Healthier Populations

Social, physical, and environmental factors play a significant role in health outcomes. Efforts to improve access to quality health care and community resources could profoundly improve health at the population level, yet these factors tend not to be the primary focus of health improvement interventions.

RAND Health researchers use their extensive expertise in health policy, quality measurement, statistical analysis, and data science capabilities to helps policymakers gain insights into how to encourage healthy behaviors, combat chronic illness, and improve public health.

Encouraging Healthy Behaviors

RAND works with foundations and other clients to re-imagine how community programs and structures can spur people to take healthy action—and to understand the factors that can stand in the way.

Holistic approach to healthy: Most people know that some behaviors lead to better health than others. But being persistent in maintaining healthy behavior is often easier said than done.

• Culture of Health. In partnership with the Robert Wood Johnson Foundation, RAND has developed an approach toward implementing community interventions that promote health and well-being. The ALIGN toolkit uses exercises and examples to guide community leaders in their health promotion efforts.
• Libraries for Health. RAND researchers worked with the St. David’s Foundation in central Texas to design and evaluate a pilot effort to bring mental health programming and services into rural libraries. Peer specialists led group and one-on-one interactions, and library leaders participated in professional learning and had access to flexible funding. A toolkit offers lessons learned and best practices for libraries interested in pursuing a similar model.
• Care access and capacity. Interventions could help address patient literacy, provider recruitment and retention, and geographic barriers to care that lead to lower quality of care for people in rural areas and for some urban residents.
• Social and economic factors. RAND has been analyzing the many factors—the social determinants of health—that contribute to a person’s access to a healthy lifestyle, including access to affordable housing, safe neighborhoods, and a reliable source of food.

Combating Chronic Disease

With timely diagnosis and treatment, many chronic diseases can be curtailed—or even prevented. However, lack of patient education, provider availability, and efficient interventions often stand in the way of good health care and take a toll on health across the lifespan, from early childhood to older age.

Solutions-focused research: RAND research teams bring systems-level thinking to their analyses of health care access, emerging interventions, and the value of care.

• Diabetes: With the availability of new GLP-1 medications to people manage their blood sugar and weight, our researchers have used its unique, nationally representative survey panel to monitor who is most likely to use the drugs and the side effects they are experiencing. Researchers have also used microsimulations to predict the 30-year impact of interventions to improve diet across multiple populations.
• Alzheimer’s disease: RAND projects examined the pathway of detection to treatment for Alzheimer’s disease and related dementias. Researchers found benefits of early detection and advanced planning, and they analyzed patient demand for care and the capacity of U.S. health care systems to deliver it. An interactive tool allows users to modify assumptions about patient demand, provider supply, and other relevant factors to illustrate the effects of potential alternative actions to improve care delivery.
• Health screening: RAND researchers estimated the value of colorectal cancer screening, finding that because of its cost-effectiveness relative to no screening, insurance should still be required to cover it.
• Childhood stress: For the California Department of Health Care Services, RAND has been evaluating efforts to expand screening and response to adverse childhood experiences (ACEs), such as abuse and neglect, which can disrupt healthy development and lead to health conditions.

Improving Public Health Systems and Security

Infectious diseases can spread rapidly through communities without notice—in times of calm or emergency. Public health departments across the United States provide a patchwork of monitoring, but weaknesses in communication and ability to mount a response can greatly increase risks to the public’s health.

Multidisciplinary insights: RAND research teams include physicians, nurses, data scientists, statisticians, and other specialties with a unique perspective on localities and policymakers could be approaching public health and preparedness issues.

• Strain on systems: Emergency departments represent a first-line defense for acute and infectious disease, as well as disaster situations. RAND researchers have been evaluating the health of the U.S. emergency care system and recommending strategies to support it.
• Monitoring: Environmental sampling of wastewater and air emerged as a new approach to measuring the amount of pathogens circulating within a community—and for comparing amounts across communities. RAND research estimates that this approach could give a five-day early warning in comparison to the status quo approach of monitoring symptoms. Volunteer “citizen scientist” groups could also expand the capacity of local health departments, but legal and regulatory constraints limit the usage of data from volunteer groups.
• Emergency preparedness: Because new information emerges during public health incidents, potentially changing priorities, RAND developed a tool to help officials pivot during an emergency or exercise. RAND also developed a toolkit to help state, territorial, local, and tribal public health agencies conduct effective behavioral health surveillance, in the context of a public health emergency (such as a hurricane, wildfire, flooding, or pandemic) response.