MyGoals for Healthy Aging
We all know that poverty can limit people’s access to healthy food or medical care. But scientists believe that povety and the stress that comes with it can lead to a cascade of risks that ultimately lead to premature aging, frailty, dementia, and death.
For one, the psychological stress that comes with poverty can damage areas of the brain linked with planning, memory, and the body's regulation of blood sugar and blood pressure. It can also make the hippocampus--brain a region associated with memory--shrink in size. Scientists not only believe that it is possible to prevent this brain damage before it occurs, but it is also possible to reverse the damage after it has already happened.
The Goal of “MyGoals”
One big idea in public health is that we can greatly improve people’s health and well-being (a two-for-one) if we could only fine tune our welfare policies. Part of “getting it right” means figuring out how to reverse the damaging effects that poverty has on the brain by reducing stress and by “training” the brain to overcome the damage that has already occurred.
MyGoals for Healthy Aging is a multi-center randomized controlled trial (RCT) of a two-pronged anti-poverty program that both addresses deprivation and stress-associated neural damage. We will work with roughly 2,000 unemployed public housing recipients, who have already either received public housing (the control group) or public housing coupled with proven cash incentives for employment and an intensive, 3-year-long "executive function" coaching program (to help people set goals and achieve them).
How MyGoals for Healthy Aging Might Change the Way That Welfare Is Administered
The United States currently has many thousands of welfare programs. Some recipients are disabled or otherwise unable to work. However, those who can work often find themselves unable to figure out how to escape the poverty trap. One problem is some welfare programs discourage work by linking welfare receipt to income. It doesn't make sense to work for $7.75/hour when that is not enough money to buy food and health insurance. Another is that poverty is stressful and this stress reduces one's ability to plan and execute tasks, like eating healthy or getting a job. A welfare program that offers large cash incentives for employment coupled with large cash incentives for a coaching program that helps people overcome the effects of toxic stress might just work to boost people out of the poverty trap. If it does, MyGoals could become a national welfare model.
But it is also a very expensive program. Version 1.0 of MyGoals (an experiment called "Work Rewards") showed that if the cash incentives to work are large enough, some unemployed people will get a job, but it not effective enough to merit the cost. MyGoals for Healthy Aging could produce the extra dose of effectiveness needed to give the program good value for the taxpayer dollar.