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Health Disparities

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Population-specific differences in access to quality health care, whether caused by gender, race, geography, environment, or other factors, can affect individual and community health. RAND research aims to understand the causes of—and thereby reduce disparities in—health outcomes, access, and care at the individual, community, and international levels.

Essay

Reducing Disparities in Infant Mortality: Using Big Data to Help Babies at Risk

Jul 1, 2021

Black babies in Pittsburgh, Pennsylvania—and across America—face much higher mortality rates than white babies. Researchers pulled together thousands of data points on more than 150,000 births to better predict who is at risk and how to help them.
Commentary

Collect Data on Sexual Orientation and Gender Identity in Health Surveys

Jun 25, 2021

The Biden administration wants to promote programs and policies informed by science and to help lesbian, gay, bisexual, and transgender Americans. For researchers to confidently answer that call, the first step is for the government to consistently collect sexual orientation and gender identity data.

Explore Health Disparities

Journal Article

Tackling Persistent and Large Disparities in Birth Outcomes in Allegheny County, Pennsylvania

The IMPreSIv database allowed us to summarize the maternal health, behavioral, and contextual factors associated with birth outcomes and describe the participation rates in available medical and community setting interventions in Allegheny County.

Jan 5, 2022
Commentary

Rethinking the Impact of Audio-Only Visits on Health Equity

New pandemic-era flexibility that allowed audio-only health visits to be routinely reimbursed as telehealth may be leading to substandard care for those it was meant to serve. It may be time to consider limiting audio-only visits in the pursuit of health equity.

Dec 17, 2021
Journal Article

Health Disparities in the U.S. Gulf Coast: The Interplay of Environmental Disaster, Material Loss, and Residential Segregation

We study the interrelationships between health, residential segregation, and disaster-related material losses (income loss, job loss, economic/property damages) due to the worst ever man-made disaster of its kind, the Deepwater Horizon oil spill.

Dec 15, 2021
Commentary

The Health of Asian Americans Depends on Not Grouping Communities Under the Catch-All Term

Health data have historically lumped all Asian American people together, obscuring distinct health disparities and leaving vulnerable communities neglected by researchers and policymakers. What would be needed to construct a fuller representation of Asian American communities and their well-being?

Dec 13, 2021
Commentary

American Attitudes About Vaccine Globalism

Overall, American support for sharing vaccines with other countries was high even before the Omicron variant. This may reflect recognition of the need to proactively address the pandemic beyond U.S. borders to truly be on the path to recovery.

Dec 9, 2021
Report

COVID-19 and the Experiences of Populations at Greater Risk: Description and Top-Line Summary Data — Wave 4, Fall 2021

This report summarizes descriptive findings from the last of four waves of a survey on how Americans' health views and values have been affected by the COVID-19 pandemic, with a focus on populations deemed vulnerable or underserved.

Dec 9, 2021
Journal Article

Adjusting Medicare Advantage Star Ratings for Socioeconomic Status and Disability

We examine the impact of socioeconomic status and disability adjustments on Medicare Advantage plans' and prescription drug plans' contract star ratings.

Oct 29, 2021
Journal Article

Racial, Ethnic, and Gender Disparities in Health Care in Medicare Advantage: April 2021

The analysis revealed patterns in which Black and Hispanic beneficiaries had worse results than White beneficiaries on numerous clinical care measures.

Sep 29, 2021
Journal Article

Racial, Ethnic, and Gender Disparities in Health Care in Medicare Advantage: April 2020

This report describes the quality of health care received in 2018 by Medicare beneficiaries enrolled in Medicare Advantage plans nationwide. This 2020 report is the fifth in a series of reports that are updated annually.

Sep 17, 2021
Commentary

Tech Assets Might Help Make Public Health Data More Equity-Centered

The COVID-19 pandemic has amplified broad societal inequities and trained a spotlight on the strengths and weaknesses of the U.S. public health system. What would more equity-centered, tech-engaged public health data look like?

Sep 9, 2021
Journal Article

Disparities in Social and Economic Determinants of Health by Sexual Identity, Gender, and Age: Results from the 2015–2018 National Survey on Drug Use and Health

Characterizing disparities between lesbian, gay, and bisexual (LGB) adults and heterosexual adults across multiple health determinants, we found that LGB females experience significant economic disparities and all LGB subgroups exhibited disparities on some social determinants of health.

Sep 2, 2021
Journal Article

Longitudinal Associations Between Changes in Cigarette Smoking and Alcohol Use, Eating Behavior, Perceived Stress, and Self-Rated Health in a Cohort of Low-Income Black Adults

We found significant longitudinal associations between smoking behavior and eating behavior, perceived stress, and self-rated health. This has implications for the development of behavior change programs and community-level interventions and policies.

Aug 27, 2021
Report

Assessing Health and Human Services Needs to Support an Integrated Health in All Policies Plan for Prince George's County, Maryland

This report describes a health and human services needs assessment of Prince George's County, Maryland. Findings from this report can inform Prince George's County's pursuit of a Health in All Policies approach to policymaking.

Aug 26, 2021
Commentary

Equitable Data Analysis: Lessons from a COVID-19 Research Collaborative

The health inequities exposed by COVID-19 underscored the importance of collecting race-stratified data to inform local policymakers. For the public health researchers trying to provide that, the pandemic also revealed some major pitfalls, especially about relying on open-source data.

Jul 27, 2021
Tool

Vulnerability, Inequity, and COVID-19: A Portrait of the Pandemic in Allegheny County: Tracking Evolving Disparities in Testing, Cases, Hospitalizations, Deaths, and the Ability to Practice Physical Distancing

RAND researchers, the Black Equity Coalition, and Surgo Ventures created an interactive online tool to consider disparities and community vulnerability to COVID-19 in Allegheny County.

Jul 19, 2021
Journal Article

Cannabis Legalization and Social Equity: Some Opportunities, Puzzles, and Trade-Offs

Legalization for nonmedical purposes may create new sources of disproportionate harm even as it alleviates some inequities associated with cannabis prohibition.

Jul 16, 2021
Blog

Pandemic-Era Parties, China's Global Influence, Reducing Infant Mortality: RAND Weekly Recap

This weekly recap focuses on assessing the risk of small gatherings during the pandemic, China's ability to exert influence around the world, using big data to help reduce infant mortality, and more.

Jul 2, 2021
Journal Article

Vaccine Confidence And Black Communities: Where Do We Go From Here? Town Hall Recap

This event, "Vaccine Confidence and Black Communities: Where do we go from here?", aimed to share lessons learned about COVID-19 vaccine messaging and access in order to reduce inequities.

Jul 2, 2021
Periodical

RAND Review: July-August 2021

One feature highlights how researchers apply an equity lens to projects on environmental racism, incarcerated parents, and the lives of Black service members; a second describes interventions to address disparities in infant mortality rates.

Jul 1, 2021

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