Latest / Becker’s Payer Issues Podcast / America’s Health Rankings Senior Report: Key Trends in Healthy Aging with Rhonda Randall, DO

Transcript

America’s Health Rankings Senior Report: Key Trends in Healthy Aging with Rhonda Randall, DO · Becker’s Payer Issues Podcast

• 0:01
  - The payer provider relationship has never been simple,
• 0:04
  - but what's happening now is something different.
• 0:07
  - Value based models are maturing unevenly,
• 0:10
  - prior authorization reform is reshaping workflows on both
• 0:13
  - sides, and affordability
• 0:15
  - pressure is intensifying.
• 0:16
  - The organizations that figure out how to collaborate
• 0:19
  - genuinely, not just contractually,
• 0:21
  - are the ones that will set the terms
• 0:23
  - for what comes next.
• 0:24
  - Becker's fifth annual fall payer issues roundtable brings
• 0:27
  - together more than 500 executive level attendees
• 0:30
  - and 70 plus speakers for two days of
• 0:32
  - focused senior level conversation on benefit design, network
• 0:36
  - strategy, transparency,
• 0:38
  - and the financial and regulatory
• 0:46
  - Hotel Chicago. For the agenda and event details,
• 0:49
  - visit beckerspayer.com
• 0:50
  - and click on the events tab in the
• 0:52
  - upper right.
• 0:54
  - Hi, everyone. This is Elizabeth Cassello with the
• 0:56
  - Becker's Payer Issues podcast.
• 0:59
  - I'm thrilled today to be joined by doctor
• 1:00
  - Rhonda Randall, executive vice president and chief medical
• 1:04
  - officer of UnitedHealthcare's
• 1:05
  - commercial business and also a board member of
• 1:08
  - the UnitedHealth Foundation.
• 1:09
  - Doctor. Randall, we're so excited to have you
• 1:11
  - today, and I look forward to discussing the
• 1:13
  - UnitedHealth Foundation's America's Health Rankings 2026 senior report
• 1:17
  - with you. Thank you for having me.
• 1:20
  - So before we jump in, could you just
• 1:22
  - give our listeners a little bit of context
• 1:23
  - about you,
• 1:25
  - your health care career, and your current role
• 1:26
  - at UnitedHealthcare?
• 1:28
  - Certainly. Well, I'm a board certified family physician
• 1:31
  - and a fellowship trained geriatrician,
• 1:34
  - and I have over two decades of experience
• 1:36
  - in the health care industry,
• 1:39
  - both as, a direct provider of care, particularly
• 1:42
  - in,
• 1:43
  - the senior care space,
• 1:45
  - home care, long term care, hospice and palliative
• 1:47
  - care,
• 1:48
  - as well as in, health plan experience, including
• 1:52
  - Medicaid, Medicare,
• 1:54
  - and employer based health plans.
• 1:56
  - So this report came out a little while
• 1:58
  - ago, so I'd love to hear what your
• 2:00
  - biggest takeaways are as we dive into this
• 2:02
  - conversation a bit.
• 2:04
  - Well, it's been an honor to serve as
• 2:06
  - as one of the scientific advisers for this
• 2:09
  - report since its inception.
• 2:11
  - And now,
• 2:12
  - in its fourteenth publication,
• 2:14
  - the,
• 2:16
  - America's Health Rankings Senior Report builds on that
• 2:19
  - more than thirty five year foundation of the
• 2:22
  - America's Health Rankings suite of reports.
• 2:25
  - Those broader suite of reports include more than
• 2:27
  - 50 different publicly available data sources and more
• 2:30
  - than 250
• 2:32
  - measures of our comprehensive
• 2:34
  - health. And I always like to start by
• 2:36
  - grounding in what this report means and what
• 2:38
  - it says, and it really is in the
• 2:40
  - title. This is America's data. It's not UnitedHealthcare's
• 2:43
  - data. This comes from public data sources.
• 2:45
  - And it is a broad
• 2:47
  - as the WHO defines health very broadly, it
• 2:50
  - includes our,
• 2:52
  - our individual choices and behaviors around our health,
• 2:55
  - and it obviously includes the clinical care that
• 2:57
  - we receive when we go to the doctor
• 2:59
  - or the hospital and engage with the health
• 3:01
  - care delivery system.
• 3:03
  - It includes social and economic considerations
• 3:06
  - as well
• 3:07
  - and environmental factors
• 3:09
  - and and,
• 3:11
  - most importantly, our health care outcomes.
• 3:14
  - So the senior report in particular focuses on
• 3:17
  - older Americans.
• 3:18
  - And as we look at this report, we
• 3:21
  - not only look at the changes that happen
• 3:23
  - year to year, but we look at the
• 3:24
  - changes that have happened over more than a
• 3:26
  - decade of reporting on on
• 3:29
  - health and outcomes in the older adult population.
• 3:32
  - And this year,
• 3:34
  - we see some encouraging improvements
• 3:37
  - in
• 3:38
  - proactive measures. I'm talking about things like cancer
• 3:41
  - screening.
• 3:42
  - Those are on the rise. Physical inactivity
• 3:45
  - is on the decline.
• 3:47
  - That measure of physical activity is a survey,
• 3:50
  - and it asks
• 3:51
  - seniors who have good or better health how
• 3:54
  - much physical activity do you get. So more
• 3:56
  - seniors are moving. That's great. We're also seeing
• 3:59
  - the number of individuals who are pursuing
• 4:02
  - careers
• 4:03
  - as health care professionals in the geriatric space
• 4:05
  - like geriatricians and geriatric nurse practitioners
• 4:09
  - and home health aids continues to
• 4:11
  - increase.
• 4:13
  - And an important outcome measure that we're starting
• 4:15
  - to see improvement in is a decline in
• 4:18
  - premature deaths. So these are years lost,
• 4:21
  - before the age of 75.
• 4:24
  - At the same time, I see some concerning
• 4:26
  - things in here, and some many of them
• 4:28
  - are preventable.
• 4:29
  - We're seeing worsening trends in drug deaths, worsening
• 4:33
  - trends in excessive drinkings,
• 4:35
  - work worsening trends in suicide,
• 4:38
  - and then a mixed picture around
• 4:41
  - food and nutrition
• 4:42
  - where more seniors than ever are signed up
• 4:45
  - for the SNAP benefit to get supplemental nutrition
• 4:48
  - assistance,
• 4:49
  - often home delivered meals in their home and
• 4:51
  - other,
• 4:52
  - assistance with
• 4:53
  - getting access to healthy food. At the same
• 4:56
  - time, seniors are telling us they worry
• 4:58
  - more than ever about food insecurity.
• 5:01
  - So that's a a complicated,
• 5:04
  - thing to take a look at there. And
• 5:05
  - all of this matters because it tells health
• 5:07
  - care leaders
• 5:08
  - that healthy aging, it's not just about medical
• 5:12
  - care. It's also about
• 5:14
  - social connections. It's about behavioral health. It's about
• 5:17
  - access to care, affordability, and the conditions where
• 5:19
  - you live.
• 5:21
  - So just to give our listeners a little
• 5:22
  - bit more background, I'll go through some of
• 5:25
  - the numbers that you just hinted at here.
• 5:27
  - So the early death rate for adults aged
• 5:29
  - 65 to 74 dropped two percent between 2023
• 5:33
  - and 2024.
• 5:34
  - But compared to 2019 to 2021,
• 5:37
  - drug deaths were up thirty eight percent for
• 5:39
  - older adults from 2022 to 2024,
• 5:42
  - and suicides increased four percent over that same
• 5:44
  - period.
• 5:45
  - As well, excessive drinking increased ten percent for
• 5:48
  - older adults between 2023 and 2024.
• 5:51
  - So can you break down some of those
• 5:53
  - trends there, especially given how the early death
• 5:55
  - rate has been improving?
• 5:57
  - Yeah. Thank you. You know, this this report
• 5:59
  - contains
• 6:00
  - over 56
• 6:02
  - measures in five categories of our health coming
• 6:05
  - from more than two dozen public data sources.
• 6:08
  - And
• 6:09
  - those measures give us a really good comprehensive
• 6:12
  - look at what our health is happening at
• 6:14
  - a local, state, and national level.
• 6:17
  - And although the report doesn't tell us at
• 6:20
  - a major level cause and effect, we certainly
• 6:22
  - can see correlations,
• 6:24
  - measures that are related to each other,
• 6:26
  - and gives us a good insight to how
• 6:28
  - that complexity
• 6:30
  - intersects.
• 6:31
  - What I mean by that when you ask
• 6:32
  - a question about that early death rate dropping,
• 6:35
  - what are some of the reasons for that?
• 6:38
  - Certainly,
• 6:39
  - after a period of time, the more we
• 6:42
  - as individuals make healthy choices
• 6:44
  - about physical activity, about not smoking, about healthy
• 6:48
  - weight,
• 6:49
  - and
• 6:50
  - avoiding avoiding excessive alcohol use and substance use,
• 6:54
  - for example, we see improvements
• 6:57
  - in longevity
• 6:58
  - over time. We also see that as we
• 7:01
  - have more
• 7:02
  - access to care,
• 7:04
  - and
• 7:05
  - more preventative
• 7:06
  - screenings, you see years of that culminate in
• 7:09
  - improvement in the early death
• 7:11
  - rate. But we also see that some of
• 7:14
  - those opportunities,
• 7:16
  - and on the other side, some of those
• 7:17
  - burdens
• 7:18
  - are not evenly distributed
• 7:20
  - even at a state level.
• 7:22
  - So you can see in older men, for
• 7:24
  - example, they have
• 7:26
  - substantially higher rates
• 7:28
  - of drug deaths, of excessive drinking, and of
• 7:31
  - suicide
• 7:32
  - than their female counterparts.
• 7:34
  - That tells us it's not just a broad
• 7:37
  - aging issue. We really do need to look
• 7:39
  - at subpopulations
• 7:40
  - so that if you are a
• 7:42
  - a health care leader, if you're a policymaker,
• 7:44
  - or if you're an individual, you understand what
• 7:47
  - that means for you at a local level
• 7:49
  - and where you need to target those resources
• 7:51
  - and and and,
• 7:53
  - provide support.
• 7:54
  - So you can see all of these trends
• 7:56
  - happening
• 7:57
  - at the same time because they're reflecting the
• 8:00
  - complexity of those different dimensions of our health.
• 8:03
  - So I'm encouraged to see that we're living
• 8:05
  - longer,
• 8:07
  - but
• 8:08
  - there are headwinds here that concern us as
• 8:11
  - well. So those pieces around
• 8:14
  - prevention, treatment, chronic disease management,
• 8:17
  - we know we can't medicalize
• 8:18
  - ourselves out of some of these. So, you
• 8:21
  - know, where we're seeing
• 8:22
  - drug deaths, suicide, and excessive drinking
• 8:25
  - are persistent. And in the senior population,
• 8:28
  - that increase in drug deaths was the only
• 8:31
  - population
• 8:32
  - that we saw an increase in The United
• 8:34
  - States.
• 8:35
  - And there sometimes are biases where when we
• 8:38
  - think about drug deaths, we're not thinking of
• 8:41
  - older adults, and we should be. And this
• 8:43
  - report calls,
• 8:44
  - calls that to attention.
• 8:47
  - Okay. So you also talked about
• 8:49
  - bright spots a little bit earlier. So you
• 8:52
  - touched upon physical activity, and then the other
• 8:54
  - thing I saw in the report was state
• 8:56
  - specific strengths for older adults in rural communities,
• 8:59
  - and you talked about other sorts of proactive
• 9:01
  - measures as well. So,
• 9:03
  - could you talk a little bit more about
• 9:04
  - the correlations,
• 9:06
  - with those ones?
• 9:08
  - Yeah. It's important to note that as this
• 9:10
  - report looks at
• 9:12
  - 56 measures of our health across these five
• 9:15
  - broad categories coming from more than two dozen
• 9:18
  - sources of public information
• 9:20
  - that we really look at that complexity of
• 9:23
  - the intersection of each of those
• 9:26
  - factors.
• 9:27
  - And we can put together correlations
• 9:30
  - and make some assumptions of things that are
• 9:32
  - in other publicly reported sources about what may
• 9:36
  - be,
• 9:36
  - causing some of the trends that we're seeing.
• 9:39
  - However, the report doesn't show us
• 9:42
  - clear cause and effect at a major level.
• 9:46
  - But what I can tell you when we
• 9:47
  - look at things like increases in,
• 9:50
  - excessive
• 9:52
  - drinking, increases in substance use, increases in suicide,
• 9:56
  - increases in drug deaths, It's really important to
• 9:59
  - pay attention to these trends in the senior
• 10:01
  - population
• 10:02
  - because they're reflecting
• 10:03
  - different dimensions of health. And some of the
• 10:05
  - things that are going well,
• 10:08
  - like prevention,
• 10:10
  - cancer screenings,
• 10:12
  - treatment for chronic disease, etcetera, are happening at
• 10:15
  - the exact same time that we're seeing increases
• 10:17
  - in drug deaths and suicide.
• 10:19
  - So that points to
• 10:22
  - some concerning
• 10:23
  - things that are on the rise. For example,
• 10:26
  - a very important point here is that older
• 10:28
  - adults were the only age group in The
• 10:30
  - United States to see an increase
• 10:32
  - in drug deaths in the most recent period.
• 10:35
  - So while it either leveled off or improved
• 10:37
  - for all other demographic areas and, you know,
• 10:40
  - we know this is a part of an
• 10:41
  - important national conversation,
• 10:43
  - it's a reminder that older adults might be
• 10:46
  - getting missed
• 10:47
  - in prevention and intervention strategies because there may
• 10:50
  - be some bias there that seniors aren't the
• 10:52
  - ones that have substance use disorders or behavioral
• 10:55
  - health disorders,
• 10:56
  - and they have a growing trend in this
• 10:58
  - area. So this report shines a bright spotlight
• 11:01
  - on that and should be a call to
• 11:03
  - action for all of us.
• 11:05
  - So I know you also talked earlier about
• 11:07
  - some bright spots in the report. And,
• 11:10
  - one thing that was specifically mentioned were state
• 11:12
  - specific strengths for older adults and rural communities.
• 11:15
  - So could you elaborate about what you think
• 11:17
  - is driving that and any correlations there?
• 11:20
  - Yeah. That's a great
• 11:21
  - positive thing that we saw here.
• 11:24
  - We break every measure
• 11:26
  - to as many subpopulations
• 11:28
  - as is in the reported
• 11:30
  - original
• 11:30
  - public data.
• 11:32
  - So
• 11:33
  - the demographics of where somebody lives in metropolitan
• 11:36
  - or non metropolitan
• 11:38
  - are one of those subpopulations that we can
• 11:40
  - parse out the data. And so what we're
• 11:42
  - seeing is
• 11:43
  - better access,
• 11:44
  - more awareness, and sustain
• 11:46
  - both community and clinical efforts,
• 11:49
  - things like cancer screenings,
• 11:51
  - improvements in physical inactivity,
• 11:54
  - growth across those work health care workforce measures
• 11:57
  - that we spoke about earlier, like home health
• 11:59
  - care workers and geriatricians,
• 12:01
  - for example. So
• 12:04
  - physical inactivity,
• 12:05
  - specifically,
• 12:06
  - the number of adults who are in fair
• 12:09
  - or better health,
• 12:10
  - who reported doing no physical activity or no
• 12:13
  - exercise in the past thirty days
• 12:16
  - improved significantly
• 12:17
  - in this measurement period. And And I'm hoping
• 12:20
  - that that's reflective of an increased attention to
• 12:23
  - healthy aging, what's happening in in our communities.
• 12:26
  - Are they promoting are they safe places to,
• 12:30
  - get out and get moving,
• 12:32
  - and that recognition
• 12:33
  - of how important
• 12:35
  - muscle mass, bone density, and,
• 12:39
  - aerobic
• 12:40
  - conditioning are to maintaining our independence. So as
• 12:44
  - we
• 12:45
  - have more birthdays and reach that milestone
• 12:48
  - of 65 and older,
• 12:50
  - what's really important is our ability to maintain
• 12:53
  - our independence and minimize
• 12:55
  - frailty. Right? So that, that we
• 12:59
  - retain that independence and we are less dependent
• 13:01
  - on someone else for our overall health. So
• 13:04
  - all of those things that we're seeing in
• 13:05
  - the preventative care, both individual behaviors,
• 13:08
  - the things that our communities are doing in
• 13:10
  - the health care workforce
• 13:12
  - are doing are really important. That rural picture
• 13:15
  - starts to get more mixed.
• 13:18
  - So there's still higher burdens on some measures,
• 13:21
  - but we also see some things that are
• 13:23
  - healthier for rural adults.
• 13:25
  - And that's because
• 13:27
  - that's important because not only do we see
• 13:30
  - that there may be access issues, but we
• 13:32
  - see a good thing which might be stronger
• 13:34
  - social ties. And I think there's been more
• 13:36
  - and more of a recognition
• 13:38
  - of something that geriatricians
• 13:40
  - have known for a long time, which is
• 13:42
  - how important our social connection is
• 13:44
  - to our health and our longevity.
• 13:47
  - So, they we've been measuring and reporting,
• 13:51
  - for a number of years in this report,
• 13:53
  - a risk of social isolation.
• 13:56
  - And
• 13:57
  - in rural communities, that risk is often lower
• 14:00
  - than it is in metropolitan areas, which might
• 14:02
  - be counterintuitive, but it's that access to meaningful
• 14:06
  - relationships,
• 14:07
  - that really matters. And there's a lesson there
• 14:10
  - thinking about what we do to take these
• 14:12
  - things that are going well and scale them.
• 14:15
  - So thinking about things that are going well
• 14:18
  - and also looking at states that might be
• 14:20
  - struggling a bit more, Vermont, Utah, and New
• 14:22
  - Hampshire were listed as the healthiest states for
• 14:24
  - older adults, whereas Louisiana, Mississippi, and Kentucky were
• 14:28
  - considered the unhealthiest. So, you know, looking at
• 14:31
  - all of the factors you considered here, what
• 14:33
  - were the biggest drivers of those rankings, and
• 14:35
  - does anything stand out in regards to those
• 14:37
  - states?
• 14:38
  - Yeah. You point out a really important point
• 14:41
  - here. The third,
• 14:42
  - word in the title of this report is
• 14:44
  - rankings. Right? So,
• 14:46
  - we are ranking each state in relativity to
• 14:48
  - one another, not just at a composite level,
• 14:51
  - but probably even more importantly at a measure
• 14:53
  - level. So each of those 56 measures
• 14:56
  - are either ranked or unweighted where we're reporting
• 14:59
  - them. So 36 of them, we're able to
• 15:01
  - report a rank on how you're doing as
• 15:04
  - an individual measure. And I will tell you
• 15:06
  - that all 50 states
• 15:08
  - in this report have measures in the top
• 15:11
  - 10, and all of them have measures in
• 15:13
  - the bottom 10 once you start to look
• 15:15
  - at it at an individual 36,
• 15:18
  - measure,
• 15:19
  - perspective.
• 15:21
  - So,
• 15:22
  - at a high level, when we look at
• 15:24
  - the states that are ranked the highest, whether
• 15:26
  - it's the senior report or others, they have
• 15:28
  - a tendency to be the states that
• 15:30
  - do really well with
• 15:33
  - personal choices. So getting physical activity, not smoking,
• 15:37
  - lower rates of obesity,
• 15:39
  - lower rates
• 15:41
  - of alcohol and substance use, for example.
• 15:44
  - And then, conversely, those states that are the
• 15:46
  - most challenged,
• 15:48
  - they have a tendency to struggle with premature
• 15:50
  - death. And if you look at the root
• 15:52
  - causes of premature death in those states, it's
• 15:55
  - the opposite of what we just talked about.
• 15:57
  - A lot of it is about,
• 15:59
  - long term healthy choices.
• 16:01
  - Thank you for giving us a little bit
• 16:03
  - more context on the rankings component.
• 16:05
  - But I also want to ask, you know,
• 16:07
  - for the states that are struggling,
• 16:09
  - if you're operating a health plan in one
• 16:11
  - of those states, like, what are some immediate
• 16:13
  - priorities? Also, just looking ahead, what are more
• 16:16
  - longer term priorities
• 16:17
  - that could be used to close gaps there
• 16:19
  - in regards to some of the measures you
• 16:21
  - were talking about.
• 16:23
  - Yeah. Thank you. So if you I put
• 16:24
  - on, you know, my other hat and and
• 16:27
  - think about,
• 16:28
  - the opportunities from a health plan. When when
• 16:30
  - you see those greater disparities,
• 16:33
  - it really is important to think about
• 16:37
  - the comprehensiveness
• 16:38
  - of the solutions. Right? It's it's whether it
• 16:41
  - is America's health rankings and you're looking at
• 16:43
  - the data and you're doing a good job
• 16:45
  - studying the states that have slow and steady
• 16:48
  - moved up from
• 16:50
  - moved up a significant amount in their rank
• 16:52
  - over thirteen, fourteen years of reporting
• 16:56
  - on this, you see that it is generally
• 16:59
  - a comprehensive
• 17:01
  - effort that got them there. So smoking, for
• 17:04
  - example.
• 17:05
  - Right? Not
• 17:06
  - every state
• 17:07
  - did that the same.
• 17:09
  - Not every community handled that the same way,
• 17:12
  - but in most circumstances,
• 17:13
  - it was
• 17:14
  - some type of health care policy.
• 17:17
  - It was individuals making a decision that I
• 17:19
  - don't wanna do this anymore. It was their
• 17:22
  - doctor providing the asking the questions and providing
• 17:24
  - them with the clinical support they needed and
• 17:26
  - maybe nicotine
• 17:27
  - replacement or other therapy, for example.
• 17:30
  - It might have been,
• 17:32
  - you know, in in the local community
• 17:34
  - where local businesses just decided to have smoking
• 17:38
  - policies, you know, for for their local community.
• 17:40
  - So you see all of those things
• 17:43
  - come together in The States that moved up
• 17:45
  - significantly in that measure. And that's the same
• 17:47
  - way we think about population health from a
• 17:50
  - health plan perspective is
• 17:52
  - what are the what are the,
• 17:54
  - things that we can do directly around
• 17:57
  - benefit design,
• 17:59
  - care coordination, and providing people with an advocate
• 18:02
  - and a care manager,
• 18:04
  - to partnering with the primary care physician and
• 18:07
  - the health care delivery system in particular,
• 18:10
  - all
• 18:11
  - altogether in the advancement of health. And then,
• 18:13
  - and then, you know,
• 18:15
  - other important constituents like employers
• 18:18
  - and what they're doing with their strategy.
• 18:21
  - So thinking about your role more broadly
• 18:24
  - and your work in the commercial space, but
• 18:26
  - also your background in geriatrics.
• 18:28
  - What takeaways do you have as you watch
• 18:30
  - commercial members age?
• 18:32
  - Yeah. It's that's a terrific question.
• 18:35
  - Prior to,
• 18:36
  - being a chief medical officer of our employer
• 18:39
  - line of business. I was a chief medical
• 18:40
  - officer of our Medicare line of business. So
• 18:42
  - that's actually
• 18:43
  - a question that I,
• 18:45
  - absolutely thought about and it was one of
• 18:47
  - my motivations for wanting to work with employer
• 18:50
  - sponsored plans.
• 18:51
  - Is, you know, healthy aging starts now,
• 18:55
  - right for every one of us at every
• 18:57
  - stage of life. So whether that's
• 19:00
  - pediatrics,
• 19:02
  - adults, or as we're getting getting closer to
• 19:05
  - a retirement age,
• 19:07
  - the the importance of
• 19:09
  - developing those healthy habits, having a primary care
• 19:12
  - physician, the social connectedness,
• 19:16
  - and having,
• 19:17
  - good
• 19:18
  - transparency
• 19:19
  - and data reporting for
• 19:22
  - policy makers and employers,
• 19:24
  - really plays into all of this. Right? They
• 19:26
  - need to understand,
• 19:28
  - where things
• 19:30
  - are trending
• 19:31
  - and where things are actionable so that they're
• 19:34
  - making good decisions on where to invest for
• 19:37
  - healthier workforce
• 19:38
  - and healthier communities. So employers,
• 19:41
  - for example, think it's wise, but they're also
• 19:44
  - thinking about,
• 19:46
  - how their future workforce is today in the
• 19:49
  - education system. Right? And so how do they
• 19:51
  - think about
• 19:52
  - the the schools in their communities and
• 19:55
  - how important graduation rates and those things are
• 19:58
  - to the health of their future workforce?
• 20:00
  - And then that continues to flow through as
• 20:03
  - we get closer to retirement.
• 20:05
  - Well, as we wrap up, is there anything
• 20:06
  - else that you wanna touch upon as it
• 20:08
  - relates to the report?
• 20:10
  - Yeah. You know, when you think about this
• 20:11
  - report,
• 20:12
  - treat it not just as the report came
• 20:15
  - out this year and there is a significant
• 20:17
  - trend that happened from 2025
• 20:19
  - to 2026.
• 20:20
  - But look at what's happening over the course
• 20:23
  - of more than a decade's worth of data
• 20:26
  - here, and don't just focus on
• 20:29
  - your state ranked number 10.
• 20:32
  - There's so much there's so much rich data
• 20:34
  - in that subpopulation
• 20:37
  - information that really
• 20:38
  - points to where
• 20:41
  - taking action can make a meaningful difference in
• 20:43
  - the lives of individuals in their communities. So
• 20:46
  - that precision
• 20:48
  - of reporting
• 20:49
  - and then what we just talked about a
• 20:51
  - moment ago, the collaboration
• 20:53
  - and the multi sector partnership,
• 20:56
  - that intersection of primary care and public health
• 20:58
  - is a great example.
• 21:00
  - And understanding
• 21:02
  - what we need to do
• 21:03
  - together,
• 21:05
  - to work towards
• 21:07
  - continue to see the gains
• 21:09
  - that we have and focus on some of
• 21:11
  - these issues that have concerning trends, like
• 21:14
  - rising rates of suicide and drug deaths in
• 21:16
  - a senior population.
• 21:18
  - But the bright spots are, you know, really
• 21:20
  - where I wanna wanna leave us. This is
• 21:23
  - great news that more seniors are physically active.
• 21:27
  - It's great news that more people have are
• 21:29
  - inspired to choose careers in taking care of
• 21:32
  - an aging populations
• 21:34
  - an aging population.
• 21:36
  - Right. So there's there's a lot of really
• 21:38
  - nice bright spots in this report, and that's
• 21:40
  - a it's a terrific way to conclude.
• 21:42
  - Doctor Randall, thank you so much for joining
• 21:44
  - us today. Thank you for having me. Be
• 21:46
  - well. And to our listeners, you can check
• 21:48
  - out our website if you would like to
• 21:50
  - hear more podcasts from Becker's Healthcare. Thank you.