Roland Sturm

Senior Economist; Professor, Pardee RAND Graduate School

Santa Monica Office

Education

Ph.D. in economics, Stanford University; M.S in statistics, Stanford University; M.A. in economics, University of Florida

One Page Bio

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

Roland Sturm is a senior economist at the RAND Corporation and a professor at the Pardee RAND Graduate School, where he teaches advanced econometrics and statistics. He is the author of 170 scientific publications. Sturm has analyzed “big data” for more than 25 years, including operating records of nuclear power plants, medical records, insurance claims, credit card purchases, and supermarket scanner data. Current projects develop microsimulation tools to predict policy impacts on long-term population outcomes. Previous projects studied how urban design and neighborhood characteristics affect lifestyles and health; the effects of zoning and labeling regulations; the effects of health behaviors on health care costs; and how managed care and policy changes affect behavioral health. He has testified before the U.S. Senate, House of Representatives, and numerous state legislatures. Sturm received a Ph.D. in economics and an M.A. in statistics from Stanford University and an M.S. in economics from the University of Florida.

Research Focus

Pardee RAND Graduate School Courses

Recent Projects

Microsimulation of Obesity Policies
Discrete Choice Experiment on Menu Labeling
Eating Better For Less: Evaluating A National Discount Program on Healthy Food Purchases in South Africa
Behavioral Economics: Incentives for Preventive Care
The effect of urban design, neighborhood characteristics, and the food environment on lifestyles, health outcomes, and health care costs

Selected Publications

Herman R, Chen A, Sturm R, "Improving Diet Quality in US Adults: A 30-year Health and Economic Impact Microsimulation," American Journal of Preventive Medicine, 2022

Roland Sturm, Haijing Crystal Huang, Flavia Tsang, Liisa Hiatt, Rosanna Smart, Cameron Wright, Helen Wu , Examining Consumer Responses to Calorie Information on Restaurant Menus in a Discrete Choice Experiment, RAND (RR-1957), 2018

Sturm R, An R, "Obesity and economic environments," CA Cancer J Clin, 64(5), 2014

Sturm R, Hattori A, "Diet and obesity in Los Angeles County 2007-2012: Evaluating the Fast Food Ban," Soc Sci Med, 2015

Sturm R, An R, Segal D, Patel P, "A cash-back rebate program for healthy food purchases in South Africa: results from scanner data," American Journal of Preventive Medicine, 44(6), 2013

Sturm R, Powell LM, Chriqui JF, Chaloupka FJ, "Soda Taxes, Soft Drink Consumption, and Children's Body Mass Index," Health Affairs, 29(5), 2010

Wells KB, Sturm R, Sherbourne CD, Meredith LS, Caring For Depression, Harvard University Press

Honors & Awards

Willard Manning Award in Health Policy and Economic Research, ICMPE
Edwin E. and Mary T. Huddleson Outstanding Teacher Award, Pardee RAND Graduate School of Policy Analysis
Award for Excellence in Health Services Research, National Institute of Health Care Management

Recent Media Appearances

Interviews: ABC; Associated Press; Chicago Sun-Times; CNN; Health & Medicine Week; KCRW-FM; KNX-AM; Los Angeles Times; NBC Nightly News; New York Times; NewsRx.com; NPR; Reuters; Scripps Howard News Service; USA Today; Wall Street Journal; Marketplace Radio; Washington Post

Commentary

Obesity

Five Myths About American Obesity
Two in three Americans are overweight or obese. There are many popular theories about what's causing the obesity epidemic, but many are not supported by data. What's clear is that most U.S. adults eat too many calories.
Mar 13, 2017
Politico
Obesity

What's Behind the Obesity Epidemic? Easily Accessible Food, and Lots of It
That no group is immune to rising obesity rates suggests that universal environmental factors are driving the trend. The clearest change concerns food availability and cost.
Jul 22, 2014
The Health Care Blog
Health Behaviors

Eating Better for Less
A combination of things might well slow the obesity epidemic while also improving the American people's overall nutritional well-being: lowering prices on healthier food, initiatives to control portion sizes, and a long-term campaign to support better food quality.
May 28, 2013
Modern Healthcare
Public Health

Worth Its Weight in Gold?
In terms of healthcare use and chronic health conditions, obesity is comparable to aging 20 years, with the health of a 30 year old resembling that of a 50 year old, writes Roland Sturm.
Apr 21, 2011
Public Service Review: European Union

Publications

Journal Article
Improving Diet Quality in U.S. Adults: A 30-Year Health and Economic Impact Microsimulation
Microsimulation (Future Adult Model) predicted 30-year improved diet quality impacts across 12 demographic groups. Diet improvement reduced prevalence of heart disease by 7.6% to 13.8% across groups and reduced healthcare costs by $10B in year 30.
Jul 12, 2022
Journal Article
Depressive Symptoms Among US Adults During the Great Recession and Economic Recovery
National Health and Nutrition Examination Survey data show a statistically significant increase in depressive symptoms from 2005/2006 to 2007/2008 (the beginning of the Great Recession), but there were no significant or consistent changes after 2007/2008.
Jul 7, 2022
Journal Article
Diet Quality in the United States Improved During the Great Recession and Deteriorated During Economic Recovery
During the Great Recession, American diets became more consistent with Dietary Guidelines for Americans recommendations, possibly because of a shift toward food prepared at home instead of prepared food bought away from home.
Jul 7, 2022
Journal Article
Diet Quality Improvement and 30-Year Population Health and Economic Outcomes: A Microsimulation Study
Microsimulation (Future Adult Model) predicted 30-year US population changes from improved diet quality. Diet improvement reduced prevalence of diabetes, heart disease and stroke by 11%, 7%, and 10%, and reduced healthcare costs by $144B in year 30.
2021
Tool
How Would a Better Diet Affect Health and Economic Outcomes in the United States?
An online tool shows the effect that improving diet quality in the United States could have on health and economic outcomes, such as the prevalence of diet-related illness, health care spending, and labor force participation, over a 30-year period.
Sep 21, 2020
Journal Article
Obesity Prevention Interventions and Implications for Energy Balance in the United States and Mexico: A Systematic Review of the Evidence and Meta-Analysis
Obesity is preventable and yet continues to be a major risk factor for chronic disease. This review searched the vast literature on obesity prevention interventions to assess their effects on daily energy consumed and energy expended.
Aug 8, 2019
Report
Examining Consumer Responses to Calorie Information on Restaurant Menus in a Discrete Choice Experiment
In light of the 2014 U.S. Food and Drug Administration final rule requiring the calorie content of food items to be clearly displayed on menus, RAND researchers designed an online survey to look at how this information affects consumers.
Mar 28, 2018
Journal Article
Neighborhood Food Environment, Diet, and Obesity Among Los Angeles County Adults, 2011
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Nov 19, 2015
Journal Article
Diet and Obesity in Los Angeles County 2007-2012: Is There a Measurable Effect of the 2008 "Fast-Food Ban"?
We evaluate the impact of the Los Angeles Fast-Food Ban, a zoning regulation that has restricted opening/remodeling of standalone fast-food restaurants in South Los Angeles since 2008.
Mar 17, 2015
Report
Quantifying the Contribution of Public Parks to Physical Activity and Health: Introducing SOPARC
This paper introduces the System for Observing Play and Recreation in Communities (SOPARC), a reliable, valid, and easy-to-use tool for quantifying park use and park-based physical activity.
Dec 2, 2014
Research Brief
Too Much of a Good Thing? How the Economic Environment Plays a Role in the Obesity Epidemic
RAND researchers looking at the growth of obesity rates over time found that the epidemic has been fueled by historically low food prices relative to income and constant availability, which have driven high consumption.
Aug 22, 2014
Journal Article
Impact of a Patient Incentive Program on Receipt of Preventive Care
Patient financial incentives are being promoted as a mechanism to increase receipt of preventive care, encourage healthy behavior, and improve chronic disease management. However, few empirical evaluations have assessed such incentive programs.
Jun 1, 2014
Infographic
Check, Please: Many Single Entrées at U.S. Chain Restaurants Serve Up Masses of Calories, Fat, and Sodium
This infographic breaks down just how bad a full meal at a chain restaurant can be.
May 20, 2014
Journal Article
Proximity to Urban Parks and Mental Health
Policy evaluations should incorporate mental health measures when assessing neighborhood improvement programs and physical environments.
Mar 1, 2014
Journal Article
Obesity and Economic Environments
This review summarizes current understanding of economic factors during the obesity epidemic and dispels some widely held, but incorrect, beliefs.
2014
Journal Article
Changes in the Energy and Sodium Content of Main Entrées in US Chain Restaurants from 2010 to 2011
Industry marketing and pledges may create a misleading perception that restaurant menus are becoming substantially healthier, but both healthy and unhealthy menu changes can occur simultaneously.
2014
Journal Article
The Effects of Obesity, Smoking, and Excessive Alcohol Intake on Healthcare Expenditure in a Comprehensive Medical Scheme
Health risks such as tobacco use, excessive alcohol consumption and unhealthy body weight contribute to the development of chronic health problems.
Nov 1, 2013
Journal Article
The Obesity Epidemic and Changes in Self-Report Biases in BMI
Increases in obesity rates based on self-reported height and weight are likely to reflect actual weight increases and are not inflated by changes in reporting accuracy.
Apr 1, 2013
Journal Article
Neighborhood Food Outlets, Diet, and Obesity Among California Adults, 2007 and 2009
The presence of food outlets near home is not associated with dietary intake or BMI. In general, shopping patterns are weakly related, if at all, to neighborhoods, perhaps because of easy access to cars.
Mar 1, 2013
Journal Article
A Cash-Back Rebate Program for Healthy Food Purchases in South Africa: Results from Scanner Data
This study examines the effect of a price reduction for healthy food items on household grocery shopping behavior among members of South Africa's largest health plan.
2013
Journal Article
Eating Better for Less: A National Discount Program for Healthy Food Purchases in South Africa
Examines whether reducing prices for healthy food purchases leads to changes in self-reported measures of food consumption and weight status.
2013
Journal Article
Provincial Screening Rates for Chronic Diseases of Lifestyle, Cancers and HIV in a Health-Insured Population
Screening for asymptomatic diseases can reduce the burden of morbidity and mortality in all population groups.
2013
Journal Article
Morbid Obesity Rates Continue to Rise Rapidly in the United States
Morbid obesity rates in the United States continue to rise rapidly. The relative rate of increase is similar across population subgroups, even though the prevalence at every point in time differs across groups.
2013
Journal Article
What's on the Menu? A Review of the Energy and Nutritional Content of US Chain Restaurant Menus
The paper provides a comprehensive view of chain restaurant menu nutrition prior to nationwide labeling laws. It offers baseline data to evaluate how restaurants respond after laws are implemented.
2013
Journal Article
Is There a Robust Relationship Between Neighbourhood Food Environment and Childhood Obesity in the USA?
To the extent that there is an association between food environment and youth obesity, the existence of more types of food outlets in an area, including supermarkets, is associated with higher BMI.
Sep 1, 2012
Journal Article
School and Residential Neighborhood Food Environment and Diet Among California Youth
This study examines the relationship between school and residential neighborhood food environment and diet among youth in California.
Feb 1, 2012
Journal Article
Changes in Body Mass During Elementary and Middle School in a National Cohort of Kindergarteners
Many children gained substantial weight in elementary school, especially in grades 1-3. Gains were not just among children who were already overweight or obese; children who entered kindergarten at normal weight also gained substantially.
Dec 1, 2011
Research Brief
Preventing Obesity and Its Consequences: Highlights of RAND Health Research
Summarizes key RAND studies on the causes of obesity, its economic and health consequences, and potential strategies for prevention, including work on health care costs, junk food, food deserts, school meals, and proximity of parks.
Aug 3, 2011
Journal Article
Does the Response to Alcohol Taxes Differ Across Racial/Ethnic Groups? Some Evidence from 1984-2009 Behavioral Risk Factor Surveillance System
This study examines how the effect of alcohol excise taxes on the demand for alcohol varies across different racial and ethnic groups.
Apr 1, 2011
Journal Article
Economic Analysis of Physical Activity Interventions
This study compared the cost-effectiveness of different public interventions for promoting exercise and found that community-based campaigns and school-based interventions have the greatest potential to be scaled up at the lowest costs.
Feb 1, 2011
Journal Article
Regional Price Differences and Food Consumption Frequency Among Elementary School Children
Geographic variation in food prices across the US affects youth's consumption of fruit, vegetables and milk; price variation does not seem to affect consumption of fast food or soft drinks, perhaps because consumption is less price sensitive.
Feb 1, 2011
Journal Article
The Role of School Physical Activity Programs in Child Body Mass Trajectory
Meeting the national recommendation for physical education and recess at school can help prevent obesity in children.
Feb 1, 2011
Journal Article
Discretionary Calorie Intake a Priority for Obesity Prevention: Results of Rapid Participatory Approaches in Low-Income US Communities
Reducing consumption of salty snacks, candy, cookies may be more effective than exercise in combating obesity
Sep 1, 2010
Journal Article
Soda Taxes, Soft Drink Consumption, and Children's Body Mass Index
Taxes on sugar-sweetened beverages have been proposed to combat obesity.
May 1, 2010
Journal Article
Facility Provision in Elementary Schools: Correlates with Physical Education, Recess, and Obesity
The objectives were to: (1) document correlations among facility provision (availability and adequacy) in elementary schools, child sociodemographic factors, and school characteristics nationwide; and (2) investigate whether facility provision
2010
Journal Article
Measuring the Physical Food Environment and Its Relationship with Obesity: Evidence from California
This study proposes an alternative measure to the Retail Food Environment Index (RFEI) called the 'Physical Food Environment Indicator' (PFEI), and tests its association with adult body mass index (BMI) and obesity in California.
2010
Journal Article
Not Enough Fruit and Vegetables or Too Many Cookies, Candies, Salty Snacks, and Soft Drinks?
There are many contributors to obesity, including excess consumption of discretionary calories (foods high in sugar and fat and low in essential nutrients), lack of fruit/vegetable consumption, and insufficient physical activity.
2010
Journal Article
Self-reported Unmet Need for Mental Health Care After California's Parity Legislation
Following passage of mental health parity legislation in California, perceived need for mental health care services increased significantly for all groups, regardless of insurance, resulting in a net increase of unmet need among the privately insured, among those with public insurance, and among the uninsured.
2010
Research Brief
South Los Angeles Ban on Fast-Food Chains Misses the Mark
Summarizes the evidence for the ban on new fast-food chain restaurants in South Los Angeles (LA), including the density of such restaurants in the area and the eating habits of South LA residents, and concludes that the data do not support the ban.
Nov 2, 2009
Research Brief
Hold the Salt: Lowering Sodium Intake Would Improve Health and Save Money
Details the benefits that would accrue from reducing sodium consumption among Americans, including a reduced prevalence of high blood pressure, lower medical costs, and improved quality of life.
Oct 9, 2009
Journal Article
Zoning for Health? The Year-Old Ban on New Fast-Food Restaurants in South LA
A regulation banning new fast-food establishments for one year in Los Angeles, California, was passed unanimously by the city council in July 2008, motivated by health concerns and excessive obesity rates in South Los Angeles. This paper reviews the empirical evidence for the regulation and whether it is likely to target the primary levers of obesity.
Oct 6, 2009
Journal Article
Affordability and Obesity: Issues in the Multifunctionality of Agricultural/Food Systems
This commentary argues that using obesity as an argument to promote local produce or other multifunctional outcomes is questionable; framing obesity as an issue of poverty or food insecurity trivializes the continuing major problem of hunger worldwide.
2009
Journal Article
Alcohol Environments and Disparities in Exposure Associated with Adolescent Drinking in California
The authors investigated sociodemographic disparities in alcohol environments and their relationship with adolescent drinking.
2009
Journal Article
Developing Policy Solutions for a More Active Nation: Integrating Economic and Public Health Perspectives
Both economic and public health/medical perspectives play an important role in the policy process but often approach policy questions in an incompatible way. Harnessing any synergy requires an understanding of the other perspective.
2009
Journal Article
Potential Societal Savings from Reduced Sodium Consumption in the U.S. Adult Population
Cross-sectional simulation scenarios were developed to estimate the effect of hypertension prevalence, direct medical costs, and quality of life years (QALYs) saved by reductions in sodium consumption. Population-level data on blood pressure, antihypertensive medication use, and sodium intake were from the National Health and Nutrition Examination Survey 1999-2004.
2009
Journal Article
Food Prices and Weight Gain During Elementary School: 5-Year Update
Childhood overweight has increased rapidly over the last two decades. Energy-dense foods are cheaper per calorie, which could be a partial explanation for why the highest rates of obesity are observed among groups of limited economic means.
Nov 1, 2008
Journal Article
Stemming the Global Obesity Epidemic: What Can We Learn from Data About Social and Economic Trends?
Significant effort is devoted to promoting increased fruit/vegetable consumption and physical activity to fight obesity, but environmental intervention and economic incentives to reduce energy intake and sedentary entertainment may be more effective.
Aug 1, 2008
Journal Article
Disparities in the Food Environment Surrounding US Middle and High Schools
Hispanic youth are likely to attend schools surrounded by convenience stores, restaurants, or off-licenses. Middle schools have fewer surrounding businesses than high schools, and larger schools have fewer surrounding businesses than smaller schools.
Jul 1, 2008
Journal Article
Body Mass Index Is Increasing Faster Among Taller Persons
Taller people have been increasing their body mass indexes during the past 40 years at a faster rate than shorter people. Constraints on weight gain for taller people that existed in a more calorie-constrained environment may have been eliminated.
2008
Research Brief
How Neighborhoods Can Reduce the Risk of Obesity
This research brief explores the relationship of a neighborhood's characteristics to obesity in its residents.
Jun 12, 2007
Research Brief
Obesity and Disability: The Shape of Things to Come
This research brief summarizes studies that found that individuals who are obese face greater challenges in terms of disability and chronic disease than do their non-obese counterparts.
Apr 8, 2007
Report
Alcohol and Environmental Justice: The Density of Liquor Stores and Bars in Urban Neighborhoods in the United States
Characterizes the density of liquor stores and bars that individuals face according to race, economic status, and age in the urban United States and finds mismatches between alcohol demand and the supply of liquor stores.
Jan 1, 2007
Journal Article
Increases in Morbid Obesity in the USA: 2000-2005
The aggressive and costly expansion of bariatric surgery in recent years has had no visible effect on containing morbid obesity rates in the USA.
2007
Journal Article
School Characteristics and Behavior Problems of U.S. Fifth-Graders
Report based on a national survey of 11,283 fifth-graders in 2,390 schools from the Early Childhood Longitudinal Study-Kindergarten in 2003-2004.
2007
Report
Park Use and Physical Activity in a Sample of Public Parks in the City of Los Angeles
Investigates how parks promote physical activity for individuals and how well parks serve the surrounding community.
Jan 30, 2006
Journal Article
Alcohol Outlets and Problem Drinking Among Adults in California
The purpose of the study was to examine the relationship between alcohol environments and problem drinking.
2006
Report
Childhood Overweight and Elementary School Outcomes
Examines the link between childhood overweight status and elementary school outcome and finds that change in overweight status during the first four years in school is a significant risk factor for adverse school outcomes among girls but not boys.
2006
Report
Physical Activity and Changes in Health Care Costs in Late Middle Age
Finds that regular physical activity in late middle age may lower health expenditure over time and that the effect is likely to be more pronounced for the obese, smokers, and individuals with some health problems.
Jan 1, 2006
Journal Article
US-based Indices of Area-Level Deprivation: Results from HealthCare for Communities
The authors find that area-level deprivation predicts poor mental and physical health outcomes, but different components of deprivation have different effects.
2006
Journal Article
Body Mass Index in Elementary School Children, Metropolitan Area Food Prices and Food Outlet Density
The authors found no effects of food outlet density at the neighbourhood level, possibly because availability is not an issue in metropolitan areas.
2005
Journal Article
Childhood Obesity: What We Can Learn from Existing Data on Societal Trends, Pt. 2
Number of overweight and obese youth has increased in recent decades, few data assess how lives of children have changed during the obesity epidemic
2005
Journal Article
Childhood Obesity: What We Can Learn from Existing Data on Societal Trends, Pt. 1
The number of overweight and obese youth has increased in recent decades, and numerous theories on causes have been proposed.
2005
Journal Article
Depression and Comorbid Pain as Predictors of Disability, Employment, Insurance Status, and Health Care Costs
Relative to depression alone, depression plus pain and pain alone were associated with significant functional limitations and economic burdens.
2005
Journal Article
Economics and Physical Activity: A Research Agenda
Economic and public health/medical perspectives play an important role in the policy process, often approach policy questions in an incompatible way.
2005
Journal Article
Labor Market, Financial, Insurance and Disability Outcomes Among Near Elderly Americans with Depression and Pain
Economic burden of depression has been documented, but the role of comorbid pain among the depressed is unclear. Using Wave 3 of the Health and Retirement Survey in 1996, we conducted multivariate regression analyses to estimate associations between depression and comorbid pain, and labor market, financial, insurance and disability outcomes among near elderly Americans aged 55-65, controlling for socio-demographics and health conditions.
2005
Journal Article
Use of Mental Health Care Among Youths in 1997 and 2002
This column examines mental health service use among youths in 1997 and 2002 for 13 U.S. states and for the nation.
2005
Journal Article
Weight Gain Trends Across Sociodemographic Groups in the United States
To better understand health disparities, the authors compared US weight gain trends across sociodemographic groups between 1986 and 2002.
2005
Journal Article
Moderate and Severe Obesity Have Large Differences in Health Care Costs
Obesity imposes a burden on the health care system, and that burden grows disproportionately large for the most obese segment of the U.S. population.
Dec 1, 2004
Journal Article
Childhood Overweight and Academic Performance: National Study of Kindergartners and First-Graders
To examine the association between children's overweight status in kindergarten and their academic achievement in kindergarten and first grade.
2004
Journal Article
Childhood Overweight and Parent- and Teacher-Reported Behavior Problems: Evidence from a Prospective Study of Kindergartners
To determine if there is a relationship between overweight and behavior problems among children as young as 5 years old by studying the association between overweight and behavioral health at entry into kindergarten and to determine whether overweight status is a risk factor for the onset of new behavior problems during the first 2 years in school.
2004
Journal Article
Depression and Leaving Employment Among Older Adult Americans
The author's study suggests that depression takes a higher toll among older women in the workforce.
2004
Journal Article
Does Relative Deprivation Predict the Need for Mental Health Services?
Investigates whether low income relative to a reference group is associated with a higher probability of depressive disorders or anxiety disorders.
2004
Journal Article
The Economics of Physical Activity: Societal Trends and Rationales for Interventions
What are Americans doing with their time and their money and what has changed in recent decades?
2004
Journal Article
The Effects of State Mental Health Parity Legislation on Perceived Quality of Insurance Coverage, Perceived Access to Care, and Use of Mental Health Specialty Care
Comprehensiveness of state legislation appears to be related to the traditional level of use of mental health specialty care.
2004
Journal Article
Increasing Obesity Rates and Disability Trends: If It Continues at Its Current Rate, Rising Obesity Could Wipe Out Recent Improvements in Disability Among Older Americans
Unhealthy body weight has increased dramatically, but other data show that disability rates have declined.
2004
Journal Article
Mental Health and Employment Transitions
This paper provides insight into the ways in which women and men are affected by mental illness in the labor market.
2004
Report
Nuclear Power in Eastern Europe: Learning or Forgetting Curves?
Nuclear Power in Eastern Europe: Learning or Forgetting Curves?
2004
Journal Article
Physical Education in Elementary School and Body Mass Index: Evidence from the Early Childhood Longitudinal Study
The authors examined the effect of physical education instruction time on body mass index (BMI) change in elementary school.
2004
Periodical
RAND Review: Vol. 28, No. 1, Spring 2004
Argues that new threats to national security represent fundamental changes in the ecology of conflict and that America's approach must evolve to meet the challenges; education, obesity, and wind tunnels in aeronautical research are also discussed.
2004
Journal Article
Suburban Sprawl and Physical and Mental Health
Suburban design may be an important new avenue for health promotion and disease prevention.
2004
Journal Article
Geographic Disparities in Children's Mental Health Care
It is widely believed that only a minority of vulnerable children and adolescents receive any mental health services.
2003
Journal Article
Increases in Clinically Severe Obesity in the United States, 1986-2000
The prevalence of clinically severe obesity is increasing much faster than obesity.
2003
Journal Article
A National Study of the Effect of Chronic Pain on the Use of Health Care by Depressed Persons
Comorbid pain among persons with depression is associated with intensive use of medical services but lower rates of use of mental health services.
2003
Journal Article
The Role of Managed Care and Financing in Medical Practices: How Does Psychiatry Differ from Other Medical Fields?
The organization and financing of medical practice has experienced substantial changes during the past decade.
2003
Journal Article
Adverse Selection and Generosity of Alcohol Treatment Benefits
Two potential avenues of adverse selection, namely biased enrollment into plans and biased exit from plans offered by employers between 1991 and 1997.
2002
Journal Article
Alcohol, Drug Abuse, and Mental Health Care for Uninsured and Insured Adults
To compare adults with different insurance coverage in care for alcohol, drug abuse, and mental health (ADM) problems.
2002
Journal Article
An Early Case Study of the Effects of California's Mental Health Parity Legislation
In 2001, Congress defeated a proposed amendment that would have mandated nationwide parity for mental health coverage.
2002
Journal Article
Effect of Managed Care and Financing on Practice Constraints and Career Satisfaction in Primary Care
Physicians in solo and 2-physician practices were least satisfied with careers and reported more constraints on their clinical freedom and income.
2002
Report
Effects of Cost-Containment Strategies Within Managed Care on Continuity of The Relationship Between Patients with Depression and Their Primary Care Providers
Effects of Cost-Containment Strategies Within Managed Care on Continuity of The Relationship Between Patients with Depression and Their Primary Care Providers
2002
Report
The Effects of Obesity, Smoking, and Drinking on Medical Problems and Costs
The Effects of Obesity, Smoking, and Drinking on Medical Problems and Costs
2002
Journal Article
Evidence-based Health Policy Versus Evidence-Based Medicine
Argues that the most valuable research integrates information from three levels of investigation: clinical efficacy studies; real life effectiveness research, including studies of cost-effectiveness; and health policy research.
2002
Research Brief
The Health Risks of Obesity: Worse Than Smoking, Drinking or Poverty
Obesity is the most serious problem. It is linked to a big increase in chronic health conditions and significantly higher health expenditures. And it affects more people than smoking, heavy drinking, or poverty.
2002
Journal Article
The Impact of Practice Setting and Financial Incentives on Career Satisfaction and Perceived Practice Limitations Among Surgeons
To study how practice setting and financial incentives affect career satisfaction and perceived impact on practice in surgery.
2002
Journal Article
Relations of Income Inequality and Family Income to Chronic Medical Conditions and Mental Health Disorders: National Survey
This study provides no evidence for the hypothesis that income inequality is a major risk factor for common disorders of physical or mental health.
2002
Journal Article
Variations in Mental Health Specialty Care Across Metropolitan Areas
Investigates how area of residence affects use of health care services.
2002
Journal Article
Alcoholism Treatment in Managed Private Sector Plans How Are Carve-Out Arrangements Affecting Costs and Utilization?
Many U.S. employers and health plans have carved out their mental health and substance abuse benefits from a comprehensive health care plan.
2001
Report
Are Barriers to Mental Health and Substance Abuse Care Still Rising?
Uses data from a national household survey to estimate unmet need and barriers to alcohol, drug, and mental health services.
2001
Journal Article
Are Psychiatrists More Dissatisfied with Their Careers Than Other Physicians?
The growth of managed care has been associated with a decrease in physicians' professional satisfaction.
2001
Journal Article
Can Utility-Weighted Health-Related Quality-of-Life Estimates Capture Health Effects of Quality Improvement for Depression?
Utility measures that capture the mental health and non-health outcomes associated with treatment for depression are needed.
2001
Journal Article
Changes in Alcohol-Related Inpatient Care: An International Trend Comparison
Paper studies two utilization measures of alcoholism treatment, discharge rate and average length of stay, in the US, Australia, Sweden and Canada.
2001
Testimony
The Costs of Covering Mental Health and Substance Abuse Care at the Same Level as Medical Care in Private Insurance Plans
Testimony presented to the Health Insurance Committee, National Conference of Insurance Legislators on July 13, 2001.
2001
Report
Does Obesity Contribute as Much to Morbidity as Poverty or Smoking?
This paper compares the effects of overweight, poverty, smoking, and problem drinking on occurrence of chronic conditions and health-related quality-of-life.
2001
Journal Article
Does the Sunset of Mental Health Parity Really Matter?
The 1996 Mental Health Parity Act (MHPA), which became effective in January 1998, is scheduled to expire in September 2001.
2001
Journal Article
Financial Burden and Out-Of-pocket Expenditures for Mental Health Across Different Socioeconomic Groups: Results from Health Care for Communities
2001
Report
Financial Burden and Out-of-Pocket Expenditures for Mental Health across Different Socioeconomic Groups: Results from HealthCare for Communities
Examines differences in out-of-pocket expenditures for mental health services and their burden across different populations.
Jan 1, 2001
Journal Article
How Do Trends for Behavioral Health Inpatient Care Differ from Medical Inpatient Care in U.S. Community Hospitals?
Inpatient care in the United States accounts for one third of the health care expenditures
2001
Report
Income and Mental Health: Unraveling Community and Individual Level Relationships
Explores the relationships between mental disorders and socioeconomic status and environment and find a strong association between individual income and mental health.
2001
Journal Article
Medical Cost Offset: Do the Numbers Add Up?
Two field experts discuss whether evidence of a medical cost offset exists.
2001
Research Brief
Mental Health Care for Youth: Who Gets It? How Much Does It Cost? Who Pays? Where Does the Money Go?
A team of RAND researchers has assembled a current national picture of mental health costs and utilization for children ages 1-17.
2001
Journal Article
The Myth of Medical Cost Offset
Increased access to or use of behavioral health services can substantially reduce expenditures in other medical care services.
2001
Journal Article
National Estimates of Mental Health Utilization and Expenditures for Children in 1998
No recent data on expenditures and utilization are available to provide a benchmark for reform of mental health systems for children and adolescents.
2001
Journal Article
Psychotropic Medication Costs Among Youth with Private Insurance in 1998
Recent studies have documented a substantial increase in the use of psychotropic medications by children and adolescents.
2001
Journal Article
The Role of Computer Use in Different Medical Specialties
Health-related Web sites are among the most visited sites on the Internet, and their use may change the patient-provider relationship.
2001
Journal Article
Toward Full Mental Health Parity and Beyond: Managed Behavioral Health Care Has Made Full Parity Affordable--And Therefore Thinkable
The 1996 Mental Health Parity Act (MHPA), which became effective in January 1998, is scheduled to expire in September 2001.
2001
Research Brief
Are People With Mental Illness Getting the Help They Need? New Findings About Parity Laws, Insurance Coverage, and Access to Care
In recent years, concerns about the adequacy of insurance benefits and quality of care for individuals with mental illness have led the majority of states and the federal government to require equal coverage for both mental health and medical conditions.
2000
Journal Article
The Effect of Copayments on Drug and Alcohol Treatment Following Inpatient Detoxification Under Managed Care
These findings indicate that the rate of participation in outpatient treatment after detoxification is high, but room for improvement remains.
2000
Research Brief
Extending Health Care Insurance to Specific Populations: Profile of RAND Work
In a series of studies, we have assessed the cost and consequences of various approaches to providing coverage for these groups (children, employees in small businesses, substance abusers, the uninsured, and the near-elderly).
2000
Report
Health Insurance May Be Improving, But Not For Individuals With Mental Illness
To explore the question of how insurance coverage has changed among individuals with mental problems compared to the general population in the last two years.
2000
Report
How Does Risk Sharing Between Employers and Managed Behavioral Health Organization Affect Mental Health Care?
To study the ways in which allocating the risk for behavioral health care expenses between employers and a managed behavioral health organization affects costs and the use of services.
2000
Report
How Expensive are Unlimited Substance Abuse Benefits Under Managed Care?
This article studies how many patients are affected by SA coverage limits and the likely implications of limits on insurance payments, using 1996-97 claims from 25 managed care plans with unlimited SA benefits.
2000
Journal Article
The Impact of Prior Authorization on Outpatient Utilization in Managed Behavioral Health Plans
The authorization effect differs by provider type and is weaker among psychiatrists than among nonphysician providers.
2000
Journal Article
Managed Care and Unmet Need for Mental Health and Substance Abuse Care in 1998
This report demonstrates the importance of defining access to care more broadly.
2000
Report
Managed Care Risk Contracts and Substance Abuse Treatment
Several pending health care bills propose employer mandates to improve coverage for substance abuse treatment. In today's managed care environment, however, mandating "nominal" benefits no longer may achieve intended goals.
2000
Journal Article
Mental Disorders and the Use of Alternative Medicine: Results from a National Survey
The study examined the relationship between mental disorders and the use of complementary and alternative medicine.
2000
Journal Article
Mental Health Parity and Employer-Sponsored Health Insurance in 1999-2000
The authors examined changes in copayments and coinsurance for covered benefits.
2000
Journal Article
Mental Health Parity and Employer-Sponsored Health Insurance in 1999-2000
Limits protect the insurer against high costs, not the individual.
2000
Report
Mental Health Parity Legislation: Much Ado About Nothing?
To determine whether state-level parity legislation has led to an increase in utilization of mental health services.
2000
Journal Article
New Dimensions of Economic Well-Being Among People with Mental Illness: Evidence from Health Care for Communities
Less the sizeable gap in the percentage of savers among individuals who have and do not have a mental disorder than the strong interaction with age.
2000
Journal Article
Patient Risk-Taking Attitude and the Use of Complementary and Alternative Medical Services
2000
Report
Patient Risk-Taking Attitude and the Use of Complementary and Alternative Medical Services
Reports the results of a survey of users and nonusers of complementary and alternative medicine with respect to their attitude toward risk.
Jan 1, 2000
Journal Article
Psychiatric Care Expenditures and Length of Stay: Trends in Industrialized Countries
The report shows that the share of inpatient expenditures for psychiatric disorders has been decreasing in many industrialized countries.
2000
Journal Article
State Legislation and the Use of Complementary and Alternative Medicine
There are increasing attempts at the federal and state levels to change regulations for complementary and alternative medicine (CAM).
2000
Report
State Mental Health Parity Laws: Cause Or Consequence Of Differences In Use?
State Mental Health Parity Laws: Cause Or Consequence Of Differences In Use?
2000
Journal Article
State Parity Legislation and Changes in Health Insurance and Perceived Access to Care Among Individuals with Mental Illness: 1996-1998
This paper contrasts how insurance coverage has changed for individuals with mental health problems in states with and without parity legislation.
2000
Research Brief
Tracking Changes in Behavioral Health Services: How Has Managed Care Changed Care?
RAND studies of managed care plans that had already implemented full parity showed that under comprehensively managed care -- today's dominant arrangement -- unlimited mental health benefits cost not much more than capped benefits.
2000
Report
Tracking Changes in Behavioral Health Services: How Have Carve-Outs Changed Care?
Tracking Changes in Behavioral Health Services: How Have Carve-Outs Changed Care?
2000
Journal Article
Labor Force Participation by Persons with Mental Illness
How individuals with probable risk for mental illness are faring in this economy, using data from the HCC survey conducted fall 1997 through 1998.
Nov 1, 1999
Journal Article
Cost and Quality Trends Under Managed Care: Is There a Learning Curve in Behavioral Health Carve-Out Plans?
This paper studies the performance of network plans over time using data from 52 managed behavioral health plans.
1999
Report
The Design of Healthcare for Communities: A Study of Health Care Delivery for Alcohol, Drug Abuse, and Mental Health Conditions
This paper describes Healthcare for Communities (HCC), a component of the Robert Wood Johnson Foundation's Health Tracking Initiative that was designed to fill this gap for alcohol, drug abuse, and mental health care.
1999
Report
Effectiveness Research and Implications for Study Design: Sample Size and Statistical Power
Contrasting a broad range of outcome and cost measures, the authors analyze the implications for sample sizes and study design using data from prior mental health and primary care studies that span a wide range of practice settings, patient populations and geographic areas.
1999
Testimony
Effects of Substance Abuse Parity in Private Insurance Plans Under Managed Care
Testimony presented Submitted to the U.S. House of Representatives Subcommittee on Criminal Justice, Drug Policy and Human Resources on October 21, 1999.
1999
Report
Mental Health and Substance Abuse Parity: A Case Study of Ohio's State Employee Program
The Ohio state case study demonstrates that 'parity' -- equal benefits for drug abuse and mental health (ADM) and medical care -- level benefits for ADM care are affordable under managed care.
Jan 1, 1999
Journal Article
A Naturalistic Study of Psychotherapy: The Medical Outcomes Study Approach
In this chapter, the authors describe the Medical Outcomes Study (MOS) approach.
1999
Journal Article
New Research Alliances in the Era of Managed Care
The rise of managed behavioral health care in the United States was accompanied by reductions in costs.
1999
Report
Substance Abuse Service Utilization under Managed Care: HMOs versus Carve-Out Plans
Evaluates changes in service utilization and costs when managed behavioral healthcare organizations use carve-outs to manage their substance abuse services compared with HMOs.
1999
Report
Use of Psychiatrists, Psychologists, and Master's-Level Therapists in Managed Behavioral Health Care Carve-Out Plans
Examines the extent to which patients using a managed behavioral health company received services from different types of mental health care provider.
1999
Report
What Outcomes Matter to Patients?
Estimates the relative value to patients of physical, mental, and social health when making treatment decisions, and concludes that health care resources should target treatments that improve mental and social health outcomes.
1999
Journal Article
What Type of Information Is Needed to Inform Mental Health Policy?
The most valuable research integrates information from three levels of investigation: clinical efficacy, real life effectiveness and policy research
1999
Journal Article
Who Leaves Managed Behavioral Health Care?
The growth of managed care and the possibility of biased enrollment and disenrollment rates have raised concerns about cost shifting.
1999
Journal Article
Costs and Use of Mental Health Services Before and After Managed Care
This paper tracks access, utilization, and costs of mental health care for a private employer over nine years.
1998
Journal Article
Costs and Utilization of Substance Abuse Care in a Privately Insured Population Under Managed Care
Cost and utilization patterns of substance abuse and mental health treatment under private, employer-sponsored, managed behavioral health care plans.
1998
Journal Article
Empirically Defined Health States for Depression from the SF-12
The authors conclude that cluster analysis is demonstrably a powerful methodology for forming clinically valid health states from health status data.
1998
Research Brief
How Does Managed Care Affect the Cost of Mental Health Services?
RAND conducted three studies examining issues surrounding mental health benefits under managed care. The studies focused on the costs of mental health services under managed care and the implications of the 1996 parity legislation for cost and benefit design.
1998
Journal Article
Implementing Publicly Funded Risk Contracts with Community Mental Health Organizations
The study analyzed the experience of the Los Angeles County Department of Mental Health.
1998
Research Brief
Improving the Quality and Cost-Effectiveness of Treatment for Depression
In a series of recent studies, RAND examined the quality and cost-effectiveness of care for severely depressed patients treated under different payment systems by general medical clinicians and mental health care professionals.
1998
Journal Article
Managed Behavioral Health Services for Children Under Carve-Out Contracts
Service costs and utilization patterns of children in carved-out behavioral health care plans were examined and compared with those of adults.
1998
Journal Article
Mental Health and Substance Abuse Benefits in Carve-Out Plans and the Mental Health Parity Act of 1996
The authors analyze the benefit designs of 4,000 current behavioral health carve-out plans and contrast them to medical benefits.
1998
Journal Article
Physician Knowledge, Financial Incentives and Treatment Decisions for Depression
Estimates the relative role of financial incentives and provider information on quality of care for less and more severely depressed patients.
1998
Report
How Expensive is Unlimited Mental Health Care Coverage Under Managed Care?
It shows that the assumptions used in 1996's policy debates overstated actual managed care costs by more than 300%.
1997
Journal Article
Instrumental Variable Methods for Effectiveness Research
Research questions such as quality of specific providers or guideline-concordant care in typical practices, commonly studied in observational setting.
1997
Journal Article
Measuring Health Outcomes for Depression
The authors describe the clinical and health-related quality of life outcome measures for depressed patients in the Medical Outcomes Study.
1997
Journal Article
Private Health Insurance and Public Expenditures in Jamaica
Many governments who have large public health care systems are looking for means to reduce the public's financial burden.
1997
Commercial Book
Caring for Depression
This book documents the inefficiencies of our national systems -- prepaid as well as fee-for-service -- for treating depression and explores how they can be improved.
1996
Report
Provider choice and continuity for the treatment of depression
Provider choice and continuity for the treatment of depression
1996
Report
Switches between Prepaid and Fee-for-Service Health Systems among Depressed Outpatients: Results from the Medical Outcomes Study
Switches between prepaid and fee-for-service health systems among depressed outpatients : results from the Medical Outcomes Study
1996
Report
Care for Depression in a Changing Environment
Focusing on care for clinical depression as a test case, this paper summarizes the authors previously published findings on the effects of various payment strategies, managed care, and primary care gatekeepers on the outcomes and costs for the treatment of mental health conditions.
1995
Report
How Can Care for Depression Become More Cost-Effective?
... to determine the cost and health effects of changes in the content and quality of care for depressed patients treated in prepaid general medical practices (internal and family medicine) and mental health specialty practices and shifts in the proportion of patients treated in general medicine.
1995
Report
Mental Health Care Utilization in Prepaid and Fee-For-Service Plans Among Depressed Patients in the Medical Outcomes Study
The authors analyzed outpatient mental health care utilization in prepaid and fee-for-service plans for a panel of depressed outpatients in the longitudinal part of the Medical Outcomes Study.
1995
Journal Article
Why Does Nuclear Power Performance Differ Across Europe?
Compares the performance of nuclear power plants in five European countries by estimating a microeconomic model of managerial decision making.
1995
Draft
Can Prepaid Care for Depression be Improved Cost-Effectively?
This report analyzes the effects of changes in (1) the content and quality of care for depressed patients treated in prepaid general medical and mental health specialty practices and (2) the proportion of patients treated in general medicine.
1994
Report
Do Soviet nuclear reactors outperform Western reactors?
Do Soviet nuclear reactors outperform Western reactors?
1994
Journal Article
Proportional Hazard Regression Models for Point Processes: An Analysis of Nuclear Power Plant Operations in Europe
The safety and reliability of nuclear power have been hotly debated in the last 30 years.
1994
Draft
Provider Choice and Continuity for the Treatment of Depression
Provider Choice and Continuity for the Treatment of Depression
1994
Report
Stochastic process analysis for nuclear power plant operations
Stochastic process analysis for nuclear power plant operations
1994
Research Brief
Trial By False Fire: Education's Role in U.S. "Economic Decline"
Most parties assume that the United States is losing its industrial core, U.S. workers are less productive than competitors' workers, U.S. education and training bear much of the blame.
1994
Draft
Using Private Health Insurance to Reduce and Better Target Public Expenditures
Using Private Health Insurance to Reduce and Better Target Public Expenditures
1994
Journal Article
V-230 Performance: How Good Is It Really?
V-230s deteriorate over time, while Western reactors generally improve.
1994
Journal Article
When Do Couples Sign the One-Child Certificate in Urban China?
Analyzes China's one-child policy: when do eligible couples sign the one-child certificate and what are socioeconomic determinants of this decision?
1994
Report
How Do Education and Training Effect a Country’s Economic Performance? A Literature Survey
This report reviews research on the role of education and training in economic performance.
1993
Journal Article
Fecundability and Social Development in China: Changes in the Distribution of the First Conception Interval
The authors find evidence that the hazard of conception of a susceptible woman is increasing with the duration of marriage in China.
1993
Draft
Health plan and provider switching among depressed outpatients in the Medical Outcomes Study
Health plan and provider switching among depressed outpatients in the Medical Outcomes Study
1993
Draft
Information and the Demand for Supplemental Medicare Insurance
... to investigate the role of uncertain information about health insurance benefits on the demand for supplemental Medicare insurance that allows imperfect information to affect both the mean and the variance of the expected benefits distribution.
1993
Report
Outcomes for adult outpatients with depression under prepaid or fee-for-service financing
Outcomes for adult outpatients with depression under prepaid or fee-for-service financing
1993
Journal Article
Educational Attainment and the Returns to Education for Australian Youth: Evidence of Self-Selection?
Debates concerning the re-introduction of tertiary fees in Australia have made rates of return on education an active topic for investigation.
1991
Journal Article
Parametric and Parametrically Smoothed Distribution-Free Proportional Hazard Models with Discrete Data
This paper discusses discrete time proportional hazard models and suggests a new class of flexible hazard functions.
1991