Issues of individual responsibility (or lack thereof) are at the heart of American cultural and political conflicts. Stereotypically, conservatives hold up individual responsibility: people who are poor and struggling have made bad choices along the way. Liberals, on the other hand, look only at structural determinants. Nicholas Kristof writes of the interplay, acknowledging that choice plays more of a role than liberals are likely to admit. At the same time, however, there's lots of evidence that programs and policy reduce these self-destructive behaviors, which don't happen in a vacuum after all. Public programs he mentions - like infant home visitation and mental health research - can save public money and promote individual responsibility. What's not to like?
Let’s also remember, though, that today we have randomized trials — the gold standard of evidence — showing that certain social programs make self-destructive behaviors less common. Infant home visitation can reduce lead exposures and help moms with breast-feeding and reading to their children. Mental health outreach reduces homelessness. Career Academies, which give at-risk teenagers work experience, boost earnings. Family-planning programs for the needy pay for themselves: An IUD or implant costs $800, a Medicaid birth is around $13,000. So as long as we’re talking about personal irresponsibility, let’s also examine our own. Don’t we have a collective responsibility to provide more of a fair start in life to all, so that children aren’t propelled toward bad choices?