Vaccine Hesitancy, Sexual Misconduct in the U.S. Military, the Iran Nuclear Deal: RAND Weekly Recap

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March 5, 2021

We discuss what's behind the high levels of vaccine hesitancy among Black Americans; the link between sexual harassment and sexual assault in the U.S. military; why President Biden can't turn back the clock on the Iran nuclear deal; a focus on civic education after the Capitol attack; International Women's Day; and bundling health care payments.

People are seen at a 24-hour COVID-19 vaccination center at the Brooklyn Army Terminal in Brooklyn, New York, January 11, 2021, photo by Brendan McDermid/Reuters

Photo by Brendan McDermid/Reuters

Vaccine Hesitancy Is High Among Black Americans

Evidence suggests that COVID-19 vaccines are extremely safe and effective. But Black Americans have high levels of hesitancy concerning immunization. For people who have long faced discrimination, medical mistrust is a rational “survival mechanism,” says RAND's Laura Bogart. But lower vaccination rates among Black Americans would only exacerbate the damaging racial inequities of the pandemic.

To better understand how to address this challenge, Bogart and her colleagues surveyed a nationally representative sample of 207 Black Americans. Here's what they found:

  • More than one-third of respondents agreed or strongly agreed that they would not get a COVID-19 vaccine. An additional 25 percent said they “don't know” if they would get vaccinated.
  • Health care workers showed higher vaccine hesitancy than those in other fields, with 48 percent indicating that they would not get vaccinated.
  • Key drivers of vaccine hesitancy appear to be mistrust of the government's motives and transparency around COVID-19, as well as beliefs about racism in health care.
  • Respondents reported higher trust in COVID-19 information that comes from health care providers and public health officials than from elected officials.

The researchers stress that it's important to address people's specific concerns. For instance, messaging about COVID-19 vaccines should first acknowledge systemic racism as a justifiable reason for mistrust, and then provide accurate information about the vaccines, including details about efficacy and safety.

U.S. Marines and sailors post security from the Wasp-class amphibious assault ship USS Essex (LHD-2) off the coast of Southern Calif., December 4, 2020, photo by Lance Cpl. Cameron Rowe/U.S. Marine Corps

U.S. Marines and sailors gather off the coast of Southern California, December 4, 2020

Photo by Lance Cpl. Cameron Rowe/U.S. Marine Corps

U.S. service members in locations with high levels of sexual harassment are at greater risk of being sexually assaulted. That's according to a new RAND report. When sexual harassment goes unpunished or ignored, it may create an environment that promotes sexually inappropriate behavior, which can lead to an escalation from harassment to assault. The authors recommend addressing sexual harassment and sexual assault in the military as a single problem.

Democratic U.S. presidential candidate and former Vice President Joe Biden speaks during a campaign event in Lancaster, Pennsylvania, June 25, 2020, photo by Mark Makela/Reuters

Then-presidential candidate Joe Biden speaks during a campaign event in Lancaster, Pennsylvania, June 25, 2020

Photo by Mark Makela/Reuters

Why Biden Can't Turn Back the Clock on the Iran Nuclear Deal

It's unclear whether the Biden administration will rejoin the Iran nuclear deal. But re-upping the agreement would be difficult, says RAND's Raphael Cohen. The long-standing flaws of the deal remain, he says, and the agreement was predicated on a geopolitical context that no longer exists. What's more, Iran's nuclear program may no longer be a top-tier U.S. policy concern. Returning to the agreement would have to be weighed against more pressing objectives.

Pro-Trump supporters hold flags as they gather at the U.S. Capitol in Washington, DC, January 6, 2021, photo by Jonathan Ernst/Reuters

Supporters of then-President Donald Trump hold flags as they gather at the U.S. Capitol in Washington, D.C., January 6, 2021

Photo by Jonathan Ernst/Reuters

Civic Education After the Capitol Attack

The attack on the U.S. Capitol two months ago has led to calls for teachers to address civic education in a much more robust way. Are U.S. educators equipped to do this? Results from a recent RAND study show that teachers lack the training and resources that could help them address history-shaping events as they happen and develop students' civic skills more broadly. RAND's Julia Kaufman says a key first step to helping teachers is to make civic education a priority in state education standards.

Sarah MacCarthy and Celia Gomez speaking on a panel during Summer Associates Week at RAND's Santa Monica headquarters, July-August 2018, photo by Diane Baldwin/RAND Corporation

RAND researchers Sarah MacCarthy (left) and Celia Gomez speak at an event at RAND's Santa Monica headquarters, July 2018

Photo by Diane Baldwin/RAND Corporation

Monday Is International Women's Day

Women have always been at the core of RAND's success, tackling some of the world's most complex and important issues—from mental health care, to counterterrorism strategies, to overcoming the health and economic hurdles of the pandemic. In honor of International Women's Day on Monday, we're highlighting the diversity of talent and experience among RAND researchers and leaders who happen to be women.

Photo by DNY59/Getty Images

Bundling Health Care Payments to Cut Costs

In an effort to reduce the cost of complicated procedures, doctors, hospitals, and other health providers bundle payments, sharing one fee for all aspects of the procedure. This can provide a substantial cost savings for both patients and health care payers, according to a new RAND study. But it remains to be seen whether these results will extend beyond a small number of big-ticket surgical procedures, such as knee replacements, and benefit a wider range of patients.

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