Publications

    Federal COVID‐19 Response Funding for Tribal Governments: Lessons from the CARES Act
    Henson, Eric C., Megan M. Hill, Miriam R. Jorgensen, and Joseph P. Kalt. 2021. “Federal COVID‐19 Response Funding for Tribal Governments: Lessons from the CARES Act”. Read the full report Abstract

    The federal response to the COVID19 pandemic has played out in varied ways over the past several months. For Native nations, the CARES Act (i.e., the Coronavirus Aid, Relief, and Economic Security Act) has been the most prominent component of this response to date. Title V of the Act earmarked $8 billion for tribes and was allocated in two rounds, with many disbursements taking place in May and June of this year.

    This federal response has been critical for many tribes because of the lower socioeconomic starting points for their community members as compared to nonIndians. Even before the pandemic, the average income of a reservationresident Native American household was barely half that of the average U.S. household. Low average incomes, chronically high unemployment rates, and dilapidated or nonexistent infrastructure are persistent challenges for tribal communities and tribal leaders. Layering extremely high coronavirus incidence rates (and the effective closure of many tribal nations’ entire economies2) on top of these already challenging circumstances presented tribal governments with a host of new concerns. In other words, at the same time tribal governments’ primary resources were decimated (i.e., the earnings of tribal governmental gaming and nongaming enterprises dried up), the demands on tribes increased. They needed these resources to fight the pandemic and to continue to meet the needs of tribal citizens.

    Randall K.Q. Akee, Eric C. Henson, Miriam R. Jorgensen, and Joseph P. Kalt; May 2020 

    This study dissects the US Department of the Treasury’s formula for distributing first-round CARES Act funds to Indian Country. The Department has indicated that its formula is intended to allocate relief funds based on tribes’ populations, but the research team behind this report finds that Treasury has employed a population data series that produces arbitrary and capricious “over-” and “under-representations” of tribes’ enrolled citizens.

    Leonard, Herman B. "Dutch", Arnold M. Howitt, and David W. Giles. 2020. “Crisis Management for Leaders Coping with COVID-19”. Read the full report Abstract

    Herman "Dutch" Leonard, Arnold Howitt, and David Giles; April 2020

    In the face of the rapidly evolving coronavirus crisis that demands many urgent decisions but provides few clear-cut cues and requires tradeoffs among many critically important values, how can leaders and their advisers make effective decisions about literally life-and-death matters?  This policy brief contrasts the current “crisis” environment with the more familiar realm of “routine emergencies.” It argues that for crises, leaders need to adopt a more agile, highly adaptive, yet deliberate decision-making method that can move expeditiously to action, while retaining the capacity to iteratively re-examine tactics in light of decision impacts. This method can help the team take account of the multiple dimensions of the COVID-19 crisis and cope as well as possible with swiftly changing conditions.

    Randall K.Q. Akee, Eric C. Henson, Miriam R. Jorgensen, and Joseph P. Kalt; May 2020 

    Title V of the CARES Act requires that the Act’s funds earmarked for tribal governments be released immediately and that they be used for actions taken to respond to the COVID‐19 pandemic. These may include costs incurred by tribal governments to respond directly to the crisis, such as medical or public health expenditures by tribal health departments. Eligible costs may also include burdens associated with what the U.S. Treasury Department calls “second‐order effects,” such as having to provide economic support to those suffering from employment or business interruptions due to pandemic‐driven business closures. Determining eligible costs is problematic.

    Title V of the CARES Act instructs that the costs to be covered are those incurred between March 1, 2020 and December 30, 2020. Not only does this create the need for some means of approximating expenditures that are not yet incurred or known, but the Act’s emphasis on the rapid release of funds to tribes also makes it imperative that a fair and feasible formula be devised to allocate the funds across 574 tribes without imposing undue delay and costs on either the federal government or the tribes.

    Recognizing the need for reasonable estimation of the burdens of the pandemic on tribes, the authors of this report propose an allocation formula that uses data‐ready drivers of those burdens.  Specifically, they propose a three‐part formula that puts 60% weight on each tribe’s population of enrolled citizens, 20% weight on each tribe’s total of tribal government and tribal enterprise employees, and 20% weight on each tribe’s background rate of coronavirus infections (as predicted by available, peer‐reviewed incidence models for Indian Country).

    Transparency for Development Team, June 2019 

    This paper assess the impact of a transparency and accountability program designed to improve maternal and newborn health (MNH) outcomes in Indonesia and Tanzania. Co-designed with local partner organizations to be community-led and non-prescriptive, the program sought to encourage community participation to address local barriers in access to high quality care for pregnant women and infants. This paper evaluates the impact of this program through randomized controlled trials (RCTs), involving 100 treatment and 100 control communities in each country, and finds that on average, this program did not have a statistically significant impact on the use or content of maternal and newborn health services, nor the sense of civic efficacy or civic participation among recent mothers in the communities who were offered it.

    Elena Fagotto, Project on Transparency and Technology for Better Health, March 2019

    The Project on Transparency and Technology for Better Health was established to conduct comparative case studies on platforms that empower patients through information to provide an inventory and typology of initiatives. This case study takes a look at Breast Cancer Straight Talk Support, a closed Facebook community for women dealing with breast cancer and survivors. With hundreds of posts every day, the group is a safe space where women can vent about feeling scared, depressed, or lonely and receive support from women who “get them.” For many members, the group is a window into other women’s cancer journeys, which gives them perspective and a more proactive attitude to fight the disease. The community is also an important resource to ask questions on treatments, side effects, surgery and more.

    Elena Fagotto, Project on Transparency and Technology for Better Health, March 2019

    The Project on Transparency and Technology for Better Health was established to conduct comparative case studies on platforms that empower patients through information to provide an inventory and typology of initiatives. This case study takes a look at IBD Partners, a research network connecting nearly 15,500 IBD patients with over 300 researchers. Patients can contribute their self-reported health data for research by filling out surveys on their health twice a year. This way, patient-generated data feeds into an extensive database that can be accessed by researchers to conduct longitudinal studies, to connect with patients for clinical trials and for prospective studies. Patients can also use the platform to suggest research questions and vote for the most interesting ideas, generating a truly patient-driven research agenda.

    Elena Fagotto, Transparency and Technology for Better Health, March 2019

    The Project on Transparency and Technology for Better Health was established to conduct comparative case studies on platforms that empower patients through information to provide an inventory and typology of initiatives. This case study details ImproveCareNow (ICN), a network of clinicians, medical centers, patients, families and researchers working together to improve the lives of children with inflammatory bowel disease (IBD). 

    Zhang, Siwen, Hua Chen, Songyu Zhu, Jorrit de Jong, and Guy Stuart. 2017. “Health Education in China's Factories: A Case of Embedded Education”. Read full paper Abstract

    Siwen Zhang, Hua Chen, Songyu Zhu, Jorrit de Jong, and Guy Stuart, January 2017 

    This case study focuses on HERhealth, the health education program within the HERproject as it was implemented in China from 2007 onwards . Based on reports supplied by BSR this case study documents the health education and its effects on the behavior of women who received the education in terms of improved reproductive health, personal hygiene, and safe sex practices.

    Wilson, Deloris, Linda Kaboolian, Jorrit de Jong, and Guy Stuart. 2017. “Barbershops and Preventative Health: A Case of Embedded Education”. Read full paper Abstract

    Deloris Wilson, Linda Kaboolian, Jorrit de Jong, and Guy Stuart, January 2017   

    This is a case study of the Colorado Black Health Collaborative (CBHC) Barbershop/Salon Health Outreach Program, a community-based initiative that targeted disproportionate rates of hypertension and other health problems within the African American community. 

     

    Zhang, Siwen, Hua Chen, Songyu Zhu, Jorrit de Jong, and Guy Stuart. 2017. “HIV/AIDS Prevention on Southern China's Road Projects: A Case of Embedded Education”. Read full paper Abstract

    Siwen Zhang, Hua Chen, Songyu Zhu, Jorrit de Jong, and Guy Stuart, January 2017  

    This is a case study of the Asia Development Bank (ADB)-sponsored HIV/AIDS prevention program implemented at expressway construction sites in Guangxi province from 2008 to 2015 . The program delivered HIV/AIDS prevention education to migrant workers working at the sites, as well as to members of the communities near the sites.