Public Safety

On Memorial Day two years ago I wrote: “There's no better way to honor the men and women who have died by suicide — and the families and friends they left behind — than to ensure that the country is doing all it can to avoid future premature deaths.” This message is even more important this year, as the U.S. Department of Defense (DoD) continues to grapple with a growing number of suicides among service members.

I believe that research can make a difference, and at RAND we're focusing considerable efforts on conducting high-quality, objective research to prevent suicide. This work began with the DoD. In 2011, RAND published The War Within, which identified the strengths and gaps in the current approaches to prevent suicide among military personnel. The conclusions and recommendations in that report helped influence Senator Patty Murray's amendment to the National Defense Authorization Act of 2013 requiring a comprehensive military suicide prevention program.

This commentary appeared on The Health Care Blog on May 21, 2013.

Monday's massive tornado ripped through Moore, a suburb of Oklahoma City, devastating homes and businesses and killing at least two dozen people. The disaster came just over a month after an explosion at a fertilizer plant devastated the town of West, Texas, killing 15 people and injuring some 200 others. Just two days earlier the bombings at the Boston Marathon left three dead and more than 260 injured.

Three mass-casualty events occurring in three very different settings show that disaster preparedness should not be limited to large cities or “target” areas in the United States. One trait that is common to all such events—whether urban, suburban or rural—is the need for coordinated, responsive trauma care for victims.

This commentary appeared on NYTimes.com on May 22, 2013.

Much of the marijuana consumed in the U.S. comes from Mexico. It's impossible to know exactly, but my colleagues and I put the range at 40 to 67 percent for 2008. Our research also suggests that legalizing commercial marijuana production at the national level could drive out most of the marijuana imported from Mexico.

With marijuana legalization at the state level, imports from Mexico would depend on several factors, like how taxes influenced the market price, whether legally sold marijuana were illegally diverted to other states, and the severity of the federal response.

We don't expect the passage of legalization in a few states to significantly affect demand for Mexican marijuana. But what would happen to Mexican drug trafficking organizations if many states legalized marijuana or if there were national legalization?

The ER is for emergencies — or at least it should be. Nearly everyone agrees on that point. But when it comes to implementing policies to reduce non-urgent use of ERs, opinions quickly diverge.

For the past few years, Washington State has been ground zero for this fight. In 2011, the state's health care authority announced its intention to stop paying for emergency department (ED) visits by Medicaid beneficiaries “when those visits are not necessary for that place of service.” Because the plan was based on a retrospective determination of what was — or was not — an emergency, the proposal faced strong opposition from a range of health care stakeholders. Ultimately, a compromise was worked out.

This commentary appeared on CNN on May 21, 2013.

The announcement by prosecutors that charges had been filed against suspected cyber thieves believed responsible for stealing $45 million in a matter of hours from ATM's in two dozen countries should send a stark message to governments around the world — banks could be the most vulnerable front in cyber space.

Plenty of people have been warning us these days to worry about cyber attacks, but generally we have been worrying about the wrong things. Most “cyber Armageddon” scenarios focus on gaps in our physical infrastructure and even far-fetched scenarios such as infant incubators in hospitals being turned off. But major swathes of the United States have routinely gone without electricity and water for days following natural disasters. Soon enough, life gradually gets back to normal. Want real chaos? Destroy confidence in the banking system (or even a part of it), and just stand back and watch....

The remainder of this commentary is available at cnn.com.

The western United States will be facing fire season in a few months and the Forest Service is preparing to respond within the budget constraints of sequestration.

The summer fire season is the most taxing time for the Forest Service's fleet of aircraft because of the sheer number of fires that start across the western half of the U.S. There have already been large fires even before the start of this year's wildfire season, such as the Camarillo wildfire near Malibu, CA, that has burned at least 28,000 acres. As part of ongoing efforts to recapitalize their fire-fighting aircraft fleet, the Forest Service recently announced that it would be using six large air tankers and a DC-10. Large air tankers drop between 1,000 and 4,000 gallons of water or fire retardant, but the DC-10 is much larger and is in a class of aircraft known as very large air tankers (or VLATs in Forest Service parlance). VLATs can drop 10,000 gallons or more of water or fire retardant to put out or contain fires.

This commentary appeared on Spotlight on Poverty and Opportunity on May 14, 2013.

At a time when government finances are stretched, there is growing interest in finding new and innovative ways to privately fund the public services that improve social outcomes. One approach that has garnered significant interest among policymakers and advocates is the Social Impact Bond, or SIB. Early experiments in the United Kingdom are testing whether these bonds could be part of the solution to reducing pressure on public spending, but, to help SIBs fulfil this promise, it's critical to address how they can be most effectively implemented.

Originating in the United Kingdom, SIBs were first brought to the United States in August 2012 when the Goldman Sachs Group committed nearly $10 million to an anti-recidivism program for adolescents at Rikers Island prison in New York.

To celebrate our first 60 years, we created 60 Ways RAND Has Made a Difference, an online book to illustrate our most notable contributions. On our 65th birthday, we provide five of the most recent ways in which we at RAND are proud to have made a difference.

1. Improving the lives of servicemembers, veterans, and their families

A RAND study of return-to-work programs for veterans with service-related health problems identified which programs are most effective, which provide the best return on investment, and what strategies are needed to encourage servicemembers and veterans to utilize them.

In response to the disturbing increase in military suicides, RAND researchers looked at the support programs offered by the Department of Defense, and identified improvements to make suicide prevention strategies more effective.

RAND revisited its research on sexual orientation and U.S. military personnel policy and provided the Senate Armed Services Committee with current data as it considered and repealed the policy known as “Don't Ask, Don't Tell.”

This commentary appeared on the Asia Healthcare Blog on May 10, 2013.

Chinese health officials announced recently that a new bird flu virus is bringing sickness and death to dozens of seemingly random victims in the eastern part of the country. Scientists have classified this new flu as subtype H7N9.

Like its cousin H5N1, this latest version of the avian flu virus successfully made the jump from birds to people. And like its predecessor it is especially deadly, according to the leader of an international investigation team from the World Health Organization (WHO). Authorities aren't certain how all its victims have been infected, but they have found no evidence, for now at least, that ongoing spread from person to person is occurring.

This commentary appeared in USA Today on April 25, 2013.

Believe me, I've heard all the pot jokes, and some of them are true. Public support for legalizing marijuana use is at an all-time high. Some state-level marijuana laws are going up in smoke. And yes, Washington and Colorado are embarking on a historic joint venture.

Puns aside, discussions about marijuana legalization are getting serious. In November, voters in Colorado and Washington made the unprecedented decision to allow commercial production, distribution and possession of marijuana for nonmedical purposes. Not even the Netherlands goes that far.