You are an analyst for a federal agency. Congress has ordered your agency to come up with policy options to find a cure for birth defects. You recognize that (a) birth defects have many causes, (b) some can be treated, (c) some can also be prevented, but (d) not all of them can be “cured.” You analyze this issue using the core functions of public health and the problem-solving process outlined under Core Functions of Public Health.
Based on the information about spina bifida in this chapter, you decide it should be the focus for policymaking on birth defects. You decide to propose four options to Congress: more research on treatment of spina bifida, more health education for women about folic acid, more promotion of birth control to reduce the proportion of unplanned pregnancies in the country, and new regulations to increase the amount of folic acid in grain products. You may also see other options, so be sure to discuss them!
1. For each option, what would you need to know to determine effectiveness? Cost-effectiveness?
2. What are the tradeoffs in each course of action?
3. Who would support this option, who would be opposed, and does it matter?
4. Is there a single best option? Why?
