Jan. 05 2022

How Policymakers Can Learn from People Who Overcome Poverty

Researchers at Columbia University Mailman School of Public Health argue that policymakers should design programs based on the behaviors of individuals who succeed in spite of their circumstances. These positive outliers who the researchers term “positive deviants” (PD) appear to make marginally better choices such as saving money or electing to get a flu shot compared to similarly situated peers. Their paper is published in the journal Perspectives on Psychological Science.

The researchers argue that the positive deviance framework offers a better model for policy interventions than those that seek to impose a one-size-fits-all solution to diverse populations. Interventions that have demonstrated effectiveness among the general public tend to be less successful for disadvantaged populations, who in theory stand to benefit the most.

Kai Ruggeri, PhD, lead author and assistant professor in the Department of Health Policy and Management at Columbia Mailman, gives the example of programs that aim to support child nutrition but often lead to unintended consequences: “The typical approach is guidelines,” he says. “Parents get them from clinics or schools or look them up online. However, not every parent can enact the same nutrition behaviors, and assuming so can widen inequalities. If the best practice costs money that parents with low incomes don’t have, they either watch their children fall behind or they pay on credit, which worsens the financial situation.” By contrast, under the PD model, he says, “you look at the low-income parents who are raising healthy children and you make those practices the focus of the intervention because it takes into account the common resource limitations.”

Even traditional programs that account for lack of financial resources without addressing related impacts of inequality can miss the point, according to Ruggeri. He gives the example of a policy that simply advises low-income people to save money. “Low-income communities often have fewer banks but more payday lenders. If you are low-income but have a job, you might not even be able to simply deposit your paycheck each week. Instead, you might have to pay a high fee just to access the money you earned. Advising people to save the most they can is already a problem, but it gets worse if you’re losing up to 20 percent of your paycheck just to get access to it. With a PD approach, we track the behaviors of people in the same circumstances who have figured out how to overcome these issues and then build those into our policy interventions.”

The article demonstrates PD behaviors in several ways. First, using data from a network of Federally Qualified Health Centers (FQHC) in New York City providing care to low-income families, they identified a small number of individuals that consistently make use of preventive services. This is important because FQHCs notoriously have low attendance rates. Similarly, using experimental data from two studies (one from 19 countries and another from California), they show individuals that overcame being poor in childhood are also more likely as adults to save/invest wisely and less likely to take on debt or make unnecessary purchases.

In an ongoing study whose results are forthcoming, Ruggeri and colleagues are applying the PD approach to examine how people spent their stimulus checks. The research aims to take lessons from the choices of the 5 percent of individuals who saved or invested this money. “We want to learn from those individuals who took ‘good risks’ by saving the money for retirement.  We want to understand the motivations and traits like positive outlook and resilience that support these decisions. What we learn can then be tested in a future intervention.”

The study’s co-author is Tomas Folke, PhD, a postdoctoral researcher at Rutgers University and previously a postdoctoral researcher at Columbia Mailman.