And again, I haven’t figured this out, but I think it is a real tension that we’re going to have to continue to work with as a field.
Beth Jarosz: So, um, so, so many more questions. We have time for one, maybe two more. So let’s see if I can package these together. Um, I have sort of a very broad question. I think all of you have touched on this, and that is, What’s a research question you really wish you could answer but don’t have the data now? And one specific question from an audience member is, Do you have statistics on covert delivery? Um, sort of these, uh, abortions that are happening in the states that, that perhaps that have banned abortion, um, in the wake of Dobbs.
Alison Gemmill: Um, I guess I’ll start. And mine is a pretty easy ask. I think I talked about state inpatient data, so that’s people who are hospitalized. I think the next step would be thinking about emergency room departments as a source of care. Um, and those data do exist, but again, not for every state. So that’s a big challenge. And then I think, like what Laura said about longitudinal data, I would love to have longitudinal data to link people over time, whether that’s within administrative claims data or a survey using secondary data. So I, I would love to see data like that eventually to answer some of the questions that we have.
Beth Jarosz: Laura, I know you had a call for data on adolescents. Do you want to renew or repeat them?
Laura Lindberg: Yeah. I mean, I think for, for adolescents, from a research perspective, from an IRB perspective, from a policy perspective, we need to be thinking more about what the harms are for adolescents who wanted an abortion and couldn’t get it, who want and were not telling their stories in our research, that the harm that when we think we’re protecting them by not including them in our research. In fact, so many harms happen when we can’t tell the stories and they’re not included.
And this happens not just for abortion research, by the way, but sexual reproductive health research more generally. So do we, if we don’t include minors in our contraceptive studies, we can’t show that contraception is safe for them because they weren’t in the study to begin with. They need to be included more to in fact increase their safety, not harm it.
Beth Jarosz: And I think I have one more question for Alison. And it’s, you know, you talked about the maternal morbidity data and the research that you’ve done around the challenges with that on the birth certificate record. Um, if you could make recommendations for how to improve, and you probably have that in your paper, but if you could make recommendations about how to improve that data collection system, what would you say?
Alison Gemmill: Yeah. I think, thank you. That’s great. And it was a research letter so I couldn’t say much, but I would, I mean, my understanding is that the National Center for Health Statistics has not had the resources to really check the validity of items. Um, and so first of all, I would want an evaluation of the validity of items on the birth certificate. That would be number one. But then second, it’s really a state’s issue, right? And the data are collected within states at their health departments. And it seems like there is varying data quality. So if there’s a way to train people that fill out the birth certificate to improve the way that they do that, I think that would go really far, because there’s some pretty potential rich data on maternal health there that we could be using.
Beth Jarosz: I think we have time for one more question, and I think this one is for Jane. And it’s, How does a researcher assure that a source for qualitative data like Reddit is reliable and meaningful?
Jane Seymour: That’s a fabulous question. Um, I think that in qualitative data, you know, the aim is not to be generalizable. The aim is to understand the experiences of those people for whom data exists. Um, you know, unfortunately, this is, I have not worked, some of my colleagues at CORE have worked with Reddit. Um, I have not worked directly, worked with Reddit data, but know that there’s quite a literature, which Alison you’ve referenced here. And Alison, forgive me, I’m not sure if you’ve worked with Reddit data, so please feel free to chime in if you have, or anyone else on the panel.
But I think that that Reddit data is a source of data that we can use to understand the experiences of some people who are searching for abortion, have had abortion, or have been denied abortion. And it’s never going to give us the full picture of the experience of everyone, but I want to be really clear that a lot of our quantitative research also doesn’t do that. So these are all important pieces to a larger puzzle that we can put together when we work effectively together to, to gather high-quality, rigorous data.
Beth Jarosz: Thank you. So I want to thank you again for sharing your expertise and your time with us today.
April 2002
Michael R. Fischbach
(April 2002) The West Bank and Gaza are unique entities in today’s world. Parts of the two areas consist of a series of autonomous, Palestinian-governed regions. The West Bank, approximately the size of Delaware, is bordered by Israel to the west and Jordan to the east. Gaza (also called the Gaza Strip) is approximately twice the size of Washington, DC, and shares a border with Israel to the north and east and Egypt to the south.
Britain ruled the area it called Palestine after World War I under a mandate from the League of Nations. Following Britain’s withdrawal in 1948, war broke out between Palestine’s Arab majority and Jewish minority for control of the territory, the former eventually supported by troops from surrounding Arab states. Jewish forces won, and the State of Israel was created from 77 percent of Palestine. Jordan and Egypt took control of the remaining 23 percent. Jordan annexed the area under its control and called it the West Bank; Egypt maintained control over what became known as Gaza but never annexed it. Israel seized both areas during the 1967 Arab-Israeli war, and later annexed East Jerusalem while keeping the bulk of the West Bank and Gaza under occupation. Israel also drew international criticism by erecting more than 180 Jewish settlements in the areas.
As part of the peace process between Israel and the Palestine Liberation Organization (PLO), the two sides signed a series of agreements beginning in 1993 that provided for a limited withdrawal of Israeli forces from parts of the West Bank and Gaza and the establishment of an autonomous, PLO-run government in areas inhabited by Palestinians. The Palestinian Authority (PA) began functioning in 1994.
The two sides deferred negotiations over “final status issues” to a later date. Among these issues were whether the Palestinian-governed regions of the West Bank and Gaza would become an independent state and what its borders would be. The result is that the autonomous Palestinian areas remain locked in an unviable, semi-statal condition. Following the staged Israeli withdrawal, the PA exercises full civil and security control over 80 percent of Gaza. The remainder contains Jewish settlements and is still under Israeli control.
The situation in the West Bank is much more complicated. The Israeli-Palestinian agreements created three zones: Area A consists of territory under the full civil and security control of the PA; Area B is territory under the PA’s civil and partial security control, but Israeli forces exercise predominant control; and Area C remains under full Israeli control and contains the Israeli settlements. By 2000, 17 percent of the West Bank was classified as Area A, 29 percent as Area B, and 59 percent as Area C. Much of the area where the PA exercises some type of control does not form a contiguous territory, however. Gaza is separated from the West Bank, while in the West Bank, Areas A and B are themselves divided among 227 separate areas (199 of which are smaller than 2 square kilometers) that are separated from one another by Israeli-controlled Area C. All but 40,000 West Bank Palestinians live in Areas A and B.
The population of the West Bank and Gaza is almost completely Palestinian Arab. The bulk of these are Sunni Muslims: 92 percent of West Bankers and 99 percent of Gazans, with the rest Christians. In addition to the Palestinian population, approximately 214,000 Jewish settlers live in the West Bank and Gaza, according to the Foundation for Middle East Peace in Washington, DC [Data are from 2002.]
West Bank | Gaza | |
---|---|---|
Population (2000 estimates) | 2.0 million | 1.1 million |
Births per 1,000 population* | 37 | 43 |
Deaths per 1,000 population* | 4 | 4 |
Infant deaths per 1,000 live births* | 22 | 26 |
Rate of natural increase* | 3.2% | 3.9% |
Total fertility rate* | 5.0 | 6.6 |
Life expectancy at birth* | 72 years | 71 years |
Capital | The Palestinians claim Jerusalem as their capital, although they do not exercise authority over the city. Ramallah and Gaza City serve as the de facto capitals of the West Bank and Gaza, respectively. |
* Palestinian population only.
Source: US Census Bureau.
The population of the West Bank and Gaza boasts several notable features. The population growth rate is among the highest in the world: 3.4 percent in the West Bank and 4.0 percent in Gaza, according to US Census Bureau estimates. A full 45 percent of the West Bank population are children under 15 years of age, compared with 50 percent in Gaza. Palestinian-controlled Gaza is also one of the most densely populated places on earth with some 4,091 people per square kilometer. Regionally, the Palestinians exhibit high levels of literacy. Among those 15 years and older, the rate is 92 percent for males and 80 percent for females, according to the Palestinian Central Bureau of Statistics. About 825,000 Gazans (78 percent of total) and their descendants are registered refugees from the 1948 war as are 583,000 West Bankers (30 percent of total). Not all refugees reside in refugee camps: 55 percent of Gaza refugees live in 8 refugee camps while only 27 percent of West Bank refugees live in 19 camps.
Life expectancy at birth is relatively high compared with Arab countries. But the territory faces several significant health concerns relating to underdevelopment, the legacy of occupation, and ongoing political turbulence and violence. The Palestinian uprising since October 2000 itself includes a major health problem. Between October 2000 and late February 2002, more than 1,000 Palestinians were killed and over 17,000 injured in clashes with Israelis. Israeli forces have reentered parts of Areas A and B, prevented movement among many Palestinian areas, and laid siege to Palestinian towns. The escalation in tensions between the two sides has resulted in reduced access to health and medical facilities for some Palestinians.
Some economic indicators actually declined during the early years of the peace process and have recently worsened. During 1992-1996, real per capita gross domestic product for Palestinians declined by over 36 percent, because of the combined effects of falling aggregate incomes and high population growth, according to Palestinian Chambers of Commerce, Industry, and Agriculture. The poverty rate in September 2000 stood at 21 percent. During the first three months of the uprising that began in October 2000, the situation worsened as the Palestinian economy contracted by 50 percent and unemployment rose to 40 percent. The Jordan Investment Trust estimates that the economy suffered a total of US$6.8 billion in losses during the first 12 months of the uprising.
Pollution is an environmental and health risk. Of particular concern is groundwater pollution by organic and inorganic contaminants that seep into the aquifers, especially in Gaza. These include untreated sewage (only 38 percent of households are connected to sewage systems), garbage and industrial waste, and fertilizers from agricultural runoff. The West Bank and Gaza also face problems from dumps, including Israeli dumps over which Palestinians have no control.
Michael R. Fischbach is an associate professor of history at Randolph-Macon College in Ashland, Virginia, where he specializes in modern Middle Eastern history.
March 21, 2024
Have you ever wondered how to get your research into the hands of policymakers, or wished your findings were known by a wider audience? PRB and the Association of Population Centers (APC) organized a webinar to highlight ways to expand the reach of your research by distilling your findings into messages and formats tailored for non-technical audiences, including policymakers and the media. Panelists from Syracuse University and PRB describe how to write an effective research brief, common pitfalls in writing for non-technical audiences, and using social media to communicate about your research.
Date: March 7, 2024, 2:00-3:00 p.m. ET
Moderator: Diana Elliott, Vice President, U.S. Programs, PRB
Panelists:
Support for this event was provided by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
Diana Elliott, moderator: Hi everyone. Thank you for joining. Welcome to today’s today’s webinar on writing about population research for non-scientists. I’m Diana Elliott, Vice President of U.S. Programs. Though this webinar was organized by the Population Reference Bureau and the Association of Population Centers, with funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
I’m pleased to introduce four speakers to today’s event. Shannon Monette is the Lerner Chair in Public Health Promotion and Population Health at Syracuse University, and we’ll cover some of the benefits of writing research briefs and examples of impact at the Lerner Center. Following Shannon, we’ll have Beth Jarosz, Senior Program Director; Paul Scommegna, Senior Writer; and Mark Mather, Associate Vice President, all in the U.S. Programs department at PRB. And we’ll be providing some additional guidance for writing briefs and bridging the research and policy gap.
We’re going to save the Q&A till the end, and we encourage people to use the raise-hand feature in Zoom and to unmute yourself to ask questions. So for those of you who aren’t familiar with where this is in zoom, if you go to reactions at the bottom of the screen, you’ll see that there’s a raise hand feature under that reactions tab. The webinar is also being recorded and will send you a link to the recording and the slides in a few days. Closed captions are also available. Participants can turn on captions by selecting the Show Captions option from the Zoom control bar. Now I’ll turn it over to Shannon.
Shannon Monette: Thank you, Diana. Welcome, everybody. I’m looking forward to the conversation that we’re going to have today about writing population research for non-scientists, in addition to being Lerner Chair at Syracuse University. As Diana mentioned, I’m also the director of the Center for Policy Research here and a professor in the sociology department. And we have two brief series, one through the Learner Center and one through the Center for Policy Research. And they’ve both been quite successful. So what I’m going to do is, um, provide a motivation for writing briefs. Presumably you all think that it’s important and that’s why you’re here. But I’m going to give you a few reasons why I think that, um, writing policy and research briefs can be really exciting. Uh, I’ll talk a little bit about the purposes of and audiences for these briefs. I’m going to provide a couple of overarching tips about structure. In a couple of examples. Uh, Paola will cover more detail later about some tips for writing effective briefs. And then I’ll finish up by sharing some examples of how some of our briefs have resulted in broader attention, uh, or impact that that’s been really exciting.
Uh, so first, why might we want to disseminate our research to nonacademic audiences or non-scientists? Well, one reason is that it’s just super fun. Um, I think it’s way more fun than writing academic papers or presenting academic talks, because you can be more free in your language and your style. You can be provocative. Um, it provides the opportunity to meet different kinds of people that you might not otherwise meet and interact with. Another good reason is to help break down barriers between academics, between scientists, and between the public, and show people outside of academia that what we do can be relevant and is relevant to their lives. Um, it’s also an opportunity to show the public that we’re people to into to help build trust, which is particularly important during an era where there’s declining trust in academics and experts. Another reason is that your dean, your department chair, your research center director, your parent, your partners can use it to show off your work. Um, provost and deans love this kind of stuff because it’s really easy for them to share with donors. Um, and rather than an academic article which can be 40 pages or even longer if you consider the supplementary materials, these short 2 to 3 page briefs or something that you know the dean can share with alumni or with their advisory board members, your parents might read these things too, like mom probably isn’t going to share your academic article with their friends, but she might post your brief on Facebook. Another reason is that it’s a way to get really timely findings out more quickly than an academic journal, you know? We all know it can take forever for academic articles to come out. Sometimes we’re working on time pressing issues, and we want people to know what’s happening right now, so it’s a really good outlet for that.
Um, briefs can also get you research into the hands of unexpected audiences. It can launch unexpected opportunities. I’ll talk about some of our successes and those unexpected opportunities at the end of my presentation here. Um, and of course, these things can generate a lot of impact. They may… They may actually be your best shot at someone paying attention to and using the hard work that you’ve done. Um, academic articles are behind a paywall. They’re long, they’re dense, they’re difficult to get through. But briefs and things like op eds even get to main points quickly so they can have a lot of impact.
Uh, and so in terms of like, what are the purposes of research briefs or policy briefs and who are the audiences? Well, the purpose of briefs are to translate your findings and disseminate your findings in publicly accessible and easily digestible formats, toward some purpose, towards some action. So that purpose or that action might be to enhance knowledge or raise awareness. It could be that you want to change hearts and minds about some topic. It could be you actually want to change behaviors or practices. Um, or it could be that you want to influence policy debates. Um, the audience for these are varied. I think it’s, it’s somewhat important going into the writing that you have a target audience in mind. So your target audience may be policymakers at the national level, the state level, the local level. Um, your audience may be practitioners. If you’re writing about health care, for example, um, your audience may be reporters. A lot of faculty actually use these briefs for their undergraduate classes. So the audience may be students and the audience might also just be the general public.
Um, what I like to tell our authors when they’re writing briefs is, would your uncle Bob understand what you’re writing here, what you’re saying here? Um, so in terms of writing style, these audiences are important to keep in mind. Just a few words about brief structure. Paola is going to discuss a suggested approach for writing briefs for PRB and a checklist of things that they consider at PRB, but I thought I’d quickly provide some suggestions for how you might think about structuring a brief. And here I’ve just provided an example of our brief template that we use at the Syracuse University Center for Policy Research. Generally, policy briefs or research briefs, um, summarize 1 or 2 main findings or big picture takeaways. They’re not bogged down with a lot of detail or nuance. Is this 1 or 2 big things that you want your audience to know? They’re usually 2 to 4 pages. Sometimes they’re one page. They’re definitely not 20 pages. Briefs are, as they’re called, very brief. Um, they should provide a short intro of the problem and why your reader should care about this problem. Our briefs, we have the authors provide 1 or 2 main research findings, include visualizations if possible. Pictures are worth a lot. And also our briefs include implications for policy. And I know that that PR, er, PRB’s briefs do as well. Now, what you don’t see here is theory, a lit review, or a lengthy data or methods section for our briefs. We do include a very short data and methods section at the very end. Um, they’re very short, and we just sort of just describe what the data set is, the, the years that are represented, the sample size, and maybe a couple of sentences about variables. But then we direct the reader to a published journal article, if there’s one that exists from which the brief is, is summarizing findings.
So just show you a couple of examples from brief series here at SU. So, this first one is a brief that was led by my colleague here, Jennifer Karras Montes. You can see it’s just three pages. It provides a nice snappy title: Democratic erosion predicts rising deaths from drug poisoning and infectious disease. So, it gives the main takeaway right there in the title. It includes a couple of key findings so that if someone only read those key findings, they would know right away, uh, everything they need to know about that. The takeaways of this brief, you’ll see there’s a short introduction about the problem. Um, there are a couple of really easily understandable figures in here. And then at the very end, there is a section about what should be done about this problem. What are the policy implications? And in this section, we ask our authors to be concrete to identify the actors. Um, they’re not the place where you advocate for future research. They’re the place where you advocate for changes, for policy or practice. And I think you can be provocative here. Um, it’s okay that you didn’t study a specific policy. You’re the expert. You can speak to what you think the implications are of what you found.
Here’s just another quick example. This one is from our Center for Policy Research brief series. Again, similar sort of format. We have a snappy title, key findings, um, an easily understandable figure, a couple of sections with a little bit of information about the findings and then, um, what the policy implications are here. And so again, just notice the title and notice the headings. They provide statements about the key takeaways and the conclusions. I wanted to just quickly give you a couple of examples, um, of the difference between academic writing and public language. Okay. So, the way that we’re trained to write for journal articles is academics is not the way that we want to write for public audiences. In fact, I would actually say that I would prefer the writing for public audiences, even for academic journal articles. But, um, people might fight me on that. So, the academic text here is on the left, the public brief text is on the right. And this is from an article that, uh, coauthored with some colleagues here at SU. And you can see this lengthy academic text, um, we’re using technical language in it, things like controlling for confounders, estimated models, um, county and state level data, just all kinds of technical information that a public audience may not understand or care about. Compare that to the short end text from the brief, and we’ve condensed all of that academic language into a very short sentence that says what this brief does in very clear and simple language. It’s much shorter, it’s much simpler, and it still delivers the intent of the research. We also present visually results differently in academic publications versus briefs. So this is just an example of how we converted a complicated technical table of our findings into a simpler figure that tells the exact same story. The table, you’ll notice, uses terms like counterfactual and IMR, which is the infant mortality rate. The figure just shows different minimum wage levels and number of infant lives saved at each different level of minimum wage, so it provides the same information but in a simpler format.
This is a similar example from a paper in a brief written by Andrew London. Another one of my colleagues here at SU. And this table shows a lot of numbers with various symbols. This is from his academic paper. There are odds ratios in here. There are confidence intervals and p values. Um, which is great. This is what we want for academic papers and this is what reviewers demand. But for the brief, the bar chart shows simple probabilities of the outcome. Much easier for a policymaker or reporter or for your Uncle Bob to understand and digest.
So I’ll finish up just by talking about some successes that we’ve experienced from our from our brief series. We’ve had lots of media attention from places like NPR and CBS News and New York Times and in many other outlets. Um, we’ve gotten attention from the public. So random readers will write in to our authors to thank them for writing the brief. We get a lot more of those than we get, like, the nasty emails. Those happen once in a while, too, depending on the topic and how controversial it is. But we get a lot more just random, you know, my daughter experiences this thing. Or thank you so much for writing about this. Or like, what do you think about what’s going on with this thing? And in my city, um, we’ve also had attention from policymakers. So one of our, our graduate students here in the Lerner Center, for example, wrote a brief a couple of summers ago that that ended up being shared with a staffer for a New York state senator here. Uh, and from that, our student was invited to testify at a New York State Senate subcommittee hearing on aging, which was really exciting for her. Of course, um, one of our Center affiliates has been asked to participate in congressional briefings and give Senate testimony as a result of her briefs on veteran food insecurity. And you never know when, when this kind of thing might happen. It doesn’t happen with all briefs, but I think it’s more likely to happen with briefs than with, with academic articles, because they’re so accessible and easily digestible and people can read them in a couple of minutes there.
Um, there are also unexpected invitations and benefits that come from, from writing briefs. And I’ll just give you an example from my own experience, one of the very first briefs I ever wrote was for the Carsey School of Public Policy at University of New Hampshire, and it was on rural urban differences and adolescent opioid misuse. Now, that brief was based on a peer reviewed, published journal article. So I had the article published, and then one of my colleagues, Ken Johnson at Carsey School, said, you know, why don’t you turn this into a brief? He, he had done a lot of these and had a lot of success. So I wrote this brief. They published it through the Carsey School. And then that led to an invitation to attend a conference at the United Nations Office on Drugs and Crime in Vienna, Austria. Like, these people paid for me to fly to Vienna to give a presentation on this, this topic that I was doing research on, not because they found my academic journal article even though it existed, but because they found my brief. Um, so it was, you know, a really exciting opportunity this, you know, working class kid from rural upstate New York gets to go to Vienna, Austria, which was super cool. And I’ve had similar experiences from other briefs. So I wrote a brief while it was at Penn State on, uh, deaths of despair and support for Trump in the 2016 presidential election. And that led to a lot of media attention. But it also led to, um, this research director from this organization called the Institute for New Economic Thinking calling me up and saying, we want to give you some grant money to study this topic more. It’s, like, unheard of. It doesn’t happen. People don’t just call you and say, we want to give you money. But, but he did. And in addition to, you know, that that grant that I got to conduct more research on that topic, that organization also paid for me to, um, to go to Trento, Italy, and to Edinburgh, Scotland, to give presentations on this topic.
So again, you never know when these things are going to happen. Um, it depends a lot on the topic. It depends on who sees your brief. But I think that these types of opportunities on anticipated benefits are more likely to happen when you’re writing in a style that’s accessible for people outside of academia. So I’ll just leave you here with a couple of examples of other media coverage from some of our Lerner Center briefs, and I’ll go ahead and turn this over to Beth. Thank you.
Beth Jarosz: Thank you. Take me a minute to switch sharing screen. And we did this into our run. So, if you can’t see my slides, please let me know. I’ll assume silence means it’s okay. Um, and Shannon described there being a barrier between research and sort of the wider public, whether it’s policymakers or the public or journalists, and I’m going to describe it as a gap. But, essentially, we’re talking about the same problem. And I think I wanted to start with, um, you know, a focus on public policy specifically because most of my career has been in informing elected officials and policymakers about data so that they can make good decisions.
So I’m going to focus a little bit on that policy piece. And when I say public policy, I mean a set of actions, plans, laws, behaviors that are adopted by a government and that can be enacted through things like agency guidance or court decisions, executive orders, funding priorities, policy documents, laws, legislation, rules, regulations and so on. So that’s the angle I’m going to take. In talking about that, the really good news is that evidence can matter. Um, and as Sutcliffe said in 2005, the bad news is that often it does not. Um, and so let’s talk about some of the reasons why that gap exists.
Um, there is a deep communication gap. And I think a piece of it is different languages and different skill sets. And I’ll talk about that. But part is also that stereotypes are part of the problem. Um, so before I go on to the next slide, I want to ask each of you to take a moment and picture a policymaker. Think about the words or the phrases or the sort of emotions that come to mind when you think of someone who’s in elected office. And, and when we have asked this in the past, um, we get things like that they have very limited perspective, that they distrust research. Or if people are feeling less generous, that policymakers don’t understand research and that they are the ones who are responsible for digging up evidence and data to inform their policymaking, that their actions aren’t evidence based, and all of these have the sort of undercurrent of that policymakers are partisan. Um, which may be true in some cases, but in my career, I’ve worked with a lot of elected officials. And even when we don’t necessarily agree on policy or policy ways of achieving things, um, I think that there is a lot more, uh, appetite for having evidence informed public policy than I think sometimes they get credit for. And of course, policymakers may have stereotypes about researchers. Things like excessive use of technical jargon, um, researchers and journal articles, in particular, being very general and theoretical rather than the sort of real world or real problems that policymakers are dealing with day to day. I use if you can’t see, I use real problems, in sort of air quotes, but that that is seen as a gap between the two worlds and that researchers tend to avoid policy. I know those of us who are in the research world, um, we don’t want to assume causality when we’re when we’re looking at data where there’s a correlation. Um, and so therefore there can be an interest in shying away from policy implications when what reason, what policymakers need are those policy implications or implementations. And sort of the summary in one word of that, of that series of stereotypes is sort of the tower piece.
And all of that said, it is possible to bridge the gap between researchers and policymakers. And I’ve got a couple of practical examples of how to do that. Um, longer term and sort of fodder, perhaps, for a different workshop is thinking about that research uptake and engaging policymakers up front. Um, but what we’re going to do today, just in the interest of time, is focus on that third piece about communicating strategically. And if you take nothing else away from what I say today, I would say: assume competence, but not expertise. So assume that the person who’s going to be reading it is smart, but that they’re not using the same terminology. They don’t have the same depth of knowledge about the theory. And what their goal is, is to be educated in order to make good policy decisions.
So how do we do that? A couple of a couple of tips are to use clear and concise language and avoid jargon. Um, and what I’m going to, uh, offer to all of you is an activity. I know we’re going to take Q&A at the end, but if in the chat you could type some jargony terms that you use. Maybe there’s a term that’s very specific to your research. And those of us who are here can start to give you alternatives, but we can be your sort of live thesaurus. So if you have a term like etiology, um, maybe we would respond with the cause of disease and use that phrase instead. Um, if you regularly use a phrase like externalizing behavior, um, it could be aggressive, impulsive, or antisocial behavior. Replace it with, um, so thinking sort of about the jargon that we use can be challenging, um, but one of the tips here is write what you would write academically and then go back and, try and go back and use a thesaurus and sort of work those words back out again so that your work is more accessible to a policy audience, like, so, um, Go ahead and type those. If there’s a key, a term, a jargony term that you use that’s really important to your work, type that into the chat. And Mark, Paula, Diana, and maybe Shannon can live give you examples of what you could replace that with. A couple of, a couple of suggestions coming into the chat. So, I will let people keep working on that and move on to the next sort of two, uh, tips for work for bridging that research to policy gap. And it speaks directly to issues that policymakers care about and provide information that allows them to feel confident taking action. I’ve grouped these two together, um, because, you know, we, we as researchers might think there’s a really compelling arc about sort of the, the life-saving implications of an investment or the, the sort of social, emotional well-being of a particular marginalized group is the most important thing. But you need to know your audience. And so if, if you’re talking to a set of policymakers who, what they’re going to care about most is the budget implications of something or the fiscal impact or whether or not it brings jobs to their community, it is okay to make that the primary selling point when you’re making your policy case. It’s not pandering. It’s not disingenuous. It’s meeting a person where they are with the issue they care about.
You can and think, think about one of the more polarized issues, you know, uh, diversity, equity and inclusion. I think most of the people on this call probably care very deeply about that. But if you start out with that in a talk with someone who has been sort of socialized to resist, that they might not hear anything else that you’re going to say. So maybe start talking about, more generally, human interest, maybe talk about fiscal impact, and then you can sort of lead into those other issues, um, that might have been more sensitive before you built on that report. Just, and in terms of providing information that helps them feel confident taking action, give them data that they know the sample size is big enough. You know you’re not going to put a whole literature review in there, but you can signal things like a wide body of research also finds that this policy matters, um, you know, or study after study shows that if you do X, Y will happen. Um, you don’t have to do a full lit review to signal that they can feel confident that if they take this policy action, there’s going to be an outcome at the end that they expect.
And then, last but not least, um, propose with that solution is, and Shannon alluded to this when she did her overview. What is that concrete action step that they can take? Is it expanding a program? Is it making a budgetary change? Is it funding, um, additional health care services? Make it clear what the ask is in your writing and what the outcome is going. And so with that, I am going to turn it over to Paola to give you some specifics about how to write a brief working in those cases that I’ve talked about in terms of adding some more.
Paola Scommegna: Thanks, Beth. What I’m going to do is share some very specific techniques, um, that we use at PRB so you can recognize them and really understand the reading, the reasons behind them. And the first thing I want to share is it’s crucial to understand the, the differences between academic and journalistic writing. Academic writing, um, builds to a conclusion, starts with background, findings, and the conclusion is at the end. Next slide. But journalistic writing turns that format on its head. It’s called the inverted pyramid, and the most important information is shared first. Generally, that’s the conclusion. And then additional evidence and background comes later. And this format is used in newspapers, but also in writing for the web and policy memos. And this is what people are very used to reading. So as you begin writing for non-scientists and are aiming to communicate in a non-technical way, I would almost I would encourage you to go sit in a different desk or have a picture of your audience there so that you can think of this totally different way of communicating. And next slide. Oops.
Beth Jarosz: But I apologize. I have no idea what just happened to my computer.
Paola Scommegna: All right, well, the next one is, is on, um, writing headlines, and, um, let’s see if we can get to it. There. There we go. Okay, so these are some tips on writing headlines. It’s the first thing that you’ll do, and what we suggest is you state the main finding clearly like a newspaper headline. You may describe the action needed. You may aim for about 20 words, and it must have a verb. So, next slide, will give you some examples. And, and these examples are from recent population research. And what I’ve done is I’ve highlighted some of the verbs in red.
So you can see that these have verbs, and there’s action here. The first one: U.S. Teenage Births Hit Record Lows and Could Drop Further if Contraceptives Were More Accessible. It outlines the findings of the research, and it also implies the implications of the research. The next one was on, um, describes a natural experiment: When High Schools Moved Start Times to After 8:30 a.m., Attendance and Test Scores Rose. Um. I, very. The main message is right there. The third one is, um, looks at some pilot studies or small-scale research on, um, and the finding is: Taxes and Health Warning Labels on Sugary Beverages May Help Limit Consumption and Improve Health.
Um, next slide. And so the next thing we suggest is you begin writing with a summary of the main message. Now, Shannon shared how you can break that into three bullet points. Um, and, and, and that works quite well. And what we suggest is try to get it in the first paragraph. Um, clearly state the main problem or issue. Summarize your main research findings. Name the implications for policymakers and these three things together. Answer what we call with each other the “so what?” question. Why should people care about your research? Why should they be interested in what you found?
Um, next slide. So, this is some research out of Penn State that does that in the first two sentences. Um, the main finding of the research is the first section. The first sentence, Children in households that receive federal rental assistance are healthier and miss less school due to illness than those whose households are waiting for help. The research is summarized there. The second sentence, however: Up to 75% of renters who need federal housing assistance, including public housing or rental vouchers, don’t receive it. So the problem, the issue, the why people should care, is right there in the second sentence.
Next slide. So, here are some style tips to keep in mind. We talked about jargon with Beth, that, be conversational, and one way to do that is once you’ve written something, is to read it out loud and make sure it sounds like how you speak. The second thing is to define acronyms and technical terms. For example, if you write on the EitC, you need to say “earned income tax credit,” and then in, include a few words to explain what that is: lower, middle and lower income workers tax bills. Um, and that’s certainly how you would talk with someone who isn’t familiar with the acronyms that you use often.
Third, um, write in first person. I. I did this. We investigated this. And that will help you use active voice rather than passive voice. So, you would say, “we surveyed a representative sample,” rather than “a representative sample was surveyed.” And the reason we’re so fussy about passive voice is that it’s not conversational. It takes all the action out and the actor is unclear. And so it’s something we strive to avoid in the, the things we publish.
Finally, insert citations as numbered end notes. You saw that in the pieces Shannon shared with you, and you’ll see it in the pieces on the PRB website as well.
Next slide. Um, subheads. What are they, and why use them? Um, they’re descriptive phrases with a verb, and they’re really important. They break up the text. Highlight the main points for a reader who’s skimming, and research shows that many of us are skimming, particularly when we’re reading online. It. They reinforce the main message and they provide signposting. They signal to the reader what to expect in the text in the following section.
So, next slide. So what I did here was I pulled some subheads out of a brief so you could see them separate from the text that follows them, and can see how they summarize the main messages. Um, and this piece was on parental incarceration and its impacts. Parental Incarceration Is Widespread and Taking a Severe Toll on Children’s Lives. When a Parent Is Incarcerated, Children Are More Likely to Develop Behavior Problems, Face Homelessness, and Experience Harsh Parenting. Those are the research findings, in brief. The third subhead, um, points toward the action. The policy implications: Screen Students for Parental Incarceration, Rethink Sentencing Policies. So, it’s a succinct way to communicate your, your findings and, and the main message of a piece and keep the reader going through your piece, even if they have a tendency to skim. Um.
Next slide. And now, um, finally, I have some advice on data and graphics from PB. We find that bar charts and maps are much better than tables. We aim for no more than 8 to 10 data points. The title should be non-technical and have a verb like a headline. Xs and Y axes is clearly labeled. Use whole numbers if possible. And next is a sample of a PRB figure in PRB style. And the first thing I want you to see is that the, the main title is in more conversational, less technical style. Female, White, and Highly Educated Older Adults Were Most Likely to Feel Lonelier During the Pandemic. But below it, we include a much more technically accurate description for people who might want to know more specific things. So that is there, too. Um, the, um, numbers are whole numbers. The axes are labeled. And look what we’ve done here with the colors. They are designed to help you, uh, help a reader look at what we want them to focus on. So the first two bars are age, the second two in another color or gender. The third are, um, race/ethnicity, and the fourth are related to education. So, the colors work to focus the communication as well. So, I’ll stop here and pass it over to Mark.
Mark Mather: Right. Thank you, Paola. I wanted to end just by talking a little bit about how PRB can help, what we’re, what we’re trying to do to, um, help you write your own research briefs. And so the last thing I wanted to mention in this, uh, in today’s presentation is that we have a, a new research brief series with the Association of Population Centers where we’re helping researchers. Uh, well, there’s two different options. Uh, one is that you draft a research brief, and we can assist at PRB with editing and production of that brief. Or if you prefer, we can draft a brief, a research brief on your behalf. The, um, we’re aiming for, for about a thousand words for these briefs, which is pretty typical. Uh, we try to include some simple interactive charts, and we’ll publish these, uh, materials on previous websites and share them through social media. And Lillian, you can see, just put in a link in the chat here. So this is where you can find a sample template that’s available. It shows you, uh, the basic structure for one of these briefs and as well as provide an example. And then there’s also a short online form that you can fill out if you would like to have assistance. Lillian, just put that in the chat as well. If you don’t want to fill out the form, you don’t have to. You can just send us an email and we’ll be sure to respond to you. Um, there’s no cost to you for this work. The only requirement is that the topic really needs to be related to demography and/or reproductive health and population health topics.
So, in the next slide, I just wanted to provide a list of some of the new and forthcoming research briefs that we have at PRB. The first three are currently available on our website, whereas the other, I guess five of them, are currently in production. So those have been drafted and they’re in the process of being copyedited. And just so you know, it does take a little bit of time to produce these. There’s a, you know, we want to make sure we get the data right. So there’s a fair amount of back and forth with the researcher. And then it goes to our communications team for copyediting. So, the whole process can take, um, sometimes 5 or 6 weeks, sometimes a little bit longer than that depending on people’s schedules. And you can see that these briefs are on a wide range of topics. Um, we’ve got briefs on, recent briefs on marriage, child care, coastal hazards, and gender norms.
And then I thought I’d end the next slide. Just, um. I think there’s one slide before this one. Beth. There is not. So yeah, you can just go to the next slide. But I don’t know what happened to this, the intervening slide. But, um, I thought I’d end with this because, um, this is an example where PRB wrote a research brief and, um, it ended up being picked up for a maternal mortality awareness campaign last year. And it’s, it’s, so it started with a research brief that Paola had written, and we’re really proud of this one, because it took a lot of work to, um, to work with the advocates who were organizing this campaign. There was a lot of back and forth to make sure that they were representing the NICHD-funded research. So we wanted to make sure that everything was, was accurate. Um, and, you know, not everything that we publish gets a lot of attention. But if you keep working at this, you’ll find that, um, you can have an impact. And again, um, Lillian has just shared the link to this, uh, this brief and the related materials on our website, and I think I will stop there, and we can open it up for questions.
Diana Elliott, moderator: Right. Um, so. Just to remember, as part of the Q&A, um, we’re going to ask people to use the raise hand feature and then to jump in and ask their questions when they have them. Um, raise hand feature is at the bottom as part of the reactions, um, tab at the bottom of Zoom. Um, but we have a couple of, of questions that have come in. Oh, great. Alex, Kaylee, I see your questions. I’m going to ask the ones in the chat, and then we’ll turn to Alex and then Kaylee for their questions. So, we had one question come in through the chat, which is, what is the optimal timing for composing and publishing a research brief to mitigate potential copyright issues with journal article publication. Anyone want to jump in and, and speak to that one?
Shannon Monnat: I can, um. I suppose because we publish these briefs all the time, we don’t have any problems with, with copyright, um, concerns. And this is because you’re not actually reproducing the journal article. You’re summarizing the findings from that paper, if you have one. Um, and you are not copying and pasting the figures, for example, from the article, you know, we’re reproducing the figures to be more inclined for a public audience anyway, it’s your work. So there’s no, there are no copyright infringement concerns in terms of the best timing. If these are briefs that you want to pair up with an academic journal article, and for example, you want to link the journal article into the brief which, which I would recommend, um, I would suggest drafting the brief after you’ve gotten a revise and resubmit on your paper, or it’s pretty clear that it’s going to be accepted. Maybe you’ve gotten a conditional acceptance to have it ready to go so that once the, you know, you’re sending the proofs back to the journal, um, you have this brief done, and all you’re really waiting for at that point is the link from the journal article that you can embed into the brief. But if for some reason you don’t do that, that’s not to say that you can’t publish a brief after the article is already out. Um, this happens a lot with our authors, where they have an article that’s come out, they decide they want to write a brief. It’s targeted to a different audience. So it’s not like you’re missing out on anything if you don’t have the brief done right away. That’s, that’s my $0.02 on that.
Diana Elliott, moderator: Thanks, Shannon. Um, I’ll jump to the next question, um, which is, what platforms have you been most successful with reaching different audiences?
Beth Jarosz: I can, I can probably take a first crack at that. And I think we all probably have different perspectives. Um. I have found two things to be particularly helpful. One is social media, I’m assuming this is social media platforms, um, X before it became a terrible place to be. It was very effective for communicating with journalists and sharing information out. Um, I also am in the, the sort of unique position of I regularly present work to elected officials because of some work I do here in California. So I’ve got, like, a very direct line here that I don’t think counts. Um, but LinkedIn, weirdly, can be a good place because you’ve got an audience that is, uh, sort of issue focused, can be a really good platform to share. Um, and outside of that, one-on-one communications, you know that nothing—I know we’re talking about writing for these audiences, but, but nothing really beats building a relationship with whether it’s a policymaker. And again, I kind of mentioned this in the beginning to think about how to engage policymakers early on. If what you really want to do is policy change, start building those relationships, personal relationships, early on. Same thing goes with journalists that nothing beats knowing the person on the other end of the email.
Diana Elliott, moderator: Anyone else want to chime in on that one?
Shannon Monnat: Our briefs are indexed in Google, and I presume yours are as well. And actually, most of our hits come from that, from people doing Google searches. So we, we, we post the briefs and all the outlets that Beth mentioned. And, you know, we’ll get hits on those once in a while. Um, but when you look at the, the download statistics, most of it is from people doing Google searches because those terms kind of pop up at the top. Um, so, you know, just making sure you’re publishing with a brief series that does index on Google is a good strategy.
Mark Mather: I’ll just add, it’s, it’s good to have some, it’s okay to publish these in PDF format. But um, if you do that, it’s also good to have the short blurb so that people can find it easily, so they don’t have to take that extra step of opening up a PDF. I mean, that’s what social media is all about to you want to get people to see it first, and then if they if you get their interest, then they might click to see the whole thing in a PDF format. But as a general rule, we do now publish all of our briefs in HTML format so that they’re easier to search and easier to find.
Diana Elliott, moderator: Right. I think I’ll switch to, uh, folks with their raised hands. Alex, do you want to chime in and ask your question?
Alex: Sure. Hi everyone, thanks for holding this webinar. It’s been great so far. My question is related to, I think the question was just answered, but I wanted to know basically like, you write a brief, how does it get into the hands of a journalist or, or one of these people? And I understand there’s these research series, but do you contact journalists as well? Obviously, like you use your social media presence, but are there any other tricks to kind of get it in front of people? Um, and, and yeah.
Diana Elliott, moderator: Paola, I wonder if you have some thoughts on this.
Paola Scommegna: Um, it really helps that they’re, um, indexed in Google so that when a journalist is writing on your topic and they do a search, they find you. But I also follow who’s writing about the things I’m writing about in, um, in the national media. And I will send them something, um, through the, the addresses they provide, say, the aging reporter at the New York Times. I, I do send them things. Yeah. Usually, I’ll compliment them on something they’ve written and then saying, you might be interested in this.
Beth Jarosz: So excellent strategy. The only thing I would add to that is that if there’s a particular writer who you really hope will take up the article, if you can send them an early draft before it’s live and they feel like they have an exclusive, they’re more likely to respond favorably.
Diana Elliott, moderator: Not always a guarantee that they will write, though, and sometimes that’s very disappointing. Um, but they’re also, they’ve got other competing demands or editors who have opinions as well. So, um. Anyone else want to chime in to that or should I switch to Kaylee? All right. Let me switch to Kaylee’s question. Kaylee, do you want to chime in? And I’m sorry if I’m not pronouncing your name correctly.
Kaylee: Nope. That was spot on. Um, thank you all for your presentations today. It’s been incredibly helpful. I’ve just been taking notes frantically. So, my question is, um, pretty demography specific, but one of the things that I would love to hear about your experiences with or best practices is in terms of, um, when you’re trying to express uncertainty with your results. So, I’m thinking about, in the case of, for example, like demographic forecasting, um, or modeling in that way where, you know, you might have a point estimate, but what you really want to convey is like, here’s the possible range of outcomes. Um, how do you ,how do you manage the, the balance between like being honest to what your results are actually telling you versus wanting to tell this compelling story?
Beth Jarosz: This is, I, this is what I do all the time. So a, a big piece of my work is, is doing forecasting work for regional governments in California and um. I would say, where I started my career, point estimates were the only thing that people wanted to talk about. And now, particularly in the post-COVID context, there’s an appetite and an interest for having uncertainty ranges. Um, and I have had no problem just being really clear about that. Like, here’s the point estimate we’re going to use. And then here’s how widely it might diverge at the end. And um, really appreciated and no challenges with, um, sort of understanding among that policy audience.
Diana Elliott, moderator: Shannon, do you have anything to add based on your experience?
Shannon Monnat: Um, there, there’s a sociologist who wrote a journal article a few years ago with the title that said “eff nuance.” And the point was like, you’re going to get your point across much more clearly if you provide, you know, like not all kinds of little ifs, ands, or buts about what you’re trying to present, but you just say it straight. Um, having said that, I agree with Beth that it’s perfectly reasonable to just provide a range to say, you know, like our estimates suggest this is going to be the number. But because this type of projection can be uncertain, the range might be between x and x. And just say it like that. But what I would avoid is, um, all kinds of details that are things like, well, under this conditions, this thing happens, but only for this group and only on like Mondays. Right. So, um, then you have way too much detail and nobody really knows what to do about it.
Beth Jarosz: Yes to all of that.
Diana Elliott, moderator: Do we have any other questions from the audience? I don’t see any other raised hands. Um, and there was another question that was asked, but I believe it was already answered through the course. Yeah. Winnie, would you like to go ahead and ask your question?
Winnie: Yes. Thank you. So I wanted to know, can I, can a policy brief be publicly based on someone else’s research and not necessarily my own?
Mark Mather: Wait, you’re talking about, um, summarizing someone else’s research in a brief.
Winnie: That’s right. So, uh, without necessarily being the first author or whatever, like, you just find an interesting research and then you want to turn it into a book.
Mark Mather: Yeah, absolutely. I think it’s, it’s good to, um, you know, the first thing you would do is probably just reach out to that person to let them know that you’re starting this process and because they will be important, uh, an important reviewer, we always send out our we we’re always writing briefs based on other people’s research. And, um, we send it out to them to make sure that we’re getting it right. And they like they also like to have, uh, they like to know when it, when it’s being published to so that, uh, in case somebody does come across that they’re not kind of taken by surprise when they get a call, um, that they, you know, a journalist just found this, this brief, and they want to talk to somebody about it.
Winnie: Great. Thank you.
Diana Elliott, moderator: Jan [German pronunciation]. It’s good to see you.
Jan: Good to see you, too. Thanks for the great presentations. Um, I was wondering if any of you had any, any experience with using a, AI to get a policy brief started, and if that is helpful.
Shannon Monnat: No, but that’s a great idea. I think I am. Part of me wonders. You know what I would spit back if you put in, you know, the abstract of a journal article and said, please simplify this using non-technical language. It might spit back something that could get you started. Um, and then once you’re started, it’s easier to, to proceed because it would probably identify what the most important parts of that abstract were for you. It’s worth giving it a shot.
Mark Mather: I agree. And there is one of our colleagues at PRB is using, I think it’s called a PDF or something, where you can upload a paper and ask it to pull out the key points. You can query AI for whatever you want to know about that paper. And I do think in some years’ time, you know, this business of writing my technical research briefs, we might be out of business when AI becomes much better at this. For the time being, I don’t think there, the, you know, I think that people can still tell the difference between one of Paola’s briefs and something that ChatGPT created, but who knows in ten years.
Diana Elliott, moderator: I still think there’s going to be a place for people, technical people, to review things. Well, I hold on to that, that hope for the future. Um, so, uh, I wonder if we have any other questions. Um. If not, I’d like to just sort of turn it back to the panel, and we’ve heard a few, I’d like to leave this on an uplifting note, right. We’ve heard a few, sort of tales, of success stories. I’m wondering if, if people want to chime in with some other success stories, to kind of inspire folks to write their first policy brief.
Beth Jarosz: You want that from the panelists? Or do you want anyone who’s participating to also share if they’re interested? Right, I think.
Diana Elliott, moderator: Yeah, I was thinking of the panelists, but yeah, we can absolutely open it up if if other people have success stories.
Beth Jarosz: Um, I would say in this sort of relates to the forecast question that was asked earlier. Uh, there, I wrote a brief about population decline, um, in the United States, that population growth has slowed dramatically in the wake of the pandemic, um, had been slowing leading up to that. And, you know, new Census Bureau projections show that we’re going to reach an inflection point at some point, certainly in the next several decades, if not in the next couple. So, I wrote a blog summarizing that, and a, a journalist from The Economist reached out and said, hey, I saw this blog you wrote. Would you be willing to talk about population change? So, it’s that, um, not every article you write, not every blog, not every policy brief, not every research brief is going to get picked up, but it’s having that sort of base of articles that are out there that gets you into the universe of the journalists that might be interested or the policymakers going to be interested. And then that builds. Now that journalist knows that, you know, I’m a resource for issues about population change and, and may come back to that again, you know, a year from.
Diana Elliott, moderator: And you developed a budding relationship with that journalist too, which is also really helpful. So, when Beth has something new out, she’ll send it to that journalist. And, and it helps. Um, Shannon, you had some great success stories. Not many people get to travel to such fabulous places because of their research. Um, I’m wondering if you have anything else to share on that front.
Shannon Monnat: This is the reason I keep writing briefs. I’m like, who’s going to send me on a trip next? Oh, it’s, uh, it’s so random, you know, like, I, I, um, I probably shouldn’t say it’s the reason I keep writing briefs. Because you shouldn’t write the briefs to get this kind of attention, because most often it doesn’t happen that way. So this idea that you’re building up this portfolio, that you become the go to person on this topic, that’s more likely to happen if your research is out there in the public, easily findable, not behind a paywall. When a reporter is looking for someone who’s an expert on X, you know, population projections for Beth or, you know, rural mortality. And in my case, they’re going to be more likely to find me through a brief than through a, through a journal article. And then these kinds of things happen, which can be exciting. And then you have to start saying no to things.
Mark Mather: I was just going to quickly use Paola again as an example because she, she drafted an article, I think it was 2019, Paola, the one on measuring longevity. So it’s pre-COVID, and it’s just an example of uh, if you, if you just keep producing these things, some of them will become very, uh, widely used. So when COVID, uh, happened the following year, that article started to get a ton of attention and ended up with several hundred thousand views in the first six months of 2020. So, um, so sometimes you might not get attention when you write the brief, but when certain current event, uh, policy, you know, issue comes around, it will start to get attention.
Paola Scommegna: And Mark, I was thinking of something you worked on a related to the burden renters feel or experience, and you gave data for every state, I think. And the governor of New York kept mentioning it, it just keeps turning up. Um, so there’s something you did a while back that’s driving policy.
Diana Elliott, moderator: Right. Um, hopefully that gives a little bit of inspiration for everyone on the call to ,to write, um, a policy brief, whether using AI or not. We support this completely. Um, and we can’t wait to read your briefs or to help you out with that, as Mark referenced before. So, just a reminder that this webinar has been recorded and there are slides and that link for the recording will be sent out afterwards. And I want to just thank everyone who participated who chimed in. Special thanks to Mark, Shannon, Beth, and Paola, um, for their terrific presentations and we look forward to being in touch.
This how-to guide documents Uganda’s approach to developing and testing a self-care guideline, and illuminates a five-phase process that may be helpful for other countries looking to nationalize the WHO guideline. / Ce guide pratique documente l'approche de l'Ouganda pour développer et tester la mise en œuvre de directive pour l'autosoin et illustre un processus en cinq phases qui pourrait être utile pour d'autres pays souhaitant adopter les recommandations de l'OMS.
PROPEL Health
In 2020, Uganda began the process of developing a national self-care guideline for sexual and reproductive health and rights. The guideline was based on the World Health Organization (WHO)’s guideline on self-care, released in June 2019 and revised in 2022.
Uganda’s process to develop and test this guideline, led by the Ministry of Health, an expert panel, and a national consultant from Samasha Medical Foundation, was effective in creating a policy tailored to the Ugandan context. The innovative approach also included pilot testing the draft guideline at the subnational level to inform revisions before national launch and scale-up.
Under USAID’s PROPEL Health project, PRB partnered with Samasha Medical Foundation to create a how-to guide based on this work. “Localizing WHO Guidelines on Self-Care: A Practical Guide From Uganda” documents Uganda’s approach and illuminates a five-phase guideline development process that may be helpful for other countries looking to nationalize the WHO guideline. For each phase, the guide shares the purpose and objectives, Uganda’s experience, lessons learned, and suggested activities and tools.
Learn more about PROPEL Health
En 2020, l’Ouganda a entamé le processus d’élaboration de directives nationales pour l’autosoin pour la santé et les droits sexuels et reproductifs. Ces directives sont basées sur les recommandations de l’Organisation mondiale de la santé (OMS) sur l’autosoin, publiées en juin 2019 et révisées en 2022.
Le processus de l’Ouganda pour développer et tester ces directives, conduit par le ministère de la Santé, un panel d’experts et un consultant national de Samasha Medical Foundation, a été efficace pour créer une politique adaptée au contexte ougandais. L’approche innovante a également inclus un test pilote de l’ébauche de la directive au niveau infranational pour révision avant le lancement et le déploiement national.
Dans le cadre du projet PROPEL Health de l’USAID, PRB s’est associé à Samasha Medical Foundation pour créer un guide pratique basé sur ce travail. « Localiser les recommandations de l’OMS sur l’autosoin : un guide pratique de l’Ouganda » documente l’approche de l’Ouganda et illustre un processus de développement de directives en cinq phases qui pourrait être utile pour d’autres pays souhaitant adopter les recommandations de l’OMS. Pour chaque phase, le guide présente l’objectif et les objectifs, l’expérience de l’Ouganda, les leçons apprises et les activités et outils suggérés.
Families with limited resources or inconsistent insurance are more likely to face hurdles, new study finds.
January 31, 2024
Senior Research Associate
Children and youth with special health care needs (CYSHCN) who receive family-centered care generally have better health outcomes, research shows. When health care providers engage and prioritize the needs of the family, CYSHCN enjoy better overall health; better access to coordinated, ongoing, comprehensive health care within a medical home; fewer emergency department visits; and fewer unmet health needs.
Yet in the United States, CYSHCN families from disadvantaged groups face barriers to receiving high-quality family-centered care, according to a new analysis of national survey data by Paul Morgan, now at the University at Albany, SUNY, and colleagues at Penn State University and SRI International.1
The researchers assessed family-centered care by measuring the extent to which doctors or other health providers:
Data were from the 2016–2019 National Survey of Children’s Health (NSCH), which uses a five-question screener to identify CYSHCN.
The study focused on the quality of care received by CYSHCN families in visits to health professionals in the previous year and controlled for potentially confounding factors including children’s general health status and the severity of their impairments.
Morgan and colleagues found that some CYSHCN families report greater barriers to receiving high-quality family-centered health care, including:
By contrast, families of CYSHCN with asthma—the most commonly reported special health care need—were significantly more likely to receive family-centered care than families of CYSHCN without asthma.
The results did not show consistent racial/ethnic disparities across all the measures of family-centered care—a finding that surprised the researchers. However, families of Black and Hispanic CYSHCN reported that providers spent relatively less time with their children compared with families of white CYSHCN. Families of Hispanic CYSHCN also said that providers showed less sensitivity to their family’s culture and customs.
Evidence from the study suggests that socioeconomic factors, rather than race or ethnicity, are central drivers of disparities in family-centered care among CYSHCN in the United States. To address these disparities, policies and systems of care serving these young people and their families can adopt comprehensive, coordinated approaches to increase provider-family engagement, cultural responsiveness, and shared decision-making, the authors noted.
To help particularly vulnerable CYSHCN families, targeted actions should focus on care provided in emergency departments, community clinics/health centers, and other non-office settings, and on providers caring for children with autism spectrum disorders or internalizing disorders, the authors suggested.
This article was produced under a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). The work of researchers from Penn State University was highlighted.