In Pew’s new “After the Fact” podcast season, States of Innovation, we explore innovative ways that states are using data to solve some of today’s biggest challenges. We discuss how government can work more effectively and better serve the public interest in an in-depth conversation with Pew’s new president and CEO, Sue Urahn. This interview has been edited for clarity and length.
A: After joining Pew, one of the very first projects I worked on was a significant multiyear investment to help states invest in preschool for kids. There was compelling research, not widely known at that time, that pre-K had a positive economic return on investment, and it was an area ripe for progress in the states. Through this approach, it became very clear that the opportunity to engage in different kinds of policy areas at the state level was something that Pew should really take a very close look at.
That led Pew to launch the Pew Center on the States. This allowed us to bring together different kinds of policy—from education, to how well states perform, to sentencing and corrections—and develop a capacity to work across different issue areas while bringing in thoughtful research to help state policymakers make better decisions. That state level work now exists across many different programs at the institution.
A: We look for issues where there’s a real opportunity to make a difference, a window of opportunity, if you will, where policymakers are aware that there are challenges and have a willingness to look at the research, welcome some help and technical assistance from organizations like Pew, and find ways to move forward with some thoughtful solutions.
In some cases, we may conduct or commission research that will help us better understand the impact of a different policy solution or compare one policy solution to another. One of the things that’s fascinating about research is that—in the best of cases—it provides a language or foundation for people with opposing views to come together and have a conversation about what needs to happen and why.
A: The work in the states on dental health makes for a great case study. Good oral health is really critical for an individual’s health, so we have worked for nearly a decade on helping states look at allowing dental therapists to provide care, particularly in rural areas and to communities at an economic disadvantage.
When we started, there was research showing that significant portions of populations are underserved for dental care, which helped people and policymakers understand the scope and scale of the problem. We also saw research that demonstrated positive results in other countries for the introduction of dental therapists to provide care. Dental therapists could perform a limited set of procedures effectively for patients at a lower cost.
We conducted economic studies which showed how practices could incorporate dental therapists and enhance access for patients while ensuring a revenue stream for their business. We then worked with policymakers to understand the specific changes that could enhance care; in this case, changing licensing requirements to allow dental therapists to practice in the state.
To date, several states have moved forward in providing better health care, often at a lower cost, to communities that have had barriers to receiving that kind of care in the past. So that’s been a terrific—that’s been a terrific innovation. As we look out over the next five to 10 years, we’ll see steady adoption of that approach, as other states see the improvements from these types of policy innovations.
A: There are some clear challenges that states, along with the federal government, are going to face in the coming years. One of those is enhancing pathways for states and the federal government to work together effectively to solve problems.
Certainly, states are going to be dealing with budget issues for some time, with different segments of the population being hit in different ways economically from the pandemic—from tourism to restaurant industries. Peoples’ lives have been deeply impacted, and states are going to have to figure out how to respond fiscally or through more services. All of those things are going to be challenges for states.
A: The wonderful thing about states is that there are 50 of them, and they are all incredibly different. Justice Louis Brandeis once said that states can be the “laboratories of democracy.” And I think it’s very true.
What works in one state may not work as well in another. However, if states have the freedom and the flexibility to try different approaches and customize them for the particular challenges facing them, they will come up with different solutions. That’s a tremendous benefit. Not only will they come up with varying and innovative approaches, but often they will then be able to share those solutions with other states. And those states can adapt solutions to fit particular challenges as required, creating a virtuous cycle of innovation across the states.