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Understanding Health Equity w/ Dr. Jerome Adams · Making Medicine

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You're listening to Making Medicine Stories from the Early Stage life Sciences Ecosystem, a
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podcast that explores the people and deals that have led to the medicines, devices,
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and technologies that keep us healthy. Let's get into the show. Welcome
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to the Making Medicine Podcast live from the Aspen Institute in Aspen, Colorado.
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Thanks for joining us for what is going to be one of the best conversations
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we've had on the podcast. I'm your host, John Stanford, and I
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have the real pleasure to be here with someone who I ran into at the
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Health Summit at the Aspen Institute, and that's doctor Jerome Adams. He's currently
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the director of Produce Health Equity Work. He's mostly known as the twentieth Surgeon
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General of the United States, which of course makes him likely the only person
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on the podcast who will ever wear the title Vice Admiral, and before that,
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he was Indiana's Health Commissioner. So there could not be a more leading
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voice in the state of healthcare in the United States, and certainly a leader
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on health equity issues, which is what we're going to get into. So
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doctor Adams, thanks for joining us. Well, really glad to be be
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here with you today. It's a great time to be talking about health equity.
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It's an exciting time to be talking about health equity, and we're better
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to do with an Aspen. That's absolutely right. As we sit recording this
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podcast, you know, we are just absolutely in one of those stunningly beautiful
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places and having important conversations. And I had the pleasure of sitting in with
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doctor Adams and a handful of other leading folks from industry, from academia,
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from science talking about this concept of health equity. And I thought you made
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so many good points on the panel, which we're going to unpack today on
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the podcast. But let's start with that all famous question of the contemporary moment.
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What when we say health equity, which has come to mean something different
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to everyone else, what does it mean to doctor Adams? Well, health
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equity at its core means people have appropriate and fair operatunities to make good decisions
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about their health. And we talked about being here in Aspen. Aspen has
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some of the best health rankings of any place in the United States. Why
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is that, Well, you've got a lot of affluent residents who have the
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ability to purchase the things that they need to support their health. They have
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the ability to eat healthy foods and have the ability to get out and go
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skiing or exercise if they need to. And we know that in many communities
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across America, both rural and urban, that folks don't have those opportunities.
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So quick story that I love to tell about my own daughter. My daughter's
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twelve. She likes to spend a little bit too much time on her devices.
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And when she does, I say, Millie, give me your phone,
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go out, rode your bike. I don't want to see you for
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an hour. That actually makes me a good dad, because I'm lowering her
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diabetes rates, I'm promoting her mental health. But I can do that because
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we live in a neighborhood where we have sidewalks, complete streets, where the
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neighbors know her, where I'm not worried about her getting accosted by someone.
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You go six miles away from where I live to downtown Indianapolis, different dad,
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different twelve year old daughter. He sends his daughter out and says,
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I don't want to see you for an hour, give me your phone.
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That's actually child neglect. Why because that's the community where they don't have complete
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streets. My daughter could get hit by a car. That's a community that
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is rife with crime, where she may get shot or she may get accosted
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by someone. And we need to understand that everyone wants to make healthy choices,
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but we don't always have an opportunity to make healthy choices. And as
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Director of Health Equity at Purdue University, one of the things I'm trying to
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do is figure out how we can create communities where more people have those healthy
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choices. One of the quick point I'd make is there's a difference between equity
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and equality. Equality is everyone getting the same thing. So you want I
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entered this building the same way. There are steps to get into a building
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that's equal. But what if you're in a wheelchair? Can you get in
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that building now? No? So you may need a ramp to get into
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that building. Does everyone need a ramp to get into that building? No?
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So equality doesn't always get us to the place we need to be where
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people can actually access the services they need. We need to look at communities
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and figure out what do you need to be able to make a healthy choice
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and understand that if we give it to them, more people are going to
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make those choices. I think that's such a good way of framing it,
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because one sort of the pushing easy button of this conversation is Okay, well
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we'll just give everybody the same thing. And I think you made really good
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points that actually that's not going to get us any closer to solving the problem.
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And I think that the side by side of what you laid out your
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neighborhood and just one neighborhood over I'm paraphrasing a bit. I don't remember if
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it was you or someone else us on the panel, but for some folks,
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we just make it damn hard to make good choices, and that's what
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tackling health equity. That was me, Sorry for a person on the panel,
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but it frustrates me because we talk about personal responsibility, and I one
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hundred percent believe in personal responsibility, but I believe the choices we make or
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dependent on the choices we have in front of us. And we've got to
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realize some people only have bad choices in front of them, and they're choosing
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from a ray of bad choices, and other people have an array of good
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choices, and we want to make sure everyone has that opportunity to make a
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good choice. Yeah, I think for anyone not really familiar with or thinks
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it's too hard of an issue to tackle, I think you lay it out
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really clearly that that's what we've just got to give people the opportunity to make
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good choice, and that doesn't currently exist. But something else I took away
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is you talked about health equity. You know, not just in the context
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of race. We spend a lot of time because we have so many system
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demic racial issues, but you've also talked about health equity being bigger that can
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you go a little bit more into that. I really do think it's important
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that we understand that we all fit under the tent in different ways and in
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different times. When we're talking about health equity, and you're right, a
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lot of the conversation is focused on race, and appropriately so, because we
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have ignored systemic racism for far too long. But that said, when I'm
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talking about health equity, I'm talking about people who live in rural communities who
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may not have access to healthcare. I'm talking about gender issues, and we
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know that men and women have differential health status in different ways. I'm talking
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about agism, and do people who are extremely young or extremely old bear a
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disproportionate burden of disease. And look at COVID. Yeah, look at look
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at who was last to get vaccinated on the one end, and on the
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other end, look who been hardest hit by this pandemic. And then ask
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yourself our policies reflecting a commitment to making sure the most vulnerable among us have
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the opportunities to make healthy choices and live along healthy life. I'm talking about
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people with disabilities. I gave the example of the wheelchair. Um uh that
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that that's health equity. Looking at veterans, we know that veterans have poorer
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health, higher rates of mental health issues, higher rates of suicidality. Looking
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at these particular populations, we when we look at the data, see disparities.
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And though the disparities often relate back to the communities and the circumstances these
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folks are in and the choices that they have or don't have, I want
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to cast memory back a little bit. You know, talk thinking of your
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time as Surgeon General, and you know how what an incredible role. And
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I think we could fill multiple podcasts with your experiences. We could use other
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adjectives besides incredible, but man, I'm blessed to have been, to have
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been able to serve and you at this fascinating time because of course, at
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the end of your tenure, you know, of course COVID healthcare equals COVID.
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But of course when you came in in twenty seventeen, we weren't thinking
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about COVID. We weren't necessarily thinking about pandemics. And if I remember correctly,
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one of the things you really wanted to champion, which I think is
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going to define the next decade, was mental health. And you know,
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where do we go from here? Work here as a country? What do
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we need to do to begin to tackle mental health? Because I know that
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was a real priority of yours before. Of course COVID took over a great
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question. And I often say, a long time ago, we cut the
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head off from the rest of the body. And what I mean when I
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say that is, if you have a problem from your neck down, your
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primary care physician will see you now, and your insurance will pay for it.
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If you have a problem above your neck, whether it's vision health or
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auditory health, or dental health or mental health, it's we don't know if
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your insurance is going to cover it, and we're not going to be able
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to get you in for four to six weeks or four to six months,
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and we need to understand you can't be healthy and the rest of your body
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if you're not mentally, emotionally and spiritually healthy. So one of the things
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I've focused on is SURGE in general is really talking about integrative healthcare. We
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do an assessment for your blood pressure, for your heart rate, for your
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reflexes when you come in for your physical exam. We should be doing a
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mental health assessment at the same time. That is from the healthcare perspective,
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but we also need to understand, again going back to those opportunities for health,
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that our mental health is determined by the communities that we live in.
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If you live in a community where there are gunshots ringing all the time and
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you're constantly under stress, that's going to lead to poorer mental health and poorer
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physical health. We need to understand that when you make greener communities a concept
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called greening, it's been shown that you lower the rate of firearm injuries in
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those communities, you lower the chances that someone is going to commit or be
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a victim of a horrific act. And so there are things that we can
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do at the community level to really focus on mental health and wellness. And
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that's one more point I want to tease out. We talk a lot about
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mental illness and mental health from a deficit standpoint. Are you anxious, are
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you're depressed? Do you have bipolar disorder? Do you have schizophrenia? That's
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important. That's one end of the spectrum. The other end of the spectrum
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is what are the resilience factors that we have in your community that allow you
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to maintain health so that you don't become anxious, you don't become depressed.
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And it's children. We know that having a positive adult role model in your
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life as a predictive factor positively for mental health. We know that playing youth
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sports is important, and so it's why I'm involved with the Pro Football Hall
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of Fame's Health Advisory Committee and why I'm such a proponent of sports, and
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wife coached all my kids in sports. So we need to look at these
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protective factors that exist in communities that have better health and try to make those
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resources available to all communities well. And I think the linkage between everything you've
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talked about so far is so obvious that that mental health, health equity,
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you name it. It all gets to this broader sense that we have to
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make some serious changes in this country and even globally to enable people to have
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the most fulfilling lives that they can. And what I've liked about you know,
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I've come to a couple of your sessions. You even talked about gun
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violence, and that comes into this conversation as well. And your point about
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greening is is well taken, and so I commend you on being able to
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draw out that linkage because I think sometimes we just say, oh, we're
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gonna have a mental health summit. All the mental health advocates get together,
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and then we're gonna have a separate well being summit, and we're gonna have
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a separate health equity summit, and cancer summit and a separate diabetes summit.
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And the fact is, if we get up stream and build healthier communities,
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then we won't need to have all those summits because we'll lessen the occurrence and
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severity of all of those problems. There's a quick story I want to tell,
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and we tell it in public health. There was a man sitting by
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the side of a stream and someone was floating down the stream and they were
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drowning, and the man jumped in, fished them out, saved his life.
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They're sitting there and then another person comes down the stream and they're drowning
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and the man jumps in, fishes them out, saves his life. And
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this happens over and over in a crowd build and they're cheering on the gentleman
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who's saving life after life after life. And the gentleman finally just stands up
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and walks away, and they say, well, what are you doing.
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There's more people in the stream. He says, I'm going up stream to
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find out why all these people are falling in in the first place. And
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I think it's important for us to understand that we aren't going to solve these
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problems playing whack amole or focusing solely on phishing people out of the stream at
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the back end. We've got to get upstream and figure out why the heck
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people are falling in in the first place. And if we do that,
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it's actually shown to be more cost effective, it's actually shown to be more
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practical, and people will live longer live. But unfortunately, in the United
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States, we don't have a healthcare system. We have a sick reimbursement system,
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and our system waits until you get sick, till you've fallen in the
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stream, and then we have all these convoluted systems for cost shifting to pay
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people to fish you out of the stream, but we don't have systems in
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place to pay someone to stand at the front of the stream and keep people
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from falling in in the first places. That parable is so I think exactly
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where we are because for whatever reason, the way the system is now,
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we will let people deteriorate to a place where they will cost the system.
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We're going to turn to economic benefits in a second, but I think that
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that's such a good example, and I think your work could be described as
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you're walking up scream. You're trying to figure out why people are falling in
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in the first place. And it's hard. It is so hard because the
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other thing I love about that parable is because it shocking is jarring to us
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to think that someone is walking away from folks who are drowning in the stream,
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and it's a real challenge. We've got to figure out how to do
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both at the same time. We've got to save live Look at the opioid
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epidemic. We want to give people in the lock zone. We want to
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prevent them from dying from an opioid overdose, but we don't want to focus
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on that so much that we forget about prevention efforts so that people don't become
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addicted to opioids in the first place. We have got to figure out how
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to do both, and how to compensate people for and do research on and
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develop plans for prevention while we also focus on treatment, which gets all the
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attention. Which brings me to I think some of the compelling work you did
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towards the end of your time a surgeon general. You looked into not not
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just the business of healthcare, which we talk about a great deal on this
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podcast, but just the role of business in the employer. This report came
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out in twenty twenty. We'll make sure it's up on the Incubate website with
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the podcast that. I'm sorry maybe it came out early twenty twenty one,
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but I know it. Can you tell us a little bit about this work
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you did with Darden, the great business school at the University of Virginia as
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a William Mary guy. I'm disappointed to say to talk about Darden, but
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tell us tell us a little bit about the report and some of the interesting
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takeaways from it. Well, the report is called Community Health in Economic Prosperity,
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and it's really about making the business case for building healthier communities. I've
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run a state health department, I've been Surgeon General of the United States,
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and I've found that over and over again, when health is pitted against business,
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health loses. When you look at the climate change discussion, we all
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want to leave a better world for our kids in the world that was given
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to us, but we're not willing to pay the economic cost to actually make
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that happen. When you look at tobacco, everybody knows tobacco is bad for
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you. A three year olds, tobacco is bad for you. But that
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said, we still can't get rid of cigarettes or race tobacco taxes. In
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Indiana. We've had the same load tobacco taxes for two decades. Why because
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every time we try to raise them, the business community, the mom and
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pop bars, the gas stations, the casinos come in and say, well,
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that's all well and good. We know it's unhealthy, but hey,
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you're gonna cost jobs in our state. You're gonna cost you're gonna hurt our
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economy if you just force people to go over the border to Kentucky and buy
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their cigarettes instead of buying in them make gas stations in Indiana and so I.
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That didn't ring true to me. And the reason why it didn't ring
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true to me is because we know that the number two expense for all businesses
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that provide employer provided insurance, which is a fifty percent of insurance in this
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country, the number two expenses healthcare. If you were going to create a
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product and you need to source materials, would you move and put your company
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in a place where those source materials cost twice as much as as somewhere else.
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Well, we're doing that right now in the United States. The US
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spends twice as much money on healthcare per capita than any other OECD or rich
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nation. And you might say, well, but we have great healthcare in
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the US, and depending on how you look at it, we do.
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There's nowhere else in the world I'd rather be if I have a cancer diagnosis,
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for instance, But that healthcare is not equitably distributed and it is still
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very far downstream. Proof of this. We spend twice as much as any
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other country on healthcare, but in nineteen ninety five, those other countries that
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have s been less than us actually surpassed us in life expectancy. We have
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the highest suicide rates in the world. We have the highest obesity rates in
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the world. We are not getting our ROI, our return on investment,
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and that is hurting the competitiveness of businesses from an expensive point of view.
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Number one. Number two, we're in the midst of a great resignation.
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Workforce is a big issue, and many people have checked out of the workforce
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due to health issues, due to addiction, due to mental health issues,
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due to diabetes, due to these health concerns that they have. If you
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don't have a healthy pool to choose from, then you're not going to be
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able to maintain a healthy workforce. Shocking stat and this isn't a particularly work
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a business issue. But if you look at the military as a workforce,
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seven out of ten of our eighteen to twenty four year old in this country
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are ineligible for the military seventy one percent. Why because they can't pass the
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physical can't meet the educational requirements, or have a criminal background record. In
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other words, because they have poor mental and physical health. And so the
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military seeing it. All of our other companies are seeing it. That's why
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I worked with the UVA Garden School of Business to put together this first of
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its kind Surgeon General's Report. Why is that the first of its kind?
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Because every other Surgeon General's report that's been written is written in health lingo for
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a health audience. And we've got to stop preaching to the choir, and
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we've got to go out and create some new converts. And so I worked
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with the business community to figure out, Okay, number one, what type
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of language do you all use? What motivates you? And one of the
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big motivators is workforce. It's healthcare costs and its workforce. And are there
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some examples out there of people who are actually doing this? And there were
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some great examples Starbucks, Patagonia, companies that you know, Amazon really expanded
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its benefits for women so that they could stay in the workforce. But then
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there are also middle and small size companies. So great example is graced in
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Bakery and Yonkers, New York, and they have an open application process where
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they don't make you put down your criminal history, your work history. They
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just say, if you want to work here, just put your name down
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and when we have a job opening, we'll call you up, and they
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call you up and if you still want to work, you come in.
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And instead of spending money screening people out of the process, they actually spend
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that money on job training and on social workers on site, and they found
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that their employees are more loyal, miss less time from work, and are
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more productive. And then employee that other companies who've spent thousands of dollars screening
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people out the point they're being there's a better way to do things, and
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when companies invest in healthier communities, they actually see a healthier bottom line,
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which I completely agree. We talk a lot on this show about capital,
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and I talk a lot about capital flowing like water, and I tell policymakers
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there's really not going to be too many surprises out of the business community,
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for better or for worse. They're fairly rational actors and we can tend to
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know what we're going to do. I think one I want to commend you
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in your time, you were thinking about mental health, and you were thinking
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about the linkage between healthcare and business as it relates to a workforce. Here
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we are facing a mental health crisis and a workforce crisis. So you have
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some crystal ball with where you were trying to take the government in your leadership
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role. Well, and I want to jump in really quickly there because you
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say the business community is rational, and I agree with that. But the
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problem is you can't make rational decisions if you don't have the data and people
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don't respond to health metrics, to human global A ONEC and systolic blood pressure
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the way they respond to business metrics. We know this. The number one
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issue Democrat or Republican, black or white, rural or urban that people vote
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on in elections consistently, including the last election, is actually the economy.
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Number one issue in the last presidential election wasn't COVID, it was economic recovery.
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And so we've got to speak to people in a way that resonates with
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them, and that starts with collecting the data. We need to do studies
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that show, hey, we didn't just lower your blood sugar by ten percent,
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we increased your workforce productivity or lowered your apps and teeism at work.
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We need to look at those types of measures so that people can make rational
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decisions moving forward. Another problem that we have is that again people think of
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health as healthcare but healthcare what happens in a hospital or a clinic, that's
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only about twenty percent of what determines your overall health. What actually determines eighty
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percent of your health or things like transportation, Are things like paid time off,
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so you're not going to go to the doctor's office if you don't have
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paid time off. Are things like like childcare. Are things like do you
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have a living wage or are you having to work three jobs to get by
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and so you don't have time to go get your COVID vaccination or you don't
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have time to take your kid in for their check up. When we invest
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in healthier communities, we actually see those social determinants of health is what we
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call those community determinants of health improve and that actually does more to create healthier
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people in healthier societies than increasing access to healthcare. The number one reason for
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inpatient diabetes admissions isn't people not getting insulin again fishing people out of the stream
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on the back end, it's actually making sure they have access to affordable,
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healthy foods. We see emergency remomissions go up at the end of every month.
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Why because people's checks run out and they run out of food and then
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their blood sugars get out of whack and they get admitted to the hospital,
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and we paid thousands of dollars to stabilize their blood sugar and then we send
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them back home again and wait for it to happen the next month. We
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can't do that anymore. Well, I think you tapped into something there because
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we're sitting here with all the thought leadership of the healthcare world, and even
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some of the conversations I've had, we're so grounded many MD PhDs here who
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are grounded in health lingo. What your report said is, Look, employers
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big and small are going to be one of the key factors in how we
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live our lives. If we're speaking a language they don't understand the language of
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a ONEC, we're not going to get them to take the steps they need.
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And we're not going to get to healthy communities if our employers are not
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pushing for healthy community And so I just I think the report is a good
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starting point for a conversation because I think the business community has got a tremendous
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role to play in advancing these communities. And we've also seen that businesses that
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invest in ESG, environmental, social, and governance policies perform better in the
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stock market. So we're starting to see that they have a better brand reputation.
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People want to invest in them, and people want to buy their products.
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The new generation of young adults out there, they want to know if
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I'm going to spend my money on this shirt or on this car, or
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on whatever. They want to know what are the goals the ideals that this
25:40
company is committed to. Are they committed to sustainability, Are they committed to
25:44
local hiring, or they committed to the thing? And they don't mind paying
25:47
a little bit more for a product if they know that the company is being
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being responsible. So incredibly important. But I want to wrap that section up
25:56
with another story that I love to tell. Was in Columbia, South Carolina
26:00
with Mayor Benjamin, who's the mayor there, and he was hosting the US
26:06
Conference of Mayors and we were talking about walkable communities. And so I had
26:11
Mayor de Blasio from New York, Mayor Benjamin, and a host of mayors
26:14
from around the country and we were talking about why mayors created walkable communities.
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And I asked the question and said, how many of you all ran for
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office on lowering your community him A globe an A one c rates by fifteen
26:29
percent. Not a single mayor raised their hand. I'm a doctor, I'm
26:33
a public health person. Why not that you know? We know that that's
26:36
a big problem. And what I was told by those mayors is they created
26:40
walkable communities not to lower heima globe and A one c rates. They created
26:44
walkable communities because it creates foot traffic downtown and increases business productivity, more customers.
26:51
It's because when you have walkable communities that are well, let you have
26:55
less violence downtown, so safety, security, property go up. So people's
27:00
how they are worth more. Either of the reasons that mayors create walkable communities,
27:06
and oh guess what, don't tell them it lowers their human globe and
27:07
A one c rates in the community too. But we've got to learn to
27:11
speak in the language that motivates those folks. Well, I I think that's
27:15
a place of enormous alignment because where I just think you're so right. It
27:19
is like you said, voters choose on economic issues. Businesses look at economic
27:26
indicators. We can't have healthcare ignore that good healthcare is also going to be
27:30
a good do well, do good by doing well, do well, by
27:34
doing good, I think it plays out here. I want to close with
27:37
two things. I'll give you the closing question we normally give people, but
27:42
everyone's got to hear this quote that I wrote down from you yesterday, and
27:47
I need to find it actually in front of me. And it was make
27:53
sure I get this right. People need to know you care before they care
27:59
about what you know. Tell me about that. I was so struck by
28:02
that. Well again, and with apologies. I love stories, so I'll
28:07
tell you a quick story. I became famous or infamous in the health world
28:12
because I was running the Indiana State Department of Health when we had the largest
28:15
HIV outbreak related to injection drug use in the history of the United States.
28:19
Scott County, Indiana, rural community about two hours south of Indianapolis. About
28:25
four thousand people in this community of Austin, Indiana, all white farm community.
28:30
I've never had more than one case of HIV in a year, and
28:36
in just over a year, we had over two hundred cases of HIV related
28:41
to injection drug use. And the solution from a public health standpoint was the
28:45
implement a syringe service program, but that was illegal in Indiana. And it
28:49
was socially, culturally not a place the community wanted to go to. I
28:55
could have used my public health authority as state health commissioner to go down and
28:59
start pass out needles. But guess what the local sheriff actually told me.
29:03
If you did that, I would have just set up a roadblock, you
29:06
know, a little bit outside of your your your surringe service program and pulled
29:11
people over as they were coming in and out and check them for syringes and
29:14
drugs. And that would have shut down your program. So what did I
29:18
have to do? Well, I had to get out of Indianapolis, my
29:22
ivory tower, and drive two hours each way every day and go down there
29:27
and have lunch with people. I have beer, I have a beer with
29:30
with people, going to ride along with the with the sheriff and the police
29:34
chief, go to church with them. I had to show them that I
29:37
cared. And once I created that relationship, that connection. Because I grew
29:41
up in a rural community much like Scott County, m I understood the challenges
29:45
that they faced. My own brother sufferers from substance shoose disorder, as some
29:49
of your listeners may know. Once I created that connection, that opened the
29:55
doorway for having conversations about what we needed to do to respond to the HIV
30:00
crisis, and we were able to get to a place where Scott County opened
30:04
up a syringe service program. It changed the state law in Indiana subsequently,
30:10
and then Kentucky went from zero to seventy surringe service programs. Neighboring Kentucky,
30:14
Ohio, doubled their number of syringe service programs. Conservative states like Arizona and
30:18
Florida were open to the idea of harm reduction, And so I got criticized
30:23
by a lot of pure health advocates for moving too slow. But if I
30:29
had moved too fast, it would have destroyed any ability I had to create
30:33
trust to show people that I cared, and they would wouldn't have given a
30:37
darn about what I knew. And so I really do believe that quote and
30:44
I try to live by it that once you show people that you care,
30:48
then people will care what you know. And I think there's just not enough
30:52
of that out there now. We want to hammer people with the data and
30:55
oh, my gosh, you're an idiot because you don't see how many people
30:57
are dying from guns. Stupid because you don't understand the impact of prescription opioids
31:04
on the addiction crisis that we have in our country, Or oh, my
31:07
gosh, can't you understand how many women are dying for lack of of of
31:12
of women's health services. The data is important, but just as important are
31:18
those relationships well, and I think we could extrapolate that to almost any aspect
31:22
of American society right now. And you have lived not just talking the talk,
31:27
but walking the walk of building that trust. And we don't, especially
31:32
in the healthcare community, We throw so much data around and don't invest the
31:37
time and energy in building that trust. I don't want to close on because
31:42
that trust will be built good people like you and others will keep building that
31:47
trust in neighborhoods, network cities, and across the country. But I want
31:52
to close on a positive note, whether it's in your personal life, your
31:56
work at Purdue on health equity, you know, as being a healthcare leader
32:00
in this Country's what's something you're optimistic about you're looking forward to you think we're
32:06
making moves in the right direction, Well, really quickly. I'm optimistic that
32:10
more people even are talking about health equity Purdue. I'm their first ever director
32:16
of health Equity. The board and President Daniels felt strongly enough about it that
32:22
they brought me on and hired me. Here at the Ideas Festival, we're
32:27
talking with many other companies who two years ago didn't have a health equity director
32:32
and they've hired someone because they now see that it is a business imperative for
32:37
them to be thinking about these issues. So that's one thing I'm incredibly excited
32:40
about. I'm also excited because I believe in in disruptive innovation. We don't
32:47
change things when the caesarre calm and when the ship is just cruising along.
32:53
We need a little storm, we need a little wind to say, Okay,
32:57
we're going to change our course. While everyone admits the system health care
33:02
system in the United States is broken, no one has been willing to take
33:06
the bold steps necessary to change course. While COVID really shook us up and
33:13
it caused us to do some things that I think going to pay dividends down
33:16
the road. So for instance, telehealth, we were paying for about ten
33:21
thousand telehealth visits per week via CMS pre pandemic. At the peak of the
33:24
pandemic that was up to a million visits per week. You have thirty eight
33:30
times the amount of telehealth services being provided now as you did pre pandemic.
33:34
That's going to change the way care is delivered, from mental health, for
33:37
physical health, and for vulnerable communities across the nation. We know that times
33:42
of the crisis spur us to make good changes, and so I'm excited about
33:45
that. And the final thing I'm excited about is our young, our young
33:50
population, the young people out there. Now. I've had a chance to
33:52
speak with many of them here and ask them, and they think differently.
33:59
They think much more about the world that they're living in in their impact on
34:04
that world, even if all you're hearing about or us old fogies the adults
34:07
out there arguing over our individual and personal rights and freedoms, and we need
34:13
to find that right balance. But I think the young people out there understand
34:15
that they aren't going to have that ability to make good individual choices if they
34:22
don't have an environment around them that is supportive and that is healthy. And
34:27
so I think they're going to lead the way. I think they're going to
34:30
continue to forge change and to demand change, and I think ultimately we're going
34:35
to see that we're going to be in a better place moving forward. And
34:40
it's not to dismiss the tragedy of lives lost and people learned from COVID,
34:45
but it is to say that shame on us if we don't recognize the opportunity
34:50
to turn some of those negatives into positives in terms of fixing the broken parts
34:57
of our system that have existed for far too long. Well think that brings
35:00
us back full circle that the work you're doing, the work we should all
35:04
be doing, is enabling people to make good choices, removing the bad choices.
35:09
And you are right. There is a silver lining of any crisis,
35:13
and it is opportunity, and it's opportunity we have to seize. He is
35:17
doctor Jerome Adams, currently the director at Purdue for Health Equity. He was
35:22
the twentieth Surgeon General of the United States. He's joined me today here at
35:27
Aspen Ideas at the Aspena Institute. I am so grateful for the time,
35:31
doctor Adams. This is, without a doubt, one of the most informative
35:35
and best episodes we've done. So thank you well, it's been wonderful.
35:37
Thank you for the opportunity. And the one accolades you didn't mention is that
35:42
I'm a dad, and so I've got an eighteen, a sixteen, and
35:45
a twelve year old, and my eighteen year old just had a birthday.
35:47
So happy birthday, Caden, and thank you for the opportunity to be on
35:51
the day. Happy birthday. Indeed, we've celebrated, we've celebrated being dad's
35:55
in our conversations, and I love that you bring so much of your personal
35:59
life to your work. So thanks for being here, and as always,
36:01
thanks to our listeners. You can learn more about Incubate at www dot Incubate
36:07
Coalition dot org. Thanks to our incredible team helping produce this podcast, and
36:12
as always, keep innovating. You've been listening to Making Medicine. To ensure
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