Christopher Nelson

Senior Political Scientist; Professor of Public Policy, Pardee RAND Graduate School

Santa Monica Office

Education

Ph.D. and M.A. in political science, The University of North Carolina at Chapel Hill; B.A. in political science, University of Minnesota

Media Resources

This researcher is available for interviews.

To arrange an interview, contact the RAND Office of Media Relations at (310) 451-6913, or email media@rand.org.

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Overview

Christopher Nelson is a senior political scientist at the RAND Corporation and a professor at the Pardee RAND Graduate School. He has over 20 years of experience as a policy analyst and evaluator. His work often involves leading multi-disciplinary teams in designing systems for performance measurement, system improvement, and organizational learning.

Nelson has worked in a wide range of policy areas, including public health, healthcare, workplace safety, education, and others. For instance, he has helped agencies in the United States and European Union develop and implement new systems for measuring state/local capacity to respond to bioterrorism attacks, infectious disease outbreaks, and other health emergencies. His teams have also developed user-friendly game-based tools for improving emergency response capabilities in hospitals, health departments, and community-level healthcare coalitions. Nelson also was founding director of the RAND Center for Health and Safety in the Workplace. Prior to coming to RAND, he authored What's Public About Charter Schools: Lessons Learned About Choice and Accountability (Corwin Press, 2002) and numerous papers and technical reports on charter schools reforms in the U.S.

Previously Nelson held positions on the research staff of the Illinois state legislature, Carnegie Mellon University’s Heinz School of Public Policy and Management, and the Western Michigan University Evaluation Center. He holds an M.A. and Ph.D. in political science from the University of North Carolina at Chapel Hill.

Research Focus

Pardee RAND Graduate School Courses

Previous Positions

Visiting Faculty, Heinz School of Public Policy and Management, Carnegie Mellon University

Recent Projects

Incident Management Systems: Promising Measures of Performance and Effectiveness
Enhancing Prehospital Outcomes for Cardiac Arrest
Hurricane Recovery Plan for Puerto Rico
A New Governance and Management System for the University California Health System.
Organizing the Healthcare System for High Consequence Infectious Diseases.

Selected Publications

Stoto M, C Nelson, E Savoia, I Ljungqvist, M Ciotti. , "Public Health Preparedness Logic Model: Assessing Preparedness for Cross-border Threats in the European Region. ," Health Security, 15(5), 2006

Christopher Nelson et al., "Assessing Public Health Emergency Preparedness: Concepts, Tools, and Challenges," Annual Review of Public Health, 28, 2007

Christopher Nelson et al., "Conceptualizing and Defining Public Health Emergency Preparedness," American Journal of Public Health, 97, 2007

N. Lurie et al., "Public Health Preparedness: Evolution or Revolution?" Health Affairs, 25(4), 2006

Ranney J, C Nelson, & M Coplen, "The Efficacy of Behavior-based Safety in the U.S. Railroad Industry: Evidence from Amtrak-Chicago," Human Factors in Organizational Design and Management, 8, 2005

Ranney J, C Nelson, "The Impacts of Participatory Safety Rules Revision in the U.S. Railroad Industry: An Exploratory Assessment," Transportation Research Record, (1899), 2004

Dubowitz T, T Orleans, C Nelson, J Sloan, L May., "Creating Healthier, More Equitable Communities By Improving Governance And Policy," Health Affairs, 35(11), 2016

Nelson C, J Sloan, A Chandra. , Examining Civic Engagement Links to Health: Findings from the Literature and Implications for a Culture of Health. , RAND (RR-3163-RWJ )

Honors & Awards

Thomas Lord Distinguished Scholar, RAND Institute for Civil Justice

Recent Media Appearances

Interviews: Los Angeles Times; United Press International

Commentary: San Diego Union-Tribune

Commentary

COVID-19 Has Offered Opportunities for Communities to Come Together
The past year has been among the most turbulent in recent memory. Might the crises of the past year provide a catalyst for a renewed sense of civic engagement that transcends some of the race and class divisions COVID-19 has exacerbated?
Jan 13, 2021 The RAND Blog
How Much Do Americans Value Their Health During the Pandemic?
Do Americans believe that limiting the spread of COVID-19 justifies the social and economic costs of physical-distancing measures? Researchers conducted a survey to better understand how Americans weigh health against other priorities.
Oct 29, 2020 The RAND Blog
Out of the Ashes: Forging the Post-Pandemic U.S. Health System
With shifting insights, new problems, and exacerbation of old problems revealed by the pandemic, innovative solutions in the U.S. health system are being adopted where rapid change would normally have been rare. There is both an opportunity and a responsibility to assess how these changes are working and where they can improve health, reduce inequity, and save money.
Jul 31, 2020 The RAND Blog
Needed: A Blueprint for a Post-Vaccine World
When a COVID-19 vaccine is developed, many in rich countries may be able to afford it while the poor and uninsured may not. The time to plan for equitable access, financing, intellectual property rights, and global production is now.
May 11, 2020 The Hill
Don't Waste This Crisis: How America Can Begin Building a System of Health
COVID-19 is shining a harsh spotlight on long-recognized but under-addressed gaps in the U.S. health system. There may never have been a more pressing time to think differently, broadening from health care services to a health-producing System of Health.
May 4, 2020 The RAND Blog
Implement Critical Care Surge Strategies Now to Save Lives
As COVID-19 continues to spread, hospitals are bracing for a surge of patients requiring critical care. To meet the demand, U.S. health care facilities may need to fundamentally change the way they allocate space, staff, and equipment.
Apr 1, 2020 Health Affairs Blog
COVID-19: A Stress Test for a U.S. Health Care System Already Under Stress
There are many things hospitals and health systems could be doing in the coming weeks to best prepare for the advancing novel coronavirus (COVID-19) outbreak. Evaluating their surge response plans will be critical.
Mar 12, 2020 Health Affairs Blog
Rx Civic Engagement: Keeping the Public Engaged in Public Health
Civic engagement—activities like voting and volunteering—is essential for the health of democracy. A turn at the ballot box might also improve physical and mental health.
Feb 4, 2020 Las Vegas Sun
After School Shootings, Children and Communities Struggle to Heal
School shootings leave wounds that affect students, school staff, families, and communities for years. Building community resilience, implementing evidence-based mental health support early, and providing access for survivors and the community immediately and in the long term could help promote healing and prevent more tragedy.
Jul 19, 2019 Health Affairs Blog
Lessons for First Responders on the Front Lines of Terrorism
Given the persistent risk of terrorist attacks, it is critical to learn from past incidents to prepare for future ones. Medical and nonmedical first responders need more training in basic lifesaving skills. Open communication lines such as a dedicated radio frequency could help responders better coordinate. Disaster drills are also essential.
Jul 10, 2017 The Conversation
Saving Lives After Tragedy
Natural and man-made mass-casualty incidents are a growing threat. Evaluating successes and shortcomings after each crisis can contribute to the design and implementation of robust and resilient response systems and ensure the best possible outcomes for individuals and impacted communities.
Dec 14, 2015 U.S. News & World Report
Navigating Research on Alternative Schools
Published commentary by RAND staff.
Sep 19, 2004 San Diego Union-Tribune

Publications

Report
COVID-19 and the Experiences of Populations at Greater Risk: Description and Top-Line Summary Data — Wave 2, Fall 2020
This report presents the results of the second of four surveys on how Americans' health views and values have been affected by the COVID-19 pandemic, with a focus on populations deemed vulnerable or underserved.
Jan 13, 2021
Report
COVID-19 and the Experiences of Populations at Greater Risk: Description and Top-Line Summary Data — Wave 1, Summer 2020
This report presents the results of the first of four surveys on how Americans' health views and values have been affected by the COVID-19 pandemic, with a focus on populations deemed vulnerable or underserved.
Oct 29, 2020
Report
Health and Social Services in Puerto Rico Before and After Hurricane Maria: Predisaster Conditions, Hurricane Damage, and Themes for Recovery
This overview of health and social services in Puerto Rico includes 31 courses of action to better recover from health crises, build a more resilient system to future disasters, and actively promote health and well-being.
Sep 30, 2020
Report
The Education Sector in Puerto Rico After Hurricane Maria: Predisaster Conditions, Hurricane Damage, and Themes for Recovery
Presenting a strategic approach to aid Puerto Rico's recovery from Hurricanes Irma and Maria, the report details prestorm conditions, assesses damage and recovery needs, and describes courses of action for the Education sector.
Sep 30, 2020
Journal Article
Amplifying Stewardship: Characteristics and Trends Stewards Consider When Expanding Equitable Well-Being
This report profiles characteristics of people who are not only impressive stewards, but also are helping to grow the entire field of system stewardship for well-being.
Aug 4, 2020
Journal Article
Factors Related to Health Civic Engagement: Results from the 2018 National Survey of Health Attitudes to Understand Progress Towards a Culture of Health
Health civic engagement may help improve conditions that influence health and well-being for all. Focusing on individuals' sense of community and highlighting investments in community health may be associated with increased health civic engagement and improved community and population health.
Jul 24, 2020
Research Brief
Critical Care Surge Capacity in U.S. Hospitals: Strategies for Responding to the COVID-19 Pandemic
In this brief, the authors present methods for creating critical care surge capacity in hospitals in response to the COVID-19 pandemic and estimate patient capacity, given the number of doctors, nurses, respiratory therapists, ventilators, and beds.
May 5, 2020
Report
Critical Care Surge Response Strategies for the 2020 COVID-19 Outbreak in the United States
In this report, the authors present strategies for creating critical care surge capacity in hospitals and estimate patient capacity, given the number of available critical care doctors and nurses, respiratory therapists, ventilators, and beds.
Apr 3, 2020
Tool
RAND Critical Care Surge Response Tool: An Excel-Based Model for Helping Hospitals Respond to the COVID-19 Crisis
A Microsoft Excel-based tool that allows decisionmakers at all levels -- hospitals, health care systems, states, regions -- responding to the COVID-19 crisis to estimate current critical care capacity and rapidly explore strategies for increasing it.
Apr 3, 2020
Report
Does the United States Need to Strengthen the System of Care for Infectious Diseases?
RAND researchers consider responses to prior infectious disease outbreaks, identify options that could strengthen the current system of care for rare but serious infectious diseases, and discuss key financial considerations for sustainability.
Feb 7, 2020
Report
Examining Civic Engagement Links to Health: Findings from the Literature and Implications for a Culture of Health
This report summarizes a structured review to understand what the current scientific literature indicates about whether health is a cause of civic engagement, a consequence of it, or both.
Sep 18, 2019
Report
Updating the Costs of Compliance for California's Hospital Seismic Safety Standards
California Senate Bill 1953 requires structural and nonstructural upgrades to hospital buildings to enhance resilience to seismic events. This report estimates the costs to hospitals of compliance, with a focus on the 2030 deadline.
Mar 28, 2019
Report
Supporting the Development of a Vision and Strategic Plan for Zhejiang University's Academic Medical Center (为浙江大学学术型医学中心制定愿景与战略规划): Chinese Translation (simplified characters)
This is a Chinese translation of a report that identifies and assesses potential models of organization to help achieve the goals of Zhejiang University's academic medical center.
Mar 1, 2019
Report
Supporting the Development of a Vision and Strategic Plan for Zhejiang University's Academic Medical Center
This report identifies and assesses potential models of organization to help achieve the goals of Zhejiang University's academic medical center.
Jan 3, 2019
Report
Understanding the Economic Benefit Associated with Research and Services at the National Institute for Occupational Safety and Health: An Approach and Three Case Studies
The National Institute for Occupational Safety and Health (NIOSH) asked the RAND Corporation to develop an approach for estimating the economic benefit of NIOSH research, using three case studies. A new report details findings and recommendations.
Jan 2, 2018
Journal Article
Can Measures Change the World?
The purpose of this article is to start a dialogue about how one can better use measurement to promote large-scale system change.
2018
Journal Article
Governing Academic Medical Center Systems: Choosing Among Alternative Governance Approaches
This assessment of governance approaches for academic medical centers (AMCs) helped the University of California respond to changes in the funding environment and provides a systematic way for any AMC to weigh the strengths and weaknesses of its governance approaches..
Oct 10, 2017
Report
Process and Outcome Evaluation of the Alternative and Renewable Fuel and Vehicle Technology Program
Presents the results of a process and outcome evaluation of the California Energy Commission's Alternative and Renewable Fuel and Vehicle Technology Program, relying on quantitative and qualitative methods.
Sep 6, 2017
Journal Article
Assessing and Improving Hospital Mass-Casualty Preparedness: A No-Notice Exercise
An exercise developed for hospitals helps them assess and improve their readiness for mass casualty incidents.
Sep 1, 2017
Journal Article
Creating Healthier, More Equitable Communities by Improving Governance and Policy
Political and governance considerations should play a central role in the national conversation about improving health and health equity.
Nov 28, 2016
Journal Article
Using Insights from Behavioral Economics to Strengthen Disaster Preparedness and Response
Behavioral economics has achieved positive results in decision-making contexts similar to those surrounding disaster preparedness and response, and therefore the low cost and potentially high impact of behavioral economics-based interventions warrant further investigation.
Jun 2, 2016
Report
Building a National Culture of Health: Background, Action Framework, Measures, and Next Steps
In 2013, the Robert Wood Johnson Foundation (RWJF) began its Culture of Health initiative. To implement the primary Culture of Health outcome of improved population health, well-being, and equity, RWJF worked with RAND to develop an action framework.
Mar 11, 2016
Journal Article
Wearing Many Hats: Lessons About Emergency Preparedness and Routine Public Health from the H1N1 Response
Describes some of the challenges the Los Angeles County Department of Public Health (LACDPH) faced during the pH1N1 response associated with simultaneous operation of emergency and routine operations.
Apr 7, 2015
Journal Article
Lessons About the State and Local Public Health System Response to 2009 H1N1 Pandemic: A Workshop Summary
The response to the 2009 H1N1 influenza pandemic provides an opportunity to learn about the public health system's emergency response capabilities and to identify ways to improve preparedness for future events.
Aug 26, 2013
Report
CMS Innovation Center Health Care Innovation Awards: Evaluation Plan
The Center for Medicare and Medicaid Innovation has funded 108 projects implementing new service delivery or payment models intended to deliver lower cost through improving quality of care. This report describes a strategy for evaluating the results.
Aug 15, 2013
Journal Article
Learning About After Action Reporting from the 2009 H1N1 Pandemic: A Workshop Summary
The after action report/improvement plan (AAR/IP) can be useful for both accountability and quality improvement, but these objectives require different foci and methodological approaches.
Apr 12, 2013
Journal Article
Building Performance-Based Accountability with Limited Empirical Evidence: Performance Measurement for Public Health Preparedness
Efforts to respond to performance-based accountability mandates for public health emergency preparedness have been hindered by a weak evidence base linking preparedness activities with response outcomes.
2013
Report
Analysis of the Cities Readiness Initiative
Examines (1) the status of communities' capability to deliver medical countermeasures within 48 hours of a federal decision to deploy assets and (2) whether the Cities Readiness Initiative has improved communities' capability to meet that goal.
Mar 27, 2012
Journal Article
Assessing Relationships Between State and Local Public Health Organizations: Evidence from the NACCHO 2008 Profile of Local Health Departments
Public health systems vary by degree of centralization, reflecting the distribution of authority, responsibility, and effort between state and local public health agencies.
Mar 1, 2012
Journal Article
Developing and Pilot Testing a Laboratory Specific Continuity of Operations Tabletop Exercise
Describes the importance of a Continuity of Operations Plan (COOP), and identifies common strengths and potential vulnerabilities of laboratoy-specific COOPs.
2012
Journal Article
Developing National Standards for Public Health Emergency Preparedness with a Limited Evidence Base
National performance standards for public health preparedness can be developed based on existing evidence, but would be helped immensely by a stronger evidence base.
Dec 1, 2010
Research Brief
Are Performance-Based Accountability Systems Effective? Evidence from Five Sectors
Effective performance-based accountability systems (PBAS) require careful attention to selecting an appropriate design for the PBAS, given the context in which it is to operate, and to monitor, evaluate, and adjust the system, as appropriate.
Jul 28, 2010
Report
Toward a Culture of Consequences: Performance-Based Accountability Systems for Public Services — Executive Summary
Performance-based accountability systems (PBASs) link incentives to measured performance to improve public services. This report explores PBAS design and effectiveness in child care, education, health care, emergency preparedness, and transportation.
Jul 21, 2010
Report
Toward a Culture of Consequences: Performance-Based Accountability Systems for Public Services
Performance-based accountability systems (PBASs) link incentives to measured performance to improve services to the public. This book discusses PBASs' effectiveness in child care, education, health care, emergency preparedness, and transportation.
Jul 19, 2010
Report
An Assessment of the U.S. Environmental Protection Agency's National Environmental Performance Track Program
The National Environmental Performance Track program sought to encourage facilities to improve their environmental performance. The U.S. Environmental Protection Agency should continue to find ways to enhance traditional regulatory approaches.
May 7, 2010
Journal Article
Federal Initiative Increases Community Preparedness for Public Health Emergencies
This article describes an evaluation of the Cities Readiness Initiative, a federal program to improve communities' ability to dispense medications rapidly during emergencies.
2010
Journal Article
The Pennsylvania Certified Safety Committee Program: An Evaluation of Participation and Effects on Work Injury Rates
Since 1994, Pennsylvania, has provided a 5% discount on workers' compensation premiums for firms with a certified joint labor-management safety committee. This study found that injury rates at participating firms with good compliance records dropped more than at other firms.
2010
Draft
Decision-Making Modules for the RSS-POD Supply Management Game: A Game-Based Assessment of Crisis Decision Making During Inventory Management and Distribution of Medical Countermeasures
Introduces and explains two new modules for the RSS-POD Supply Chain Management Game, an Excel-based computer simulation game designed to provide practice in managing inventories of medical countermeasures during a largescale public health emergency.
Oct 11, 2009
Draft
The RSS-POD Supply Chain Management Game: An Exercise for Improving the Inventory Management and Distribution of Medical Countermeasures
Introduces and explains the RSS-POD Supply Chain Management Game, a Microsoft Excel-based simulation game designed to provide practice in managing inventory of medical countermeasures during large-scale public health emergency.
Sep 25, 2009
Report
New Tools for Assessing State and Local Capabilities for Countermeasure Delivery
Presents assessments that test five critical elements of state and local health departments' capability to deliver countermeasures to the population under rapid timeframes.
Sep 3, 2009
Report
Measuring Crisis Decision Making for Public Health Emergencies
Describes a tool for assessing key features of good crisis decision making that focuses on the processes of decision making -- situational awareness, action planning, and process control -- and can be used for exploratory analysis and process improvement.
Aug 17, 2009
Report
A National Agenda for Public Health Systems Research on Emergency Preparedness
The Office of the Assistant Secretary for Preparedness and Response asked RAND to facilitate the development of a public health systems research agenda for emergency preparedness with a focus on both short- and long-term priorities.
Aug 11, 2009
Draft
A Workshop Template to Assess and Improve SNS Planning
Contains a template that public health agencies can use to conduct a workshop to improve key aspects of Strategic National Stockpile planning: pediatric dispensing, altered standards of care, and allocation of scarce resources.
Aug 4, 2009
Research Brief
Are Communities Ready to Conduct Rapid and Large-Scale Dispensing of Medications During a Public Health Emergency?
This research highlight summarizes the findings of RAND's initial evaluation of the Cities Readiness Initiative and the program's impact on communities' readiness to conduct mass dispensing of medications and other medical supplies.
Apr 1, 2009
Report
Initial Evaluation of the Cities Readiness Initiative
The Centers for Disease Control and Prevention asked RAND to provide an initial evaluation of the impact of the Cities Readiness Initiative on awardees' readiness and capability to conduct mass countermeasure dispensing.
Jan 30, 2009
Report
Foundation for Integrating Employee Health Activities for Active Duty Personnel in the Department of Defense
Describes current Department of Defense (DoD) safety and occupational health programs and health information systems, and employee health programs outside of DoD as a foundation for considering a more integrated DoD employee health program.
Jan 13, 2009
Research Brief
A Step Forward in Accountability for Public Health Emergency Preparedness: Developing Standards for Mass Antibiotic Dispensing
This fact sheet summarizes the results of a RAND initiative to develop performance standards for distributing antibiotics and other lifesaving medical countermeasures on a large scale within the critical first 48 hours of a public health emergency.
Nov 10, 2008
Report
Recommended Infrastructure Standards for Mass Antibiotic Dispensing
This report presents recommended standards for points of dispensing (or PODs), locations where the public would receive life-saving antibiotics or other medical countermeasures during a large-scale public health emergency.
Sep 29, 2008
Draft
The Pennsylvania Certified Safety Committee Program: An Evaluation of Participation and Effects on Work Injury Rates
This evaluation of the voluntary Pennsylvania Certified Safety Committee program found that although compliance did reduce injuries, most participants did not comply and injury rates did not decline more at participating firms.
Sep 18, 2008
Draft
Conceptualizing and Defining Public Health Emergency Preparedness
Discusses an effort to develop a clear and widely applicable definition of public health emergency preparedness (PHEP) that can provide a basis on which to develop PHEP standards and measures.
May 16, 2008
Journal Article
How Can We Strengthen the Evidence Base in Public Health Preparedness?
In this article, the authors argue that initial funding priorities for public health systems research on preparedness should focus on using engineering-style methods to identify core preparedness processes, developing novel data sources and measures based on smaller-scale proxy events, and developing performance improvement approaches to support the translation of research into practice within the wide variety of public health systems found in the nation.
2008
Research Brief
Promoting Accountability in Public Health Emergency Preparedness
This research brief summarizes research that has identified the advantages and disadvantages of some approaches used to measure public health preparedness and suggested avenues for developing new preparedness tools.
Sep 5, 2007
Journal Article
Assessing Public Health Emergency Preparedness: Concepts, Tools, and Challenges
Have government investments in public health preparedness left the public health system prepared to respond to large-scale public health emergencies?
Apr 1, 2007
Journal Article
Quality Improvement in Public Health Emergency Preparedness
Quality improvement (QI) methods have been used in many industries to improve performance and outcomes.
Apr 1, 2007
Journal Article
Conceptualizing and Defining Public Health Emergency Preparedness
A substantial federal investment has been made to increase our nation's ability to prepare for, and respond to, public health emergencies.
2007
Research Brief
Emergency Preparedness Is Stimulating Changes in Public Health Practice
This fact sheet summarizes interrelated RAND projects to examine public health infrastructure and how public health preparedness is transforming public health agencies.
Sep 6, 2006
Research Brief
Quality Improvement Methods Can Be Used to Improve Public Health Emergency Preparedness
This fact sheet summarizes a RAND study to show how quality improvement methods can be used to improve the emergency preparedness of the U.S. public health system.
Sep 6, 2006
Report
Organizing State and Local Health Departments for Public Health Preparedness
Assesses whether there is a link between how state and local public health departments are organized and their level of emergency preparedness.
May 19, 2006
Research Brief
Are Small Businesses Riskier Than Larger Ones?
This research brief summarizes research that provides a more complete picture of fatality risks found at both smaller establishments and smaller firms, to help inform effective policies toward small businesses.
Apr 26, 2006
Report
Small Businesses and Workplace Fatality Risk: An Exploratory Analysis
Analyzes the relationship between fatality rate and business size, both in terms of establishment and firm size, from 1992 to 2001.
Apr 20, 2006
Report
Quality Improvement: Implications for Public Health Preparedness
Develops a framework for applying quality improvement (QI) in public health; investigates the applicability of those models to public health emergency preparedness.
Apr 14, 2006
Research Brief
Disparities in Care for HIV Patients: Results of the HCSUS Study
This research brief summarizes the findings on access to care from the HIV Costs and Services Utilization Study (HCSUS), the first comprehensive U.S. survey of health care use among a nationally representative sample of HIV-positive patients.
Apr 3, 2006
Journal Article
Public Health Preparedness: Evolution or Revolution?
This paper describes how public health preparedness is transforming public health agencies.
2006
Report
Evaluation of a Patient Safety Training Program
Evaluates a pilot fellowship program on patient safety concepts that addresses the issue of deaths from preventable medical errors.
Aug 4, 2005
Report
Assessment of 24-Hour Care Options for California
Assesses the value of 24-hour care--an insurance plan that consolidates employers' health care benefits for work-related and non-work-related claims--as a mechanism for reducing workers' compensation costs.
Dec 13, 2004

Multimedia

4:09
The Connection Between Civic Engagement and Health
Mar 2, 2020