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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

Commentary

Diversity, Equality and Inclusion in Healthcare Innovation: Considerations for Future Research, Policy and Practice

For healthcare innovations to have the fairest and broadest possible benefit to society, efforts could be made to attend to all stages of the innovation pathway to identify opportunities to mitigate biases through diversity, equality and inclusion.

Jul 6, 2022
Essay

Environmental Racism: How Historic Redlining Continues to Affect Communities

Starting in the 1930s, neighborhoods across America were redlined—marked on government maps as too hazardous, as in, too Black or too immigrant, for federal home loans. When zoning officials needed somewhere to put a new factory or freeway, those redlined neighborhoods were like a bullseye that they hit again and again.

Jun 27, 2022
Journal Article

Trends in Missing Race and Ethnicity Information After Imputation in HealthCare.gov Marketplace Enrollment Data, 2015–2021

More than 30% of HealthCare.gov enrollees do not report race and ethnicity. We used modified Bayesian Improved First Name Surname geocoding imputations to describe enrollment data and assess patterns of missing enrollee race and ethnicity.

Jun 24, 2022
Report

Imputation of Race and Ethnicity in Health Insurance Marketplace Enrollment Data, 2015–2022 Open Enrollment Periods

This report presents the results of imputing race and ethnicity for HealthCare.gov Marketplace enrollees from 2015 through 2022 with an approach that uses surnames, first names, and residential addresses to estimate race and ethnicity.

Jun 23, 2022
News Release

Poor Sleep and Nighttime Wakefulness Associated with Diminished Cognitive Function Among African Americans

More fragmented sleep and longer periods of wakefulness after bedtime among a group of low-income African American adults were associated with lower cognitive function such as poor attention and visuospatial ability. Improving sleep may support prevention of Alzheimer's and related dementias.

Jun 15, 2022
Journal Article

Perceived Discrimination, Adherence to Antiretroviral Therapy, and HIV Care Engagement Among HIV-positive Black Adults: The Mediating Role of Medical Mistrust

Perceived discrimination and mistrust have indirect negative effects on adherence to antiretroviral therapy among HIV-positive Black adults.

Mar 31, 2022
Tool

Environmental Racism: A Tool for Exploring the Enduring Legacy of Redlining on Urban Environments

Researchers developed an online tool for visualizing the spatial relationships between the discriminatory practice of redlining and exposure to environmental hazards (e.g., pollution, waste sites).

Mar 31, 2022
Journal Article

Disparities in Use/Misuse of Specific Illicit and Prescription Drugs Among Sexual Minority Adults in a National Sample

We examined disparities by sexual identity and sex for 8 illicit and prescription drugs using 2015-2019 National Survey on Drug Use and Health data.

Feb 11, 2022
Journal Article

Loneliness and Multiple Health Domains: Associations Among Emerging Adults

We examine associations of loneliness with physical, behavioral, and health behavior outcomes, and investigate moderating effects by sex, race/ethnicity, and sexual/gender minority status.

Feb 8, 2022
Journal Article

Alcohol Use and Cannabis Use Trajectories and Sexual/Gender Minority Disparities in Young Adulthood

At the same levels of alcohol/cannabis use from middle school through young adulthood, SGM individuals show disparities in multiple domains compared to non-SGM peers. Efforts to reduce substance use and structural disadvantages experienced by SGM youths are needed.

Feb 8, 2022
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

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