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Journal Article

Oct 3, 2024

Forecasting the Fallout from AMR: Averting the Health and Economic Impacts Through One Health Policy and Investment

This brief presents policy recommendations on how to mitigate the potential economic impacts of antimicrobial resistance (AMR).

Birhanu A. Adamie, Holy T. Akwar, Montserrat Arroyo, Heather Bayko, Marco Hafner, Stella Harrison, Morgan Jeannin, Deborah King, Sohwon Kweon, Nohkyum Daniel Kyeong, Fifi Olumogba, Ishmeala Rigby, Shinae Joy Song, Erez Yerushalmi, Javier Yugueros-Marcos, Sana Zakaria
Journal Article

Oct 3, 2024

Forecasting the Fallout from AMR: Economic Impacts of Antimicrobial Resistance in Food-Producing Animals

This study aims to understand the economic burden of antimicrobial resistance (AMR) and antimicrobial use (AMU) in livestock, and to present recommendations on how to mitigate the potential economic impacts of AMR.

Birhanu A. Adamie, Holy T. Akwar, Montserrat Arroyo, Heather Bayko, Marco Hafner, Stella Harrison, Morgan Jeannin, Deborah King, Sohwon Kweon, Nohkyum Daniel Kyeong, Fifi Olumogba, Ishmeala Rigby, Shinae Joy Song, Erez Yerushalmi, Javier Yugueros-Marcos, Sana Zakaria
Commentary

Oct 1, 2024

Strengthening societal resilience: A perspective on strategic priorities for the Netherlands amidst geopolitical tensions

To enhance Dutch societal resilience, coordination across sectors, tailored approaches, and economic strategies are vital for stability and security.

Mattias Eken, Rebecca Lucas, Stijn Hoorens, Fook Nederveen
Journal Article

Sep 20, 2024

Clinician Actions in Response to Adverse Childhood Experience (ACE) Screening

This paper examined clinician responses to adverse childhood experience (ACE) screening at five California pediatric clinics in a large public health care system. Findings provide early information that ACE screening results are associated with patient care.

J. Scott Ashwood, Nipher Malika, Stephanie Williamson, Charles C. Engel, Edward L. Machtinger, Nina Thompson, Amy Shekarchi, Shannon Thyne, Brigid McCaw, Marguerita Lightfoot, Anda Kuo, Eric Herschel Fein, Darcy Benedict, Lisa Gantz, Raymond Perry, Nancy Yap, Nicole K. Eberhart
Journal Article

Sep 19, 2024

Mortality in Extreme Heat Events: An Analysis of Los Angeles County Medical Examiner Data

This study investigates the impact of heat events on unexpected mortality, using deaths investigated by the Medical Examiner in Los Angeles County. We find increases in mortality during heat events, especially among homeless people.

Lawrence Baker, Roland Sturm
Report

Sep 16, 2024

Modern Biosurveillance Methods: A Lay Introduction to Effective Use of Nucleic Acid Methods

In this report, the authors summarize for the nonscientific community how current and emerging nucleic acid biosurveillance techniques work, describe their capabilities and limitations, and discuss the promise of emerging technologies.

Sara Duhachek Muggy, Mary Avriette, Derek Roberts, Kristin J. Leuschner
Report

Sep 16, 2024

Health and Social Services During Heat Events: Demand for Services in Los Angeles County

The authors analyze the relationship between extreme heat events in Los Angeles County and increases in (1) emergency medical services, (2) emergency room visits, (3) deaths investigated by the medical examiner, and (4) bookings for violent offenses.

Roland Sturm, Lawrence Baker, Avery Krovetz
Multimedia

Sep 16, 2024

Alerting the Nation: Results from the National Survey on the October 2023 National Test of the Wireless Emergency Alert (WEA) System

In this RAND webinar, Andrew Parker and Rachel Steratore summarize the results of a large, national survey fielded to the American public immediately following the nationwide test of the Wireless Emergency Alerts system.

Andrew M. Parker, Rachel Steratore, Jason Thomas Barnosky
Journal Article

Sep 13, 2024

Incorporating Equity and Social Dimension Into Community Climate Adaptation Planning and Watershed Management: A Review of the Literature and Resources

This literature and case study review summarizes information on integrating equity considerations into watershed management, including dimensions and definitions of equity; water management functions; and existing data, tools, guidance documents.

Linnea Warren May, Michelle E. Miro, Loveline Chizobam Phillips
Journal Article

Sep 9, 2024

Medicaid Managed Care and Pediatric Dental Emergency Department Visits

In this cohort study of nontraumatic dental emergency department visits among children enrolled in Florida Medicaid, the introduction of a managed care plan was associated with an increase in the number of pediatric emergency department visits.

Lawrence Baker, Elizabeth L. Munnich, Ashley M. Kranz
Journal Article

Sep 5, 2024

Using Longitudinal Surveillance of Unemployment Claims During Public Health Emergencies to Provide Timely and Granular Data on the Social Determinants of Health

We examined trends in unemployment overall and by gender, by race or ethnic group, and by their interaction for two public health emergencies (the COVID-19 pandemic and the 2020 California wildfires).

Joie D. Acosta, Laura J. Faherty, Margaret M. Weden
Tool

Aug 27, 2024

Community Learning and Outreach Toolkit for Countering Anti-Asian Hate

This toolkit aims to be an essential guide to help community-based organizations foster understanding, enhance response efficacy, and promote positive engagement with Asian American community members facing racism-related challenges.

Jennifer Bouey, Lu Dong, Grace Tang, Stacey Yi, Lynn Hu, Douglas Yeung, June Lim, Steven Zhang, Yannan Li
Journal Article

Aug 21, 2024

The Process of Team Building Among Content Experts and Methodologists: An Example From an Emergency Medical Services Research Investigation Kick-Off Meeting

Through a study of community emergency medical services, our aim was to understand team building among content experts and methodologists to advance the framework for adaptive community-engaged research.

Timothy Guetterman, Mahshid Abir, Brahmajee Nallamothu, Sydney Fouche, Wilson Nham, Christopher Nelson, Peter Mendel, Bill Forbush, Theresa A. Shields, Claude Messan Setodji, Anthony P. Hsu, Robert M. Domeier, Steven L. Kronick, Robert Neumar, Michael D. Fetters
Journal Article

Aug 15, 2024

Ground Ambulance Industry Trends, 2017-2020: Analysis of Medicare Fee-for-Service Claims

This report includes descriptive analyses of ground ambulance trends from 2017 to 2022.

Petra W. Rasmussen, Jonathan H. Cantor, Jennifer Gildner, Sara E. Heins, Andrew W. Mulcahy
Journal Article

Aug 15, 2024

Ground Ambulance Industry Trends, 2017–2022: An Analysis of Ground Ambulance Organization Entrance and Exit

This report includes descriptive analyses of ground ambulance trends from 2017 to 2022.

Jonathan H. Cantor, Sara E. Heins, Petra W. Rasmussen, Christine Buttorff, Andrew W. Mulcahy
Journal Article

Aug 5, 2024

Understanding Uptake of Information About Innovations Among Emergency Department Clinicians During the COVID-19 Pandemic

We used focus groups to assess how emergency department clinicians learned about innovations and how they assessed them for credibility during the COVID-19 pandemic.

Nabeel Qureshi, Shreya S. Huilgol, Carl Berdahl, Catherine C. Cohen, Peter Mendel, Shira H. Fischer
Journal Article

Jul 24, 2024

Spatial Accessibility and Uptake of Pediatric COVID-19 Vaccinations by Social Vulnerability

An examination of how the spatial accessibility of COVID-19 vaccination sites affects COVID-19 pediatric vaccine uptake.

Rohan Khazanchi, Benjamin Rader, Jonathan H. Cantor, Kathleen A. McManus, Dena M. Bravata, Rebecca L. Weintraub, Christopher M. Whaley, John Samuel Brownstein
Journal Article

Jul 22, 2024

Distilling the Fundamentals of Evidence-Based Public Health Policy

Public health policy interventions have historically driven many significant public health advancements. In this discussion, we outline the key characteristics and benefits that set these interventions apart from programmatic approaches.

Megan A. Kelly, Richard W. Puddy, Sameer M. Siddiqi, Christopher Nelson, Alexandra Ntazinda, James E. Kucik, Diane Hall, Christian T. Murray, Andrada Tomoaia-Cotisel
Journal Article

Jul 19, 2024

Strengthening the US Public Health Lab System: Summary of Coronavirus Disease (COVID-19) After Action Review Workshop

The objective of this paper is to identify actionable recommendations for building a more resilient public health laboratory system based on previously published lessons learned from COVID-19.

Shoshana R. Shelton, Christopher Nelson, Maureen Sullivan, Kelly E. Wroblewski, Erik E. Mueller, Tyler Wolford
Report

Jun 11, 2024

Threats to Critical Infrastructure: A Survey

In this report, the authors analyze infrastructure threats and hazards and examine vectors by which an adversary might conduct attacks. They also look at other impacts resulting from infrastructure age and maintenance and from weather challenges.

Bridget R. Kane, Stephen Webber, Katherine H. Tucker, Sam Wallace, Joan Chang, Devin McCarthy, Dennis Murphy, Daniel Egel, Tom Wingfield
Journal Article

May 31, 2024

Ransomware Attacks, ED Visits and Inpatient Admissions in Targeted and Nearby Hospitals

This paper studied the implications of hospital ransomware attacks on inpatient and emergency department visits. It considered how the attacked hospital was affected and how nearby hospitals were impacted.

Rahi Abouk, David Powell
Journal Article

May 28, 2024

Advancing Evidence-Based Public Health Policy: How Core Component Thinking Can Illuminate the Multilevel Nature of Public Health Policy

This paper explores how shifting the unit of analysis from "whole policy" to "core components" might improve the accumulation of evidence on multi-level public health policies.

Richard W. Puddy, Megan A. Kelly, Christopher Nelson, Alexandra Ntazinda, Sameer M. Siddiqi, Diane Hall, Christian T. Murray, James E. Kucik
Research Brief

May 17, 2024

Identifying and Serving Areas of Food Insecurity

Food insecurity affects about one in ten Americans. This brief summarizes efforts to better understand the potential scope of food insecurity in Los Angeles County, particularly in the Westside Food Bank service area.

Alina I. Palimaru, Andrea S. Richardson, Leah Dion, Wendy Hawkins
Journal Article

May 1, 2024

Innovation Adoption, Use and Implementation in Emergency Departments During the COVID-19 Pandemic

The goals of this study were to understand how emergency department clinicians decided to implement innovations and to describe the facilitators and challenges they faced during implementation.

Shreya S. Huilgol, Carl Berdahl, Nabeel Qureshi, Catherine C. Cohen, Peter Mendel, Shira H. Fischer
Report

Apr 30, 2024

The Sources of Renewed National Dynamism

The authors explore the challenge of renewing competitive dynamism in the face of national decline by nominating key qualities that determine a society's competitiveness and analyzing historical cases in which nations achieved anticipatory renewal.

Michael J. Mazarr, Tim Sweijs, Daniel Tapia
Report

Mar 27, 2024

Keeping Soft Targets and Crowded Places Safe from Mass-Casualty Attacks: Insights from a Landscape Assessment

Soft targets and crowded places, such as schools, are accessible to large numbers of people and have limited security measures in place. Researchers assessed vulnerabilities and recommended investments and priorities to prevent future attacks.

John S. Hollywood, Keith Gierlack, Pauline Moore, Thomas Goode, Henry H. Willis, Devon Hill, Rahim Ali, Annie Brothers, Ryan Bauer, Jonathan Tran
Tool

Mar 26, 2024

Incident Management Measurement Toolkit

This toolkit is designed to assess the effectiveness of incident management during and after real-life public health incidents and realistic exercises, which will help incident managers identify opportunities for improvement.

Christopher Nelson, Aaron Clark-Ginsberg, Vanessa Parks, Jalal Awan, Jay Balagna, Laura Fraade-Blanar, Grace Hindmarch
Research Brief

Mar 20, 2024

Lessons on 988 and 911 Interoperability: Case Studies on Implementation

This brief summarizes findings from jurisdictions that have established interoperability between 911 and the 988 Suicide and Crisis Lifeline—the national mental health emergency hotline—allowing the transfer of calls from 988 to 911 and vice versa.

Stephanie Brooks Holliday, Samantha Matthews, Wendy Hawkins, Jonathan H. Cantor, Ryan K. McBain
Report

Mar 20, 2024

The Road to 988/911 Interoperability: Three Case Studies on Call Transfer, Colocation, and Community Response

This report presents case studies of jurisdictions that have established interoperability between 911 and the 988 Suicide and Crisis Lifeline—the national mental health emergency hotline—allowing the transfer of calls from 988 to 911 and vice versa.

Stephanie Brooks Holliday, Samantha Matthews, Wendy Hawkins, Jonathan H. Cantor, Ryan K. McBain
Journal Article

Feb 28, 2024

Punt Politics as Failure of Health System Stewardship: Evidence from the COVID-19 Pandemic Response in Brazil and Mexico

This paper presents a new concept, Punt Politics, and applies it to the COVID-19 non-pharmaceutical interventions (NPI) in two epicenters of the pandemic: Mexico and Brazil.

Felicia Marie Knaul, Michael Touchton, Héctor Arreola-Ornelas, Rifat A. Atun, Renzo JC Calderon Anyosa, Julio Frenk, Adolfo Martínez-Valle, Tim McDonald, Thalia Porteny, Mariano Sánchez-Talanquer, Cesar G. Victora
Journal Article

Feb 28, 2024

U.S.-China Collaboration on HIV/AIDS: Perspectives on Global Health Collaborations Amid Geopolitical Changes

Social behavioral epidemiologist Dr. Jennifer Bouey explores collaborative public health efforts between the U.S. and China in combating HIV/AIDS, an effort that produced notable benefits both globally and synergistically for the partner states.

Jennifer Bouey
Report

Feb 15, 2024

Emerging Technology and Risk Analysis: Synthetic Pandemics

Researchers provide an assessment of the risk of a nefarious actor developing a synthetic pandemic using an engineered virus. They considered technology availability, threat, vulnerability, and consequences.

Daniel M. Gerstein, Bianca Espinosa, Erin N. Leidy
Journal Article

Feb 12, 2024

Survey of Trauma, Resilience, and Opportunity Among Neighborhoods in the Gulf (STRONG) II: Louisiana, Alabama, Florida, Mississippi

STRONG II (Louisiana, Alabama, Florida, and Mississippi), re-contacted STRONG I participants to ask about hurricane exposure, damages and losses, and dimensions of health and well-being. The sample includes 751 respondents from those states.

Melissa L. Finucane
Journal Article

Feb 12, 2024

Survey of Trauma, Resilience, and Opportunity Among Neighborhoods in the Gulf (STRONG) II, Texas

STRONG II, Texas, re-contacted STRONG I Texas participants after Hurricane Harvey to ask about hurricane exposure, damages and losses, and dimensions of health and well-being. The sample includes 295 respondents in 16 counties.

Melissa L. Finucane
Journal Article

Feb 12, 2024

Survey of Trauma, Resilience, and Opportunity Among Neighborhoods in the Gulf (STRONG)

The STRONG is a telephone survey of 2,520 residents of coastal counties and parishes in Texas, Louisiana, Mississippi, Alabama, and Florida, focused on mental and physical health, traumatic experiences, oil spill exposure, and alcohol use.

Melissa L. Finucane, Matthew R. Lee, Rajeev Ramchand
Journal Article

Feb 8, 2024

AMR Industry Alliance Fourth Progress Report

These reports represent collective results from across the AMR Industry Alliance membership on their current AMR activities related to research and science, access, appropriate use, and manufacturing and the environment.

Frances Wu, Daniel Lee, Sonja Marjanovic
Journal Article

Feb 7, 2024

Predicting COVID-19 Outbreaks in Correctional Facilities Using Machine Learning

Using machine learning methods with data collected from 24 prison facilities in the Pennsylvania Department of Corrections, we determine which sources of data best predict a coming COVID-19 outbreak in a prison facility.

Giovanni Malloy, Lisa B. Puglisi, Kristofer B. Bucklen, Tyler D. Harvey, Emily Wang, Margaret L. Brandeau
Report

Feb 1, 2024

Weerbaarheid becijferd [Resilience quantified]: Een methode om weerbaarheid tegen dreigingen voor de nationale veiligheid inzichtelijk te maken [A method for understanding resilience to threats to national security]

This study develops a method to determine the resilience of Dutch society against current and future threats to national security. The method uses a "resilience matrix" to be populated through expert sessions based on the Delphi technique.

Fook Nederveen, Stijn Hoorens, Erik J. Frinking, Henri van Soest
Report

Jan 25, 2024

The Operational Risks of AI in Large-Scale Biological Attacks: Results of a Red-Team Study

In this report, the authors share final results of a study of potential risks of artificial intelligence (AI) in the context of biological weapon attacks. The findings indicate that AI did not measurably change the operational risk of such an attack.

Christopher A. Mouton, Caleb Lucas, Ella Guest
Report

Dec 18, 2023

The Role of Nonprofit Organizations in Community Recovery After Nondeclared Disasters

Researchers describe six case studies of nondeclared disasters in diverse community contexts, considering innovations that support recovery in underserved communities and metrics for assessing nonprofits’ role in socioeconomic recovery.

Melissa L. Finucane, Jessica Welburn Paige, Andrew M. Parker, Anu Narayanan, Peggy Wilcox, David DeSmet, Jhacova Williams, Kristin Van Abel
Report

Dec 15, 2023

Defining and Mapping Social Vulnerability as a Proxy for Food Insecurity in Los Angeles County

Food insecurity is a significant public health problem. RAND researchers used publicly available data to map the extent of social vulnerability in Los Angeles County and in the service area of West Side Food Bank to help better target food bank resources.

Alina I. Palimaru, Andrea S. Richardson, Leah Dion, Wendy Hawkins
Journal Article

Dec 14, 2023

Navigating Uncertainty in Public Health Decisionmaking: The Role of a Value of Information Framework in Threat Agnostic Biosurveillance

This paper uses the illustrative case of an emerging biosurveillance technology, Next Generation Sequencing, to illustrate the potential role of a value of information (VOI) framework to enrich public health decisionmaking.

Jalal Awan, Laura J. Faherty, Henry H. Willis
Report

Dec 11, 2023

Improving the Financial Resilience of Public Entities and Individuals for Natural Disasters: A Resource Guide for State and Local Government

Gaps remain in federal assistance for disaster response and recovery for both individuals and public entities. Authors document programs and products that some communities have adopted to help improve individual and community financial resilience.

Noreen Clancy, Lloyd Dixon, Jessica Welburn Paige, Sam Morales, Brian Wong, Andrew M. Parker, Katherine Grace Carman
Report

Nov 30, 2023

Assessing Shifts in U.S. Department of Homeland Security Targeted Violence Prevention Efforts Through Early 2022

This report characterizes changes made in U.S. Department of Homeland Security efforts to prevent targeted violence, including the extent of change and how those changes responded to concerns about efforts to counter violent extremism.

Caitlin McCulloch, Brian A. Jackson, Sameer M. Siddiqi, Jordan R. Reimer, Emily Allendorf
Report

Nov 15, 2023

Data collection and sharing for pathogen surveillance: Making sense of a fragmented global system

Study providing an overview of the pathogen surveillance space, involved stakeholders, strengths and weaknesses of initiatives, challenges of pathogen surveillance, and how data has been used to inform public health decision making.

Sarah Parkinson, Jessica Dawney, Avery Adams, Ben Senator
Journal Article

Nov 13, 2023

Overcoming the Challenges of Using Automated Technologies for Public Health Evidence Synthesis

This study outlines the challenges associated with the adoption of automated technologies to conduct evidence reviews within the public health sector, and the potential solutions and actions that can be taken to mitigate these.

Lucy Hocking, Sarah Parkinson, Avery Adams, Emmanuel Nielsen, Cecilia Ang, Helena de Carvalho Gomes
Journal Article

Oct 25, 2023

A Qualitative Investigation of Preparedness for the Launch of 988: Implications for the Continuum of Emergency Mental Health Care

On July 16, 2022, the 988 mental health crisis hotline launched nationwide. We conducted 15 qualitative interviews with state and local mental health program directors representing 10 states to explore planning for 988.

Stephanie Brooks Holliday, Samantha Matthews, Armenda Bialas, Ryan K. McBain, Jonathan H. Cantor, Nicole K. Eberhart, Joshua Breslau
Report

Oct 16, 2023

The Operational Risks of AI in Large-Scale Biological Attacks: A Red-Team Approach

In this report, the authors address the emerging issue of identifying and mitigating the risks posed by the misuse of artificial intelligence—specifically, large language models—in the context of biological attacks and present preliminary findings.

Christopher A. Mouton, Caleb Lucas, Ella Guest
Journal Article

Oct 4, 2023

National Travel Distances for Emergency Care

The paper examines the travel time/distance between a patient’s actual home address and the ED they visited and how these distances/times vary by hospital and patient characteristics using geocoded data from 50 hospital-based EDs from across the US.

Anagha Alka Tolpadi, Marc N. Elliott, Daniel A. Waxman, Kirsten Becker, Elizabeth Flow-Delwiche, William Lehrman, Debra S. Stark, Layla Parast
Multimedia

Sep 29, 2023

59:56

Can South Korea Help the World Beat the Next Pandemic?

How can South Korea turn its COVID-19 control success into a successful “soft power asset” for health diplomacy? The RAND Center for Asia Pacific Policy hosted a webinar discussion to promote the sharing of innovative ideas and best practices.

Kathleen Stephens, Youngmee Jee, Tikki Pang, Jennifer Bouey
Report

Sep 27, 2023

Syndromic Surveillance 2.0: Emerging Global Surveillance Strategies for Infectious Disease Epidemics

To aid in the detection of emerging epidemics and pandemics, researchers investigate the effectiveness of the newest syndromic surveillance strategies — those designed to identify outbreaks before clinical data are available.

Rajeev Ramchand, Sangeeta C. Ahluwalia, Mary Avriette, Gary Cecchine, Monika Cooper, Christy Foran, Daniel Hicks, Natasha Lander, Sarita D. Lee
Journal Article

Sep 18, 2023

Exploring Which Patients Use Their Closest Emergency Departments Using Geocoded Data

Each year, roughly 20% of U.S. adults visit an emergency department (ED). Examining ED use, Fewer than half of patients visited the closest ED. Patients who chose a farther ED sought higher-rated hospitals and reported more favorable experiences.

Anagha Alka Tolpadi, Marc N. Elliott, Kirsten Becker, William Lehrman, Debra S. Stark, Layla Parast

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