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Book
Analysis of the Cities Readiness Initiative
Authors: ---
Year: 2012 Publisher: Santa Monica, CA : RAND Corporation,

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Abstract

The Centers for Disease Control and Prevention's (CDC's) Cities Readiness Initiative (CRI) provides funding, program guidance, and technical assistance to improve communities' ability to rapidly provide life-saving medications in response to a large-scale bioterrorist attack, naturally occurring disease outbreak, or other public health emergency. Focusing on both capacities and operational capabilities, the authors examine (1) the current status of communities' operational capability to meet CRI program goals related to delivering medical countermeasures within 48 hours of a federal decision to deploy assets and (2) whether there is evidence that CRI has improved communities' capability to meet the 48-hour goal. Analysis shows that, overall, state capacity appears to be strong; CRI appears to have improved state capacity, but the data are not conclusive. Performance across Metropolitan Statistical Areas varies considerably, as does performance in particular functional areas. The authors also note that testing of operational capabilities has not been conducted at a large enough scale to measure readiness for the 48-hour scenario, recommending that jurisdictions be required to conduct drills at a larger scale. Other proposed recommendations include improving CDC feedback to jurisdictions, attempting to leverage assessments of non-CRI sites as a comparison group, and assessing program cost-effectiveness.


Book
Examining civic engagement links to health : findings from literature and implications for a culture of health

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The Robert Wood Johnson Foundation (RWJF) is leading a pioneering effort to advance a culture of health that "enables all in our diverse society to lead healthier lives, now and for generations to come." The RWJF Culture of Health Action Framework is divided into four Action Areas, and civic engagement (which RWJF defines broadly as participating in activities that advance the public good) is identified as one of the three drivers for the Action Area, Making Health a Shared Value, along with mindset and expectations, and sense of community. Civic engagement can serve as a mechanism for translating changes in a health-related mindset and sense of community into tangible actions that could lead to new health-promoting partnerships, improvements in community health conditions, and the degree of integration among health services and systems for better health outcomes. The authors of this report seek a closer focus on the causal relationship between civic engagement and health and well-being — that is, whether better health and well-being might promote more civic engagement, whether civic engagement might promote health or well-being, or perhaps both. In this report, authors conduct a structured review to understand what the scientific literature presents about the empirical relationship between health and civic engagement. The authors specifically examine whether health is a cause of civic engagement, a consequence of it, or both; what causal mechanisms underlie this link; and where there are gaps in knowledge for the field.


Book
Health and social Services in Puerto Rico before and after Hurricane Maria : predisaster conditions, hurricane damage, and themes for recovery
Authors: --- --- --- --- --- et al.
Year: 2020 Publisher: Santa Monica, Calif. RAND Corporation

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Abstract

In September 2017, Puerto Rico was struck by two major hurricanes—Irma and Maria—that intensified existing challenges in Puerto Rico's health and social services infrastructure. In the aftermath, the government of Puerto Rico created a long-term recovery plan built on an evidence-based assessment of the damage from the hurricanes and the ongoing needs across Puerto Rico. Development of the recovery plan was supported by the Federal Emergency Management Agency, other federal agencies, local stakeholders, and analysis from the Homeland Security Operational Analysis Center (HSOAC), operated by RAND Corporation under contract with the U.S. Department of Homeland Security. HSOAC research provided the foundation for the 31 courses of action in the recovery plan addressing the health and social services sector. These actions are a mix of social, governmental, fiscal, and economic policies and reforms. This collection of actions presents an opportunity to build a more resilient health and social services infrastructure and regional health care networks to ensure reliable access to services, promote health and well-being, and more efficiently and effectively respond to public health crises and future disasters. The actions span the areas of health care, public health and emergency preparedness, environmental health, mental and behavioral health, and social services. The damage and needs assessment and courses of actions cover four major themes: building system capacity to respond both during disasters and routine times; strengthening the health and social services workforce; strengthening support services for at-need populations; and creating health-promoting communities.


Book
The education sector in Puerto Rico after Hurricane Maria : predisaster conditions, hurricane damage, and themes for recovery

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The government of Puerto Rico developed a plan to recover from the destruction caused by Hurricanes Irma and Maria, build resilience to withstand future disasters, and restore the struggling economy. The Homeland Security Operational Analysis Center (HSOAC), operated by RAND Corporation under contract with the U.S. Department of Homeland Security, worked with the Federal Emergency Management Agency (FEMA) to assist with the development of the plan. Acting in support of FEMA's Education sector, HSOAC analyzed data sources to conduct an assessment of the damage and recovery needs, and engaged with stakeholders to identify recovery courses of action, costs, and possible funding mechanisms. Education system reforms initiated prior to the hurricanes and poststorm legislation set the strategy for the recovery actions. This report details prestorm conditions, assesses the damage and recovery needs, and describes the courses of action represented in the recovery plan for the Education sector. The analyses, coupled with discussions with local education stakeholders and subject-matter experts, informed the development of 13 courses of action to support Puerto Rico's recovery plan and efforts to transform the education system. The courses of action cover four major themes related to Education sector recovery: rebuilding, repairing, and upgrading infrastructure; strengthening and supporting the government's K–12 system reform; expanding and improving out-of-school and preschool learning opportunities; and increasing access to vocational, technical, and career education and strengthening school-to-work transitions.

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