By Cathryn Richmond (NPSC), Amanda J. Khan (NPSC) and Sharon Kingston (NPSC, Dickinson College)
The National Prevention Science Coalition to Improve Lives (NPSC) works in a nonpartisan manner with congressional offices and caucuses, as well as with administrators of federal agencies, to assist the federal government in adopting evidence-based prevention policies, programs and practices. The NPSC is composed of scientists, educators, community stakeholders, practitioners and clinicians, policy makers, advocates, and foundation representatives who believe that the wide-scale and high-quality implementation of evidence-based prevention will:
- substantially improve the quality of Americans’ lives, and
- result in major long-term cost savings by decreasing the prevalence of serious social problems and improving the mental and physical health of our citizens.
As an organization committed to working with the federal government to improve the lives of Americans in a fiscally responsible manner, the NPSC has serious concerns about President Trump’s federal budget proposal. President Trump’s budget promises to substantially increase spending on defense and law enforcement without adding to the federal debt. The budget proposes to achieve this goal by cutting 54 billion dollars from non-defense spending. The budget explicitly promises to adopt a data-driven, evidence-based approach to improve government programs and create cost saving efficiencies.
While the NPSC strongly supports the use of data-driven, evidence- based practices and policies, we believe that many of the proposed budget cuts would, in fact, betray this worthy goal by sacrificing long-term improvements in the lives of Americans and substantial long-term cost savings by eliminating programs and practices that have strong supporting evidence. Proposed cuts to two federal agencies, namely the Department of Agriculture and the Department of Education, exemplify the potential harm that could result from a budget that prioritizes short-term cost savings over the long-term well-being and financial security of the United States and its citizens.
The President’s proposed budget cuts to the Department of Agriculture include a 200 million cut to the Supplemental Nutrition Program for Women, Infants and Children (WIC). This budget reduction could significantly impact funding for vital educational programs related to prenatal and childhood nutrition and breastfeeding. Research consistently shows that breastfeeding is the best source of nutrition for infants (Ip et al., 2007). Babies who are breastfed have significantly lower risks for asthma, sudden infant death syndrome (SIDS), ear and respiratory infections, diabetes, and obesity (CDC, 2015). However, only 22% of babies in the United States (US) are exclusively breastfed for six months, possibly because only 32% of hospitals provide adequate support for breastfeeding mothers once they leave the hospital (CDC, 2015).
Luckily, programs such as the CDC’s Best Fed Beginnings and USDA Food and Nutrition Service’s Loving Support providing breastfeeding education prior to-and-after birth are available to support women and their babies’ care. Moreover, under the Affordable Care Act (ACA), insurance coverage provides preventative and treatment support through comprehensive lactation support and counseling as well as providing breastfeeding supplies (HRSA, 2016). Given the significant impact of prenatal and postpartum breastfeeding and nutritional counseling, cuts to these programs would severely impact the health of the nation for generations to come.
The proposed 9 billion dollar cut to the Department of Education includes the elimination of 21st Century Learning Centers Programs that fund before and after school programs and summer programs. Research across a variety of disciplines has provided extensive empirical support for the value and utility of structured programs for children and adolescents, including before- and after- school programs and summer camps. These programs benefit typically developing children at low- risk of developmental difficulties and children at higher risk of developmental difficulties. In fact, the efficacy of structured programs has been particularly evidenced for more vulnerable populations including children from low-income families or neighborhoods, children experiencing homelessness, and children with developmental difficulties such as an Autism Spectrum Disorder, Attention-Deficit/Hyperactivity Disorder, learning disabilities or other developmental disabilities, psychosocial problems (Brookman et al., 2003; Hupp & Reitman, 199; Lawson et al., 2012; Majoney, Lord & Carryl, 2005; Michalski, Mishna, Worthington, & Cummings, 2003; Nabors, Hines, & Monnier, 2002; Wetzel, McNaboe, & McNaboe, 1995).
The benefits of such programs can be substantial and influence a variety of domains, influencing academic achievement, physical health, mental health, skills and abilities, and behavior. Children participating in structured programs outside of school demonstrate higher reading achievement, increased reading, math and conduct grades, more positive feelings towards school and teachers, and increased school attendance compared to peers not participating in such programs (Durlak, Weissberg, & Pachan, 2010; Mahoney, Lord, & Carryl, 2005; Posner & Vandell, 1994). In addition to academic activities, involvement in such programs are can lead to increased participation in physical activities while decreasing participation in sedentary or passive activities (Mahoney, Lord, & Carryl, 2005; Veugelers & Fitzgerald, 2005), decreased rates of obesity and increased rates of high-quality dietary habits among participants (Veugelers & Fitzgerald, 2005).
Structured programs foster positive identity development, high self-esteem and self-confidence, increased understanding of diversity and inclusion, and improved emotional adjustment and regulation (Brookman et al., 2003; Durlak, Weissberg, & Pachan, 2010; Larson, Hansen, & Moneta, 2006; Michalski et al., 2003; Posner & Vandell, 1994). Similarly, children in such programs demonstrate more self-control, leadership and teamwork skills, and better work habits and social skills (Durlak, Weissberg, & Pachan, 2010; Larson, Hansen, & Moneta, 2006; Pierce, Hamm, & Vandell, 1999; Posner & Vandell, 1994). Specifically, children in structured programs outside of school demonstrate more prosocial behavior, including peer engagement, sportsmanship, cooperation, responsibility, helping others, and appropriate role model behavior ( Hupp & Reitman, 1999; Michalski et al., 2003; Nabors, Hines, & Monnier, 2002; Posner & Vandell, 1994) and less problem behavior and conduct problems including drug use, antisocial behavior and social isolation, aggression, delinquency, noncompliance,rebelliousness, and unkind behavior (Durlak, Weissberg, & Pachan, 2010; Michalski et al., 2003; Nabors, Hines, & Monnier, 2002; Posner & Vandell, 1994; Wetzel, McNaboe, & McNaboe, 1995).
As these examples illustrate, strategic investments in well-implemented, evidence-based prevention programs and practices can yield immense benefits by preventing the onset of costly and debilitating problems and by preparing our children to take their place as healthy, skilled and productive citizens that can positively contribute to our society. We need also to consider the impact of substantial proposed cuts to NIH-funded research. NIH is a major funding source for prevention science that provides the evidence-base for the types of programs mentioned above.
Current funding for prevention science that tests interventions for behavioral health problems is already insufficient. Further reductions could be devastating to the development and evaluation of social programs that can make a huge difference for individuals and families. If successful behavioral interventions are implemented widely they have the potential to greatly improve the health, well-being and financial security of our nation. The NPSC urges the current Administration and Members of Congress to look to the future and make the kind of investments necessary to yield long-term cost savings and improved health and productivity among our citizens.
Brookman, L., Boettcher, M., Klein, E., Openden, D., Koegel, R. L., & Koegel, L. K. (2003). Facilitating social interactions in a community summer camp setting for children with autism. Journal of Positive Behavior Interventions, 5(4), 249-252.
Centers for Disease Control and Prevention (2015, October 6). CDC’s maternity practices in infant nutrition and care survey. Retrieved April 10, 2017 from https://www.cdc.gov/vitalsigns/breastfeeding2015/infographic.html#infographic.
Centers for Disease Control and Prevention (2015, October 6). Strategies to prevent obesity and other chronic diseases: The CDC guide to strategies to support breastfeeding mothers and babies. Retrieved April 10, 2017 from https://www.cdc.gov/breastfeeding/pdf/BF-Guide- 508.PDF.
Durlak, J. A., Weissberg, R. P., & Pachan, M. (2010). A meta‐analysis of after‐school programs that seek to promote personal and social skills in children and adolescents. American Journal of Community Psychology, 45(3-4), 294-309.
Health Resources and Services Administration (2016, December 2016). Women’s preventative service guidelines. Retrieved April 10, 2017 from https://www.hrsa.gov/womensguidelines/.
Hupp, S. D., & Reitman, D. (1999). Improving sports skills and sportsmanship in children diagnosed with attention-deficit/hyperactivity disorder. Child & Family Behavior Therapy, 21(3), 35- 51.
Ip, S., Chung, M., Raman, G., et al. (2007). Breastfeeding and maternal and infant health outcomes in developed countries. Evidence Report/Technology Assessment, 153, 1-186.
Larson, R. W., Hansen, D. M., & Moneta, G. (2006). Differing profiles of developmental experiences across types of organized youth activities. Developmental Psychology, 42(5), 849.
Lawson, K. A., Duzinski, S. V., Wheeler, T., Yuma-Guerrero, P. J., Johnson, K. M., Maxson, R. T., & Schlechter, R. (2012). Teaching safety at a summer camp evaluation of a water safety curriculum in an urban community setting. Health Promotion Practice, 13(6), 835-841.
Mahoney, J. L., Lord, H., & Carryl, E. (2005). An ecological analysis of after‐school program participation and the development of academic performance and motivational attributes for disadvantaged children. Child Development, 76(4), 811-825.
Michalski, J. H., Mishna, F., Worthington, C., & Cummings, R. (2003). A multi-method impact evaluation of a therapeutic summer camp program. Child and Adolescent Social Work Journal, 20(1), 53-76.
Nabors, L. A., Hines, A., & Monnier, L. (2002). Evaluation of an incentive system at a summer camp for youth experiencing homelessness. Journal of Prevention & Intervention in the Community, 24(2), 17-30.
Pierce, K. M., Hamm, J. V., & Vandell, D. L. (1999). Experiences in after‐school programs and children’s adjustment in first‐grade classrooms. Child Development, 70(3), 756-767.
Posner, J. K., & Vandell, D. L. (1994). Low‐income children’s after‐school care: Are there beneficial effects of after‐school programs? Child Development, 65(2), 440-456.
Veugelers, P. J., & Fitzgerald, A. L. (2005). Effectiveness of school programs in preventing childhood obesity: a multilevel comparison. American Journal of Public Health, 95(3), 432-435.
Wetzel, M. C., McNaboe, C., & McNaboe, K. A. (1995). A mission based ecological evaluation of a summer camp for youth with developmental disabilities. Evaluation and Program Planning, 18(1), 37-46.