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

辅助生殖技术正在改变夫妇怀孕的能力，产前筛查技术使父母能够在怀孕期间获得有关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卫生不公平现象，这强调了规范其可及性和可负担性的公共政策的作用。了解辅助生殖技术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。CAREER研究项目结合了人口范围内的行政数据、个人层面使用这些技术的独特详细信息，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策，以及这些技术是否会影响家庭之间的不平等。该提案的教育计划侧重于培训学生如何获取和使用用于研究的大行政数据——这些知识通常是通过个人关系传递的——以帮助为下一代研究人员创造公平的职业竞争环境。这一研究项目的结果将对公共生育政策和一般保健政策的实施产生重大影响。研究结果可以帮助改善美国人的健康状况，并帮助美国在生殖保健政策方面成为全球领导者。这个CAREER研究项目有四个组成部分。第一个项目的动机是不同社会经济群体在利用辅助生殖技术方面的巨大差异。它利用抗逆转录病毒药物公共健康保险覆盖范围的年龄阈值，调查可负担性在推动这种不平等方面的作用；此外，报告还审查了接受抗逆转录病毒药物对使用这些药物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、优越的——但昂贵的——用于识别染色体异常的筛选技术。它将结合利用保险资格阈值的简化形式证据和父母产前检测决定的理论模型，以检查先进技术对父母检测选择、出生结果和总体人口健康措施的影响。第三个项目侧重于一种特殊类型的辅助生殖技术，即体外受精（IVF）。该项目是基于对捐赠配子（精子和卵母细胞）的体外受精的观察，即婴儿在子宫内的环境与婴儿的遗传物质分离。该项目使用包含捐赠配子的体外受精婴儿信息的数据，将为“先天”与“后天”在父母的社会经济地位与儿童健康之间的关系中的重要性的辩论提供新的证据。第四个组成部分是一个指导讲习班，旨在减少学生在获取关于在研究中使用大规模行政数据的信息方面的不平等。研究结果可以帮助改善美国人的健康状况，并帮助美国在生殖保健政策方面成为全球领导者。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识价值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.