2023 National Survey of Health Attitudes: Description and Top-Line Summary Data.

RAND is supporting the Robert Wood Johnson Foundation in advancing understanding of U.S. public mindsets and attitudes toward health and well-being.

Has COVID-19 changed how people think about the drivers of health? If so, does it matter?

Background: Could the COVID-19 pandemic prompt shifts in Americans' basic views on health mindset and policy solutions to health crises?

Methods: A sample of 1,637 individuals rated the extent to which items (e.g., the role of environmental vs.

What drives health mindset and expectations in the United States?

Health mindset is a group of beliefs or assumptions that individuals hold about the causes of health and well-being. Strengthening our understanding of factors that shape mindset and how mindset shapes expectations for who can and should be responsible for health can inform the success and sustainability of solutions to current health crises including the COVID-19 pandemic, ongoing disparities in health outcomes, and gun violence. We first examined associations between personal characteristics and experiences with health mindset.

Technology and Data Implications for the Public Health Workforce.

Achieving a modern equity-oriented public health system requires the development of a public health workforce with the skills and competencies needed to generate findings and integrate knowledge using diverse data. Yet current workforce capabilities and infrastructure are misaligned with what is needed to harness both new and older forms of data and to translate them into information that is equity contextualized. As with other articles in this supplement, this article builds from a literature review, environmental scan, and deliberations from the National Commission to Transform Public Health Data Systems.

The Issues of Interoperability and Data Connectedness for Public Health.

An unprecedented amount of data is being collected across a diversity of sectors, which, if harnessed, could transform public health decision-making. Yet significant challenges stand in the way of such a vision, including the need to establish standards of data sharing and interoperability, the need for innovation in both methodological approaches and workforce models, and the need for data stewardship and governance models to ensure the protection and integrity of the public health data system. As with other articles in this supplement, this article builds from a literature review, environmental scan, and deliberations from the National Commission to Transform Public Health Data Systems.

What Data Should Be Included in a Modern Public Health Data System.

The public is inundated with data, both in where data are ubiquitously collected and in how organizations are using data to drive public sector and commercial decisions. The public health data system is no exception to this flood of data, both in growing data volume and variety. However, what are collected and analyzed about the health status of the nation, how particular data and measures are prioritized for parsimony, and how those data provide a signal for where to invest to address health inequities are in dire need of a reboot.

Equity as a Guiding Principle for the Public Health Data System.

The growing centering of equity in health has elevated a conversation about how those interests should translate within the systems and sectors that influence health. In particular, the public health data system has been relatively limited in capturing the drivers and consequences of health inequity as well as the varying dimensions of equity. This article examines what it means to use equity as a guiding principle throughout the components and functions of a modern public health data system.

Drivers of differential views of health equity in the U.S.: is the U.S. ready to make progress? Results from the 2018 National Survey of Health Attitudes.

Objectives: The public health sector has long recognized the role of the social determinants of health in health disparities and the importance of achieving health equity. We now appear to be at an inflection point, as we hear increasing demands to dismantle structures that have perpetuated inequalities. Assessing prevailing mindsets about what causes health inequalities and the value of health equity is critical to addressing larger issues of inequity, including racial inequity and other dimensions.

Effects of Estimated Community-Level Health Literacy on Treatment Initiation and Preventive Care Among Older Adults with Newly Diagnosed Diabetes.

Purpose: Individual measures of health literacy are not feasible for administration on a large scale, yet estimates of community-level health literacy in the US recently became available. We sought to investigate whether community-level health literacy estimates are associated with the initiation of oral antihyperglycemic agents (OHA) and the use of standard preventive care services among older adults with newly diagnosed diabetes.

Patients And Methods: We conducted a retrospective cohort study of 169,758 patients, ≥65 years old with hypertension and newly diagnosed type 2 diabetes using 2007-2011 data from the Center for Medicare and Medicaid Services Chronic Conditions Warehouse.

Are Publicly Funded Health Databases Geographically Detailed and Timely Enough to Support Patient-Centered Outcomes Research?

Emerging health care research paradigms such as comparative effectiveness research (CER), patient-centered outcome research (PCOR), and precision medicine (PM) share one ultimate goal: constructing evidence to provide the right treatment to the right patient at the right time. We argue that to succeed at this goal, it is crucial to have both timely access to individual-level data and fine geographic granularity in the data. Existing data will continue to be an important resource for observational studies as new data sources are developed.

An Evaluation of U.S. Military Non-Medical Counseling Programs.

This study evaluates two programs offered by the U.S. Department of Defense (DoD) that provide short-term, solution-focused counseling for common personal and family issues to members of the U.

How Cultural Alignment and the Use of Incentives Can Promote a Culture of Health: Stakeholder Perspectives.

In 2013, the Robert Wood Johnson Foundation embarked on a pioneering effort to advance a Culture of Health. This report focuses on two questions that are central to understanding how individuals and sectors think about health and are motivated to promote it: How can the commonly understood concepts of cultural identity (e.g.

Assessing the Role of State and Local Public Health in Outreach and Enrollment for Expanded Coverage: A Case Study on West Virginia.

The Patient Protection and Affordable Care Act (ACA) laid the groundwork for a substantial increase in the number of people who have access to health insurance through Medicaid expansion or health insurance marketplaces. During the first open-enrollment season, states used a variety of strategies to reach out to and enroll newly eligible people. Typically, they used federal and state funding to develop navigator programs.

Assessing the Role of State and Local Public Health in Outreach and Enrollment for Expanded Coverage: A Case Study on Tacoma-Pierce County, Washington.

The Patient Protection and Affordable Care Act (ACA) laid the groundwork for a substantial increase in the number of people who have access to health insurance through Medicaid expansion or health insurance marketplaces. During the first open-enrollment season, states used a variety of strategies to reach out to and enroll newly eligible people. Typically, they used federal and state funding to develop navigator programs.

Assessing the Role of State and Local Public Health in Outreach and Enrollment for Expanded Coverage: A Case Study on New Orleans, Louisiana.

The Patient Protection and Affordable Care Act (ACA) laid the groundwork for a substantial increase in the number of people who have access to health insurance through Medicaid expansion or health insurance marketplaces. During the first open-enrollment season, states used a variety of strategies to reach out to and enroll newly eligible people. Typically, they used federal and state funding to develop navigator programs.

Assessing the Role of State and Local Public Health in Outreach and Enrollment for Expanded Coverage: A Case Study on Illinois.

The Patient Protection and Affordable Care Act (ACA) laid the groundwork for a substantial increase in the number of people who have access to health insurance through Medicaid expansion or health insurance marketplaces. During the first open-enrollment season, states used a variety of strategies to reach out to and enroll newly eligible people. Typically, they used federal and state funding to develop navigator programs.

Assessing the Role of State and Local Public Health in Outreach and Enrollment for Expanded Coverage: A Case Study on Boston and Massachusetts.

The Patient Protection and Affordable Care Act (ACA) laid the groundwork for a substantial increase in the number of people who have access to health insurance through Medicaid expansion or health insurance marketplaces. During the first open-enrollment season, states used a variety of strategies to reach out to and enroll newly eligible people. Typically, they used federal and state funding to develop navigator programs.

Building a National Culture of Health: Background, Action Framework, Measures, and Next Steps.

Because health is a function of more than medical care, solutions to U.S. health problems must encompass more than reforms to health care systems.

Supporting the Mental Health Needs of Veterans in the Metro Detroit Area.

Supporting the mental health needs of veterans is a national priority. Over the past decade, there have been several studies describing the needs of the veteran population, particularly those who served in the post-9/11 era, calling for improved access to high-quality mental health services. In response, the federal government has expanded funding and services to meet increasing demand.

Family Resilience in the Military: Definitions, Models, and Policies.

Military life presents a variety of challenges to military families, including frequent separations and relocations as well as the risks that service members face during deployment; however, many families successfully navigate these challenges. Despite a recent emphasis on family resilience, the U.S.

Strengthening Integration Of Health Services And Systems.

New care delivery models that hold providers more accountable for coordinated, high-quality care and the overall health of their patients have appeared in the US health care system, spurred by recent legislation such as the Affordable Care Act. These models support the integration of health care systems, but maximizing health and well-being for all individuals will require a broader conceptualization of health and more explicit connections between diverse partners. Integration of health services and systems constitutes the fourth Action Area in the Robert Wood Johnson Foundation's Culture of Health Action Framework, which is the subject of this article.

From Coverage to Care: Strengthening and Facilitating Consumer Connections to the Health System.

To date, most Affordable Care Act implementation efforts have focused on getting individuals enrolled in health insurance coverage; indeed, millions of Americans, many of whom had never been insured, have since obtained health coverage, either through the health insurance marketplaces or through expanded Medicaid eligibility, if available in their state. Yet reducing the number of uninsured is only part of the law's goal. It also aims to improve population health and lower health care costs.

Barriers to Enrollment in Health Coverage in Colorado.

As part of the implementation of the Affordable Care Act, Colorado has expanded Medicaid and also now operates its own health insurance exchange for individuals (called Connect for Health Colorado). As of early 2014, more than 300,000 Coloradans have newly enrolled in Medicaid or health insurance through Connect for Health Colorado, but there also continues to be a diverse mix of individuals in Colorado who remain eligible for but not enrolled in either private insurance or Medicaid. The Colorado Health Foundation commissioned the RAND Corporation to conduct a study to better understand why these individuals are not enrolled in health insurance coverage and to develop recommendations for how Colorado can strengthen its outreach and enrollment efforts during the next open enrollment period, which starts in November 2014.

Education and coronary heart disease risk: potential mechanisms such as literacy, perceived constraints, and depressive symptoms.

Objective: Education is inversely associated with coronary heart disease (CHD) risk; however the mechanisms are poorly understood. The study objectives were to evaluate the extent to which rarely measured factors (literacy, time preference, sense of control) and more commonly measured factors (income, depressive symptomatology, body mass index) in the education-CHD literature explain the associations between education and CHD risk.

Method: The study sample included 346 participants, aged 38 to 47 years (59.

A Systematic Process to Facilitate Evidence-Informed Decisionmaking Regarding Program Expansion.

While the Department of Defense supports more than 200 psychological health and traumatic brain injury programs, it lacks an approach and process to systematically develop, track, and assess the performance of this portfolio of programs. Further, there is not yet a uniform approach to decisionmaking around program support and expansion of particularly promising, evidence-based programs. This lack of centralized oversight may result in the proliferation of untested programs that are developed without an evidence base; an inefficient use of resources; and added cost and administrative inefficiencies.