CAREER: Family Behavior, Health Technologies, and Government Policy: Research and Training

辅助生殖技术(ARTS)正在改变夫妇的受孕能力，产前筛查技术使父母能够获得关于怀孕期间胎儿健康的准确信息。这些技术有可能从根本上改变家庭结构和家庭幸福。然而，由于这些技术价格昂贵，它们的到来可能会带来新的健康不平等，这突显了规范这些技术的可获得性和可负担性的公共政策的作用。了解ART和产前筛查技术对家庭决策、家庭结果和不平等的影响，对于为公共生育相关政策提供信息，从而促进国家健康、繁荣和福利至关重要。这项职业研究计划结合了全人口的管理数据，以及关于这些技术在个人层面上使用的独特详细信息，以及实验和理论研究方法，以更好地了解它们对家庭的影响。该研究项目将研究ART和产前筛查技术如何影响家庭生育决定，以及这些技术是否影响家庭之间的不平等。这项提议的教育计划侧重于培训学生如何访问和使用大数据进行研究--这些知识通常是通过人际关系传递的--以帮助为下一代研究人员在该行业创造公平的竞争环境。这一研究项目的结果将对公共生育政策的实施以及整个医疗保健政策产生重大影响。研究结果可能有助于改善美国人的健康状况，并帮助美国在生殖保健政策方面确立全球领先地位。这项职业研究项目由四个部分组成。第一个项目的动机是不同社会经济群体对辅助生殖技术(ARTS)的使用存在明显差异。它利用ART公共健康保险覆盖范围中的年龄门槛来调查负担能力在推动这种不平等中的作用；此外，它还研究了ART对使用ART的妇女及其家庭的健康和福祉的长期影响。第二个项目将研究一种新的、优越但昂贵的筛查技术的到来，以识别染色体异常。它将结合利用保险资格门槛的简化证据和父母产前检查决定的理论模型，以检查优越技术对父母的检查选择、生育结果和总体人口健康衡量标准的影响。第三个项目侧重于一种特殊类型的艺术，即体外受精(IVF)。该项目的基础是观察到，通过捐赠配子(精子和卵母细胞)进行试管受精，可以将婴儿在子宫内的环境与婴儿的遗传物质分离。该项目利用含有捐献配子出生的试管婴儿的信息的数据，将为关于父母的社会经济地位与儿童健康之间的关系中“先天”与“后天”的重要性的辩论带来新的证据。第四个组成部分是指导讲习班，旨在减少学生在获取有关在研究中使用大规模行政数据的信息方面的不平等。这一结果可能有助于改善美国人的健康，并有助于建立美国在生殖健康保健政策方面的全球领先地位。这一奖项反映了NSF的法定使命，并通过使用基金会的智力优势和更广泛的影响审查标准进行评估，被认为值得支持。

Assisted reproductive technologies (ARTs) are transforming couples' ability to conceive, and prenatal screening technologies allow parents to gain precise information about fetal health during pregnancy. These technologies have the potential to fundamentally alter family structure and family wellbeing. However, because these technologies are expensive, their arrival may introduce new health inequities, which underscores the role of public policies that regulate their accessibility and affordability. Understanding the consequences of ARTs and prenatal screening technologies for family decisions, family outcomes, and inequality is essential for informing public fertility-related policies, and thereby advancing national health, prosperity, and welfare. This CAREER research program combines population-wide administrative data, with uniquely detailed information on individual-level use of these technologies, and experimental and theoretical research methods to better understand their effects on families. The research project will study how ARTs and prenatal screening technologies affect family reproductive decisions, as well as whether these technologies affect inequalities across families. This proposal's education plan focuses on training students in how to access and use big administrative data for research - knowledge that is often passed through personal connections - to help level the playing field in the profession for the next generation of researchers. The results of this research project will have major influence on the conduct of public fertility policy, and health care policy generally. The results could help improve the health of Americans as well as help establish the US a global leader in reproductive health care policy.This CAREER research project has four components. The first project is motivated by sharp differences in utilization of assisted reproductive technologies (ARTs) across socioeconomic groups. It exploits age thresholds in public health insurance coverage of ARTs to investigate the role of affordability in driving this inequality; further, it examines the long-run consequences of ARTs uptake on the health and well-being of women who use them and their families. The second project will study the arrival of a new and superior - but expensive - screening technology for identifying chromosomal abnormalities. It will combine reduced-form evidence leveraging insurance eligibility thresholds with a theoretical model of parents' prenatal testing decisions to examine the implications of the superior technology on parents' testing choices, birth outcomes, and measures of aggregate population health. The third project focuses on a particular type of ARTs, In Vitro Fertilization (IVF). The project is based on the observation that IVF with donated gametes (sperm and oocytes) decouples a baby's environment in utero from the baby's genetic material. Using data containing information about IVF children born with donated gametes, this project will bring novel evidence to the debate on the importance of "nature" versus "nurture" in the association between parents' socioeconomic standing and children's health. The fourth component is a mentoring workshop that aims to reduce inequality among students in access to information about the use of large-scale administrative data in research. The results could help improve the health of Americans as well as help establish the US a global leader in reproductive health care policy.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.