Scholars in Health Policy Research Reboots a Career

    • April 9, 2013

A strong foundation sets the stage. Harold A. Pollack, PhD, is a public education success story. He began school in Brighton, N.Y., a suburb of Rochester. “The Brighton Public Schools gave me a great education,” he says. “I believe I was the fifth PhD recipient from my cafeteria table. I shared my paper route with two other kids. One is now a professor at Harvard Business School and the other directs a center for entrepreneurship at the University of California at Berkeley.” His high school experience in Leonia, N.J., was similarly encouraging. “Instead of normal AP classes I got on a bus and took math and physics at Columbia University in New York City.”

Pollack was raised to appreciate community resources, and social capital. “My parents were divorced,” he says. “We didn't have a lot of money, but we had a high degree of social capital that helped us out.” The importance of social ties and family support prompted an awareness of the value of family dynamics and social connection that is woven throughout Pollack’s varied career.

From computer science to health policy. Pollack’s route to tenured academia began with a bachelor's degree in electrical engineering and computer science from Princeton University in 1985. After graduation he joined Draper Laboratory in Cambridge, Mass., working in weapons design. Pollack loved math and physics (still does) and “had terrific coworkers, but that work wasn't for me. Perhaps if I were in biomedical engineering, I would have stayed in the field,” he says. Nonetheless, the pragmatic perspective inherent in engineering—“the focus on getting things done and knowing that ‘the bridge has to hold up’”—continues to influence his approach to his professional work.

Two experiences combined to steer Pollack's career in a different direction. First, while working for Draper Labs, he volunteered at a homeless shelter, where he learned about the struggles of vulnerable people and the shortcomings of the systems that were supposed to help them. Second, “Harvard’s Kennedy School was down the street. I started hanging out there.” Pollack received a master’s degree in public policy from Harvard in 1989 and a PhD, also in Public Policy, in 1994. For his dissertation, he studied how low-income families developed informal help systems, exploring how and where women on welfare got money to survive.

After Harvard, Pollack joined the first cohort of the Robert Wood Johnson Foundation Scholars in Health Policy Research program. The program provides paid full-time two-year fellowships to outstanding new PhDs in economics, political science, and sociology to advance their involvement in health policy research. See Program Results Report for more information. “I applied to the program because I had interests at the intersection of poverty and health policy,” he says.

Pollack spent his two years (1994 to 1996) as a Scholar at Yale University. Pollack believes the Scholars program “saved my career” and says “I did a reboot and became a public health researcher.” He recalls his work until this time as lacking focus. The program, he says, “allowed me to develop myself in a way I wouldn't have done otherwise.” While at Yale, Pollack focused on HIV/AIDS research. “New Haven had a terrible HIV/AIDS problem, but it also had a group of very talented health policy and HIV/AIDS people.”

Pollack also found significant value in the interdisciplinary nature of the Scholars program and the openness that created.

A career develops and evolves. Since leaving the Scholars program, Pollack has built a career as a researcher, teacher, and leader. In 1997, he joined the University of Michigan Department of Health Management and Policy, receiving tenure in 2002. In 2003, he joined the faculty at the University of Chicago School of Social Service Administration as a tenured associate professor. There he has been faculty chair at the Center for Health Administration Studies and deputy dean for Faculty Development and Research. Currently he is Helen Ross Professor at the school and co-director of the University of Chicago Crime Lab.

Pollack has continued conducting policy research and writing about HIV/AIDS, welfare dependence, substance abuse, and other social problems. He sees commonality across these apparently disparate topics: they “involve cross-cutting issues in severely disadvantaged populations,” as he describes it. His analyses of substance use among women on welfare, published in the early 2000s, provided state agency staff with timely information about the nature and extent of substance abuse among welfare recipients, thereby helping states develop policies regarding screening welfare recipients for possible substance use and creating treatment opportunities for recipients with substance use problems.

Pollack's articles have been published in peer-reviewed journals including, among many others, Addiction; Journal of the American Medical Association; Health Economics; Management Science; Journal of Health Politics, Policy and Law; Health Services Research; and American Journal of Public Health.

He also frequently writes for a broader, nonresearch-based audience, contributing to publications such as the New York Times, New Republic, and the Nation. His essay “Lessons from an Emergency Room Nightmare,” published in American Prospect, was selected for inclusion in Best American Medical Writing, 2009. In it he writes in detail about his wife’s medical emergency and the multi-layered mistakes made in her diagnosis, care, and treatment.

Pollack teaches a “microeconomics boot camp” to graduate students who are not going to be economists. He describes the course as engaging the students “in 'what is useful to you'” and notes that “the multidisciplinary nature of the Scholars in Health Policy Research program helped in doing that. I can bring in some real world experience.” He also teaches a course in medical decision-making and cost effectiveness and a course about AIDS.

The University of Chicago Crime Lab that Pollack co-directs works with government and nonprofit agencies to design and conduct randomized controlled trials that test innovative ways to reduce crime and develop effective crime-reduction policies. Projects include work with the Chicago Police Department to identify and interrupt sources of guns used in crime, an initiative with the U.S. Department of Justice to study the effects of putting more police on the streets, and projects with the Chicago Public Schools to reduce truancy and dropout.

“The crime challenge brings to mind many of the things I struggled with in the Scholars program,” explains Pollack. “You have multiple causes of the problem and you have to bring a mix of skills to address it. You have to do things in a way that won't work if you are narrow in your discipline and are looking only at your own dataset.” And addressing crime demands both immediate and longer-term solutions. Pollack notes of this work, “We say, ‘Two teenagers, plus a beef, plus a gun = a dead body.’ So you have to address the ‘plus a gun’ piece, but then you have to look at the longer term issues and get to other factors. too.”

Pollack's interest in health policy has expanded to include the area of developmental disability and the American welfare state. He comes to this interest from personal experience—his brother-in-law is developmentally disabled. “That has radicalized me in terms of my own personal advocacy” he says. In January 2012, Pollack received an RWJF Investigator Awards in Health Policy Research grant (ID# 69765) to “explore accomplishments and shortcomings of our welfare state in helping individuals and families affected by intellectual or developmental disability.”

Pollack sees notable differences in the effectiveness of American social policy in addressing development disability versus welfare, substance abuse, and HIV. “I find developmental disability to be a more heartening topic and a very successful area of social policy. If you look at HIV and welfare, in many ways you see the worst of American social policy. Unknown numbers of people contracted HIV and died because of our tenuous commitment to them. We failed to protect so many people.”

In comparison, he points out, “You now see the embrace of people with developmental disabilities in popular culture, the commitment of resources, and the mainstreaming of people with these challenges.”

A few reflections. Though he counsels his graduate students about the importance of efficiency and focus in their work, Pollack has struggled to accommodate and manage his own wide range of interests and commitments. “My career is haphazard—I wish I had pursued things in a more efficient manner. I tell my students that in some ways I am not a good role model because I didn't focus for a long time. But, in other ways I may be a good model—people know they can go down a blind alley and come out.”

Teaching is serious business to Pollack. He credits his mentors from the Scholars program with helping him to establish his career and says, “We need to do that for the next folks coming along. None of us makes it on our own. I had a lot of help.”

Pollack knows what drives his work and life—it goes back to his upbringing and has been reinforced by his experience with his brother-in-law. “I am passionate about the importance of social insurance—the idea that, acting together, we can all protect each other from life's risks that would crush any one of us if we were left to face these burdens alone. Almost all my popular journalism is somehow rooted in that theme. I've written about our family's experience as caregivers. We have certainly experienced the benefits of these social insurance efforts.”

RWJF Perspective. The Robert Wood Johnson Foundation Scholars in Health Policy Research program is designed to foster a new generation of creative thinkers in health policy research within the disciplines of economics, political science, and sociology. The fellowship program, established in 1991, annually selects a total of nine recent PhD graduates from among those three disciplines to spend two years studying at one of three participating sites (currently Harvard University, University of California-Berkeley/San Francisco, and University of Michigan).

Participants learn about health and health policy, gain exposure to the perspectives of the other two disciplines through seminars with peers, receive mentoring from prominent scholars, develop research ideas, and conduct research while receiving a stipend and benefits that free them from other professional obligations. “We’re looking for people who aren’t too far along in pursuing a specific research agenda. Our goal is to catch people early and tempt them into the field of health policy,” says Lori Melichar, PhD, RWJF director for the program.

While in the Scholars program, participants have conducted research on issues and policies related to individual health, public health, social and economic determinants of health and health care, health care financing, and health care systems and institutions. After completing the program, alumni stay connected to their peers through a network facilitated by the Boston University Health Policy Institute, which serves as the national program office.

Scholars from the Health Policy Research Program have made significant contributions to their disciplines and to the field of health policy research. The program’s 200-plus alumni, many of whom hold faculty appointments at universities and colleges, have authored hundreds of widely cited books and articles; held editorial posts at top scholarly journals; sat on scientific advisory panels; served as senior advisors to presidential, Congressional, federal agency, and national scientific councils; and received numerous professional awards for their research.

Although the original purpose of the program—to increase the number of economists, sociologists, and political scientists conducting health policy research—remains important, RWJF’s focus has expanded to include “building the community” of health policy researchers and supporting them at institutions nationwide. “Now it’s more about creating a critical mass so that we have a self-sustaining community [of researchers],” Melichar says.

Harold A. Pollack, PhD

Harold A. Pollack, PhD
Scholar in Health Policy Research

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Economist Harold A. Pollack, PhD, studied the intersection of poverty and health policy