Racism and Patient Safety, Abortion After Dobbs, Homelessness: RAND Weekly Recap

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RAND Weekly Recap

October 28, 2022

This week, we discuss how racism impacts patient safety; the effects of overturning Roe v. Wade; trauma in the U.S. Intelligence Community; addressing homelessness in L.A.; disputes in the South China Sea; and how space mirrors might help address climate change.

Members from historic African-American churches in the Tampa Bay Area wait in line to receive the Pfizer-BioNTech COVID-19 vaccine at the Greater Bethel Missionary Baptist Church in Tampa, Florida, February 14, 2021, photo by Octavio Jones/Reuters

Photo by Octavio Jones/Reuters

The Impact of Racism on Patient Safety

The medical field uses the term “patient safety events” to refer to a wide range of harms, from bad drug interactions to surgical site infections to missed diagnoses. A recent RAND study found that minoritized patients are at especially high risk of such events.

The researchers found no shortage of explanations for the disparity. For example, minoritized communities often lack access to top-quality hospitals. They're also less likely to have health insurance. But the findings also suggest that racism is a root cause. In fact, the doctors, nurses, and other professionals interviewed for the study were almost unanimous in describing racism as a factor in some or all patient safety events.

Addressing this problem will require hospitals and other health care providers to improve how they track patient safety and demographics. But stakeholders may need to first acknowledge the role that racism plays in patient safety events.

“We need to start thinking differently,” said RAND's Lucy Schulson, lead author of the study and a practicing internist at Boston Medical Center. “That starts by naming the problem for what it is.”

Abortion rights supporters protest outside the U.S. Supreme Court the day after its ruling that overturned Roe v Wade, in Washington, D.C., June 25, 2022, photo by Elizabeth Frantz/Reuters

Abortion rights supporters protest outside the U.S. Supreme Court the day after its ruling that overturned Roe v. Wade, in Washington, D.C., June 25, 2022

Photo by Elizabeth Frantz/Reuters

Abortion After the Dobbs Ruling

With the Supreme Court's decision to overturn Roe v. Wade, Americans find themselves living in a country that, for the first time since 1973, does not promise a constitutional right to an abortion. In a new Q&A, RAND researchers discuss what this new reality could mean for especially vulnerable populations, how the ruling might exacerbate misinformation about abortion, what the policy responses could look like, and more.

The seal of the Central Intelligence Agency is shown at the entrance of its headquarters in McLean, Virginia, September 24, 2022, photo by Evelyn Hockstein/Reuters

The seal of the Central Intelligence Agency is shown at the entrance of its headquarters in McLean, Virginia, September 24, 2022

Photo by Evelyn Hockstein/Reuters

Understanding and Addressing Trauma in the Intelligence Community

Members of the U.S. Intelligence Community collect and protect national secrets, often face violent and difficult problems, and frequently work under strenuous conditions. Whether they're deployed in the field or serving at an office in D.C., these individuals may face heightened risk of experiencing trauma. A new RAND paper examines the complex ways that trauma affects intelligence personnel and how to better support their well-being.

Tents of people experiencing homelessness at Echo Park Lake, Los Angeles, California, March 24, 2021, photo by Ted Soqui/Reuters

Tents of people experiencing homelessness at Echo Park Lake, Los Angeles, March 24, 2021.

Photo by Ted Soqui/Reuters

In L.A., the Debate About Homelessness Is Misleading

As the Los Angeles mayoral election draws nearer, discussions about addressing the citywide homelessness crisis sometimes imply that there are simple fixes, such as temporary shelters or permanent supportive housing. But according to RAND's Sarah Hunter, these solutions are just “pieces of a very complex puzzle.” The region needs a robust continuum of care, she says, ranging from financial support that helps prevent evictions to 24/7 care for people with severe health conditions.

Map of the Spratly Islands, 2015, image by U.S. Department of State

Map of the Spratly Islands in the South China Sea, 2015.

Image by U.S. Department of State

A Primer on the South China Sea

The South China Sea is one of the world's most important and contentious bodies of water. But the disputes over this region are not always well understood. In a new paper, RAND's Benjamin Sacks provides insights into the history of territorial claims made by China and other regional players. Sacks points out a key concern about ongoing militarization: It may threaten safe transit in this part of the world.

A view of Earth's surface from space, photo by Blue Planet Studio/Adobe Stock

Photo by Blue Planet Studio/Adobe Stock

Why Not Space Mirrors?

Could sending mirrors the size of Brazil into space reflect sunlight away from Earth and help cool the planet? This approach is still “very theoretical,” says RAND physical scientist Emmi Yonekura, but the idea deserves a closer look. As decisionmakers consider ways to address climate change, they need more information about space mirrors and other new geoengineering technologies, including their potential costs and risks.

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