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HELLO EVERYONE. MY NAME IS

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JANET FROM THE GNASHNA INSTITUTE

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OF DRUG ABUSE NIDA. I WOULD LIKE

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TO WELCOME YOU TO GEOSPATIAL

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DATA SCIENCE AND DRUG USE

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RESEARCH. ON BEHALF OF THE

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MEMBERS WHICH INCLUDE MYSELF,

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DR. COURTE VAN VOORHEES, WE

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THANK YOU FOR JOINING THE WORK

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SHOT.  WE HAVE AN EXCITING

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PACKED AGENDA WITH WELCOMING

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REMARKS FOLLOWED BY NIH GUEST

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SPEAKER AND SIX OUTSTANDING

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RESEARCHERS ACROSS THE COUNTRY

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ENGAGING IN GEOSPATIAL DATA

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SCIENCE RESEARCH AS RELATES TO

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DRUG USE.  BEFORE WE GET

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STARTED, I WOULD LIKE TO SHARE

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WITH YOU A FEW HOUSEKEEPING

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ITEMS. FIRST THIS MEETING LAB LB

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REPORTED RECORDED.  T THE

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PARTICIPANTS CAN USE THE Q&A
BOX

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ON THE MENU BAR TO ASK

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QUESTIONS.  WE KINDLY ASK IF YOU

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ARE ASKING A QUESTION TO NAME

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THE PARTICULAR SPEAKER THAT THE

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QUESTION IS ATTENDED FOR --

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INTENDED FOR. IT CAN ENABLE

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CLOSE CAPTIONING USING THE

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BUTTON ON THE BOTTOM OF THE

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SCREEN. HERE WE ARE EXCITED TO

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HAVE TWO OVERRIDING LEADERSHIP

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JOINING US TODAY.  IT IS MY

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PLEASURE TO INTRODUCE YOU,

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(INAUDIBLE) WHO WILL BE

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PROVIDING WELCOMING REMARKS.

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FIRST I WOULD LIKE TO WELCOME

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DR. NORA VOLKOW, NATIONAL

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INSTITUTE ON DRUG ABUSE.  SHE'S

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STREW MENTAL DEMONSTRATING DRUG

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ADDICTION IS A BRAIN DISORDER

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AND AS RESEARCH PSYCHIATRIST SHE

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PIONEERED IN BRAIN IMAGING TO

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SEE HOW SUBSTANCE ABUSE AFFECTS

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BRAIN FUNCTION. WE ARE PROUD TO

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LEVERAGE DATA SCIENCE AND

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ANALYTICS TO FURTHER UNDERSTAND

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THE REAL WORLD COMPLEXITY WHICH

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WAS HIGHLIGHTED IN THE NIDA

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STRATEGIC PLAN. AFTER DR.

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VOLKOW'S OPENING REMARKS, I

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WOULD LIKE TO INTRODUCE DR. CA

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BLONCO, DIRECTOR OF DIVISION OF

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EPIDEMIOLOGY, SERVICES

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PREVENTION RESEARCH. DR. BANCO

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IS A NATIONAL KNOWN EXPERT IN

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EPIDEMIOLOGY AN TREATMENT OF

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ADDICTIVE BEHAVIORS.  PRIOR TO

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NIDA HE WAS PROFESSOR PSYCHIATRY

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AT COLUMBIA UNIVERSITY MEDICAL

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CENTER AND RESEARCH SCIENTIST AT

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NEW YORK STATE PSYCHIATRIC

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INSTITUTE.  HE IS INFLUENTIAL IN

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EMPHASIZING RESEARCH AND

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APPROACHES FOCUSING ON DATA AND

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USERS SO WITHOUT FURTHER ADIEU,

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PLEASE HELP ME WELCOME DR. NOVA

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VOLKOW. THANK YOU.

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>> THANKS VERY MUCH. GOOD

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AFTERNOON, EVERYONE. IT IS A

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PLEASURE TO BE HERE WITH ALL OF

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YOU. I ALSO WANT TO THANK NOT

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JUST JANET BUT ALSO

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(INDISCERNIBLE) VOORHEES FOR

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ORGANIZING THIS EXTREMELY

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EXCITING MEETING. I HAVE BEEN

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AWARE ABOUT THE IMPORTANCE OF

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GEOSPATIAL RESEARCH, CLOSE TO

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TWO DECADES AGO, I HAD FLUTE

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SLEUTHLY NO IDEA IT WOULD BE SO

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GREATLY IMPORTANT NOT JUST IN

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ADDICTION SCIENCE BUT IN IN

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GENERAL. IN THE MEETING YOU WILL

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BE HEARING WHY THIS ASPECT OF

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SCIENCE IS SO VERY IMPORTANT FOR

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US AND AGENCY AT NIDA BUT ACROSS

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ALL THE NIH. JANET WAS SAYING,

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YES, WE -- PART OF MY CAREER HAS

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BEEN VERY MUCH TRYING TO

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UNDERSTAND HOW DRUGS AFFECT THE

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HUMAN BRAIN WHICH IS WHAT LED TO

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PROVIDE EVIDENCE THAT ADDICTION

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IS A DISEASE OF THE BRAIN BUT

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ALL THE DATA THAT HAS COME FROM

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EPIDEMIOLOGY ALSO SHOWS THAT

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YES, IT IS ADDICTION IS OF BRAIN

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BUT IT IS STRONGLY INFLUENCED BY

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OUR CONTEXT OUR ENVIRONMENTS.

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AND OUR CULTU CULTURE. HERE IS E

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WE HAVE THE EXTRAORDINARY VALUE

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THAT GEOSPATIAL SCIENCE HAS,

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BECAUSE IT PROVIDES THOSE

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OBJECTIVE TOOLS WE CAN ACTUALLY

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UNDERSTAND THAT INTERACTION THAT

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COMES ABOUT BETWEEN THE AFFECTS

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OF DRUGS IN THE BRAIN AND

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ULTIMATELY OUR SOCIAL

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ENVIRONMENTS OR OTHER ASPECTS OF

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THAT ENVIRONMENT THAT SURROUND

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US AND THAT INFLUENCES OUR

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DEVELOPMENT AS HUMAN BEINGS FROM

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INCEPTION ONWARD. AS I THINK

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ABOUT THE VALUE OF YOUR SPATIAL

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SCIENCE IN ADDICTION RESEARCH I

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WOULD LIKE TO ANCHOR IT INTO

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THREE MAIN AREAS IN TERMS OF

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PRIORITIES OF NIDA. WITH DO

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SCIENCE FOR A PURPOSE, A PURPOSE

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THAN CAN HELP US ADVANCE

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PREVENTION OF SUBSTANCE USE AND

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SUBSTANCE USE DISORDERS. TO HELP

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US ADVANCE THE TREATMENT OF

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SUBSTANCE USE DISORDERS, AND

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THAT HELPS US DEVELOP POLICIES

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THAT ARE GOING TO BE INFLUENTIAL

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AT LEVEL OF THE POPULATION. IF

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YOU THINK ABOUT EACH ONE OF

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THEM, YOU CAN CLEARLY SEE HOW

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CRUCIAL GEOSPATIAL SCIENCE IS. 

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FOR EXAMPLE, IN THE FIELD OF

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PREVENTION I CANNOT NOT THINK

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ABOUT HOW IT HAS INFORMED TO

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PARTICULARLY THE MOST AMBITIOUS

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STORIES WE HAVE LAUNCH IN BRAIN

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DEVELOPMENT AND THAT'S THE ABCD,

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IT STARTED THROUGH THE USE OF

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GEOSPATIAL SCIENCE HAS BEEN ABLE

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TO DELINEATE WHAT WE HAVE KNOWN

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ALL ALONG, ADVERSE SOCIAL

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ENVIRONMENTS NEGATIVELY AFFECT

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US. BUT HOW DOES THAT TRANSLATE

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INTO THE BRAIN AND INTO

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BEHAVIORS? AND THIS IS POSSIBLE

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BECAUSE OF THE MARRIAGE OF

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GEOSPATIAL SCIENCE WITH THE

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CHARACTERIZATIONS WE ARE DOING

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ON THE ABCD STUDY.  LAST YEAR WE

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INITIATED AN EQUIVALENT TO THE A

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B C D SAW STUDY BUT STARTING IN

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INFANCY RATHER THAN ADOLESCENCE.

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WE ARE ALSO GOING TO CAPITALIZE

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ON THE POWER OF GEOSPATIAL

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SCIENCES TO INVESTIGATE HOW

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ENVIRONMENTS INFLUENCE EARLY

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DEVELOPMENT OF THE HUMAN BRAIN

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AND BEHAVIORS.  IN THE FIELD OF

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TREATMENT, I CAN ACTUALLY

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REALIZE ONE OF THE THINGS I COME

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TO REALIZE THIS LATER HOW

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FUNDAMENTALLY IMPORTANT CONTEXT

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ARE AND HOW WE HAVE NEGLECTED

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THAT ASPECT OF SCIENCE WHEN

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TRYING TO INTERPRET THE RESULTS

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OF RANDOMIZE CLINICAL TRIALS OR

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OTHER TYPES OF CLINICAL TRIALS,

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WHERE WE EVALUATE HOW EFFECTIVE

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OUR INTERVENTION IS. WHAT WE

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HAVE NEGLECTED TO CONSIDER THAT

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IT WOULDN'T BE SURPRISING THAT

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IT WOULD GIVE MEDICATION OR

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ANOTHER TYPE OF TREATMENT ON

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SOMEONE WHOSE ENVIRONMENT IS

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VERY DISRUPTIVE, THAT IS GOING

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TO EFFECT HOW AFFECTIVE THAT

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MEDICATION MAY BE, OR THE

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ABILITY OF THAT INDIVIDUAL TO

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ACHIEVE REMISSION AND ULTIMATELY

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RECOVERY. WE CAN BECOME VERY

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SOPHISTICATED IN THAT MARRIAGE

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OF SCIENCE WHICH IS ACTUALLY HAS

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BEEN SHOWN HOW IMPORTANT IT IS

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THAT CONTEXT IN WHICH INDIVIDUAL

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THAT IS AIMING TO ACHIEVE

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RECOVERY IS IN DETERMINING THE

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RISK OF RELAPSE. THIS CAN BE NOW

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TRACED REAL TIME USING GPS

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DEVICES THAT CAN ALERT THE

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INDIVIDUAL WHEN IN ENVIRONMENTS

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OF HIGH RISK. FINALLY, THE AREA

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OF OF POLICY, IN MANY WAYS IT

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ALMOST SPEAKS BY ITSELF, IT IS

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SO VERY EVIDENT. FOR EXAMPLE AN

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AREA THAT WE HAVE BEEN VERY

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INTERESTED ON EXPANDING AND I

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HOPE TO ACTUALLY SEE IT FURTHER

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TAKEN ADVANTAGE OF, IS THE

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MARRIAGE OF WASTE WATER

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GEOSPATIAL INDICATORS, AND

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EPIDEMIOLOGY AND TREATMENT AND

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PREVENTION IN WAYS THAT CAN HELP

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GUIDE POLICY.  SO TO WASTE WATER

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WE CAN FOR EXAMPLE DETERMINE IF

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AN AREA IS AT HIGHER RISK THAN

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ANOTHER ONE AND THAT CAN FOR

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EXAMPLE HELP TAYLOR LOCAL

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INTERVENTIONS AND RESOURCES IN

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AREAS THAT ARE OF GREAT NEED. I

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COULD GO ON AND ON AND ON GIVING

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EXAMPLES ABOUT HOW EXTREMELY

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IMPORTANT THIS AREA OF SCIENCE

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IS, TO WHAT WE DO. AND NOW THAT

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WE ARE IN THE AREA OF DATA

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SCIENCE AND ARTIFICIAL

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INTELLIGENCE IT BEHOOVES US AND

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I LOOK FORWARD TO GETTING THE

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RECOMMENDATIONS THAT COME OUT OF

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THESE MEETING TO SEE WAYS WE CAN

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CONTINUE TO FURTHER INNOVATE SO

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WE CAN TAKE THE MOST ADVANTAGE

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OF THE DATA WE ARE OBTAINING. SO

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I WANT TO THANK EVERYONE FOR

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PARTICIPATING IN THIS MEETING

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AND NOW I'M GOING TO PASS THE

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MICROPHONE TO DR. CA BLANCO.

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>> THANKS, NORA I WANT TO
ECHO

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YOUR WORDS THANKING JANET TAMARA

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AND COURTE FOR ORGANIZING THIS

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SUCCESSFUL WORKSHOP, CLOSE TO

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200 PARTICIPANTS SO THAT IS

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AMAZING. I WANT TO FOR YOUR

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LEADERSHIP ORGANIZING THE

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WORKSHOP AND TO THANK THE

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PARTICIPANTS WITHOUT WHICH

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DOESN'T MAKE ANY SENSE. I WANT

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TO ALSO ECHO NORA'S WORD WORDS.D

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EMPHASIZE POTENTIAL DIRECTIONS

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AS WE MOVE THROUGH THE WORKSHOP.

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ONE IS AS NORA SAID, ONE OF THE

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EMPHASIS THAT WE HAVE AT NIDA

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AND IN PARTICULAR IN OUR

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DIVISION IS THAT WE AS

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SCIENTISTS ARE CURIOUS AND WE

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WANT TO KNOW THINGS BUT AS

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PRACTITIONERS WE WANT THAT

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KNOWLEDGE TO HAVE SOME USE. SO

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WE ARE VERY, VERY FOCUSED ON

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USING APPROACHES AN AS WE MOVE

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THROUGH THE WORKSHOP I WANT YOU

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TO THINK FOR WHOM OR WHAT THIS

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KNOWLEDGE WOULD BE USEFUL. NOT

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ONLY WHY IS THIS INTERESTING

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ASPECT BUT WHAT ARE THE

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PRACTICAL APPLICATIONS IN TERMS

254
00:10:30,774 --> 00:10:33,176
OF ADVANCING PUBLIC HEALTH.

255
00:10:33,176 --> 00:10:35,612
THOSE COULD BE AS NORA

256
00:10:35,612 --> 00:10:37,881
MENTIONED, IMPROVED

257
00:10:37,881 --> 00:10:39,316
SURVEILLANCE, BETTER PREVENTION,

258
00:10:39,316 --> 00:10:40,684
FACILITATING TREATMENT, IT COULD

259
00:10:40,684 --> 00:10:43,486
BE EVALUATING POLICIES. IT COULD

260
00:10:43,486 --> 00:10:46,723
BE GIVE US US IDEAS HOW TO

261
00:10:46,723 --> 00:10:47,524
BETTER UNDERSTAND OR GENERAL

262
00:10:47,524 --> 00:10:49,826
RATE HYPOTHESIS FOR

263
00:10:49,826 --> 00:10:52,629
NEUROBIOLOGICAL STUDIES FOR

264
00:10:52,629 --> 00:10:53,797
INTERACTIONS BETWEEN BIOLOGY AND

265
00:10:53,797 --> 00:10:55,298
ENVIRONMENT. SO THAT'S ONE

266
00:10:55,298 --> 00:10:59,936
DIRECTION. HOW ARE THESE DATA

267
00:10:59,936 --> 00:11:02,138
USEFUL? SECOND DIRECTION, I HOPE

268
00:11:02,138 --> 00:11:04,941
THAT AS INDIVIDUALS YOU ARE

269
00:11:04,941 --> 00:11:07,677
HAPPY BUT I MOPE SOCIETY YOU ARE

270
00:11:07,677 --> 00:11:09,512
UNHAPPY BECAUSE WE NEED TO BE

271
00:11:09,512 --> 00:11:12,382
UNHAPPY TO CONTINUE TO MOVE

272
00:11:12,382 --> 00:11:13,483
FORWARD. I WANT YOU DISSATISFIED

273
00:11:13,483 --> 00:11:17,454
WITH WHAT WE HAVE. SO I WANT YOU

274
00:11:17,454 --> 00:11:19,022
TO THINK HOPEFULLY THESE ARE

275
00:11:19,022 --> 00:11:20,757
GOOD METHODS BUT WHAT OTHER

276
00:11:20,757 --> 00:11:22,258
METHODS WHAT BETTER METHODS DO

277
00:11:22,258 --> 00:11:24,594
WE NEED TO CONTINUE TO MAKE

278
00:11:24,594 --> 00:11:29,099
PROGRESS? HOW CAN NIDA SUPPORT

279
00:11:29,099 --> 00:11:31,768
THESE ADVANCES? THE THIRD AREA

280
00:11:31,768 --> 00:11:37,140
IS THAT WORKSHOP IS ENTITLED

281
00:11:37,140 --> 00:11:38,308
GEOSPATIAL METHODS BUT AT THE

282
00:11:38,308 --> 00:11:40,410
END OF THE DAY YOU FORGET ABOUT

283
00:11:40,410 --> 00:11:42,212
GEO AND FOCUS ON SPATIAL, THE

284
00:11:42,212 --> 00:11:44,981
SPACE IS REALLY JUST THE

285
00:11:44,981 --> 00:11:46,416
RELATIONSHIP BETWEEN THINGS, NO?

286
00:11:46,416 --> 00:11:51,955
AND THE MORE YOU GOT IT THE MORE

287
00:11:51,955 --> 00:11:53,223
ABSTRACT. SO THESE METHODS WE

288
00:11:53,223 --> 00:11:56,092
ARE GOING TO EXAMINE TODAY FOCUS

289
00:11:56,092 --> 00:11:57,961
ON GEOSPATIAL DOES BUT IF WE GO

290
00:11:57,961 --> 00:11:59,295
MORE GENERALLY, HOW COULD THE

291
00:11:59,295 --> 00:12:02,899
METHODS WE USE AND THE METHODS

292
00:12:02,899 --> 00:12:05,669
WE COULD DEVELOP HELP MAP OTHER

293
00:12:05,669 --> 00:12:08,171
SPACES? NOVA OF COURSE HAS

294
00:12:08,171 --> 00:12:09,939
DEVELOPED HER CAREER TO STUDY

295
00:12:09,939 --> 00:12:12,409
THE BRAIN. SO COULD WE USE SOME

296
00:12:12,409 --> 00:12:14,044
OF THESE SPECIAL METHODS TO

297
00:12:14,044 --> 00:12:15,545
UNDERSTAND THE BRAIN BETTER,

298
00:12:15,545 --> 00:12:17,347
COULD WE INTERACT WITH OTHER

299
00:12:17,347 --> 00:12:18,348
DATA SCIENTISTS AND WORK ON

300
00:12:18,348 --> 00:12:20,250
OTHER AREAS TO IMPROVE OUR

301
00:12:20,250 --> 00:12:21,651
METHODS AND ALSO IMPROVE THEIR

302
00:12:21,651 --> 00:12:24,087
METHODS WITH WHAT WE KNOW? WE

303
00:12:24,087 --> 00:12:26,356
ALSO HAVE IN PSYCHOPATHOLOGY

304
00:12:26,356 --> 00:12:27,490
CONSTELLATION OF SYMPTOMS THAT

305
00:12:27,490 --> 00:12:28,858
ARE RELATED TO THE OTHERS SO WE

306
00:12:28,858 --> 00:12:31,294
CAN THINK OF SPACE OF

307
00:12:31,294 --> 00:12:33,730
PSYCHOPATHOLOGY CAN WE USE THESE

308
00:12:33,730 --> 00:12:35,231
METHODS TO UNDERSTAND

309
00:12:35,231 --> 00:12:36,599
PSYCHOPATHOLOGY BETTER BASIC

310
00:12:36,599 --> 00:12:39,102
THAN INTERESTS OF BEHAVIOR? SO I

311
00:12:39,102 --> 00:12:40,537
ENCOURAGE YOU TO NOT ONLY THINK

312
00:12:40,537 --> 00:12:42,906
HOW TO ADVANCE METHODS BUT HELP

313
00:12:42,906 --> 00:12:44,974
TO HAVE DIALOGUE IN OTHER YARRS

314
00:12:44,974 --> 00:12:47,110
OF SCIENCE AND SIGNS IN GENERAL

315
00:12:47,110 --> 00:12:49,012
SO WE CAN -- AREAS OF SCIENCE SO

316
00:12:49,012 --> 00:12:50,980
WE CAN ADVANCE IN DIFFERENT

317
00:12:50,980 --> 00:12:52,782
DIRECTIONS SO TO RECAPITULATE

318
00:12:52,782 --> 00:12:54,117
THE THREE THINGS I WOULD LIKE TO

319
00:12:54,117 --> 00:12:56,319
ADVANCE, WHAT ARE THE USER

320
00:12:56,319 --> 00:12:58,321
ACCEPT TRICK APPROACHES OR

321
00:12:58,321 --> 00:12:58,988
APPLICATIONS FOR THE KNOWLEDGE

322
00:12:58,988 --> 00:13:02,625
YOU ARE GOING TO PRESENT AND

323
00:13:02,625 --> 00:13:03,993
DISCUSS, WHAT METHODS COULD WE

324
00:13:03,993 --> 00:13:05,762
DEVELOP THAT WE WILL HELP

325
00:13:05,762 --> 00:13:08,732
ADVANCE SCIENCE AND WHAT WE HAVE

326
00:13:08,732 --> 00:13:10,600
A DIALOGUE BETWEEN METHODS WE

327
00:13:10,600 --> 00:13:12,635
HAVE AND THE METHODS BASICALLY

328
00:13:12,635 --> 00:13:16,906
HAVE DEVELOPED TO APPLY TO OTHER

329
00:13:16,906 --> 00:13:17,874
POTENTIAL SPACES NOT ONLY

330
00:13:17,874 --> 00:13:19,709
GEOSPATIAL APPLICATIONS. SO WITH

331
00:13:19,709 --> 00:13:21,711
THAT, I HAND IT BACK TO JANET.

332
00:13:21,711 --> 00:13:25,482
AND I HOPE THAT YOU CAN GUIDE US

333
00:13:25,482 --> 00:13:26,449
THROUGH THIS VERY EXCITING

334
00:13:26,449 --> 00:13:28,351
WORKSHOP.

335
00:13:28,351 --> 00:13:30,120
>> THANK YOU VERY MUCH,
DR.

336
00:13:30,120 --> 00:13:32,655
VOLKOW AND BLANCO FOR YOUR

337
00:13:32,655 --> 00:13:33,790
WELCOMING REMARKS AND YOUR

338
00:13:33,790 --> 00:13:36,326
SUPPORT FOR THIS WORKSHOP.  NOW

339
00:13:36,326 --> 00:13:38,461
TO DELVE DEEPER INTO THIS TOPIC

340
00:13:38,461 --> 00:13:40,163
I WOULD LIKE TO INTRODUCE OUR

341
00:13:40,163 --> 00:13:44,834
NIH GUEST SPEAKER, DR. SAM

342
00:13:44,834 --> 00:13:45,802
(INAUDIBLE) LEAD PROGRAM

343
00:13:45,802 --> 00:13:48,104
DIRECTOR FOR THE NIH ARTIFICIAL

344
00:13:48,104 --> 00:13:49,472
INTELLIGENCE MACHINE LEARNING

345
00:13:49,472 --> 00:13:53,676
CONSORTIUM TO ADVANCE RESEARCH

346
00:13:53,676 --> 00:13:55,311
AND DIVERSITY. ALSO KNOWN AS THE

347
00:13:55,311 --> 00:13:57,647
AIM AHEAD PROGRAM AT THE OFFICE

348
00:13:57,647 --> 00:13:59,149
OF DATA SCIENCE AND STRATEGY

349
00:13:59,149 --> 00:14:01,351
ALSO KNOWN AS ODSS.  HIS ROLE

350
00:14:01,351 --> 00:14:04,287
DR. GEBREAB IS RESPONSIBLE FOR

351
00:14:04,287 --> 00:14:06,356
OVERALL MANAGEMENT OVERSIGHT AND

352
00:14:06,356 --> 00:14:07,791
IMPLEMENTATION OF THE AIM AHEAD

353
00:14:07,791 --> 00:14:09,192
PROGRAM AND FOR ENSURING THE

354
00:14:09,192 --> 00:14:11,995
BENEFITS OF BIG DATA AND AI

355
00:14:11,995 --> 00:14:14,097
TECHNOLOGIES ARE EQUALLY FELT

356
00:14:14,097 --> 00:14:16,766
ACROSS DIVERSE POPULATIONS.  

357
00:14:16,766 --> 00:14:19,169
PREVIOUSLY DR. GEBREAB WAS

358
00:14:19,169 --> 00:14:22,372
PROGRAM DIRECTOR AT THE NCI TO

359
00:14:22,372 --> 00:14:24,274
REDUCE CANCER HEALTH DISPARITIES

360
00:14:24,274 --> 00:14:25,742
AN PRIDE THE NCI HE WORKED AT

361
00:14:25,742 --> 00:14:30,346
FDA AND NHGRI. DR. GEBREAB

362
00:14:30,346 --> 00:14:34,517
RECEIVED HEARSAY MSD AND Ph.D.

363
00:14:34,517 --> 00:14:36,052
IN GEOSPATIAL TECHNOLOGY FROM

364
00:14:36,052 --> 00:14:38,488
UTAH STATE AND RECEIVED HIS MSC

365
00:14:38,488 --> 00:14:41,558
IN GEOGRAPHIC INFORMATION

366
00:14:41,558 --> 00:14:42,759
SCIENCE FROM (INAUDIBLE)

367
00:14:42,759 --> 00:14:44,494
UNIVERSITY IN THE NETHERLANDS.

368
00:14:44,494 --> 00:14:48,097
DR. GEBREAB COMPLETED

369
00:14:48,097 --> 00:14:49,666
POST-DOCTORAL TRAINING AT

370
00:14:49,666 --> 00:14:51,334
MICHIGAN SCHOOL OF HEALTH. WOW

371
00:14:51,334 --> 00:14:52,769
FURTHER ADIEU I WOULD LIKE TO

372
00:14:52,769 --> 00:14:55,104
WELCOME DR. GEBREAB, THANK YOU

373
00:14:55,104 --> 00:14:56,806
FOR JOINING US TODAY. 

374
00:14:56,806 --> 00:14:59,475
>> THANK YOU SO MUCH,
JANET, FOR

375
00:14:59,475 --> 00:15:03,379
THAT WONDERFUL INTRODUCTION.  

376
00:15:03,379 --> 00:15:03,980
GOOD AFTERNOON, EVERYONE. CAN

377
00:15:03,980 --> 00:15:14,490
YOU HEAR ME? OKAY. MY NAME IS

378
00:15:15,525 --> 00:15:18,695
SAMSON GEHREAB, I WORK FOR THE

379
00:15:18,695 --> 00:15:20,730
OFFICE OF THE DIRECTOR OFFICE OF

380
00:15:20,730 --> 00:15:24,100
DATA SCIENCE STRATEGY, AS JANET

381
00:15:24,100 --> 00:15:25,401
MENTIONED IT IS AN

382
00:15:25,401 --> 00:15:29,005
INTERDISCIPLINARY STUDY,

383
00:15:29,005 --> 00:15:30,306
EPIDEMIOLOGICAL STUDY, TODAY I

384
00:15:30,306 --> 00:15:32,308
WILL PROVIDE HIGHLIGHTS ON NIH

385
00:15:32,308 --> 00:15:36,212
LANDSCAPE IN APPLICATION OF

386
00:15:36,212 --> 00:15:37,046
GEOSPATIAL DATA AND PRIOR

387
00:15:37,046 --> 00:15:41,351
APPROACHES IN THE SAME

388
00:15:41,351 --> 00:15:43,519
CHALLENGE. WE ARE AT THE

389
00:15:43,519 --> 00:15:46,522
EXCITING MOMENT FOR GEOSPATIAL

390
00:15:46,522 --> 00:15:48,858
DATA BECAUSE GEOSPATIAL DATA ARE

391
00:15:48,858 --> 00:15:51,327
INCREASINGLY BEING COLLECTED

392
00:15:51,327 --> 00:15:52,395
FROM VARIETY OF SOURCES

393
00:15:52,395 --> 00:15:55,565
INCLUDING GPS, SATELLITES,

394
00:15:55,565 --> 00:15:58,635
DRONES AN SENSORS THAT COLLECT

395
00:15:58,635 --> 00:15:59,936
BEHAVIORAL AND ENVIRONMENTAL

396
00:15:59,936 --> 00:16:01,504
DATA, SMART PHONES AN SOCIAL

397
00:16:01,504 --> 00:16:05,909
MEDIA. ALL THOSE DIVERSE

398
00:16:05,909 --> 00:16:07,076
GEOSPATIAL DATA OFFER NEW

399
00:16:07,076 --> 00:16:10,079
OPPORTUNITIES FOR NUMEROUS

400
00:16:10,079 --> 00:16:11,314
PUBLIC HEALTH AND ALSO

401
00:16:11,314 --> 00:16:11,981
BIOLOGICAL AND BEHAVIORAL

402
00:16:11,981 --> 00:16:21,658
RESEARCH. RECEIVE WHY CARE ABOUT

403
00:16:21,658 --> 00:16:25,495
GEOSPATIAL DATA? AS DR. VOLKOW

404
00:16:25,495 --> 00:16:28,531
MENTION, IN THE CONTEXT WHERE WE

405
00:16:28,531 --> 00:16:31,434
LIVE IS IMPORTANT AND RESEARCH

406
00:16:31,434 --> 00:16:35,805
HAS SHOWN THAT IT IS CRITICAL IN

407
00:16:35,805 --> 00:16:38,041
BETTER MINING HEALTH OUTCOMES

408
00:16:38,041 --> 00:16:39,976
ALSO MORE THAN GENETIC CODE

409
00:16:39,976 --> 00:16:42,078
ITSELF, THIS IS BECAUSE WHERE WE

410
00:16:42,078 --> 00:16:44,547
LIVE CAN PROFOUNDLY AFFECT MANY

411
00:16:44,547 --> 00:16:47,784
DIFFERENT FACETS OF HEALTH

412
00:16:47,784 --> 00:16:51,854
INCLUDING QUALITY OF HEALTHCARE;

413
00:16:51,854 --> 00:16:53,589
FOOD, SAFE NEIGHBORHOOD AND

414
00:16:53,589 --> 00:16:55,925
THOSE OTHER PLAY A ROLE IN

415
00:16:55,925 --> 00:16:59,228
HEALTH OUTCOMES AND BEHAVIORAL

416
00:16:59,228 --> 00:17:00,463
HEALTH INCLUDING LIVE

417
00:17:00,463 --> 00:17:01,798
EXPECTANCY, RATES IN OVERALL

418
00:17:01,798 --> 00:17:08,037
QUALITY OF LIFE. I'M GOING TO

419
00:17:08,037 --> 00:17:10,640
GIVE YOU TWO (INAUDIBLE) OF THE

420
00:17:10,640 --> 00:17:13,409
GEOSPATIAL DATA IN THIS CASE. AS

421
00:17:13,409 --> 00:17:17,046
YOU CAN SEE I -- PUBLISHED BY

422
00:17:17,046 --> 00:17:20,950
CUSPER IN 2015 I BELIEVE, SHOWS

423
00:17:20,950 --> 00:17:22,485
THE DRAMATIC CHANGE IN

424
00:17:22,485 --> 00:17:26,122
GEOGRAPHIC PATTERNS OF HEALTH

425
00:17:26,122 --> 00:17:29,459
MORTALITY OVER THE 40 YEARS FROM

426
00:17:29,459 --> 00:17:31,761
HIGH RATES OF (INAUDIBLE) IN THE

427
00:17:31,761 --> 00:17:34,731
NORTHEAST YOU CAN SEE HERE THE

428
00:17:34,731 --> 00:17:36,599
DEEP SOUTH. THIS INDICATES THAT

429
00:17:36,599 --> 00:17:40,336
GEOGRAPHIC PATTERNS JOG PATTERNS

430
00:17:40,336 --> 00:17:42,472
LIKE ECONOMIC FACTORS AND

431
00:17:42,472 --> 00:17:43,206
BEHAVIORAL AND SOCIAL AND

432
00:17:43,206 --> 00:17:46,342
ENVIRONMENTAL FACTORS ARE

433
00:17:46,342 --> 00:17:47,877
IMPORTANT FOR HEALTH CASES. 

434
00:17:47,877 --> 00:17:49,479
SIMILARLY YOU CAN SEE IN THE

435
00:17:49,479 --> 00:17:55,885
OTHER ALSO GEOGRAPHIC PATTERNS

436
00:17:55,885 --> 00:17:57,253
FAIRLY CANCER IS ALSO AFFECTED

437
00:17:57,253 --> 00:18:00,289
BY DEMOGRAPHIC AND ECONOMIC

438
00:18:00,289 --> 00:18:01,524
BEHAVIORAL AND OUTCOMES.  THOSE

439
00:18:01,524 --> 00:18:04,627
THREE EXAMPLES SHOWS THAT

440
00:18:04,627 --> 00:18:08,064
GEOGRAPHIC GEOSPATIAL DATA CAN

441
00:18:08,064 --> 00:18:10,633
HELP UNCOVER GEOGRAPHIC PATTERNS

442
00:18:10,633 --> 00:18:12,435
ACROSS VARIOUS CHRONIC DISEASE

443
00:18:12,435 --> 00:18:16,906
AS DR. CALOS MENTIONED THESE

444
00:18:16,906 --> 00:18:19,375
STUDIES GENERATE EQUITABLE

445
00:18:19,375 --> 00:18:23,046
DISEASE AND IDENTIFY HOT SPOTS

446
00:18:23,046 --> 00:18:24,747
FOR INTERVENTION BUT ALSO HELP

447
00:18:24,747 --> 00:18:28,551
INFORM -- MAKE INFORM POLICY

448
00:18:28,551 --> 00:18:35,058
DECISIONS.  SO WHAT ARE THE IN

449
00:18:35,058 --> 00:18:36,993
TERMS OF GEOSPATIAL DATA BY

450
00:18:36,993 --> 00:18:39,062
AREA? THERE IS LEGISLATION

451
00:18:39,062 --> 00:18:41,697
GEOSPATIAL DATA APP OF 2018

452
00:18:41,697 --> 00:18:46,636
WHICH TRIES TO ESTABLISH ACCESS

453
00:18:46,636 --> 00:18:49,472
IN TERMS OF VALIDITY AND

454
00:18:49,472 --> 00:18:51,707
TRANSPARENCY OF GEOSPATIAL DATA

455
00:18:51,707 --> 00:18:52,775
ALONG THE PROGRAM PUBLISHED

456
00:18:52,775 --> 00:18:56,512
WHICH IS CALLED THE NATIONAL

457
00:18:56,512 --> 00:18:57,146
SPATIAL DATA INFRASTRUCTURE

458
00:18:57,146 --> 00:18:59,816
WHICH TRIES TO INTERCONNECT A

459
00:18:59,816 --> 00:19:01,751
SYSTEM OF SPATIAL DATA ADDRESS

460
00:19:01,751 --> 00:19:04,587
VARIOUS CHALLENGES LOCAL AND

461
00:19:04,587 --> 00:19:08,658
NATIONAL. WITHIN THE HHS

462
00:19:08,658 --> 00:19:11,160
DEPARTMENT THERE IS STRATEGIC

463
00:19:11,160 --> 00:19:13,996
PLAN THAT EMPHASIZE LEVERAGING

464
00:19:13,996 --> 00:19:14,564
GEOSPATIAL DATA ANDS TO AND

465
00:19:14,564 --> 00:19:17,834
MAKING THEM ACCESSIBLE

466
00:19:17,834 --> 00:19:19,969
INTEROPERABLE AND ACTIONABLE TO

467
00:19:19,969 --> 00:19:21,504
SUPPORT HHS MISSION TO IMPROVE

468
00:19:21,504 --> 00:19:24,040
PUBLIC HEALTH OUTCOME. THIS IS

469
00:19:24,040 --> 00:19:27,810
IN LINE WITH GEOSPATIAL DATA APP

470
00:19:27,810 --> 00:19:35,551
IN NCDR. WITHIN THE NIH OFFICE

471
00:19:35,551 --> 00:19:37,520
OF DATA SCIENCE STRATEGY WHICH

472
00:19:37,520 --> 00:19:38,721
OVERALL OBJECTIVE OF THIS OFFICE

473
00:19:38,721 --> 00:19:42,492
IS TO PROVIDE NIH WIDE

474
00:19:42,492 --> 00:19:49,499
LEADERSHIP AND COORDINATE FIZZ

475
00:19:49,499 --> 00:19:53,669
-- COORDINATE DATA SCIENCE

476
00:19:53,669 --> 00:19:55,338
ESPECIALLY MODERNIZING DATA

477
00:19:55,338 --> 00:19:55,905
SCIENCE ECOSYSTEM AND

478
00:19:55,905 --> 00:19:58,574
INFRASTRUCTURE INCLUDING

479
00:19:58,574 --> 00:20:00,376
GEOSPATIAL ACROSS THE NIH BUT

480
00:20:00,376 --> 00:20:04,013
ALSO TO PROVIDE ENHANCE DIVERSE

481
00:20:04,013 --> 00:20:05,748
DATA SCIENCE WORK FORCE AND

482
00:20:05,748 --> 00:20:07,116
BUILD STRATEGY PATTERN

483
00:20:07,116 --> 00:20:10,820
PARTNERSHIP TO ADVANCE METHODS.

484
00:20:10,820 --> 00:20:14,790
THIS OFFICE HAS MANY PROGRAMS

485
00:20:14,790 --> 00:20:17,660
AND UNITS THAT SUPPORT IN TERMS

486
00:20:17,660 --> 00:20:19,529
OF MODERNIZE DATA SOURCE

487
00:20:19,529 --> 00:20:20,897
ECOSYSTEM INCLUDING GEOSPATIAL

488
00:20:20,897 --> 00:20:26,369
DATA.  THE OFFICE IS NOW

489
00:20:26,369 --> 00:20:29,572
CURRENTLY FINALIZING STRATEGIC

490
00:20:29,572 --> 00:20:31,340
PLAN AND THIS PLAN GEOSPATIAL

491
00:20:31,340 --> 00:20:34,544
DATA ALONG SOCIAL DATA

492
00:20:34,544 --> 00:20:35,912
DETERMINANTS OF HEALTH WHICH

493
00:20:35,912 --> 00:20:38,681
CORRESPONDS WITH GEOSPATIAL DATA

494
00:20:38,681 --> 00:20:40,183
IS THERE AND I INVITE YOU TO

495
00:20:40,183 --> 00:20:41,751
READ IT WHEN OFFICIALLY

496
00:20:41,751 --> 00:20:52,228
RELEASED.  SO WITHIN NIH THE

497
00:20:52,962 --> 00:20:55,298
GEOSPATIAL DATA HAS BEEN IN --

498
00:20:55,298 --> 00:20:57,166
HAS BEEN IN NUMEROUS BIOMEDICAL

499
00:20:57,166 --> 00:20:59,235
AND PUBLIC HEALTH RESEARCH. AS

500
00:20:59,235 --> 00:21:02,271
YOU CAN SEE IN THIS LAST TEN

501
00:21:02,271 --> 00:21:10,146
YEARS NIH HAS FUNDED NEARLY

502
00:21:10,146 --> 00:21:14,083
2,000 PROJECTS USING BIOMEDICAL

503
00:21:14,083 --> 00:21:16,118
AND BEHAVIORAL RESEARCH. MANY

504
00:21:16,118 --> 00:21:17,920
INSTITUTES AND CENTERS

505
00:21:17,920 --> 00:21:18,721
INCREASINGLY RECOGNIZE THE

506
00:21:18,721 --> 00:21:21,357
IMPORTANCE OF GEOGRAPHIC CONTEXT

507
00:21:21,357 --> 00:21:23,025
IN ADVANCING BIOLOGICAL RESEARCH

508
00:21:23,025 --> 00:21:26,395
AND PUBLIC HEALTH FOR EXAMPLE,

509
00:21:26,395 --> 00:21:30,032
THE NCI USES AS YOU CAN SEE

510
00:21:30,032 --> 00:21:33,469
HERE, GEOSPATIAL GIS AND SPATIAL

511
00:21:33,469 --> 00:21:36,906
MODELING TO UNDERSTAND CANCER

512
00:21:36,906 --> 00:21:40,643
OUTCOMES. IN ADDITION THE NIMHD

513
00:21:40,643 --> 00:21:43,913
HERE WE WILL SEE SOON, THE

514
00:21:43,913 --> 00:21:46,682
NATIONAL INSTITUTES OF MENTAL

515
00:21:46,682 --> 00:21:48,251
AND HEALTH DISPARITY, USE

516
00:21:48,251 --> 00:21:50,720
GEOSPATIAL DATA TO STUDY HOW

517
00:21:50,720 --> 00:21:53,356
CONNECTORS IMPACT MENTAL HEALTH,

518
00:21:53,356 --> 00:21:54,590
CHRONIC STRESS AND

519
00:21:54,590 --> 00:21:56,726
CARDIOVASCULAR HEALTH AND OTHER

520
00:21:56,726 --> 00:21:59,262
CHRONIC DISEASES.  THEN THE

521
00:21:59,262 --> 00:22:01,264
NATIONAL ENVIRONMENTAL HEALTH

522
00:22:01,264 --> 00:22:04,133
SCIENCE TRIES TO USE GEOSPATIAL

523
00:22:04,133 --> 00:22:08,504
STUDY GEOSPATIAL DATA TO STUDY

524
00:22:08,504 --> 00:22:09,705
ENVIRONMENTAL HEALTH

525
00:22:09,705 --> 00:22:10,706
INTERACTION. IN THIS CASE THEY

526
00:22:10,706 --> 00:22:16,145
USE GEOSPATIAL DATA TO

527
00:22:16,145 --> 00:22:18,314
ENVIRONMENTAL. FOR ALL THIS

528
00:22:18,314 --> 00:22:21,751
SHOWS NIH INSTITUTES AND CENTERS

529
00:22:21,751 --> 00:22:23,986
RECOGNIZE IMPORTANCE OF

530
00:22:23,986 --> 00:22:26,255
GEOGRAPHIC IN ADVANCING HEALTH

531
00:22:26,255 --> 00:22:30,192
RESEARCH. IN ADDITION AS WE KNOW

532
00:22:30,192 --> 00:22:33,129
THERE IS INTERSECTION BETWEEN

533
00:22:33,129 --> 00:22:36,465
GEOSPATIAL DATA AND SOCIAL

534
00:22:36,465 --> 00:22:37,867
DETERMINANTS OF HEALTH AS ONE

535
00:22:37,867 --> 00:22:41,070
CAN MENTION, THIS INTERSECTION

536
00:22:41,070 --> 00:22:42,872
IS BECAUSE THESE HEALTH OUTCOMES

537
00:22:42,872 --> 00:22:45,174
IN SOCIAL DETERMINANTS OF HEALTH

538
00:22:45,174 --> 00:22:47,410
ARE NOT ACROSS (INAUDIBLE) AND

539
00:22:47,410 --> 00:22:53,249
THIS IS THE REASON WHY NIH IS

540
00:22:53,249 --> 00:22:55,117
HIGH PRIORITY IN TRYING TO

541
00:22:55,117 --> 00:22:57,653
IMPROVE HEALTH AND ADVANCE

542
00:22:57,653 --> 00:23:02,825
HEALTH EQUITY. HENCE IN PHYSICAL

543
00:23:02,825 --> 00:23:08,264
22 ONLY NIH FUNDED ABOUT

544
00:23:08,264 --> 00:23:11,467
$4.1 BILLION RELATED TO SDOH AND

545
00:23:11,467 --> 00:23:13,736
TRAINING PROGRAMS WHICH IS OVER

546
00:23:13,736 --> 00:23:19,575
8,000 PROJECTSS. AND THIS

547
00:23:19,575 --> 00:23:21,377
APPROACH TO LEVERAGE THE

548
00:23:21,377 --> 00:23:22,311
INTERDISCIPLINARY COLLABORATION

549
00:23:22,311 --> 00:23:24,547
BETWEEN GEOSPATIAL SCIENCES AND

550
00:23:24,547 --> 00:23:26,148
SOCIAL SCIENCES IS TO PROVIDE

551
00:23:26,148 --> 00:23:28,551
POWERFUL LENS TO UNDERSTAND AND

552
00:23:28,551 --> 00:23:37,560
ADDRESS HEALTH DISPARITIES.  AN

553
00:23:37,560 --> 00:23:38,661
EXAMPLE, THERE (INAUDIBLE) BY

554
00:23:38,661 --> 00:23:40,329
MANY INSTITUTES INCLUDING NIDA

555
00:23:40,329 --> 00:23:42,965
THAT LEVERAGE GEOSPATIAL DATA TO

556
00:23:42,965 --> 00:23:44,900
(INAUDIBLE) GEOGRAPHIC PATTERNS,

557
00:23:44,900 --> 00:23:47,470
ENVIRONMENTAL FACTORS AND SOCIAL

558
00:23:47,470 --> 00:23:48,537
DETERMINANTS ON DISEASE

559
00:23:48,537 --> 00:23:49,505
DEVELOPMENT AND HEALTH OUTCOMES.

560
00:23:49,505 --> 00:23:54,243
SO I ENCOURAGE YOU AGAIN HERE TO

561
00:23:54,243 --> 00:23:59,315
LOOK AT THIS NOSI. SO WITH

562
00:23:59,315 --> 00:24:02,752
NUMEROUS BENEFITS OF GEOSPATIAL

563
00:24:02,752 --> 00:24:05,221
DATA, THERE IS ALSO SOME

564
00:24:05,221 --> 00:24:08,491
SIGNIFICANT CHALLENGES. FOR

565
00:24:08,491 --> 00:24:10,760
EXAMPLE DATA ABILITY AND --

566
00:24:10,760 --> 00:24:12,361
AVAILABILITY AND QUALITY IS AN

567
00:24:12,361 --> 00:24:13,863
IMPERFECT ISSUE ESPECIALLY WE

568
00:24:13,863 --> 00:24:16,632
ARE INCREASING COLLECTING

569
00:24:16,632 --> 00:24:19,502
GEOSPATIAL DATA, THERE IS

570
00:24:19,502 --> 00:24:21,670
LIMITED DATA IN UNDERSERVED

571
00:24:21,670 --> 00:24:23,205
COMMUNITIES.  THERE IS CHALLENGE

572
00:24:23,205 --> 00:24:25,541
OF DATA INTEGRATION AND

573
00:24:25,541 --> 00:24:26,942
STANDARDIZATION INCONSISTENT OF

574
00:24:26,942 --> 00:24:29,612
DATA FORMAT, DEFINITIONS ACROSS

575
00:24:29,612 --> 00:24:31,714
DIFFERENT, MAKE IT DIFFICULT TO

576
00:24:31,714 --> 00:24:33,682
INTEGRATE DATA FROM DIFFERENT

577
00:24:33,682 --> 00:24:36,285
SOURCES. THERE IS THE PRIVACY

578
00:24:36,285 --> 00:24:38,587
CONCERN AS WE COLLECT MORE

579
00:24:38,587 --> 00:24:40,156
LOCATIONS OF INDIVIDUALS THIS

580
00:24:40,156 --> 00:24:42,892
COULD BE A CONCEPT AS WELL AS WE

581
00:24:42,892 --> 00:24:45,594
NEED OTHERS. AND THERE IS ALSO

582
00:24:45,594 --> 00:24:48,564
AN ISSUE MANAGING THIS VAST

583
00:24:48,564 --> 00:24:49,932
GEOSPATIAL DATA COLLECTED

584
00:24:49,932 --> 00:24:52,234
INCLUDING THE TECHNICAL

585
00:24:52,234 --> 00:24:55,538
CHALLENGE SUCH AS COMPLETING

586
00:24:55,538 --> 00:24:56,705
INFRASTRUCTURE AND STORING

587
00:24:56,705 --> 00:25:00,709
PROCESSING AND ANALYZING DATA.

588
00:25:00,709 --> 00:25:04,480
SPECIALIZED SKILLS WE NEED TO

589
00:25:04,480 --> 00:25:06,148
TRAIN NEXT GENERATION THAT COULD

590
00:25:06,148 --> 00:25:08,617
BE GEOSPATIAL DATA AND ANALYZE

591
00:25:08,617 --> 00:25:10,486
AND CHALLENGES FOR

592
00:25:10,486 --> 00:25:11,487
INTERDISCIPLINE COLLABORATION,

593
00:25:11,487 --> 00:25:12,755
THOSE ARE SOME EXAMPLE OF THE

594
00:25:12,755 --> 00:25:15,591
CHALLENGES THAT WE NEED TO

595
00:25:15,591 --> 00:25:19,862
ADDRESS IN THE COMING MONTHS AND

596
00:25:19,862 --> 00:25:24,200
WEEKS AND YEARS. SO WHAT ARE

597
00:25:24,200 --> 00:25:25,701
THOSE OPPORTUNITIES? TO OTHERS

598
00:25:25,701 --> 00:25:28,504
THOSE CHALLENGES IN MAXIMIZING

599
00:25:28,504 --> 00:25:30,272
IMPANG OF GEOSPATIAL DATA IS --

600
00:25:30,272 --> 00:25:33,175
IMPACT OF GEOSPATIAL DATA IS TO

601
00:25:33,175 --> 00:25:34,243
DEVELOP THEIR GEOSPATIAL DATA

602
00:25:34,243 --> 00:25:37,513
SET.  OUR OFFICE IS ONE OF THE

603
00:25:37,513 --> 00:25:42,485
TASK IS TO MAKE THE ECOSYSTEM

604
00:25:42,485 --> 00:25:43,786
INCLUDING GEOSPATIAL DATA ADHERE

605
00:25:43,786 --> 00:25:46,989
TO THE FAIR PERSON WHICH IS

606
00:25:46,989 --> 00:25:50,793
FINDABLE ACCESSIBLE AND

607
00:25:50,793 --> 00:25:52,962
INTEROPERABLE AND REUSABLE. SO

608
00:25:52,962 --> 00:25:54,263
THIS REQUIRES IMPLEMENTING

609
00:25:54,263 --> 00:25:56,298
COMPREHENSIVE DETAILED MYOMA

610
00:25:56,298 --> 00:25:58,234
DATA, STANDARDIZED DATA FORMATS,

611
00:25:58,234 --> 00:25:59,768
CLEAR ACCESS PROTOCOLS AND

612
00:25:59,768 --> 00:26:03,405
PROPER DOCUMENTATION. IF WE ARE

613
00:26:03,405 --> 00:26:06,709
TO ENABLE THE PRINCIPLE IN THE

614
00:26:06,709 --> 00:26:09,945
RESEARCHERS TO QUICKLY FIND

615
00:26:09,945 --> 00:26:11,947
EXISTING GEOSPATIAL POTENTIAL

616
00:26:11,947 --> 00:26:13,516
ACCELERATE RESEARCH AND IMPACT

617
00:26:13,516 --> 00:26:17,553
ON HEALTH. BUT ALSO TO ENHANCE

618
00:26:17,553 --> 00:26:20,422
AND INTEGRATE COMBINE GEOSPATIAL

619
00:26:20,422 --> 00:26:21,690
DATA WITH OTHER DATA SETS SUCH

620
00:26:21,690 --> 00:26:28,531
AS SENSORS AND SUCH AS

621
00:26:28,531 --> 00:26:29,498
ELECTRONIC METHOD RECORDS TO

622
00:26:29,498 --> 00:26:31,400
UNDERSTAND AND ADDRESS HEALTH

623
00:26:31,400 --> 00:26:35,604
DISPARITY. THE OTHER

624
00:26:35,604 --> 00:26:40,776
OPPORTUNITIES WE HAVE IS TO USE

625
00:26:40,776 --> 00:26:42,044
COMMON DATA ELEMENTS, NIH

626
00:26:42,044 --> 00:26:45,648
ENCOURAGES USE OF COMMON DATA

627
00:26:45,648 --> 00:26:47,449
ELEMENTS. GEOSPECIAL DATA COMMON

628
00:26:47,449 --> 00:26:49,251
DATA ELEMENTS THAT STANDARDIZE

629
00:26:49,251 --> 00:26:51,987
WAY OF LOCATION BASED

630
00:26:51,987 --> 00:26:54,156
INFORMATION. THIS ENABLES

631
00:26:54,156 --> 00:26:56,425
RESEARCHERS TO USE, TO COLLECT

632
00:26:56,425 --> 00:27:00,029
STANDARDIZE GEOSPATIAL DATA AND

633
00:27:00,029 --> 00:27:01,330
COLLECT AND SHARE AND ALSO THEY

634
00:27:01,330 --> 00:27:05,701
CAN MAXIMIZE THAT IMPACT. FOR

635
00:27:05,701 --> 00:27:09,104
EXAMPLE WE HAVE THE HEAL STUDY

636
00:27:09,104 --> 00:27:11,073
USING GEOSPATIAL DATA ELEMENTS

637
00:27:11,073 --> 00:27:15,578
TO CHECK STANDARDIZE GEOGRAPHIC

638
00:27:15,578 --> 00:27:17,813
INFORMATION, THAT CAN BE LINKED

639
00:27:17,813 --> 00:27:19,582
TO CLINICAL DATA SET AND OTHER

640
00:27:19,582 --> 00:27:23,185
DATA SET WHICH ALLOWS TO BETTER

641
00:27:23,185 --> 00:27:24,753
UNDERSTAND HOW GEOSPATIAL TERMS

642
00:27:24,753 --> 00:27:25,888
ARE RELATED TO PAIN AND OTHER

643
00:27:25,888 --> 00:27:28,657
CONDITIONS.  WHICH I ENCOURAGE

644
00:27:28,657 --> 00:27:32,328
YOU TO VISIT ABOUT THIS ALSO. 

645
00:27:32,328 --> 00:27:34,763
THE OTHER EXAMPLE IS THAT THERE

646
00:27:34,763 --> 00:27:38,467
IS ALSO SIMILAR RESEARCH BY

647
00:27:38,467 --> 00:27:39,802
NIMHD SHARE AND PHOENIX COMMON

648
00:27:39,802 --> 00:27:42,538
DATA ELEMENTS THIS FOCUSES ON

649
00:27:42,538 --> 00:27:45,007
THE SOCIAL DETERMINANTS OF

650
00:27:45,007 --> 00:27:48,544
HEALTH WHICH ARE ALSO ANOTHER

651
00:27:48,544 --> 00:27:50,713
RESOURCES FOR RESEARCHERS TO

652
00:27:50,713 --> 00:27:58,921
EXPLORE.  SO ONCE WE BUILD THE

653
00:27:58,921 --> 00:28:00,856
GEOSPATIAL DATA SET BASED ON

654
00:28:00,856 --> 00:28:02,524
FAIR PRINCIPLES WE NEED TO

655
00:28:02,524 --> 00:28:05,561
DEVELOP ALSO A CULTURAL FREEZE

656
00:28:05,561 --> 00:28:09,732
OF GEOSPATIAL DATA -- REUSE OF

657
00:28:09,732 --> 00:28:11,000
GEOSPATIAL DATA SO THAT WE CAN

658
00:28:11,000 --> 00:28:14,937
USE IT MANY TIMES AND ALSO

659
00:28:14,937 --> 00:28:16,772
ACROSS MULTIPLE DISCIPLINES AND

660
00:28:16,772 --> 00:28:17,773
APPLICATIONS SO WE CAN MAXIMIZE

661
00:28:17,773 --> 00:28:22,344
THE VALUE AND THE EFFECT OF THIS

662
00:28:22,344 --> 00:28:23,545
INVALUABLE DATA SETS BEING

663
00:28:23,545 --> 00:28:24,480
COLLECTED FROM DIFFERENT

664
00:28:24,480 --> 00:28:26,048
RESOURCES. THIS HELPS US TO

665
00:28:26,048 --> 00:28:28,350
ACCELERATE THE PACE OF RESEARCH,

666
00:28:28,350 --> 00:28:29,952
FUTURE RESEARCH BUT ALSO TO

667
00:28:29,952 --> 00:28:32,588
VALIDATE OUR RESEARCH FINDINGS

668
00:28:32,588 --> 00:28:35,157
AND ALSO FOSTER

669
00:28:35,157 --> 00:28:35,791
MULTI-DISCIPLINARY COLLABORATION

670
00:28:35,791 --> 00:28:40,963
IN THE ERA OF MULTI-DISCIPLINARY

671
00:28:40,963 --> 00:28:45,067
BECAUSE SILOING RESEARCH IS NOT

672
00:28:45,067 --> 00:28:46,635
GOOD AT THIS TIME BECAUSE WE

673
00:28:46,635 --> 00:28:53,442
NEED DATA SCIENTISTS AND SOCIAL

674
00:28:53,442 --> 00:28:54,810
DETERMINANTS AND CONTEXT EXPERTS

675
00:28:54,810 --> 00:28:56,345
TO WORKING TO AND LEVERAGE AND

676
00:28:56,345 --> 00:28:57,513
HARNESS THE POWER OF THE

677
00:28:57,513 --> 00:29:01,784
GEOSPATIAL DATA. THEN WE HAVE AN

678
00:29:01,784 --> 00:29:03,452
OPPORTUNITY TO INTEGRATE

679
00:29:03,452 --> 00:29:05,954
GEOSPATIAL DATA WITH SOCIAL

680
00:29:05,954 --> 00:29:07,456
DETERMINANTS OF HEALTH WEARABLE

681
00:29:07,456 --> 00:29:10,025
AND CLINICAL DATA. AND ALSO DATA

682
00:29:10,025 --> 00:29:11,727
THAT COMES FROM SOCIAL MEDIA%

683
00:29:11,727 --> 00:29:14,463
THIS IS WHERE AN OPPORTUNITY

684
00:29:14,463 --> 00:29:15,898
NEEDED IN ORDER FOR THIS TO

685
00:29:15,898 --> 00:29:18,233
HAPPEN THOUGH I THINK AS I

686
00:29:18,233 --> 00:29:21,003
MENTION, WE NEED TO STANDARDIZE

687
00:29:21,003 --> 00:29:23,872
THE WAY WE COLLECT THE DATA, WE

688
00:29:23,872 --> 00:29:26,809
NEED TO MAKE THEM FINDABLE AND

689
00:29:26,809 --> 00:29:27,609
ACCESSIBLE INTEROPERABLE. AND

690
00:29:27,609 --> 00:29:30,813
ONCE WE DO THAT, THE

691
00:29:30,813 --> 00:29:33,615
INTERVENTION WILL BE MUCH EASIER

692
00:29:33,615 --> 00:29:35,884
AND WE CAN HARNESS THAT POWER OF

693
00:29:35,884 --> 00:29:38,454
INTEGRATION TO STUDY SO MANY

694
00:29:38,454 --> 00:29:42,324
ISSUES RELATED TO BEHAVIORAL AND

695
00:29:42,324 --> 00:29:47,930
HEALTH OUTCOMES.  THE OTHER

696
00:29:47,930 --> 00:29:51,033
OPPORTUNITY WE HAVE IS WE NEED

697
00:29:51,033 --> 00:29:54,970
TO ADDRESS HEAD-ON THE ETHICAL

698
00:29:54,970 --> 00:29:56,805
AND PRIVACY HERE. AS WE COLLECT

699
00:29:56,805 --> 00:29:58,373
GEOSPATIAL DATA WHICH IS LINKED

700
00:29:58,373 --> 00:30:00,776
TO INDIVIDUAL LOCATIONS, THIS IS

701
00:30:00,776 --> 00:30:02,578
A SIGNIFICANT ISSUE FOR ETHICAL

702
00:30:02,578 --> 00:30:07,015
AND PRIVACY CONCERNS, ESPECIALLY

703
00:30:07,015 --> 00:30:09,151
FOR THOSE COMMUNITIES THAT ARE

704
00:30:09,151 --> 00:30:10,886
VULNERABLE AND MARGINALIZED, IT

705
00:30:10,886 --> 00:30:14,690
CAN CREATE A STIGMA OR SHOW OF

706
00:30:14,690 --> 00:30:17,626
DISCRIMINATION. SO WE NEED TO

707
00:30:17,626 --> 00:30:19,595
PRIORITIZE ETHICAL AND PRIVACY

708
00:30:19,595 --> 00:30:24,700
CONCERNS. SO PRACTICING INFORMED

709
00:30:24,700 --> 00:30:27,102
CONSENT, ANALLIZATION AND ROBUST

710
00:30:27,102 --> 00:30:29,271
MEASURES AND TRANSPARENCY IN

711
00:30:29,271 --> 00:30:30,472
ALGORITHMS AND MAKING SURE THE

712
00:30:30,472 --> 00:30:34,710
DATA IS INCLUSIVE, IT DOESN'T --

713
00:30:34,710 --> 00:30:40,382
DATA IS NOTTER NO GAPS IN

714
00:30:40,382 --> 00:30:42,785
MARGINALIZED COMMUNITY AND ALSO

715
00:30:42,785 --> 00:30:46,421
MAYBE USE APPROACHES LIKE

716
00:30:46,421 --> 00:30:49,324
FEDERATED DISTRIBUTED APP TO

717
00:30:49,324 --> 00:30:50,559
ANALYZE AND INTEGRATE DIFFERENT

718
00:30:50,559 --> 00:30:54,997
DATA RESOURCES.  THE OTHER

719
00:30:54,997 --> 00:30:57,132
OPPORTUNITIES WE ARE IN THE ERA

720
00:30:57,132 --> 00:31:01,236
OF ARTIFICIAL INTELLIGENCE AND

721
00:31:01,236 --> 00:31:03,105
MISSION DIFFUSION OF GEOSPATIAL

722
00:31:03,105 --> 00:31:08,177
DATA AND AI BECOMES THE GEOAI.

723
00:31:08,177 --> 00:31:10,245
THIS IS AN EMERGING AREA THAT IS

724
00:31:10,245 --> 00:31:14,783
-- COMBINES AI WITH DATA MINING

725
00:31:14,783 --> 00:31:16,752
AND COMPUTING PERFORMANCE TO

726
00:31:16,752 --> 00:31:17,753
EXTRACT KNOWLEDGE FROM

727
00:31:17,753 --> 00:31:20,222
GEOSPATIAL DATA. WE NEED TO

728
00:31:20,222 --> 00:31:22,558
LEVERAGE ALL THOSE INCLUDING THE

729
00:31:22,558 --> 00:31:24,126
DIGITAL TWINS WHICH WILL ALSO

730
00:31:24,126 --> 00:31:29,698
HELP US IN TERMS OF SIMULATION.

731
00:31:29,698 --> 00:31:32,301
THOSE TOOLS CAN HELP CRITICAL

732
00:31:32,301 --> 00:31:36,171
OUTBREAKS AND IDENTIFY HEALTH

733
00:31:36,171 --> 00:31:37,339
RISK AND UNDERSTAND THE

734
00:31:37,339 --> 00:31:39,975
SEVERITIES AS WELL AS FUTURE

735
00:31:39,975 --> 00:31:41,543
HEALTH TRENDS FROM LAUNCH OF

736
00:31:41,543 --> 00:31:43,612
GEOSPATIAL DATA IN FORMATS,

737
00:31:43,612 --> 00:31:45,147
ENGLISH TEXT AND SOCIAL MEDIA.

738
00:31:45,147 --> 00:31:48,183
THIS CAN ALSO INCREASE THE

739
00:31:48,183 --> 00:31:49,218
COMPUTATIONAL EFFICIENCY, THE

740
00:31:49,218 --> 00:31:51,453
FLEXIBILITY OF ALGORITHMS AND

741
00:31:51,453 --> 00:31:55,524
WORK FLOWS, IN OUR ANALYSIS. AND

742
00:31:55,524 --> 00:31:58,660
SCALABILITY OF THE MODELS TO

743
00:31:58,660 --> 00:32:01,630
UNDERSTAND AND TO GENERATE OTHER

744
00:32:01,630 --> 00:32:03,098
GEOGRAPHIC AREAS OR HEALTH AND

745
00:32:03,098 --> 00:32:11,773
BEHAVIORAL OUTCOMES.S. AS WELL.O

746
00:32:11,773 --> 00:32:15,744
THE NIH SPECIAL OFFICE TRYING TO

747
00:32:15,744 --> 00:32:18,313
DEMOCRATIZE ACCESS OF THE

748
00:32:18,313 --> 00:32:19,615
INFRASTRUCTURE SO WE HAVE THIS

749
00:32:19,615 --> 00:32:21,984
STRIDE INITIATIVE THAT I

750
00:32:21,984 --> 00:32:24,820
ENCOURAGE YOU TO VISIT AND

751
00:32:24,820 --> 00:32:26,755
EXPLORE. THIS INITIATIVE IS THAT

752
00:32:26,755 --> 00:32:29,524
FOR BOTH THE NIH INTRAMURAL AND

753
00:32:29,524 --> 00:32:31,093
EXTRAMURAL RESEARCHERS

754
00:32:31,093 --> 00:32:33,695
COMMUNITIES, THE POWER OF CLOUD

755
00:32:33,695 --> 00:32:35,530
TO ACCELERATE BIOMEDICAL AND

756
00:32:35,530 --> 00:32:37,432
BEHAVIORAL RESEARCH. IN USING

757
00:32:37,432 --> 00:32:41,870
THIS CLOUD, YOU CAN CONDUCT YOUR

758
00:32:41,870 --> 00:32:45,741
GEOSPATIAL ANALYSIS IN A CLOUD

759
00:32:45,741 --> 00:32:51,213
AND INTEGRATE AI AS I MENTION IN

760
00:32:51,213 --> 00:32:53,048
OTHER TOOLS TO DO CUTTING-EDGE

761
00:32:53,048 --> 00:32:58,754
RESEARCH. AND CLOUD COMPUTING IS

762
00:32:58,754 --> 00:33:03,392
A GREAT EQUALIZER. IT HELPS

763
00:33:03,392 --> 00:33:04,960
DEMOCRATIZE THE ACCESS TO

764
00:33:04,960 --> 00:33:06,161
RESEARCH AND DATA SIZE BY

765
00:33:06,161 --> 00:33:08,430
LEVELING THE PLAYING FIELD

766
00:33:08,430 --> 00:33:10,198
ESPECIALLY FOR UNDER-REPRESENTED

767
00:33:10,198 --> 00:33:11,466
RESEARCHERS IN BIOMEDICAL

768
00:33:11,466 --> 00:33:18,840
RESEARCH. WE ALSO HAVE THE NIH

769
00:33:18,840 --> 00:33:22,744
CLOUD FOR SOME OF YOU ESPECIALLY

770
00:33:22,744 --> 00:33:25,047
THOSE INVESTIGATORS, POST DOCS

771
00:33:25,047 --> 00:33:28,383
OR Ph.D.. I INVITE YOU TO

772
00:33:28,383 --> 00:33:31,320
EXPLORE THE CLOUD NIH CLOUD LAB.

773
00:33:31,320 --> 00:33:37,626
THERE IS NO FEE. YOU CAN BE ABLE

774
00:33:37,626 --> 00:33:42,497
TO EXPERIMENT, USE THE TOOLS AS

775
00:33:42,497 --> 00:33:48,036
WELL. SO IN CLOSING, WE ARE OF

776
00:33:48,036 --> 00:33:49,705
THE EXCITING TIME FOR GEOSPATIAL

777
00:33:49,705 --> 00:33:52,507
DATA IN PUBLIC HEALTH RESEARCH. 

778
00:33:52,507 --> 00:33:55,177
AND THIS IS ALSO IN ACTION TO

779
00:33:55,177 --> 00:33:58,580
THE NIH ICs AND OFFICES,

780
00:33:58,580 --> 00:34:01,650
RECOGNIZING THE VALUE OF

781
00:34:01,650 --> 00:34:04,386
GEOSPATIAL DATA IN THE COMPLEX

782
00:34:04,386 --> 00:34:05,921
CHALLENGE IN BIOMEDICAL AND

783
00:34:05,921 --> 00:34:07,189
BEHAVIORAL RESEARCH SO THERE IS

784
00:34:07,189 --> 00:34:09,558
A LOT OF FUNDING IN THIS AREA

785
00:34:09,558 --> 00:34:11,360
ESPECIALLY IF YOU COMBINE

786
00:34:11,360 --> 00:34:12,494
INTERCEPT WITH SOCIAL

787
00:34:12,494 --> 00:34:14,763
DETERMINANTS OF HEALTH

788
00:34:14,763 --> 00:34:15,630
ENVIRONMENTAL DETERMINANTS OF

789
00:34:15,630 --> 00:34:20,202
HEALTH AS WELL.  SO THEN THE

790
00:34:20,202 --> 00:34:22,537
VISION OF GEOSPATIAL DATA WITH

791
00:34:22,537 --> 00:34:25,073
ADVANCE OF AI AND CLOUD

792
00:34:25,073 --> 00:34:27,209
COMPUTING AND DIGITAL TOOLS

793
00:34:27,209 --> 00:34:28,710
ALONG WITH IMPLEMENTATION OF THE

794
00:34:28,710 --> 00:34:31,346
FAIR PRINCIPLE AND ETHICAL

795
00:34:31,346 --> 00:34:32,514
PRACTICES, ALL THIS WILL

796
00:34:32,514 --> 00:34:34,850
TRANSFER THE WAY WE LEVERAGE

797
00:34:34,850 --> 00:34:36,251
GEOSPATIAL DATA. TO UNDERSTAND

798
00:34:36,251 --> 00:34:40,122
THE NUMEROUS HEALTH AND

799
00:34:40,122 --> 00:34:42,891
BEHAVIORAL ISSUES WHILE ENSURING

800
00:34:42,891 --> 00:34:45,327
THAT THOSE -- THE BENEFIT OF

801
00:34:45,327 --> 00:34:48,597
THOSE ADVANCE GEOSPATIAL DATA

802
00:34:48,597 --> 00:34:51,933
ADVANCE IN AI ARE EQUITABLY FELT

803
00:34:51,933 --> 00:34:53,335
ACROSS ALL COMMUNITIES INCLUDING

804
00:34:53,335 --> 00:34:55,437
THOSE THAT ARE MARGINALIZED AND

805
00:34:55,437 --> 00:35:00,675
UNDERSERVED.  WITH THAT I THANK

806
00:35:00,675 --> 00:35:03,378
YOU. I'M HAPPY TO ANSWER ANY

807
00:35:03,378 --> 00:35:08,316
QUESTIONS. 

808
00:35:08,316 --> 00:35:10,685
>> GREAT.  THANK YOU SO
MUCH,

809
00:35:10,685 --> 00:35:14,656
DR. GEBREAB FOR THIS INFORMATIVE

810
00:35:14,656 --> 00:35:15,791
PRESENTATION. WE DO HAVE ONE

811
00:35:15,791 --> 00:35:19,728
QUESTION. WE ARE MINDFUL OF THE

812
00:35:19,728 --> 00:35:21,897
TIME AS WELL SO IF YOU DON'T

813
00:35:21,897 --> 00:35:25,033
MIND ANSWERING THE QUESTION AT

814
00:35:25,033 --> 00:35:26,234
THE TIME WHILE THE PRESENTATION

815
00:35:26,234 --> 00:35:29,538
IS ONGOING WE APPRECIATE IT. NOW

816
00:35:29,538 --> 00:35:34,276
I WOULD LIKE TO TURN OVER TO DR.

817
00:35:34,276 --> 00:35:35,977
COURTE VOORHEES WHO WILL

818
00:35:35,977 --> 00:35:37,712
MODERATE THE NEXT SESSION ON

819
00:35:37,712 --> 00:35:39,014
PREVENTION RESEARCH. THANK YOU

820
00:35:39,014 --> 00:35:43,051
SO MUCH.

821
00:35:43,051 --> 00:35:44,286
>> HELLO. THANK YOU AGAIN
FOR

822
00:35:44,286 --> 00:35:45,854
JOINING US. WELCOME TO THE

823
00:35:45,854 --> 00:35:47,456
SESSION ON PREVENTION RESEARCH.

824
00:35:47,456 --> 00:35:49,491
MY NAME IS COURTE VAN VOORHEES,

825
00:35:49,491 --> 00:35:50,425
PROGRAM OFFICER IN THE

826
00:35:50,425 --> 00:35:51,426
PREVENTION RESEARCH BRANCH OF

827
00:35:51,426 --> 00:35:53,028
THE DIVISION OF EPIDEMIOLOGY

828
00:35:53,028 --> 00:35:53,528
SERVICES AND PREVENTION

829
00:35:53,528 --> 00:35:56,398
RESEARCH. WE HAVE TWO GREAT

830
00:35:56,398 --> 00:35:57,566
SPEAKERS TODAY I WILL INTRODUCE

831
00:35:57,566 --> 00:35:58,700
IN A MOMENT. WE ARE LOOKING

832
00:35:58,700 --> 00:36:00,569
FORWARD TO YOUR QUESTIONS, SO

833
00:36:00,569 --> 00:36:01,970
REMINDER DURING THE SESSION

834
00:36:01,970 --> 00:36:03,505
PLEASE TYPE QUESTIONS INTO THE

835
00:36:03,505 --> 00:36:05,006
Q&A BY CLICKING ON THE ICON
AT

836
00:36:05,006 --> 00:36:06,875
THE BOTTOM OF THE ZOOM WINDOW,

837
00:36:06,875 --> 00:36:08,210
INCLUDE THE LAST NAME OF THE

838
00:36:08,210 --> 00:36:09,244
PRESENTER AT THE BEGINNING OF

839
00:36:09,244 --> 00:36:12,114
THAT QUESTION. THAT WILL HELP US

840
00:36:12,114 --> 00:36:13,949
IDENTIFY FOR DISCUSSION PERIOD

841
00:36:13,949 --> 00:36:16,151
TO MAKE IT SMOOTHER. THE FIRST

842
00:36:16,151 --> 00:36:17,085
PRESENTATION WE HAVE IS

843
00:36:17,085 --> 00:36:18,487
COMMUNITY LEVEL MEASURES OF RISK

844
00:36:18,487 --> 00:36:21,490
AND RESILIENCY IN OPIOID RELATED

845
00:36:21,490 --> 00:36:23,658
MORTALITY BY DR. LANCE WALLER,

846
00:36:23,658 --> 00:36:26,027
Ph.D.  ARE DR. WAHLER IS

847
00:36:26,027 --> 00:36:27,262
PROFESSOR FORMER CHAIR

848
00:36:27,262 --> 00:36:29,664
DEPARTMENT OF BIOSTATISTICS AND

849
00:36:29,664 --> 00:36:30,699
BIOINFORMATICS, WHILE IN SCHOOL

850
00:36:30,699 --> 00:36:31,766
OF PUBLIC HEALTH EMORY

851
00:36:31,766 --> 00:36:33,568
UNIVERSITY. HIS CO-CHAIR OF THE

852
00:36:33,568 --> 00:36:36,204
NATIONAL ACADEMIES COMMITTEE ON

853
00:36:36,204 --> 00:36:38,106
APPLIED THEORETICAL STATISTICS

854
00:36:38,106 --> 00:36:39,474
AND MEMBER OF THE U.S. CENSUS

855
00:36:39,474 --> 00:36:40,142
SCIENTIFIC AND ADVISORY

856
00:36:40,142 --> 00:36:43,178
COMMITTEE. A FELLOW OF THE

857
00:36:43,178 --> 00:36:44,379
AMERICAN STATISTICAL ASSOCIATION

858
00:36:44,379 --> 00:36:46,681
AND FELLOW OF THE LOYAL

859
00:36:46,681 --> 00:36:47,716
GEOGRAPHICAL SOCIETY.  HIS

860
00:36:47,716 --> 00:36:49,618
RESEARCH INVOLVES DEVELOPMENT OF

861
00:36:49,618 --> 00:36:51,353
METHODS FOR GEOGRAPHIC DATA

862
00:36:51,353 --> 00:36:53,688
INCLUDING APPLICATIONS AND

863
00:36:53,688 --> 00:36:55,457
ENVIRONMENTAL JUSTICE,

864
00:36:55,457 --> 00:36:57,259
EPIDEMIOLOGY, DISEASE

865
00:36:57,259 --> 00:36:59,928
SURVEILLANCE, HIS RESEARCH IS IN

866
00:36:59,928 --> 00:37:01,796
ENVIRONMENTAL HEALTH AND ECOLOGY

867
00:37:01,796 --> 00:37:03,298
JOURNALS AND TEXTBOOK APPLIED

868
00:37:03,298 --> 00:37:04,232
STATISTICS FOR PUBLIC HEALTH

869
00:37:04,232 --> 00:37:07,369
DATA. OUR SECOND PRESENTATION IS

870
00:37:07,369 --> 00:37:08,970
SPATIAL EPIDEMIOLOGY AND

871
00:37:08,970 --> 00:37:09,871
GEOSPATIAL DATA SCIENCE IN

872
00:37:09,871 --> 00:37:13,375
OPIOID RELATED RESEARCH.  BY DR.

873
00:37:13,375 --> 00:37:15,343
SOME STOPKA Ph.D. MHS. DR.

874
00:37:15,343 --> 00:37:17,078
STOPKA IS EPIDEMIOLOGIST AND

875
00:37:17,078 --> 00:37:18,180
PROFESSOR WITH THE DEPARTMENT OF

876
00:37:18,180 --> 00:37:19,381
PUBLIC HEALTH AND COMMUNITY

877
00:37:19,381 --> 00:37:20,882
MEDICINE AT THE TUFTS UNIVERSITY

878
00:37:20,882 --> 00:37:23,218
SCHOOL OF O MEDICINE. DR. STOPKA

879
00:37:23,218 --> 00:37:25,120
IS CURRENT MIXED METHODS

880
00:37:25,120 --> 00:37:26,254
RESEARCH FOCUSES ON INTERSECTION

881
00:37:26,254 --> 00:37:29,191
OF SUBSTANCE USE, OPIOID

882
00:37:29,191 --> 00:37:30,992
OVERDOSE AND INFECTIOUS DISEASE.

883
00:37:30,992 --> 00:37:34,629
HE EMPLOYS GIS SPATIAL

884
00:37:34,629 --> 00:37:35,864
QUALITATIVE AND BIOSTATISTICAL

885
00:37:35,864 --> 00:37:37,465
APPROACHES TO MULTI-SITE

886
00:37:37,465 --> 00:37:39,634
INTERDISCIPLINARY STUDIES AN

887
00:37:39,634 --> 00:37:42,470
PUBLIC HEALTH INTERVENTIONS TO

888
00:37:42,470 --> 00:37:43,905
UNDERSTAND OPIOID MORTALITY AND

889
00:37:43,905 --> 00:37:46,107
MORALED. MPI ON FOUR CLINICAL

890
00:37:46,107 --> 00:37:47,642
TRIALS AND OBSERVATIONAL STUDIES

891
00:37:47,642 --> 00:37:52,013
FUNDED BY NIH, CDC AND SAMHSA.

892
00:37:52,013 --> 00:37:53,748
HE IS CO-CHAIR OF THE TUFTS

893
00:37:53,748 --> 00:37:55,483
RESEARCH CLUSTER ON EQUITY AND

894
00:37:55,483 --> 00:37:56,518
HEALTH WEALTH AND CIVIC

895
00:37:56,518 --> 00:37:57,719
ENGAGEMENT AND CO-CHAIR PUBLIC

896
00:37:57,719 --> 00:38:00,222
HEALTH COMMUNITY MEDICINE

897
00:38:00,222 --> 00:38:00,855
DEPARTMENTAL RESEARCH COMMITTEE

898
00:38:00,855 --> 00:38:02,257
AT TUFTS.  HE TEACHES COURSES IN

899
00:38:02,257 --> 00:38:04,726
G IS AND SPECIAL EPIDEMIOLOGY,

900
00:38:04,726 --> 00:38:06,628
RESEARCH METHODS PUBLIC HEALTH

901
00:38:06,628 --> 00:38:09,698
AND EPIDEMIOLOGY. ENJOYS

902
00:38:09,698 --> 00:38:10,632
MENTORING RESEARCH ASSISTANTS

903
00:38:10,632 --> 00:38:12,300
POST-DOCTORAL FELLOWS AND

904
00:38:12,300 --> 00:38:14,669
FACULTY. NOW I WILL HAND THE

905
00:38:14,669 --> 00:38:15,870
PRESENTATION OFF TO CAPABLE

906
00:38:15,870 --> 00:38:17,072
HANDS OF DR. WAHLER, THANK YOU

907
00:38:17,072 --> 00:38:23,211
SO MUCH. DR. WALLER, THANK YOU

908
00:38:23,211 --> 00:38:23,511
SO MUCH.

909
00:38:23,511 --> 00:38:25,513
>> THANKS TO THE
ORGANIZERS FOR

910
00:38:25,513 --> 00:38:27,449
THIS WORKSHOP. I NOTICED MY

911
00:38:27,449 --> 00:38:29,918
SLIDES THE SMALLER ESTIMATION IS

912
00:38:29,918 --> 00:38:31,553
IN A SMALLER FONT SO I GUESS

913
00:38:31,553 --> 00:38:33,388
THAT'S A LITTLE BIT OF AN EASTER

914
00:38:33,388 --> 00:38:37,859
EGG TO START THINGS OFF. THIS IS

915
00:38:37,859 --> 00:38:40,295
JOIN WORK WITH (INDISCERNIBLE)

916
00:38:40,295 --> 00:38:42,330
HANNAH COOPER AND JANET

917
00:38:42,330 --> 00:38:42,998
CUMMINGS, SOMETIME BEFORE THE

918
00:38:42,998 --> 00:38:43,999
PANDEMIC. THIS WAS A PROJECT WE

919
00:38:43,999 --> 00:38:45,567
WERE WRITING UP AS THE PANDEMIC

920
00:38:45,567 --> 00:38:46,801
HIT AND IT'S BEEN ON THE BACK

921
00:38:46,801 --> 00:38:48,803
BURNER SO I WANT TO BRING THIS

922
00:38:48,803 --> 00:38:50,505
BACK UP AND WHAT I WILL TALK

923
00:38:50,505 --> 00:38:52,507
ABOUT ARE QUESTIONS AND ANSWERS

924
00:38:52,507 --> 00:38:55,410
THAT WE DO WITH GEOSPATIAL DATA

925
00:38:55,410 --> 00:38:56,978
AND GEOSPATIAL ANALYSES, NOT

926
00:38:56,978 --> 00:38:58,079
JUST WHERE IS THE HIGHEST RATE

927
00:38:58,079 --> 00:38:59,981
OR WHERE THE ASSOCIATIONS AND

928
00:38:59,981 --> 00:39:02,450
HOW ASSOCIATIONS CHANGE BUT MORE

929
00:39:02,450 --> 00:39:03,718
HOW DO YOU THINK ABOUT PROBLEMS

930
00:39:03,718 --> 00:39:07,422
LIKE THIS. AND WE WILL USE

931
00:39:07,422 --> 00:39:08,356
OPIOID OVERDOSE MORTALITY

932
00:39:08,356 --> 00:39:09,691
STATISTICS AND THINK ABOUT WHERE

933
00:39:09,691 --> 00:39:11,960
THESE CAME, WHAT ARE WE SEEING

934
00:39:11,960 --> 00:39:13,728
GEOGRAPHIC PATTERNS OF? THERE'S

935
00:39:13,728 --> 00:39:15,263
THE ACTUAL OUTCOME WE ARE

936
00:39:15,263 --> 00:39:16,298
INTERESTED IN BUT ALSO

937
00:39:16,298 --> 00:39:18,199
GEOGRAPHIC PATTERNS HOW DATA ARE

938
00:39:18,199 --> 00:39:19,668
COLLECTED AND ACCESSED THAT I

939
00:39:19,668 --> 00:39:21,569
WANT TO ADDRESS. SO WHAT DATA DO

940
00:39:21,569 --> 00:39:24,139
WE NEED TO ANSWER QUESTIONS,

941
00:39:24,139 --> 00:39:27,008
WHAT DATA DO WE WANT. BECAUSE --

942
00:39:27,008 --> 00:39:28,810
WHAT DATA CAN WE ACTUALLY SEE,

943
00:39:28,810 --> 00:39:29,911
WHAT QUESTIONS CAN WE ANSWER

944
00:39:29,911 --> 00:39:30,979
WITH THE DATA WE HAVE IN THE

945
00:39:30,979 --> 00:39:32,847
METHODS AND WHAT PATTERNS AND

946
00:39:32,847 --> 00:39:35,984
WHY, WHY ARE THESE THINGS

947
00:39:35,984 --> 00:39:40,021
HAPPENING? SO A LONG TIME AGO A

948
00:39:40,021 --> 00:39:43,058
TOXICOLOGIST EPA REGION 4 IN

949
00:39:43,058 --> 00:39:43,825
ATLANTA DREW THIS PICTURE FOR ME

950
00:39:43,825 --> 00:39:45,994
AND I HAVE BEEN USING IT IN MY

951
00:39:45,994 --> 00:39:48,797
GIS CLASS FOR 25 YEARS NOW. SO

952
00:39:48,797 --> 00:39:50,332
WE START UPPER LEFT, THIS IS A

953
00:39:50,332 --> 00:39:52,200
SCIENTIFIC PROCESS BUT IT'S IN A

954
00:39:52,200 --> 00:39:54,269
CIRCLE SO WE HAVE A QUESTION TO

955
00:39:54,269 --> 00:39:56,304
ANSWER BOX ONE, WE CAN THINK

956
00:39:56,304 --> 00:39:57,739
ABOUT BEFORE WE COLLECT DATA OR

957
00:39:57,739 --> 00:39:59,474
SEEK OUT DATA WHAT DATA WOULD BE

958
00:39:59,474 --> 00:40:01,343
THE PERFECT DATA FOR THIS, WHAT

959
00:40:01,343 --> 00:40:02,911
DATA AND METHODS ANSWER THAT

960
00:40:02,911 --> 00:40:04,279
QUESTION ONCE AND FOR ALL? BUT

961
00:40:04,279 --> 00:40:06,081
WE NEVER GET TO SEE EVERYTHING

962
00:40:06,081 --> 00:40:07,816
WE LIKE TO IN GEOSPATIAL DATA

963
00:40:07,816 --> 00:40:08,917
EVEN THOUGH WE HAVE SEEN A LOT

964
00:40:08,917 --> 00:40:12,287
OF EXAMPLES OF THE GREAT

965
00:40:12,287 --> 00:40:13,688
ADVANCES IN DATA ACCESSIBILITY

966
00:40:13,688 --> 00:40:16,124
WE HARDLY EVER SEE EXACTLY WHAT

967
00:40:16,124 --> 00:40:17,559
WE WANT. SO THERE'S DATA WE CAN

968
00:40:17,559 --> 00:40:19,361
GET AND THERE'S METHODS AN TOOLS

969
00:40:19,361 --> 00:40:21,696
WE HAVE AVAILABLE, THOSE ALLOW

970
00:40:21,696 --> 00:40:23,665
US TO MOVE TO BOX 4, THE

971
00:40:23,665 --> 00:40:24,499
QUESTIONS WE CAN ANSWER WITH THE

972
00:40:24,499 --> 00:40:26,835
DATA AND METHODS WE HAVE AND THE

973
00:40:26,835 --> 00:40:27,969
REALLY IMPORTANT PART HOW CLOSE

974
00:40:27,969 --> 00:40:29,070
ARE ARE THE QUESTIONS WE DID

975
00:40:29,070 --> 00:40:31,806
ANSWER IN BOX 4 TO QUESTION WE

976
00:40:31,806 --> 00:40:34,509
WANTED TO ANSWER IN BOX 1.

977
00:40:34,509 --> 00:40:36,211
STUDENTS ASK HOW DO WE KNOW WHEN

978
00:40:36,211 --> 00:40:37,645
WE ARE DONE IN THIS CIRCLE AND

979
00:40:37,645 --> 00:40:39,314
THE ANSWER IS WE ARE NO SINGLE

980
00:40:39,314 --> 00:40:40,115
STUDY WILL ANSWER THE QUESTION

981
00:40:40,115 --> 00:40:42,217
ONCE AND FOR ALL, THE REAL GOAL

982
00:40:42,217 --> 00:40:44,853
IS CAN WE LEARN MORE BY GOING

983
00:40:44,853 --> 00:40:47,422
AROUND THIS DATA ANALYSIS, THAN

984
00:40:47,422 --> 00:40:48,723
CAN WE LEARN MORE THAN WE KNEW

985
00:40:48,723 --> 00:40:51,126
WHEN WE STARTED? THAT'S THE

986
00:40:51,126 --> 00:40:52,327
SWIRLING VORTEX.  WE WILL KEEP

987
00:40:52,327 --> 00:40:56,464
GOING AROUND THAT. SO THE

988
00:40:56,464 --> 00:40:57,766
QUESTIONS YOU MIGHT WANT TO

989
00:40:57,766 --> 00:40:59,234
ANSWER HERE IN SOME OF THE

990
00:40:59,234 --> 00:41:01,870
SUBSTANCE USE DISORDER ARE THE

991
00:41:01,870 --> 00:41:07,041
OUTCOMES, OUTCOMES MIGHT BE

992
00:41:07,041 --> 00:41:07,876
MORTALITY, MORBIDITY, MIGHT BE

993
00:41:07,876 --> 00:41:09,778
USE, WHAT POPULATION AT RISK AND

994
00:41:09,778 --> 00:41:11,946
IF WE ARE USING CENSUS DATA WE

995
00:41:11,946 --> 00:41:13,381
ARE THINKING EVERYONE IS AT

996
00:41:13,381 --> 00:41:15,517
RISK, THAT MIGHT NOT BE, MIGHT

997
00:41:15,517 --> 00:41:19,187
NOT ALL BE EQUALLY AT RISK. 

998
00:41:19,187 --> 00:41:20,488
SALES, WHERE IS THE -- WHERE ARE

999
00:41:20,488 --> 00:41:23,291
THE SUBSTANCES BEING DRIBD?  WHO

1000
00:41:23,291 --> 00:41:24,993
BEING ARREST AND WHERE? --

1001
00:41:24,993 --> 00:41:28,062
DISTRIBUTED, WHO IS ARRESTED AND

1002
00:41:28,062 --> 00:41:29,197
WHERE? WHERE IS TREATMENT

1003
00:41:29,197 --> 00:41:30,532
AVAILABLE AND WHO HAS ACCESS TO

1004
00:41:30,532 --> 00:41:31,866
IT? WHAT ARE THE RISK FACTORS WE

1005
00:41:31,866 --> 00:41:34,536
HAVE BEEN DISCUSSING SOME OF THE

1006
00:41:34,536 --> 00:41:35,437
SOCIAL DETERMINANTS FACTORS AND

1007
00:41:35,437 --> 00:41:37,439
THE INDIVIDUAL FACTORS AND

1008
00:41:37,439 --> 00:41:39,541
INSIDE THE INDIVIDUAL FACTORS.

1009
00:41:39,541 --> 00:41:42,444
WHAT ARE RESILIENCY FACTOR, YOU

1010
00:41:42,444 --> 00:41:44,245
TAKE THE SAME INDIVIDUAL AND PUT

1011
00:41:44,245 --> 00:41:45,680
THEM IN DIFFERENT SOCIAL

1012
00:41:45,680 --> 00:41:46,915
ENVIRONMENTS, THEY MAY WELL

1013
00:41:46,915 --> 00:41:48,483
RESPOND TO A STIMULUS OR

1014
00:41:48,483 --> 00:41:50,785
EXPOSURE IN DIFFERENT WAYS. WHAT

1015
00:41:50,785 --> 00:41:52,053
SCALE ARE THESE RESILIENCY

1016
00:41:52,053 --> 00:41:54,389
FACTORS OCCURRING? IS IT THE

1017
00:41:54,389 --> 00:41:55,490
INDIVIDUAL? IS IT SOMETHING WE

1018
00:41:55,490 --> 00:41:57,025
CAN TRAIN INDIVIDUALS WITH, IS

1019
00:41:57,025 --> 00:41:59,594
IT NEIGHBORHOOD, COMMUNITIES,

1020
00:41:59,594 --> 00:42:01,062
STATE LEVEL, IS IT A COMBINATION

1021
00:42:01,062 --> 00:42:02,897
OF ALL THESE? ALL THESE

1022
00:42:02,897 --> 00:42:04,032
INTERACT. AND SOCIAL

1023
00:42:04,032 --> 00:42:05,667
DETERMINANTS OF HEALTH WE HAVE

1024
00:42:05,667 --> 00:42:06,434
BEEN TALKING ABOUT AND SOCIAL

1025
00:42:06,434 --> 00:42:08,303
DETERMINANTS OF RISK I THINK

1026
00:42:08,303 --> 00:42:10,004
PLAY A LARGE ROLE IN THIS. EVEN

1027
00:42:10,004 --> 00:42:13,675
THOUGH AS WE WERE DISCUSSING THE

1028
00:42:13,675 --> 00:42:15,610
LONG HISTORY OF SEEING ADDICTION

1029
00:42:15,610 --> 00:42:17,479
AS A MENTAL PROCESS, BUT THAT

1030
00:42:17,479 --> 00:42:19,447
CAN BE INFLUENCED BY THE SOCIAL

1031
00:42:19,447 --> 00:42:21,649
ENVIRONMENT. SO THIS IS A

1032
00:42:21,649 --> 00:42:23,384
DIAGRAM THAT I FIND HELPFUL.

1033
00:42:23,384 --> 00:42:25,186
WHAT DO WE GET TO SEE? I WORK

1034
00:42:25,186 --> 00:42:26,654
WITH PEOPLE IN DISEASE ECOLOGY

1035
00:42:26,654 --> 00:42:28,790
WHAT WE ARE LOOKING A ONE HEALTH

1036
00:42:28,790 --> 00:42:30,225
ENVIRONMENT WITH PATHOGENS AN

1037
00:42:30,225 --> 00:42:32,594
VECTORS AN ANIMALS AND PEOPLE

1038
00:42:32,594 --> 00:42:33,495
INTERACTING BUT WE CAN THINK

1039
00:42:33,495 --> 00:42:35,697
ABOUT THIS IN SUBSTANCE USE AS

1040
00:42:35,697 --> 00:42:36,831
WELL. IF EACH ONE OF THESE

1041
00:42:36,831 --> 00:42:39,234
SHAPES IS A MAP, AND WE START ON

1042
00:42:39,234 --> 00:42:41,603
THE LEFT, WE MIGHT HAVE A MAP OF

1043
00:42:41,603 --> 00:42:42,871
THE SUBSTANCE DISTRIBUTION, A

1044
00:42:42,871 --> 00:42:45,340
MAP OF SOCIAL SUPPORT, A MAP OF

1045
00:42:45,340 --> 00:42:47,242
LAW ENFORCEMENT, A MAP OF THE

1046
00:42:47,242 --> 00:42:49,043
SOCIAL ENVIRONMENT, ALL THESE

1047
00:42:49,043 --> 00:42:50,845
INTERACT TOGETHER AS INDIVIDUALS

1048
00:42:50,845 --> 00:42:52,747
LIVE AND WORK AND MOVE AROUND

1049
00:42:52,747 --> 00:42:54,182
AND THEY GENERATE THE MAP WITH

1050
00:42:54,182 --> 00:42:55,583
THE DOTS AROUND IT IN THE MIDDLE

1051
00:42:55,583 --> 00:42:56,651
WHICH IS REALLY LIKE TO SEE,

1052
00:42:56,651 --> 00:42:58,520
THIS IS THE MAP WHERE THE

1053
00:42:58,520 --> 00:42:59,854
OUTCOMES OF INTEREST ARE REALLY

1054
00:42:59,854 --> 00:43:01,589
HAPPENING, WHETHER INCREASED

1055
00:43:01,589 --> 00:43:05,493
RISK OR EXPOSURE, OR DEATH, OR

1056
00:43:05,493 --> 00:43:07,295
TREATMENT ACCESS, THERE IS A MAP

1057
00:43:07,295 --> 00:43:09,197
WE REALLY LIKE TO SEE THAT WE

1058
00:43:09,197 --> 00:43:10,832
DON'T GET TO SEE BECAUSE EVENTS

1059
00:43:10,832 --> 00:43:12,500
THERE NEED TO BE DETECTED, THEY

1060
00:43:12,500 --> 00:43:14,302
MOVE TO THE RIGHT THROUGH A

1061
00:43:14,302 --> 00:43:16,204
FILTER THAT IS ALSO A MAP ITSELF

1062
00:43:16,204 --> 00:43:18,473
IN BETWEEN THESE TWO MAPS. SOME

1063
00:43:18,473 --> 00:43:19,741
PLACES AN EVENT OCCURS IN THE

1064
00:43:19,741 --> 00:43:22,744
TRUE MAP AND GETS DETECTED RIGHT

1065
00:43:22,744 --> 00:43:23,978
AWAY. SO A DEATH MIGHT OCCUR AND

1066
00:43:23,978 --> 00:43:26,114
MIGHT BE CLEAR THAT IT'S AN

1067
00:43:26,114 --> 00:43:31,319
OVERDOSE DUE TO PARTICULAR

1068
00:43:31,319 --> 00:43:33,221
SUBSTANCE AND THAT GETS RIGHT IN

1069
00:43:33,221 --> 00:43:34,556
THERE DETECTED BUT IT MIGHT BE

1070
00:43:34,556 --> 00:43:36,758
THAT THE OVERDOSE IS HIDDEN

1071
00:43:36,758 --> 00:43:38,660
BECAUSE IT WAS INVOLVED IN A CAR

1072
00:43:38,660 --> 00:43:39,694
ACCIDENT AND THAT DOESN'T GET

1073
00:43:39,694 --> 00:43:41,896
REPORTED.  SO WE HAVE DETECTING

1074
00:43:41,896 --> 00:43:43,464
THE EVENT, WE HAVE THE REPORTING

1075
00:43:43,464 --> 00:43:44,866
EVENT TO GET O THE FINAL DATA

1076
00:43:44,866 --> 00:43:48,403
SET THAT IS AVAILABLE PERHAPS

1077
00:43:48,403 --> 00:43:49,203
THROUGH FAIR STANDARDS, AND WE

1078
00:43:49,203 --> 00:43:51,105
IN PUBLIC HEALTH WE START ON THE

1079
00:43:51,105 --> 00:43:52,106
RIGHT HAND SIDE WHAT DATA ARE

1080
00:43:52,106 --> 00:43:53,508
AVAILABLE AND TRY TO BACK INTO

1081
00:43:53,508 --> 00:43:56,344
THE MIDDLE. AND WITH SOME OF THE

1082
00:43:56,344 --> 00:43:57,946
INDIVIDUAL BASED MODELS AGENT

1083
00:43:57,946 --> 00:44:00,982
BASED MODELS, DYNAMIC SYSTEMS,

1084
00:44:00,982 --> 00:44:03,351
SIR TYPE MODELS WE ARE FAMILIAR

1085
00:44:03,351 --> 00:44:04,385
WITH FROM COVID WE MIGHT START

1086
00:44:04,385 --> 00:44:05,920
ON THE LEFT WITH WHAT KIND OF

1087
00:44:05,920 --> 00:44:07,021
ENVIRONMENT ARE YOU IN, WHAT

1088
00:44:07,021 --> 00:44:09,123
SORT OF RISK WOULD THAT GROW. SO

1089
00:44:09,123 --> 00:44:10,992
ANYWHERE ALONG THIS CONTINUUM

1090
00:44:10,992 --> 00:44:12,994
THERE ARE SPATIAL AND GEOSPATIAL

1091
00:44:12,994 --> 00:44:16,264
ASPECTS AND SOME OF THE DATA

1092
00:44:16,264 --> 00:44:17,799
AVAILABLE AT DIFFERENT

1093
00:44:17,799 --> 00:44:19,867
RESOLUTIONS.  SO I FIND THIS,

1094
00:44:19,867 --> 00:44:21,569
THIS IS USUALLY FIGURE ONE IN

1095
00:44:21,569 --> 00:44:23,471
MOST OF MY GRANT PROPOSALS SO

1096
00:44:23,471 --> 00:44:25,506
FOR THOSE OF YOU WHO REVIEWED

1097
00:44:25,506 --> 00:44:27,241
THEM MAY HAVE SEEN THIS BEFORE.

1098
00:44:27,241 --> 00:44:28,743
ALSO THINKING WHAT ARE

1099
00:44:28,743 --> 00:44:30,378
GEOSPATIAL METHODS, I'M LOOKING

1100
00:44:30,378 --> 00:44:34,282
AT THE INTERSECTION OF

1101
00:44:34,282 --> 00:44:35,249
STATISTICAL SCIENCE, GEOGRAPHIC

1102
00:44:35,249 --> 00:44:36,985
INFORMATION SCIENCE AND THE DATA

1103
00:44:36,985 --> 00:44:38,686
SCIENCE HERE. PUTTING THE

1104
00:44:38,686 --> 00:44:41,990
INTERSECTION IS GEOANALYTIANALYO

1105
00:44:41,990 --> 00:44:43,458
THOSE MIGHT BE METHODS USED TO

1106
00:44:43,458 --> 00:44:44,959
DO GEOSPATIAL ANALYSIS AND WE

1107
00:44:44,959 --> 00:44:47,128
MIGHT HAVE ANALYTICS AT THE

1108
00:44:47,128 --> 00:44:48,262
INTERSECTION OF DATA SCIENCE,

1109
00:44:48,262 --> 00:44:48,963
STATISTICAL SCIENCE, DOESN'T

1110
00:44:48,963 --> 00:44:51,633
HAVE THE GEOGRAPHY PIECE, LOOK

1111
00:44:51,633 --> 00:44:53,301
AT SOCIAL MEDIA TRENDS AND SO ON

1112
00:44:53,301 --> 00:44:54,435
BUT ONCE GEOTAGGED NOW WE ARE

1113
00:44:54,435 --> 00:44:56,504
MOVING TO A JOG IN THIS CASE

1114
00:44:56,504 --> 00:44:57,605
INFORMATION SYSTEM, WE HAVE

1115
00:44:57,605 --> 00:44:59,507
LOCATION BASED SERVICES WE MIGHT

1116
00:44:59,507 --> 00:45:01,676
MOVE TOWARD THE MIDDLE WHEN

1117
00:45:01,676 --> 00:45:04,178
DOING ANALYTICS. SIMILARLY GI

1118
00:45:04,178 --> 00:45:06,914
SCIENCE SIDE WE MIGHT HAVE

1119
00:45:06,914 --> 00:45:08,983
GEODEMOGRAPHICS. WHERE PEOPLE

1120
00:45:08,983 --> 00:45:10,184
LIVE, WHO DOES THE RACIAL AND

1121
00:45:10,184 --> 00:45:11,552
SOCIOECONOMIC STRUCTURE

1122
00:45:11,552 --> 00:45:12,186
NEIGHBORHOODS CHANGE? AND THAT

1123
00:45:12,186 --> 00:45:14,122
CAN BE PULLED INTO STATISTICAL

1124
00:45:14,122 --> 00:45:17,792
SCIENCE AS WELL.  ON THE

1125
00:45:17,792 --> 00:45:20,561
STATISTICAL SCIENCE PIECE, WE

1126
00:45:20,561 --> 00:45:21,796
MIGHT HAVE SOME OF THE THINGS

1127
00:45:21,796 --> 00:45:22,930
FAMILIAR WITH LIKE DIFFERENT

1128
00:45:22,930 --> 00:45:24,632
TYPES OF REGRESSION,

1129
00:45:24,632 --> 00:45:25,833
SENSITIVITY, SPECIFICITY AND

1130
00:45:25,833 --> 00:45:27,368
POWER, BUT IN A GEOSPATIAL, WHAT

1131
00:45:27,368 --> 00:45:31,039
IF THE POWER TO DECK AN EFFECT

1132
00:45:31,039 --> 00:45:35,543
IS INCREASING A CERTAIN LOCATION

1133
00:45:35,543 --> 00:45:37,178
AND THEN WE PUT DATA SCIENCE IN

1134
00:45:37,178 --> 00:45:38,546
THERE, WE CAN GET GEOGRAPHIC

1135
00:45:38,546 --> 00:45:39,981
ANALYTICS. NOT SURE WHO IS

1136
00:45:39,981 --> 00:45:41,883
SNORING BUT I SEEM TO HAVE PUT

1137
00:45:41,883 --> 00:45:44,185
SOMEBODY TO SLEEP. SO IF WE CAN

1138
00:45:44,185 --> 00:45:45,687
CHECK WHO IS MUTED OR NOT. 

1139
00:45:45,687 --> 00:45:49,624
THANKS. SO WHAT DATA CAN WE SEE?

1140
00:45:49,624 --> 00:45:51,759
FROM A PUBLIC HEALTH

1141
00:45:51,759 --> 00:45:53,261
SURVEILLANCE PERSPECTIVE YOU

1142
00:45:53,261 --> 00:45:54,729
MEMBER PUBLIC HEALTH

1143
00:45:54,729 --> 00:45:59,333
SURVEILLANCE YOU SAW BACK DURING

1144
00:45:59,333 --> 00:46:01,235
COVID BUT THIS GOES BACK TO

1145
00:46:01,235 --> 00:46:03,004
REPORTABLE DEI AND WE BILL A

1146
00:46:03,004 --> 00:46:03,871
SURVEILLANCE SYSTEM FROM

1147
00:46:03,871 --> 00:46:04,939
EXISTING DATA SOURCES THAT MIGHT

1148
00:46:04,939 --> 00:46:06,507
BE BASED ON MORTALITY, MIGHT BE

1149
00:46:06,507 --> 00:46:08,943
BASED ON COMMUNITY MEASURES, WE

1150
00:46:08,943 --> 00:46:11,579
WILL TALK ABOUT VULNERABILITY

1151
00:46:11,579 --> 00:46:13,381
INDICES IN A MOMENTMENT ALSO

1152
00:46:13,381 --> 00:46:14,582
FROM LAW ENFORCEMENT, THOSE WHO

1153
00:46:14,582 --> 00:46:16,484
WORKED WITH SUBSTANCE USE HAVE

1154
00:46:16,484 --> 00:46:20,521
SEEN ARRESTS RECORDS, MEDICAL

1155
00:46:20,521 --> 00:46:22,957
RECORDS, ELECTRONIC MEDICAL

1156
00:46:22,957 --> 00:46:23,725
RECORDS MENTIONED, EMERGENCY

1157
00:46:23,725 --> 00:46:26,327
RESPONSE DATA, WHERE DID EMS

1158
00:46:26,327 --> 00:46:27,795
CALLS COME FROM, AND TREATMENT,

1159
00:46:27,795 --> 00:46:30,531
TREATMENT ACCESS, TREATMENT

1160
00:46:30,531 --> 00:46:31,899
LOCATION, TREATMENT UPTAKE. ALL

1161
00:46:31,899 --> 00:46:33,034
THESE HAVE DIFFERENT PATTERNS

1162
00:46:33,034 --> 00:46:34,669
BUT NONE ARE SORT OF SIMPLE

1163
00:46:34,669 --> 00:46:36,270
RANDOM SAMPLES OF SPACE AND GIVE

1164
00:46:36,270 --> 00:46:38,272
US A CLEAR PICTURE OF THINGS.

1165
00:46:38,272 --> 00:46:41,175
THEY ARE ALL GATHERED FOR

1166
00:46:41,175 --> 00:46:42,376
DIFFERENT REASONS THAN WE USE

1167
00:46:42,376 --> 00:46:44,045
THEM FOR SO PUTTING TOGETHER WE

1168
00:46:44,045 --> 00:46:46,447
NEED TO UNDERSTAND THE REPORTING

1169
00:46:46,447 --> 00:46:48,516
AND DETECTION FILTERS. LAW

1170
00:46:48,516 --> 00:46:50,818
ENFORCEMENT IS AN IMPORTANT ONE

1171
00:46:50,818 --> 00:46:52,420
IN THAT THERE IS A LOT OF

1172
00:46:52,420 --> 00:46:54,589
LITERATURE ON WHO IS BEING

1173
00:46:54,589 --> 00:46:56,824
CHECKED FOR SUBSTANCE USE,

1174
00:46:56,824 --> 00:46:58,860
SALES, WHERE IS INCARCERATION,

1175
00:46:58,860 --> 00:47:04,532
WHERE ARE LAWS ENFORCED. SO WHAT

1176
00:47:04,532 --> 00:47:06,400
QUESTIONS CAN WE GIN TO ANSWER?

1177
00:47:06,400 --> 00:47:09,737
-- BEGIN TO ANSWER, THE GOAL OF

1178
00:47:09,737 --> 00:47:12,240
MORTALITY, WHAT ARE THE GOALS OF

1179
00:47:12,240 --> 00:47:13,508
MORTALITY, RATES HIGHER OR LOWER

1180
00:47:13,508 --> 00:47:15,309
BUT ALSO PATTERNS OF REPORTING. 

1181
00:47:15,309 --> 00:47:16,644
HOW THINGS GET INTO THE DATA

1182
00:47:16,644 --> 00:47:18,513
SETS WE USE? AND THIS TYPE OF

1183
00:47:18,513 --> 00:47:21,115
EPIDEMIOLOGY REPORTING IS ALSO

1184
00:47:21,115 --> 00:47:22,817
REALLY INTERESTING AND IMPORTANT

1185
00:47:22,817 --> 00:47:23,951
UNDERSTANDING OF THOSE FILTERS.

1186
00:47:23,951 --> 00:47:26,220
SO THERE'S PATTERNS OF RISK

1187
00:47:26,220 --> 00:47:27,889
FACTORS ABOUT WE MIGHT COMPARE

1188
00:47:27,889 --> 00:47:29,490
DATA SCIENCE PERSPECTIVE WHERE

1189
00:47:29,490 --> 00:47:31,626
YOU USE LARGE MACHINE LEARNING

1190
00:47:31,626 --> 00:47:35,663
ALGORITHM ON HUNDREDS AND

1191
00:47:35,663 --> 00:47:36,597
HUNDREDS OF VARIABLES OR

1192
00:47:36,597 --> 00:47:37,498
TRADITIONAL VARIABLE SELECTION

1193
00:47:37,498 --> 00:47:40,268
FROM THE OLDEN DAYS WHEN WE DID

1194
00:47:40,268 --> 00:47:41,903
STATISTICS THIS WAY, AND I WANT

1195
00:47:41,903 --> 00:47:44,806
TO BRING UP SOME OF THIS WHEN WE

1196
00:47:44,806 --> 00:47:46,140
TALK ABOUT SOCIAL VULNERABILITY

1197
00:47:46,140 --> 00:47:48,009
AND DISEASE IN A MOMENT. ALSO I

1198
00:47:48,009 --> 00:47:50,645
MENTION RESILIENCY, THIS TERM

1199
00:47:50,645 --> 00:47:52,213
COMES UP FROM TIME TO TIME, WHAT

1200
00:47:52,213 --> 00:47:54,015
IS IF AN INDIVIDUAL IS IN A

1201
00:47:54,015 --> 00:47:56,050
SUPPORTIVE VERSUS NOT SUPPORT TV

1202
00:47:56,050 --> 00:47:57,318
ENVIRONMENT, JUST TREAT EXPOSURE

1203
00:47:57,318 --> 00:48:00,955
TO RESILIENCY ANOTHER RISK

1204
00:48:00,955 --> 00:48:02,156
FACTORS ONE WE HOPE A NEGATIVE

1205
00:48:02,156 --> 00:48:03,858
IMPACT THAT REDUCES THE RISK AND

1206
00:48:03,858 --> 00:48:04,859
WE SHOULD THINK HOW THINGS

1207
00:48:04,859 --> 00:48:07,528
INTERACT WHEN IT COMES TO

1208
00:48:07,528 --> 00:48:08,696
REPORTING OR REPORTING INTERACT

1209
00:48:08,696 --> 00:48:10,464
WITH MORTALITY, CORRELATING WITH

1210
00:48:10,464 --> 00:48:11,799
MORTALITY? INDEPENDENT? WHAT

1211
00:48:11,799 --> 00:48:13,234
CONFOUNDING ARE WE GOING TO

1212
00:48:13,234 --> 00:48:14,869
HAVE? WHAT AFFECT MODIFICATION,

1213
00:48:14,869 --> 00:48:16,337
HOW DOES CAUSATION WORK? WHAT DO

1214
00:48:16,337 --> 00:48:17,939
WE CARE ABOUT HERE WHEN WE ARE

1215
00:48:17,939 --> 00:48:19,841
REPORTING IT. SOMETIMES THE

1216
00:48:19,841 --> 00:48:22,176
CAUSAL INFERENCES PRIMARY

1217
00:48:22,176 --> 00:48:23,778
INTEREST. WHAT IS DRIVING THE

1218
00:48:23,778 --> 00:48:24,979
RESULT? BUT SOMETIMES I THINK

1219
00:48:24,979 --> 00:48:28,049
THE DESCRIPTIVE PART HAS BEEN

1220
00:48:28,049 --> 00:48:30,484
PLAYED DOWN IN NOT CAUSAL BUT

1221
00:48:30,484 --> 00:48:33,354
STILL IMPORTANT FOR ASSESSING

1222
00:48:33,354 --> 00:48:35,523
HOW WELL POLICY IMPLEMENTED IN A

1223
00:48:35,523 --> 00:48:37,859
CERTAIN LOCATION MIGHT INFLUENCE

1224
00:48:37,859 --> 00:48:42,730
THE PATTERNS OF RISKS AROUND IT 

1225
00:48:42,730 --> 00:48:44,232
SO IN TRENDS IN MORTALITY AND

1226
00:48:44,232 --> 00:48:46,067
REPORTING, THE WORK WE WERE

1227
00:48:46,067 --> 00:48:48,536
DOING BEFORE THE -- BEFORE COVID

1228
00:48:48,536 --> 00:48:50,004
WE WERE LOOKING AT NATIONAL

1229
00:48:50,004 --> 00:48:50,838
CENTER FOR HEALTH STATISTICS

1230
00:48:50,838 --> 00:48:53,474
MULTIPLE CAUSES OF DEATH DATA.

1231
00:48:53,474 --> 00:48:55,176
THIS INCLUDES UNDERLYING PRIMARY

1232
00:48:55,176 --> 00:48:58,045
AND ICD 9 CODE AND UP TO 20

1233
00:48:58,045 --> 00:48:58,980
CONTRIBUTING CAUSES ABOUT STATE

1234
00:48:58,980 --> 00:49:00,314
AND COUNTY OF RESIDENCE SO

1235
00:49:00,314 --> 00:49:01,849
LOOKING A SMALL AREA ESTIMATION

1236
00:49:01,849 --> 00:49:05,019
AT THE COUNTY LEVEL. DEFINE

1237
00:49:05,019 --> 00:49:07,455
OPIOID MORTALITY, USING THE 2018

1238
00:49:07,455 --> 00:49:09,857
GUIDANCE FROM THE CDC, THIS IS

1239
00:49:09,857 --> 00:49:12,159
UPDATE AD BIT, THE UNDERLYING

1240
00:49:12,159 --> 00:49:13,594
OVERDOSE DEATH COULD APPEAR IN

1241
00:49:13,594 --> 00:49:15,496
THREE DIFFERENT SETS OF CODES

1242
00:49:15,496 --> 00:49:18,432
THAT GO INTO THE DEATH

1243
00:49:18,432 --> 00:49:20,401
CERTIFICATE. UNINTENTIONAL AND

1244
00:49:20,401 --> 00:49:23,437
INTENTIONAL POISONINGS ARE THE X

1245
00:49:23,437 --> 00:49:25,406
CODES. OVERDOSE OF UNDETERMINED

1246
00:49:25,406 --> 00:49:27,441
INTENT WHERE YOU CAN TELL IF

1247
00:49:27,441 --> 00:49:29,777
INTENTIONAL OR NOT AND Y CODES

1248
00:49:29,777 --> 00:49:31,445
AND HOMICIDE BY DRUGS ARE X

1249
00:49:31,445 --> 00:49:33,080
CODES.  THESE ARE UNDERLYING

1250
00:49:33,080 --> 00:49:34,482
CAUSES OF DEATH BUT THERE IS

1251
00:49:34,482 --> 00:49:37,051
ALSO CONTRIBUTING CAUSES I

1252
00:49:37,051 --> 00:49:39,287
TALKED ABOUT THE AUTOMOBILE

1253
00:49:39,287 --> 00:49:39,787
ACCIDENT WITH UNDERLYING

1254
00:49:39,787 --> 00:49:43,224
OVERDOSE.  THISs ARE

1255
00:49:43,224 --> 00:49:46,394
CLASSIFIED BY DIFFERENT DRUGS,

1256
00:49:46,394 --> 00:49:48,796
FOR OPIOID WE WERE THINKING

1257
00:49:48,796 --> 00:49:53,668
TAKING THE CODES FOR OPIUM

1258
00:49:53,668 --> 00:49:54,835
HEROINE AND OTHER OPIOID

1259
00:49:54,835 --> 00:49:56,103
INCLUDED HERE AND UNSPECIFIED

1260
00:49:56,103 --> 00:49:58,205
NARCOTICS WHICH IS A T CODE AND

1261
00:49:58,205 --> 00:49:59,974
ANY OPIOID INCLUDING ALL SIX T

1262
00:49:59,974 --> 00:50:03,945
CODES.  SO THIS OVER-- OPIOID

1263
00:50:03,945 --> 00:50:05,413
OVERDOSE IS -- CAN BE RECORDED

1264
00:50:05,413 --> 00:50:08,115
MULTIPLE WAYS AND THE ANALYSTS

1265
00:50:08,115 --> 00:50:09,684
THE GEOSPATIAL ANALYST WILL MAKE

1266
00:50:09,684 --> 00:50:12,653
SOME DECISIONS HOW TO DO SO. 

1267
00:50:12,653 --> 00:50:15,222
THESE ARE OVERALL TRENDS, UP TO

1268
00:50:15,222 --> 00:50:17,391
2017, I KNOW WE ARE AWARE OF THE

1269
00:50:17,391 --> 00:50:18,392
LEVELING OFF AND SOME OF THE

1270
00:50:18,392 --> 00:50:19,860
DECREASE OF THIS BUT YOU CAN SEE

1271
00:50:19,860 --> 00:50:21,996
THE RISE OF FENTANYL AND

1272
00:50:21,996 --> 00:50:23,998
SYNTHETIC OPIOID IN BLUE LINE

1273
00:50:23,998 --> 00:50:27,535
STARTING HERE. THE PUBLIC HEALTH

1274
00:50:27,535 --> 00:50:31,205
EMERGENCY DECLARATION FOR OPIOID

1275
00:50:31,205 --> 00:50:36,577
OVERDOSE IS PRECEDED COVID

1276
00:50:36,577 --> 00:50:37,945
OUTBREAK. THAT MADE FEDERAL

1277
00:50:37,945 --> 00:50:39,513
FUNDS AVAILABLE TO STATES FOR

1278
00:50:39,513 --> 00:50:40,614
TRACKING. SOME OF THE VALUES

1279
00:50:40,614 --> 00:50:42,216
THAT GO UP NOW THERE IS

1280
00:50:42,216 --> 00:50:44,685
INCENTIVE FROM UNSPECIFIED

1281
00:50:44,685 --> 00:50:46,487
NARCOTIC TO DETERMINE WHETHER

1282
00:50:46,487 --> 00:50:48,656
OPIOID OR NO NOT. SOME OF THESE

1283
00:50:48,656 --> 00:50:50,558
WILL DRIVE PATTERN. SO WE SEE

1284
00:50:50,558 --> 00:50:52,259
PATTERNS OF TYPE OF OPIOID

1285
00:50:52,259 --> 00:50:53,594
AVAILABLE HERE, BUT WE ARE ALSO

1286
00:50:53,594 --> 00:50:56,630
LOOKING AT HERE IS THE OPIOID

1287
00:50:56,630 --> 00:50:58,466
MORTALITY TRENDS PRE-2017 BY

1288
00:50:58,466 --> 00:51:01,135
STATE AND TYPE. SO THERE IS 50

1289
00:51:01,135 --> 00:51:02,003
GRAY LINES HERE BUT IN ORDER TO

1290
00:51:02,003 --> 00:51:03,637
SEE WHAT IS GOING ON THE BLACK

1291
00:51:03,637 --> 00:51:05,673
LINE IS THE MEDIAN ACROSS ALL

1292
00:51:05,673 --> 00:51:07,775
THE STATES, THE RED LINE IS THE

1293
00:51:07,775 --> 00:51:08,776
MEDIAN OF THE TEN STATES WITH

1294
00:51:08,776 --> 00:51:11,312
THE HIGHEST OVERDOSE RATES SO WE

1295
00:51:11,312 --> 00:51:12,947
CAN SEE HEROINE BEING HIGHER IN

1296
00:51:12,947 --> 00:51:14,749
THOSE STATES. AND THE BLUE LINE

1297
00:51:14,749 --> 00:51:16,517
IS THE MEDIAN OF TEN STATES WITH

1298
00:51:16,517 --> 00:51:19,553
THE LOWEST REPORTED OVERDOSE

1299
00:51:19,553 --> 00:51:21,589
RATES.  THOSE ARE THE BLUE LINE

1300
00:51:21,589 --> 00:51:23,224
WE SEE HERE. SO FOR HEROINE IT

1301
00:51:23,224 --> 00:51:24,658
MIGHT BE WHAT WE EXPECT STATES

1302
00:51:24,658 --> 00:51:27,661
WITH HIGHEST OVERDOSE HAD HIGHER

1303
00:51:27,661 --> 00:51:30,364
HEROINE. METHADONE A LITTLE MORE

1304
00:51:30,364 --> 00:51:32,466
MIXED BAG.  OTHER SYNTHETIC

1305
00:51:32,466 --> 00:51:34,435
NARCOTICS THE HIGHEST OVERDOSE

1306
00:51:34,435 --> 00:51:37,204
RATES ALSO FASTERS INCREASE.  --

1307
00:51:37,204 --> 00:51:39,774
FASTEST INCREASE.  UNSPECIFIED

1308
00:51:39,774 --> 00:51:43,077
NARCOTICS IS GOING DOWN BUT SOME

1309
00:51:43,077 --> 00:51:45,513
REPORTING HAS GONE DOWN AS FEWER

1310
00:51:45,513 --> 00:51:47,448
OVERDOSE DEATHS ARE CLASSIFIED

1311
00:51:47,448 --> 00:51:48,516
UNSPECIFIED. AND IT IS FITTING

1312
00:51:48,516 --> 00:51:57,024
INTO THE CATEGORIES HERE. NOW

1313
00:51:57,024 --> 00:51:59,360
WHAT DEATH MIGHT BE HIDDEN? WHAT

1314
00:51:59,360 --> 00:52:01,062
AM I REPORTING FILTER AND HOW

1315
00:52:01,062 --> 00:52:02,063
THAT MIGHT CHANGE FROM LOCATION

1316
00:52:02,063 --> 00:52:05,199
TO LOCATION? OVERDOSES THAT ARE

1317
00:52:05,199 --> 00:52:07,601
RECORDED AS A CONTRIBUTORY CAUSE

1318
00:52:07,601 --> 00:52:09,036
BUT UNDERLYING CAUSE NOT

1319
00:52:09,036 --> 00:52:11,739
OVERDOSE, THIS MIGHT BE THE CAR

1320
00:52:11,739 --> 00:52:12,907
ACCIDENT EXAMPLE, THE UNDERLYING

1321
00:52:12,907 --> 00:52:14,341
CAUSE WOULD NOT INCLUDE ANY OF

1322
00:52:14,341 --> 00:52:16,310
THE X OR Y OVERDOSE CODES

1323
00:52:16,310 --> 00:52:19,213
BECAUSE IT IS NOT THE PRIMARY

1324
00:52:19,213 --> 00:52:22,049
CAUSE. BUT LIST OF UP TO 20

1325
00:52:22,049 --> 00:52:23,818
CONTRIBUTING CAUSES DOES INCLUDE

1326
00:52:23,818 --> 00:52:25,286
OVERDOSE.  WE MIGHT HAVE

1327
00:52:25,286 --> 00:52:26,854
OVERDOSE RECORDED AS PRIMARY

1328
00:52:26,854 --> 00:52:28,789
CAUSE OF DEATH BUT CONTRIBUTING

1329
00:52:28,789 --> 00:52:31,125
CODE LISTS ONLY UNSPECIFIED

1330
00:52:31,125 --> 00:52:33,260
DRUG. SO IT MIGHT NOT COME IN AS

1331
00:52:33,260 --> 00:52:36,097
A OPIOID OVERDOSE.  SOME

1332
00:52:36,097 --> 00:52:37,665
OVERDOSES MAYBE CODED AS OTHER

1333
00:52:37,665 --> 00:52:40,000
AND UNSPECIFIED DRUGS. NOT ALL

1334
00:52:40,000 --> 00:52:42,169
ARE OPIOID DEATHS BUT SOME MAY

1335
00:52:42,169 --> 00:52:43,838
BE SO CHRISTOPHER DID NICE WORK

1336
00:52:43,838 --> 00:52:45,339
ON THIS, CONTINUES TO DO NICE

1337
00:52:45,339 --> 00:52:47,341
WORK ON THIS. AND WHAT PATTERNS

1338
00:52:47,341 --> 00:52:48,476
HOW DOES THIS VARY

1339
00:52:48,476 --> 00:52:53,647
GEOGRAPHICALLY? SO I HAVE A

1340
00:52:53,647 --> 00:52:57,818
SLIDE THE GRAPH ON THE LEFT HAS

1341
00:52:57,818 --> 00:53:00,921
THE OVERDOSE WITH OPIOID

1342
00:53:00,921 --> 00:53:02,256
CONTRIBUTING AND THEN OVERDOSE

1343
00:53:02,256 --> 00:53:04,792
IS CONTRIBUTING. THE COMBINATION

1344
00:53:04,792 --> 00:53:06,260
BY STATE, MAP ON THE RIGHT HAS

1345
00:53:06,260 --> 00:53:08,796
THE 50 STATES LISTED AND THEN

1346
00:53:08,796 --> 00:53:11,398
THE BLUE REMEMBER IS THE LOWEST

1347
00:53:11,398 --> 00:53:12,566
OVERALL OVERDOSES BUT THOSE ARE

1348
00:53:12,566 --> 00:53:14,201
THE HIGHEST NUMBER OF DEATHS

1349
00:53:14,201 --> 00:53:15,636
THAT ARE POTENTIALLY MISSING. SO

1350
00:53:15,636 --> 00:53:19,540
WHAT I'M PLOTTING ON THE Y AXIS

1351
00:53:19,540 --> 00:53:20,941
HERE IS HOW MANY DEATHS FELL

1352
00:53:20,941 --> 00:53:24,445
INTO THE CATEGORY OF POTENTIALLY

1353
00:53:24,445 --> 00:53:25,779
MISSING OVERDOSE OPIOID

1354
00:53:25,779 --> 00:53:27,181
OVERDOSE? AND IN SOME OF THE

1355
00:53:27,181 --> 00:53:29,250
STATES WITH LOWEST TOTAL

1356
00:53:29,250 --> 00:53:31,218
OVERDOSES SO IT IS AN EXAMPLE

1357
00:53:31,218 --> 00:53:32,486
THAT THERE MAYBE MORE HIDDEN

1358
00:53:32,486 --> 00:53:34,355
VALUES THERE, IN THE LOW RATES

1359
00:53:34,355 --> 00:53:35,756
THAN HIGH RATES.  SO THE RED

1360
00:53:35,756 --> 00:53:39,193
LINE IS THE LOWEST.  AND I KNOW

1361
00:53:39,193 --> 00:53:41,061
THIS IS A -- IT TOOK ME A WHILE

1362
00:53:41,061 --> 00:53:43,631
TO GO THROUGH THESE AGAIN, TO BE

1363
00:53:43,631 --> 00:53:45,399
ABLE TO EXPLAIN IT BUT WHAT THE

1364
00:53:45,399 --> 00:53:48,068
PATTERN WE ARE SEEING IN THIS

1365
00:53:48,068 --> 00:53:50,171
PLOT AND IN UNSPECIFIED CASES AS

1366
00:53:50,171 --> 00:53:52,006
THE CONTRIBUTING CAUSE, THIS IS

1367
00:53:52,006 --> 00:53:54,241
ONE WHERE THE OVERDOSE IS AN

1368
00:53:54,241 --> 00:53:57,044
UNSPECIFIED DRUG BUT NOT OPIOID,

1369
00:53:57,044 --> 00:53:59,180
AGAIN THE BLUE LINE IS ON THE

1370
00:53:59,180 --> 00:54:02,483
TOP. THE ONES WHERE -- THESE ARE

1371
00:54:02,483 --> 00:54:04,818
MEDIAN OF TEN STATES OF LOWEST

1372
00:54:04,818 --> 00:54:06,754
OVERALL OVERDOSES HAVE

1373
00:54:06,754 --> 00:54:07,755
POTENTIALLY HIGHEST NUMBER

1374
00:54:07,755 --> 00:54:09,857
FALLING INTO THIS CATEGORY OF

1375
00:54:09,857 --> 00:54:11,892
POTENTIALLY HIDDEN DEATHS THAT

1376
00:54:11,892 --> 00:54:14,762
MIGHT MERIT CLOSER LOOK.  SO

1377
00:54:14,762 --> 00:54:16,697
WHAT ARE WE SEE SOMETHING A

1378
00:54:16,697 --> 00:54:17,665
COMBINATION OF MORTALITY MA

1379
00:54:17,665 --> 00:54:19,333
ATTORNEYS AN REPORTING PATTERNS 

1380
00:54:19,333 --> 00:54:22,469
THE GEOSPATIAL ANALYSIS IS NOT

1381
00:54:22,469 --> 00:54:24,271
JUST MORTALITY OUTCOME BUT THOSE

1382
00:54:24,271 --> 00:54:25,406
DIMENSIONS OF MORTALITY IN THE

1383
00:54:25,406 --> 00:54:27,408
DEATH RECORDS.  STATES WITH THE

1384
00:54:27,408 --> 00:54:28,809
LOWER OVERDOSE MORTALITY RATES

1385
00:54:28,809 --> 00:54:30,878
HAVE HIGHER NUMBERS OF DEATH AND

1386
00:54:30,878 --> 00:54:32,079
POTENTIALLY HIDDEN CATEGORIES

1387
00:54:32,079 --> 00:54:34,215
WHICH MAY MEAN THEY HAVE A

1388
00:54:34,215 --> 00:54:36,383
HIGHER OVERDOSE MORTALITY RATE

1389
00:54:36,383 --> 00:54:37,952
THAN WERE ORIGINALLY SEEING.

1390
00:54:37,952 --> 00:54:39,620
THERE IS A FASTER THE RECLINE IN

1391
00:54:39,620 --> 00:54:41,188
HIDDEN CATEGORIES IN STATE WITH

1392
00:54:41,188 --> 00:54:42,356
HIGHER OVERDOSE MORTALITY RATES,

1393
00:54:42,356 --> 00:54:44,258
THESE ARE STATES THAT MAY BE

1394
00:54:44,258 --> 00:54:47,127
MOVING NOT MOVING BUT INSTEAD OF

1395
00:54:47,127 --> 00:54:49,930
SETTLING FOR AN UNSPECIFIED

1396
00:54:49,930 --> 00:54:51,632
OVERDOSE THEY MAY DO THE AUTOPSY

1397
00:54:51,632 --> 00:54:53,534
SO TRY TO CATEGORIZE THE DEATH.

1398
00:54:53,534 --> 00:54:56,303
SO NEGATIVE CORRELATION BETWEEN

1399
00:54:56,303 --> 00:54:58,405
CONTRIBUTING SYNTHETIC OPIOID

1400
00:54:58,405 --> 00:55:00,407
CONTRIBUTING TO CAUSE OF DEATH

1401
00:55:00,407 --> 00:55:02,643
SYNTHETIC OVERDOSE AND

1402
00:55:02,643 --> 00:55:04,745
CONTRIBUTING ONLY OVERDOSE AND

1403
00:55:04,745 --> 00:55:05,246
NEGATIVE CORRELATION

1404
00:55:05,246 --> 00:55:06,880
CONTRIBUTING SYNTHETIC OPIOID

1405
00:55:06,880 --> 00:55:08,182
AND CONTRIBUTING UNSPECIFIED

1406
00:55:08,182 --> 00:55:10,718
DRUGS SO THERE'S PATTERNS THAT

1407
00:55:10,718 --> 00:55:11,785
SEEM CONSISTENT WITH CHANGES IN

1408
00:55:11,785 --> 00:55:13,153
REPORTING THAT HAPPEN AS THE

1409
00:55:13,153 --> 00:55:18,592
OVERDOSE NUMBERS GET HIGHER. NOW

1410
00:55:18,592 --> 00:55:20,194
WHEN WE TALK SOCIAL DETERMINANTS

1411
00:55:20,194 --> 00:55:22,296
OF HEALTH SOMETIMES WE THINK OF

1412
00:55:22,296 --> 00:55:23,797
VULNERABILITY INDICES OR

1413
00:55:23,797 --> 00:55:25,499
RESILIENCY INDICES OR SOME OTHER

1414
00:55:25,499 --> 00:55:26,767
INDICES.  TRADITIONALLY

1415
00:55:26,767 --> 00:55:28,002
MEASURING ASSOCIATION BETWEEN

1416
00:55:28,002 --> 00:55:30,804
OUTCOME AN RISK FACTORS,

1417
00:55:30,804 --> 00:55:33,607
VULNERABILITY INDICES LIKE THE

1418
00:55:33,607 --> 00:55:36,543
CDC SOCIAL VULNERABILITY INDEX

1419
00:55:36,543 --> 00:55:38,212
PULL TOGETHER CENSUS INFORMATION

1420
00:55:38,212 --> 00:55:41,548
INTO INDEX AND TRY TO HELP

1421
00:55:41,548 --> 00:55:44,218
IDENTIFY VULNERABILITY OR SOCIAL

1422
00:55:44,218 --> 00:55:45,552
DETERMINANTS, GET BACK TO ONE

1423
00:55:45,552 --> 00:55:48,622
NUMBER OR COVARIANT.  AND THE

1424
00:55:48,622 --> 00:55:50,224
CLASSIC EXAMPLE OF THIS IS THE

1425
00:55:50,224 --> 00:55:52,259
CDC VULNERABILITY INDEX IN SCOTT

1426
00:55:52,259 --> 00:55:54,528
COUNTY, INDIANA, WHERE THE

1427
00:55:54,528 --> 00:55:57,031
OPIOID INJECTION USE WENT UP AND

1428
00:55:57,031 --> 00:56:01,035
RESULTED IN OUTBREAK OF HIV OR

1429
00:56:01,035 --> 00:56:03,704
INCREASE RISK FOR HIV.

1430
00:56:03,704 --> 00:56:06,073
VULNERABILITY INDICES OFTEN COME

1431
00:56:06,073 --> 00:56:08,008
FROM MULTIPLE SOCIO DEMOGRAPHIC

1432
00:56:08,008 --> 00:56:10,778
VARIABLES OFTEN FROM CENSUS FINE

1433
00:56:10,778 --> 00:56:12,246
COMBINED IN IN PRINCIPLE

1434
00:56:12,246 --> 00:56:13,580
COMPONENTS FACTOR ANALYSIS AND

1435
00:56:13,580 --> 00:56:14,448
VARIABLE SELECTION AND THE GOAL

1436
00:56:14,448 --> 00:56:16,917
FOR IDENTIFYING VULNERABILITY

1437
00:56:16,917 --> 00:56:19,286
INDEX IS DIFFERENT FROM TYPICAL

1438
00:56:19,286 --> 00:56:20,387
EPIDEMIOLOGY GOALS IN THE

1439
00:56:20,387 --> 00:56:24,391
FOLLOWING WAY.  RISK FACTOR

1440
00:56:24,391 --> 00:56:26,193
SELECTION IN TRADITIONAL

1441
00:56:26,193 --> 00:56:27,594
EPIDEMIOLOGY WHEN WE FIRST

1442
00:56:27,594 --> 00:56:28,529
STARTED EPIDEMIOLOGY WE ARE

1443
00:56:28,529 --> 00:56:31,565
TRYING TO FIGURE WHAT ARE CAUSES

1444
00:56:31,565 --> 00:56:32,933
OF DISEASE, RISK FACTOR

1445
00:56:32,933 --> 00:56:34,101
ASSOCIATIONS CAN WE MOVE TOWARD

1446
00:56:34,101 --> 00:56:35,836
THIS. WITH RESILIENCY FACTORS

1447
00:56:35,836 --> 00:56:37,705
MAYBE NOT JUST RISK FACTOR MAYBE

1448
00:56:37,705 --> 00:56:38,672
SHOULD BE INTERACTING WITH THE

1449
00:56:38,672 --> 00:56:41,241
RISK FACTOR SO WE HAVE SOMETHING

1450
00:56:41,241 --> 00:56:43,410
POLICY TO CONTROL BUT MAYBE

1451
00:56:43,410 --> 00:56:44,445
OTHER FEATURES IN THE SOCIAL

1452
00:56:44,445 --> 00:56:45,746
ENVIRONMENT THAT MAKE THAT WORK

1453
00:56:45,746 --> 00:56:47,681
BETTER OR WORSE FROM ONE COUNTY

1454
00:56:47,681 --> 00:56:50,951
OR ONE NEIGHBORHOOD TO ANOTHER. 

1455
00:56:50,951 --> 00:56:53,087
MAYBE CHANGES HOW WELL POLICY

1456
00:56:53,087 --> 00:56:54,521
WORKS, MAYBE FACTORS AFFECT --

1457
00:56:54,521 --> 00:56:56,490
MODIFY THE AFFECT OF THE POLICY.

1458
00:56:56,490 --> 00:56:58,759
MAYBE WE HAVE THE SAME SCALES,

1459
00:56:58,759 --> 00:57:01,195
WHAT HAS HAPPENED AT THE SEPSIS

1460
00:57:01,195 --> 00:57:02,863
TRACK LEVEL VERSUS THE COUNTY

1461
00:57:02,863 --> 00:57:04,531
LEVEL. HOW DO WE ADJUST

1462
00:57:04,531 --> 00:57:06,500
VULNERABILITY? SO THERE IS A LOT

1463
00:57:06,500 --> 00:57:07,935
OF INTERESTING QUESTIONS HERE,

1464
00:57:07,935 --> 00:57:09,636
NOT JUST TREATING VULNERABILITY

1465
00:57:09,636 --> 00:57:13,674
INDEX AS A COVARIANT. SO SOCIAL

1466
00:57:13,674 --> 00:57:17,845
VULNERABILITY INDEX MEASURES --

1467
00:57:17,845 --> 00:57:19,713
THE ONE FROM CDC IS ONE OFTEN

1468
00:57:19,713 --> 00:57:21,248
USED WE NEED TO REMEMBER IT IS

1469
00:57:21,248 --> 00:57:23,717
INDEX, IT IS A SUMMARY OF OTHER

1470
00:57:23,717 --> 00:57:25,719
MEASURES, SO SOCIAL DETERMINANTS

1471
00:57:25,719 --> 00:57:27,855
OF HEALTH ARE REAL THINGS BUT

1472
00:57:27,855 --> 00:57:29,556
THEY ARE HARD TO MEASURE

1473
00:57:29,556 --> 00:57:31,091
DIRECTLY.  SO WE ARE TRYING TO

1474
00:57:31,091 --> 00:57:33,827
PUT TOGETHER DIFFERENT ASPECTS

1475
00:57:33,827 --> 00:57:35,329
AND THE SOCIAL VULNERABILITY

1476
00:57:35,329 --> 00:57:36,930
INDEX THAT APPEARS IN A LOT OF

1477
00:57:36,930 --> 00:57:38,265
LITERATURE AND WE USE IN OUR

1478
00:57:38,265 --> 00:57:41,101
PAPERS AS WELL, 16 SOCIAL

1479
00:57:41,101 --> 00:57:42,936
FACTORS INCLUDING POUF SAY, LACK

1480
00:57:42,936 --> 00:57:45,139
OF VEHICLE ACCESS THAT CAN HAVE

1481
00:57:45,139 --> 00:57:45,639
INFLUENCE ON ACCESS TO

1482
00:57:45,639 --> 00:57:47,408
HEALTHCARE. CROWDED HOUSING AND

1483
00:57:47,408 --> 00:57:50,911
SO ON, GROUPED INTO FOUR RELATED

1484
00:57:50,911 --> 00:57:52,713
THEMES, SOCIOECONOMIC STATUS,

1485
00:57:52,713 --> 00:57:54,448
HOUSEHOLD CHARACTERISTICS,

1486
00:57:54,448 --> 00:57:57,284
RACIAL ETHNIC MINORITY STATUS

1487
00:57:57,284 --> 00:57:59,186
HOUSING TYPE AND TRANSPORTATION.

1488
00:57:59,186 --> 00:58:00,220
EACH HAS A SPATIAL PATTERN TO

1489
00:58:00,220 --> 00:58:04,024
IT.  SO HERE IS AN EXAMPLE, THIS

1490
00:58:04,024 --> 00:58:07,428
IS FROM THE CDC WEBSITE, I PUT

1491
00:58:07,428 --> 00:58:08,695
THE MAPS OVER THE WORDS,

1492
00:58:08,695 --> 00:58:09,930
APOLOGIZE FOR THAT. THIS IS

1493
00:58:09,930 --> 00:58:11,064
REPEATING THE FOUR CATEGORIES

1494
00:58:11,064 --> 00:58:12,866
WHICH YOU CAN SEE ON THE RIGHT. 

1495
00:58:12,866 --> 00:58:15,936
AND THE MAP ON THE OVERALL OPT

1496
00:58:15,936 --> 00:58:17,871
LEFT, FULTON COUNTY, GEORGIA,

1497
00:58:17,871 --> 00:58:19,807
CITY OF ATLANTA. AND YOU CAN SEE

1498
00:58:19,807 --> 00:58:21,575
THE COUNTY LINES ARE THICK IN

1499
00:58:21,575 --> 00:58:23,177
THE CENSUS TRACKS ARE THE SMALL

1500
00:58:23,177 --> 00:58:24,645
AREAS. SO THERE ARE DIFFERENT

1501
00:58:24,645 --> 00:58:27,247
SPATIAL PATTERNS AND

1502
00:58:27,247 --> 00:58:28,816
CARDIOGRAPHICLY I LIKE THE

1503
00:58:28,816 --> 00:58:30,651
DIFFERENT COLOR SCHEME FOR EACH

1504
00:58:30,651 --> 00:58:32,586
FOUR SO YOU CAN TELL THEM APART 

1505
00:58:32,586 --> 00:58:33,654
BUT YOU SEE A PATTERN

1506
00:58:33,654 --> 00:58:36,390
SOCIOECONOMIC STATUS ON THE

1507
00:58:36,390 --> 00:58:38,492
HIGHEST FOLLOWS THE DARKER CASH

1508
00:58:38,492 --> 00:58:40,561
FLOWS. THEN -- COLORS. 

1509
00:58:40,561 --> 00:58:41,795
HOUSEHOLD CHARACTERISTICS IS

1510
00:58:41,795 --> 00:58:43,997
SIMILAR BUT NOT THE SAME. RACIAL

1511
00:58:43,997 --> 00:58:45,466
AND ETHNIC MINORITY STATUS AND A

1512
00:58:45,466 --> 00:58:47,067
LOT OF U.S. CITIES HAVE THIS,

1513
00:58:47,067 --> 00:58:48,602
ATLANTA IS NO EXCEPTION, IN FACT

1514
00:58:48,602 --> 00:58:51,104
MAYBE STRONGER, YOU SEE THE

1515
00:58:51,104 --> 00:58:53,207
NORTH, SOUTH, SPLIT, I 20 RUNS

1516
00:58:53,207 --> 00:58:55,509
THROUGH HERE AND YOU HAVE

1517
00:58:55,509 --> 00:58:58,078
HISTORICALLY BLACK COMMUNITY IN

1518
00:58:58,078 --> 00:59:00,180
THE SOUTH AND HISTORICALLY WHITE

1519
00:59:00,180 --> 00:59:05,018
COMMUNITY IN -- AND A GROWING

1520
00:59:05,018 --> 00:59:07,287
HISPANIC COMMUNITY IN THE PURPLE

1521
00:59:07,287 --> 00:59:09,690
CLOUDCLOUD.  HEN WE HAVE HOUSINE

1522
00:59:09,690 --> 00:59:10,324
APPROXIMATE TRANSPORTATION WHICH

1523
00:59:10,324 --> 00:59:11,558
IS RED OUT.  THE FOUR LAYERS GO

1524
00:59:11,558 --> 00:59:13,193
TOGETHER AND MAKE THE SOCIAL

1525
00:59:13,193 --> 00:59:16,430
VULNERABILITY INDEX WHICH HAS

1526
00:59:16,430 --> 00:59:18,932
PATTERN TO IT, YOU CAN SEE THE

1527
00:59:18,932 --> 00:59:19,633
SOCIALIBILITY INDEX FOLLOW IT IS

1528
00:59:19,633 --> 00:59:22,236
ROADS BECAUSE OF THE

1529
00:59:22,236 --> 00:59:23,837
TRANSPORTATION TYPE. BUT THIS

1530
00:59:23,837 --> 00:59:26,006
COMBINATION OF MULTIPLE THINGS

1531
00:59:26,006 --> 00:59:28,008
GOING ON, AND ONE NEIGHBOR.

1532
00:59:28,008 --> 00:59:29,676
THERE IS A GEOSPATIAL TA PATTERN

1533
00:59:29,676 --> 00:59:31,945
TO IT AN IT IS DIFFERENT OR

1534
00:59:31,945 --> 00:59:33,180
DIFFERS BETWEEN THE FOUR

1535
00:59:33,180 --> 00:59:35,249
CATEGORIES SO THERE'S DEEP

1536
00:59:35,249 --> 00:59:36,917
THINKING TO GO ON THAT WOULD BE

1537
00:59:36,917 --> 00:59:38,018
REALLY HELPFUL AND I LOOK

1538
00:59:38,018 --> 00:59:44,258
FORWARD TO FOLLOWING

1539
00:59:44,258 --> 00:59:46,126
THERE IS A NICE INTERACTIVE MAP 

1540
00:59:46,126 --> 00:59:47,728
FOR THOSE WHO HAVEN'T USED IT ON

1541
00:59:47,728 --> 00:59:49,663
THE CDC. 

1542
00:59:49,663 --> 00:59:52,533
SEARCH ON CDC SOCIAL 

1543
00:59:52,533 --> 00:59:53,233
VULNERABILITY INDEX. 

1544
00:59:53,233 --> 00:59:54,568
WHERE I GOT THE IMAGES. 

1545
00:59:54,568 --> 00:59:57,437
DOWNLOAD THE DATA AT THE CENSUS 

1546
00:59:57,437 --> 01:00:01,975
TRACK AND COUNTY LEVEL AND WATCH

1547
01:00:01,975 --> 01:00:09,049
THE SOCIAL YOU WILL HAVE -- 

1548
01:00:09,049 --> 01:00:09,550
VULNERABILITY. 

1549
01:00:09,550 --> 01:00:11,985
THE CDC SOCIAL VULNERABILITY 

1550
01:00:11,985 --> 01:00:13,654
INDEX IS THE ONE AND ONLY?

1551
01:00:13,654 --> 01:00:15,255
IT IS NOT. 

1552
01:00:15,255 --> 01:00:19,226
S AS I SAID YOU ARE MEASURING AN

1553
01:00:19,226 --> 01:00:21,128
IMPORTANT BUT ONE MEASURABLE 

1554
01:00:21,128 --> 01:00:25,599
QUANTITY FEE WITH WHAT YOU HAVE 

1555
01:00:25,599 --> 01:00:25,899
AVAILABLE. 

1556
01:00:25,899 --> 01:00:27,968
IN A SENSE WHAT DATA IS 

1557
01:00:27,968 --> 01:00:29,670
AVAILABLE AND CREATE AN INDEX 

1558
01:00:29,670 --> 01:00:32,506
AND CONSIDER WHAT IS THE BETTER 

1559
01:00:32,506 --> 01:00:37,644
INDEX AND GO AROUND. 

1560
01:00:37,644 --> 01:00:39,746
IT IS IMPORTANT TO EPIDEMIOLOGY.

1561
01:00:39,746 --> 01:00:41,648
AND I WANT TO HIGHLIGHT THIS 

1562
01:00:41,648 --> 01:00:44,017
PAPER BY RICKLES AT ALL. 

1563
01:00:44,017 --> 01:00:47,321
TENNESSEE WAS LOOKING FOR AN 

1564
01:00:47,321 --> 01:00:54,294
INSTATE FOR HIV, HEPATITIS C AND

1565
01:00:54,294 --> 01:00:55,596
OPIOID MISUSE. 

1566
01:00:55,596 --> 01:01:01,902
THEY FOUND THE SOSOCIAL VULNERA 

1567
01:01:01,902 --> 01:01:04,037
HELPFUL AND THEY HAD A OUTLINE 

1568
01:01:04,037 --> 01:01:06,373
OF USING PRINCIPAL COMPONENTS, 

1569
01:01:06,373 --> 01:01:08,008
MACHINE LEARNING ASPECTS TO 

1570
01:01:08,008 --> 01:01:12,679
IDENTIFY COMPONENTS AND THEN 

1571
01:01:12,679 --> 01:01:13,981
THINNING THE LIST DOWN AND 

1572
01:01:13,981 --> 01:01:15,482
LOOKING AT THOSE ONE AT A TIME. 

1573
01:01:15,482 --> 01:01:17,117
I THINK NOT SO MUCH WHAT THE 

1574
01:01:17,117 --> 01:01:21,054
INDEX IS BUT WHERE IT CAME FROM 

1575
01:01:21,054 --> 01:01:23,290
AND IT IS IMPORTANT TO KNOW WHAT

1576
01:01:23,290 --> 01:01:24,591
WE ARE USING AND NOT JUST A 

1577
01:01:24,591 --> 01:01:26,460
NUMBER AND NOT JUST A 

1578
01:01:26,460 --> 01:01:26,793
NEIGHBORHOOD. 

1579
01:01:26,793 --> 01:01:28,261
WHY MIGHT YOU DEVELOP YOUR OWN?

1580
01:01:28,261 --> 01:01:29,896
I AM NOT SAYING THAT EVERYBODY 

1581
01:01:29,896 --> 01:01:31,431
NEED TO DO THEIRS FROM SCRATCH, 

1582
01:01:31,431 --> 01:01:34,635
THE BENEFIT OF USING A INDEX 

1583
01:01:34,635 --> 01:01:36,036
VALUE IS COMPARABILITY BETWEEN 

1584
01:01:36,036 --> 01:01:37,070
THINGS, BETWEEN STUDIES IN 

1585
01:01:37,070 --> 01:01:38,839
DIFFERENT STATES, SAY, BUT 

1586
01:01:38,839 --> 01:01:40,707
TENNESSEE FOUND -- THE TENNESSEE

1587
01:01:40,707 --> 01:01:41,642
DEPARTMENT OF HEALTH FOUND IT 

1588
01:01:41,642 --> 01:01:43,710
WASN'T AS HELPFUL FOR THEM AS 

1589
01:01:43,710 --> 01:01:44,911
CUSTOMIZING IT TO THEIR OWN. 

1590
01:01:44,911 --> 01:01:46,913
WE NEED TO TRADE OFF WHAT IS 

1591
01:01:46,913 --> 01:01:48,615
HELPFUL AND WHAT YOU ARE USING 

1592
01:01:48,615 --> 01:01:48,815
FOR. 

1593
01:01:48,815 --> 01:01:51,385
AND BE SURE TO DOCUMENT IT SO IT

1594
01:01:51,385 --> 01:01:52,619
IS REPRODUCIBLE AND PEOPLE 

1595
01:01:52,619 --> 01:01:55,155
UNDERSTAND WHAT CHOICES YOU 

1596
01:01:55,155 --> 01:01:57,324
MADE. SO EARLIER INDICES, YOU 

1597
01:01:57,324 --> 01:02:00,127
HAD A FEW VARIABLES AND YOU USED

1598
01:02:00,127 --> 01:02:02,029
THE SAME WEIGHTS FOR A LOT OF 

1599
01:02:02,029 --> 01:02:02,396
APPLICATIONS. 

1600
01:02:02,396 --> 01:02:05,399
NOW WE HAVE A MORE PIPELINE-TYPE

1601
01:02:05,399 --> 01:02:08,035
WORLD WHERE WE CAN ACCESS MANY 

1602
01:02:08,035 --> 01:02:09,603
VARIABLES AND TELL PEOPLE HOW TO

1603
01:02:09,603 --> 01:02:12,906
USE THEM IF WE MADE ANY 

1604
01:02:12,906 --> 01:02:13,674
CUSTOMIZATION AND CALCULATIONS. 

1605
01:02:13,674 --> 01:02:15,342
SO THE LAST COUPLE OF MINUTES 

1606
01:02:15,342 --> 01:02:17,277
HERE JUST TO SUMMARIZE. 

1607
01:02:17,277 --> 01:02:18,679
WE HAVE QUESTIONS WE WANT TO 

1608
01:02:18,679 --> 01:02:19,246
ANSWER. 

1609
01:02:19,246 --> 01:02:20,914
THERE IS A SET OF DATA YOU WOULD

1610
01:02:20,914 --> 01:02:22,916
NEED TO ANSWER THAT PERFECTLY. 

1611
01:02:22,916 --> 01:02:24,084
AND MOST OF THAT YOU PROBABLY 

1612
01:02:24,084 --> 01:02:24,818
CAN'T GET. 

1613
01:02:24,818 --> 01:02:26,687
BUT THERE IS A SET OF DATA AND 

1614
01:02:26,687 --> 01:02:31,992
LOTS OF SETS OF DATA AND 

1615
01:02:31,992 --> 01:02:32,993
GEOSPATIAL DATA THAT YOU CAN GET

1616
01:02:32,993 --> 01:02:34,895
THAT GIVES US PICTURE AND IMAGES

1617
01:02:34,895 --> 01:02:35,629
OF IT. 

1618
01:02:35,629 --> 01:02:36,863
NOT TO JUST ANSWER OUR QUESTION 

1619
01:02:36,863 --> 01:02:39,900
BUT HELP US REFINE THE QUESTION,

1620
01:02:39,900 --> 01:02:41,134
GET SUPPLEMENTAL DATA. 

1621
01:02:41,134 --> 01:02:43,136
FIND OTHER SOURCES OF DATA TO 

1622
01:02:43,136 --> 01:02:44,037
FILL IN THE GAPS. 

1623
01:02:44,037 --> 01:02:44,705
IDENTIFYING THE QUESTIONS WE 

1624
01:02:44,705 --> 01:02:46,306
CAN'T ANSWER FROM THE DATA WE 

1625
01:02:46,306 --> 01:02:47,774
CAN GET AND THEN CAREFULLY 

1626
01:02:47,774 --> 01:02:49,109
THINKING HOW CLOSE ARE THE 

1627
01:02:49,109 --> 01:02:51,244
QUESTIONS WE CAN ANSWER TO THE 

1628
01:02:51,244 --> 01:02:52,446
QUESTIONS WE WANT TO ANSWER. 

1629
01:02:52,446 --> 01:02:55,348
I WANT US TO REMEMBER THAT THE 

1630
01:02:55,348 --> 01:02:57,651
PATTERNS WE OBSERVE IN 

1631
01:02:57,651 --> 01:03:00,320
GEOSPATIAL DATA ANALYSIS ARE 

1632
01:03:00,320 --> 01:03:02,956
ECHOS OF WHAT IS REALLY 

1633
01:03:02,956 --> 01:03:04,157
HAPPENING, THE PATTERN OF 

1634
01:03:04,157 --> 01:03:05,559
OBSERVATION AND PATTERN OF 

1635
01:03:05,559 --> 01:03:07,194
REPORTING THAT WENT INTO 

1636
01:03:07,194 --> 01:03:07,527
OBSERVATION. 

1637
01:03:07,527 --> 01:03:10,197
THERE IS A TRUE MAP WE DON'T GET

1638
01:03:10,197 --> 01:03:11,398
TO SEE THAT GETS FILTERED 

1639
01:03:11,398 --> 01:03:11,665
THROUGH. 

1640
01:03:11,665 --> 01:03:13,667
THE BETTER WE UNDERSTAND THOSE 

1641
01:03:13,667 --> 01:03:15,335
FILTERS AND DRIVERS OF THOSE 

1642
01:03:15,335 --> 01:03:18,405
FILTERS THE BETTER WE CAN GET 

1643
01:03:18,405 --> 01:03:20,040
PICTURE OF THAT TRUE UNDERLYING 

1644
01:03:20,040 --> 01:03:20,407
MAP. 

1645
01:03:20,407 --> 01:03:22,909
LEARN TO SEE THE ECHOS OF THE 

1646
01:03:22,909 --> 01:03:25,645
REPORTING PROCESS. 

1647
01:03:25,645 --> 01:03:27,848
MEASURE THEM AND ADJUST ADJUST. 

1648
01:03:27,848 --> 01:03:31,551
THINGS TO THINK OF IN AGREE GEE 

1649
01:03:31,551 --> 01:03:32,753
CONTEXT. 

1650
01:03:32,753 --> 01:03:35,122
CAN WE LEARN TO SEE THE FACTOR 

1651
01:03:35,122 --> 01:03:37,491
THAT ARE ECHOS THESE. 

1652
01:03:37,491 --> 01:03:38,792
WE ARE THINKING OF A 

1653
01:03:38,792 --> 01:03:41,228
EPIDEMIOLOGY OF REPORTING AND 

1654
01:03:41,228 --> 01:03:43,196
NOT AS GAM RUSS AS THE FINAL 

1655
01:03:43,196 --> 01:03:45,665
HEALTH OUTCOME BUT MAY BE USEFUL

1656
01:03:45,665 --> 01:03:47,868
FOR THE FINAL HEALTH INCOME TO 

1657
01:03:47,868 --> 01:03:51,471
BE MORE PRECISE. 

1658
01:03:51,471 --> 01:03:53,673
I WANT TO THANK YOU FOR YOUR 

1659
01:03:53,673 --> 01:03:53,974
TIME. 

1660
01:03:53,974 --> 01:03:56,042
I MENTIONED THE CDC GUIDANCE. 

1661
01:03:56,042 --> 01:03:58,678
PAPER BY RICKLES. 

1662
01:03:58,678 --> 01:04:01,014
CHRISTOPHER RUM'S PAPER AND 

1663
01:04:01,014 --> 01:04:03,450
THE VIN DIAGRAM I HAVE OF 

1664
01:04:03,450 --> 01:04:06,720
BUILDING THE ANALYTICAL TOOLBOX 

1665
01:04:06,720 --> 01:04:07,187
FOR GEOSPATIAL DATA. 

1666
01:04:07,187 --> 01:04:09,689
THANK YOU SO MUCH FOR YOUR TIME.

1667
01:04:09,689 --> 01:04:11,792
>> THANK YOU, DR. WALLER. 

1668
01:04:11,792 --> 01:04:13,026
THAT WAS VERY INFORMATIVE. 

1669
01:04:13,026 --> 01:04:15,061
I LOOK FORWARD TO THE DISCUSSION

1670
01:04:15,061 --> 01:04:16,830
PERIOD WHERE WE CAN DIG IN 

1671
01:04:16,830 --> 01:04:17,164
FURTHER. 

1672
01:04:17,164 --> 01:04:20,066
NOW HAND THE DIGITAL PODIUM OVER

1673
01:04:20,066 --> 01:04:22,736
TO DR. STOP CA. 

1674
01:04:22,736 --> 01:04:26,039
>>Tom Stopka: THANK YOU
VERY 

1675
01:04:26,039 --> 01:04:30,377
MUCH, DR.VAN VOOHHEES. 

1676
01:04:30,377 --> 01:04:32,679
LOOKING FORWARD TO TALK TO YOU 

1677
01:04:32,679 --> 01:04:33,513
OF GEOSPATIAL DATA AND 

1678
01:04:33,513 --> 01:04:35,949
PARTICULARLY LOOKING AT THROUGH 

1679
01:04:35,949 --> 01:04:46,026
A PREVENTION LENS. 

1680
01:04:46,026 --> 01:04:46,259
SLIDES. 

1681
01:04:46,259 --> 01:04:50,363
HERE WE GO. SO I WILL GO OVER 

1682
01:04:50,363 --> 01:04:53,533
SOME CONCEPTS RELATED TO 

1683
01:04:53,533 --> 01:04:54,234
GEOSPATIAL EPIDEMIOLOGY, AND WE 

1684
01:04:54,234 --> 01:04:57,037
WILL LOOK AT A NUMBER OF 

1685
01:04:57,037 --> 01:04:58,305
APPLICATIONS OF GEOSPATIAL 

1686
01:04:58,305 --> 01:04:59,673
EPIDEMIOLOGY IN PREVENTION WORK,

1687
01:04:59,673 --> 01:05:01,575
RIGHT, IN IDENTIFYING AND 

1688
01:05:01,575 --> 01:05:02,609
CHARACTERIZING THE RISK 

1689
01:05:02,609 --> 01:05:04,211
LANDSCAPE AND ASSESSING ACCESS 

1690
01:05:04,211 --> 01:05:06,112
TO SERVICES AND RESOURCE 

1691
01:05:06,112 --> 01:05:08,114
ALLOCATIONS AND SOCIAL 

1692
01:05:08,114 --> 01:05:09,683
DETERMINANCE AND MONITORING 

1693
01:05:09,683 --> 01:05:12,319
INTERVENTIONS AND CHANGE AND 

1694
01:05:12,319 --> 01:05:13,620
CONDUCTING PREDICTIVE ANALYTICS 

1695
01:05:13,620 --> 01:05:16,756
AND SIMULATION MODELING. 

1696
01:05:16,756 --> 01:05:20,527
I WILL DO THROUGH NIH FUNDED 

1697
01:05:20,527 --> 01:05:21,061
STUDY. 

1698
01:05:21,061 --> 01:05:25,232
GREATLE FOR NIDA FOR FUNDED 

1699
01:05:25,232 --> 01:05:27,133
STUDY BUT FOCUS ON RURAL 

1700
01:05:27,133 --> 01:05:30,103
INITIATIVE IN NEW ENGLAND. 

1701
01:05:30,103 --> 01:05:32,105
PREDICT TO PREVENT OVERSHOWN 

1702
01:05:32,105 --> 01:05:34,841
STUDY AND PORTIONS OF THE 

1703
01:05:34,841 --> 01:05:36,576
EPIDEMIOLOGY STUDY IN 

1704
01:05:36,576 --> 01:05:36,943
MASSACHUSETTS. 

1705
01:05:36,943 --> 01:05:38,612
WHEN I PRESENT ON OVERDOSE AND 

1706
01:05:38,612 --> 01:05:39,713
RELATED SENSITIVE OUTCOMES, I 

1707
01:05:39,713 --> 01:05:41,648
WOULD LIKE TO BE SURE TO 

1708
01:05:41,648 --> 01:05:43,149
ACKNOWLEDGE THAT THE SYMBOLS 

1709
01:05:43,149 --> 01:05:45,252
THAT WE SHARE ON OUR MAPS 

1710
01:05:45,252 --> 01:05:47,554
REPRESENT MUCH MORE THAN DATA. 

1711
01:05:47,554 --> 01:05:47,821
RIGHT. 

1712
01:05:47,821 --> 01:05:49,656
THEY REPRESENT LIVES LOST. 

1713
01:05:49,656 --> 01:05:51,424
AND WITH RESPECT TO THE 

1714
01:05:51,424 --> 01:05:52,626
CONFIDENTIALITY FOR FAMILY 

1715
01:05:52,626 --> 01:05:53,560
MEMBERS AND NEIGHBORS WHO HAVE 

1716
01:05:53,560 --> 01:05:57,097
LOST PEOPLE WHO HAVE PASSED ON, 

1717
01:05:57,097 --> 01:05:58,632
THESE MAPS THAT I SHOW TODAY 

1718
01:05:58,632 --> 01:06:01,668
MASK THE GEOLOCATIONS OR THE 

1719
01:06:01,668 --> 01:06:04,804
EXACT LOCATIONS OF DECEASED 

1720
01:06:04,804 --> 01:06:05,238
RESIDENCES. 

1721
01:06:05,238 --> 01:06:06,806
I TRY TO ENCOURAGE MY STUDENTS 

1722
01:06:06,806 --> 01:06:09,509
TO BE THE PAUL REVERE OF PUBLIC 

1723
01:06:09,509 --> 01:06:10,210
HEALTH, BRINGING IMPORTANT 

1724
01:06:10,210 --> 01:06:12,512
INFORMATION TO KEY STAKEHOLDERS.

1725
01:06:12,512 --> 01:06:16,216
AND I POSE THIS QUESTION TO YOU.

1726
01:06:16,216 --> 01:06:20,120
CAN SPATIAL ANALYSIS AND FORM 

1727
01:06:20,120 --> 01:06:22,622
HELP WITH DISEASE PREVENTION?

1728
01:06:22,622 --> 01:06:25,592
WE VISIT THAT AS WE MOVE 

1729
01:06:25,592 --> 01:06:25,859
FORWARD. 

1730
01:06:25,859 --> 01:06:28,061
GEOSPATIAL DATA IS DESCRIPTION 

1731
01:06:28,061 --> 01:06:29,663
AND OF DISEASE AND TAKES INTO 

1732
01:06:29,663 --> 01:06:31,498
CONSIDERATION THAT PLACE 

1733
01:06:31,498 --> 01:06:31,865
MATTERS. 

1734
01:06:31,865 --> 01:06:33,133
THAT WHERE WE ARE BORN. 

1735
01:06:33,133 --> 01:06:34,034
WHERE WE LIVE. 

1736
01:06:34,034 --> 01:06:34,868
WHERE WE WORK. 

1737
01:06:34,868 --> 01:06:37,137
WHERE WE GO TO SCHOOL. 

1738
01:06:37,137 --> 01:06:42,609
WHERE WE PLAY AND RECREATE AND 

1739
01:06:42,609 --> 01:06:43,944
PLAY AND COMMUTE CAN HAVE ALL 

1740
01:06:43,944 --> 01:06:46,046
IMPORTANT IMPACTS ON OUR HEALTH 

1741
01:06:46,046 --> 01:06:48,581
BY EITHER EXPOSING US IN RISK 

1742
01:06:48,581 --> 01:06:50,016
FACTORS THAT CAN INCREASE OUR 

1743
01:06:50,016 --> 01:06:51,818
RISK FOR SPECIFIC HEALTH 

1744
01:06:51,818 --> 01:06:53,853
OUTCOMES OR INFLUENCE ACCESS TO 

1745
01:06:53,853 --> 01:06:56,790
SERVICE THAT CAN DECREASE RISK. 

1746
01:06:56,790 --> 01:06:57,924
THROUGH SPATIAL EPIDEMIOLOGY WE 

1747
01:06:57,924 --> 01:07:00,427
CAN TEASE APART THESE 

1748
01:07:00,427 --> 01:07:01,361
RELATIONSHIPS. 

1749
01:07:01,361 --> 01:07:03,730
UPWARDS OF 85% OF SPATIAL DATA 

1750
01:07:03,730 --> 01:07:05,098
HAS A SPATIAL COMPONENT TO THEM.

1751
01:07:05,098 --> 01:07:08,702
WHEN I THINK OF GI CIRCUMSTANCES

1752
01:07:08,702 --> 01:07:10,437
AND SPATIAL ANALYTIC APPROACHES 

1753
01:07:10,437 --> 01:07:11,871
AND PREVENTION, I THINK OF THREE

1754
01:07:11,871 --> 01:07:16,977
LARGE DOMAINS: MASK DESCRIPTIVE 

1755
01:07:16,977 --> 01:07:20,013
AND RISK MAPPING. 

1756
01:07:20,013 --> 01:07:21,581
VARIABLES THAT WE CAN USE FOR 

1757
01:07:21,581 --> 01:07:22,382
OUR STATISTICAL MODELS. 

1758
01:07:22,382 --> 01:07:24,150
THEN WHEN IT STARTS TO GET 

1759
01:07:24,150 --> 01:07:26,419
REALLY ONE, THE GUY YO 

1760
01:07:26,419 --> 01:07:29,489
STATISTICAL AN ALL RIGHTICS AND 

1761
01:07:29,489 --> 01:07:31,725
EPIDEMIOLOGY ANALYSES AND 

1762
01:07:31,725 --> 01:07:33,193
EXPLORATORY DATA ANALYSES 

1763
01:07:33,193 --> 01:07:38,465
OR ESDA EXPANDS THIS AS WELL. 

1764
01:07:38,465 --> 01:07:41,668
DIG IN MORE IN DEPTH OF 

1765
01:07:41,668 --> 01:07:43,503
APPLICATIONS OF IDENTIFYING AND 

1766
01:07:43,503 --> 01:07:45,572
CHARACTERIZING THE RISK 

1767
01:07:45,572 --> 01:07:49,142
LANDSCAPE AND HOT SPOTS. 

1768
01:07:49,142 --> 01:07:51,845
A FEW YEARS AGO WE FOCUSED ON 

1769
01:07:51,845 --> 01:07:53,813
IDENTIFYING AND CHARACTERIZING 

1770
01:07:53,813 --> 01:07:55,615
HEPATITISC IN MASSACHUSETTS WITH

1771
01:07:55,615 --> 01:07:57,517
THE MASSACHUSETTS DEPARTMENT OF 

1772
01:07:57,517 --> 01:08:00,754
PUBLIC HEALTH THROUGH SPATIAL 

1773
01:08:00,754 --> 01:08:01,388
EPIDEMIOLOGY APPROACH. 

1774
01:08:01,388 --> 01:08:04,391
WE DEVELOPED DESCRIPTIVE MAPS 

1775
01:08:04,391 --> 01:08:07,027
AND DELVED INTO IDENTIFYING HOT 

1776
01:08:07,027 --> 01:08:09,496
SPOTS FOR CALCULATIONS AND 

1777
01:08:09,496 --> 01:08:10,730
SPACE-TIME CLUSTER ANALYSES AS 

1778
01:08:10,730 --> 01:08:11,898
WELL TO UNDERSTAND WHERE AND 

1779
01:08:11,898 --> 01:08:15,935
WHEN HEP C MORTALITY WAS 

1780
01:08:15,935 --> 01:08:17,670
CLUSTERING ACROSS MASSACHUSETTS.

1781
01:08:17,670 --> 01:08:21,641
WE IDENTIFIED NINE HCV MORTALITY

1782
01:08:21,641 --> 01:08:21,908
CLUSTERS. 

1783
01:08:21,908 --> 01:08:24,077
OUR HOT SPOTS THROUGH 

1784
01:08:24,077 --> 01:08:25,011
STATISTICAL ANALYSES WERE FOUND 

1785
01:08:25,011 --> 01:08:26,112
TO BE POSITIVELY ASSOCIATED WITH

1786
01:08:26,112 --> 01:08:29,482
THE PERCENTAGE OF THE POPULATION

1787
01:08:29,482 --> 01:08:32,118
THAT IS HISPANIC, PERCENTAGE OF 

1788
01:08:32,118 --> 01:08:34,854
HOUSEHOLDS RECEIVING FOOD STANT,

1789
01:08:34,854 --> 01:08:35,088
STAMPS. 

1790
01:08:35,088 --> 01:08:37,657
AND AT SPOTS WERE NEGATIVE OF 

1791
01:08:37,657 --> 01:08:39,292
THE POPULATION THAT ARE HIGH 

1792
01:08:39,292 --> 01:08:44,130
SCHOOL GRADUATES OR HIGHER OR 

1793
01:08:44,130 --> 01:08:44,964
OTHER RACIAL AND ETHNIC 

1794
01:08:44,964 --> 01:08:45,665
CATEGORIES. 

1795
01:08:45,665 --> 01:08:47,000
MORE RECENTLY COLLEAGUES IN 

1796
01:08:47,000 --> 01:08:49,669
RHODE ISLAND HAVE LOOKED AT 

1797
01:08:49,669 --> 01:08:51,604
CHARACTERIZING OPIOID OVERDOSE 

1798
01:08:51,604 --> 01:08:53,840
HOT SPOTS FOR BASED PREVENTION 

1799
01:08:53,840 --> 01:08:57,444
AND TREATMENT INTERVENTION. 

1800
01:08:57,444 --> 01:09:00,213
THEY IDENTIFIED SEVEN NONFATAL 

1801
01:09:00,213 --> 01:09:02,849
THREE FATAL OVERDOSE HOT SPOTS 

1802
01:09:02,849 --> 01:09:03,750
ACROSS RHODE ISLAND AND THEY HAD

1803
01:09:03,750 --> 01:09:05,652
HIGHER PROPORTION OF BLACK AND 

1804
01:09:05,652 --> 01:09:08,621
LATIN X, RENT OR OCCUPIED, 

1805
01:09:08,621 --> 01:09:11,691
VACANT HOUSING, UNEMPLOYMENT AND

1806
01:09:11,691 --> 01:09:15,995
COST-BURDENED HOUSE POELDZ. 

1807
01:09:15,995 --> 01:09:16,329
NO

1808
01:09:16,329 --> 01:09:17,864
-- HOUSEHOLDS. 

1809
01:09:17,864 --> 01:09:20,433
THEY FOUND INTERESTINGLY, HIGHER

1810
01:09:20,433 --> 01:09:21,668
PROPORTIONS OF HOT SPOT 

1811
01:09:21,668 --> 01:09:24,003
NEIGHBORHOODS THAT HAD A 

1812
01:09:24,003 --> 01:09:25,505
RELIGIOUS ORGANIZATION, A HEALTH

1813
01:09:25,505 --> 01:09:26,906
CENTER OR POLICE STATION, RIGHT.

1814
01:09:26,906 --> 01:09:29,375
THESE COULD BE LOCATIONS WHERE 

1815
01:09:29,375 --> 01:09:29,976
INTERVENTIONS COULD BE 

1816
01:09:29,976 --> 01:09:32,112
IMPLEMENTED AND ENHANCED TO HELP

1817
01:09:32,112 --> 01:09:33,646
TO COMBAT OVERDOSE RISKS. 

1818
01:09:33,646 --> 01:09:36,216
LET'S PIVOT TO LOOK AT ASSESSING

1819
01:09:36,216 --> 01:09:38,618
ACCESS TO SERVICES AND RESOURCE 

1820
01:09:38,618 --> 01:09:43,256
ALLOCATI

1821
01:09:43,256 --> 01:09:45,291
ALLOCATIONS AND SOME EXAMPLES. 

1822
01:09:45,291 --> 01:09:48,595
MULTIPLE OF ACCESSIBILITY. 

1823
01:09:48,595 --> 01:09:50,130
A FEW. 

1824
01:09:50,130 --> 01:09:51,898
EUCLIDIAN DISTANCES, BUFFER 

1825
01:09:51,898 --> 01:09:55,668
ZONES, DRIVE AND WALK TIME 

1826
01:09:55,668 --> 01:09:58,338
ANALYSES, ENHANCED TWO OR THREE 

1827
01:09:58,338 --> 01:10:01,641
FLOATING CATCHMENT ANALYSES. 

1828
01:10:01,641 --> 01:10:04,444
RISK TERRAINAL MALL IN CEASE. 

1829
01:10:04,444 --> 01:10:08,148
LOCATION AND ALLOCATION 

1830
01:10:08,148 --> 01:10:14,187
ANALYS

1831
01:10:14,187 --> 01:10:14,821
ANALYSES. WE ARE NOT ASCERTAIN 

1832
01:10:14,821 --> 01:10:15,421
ACCESS TO KEY PUBLIC HEALTH 

1833
01:10:15,421 --> 01:10:16,356
SERVICES. 

1834
01:10:16,356 --> 01:10:19,225
PHARMACY IN SAN FRANCISCO 

1835
01:10:19,225 --> 01:10:21,427
SHOWING SYRINGES OVER THE 

1836
01:10:21,427 --> 01:10:22,729
COUNTER AND IDENTIFYING 

1837
01:10:22,729 --> 01:10:24,264
NEIGHBORHOODS BECAUSE OF THE 

1838
01:10:24,264 --> 01:10:26,132
EXISTENCE OF THOSE PHARMACIES 

1839
01:10:26,132 --> 01:10:29,335
THAT HAVE STERILE SYRINGES WERE 

1840
01:10:29,335 --> 01:10:33,540
MORE DISTANT, OF HUNTER MARKET 

1841
01:10:33,540 --> 01:10:35,141
BAY AREA NEIGHBORHOODS THAT HAVE

1842
01:10:35,141 --> 01:10:40,647
HIGH HIV RISKS OF PEOPLE THAT 

1843
01:10:40,647 --> 01:10:41,548
ADO DRUGS. 

1844
01:10:41,548 --> 01:10:42,882
AND CATCHMENT AREAS. 

1845
01:10:42,882 --> 01:10:44,384
ONE OF THE FIRST STUDIES IN 

1846
01:10:44,384 --> 01:10:45,318
MASSACHUSETTS ABOUT TEN YEARS 

1847
01:10:45,318 --> 01:10:45,652
AGO. 

1848
01:10:45,652 --> 01:10:48,555
I WAS WORKING WITH THE THEN FIVE

1849
01:10:48,555 --> 01:10:49,355
EXISTING SYRINGE SERVICE 

1850
01:10:49,355 --> 01:10:50,456
PROGRAMS ACROSS THE STATE THAT 

1851
01:10:50,456 --> 01:10:53,026
ARE NOW, THANKFULLY MORE THAN 

1852
01:10:53,026 --> 01:10:53,660
65. 

1853
01:10:53,660 --> 01:10:56,029
BUT WE COULD LOOK AT THE GEO 

1854
01:10:56,029 --> 01:11:00,200
LOCATION, RIGHT. THE ZIP CODE OF

1855
01:11:00,200 --> 01:11:01,668
RESIDENTS OF THE CLIENTS GOING 

1856
01:11:01,668 --> 01:11:04,571
TO THE SYRINGE SERVICE PROGRAM. 

1857
01:11:04,571 --> 01:11:08,007
NOTICE THE DISTANCE TRAVEL TO 

1858
01:11:08,007 --> 01:11:10,510
ACCESS SERVICES TO REDUCE 

1859
01:11:10,510 --> 01:11:12,212
HEPATITIS C. 

1860
01:11:12,212 --> 01:11:13,446
AND WESTERN MASSACHUSETTS AND 

1861
01:11:13,446 --> 01:11:15,281
HIGHLY RULE AREAS IN THE 

1862
01:11:15,281 --> 01:11:17,650
BERKSHIRES, PEOPLE TRAVELING 

1863
01:11:17,650 --> 01:11:19,586
QUITE SOME BUSINESS TO GET TO 

1864
01:11:19,586 --> 01:11:21,654
NORTHHAMPTON AND HOLYOKE. 

1865
01:11:21,654 --> 01:11:24,691
OF COURSE, WE CAN MAP THE 

1866
01:11:24,691 --> 01:11:26,092
GEOLOCATIONS OF TREATMENT 

1867
01:11:26,092 --> 01:11:26,359
CENTERS. 

1868
01:11:26,359 --> 01:11:32,165
MORE TALKS ON THIS, BUT WET YOUR

1869
01:11:32,165 --> 01:11:34,434
APPETITE, METHADONE TREATMENT 

1870
01:11:34,434 --> 01:11:36,502
PROGRAMS AND CALCULATE DRIVE 

1871
01:11:36,502 --> 01:11:41,641
TIMES AND WALK TIMES BASED ON 

1872
01:11:41,641 --> 01:11:45,411
NETWORKS TO THOSE LOCATIONS AND 

1873
01:11:45,411 --> 01:11:47,013
WITH THE BUREAU AND THE 

1874
01:11:47,013 --> 01:11:47,580
MASSACHUSETTS DEPARTMENT OF 

1875
01:11:47,580 --> 01:11:48,414
PUBLIC HEALTH. 

1876
01:11:48,414 --> 01:11:53,653
IN THE REPORT FOR, GOVERN

1877
01:11:53,653 --> 01:11:54,420
GOVERNOR HEALY. 

1878
01:11:54,420 --> 01:11:56,189
ONLY 15% LIVED WITHIN A MARK OF 

1879
01:11:56,189 --> 01:11:58,658
THE OPT. 

1880
01:11:58,658 --> 01:12:01,261
WE CAN OVERLAY THIS DEE SEND 

1881
01:12:01,261 --> 01:12:02,695
INCIDENT DATA BY RACE AND 

1882
01:12:02,695 --> 01:12:02,996
ETHNICITY. 

1883
01:12:02,996 --> 01:12:05,131
AND IN DOING SO, WE FOUND THAT 

1884
01:12:05,131 --> 01:12:08,768
ONLY 9% OF DECEDENTS LIVED 

1885
01:12:08,768 --> 01:12:10,803
WITHIN 15-MINUTE WALKING TIME TO

1886
01:12:10,803 --> 01:12:12,805
A ODP ACROSS MASSACHUSETTS. 

1887
01:12:12,805 --> 01:12:14,240
WE LOOKED COMPREHENSIVELY ACROSS

1888
01:12:14,240 --> 01:12:17,610
ALL OF OUR ANALYSES, 90% LIVED 

1889
01:12:17,610 --> 01:12:20,213
WITHIN 0-MINUTE DRIVE TIME. 

1890
01:12:20,213 --> 01:12:21,648
80% LIVED WITHIN A 15 MINUTE 

1891
01:12:21,648 --> 01:12:23,383
DRIVE TIME AT THE TIME OF THEIR 

1892
01:12:23,383 --> 01:12:25,385
FATAL OVERDOSE. 

1893
01:12:25,385 --> 01:12:30,223
2% OF DECEDENTS LIVED WITHIN A 

1894
01:12:30,223 --> 01:12:32,225
30-MINUTE WALK AND ONLY 9% OF 

1895
01:12:32,225 --> 01:12:34,627
15-MINUTE WALK OF A ODP. 

1896
01:12:34,627 --> 01:12:36,863
ACCESS IS OKAY, RIGHT, IF YOU 

1897
01:12:36,863 --> 01:12:39,198
HAVE A CAR OR ACCESS TO A RIDE 

1898
01:12:39,198 --> 01:12:42,035
FROM A FRIEND. 

1899
01:12:42,035 --> 01:12:44,203
BUT THINK OF STILL DRIVING 15 

1900
01:12:44,203 --> 01:12:45,271
MINUTES TO ARE 30 MINUTES EACH 

1901
01:12:45,271 --> 01:12:49,942
WAY TO GET TO YOUR SERVICES. 

1902
01:12:49,942 --> 01:12:51,077
ANTI-HYPER TEN SIEVE REDS. 

1903
01:12:51,077 --> 01:12:52,879
IF WE HAD TO DO THAT EVERY DAY, 

1904
01:12:52,879 --> 01:12:55,548
WHAT WOULD THAT DO FOR THE 

1905
01:12:55,548 --> 01:12:57,650
CONTINUITY OF TREATMENT OVER 

1906
01:12:57,650 --> 01:12:58,184
TIME. 

1907
01:12:58,184 --> 01:13:00,019
WE ALSO HAVE BEEN ABLE TO LOOK 

1908
01:13:00,019 --> 01:13:03,489
AT TWO-STAGE FLOATING CATCHMENT 

1909
01:13:03,489 --> 01:13:06,959
DATA ANALYSES AND THAT ALLOWS US

1910
01:13:06,959 --> 01:13:07,527
TO CALCULATE ACCESSIBILITY 

1911
01:13:07,527 --> 01:13:09,662
THROUGH A COUPLE OF STEPS. 

1912
01:13:09,662 --> 01:13:12,031
TO ASSESS THE TO PORTION OF 

1913
01:13:12,031 --> 01:13:13,466
SERVICES, LET'S SAY TREATMENT 

1914
01:13:13,466 --> 01:13:16,903
PROVIDERS TO THE POPULATION IN 

1915
01:13:16,903 --> 01:13:18,104
NEED WITHIN THE DESIGNATED 

1916
01:13:18,104 --> 01:13:19,238
SEARCH AREA. 

1917
01:13:19,238 --> 01:13:20,773
WE LOOK AT SERVICEABILITY WITHIN

1918
01:13:20,773 --> 01:13:24,010
THAT 30-MINUTE DRIVE TIME AND A 

1919
01:13:24,010 --> 01:13:25,645
MEAN TIME TO COMMUTING TO WORK 

1920
01:13:25,645 --> 01:13:26,412
IN MASSACHUSETTS. 

1921
01:13:26,412 --> 01:13:29,182
AND WHEN WE DO THIS PROCESS, I 

1922
01:13:29,182 --> 01:13:30,717
WILL GO INTO DETAIL -- I WILL 

1923
01:13:30,717 --> 01:13:33,653
GIVE YOU A VISUAL OF THIS IN A 

1924
01:13:33,653 --> 01:13:35,288
BIT. 

1925
01:13:35,288 --> 01:13:37,156
LOCATION, ALLOCATION IS ANOTHER 

1926
01:13:37,156 --> 01:13:38,825
TOOL THAT WE EMPLOY TO ASSESS 

1927
01:13:38,825 --> 01:13:41,494
WHETHER EXISTING SERVICES, GREEN

1928
01:13:41,494 --> 01:13:43,763
SQUARES, REPRESENT EXISTING ODPs

1929
01:13:43,763 --> 01:13:46,733
IN THE GREATER BOSTON AREA. 

1930
01:13:46,733 --> 01:13:48,334
WE CAN WEIGHT THESE ANALYSES IN 

1931
01:13:48,334 --> 01:13:52,872
THE MODELS BASED ON DECEDENT 

1932
01:13:52,872 --> 01:13:56,175
DATA OR NONFATAL OVERDOSE DATA 

1933
01:13:56,175 --> 01:13:57,810
AND LOCATIONS WHERE THERE IS 

1934
01:13:57,810 --> 01:13:59,245
UNMET NEED IN TERMS OF TREATMENT

1935
01:13:59,245 --> 01:14:01,581
AND WHERE NEW ODPs CAN BE PLACED

1936
01:14:01,581 --> 01:14:03,416
MOVING FORWARD. 

1937
01:14:03,416 --> 01:14:04,484
IN ASSESSING SOCIAL DETERMINANTS

1938
01:14:04,484 --> 01:14:06,686
OF HEALTH, DR. WALLER WENT INTO 

1939
01:14:06,686 --> 01:14:08,121
GREAT DETAIL OF THE SOCIAL 

1940
01:14:08,121 --> 01:14:09,689
VULNERABILITY INDEX. 

1941
01:14:09,689 --> 01:14:10,656
I WON'T DESCRIBE WHAT IT IS, 

1942
01:14:10,656 --> 01:14:12,325
BECAUSE HE JUST DID THAT. 

1943
01:14:12,325 --> 01:14:15,695
IN SOME WORK THAT WE DID AT THE 

1944
01:14:15,695 --> 01:14:19,198
EARLY STAGES OF THE COVID 

1945
01:14:19,198 --> 01:14:20,833
PANDEMIC, WE AIM TO SEE WHERE 

1946
01:14:20,833 --> 01:14:22,201
COVID-19 TESTING WAS TAKEN PLACE

1947
01:14:22,201 --> 01:14:22,769
IN MASSACHUSETTS. 

1948
01:14:22,769 --> 01:14:24,303
ZIP CODE ON THE LEFT. 

1949
01:14:24,303 --> 01:14:26,339
AND BOSTON NEIGHBORHOODS ON THE 

1950
01:14:26,339 --> 01:14:26,572
RIGHT. 

1951
01:14:26,572 --> 01:14:29,642
WE JUXTAPOSED THE LOCATION OF 

1952
01:14:29,642 --> 01:14:32,211
TREATMENT CENTERS WITH THE 

1953
01:14:32,211 --> 01:14:35,148
SOCIAL VULNERABILITY INDIANA 

1954
01:14:35,148 --> 01:14:35,815
DECKS. 

1955
01:14:35,815 --> 01:14:37,884
THE THEMATIC COLORS THAT YOU SEE

1956
01:14:37,884 --> 01:14:40,353
AND WAS ABLE TO DETERMINE UNMET 

1957
01:14:40,353 --> 01:14:41,654
NEEDS AND SOCIAL AND 

1958
01:14:41,654 --> 01:14:42,922
VULNERABILITY COMMUNITIES HAD 

1959
01:14:42,922 --> 01:14:44,257
LIMITED ACCESS IN MANY PARTS OF 

1960
01:14:44,257 --> 01:14:50,062
THE STATE TO TESTING. 

1961
01:14:50,062 --> 01:14:53,633
IN MONITORING INTERVENTIONS AND 

1962
01:14:53,633 --> 01:14:56,235
CHANGE, GEOSPATIAL DATA AND 

1963
01:14:56,235 --> 01:14:57,637
EPIDEMIOLOGY ANALYSIS CAN HELP 

1964
01:14:57,637 --> 01:15:01,207
WITH PREVENTION EFFORTS. 

1965
01:15:01,207 --> 01:15:01,841
WE ARE LOOKING THE AUTO HOLYOKE,

1966
01:15:01,841 --> 01:15:02,508
MASSACHUSETTS IN WESTERN 

1967
01:15:02,508 --> 01:15:04,477
MASSACHUSETTS ON I-91. 

1968
01:15:04,477 --> 01:15:06,112
LOWER LEFT PORTION OF THE MAP, 

1969
01:15:06,112 --> 01:15:08,347
YOU WILL SEE A GREEN SQUARE. 

1970
01:15:08,347 --> 01:15:11,083
THAT WAS THE INITIAL ODP 

1971
01:15:11,083 --> 01:15:12,452
AVAILABLE IN MASSACHUSETTS 

1972
01:15:12,452 --> 01:15:13,453
SEVERAL YEARS AGO. 

1973
01:15:13,453 --> 01:15:15,688
AND IN HOLYOKE SEVERAL YEARS 

1974
01:15:15,688 --> 01:15:15,888
AGO. 

1975
01:15:15,888 --> 01:15:17,657
AND QUITE DISTANT FROM THE 

1976
01:15:17,657 --> 01:15:19,425
CENTRAL LOCATION WHERE THERE IS 

1977
01:15:19,425 --> 01:15:21,661
MORE DENSE POPULATION. 

1978
01:15:21,661 --> 01:15:25,097
AND AS A RESULT, MORE DENSELY 

1979
01:15:25,097 --> 01:15:25,665
PACKED OVERDOSES. 

1980
01:15:25,665 --> 01:15:27,600
FATAL OVERDOSES. 

1981
01:15:27,600 --> 01:15:32,205
A NEW ODP, THIS PURPLE SQUARE 

1982
01:15:32,205 --> 01:15:33,639
WAS IDENTIFIED AND PLACED BASED 

1983
01:15:33,639 --> 01:15:36,342
ON LOCAL DATA IN A VERY 

1984
01:15:36,342 --> 01:15:37,443
HIGH-RISK AREA. 

1985
01:15:37,443 --> 01:15:39,378
WHAT THAT DOES IN TERMS OF DRIVE

1986
01:15:39,378 --> 01:15:41,080
TIME ACCESS IN THE LEFT. 

1987
01:15:41,080 --> 01:15:43,216
WALK TIME ACCESS IN THE UPPER 

1988
01:15:43,216 --> 01:15:46,953
RIGHT, FIVE-MINUTE, TEN-MINUTE, 

1989
01:15:46,953 --> 01:15:48,054
15-MINUTE DRIVE TIME TO 

1990
01:15:48,054 --> 01:15:49,255
COMMUNITIES -- OR FROM 

1991
01:15:49,255 --> 01:15:50,256
COMMUNITIES OF RESIDENCE NEARBY 

1992
01:15:50,256 --> 01:15:52,692
GREATLY IMPROVED ACCESS. 

1993
01:15:52,692 --> 01:15:54,894
THE PURPLE LINES AND DOTS ON 

1994
01:15:54,894 --> 01:15:57,129
THIS MAP REPRESENT BUS STOPS AND

1995
01:15:57,129 --> 01:15:58,130
BUS LINES. 

1996
01:15:58,130 --> 01:15:59,332
AND THERE ARE SEVERAL BUS STOPS 

1997
01:15:59,332 --> 01:16:02,401
THAT PASS THROUGH THE NEW ODP. 

1998
01:16:02,401 --> 01:16:03,936
SO IN GENERAL, WE ARE NOW 

1999
01:16:03,936 --> 01:16:05,571
DIGGING INTO THIS DATA IN MORE 

2000
01:16:05,571 --> 01:16:07,273
DETAIL TO DETERMINE WHAT THE 

2001
01:16:07,273 --> 01:16:09,709
IMPACTS HAVE BEEN ON OVERDOSE. 

2002
01:16:09,709 --> 01:16:15,348
I AM GOING TO GO IT IN DETAIL IN

2003
01:16:15,348 --> 01:16:18,284
MY TALKS OF PREDICTIVE ANALYTICS

2004
01:16:18,284 --> 01:16:19,652
AND HOW GEOSPATIAL DATA CAN COME

2005
01:16:19,652 --> 01:16:20,820
INTO PLAY, BUT LET'S JUMP INTO 

2006
01:16:20,820 --> 01:16:23,189
SOME OF THE APPLICATIONS ON SOME

2007
01:16:23,189 --> 01:16:26,259
OF OUR NIDA FUNDED STUDIES. 

2008
01:16:26,259 --> 01:16:29,662
I WILL START BY MOBILE TELE 

2009
01:16:29,662 --> 01:16:31,130
MEDICINE BASED TREATMENT OF 

2010
01:16:31,130 --> 01:16:33,633
CHRONIC HEPATITIS C OF PEOPLE 

2011
01:16:33,633 --> 01:16:35,801
WHO INJECT DRUGS IN NORTHERN 

2012
01:16:35,801 --> 01:16:36,802
RURAL NEW ENGLAND. 

2013
01:16:36,802 --> 01:16:38,638
AND WE WERE ONE OF EIGHT SITES 

2014
01:16:38,638 --> 01:16:41,407
ACROSS THE U.S. THAT WERE PART 

2015
01:16:41,407 --> 01:16:43,543
OF THE RURAL NEW ENGLAND 

2016
01:16:43,543 --> 01:16:44,410
INITIATIVE NETWORK. 

2017
01:16:44,410 --> 01:16:48,214
WE WERE FOCUSING IN THE 

2018
01:16:48,214 --> 01:16:49,649
NORTHEAST ON MASSACHUSETTS, 

2019
01:16:49,649 --> 01:16:50,917
VERMONT AND NEW HAMPSHIRE. 

2020
01:16:50,917 --> 01:17:00,026
11 COUNTIES ALONG THE I- I-91 A 

2021
01:17:00,026 --> 01:17:01,227
THE CONNECTICUT RIVER. 

2022
01:17:01,227 --> 01:17:03,029
AND BEFORE WE STARTED OUR 

2023
01:17:03,029 --> 01:17:05,598
INTERVENTION, WE WERE CONDUCTING

2024
01:17:05,598 --> 01:17:06,766
MIXED METHOD AKROECHS OF 

2025
01:17:06,766 --> 01:17:08,267
EPIDEMIOLOGY POLICY AND LEGAL 

2026
01:17:08,267 --> 01:17:10,336
ENVIRONMENTAL SCANS. 

2027
01:17:10,336 --> 01:17:13,639
AND WE WORKED WITH STATE 

2028
01:17:13,639 --> 01:17:16,842
EPIDEMIOLOGISTS AND WAS ABLE TO 

2029
01:17:16,842 --> 01:17:18,611
COMPILE SURVEILLANCE DATA TO 

2030
01:17:18,611 --> 01:17:21,647
IDENTIFY RISKS AS IT RELATES TO 

2031
01:17:21,647 --> 01:17:23,816
FATAL OVERDOSES, HEPATITIS C 

2032
01:17:23,816 --> 01:17:25,651
PREVALENCE, AND PEOPLE LIVING 

2033
01:17:25,651 --> 01:17:28,521
WITH HIV/AIDS. 

2034
01:17:28,521 --> 01:17:32,925
WE LOOKED AT SOCIOECONOMIC 

2035
01:17:32,925 --> 01:17:34,894
INEQUITIES IN TERMS OF INCOME, 

2036
01:17:34,894 --> 01:17:36,729
UNEMPLOYMENT AND UNINSURED 

2037
01:17:36,729 --> 01:17:37,029
RATES. 

2038
01:17:37,029 --> 01:17:40,299
AND LOOKED AT ACCESSIBILITY TO 

2039
01:17:40,299 --> 01:17:43,102
SYRINGE SERVICE PROGRAMS, FIRST 

2040
01:17:43,102 --> 01:17:45,304
WITH EUCLIDIAN DISTANCES AND 

2041
01:17:45,304 --> 01:17:46,672
THEN THE SERVICE ENVIRONMENT 

2042
01:17:46,672 --> 01:17:49,075
THROUGH DRIVE-TIME ANALYSIS 

2043
01:17:49,075 --> 01:17:51,877
BASED ON STREET NETWORKS AND 

2044
01:17:51,877 --> 01:17:53,646
ASSESS ACCESS TO SERVICES BASED 

2045
01:17:53,646 --> 01:17:55,047
ON DRIVE TIMES TO CERTAIN 

2046
01:17:55,047 --> 01:17:56,115
SERVICE PROGRAMS ON THE LEFT, 

2047
01:17:56,115 --> 01:17:57,883
DRUG TREATMENT PROGRAMS IN THE 

2048
01:17:57,883 --> 01:18:01,420
MIDDLE AND NALOXONE IN THE 

2049
01:18:01,420 --> 01:18:01,887
RIGHT-HAND SIDE. 

2050
01:18:01,887 --> 01:18:03,189
WHERE YOU SEE THE BROWN SHADING 

2051
01:18:03,189 --> 01:18:05,191
ON THE MAPS, THAT IS WHERE THE 

2052
01:18:05,191 --> 01:18:07,326
DRIVE TIME TO THOSE SERVICES WAS

2053
01:18:07,326 --> 01:18:09,662
30 MINUTES EACH WAY. 

2054
01:18:09,662 --> 01:18:13,532
ONE MORE. 

2055
01:18:13,532 --> 01:18:15,468
WHEN WE TRIANGULATED THE SPATIAL

2056
01:18:15,468 --> 01:18:17,637
DATA WITH OUR QUALITATIVE 

2057
01:18:17,637 --> 01:18:19,672
IN-DEPTH DATA AND SURVEYS WITH 

2058
01:18:19,672 --> 01:18:21,641
600 PEOPLE WHO USED DRUGS ACROSS

2059
01:18:21,641 --> 01:18:23,843
NORTHERN NEW ENGLAND, WE 

2060
01:18:23,843 --> 01:18:27,146
IDENTIFIED HIGH HCV POSITIVITY 

2061
01:18:27,146 --> 01:18:29,649
RATES AND HIGH LEVELS OF SHARING

2062
01:18:29,649 --> 01:18:30,950
PARTICULARLY IN NEW HAMPSHIRE. 

2063
01:18:30,950 --> 01:18:34,654
AND OVERALL, LIMITED ACCESS TO 

2064
01:18:34,654 --> 01:18:35,855
INJECTION EQUIPMENT AND 

2065
01:18:35,855 --> 01:18:38,257
HEPATITIS C TESTING AND 

2066
01:18:38,257 --> 01:18:40,226
TREATMENT, RISK FOR HIV 

2067
01:18:40,226 --> 01:18:41,727
OUTBREAKS OF THE LACK OF HARM 

2068
01:18:41,727 --> 01:18:43,529
REDUCTION SERVICES AND REUSE OF 

2069
01:18:43,529 --> 01:18:45,631
SYRINGES THAT WERE HAVING IN 

2070
01:18:45,631 --> 01:18:48,467
HIGH HCV RATES. 

2071
01:18:48,467 --> 01:18:49,635
THAT HELPED TO INFORM THE 

2072
01:18:49,635 --> 01:18:52,538
LOCATION AND THE FOCUS OF OUR 

2073
01:18:52,538 --> 01:18:55,107
INTERVENTION, THE UH-3 PHASE, 

2074
01:18:55,107 --> 01:18:57,710
THE FUNDING, WHERE WE REALLY 

2075
01:18:57,710 --> 01:18:59,879
DEVELOPED A RANDOMIZED CONTROL 

2076
01:18:59,879 --> 01:19:02,348
TRIAL AND IMPLEMENTED IT TO 

2077
01:19:02,348 --> 01:19:05,251
EVALUATE MOBILE TELEMEDICINE 

2078
01:19:05,251 --> 01:19:07,586
CARE WITH SERVICES AND ENHANCED 

2079
01:19:07,586 --> 01:19:08,921
USUAL CARE THAT INCLUDED 

2080
01:19:08,921 --> 01:19:11,023
REFERRAL AND CARE NAVIGATION TO 

2081
01:19:11,023 --> 01:19:16,495
A LOCAL ORIGINAL PROVIDER. 

2082
01:19:16,495 --> 01:19:18,664
SKIPPING TO -- JUMPING TO THE 

2083
01:19:18,664 --> 01:19:19,999
KEY OUTCOMES. 

2084
01:19:19,999 --> 01:19:24,870
THROUGH OUR STUDY, WE IDENTIFIED

2085
01:19:24,870 --> 01:19:27,673
SEVEN-FOLD INCREASE. 

2086
01:19:27,673 --> 01:19:29,642
DIRECT ANTI-VIRAL INITIATION 

2087
01:19:29,642 --> 01:19:33,412
AMONG PEOPLE WITH OUR MOBILE 

2088
01:19:33,412 --> 01:19:36,282
TELEMEDICINE GROUP COMPARED TO 

2089
01:19:36,282 --> 01:19:38,284
ENHANCED REGIONAL CARE. 

2090
01:19:38,284 --> 01:19:41,353
FOURFOLD INCREASED ODDS OF 

2091
01:19:41,353 --> 01:19:43,355
CLEARANCE IN BUY LOG CAL 

2092
01:19:43,355 --> 01:19:43,689
RESPONSE. 

2093
01:19:43,689 --> 01:19:45,658
WE DID NOT RECOGNIZE ANY 

2094
01:19:45,658 --> 01:19:47,026
DIFFERENCE BETWEEN OUR GROUPS 

2095
01:19:47,026 --> 01:19:49,662
ENSURING SHARING PRACTICES AT 

2096
01:19:49,662 --> 01:19:50,029
FOLLOW-UP. 

2097
01:19:50,029 --> 01:19:53,632
YOU HAVE ALL HEARD OF THE 

2098
01:19:53,632 --> 01:19:55,901
COMMUNITIES STUDIES AND MAIN 

2099
01:19:55,901 --> 01:19:56,268
OUTCOMES. 

2100
01:19:56,268 --> 01:20:00,005
WE HAVE CONDUCTED OUR SPATIAL 

2101
01:20:00,005 --> 01:20:01,640
EPIDEMIOLOGICAL AND OVERDOSE 

2102
01:20:01,640 --> 01:20:03,275
PREVENTION ANALYSIS HERE AT 

2103
01:20:03,275 --> 01:20:04,610
TUFTS FOR OUR MASSACHUSETTS 

2104
01:20:04,610 --> 01:20:04,810
SITE. 

2105
01:20:04,810 --> 01:20:06,278
IN COLLABORATION WITH THE 

2106
01:20:06,278 --> 01:20:08,948
OTHER HCS SITES. 

2107
01:20:08,948 --> 01:20:09,682
THE MASSACHUSETTS HEALING 

2108
01:20:09,682 --> 01:20:12,284
COMMUNITY STUDIES SITES, WAVE 

2109
01:20:12,284 --> 01:20:14,220
ONE AND WAVE TWO, URBAN AND 

2110
01:20:14,220 --> 01:20:14,453
RURAL. 

2111
01:20:14,453 --> 01:20:15,521
AND WE HAD AN OPPORTUNITY TO 

2112
01:20:15,521 --> 01:20:17,223
LOOK AT RELATIONSHIPS BETWEEN 

2113
01:20:17,223 --> 01:20:19,692
PLACES OF RESIDENCE, INJURY AND 

2114
01:20:19,692 --> 01:20:23,229
DEATH THROUGH SPATIAL AND 

2115
01:20:23,229 --> 01:20:24,630
STATISTICAL ANALYSIS OF FATAL 

2116
01:20:24,630 --> 01:20:28,234
OPIOID OVERDOSES. 

2117
01:20:28,234 --> 01:20:32,304
APPLIED RISK MAPPING OF 

2118
01:20:32,304 --> 01:20:32,905
ANALYTICS TO INFORM OVERDOSE 

2119
01:20:32,905 --> 01:20:35,908
INTERVENTIONS AND WE SHARE THESE

2120
01:20:35,908 --> 01:20:38,144
RESULTS OVER THE COURSE OF THE 

2121
01:20:38,144 --> 01:20:41,013
STUDY THROUGH THE COMMISSION. 

2122
01:20:41,013 --> 01:20:44,049
WAVE ONE AND WAVE TWO. 

2123
01:20:44,049 --> 01:20:47,419
WE HAVE ACCESS TO PRESCRIBERS 

2124
01:20:47,419 --> 01:20:48,187
FOR MORPHINE. 

2125
01:20:48,187 --> 01:20:50,356
AND TO ASSESS OPPORTUNITIES TO 

2126
01:20:50,356 --> 01:20:51,624
OPTIMIZE HARM REDUCTION SERVICES

2127
01:20:51,624 --> 01:20:54,593
IN THIS WORK FOCUSED ON OVERDOSE

2128
01:20:54,593 --> 01:20:59,398
EDUCATION, NALOXONE DISTRIBUTION

2129
01:20:59,398 --> 01:21:01,100
THROUGH LOCATION ANALYSES. 

2130
01:21:01,100 --> 01:21:03,235
LET'S DIG INTO IT A BIT MORE 

2131
01:21:03,235 --> 01:21:03,536
DEPTH. 

2132
01:21:03,536 --> 01:21:07,173
THIS WORK WAS LED BY MY 

2133
01:21:07,173 --> 01:21:09,708
COLLEAGUE JENNIFER PUTZ AT 

2134
01:21:09,708 --> 01:21:10,709
TUFTS. 

2135
01:21:10,709 --> 01:21:12,211
WAS ABLE TO LOOK AT DESCRIPTIVE 

2136
01:21:12,211 --> 01:21:14,213
MAPPING BUT THE CLUSTER 

2137
01:21:14,213 --> 01:21:14,480
ANALYSES. 

2138
01:21:14,480 --> 01:21:16,482
AND SOME LOCAL INDICATORS OF 

2139
01:21:16,482 --> 01:21:18,217
SPATIAL ASSOCIATION TO IDENTIFY 

2140
01:21:18,217 --> 01:21:20,319
CLUSTERS OF OVERDOSES OCCURRING,

2141
01:21:20,319 --> 01:21:23,155
PARTICULARLY OF NOTE IN NORTH 

2142
01:21:23,155 --> 01:21:23,823
CENTRAL MASSACHUSETTS. 

2143
01:21:23,823 --> 01:21:26,325
THAT IS THE FITCHBURG AREA. 

2144
01:21:26,325 --> 01:21:28,227
SOUTHEASTERN MASSACHUSETTS, THE 

2145
01:21:28,227 --> 01:21:34,366
UPPER CAPE -- OR KEEP C-- CAPE 

2146
01:21:34,366 --> 01:21:36,368
COD AREA. 

2147
01:21:36,368 --> 01:21:38,337
WE HAVE MODELS FOR GEOSPATIAL 

2148
01:21:38,337 --> 01:21:40,206
DATA MODELS THAT DETERMINE THE 

2149
01:21:40,206 --> 01:21:42,274
ASSOCIATION BETWEEN OVERDOSE AND

2150
01:21:42,274 --> 01:21:44,310
THE NUMBER OF CO-VAR RANTS 

2151
01:21:44,310 --> 01:21:45,244
ACROSS THE STATE. 

2152
01:21:45,244 --> 01:21:48,280
IN THESE ANALYSES, WE IDENTIFIED

2153
01:21:48,280 --> 01:21:48,981
OLDER INDIVIDUALS. 

2154
01:21:48,981 --> 01:21:51,851
WERE MORE LIKELY TO OVERDOSE IN 

2155
01:21:51,851 --> 01:21:53,752
THEIR OWN HOME IN WESTERN AND 

2156
01:21:53,752 --> 01:21:55,588
CENTRAL MASSACHUSETTS AND 

2157
01:21:55,588 --> 01:21:56,722
EASTERN MASSACHUSETTS. 

2158
01:21:56,722 --> 01:22:01,460
SIMILARLY WE FOUND THAT HISP

2159
01:22:01,460 --> 01:22:07,399
HISPANIC DESCEDENTS WAS LESS 

2160
01:22:07,399 --> 01:22:09,401
LIKELY TO OVERDOSE THAN IN 

2161
01:22:09,401 --> 01:22:10,903
WORCESTER AND BOSTON MASS AND 

2162
01:22:10,903 --> 01:22:12,504
THE EAST. 

2163
01:22:12,504 --> 01:22:13,138
IMPLICATIONS IN TERMS OF THOR.

2164
01:22:13,138 --> 01:22:15,207
>> VENTUALS NEEDED WITHIN 

2165
01:22:15,207 --> 01:22:17,109
COMMUNITIES AND HOW THEY MIGHT 

2166
01:22:17,109 --> 01:22:18,711
VARY GEOGRAPHICALLY ACROSS THE 

2167
01:22:18,711 --> 01:22:20,613
STATE BASED ON SPATIAL DATA. 

2168
01:22:20,613 --> 01:22:25,684
LET'S LOOK NOR CLOSELY AT OU

2169
01:22:25,684 --> 01:22:28,420
OUR BUFOMORPHINE INDEX. 

2170
01:22:28,420 --> 01:22:29,922
KUDOS TO MY COLLEAGUE WHO 

2171
01:22:29,922 --> 01:22:32,358
IDENTIFIED IN VISUALIZATION. 

2172
01:22:32,358 --> 01:22:34,593
LET'S PRESENT THESE ARE CENSUS 

2173
01:22:34,593 --> 01:22:35,694
TRACTS AS ADMINISTRATIVE 

2174
01:22:35,694 --> 01:22:35,961
BOUNDARY. 

2175
01:22:35,961 --> 01:22:39,298
WITHIN THEM, WE CAN LOOK AT THE 

2176
01:22:39,298 --> 01:22:39,899
LOCATI

2177
01:22:39,899 --> 01:22:43,235
LOCATIONS OF SERVICE PROVIDERS 

2178
01:22:43,235 --> 01:22:45,671
IN GREEN, POPULATION IN RED. 

2179
01:22:45,671 --> 01:22:47,840
AND AROUND NOSE, WE CAN LOOK AT 

2180
01:22:47,840 --> 01:22:52,211
THE SERVICE CATCHMENT AREA, 

2181
01:22:52,211 --> 01:22:53,679
POPULATION CATCHMENT. 

2182
01:22:53,679 --> 01:22:55,814
TWO-STAGE FLOATING CATCHMENT 

2183
01:22:55,814 --> 01:22:56,949
ANALYSES THAT TAKES INTO 

2184
01:22:56,949 --> 01:22:58,384
ASSOCIATION THE SERVICE 

2185
01:22:58,384 --> 01:22:59,551
PROVIDERS, THOSE WHO MIGHT AVAIL

2186
01:22:59,551 --> 01:23:00,753
THEY BELIEVE SELVES OF THE 

2187
01:23:00,753 --> 01:23:02,354
SERVICES AND THE SERVICE 

2188
01:23:02,354 --> 01:23:05,024
CATCHMENT AREA 30-MINUTE DRIVE 

2189
01:23:05,024 --> 01:23:05,391
TIME. 

2190
01:23:05,391 --> 01:23:08,360
AGAIN A FEEL FOR GENERAL OR MORE

2191
01:23:08,360 --> 01:23:14,300
IMPROVED ACCESS TO BUFO MORPHINE

2192
01:23:14,300 --> 01:23:14,600
PROVIDERS. 

2193
01:23:14,600 --> 01:23:16,468
WE ARE GOING BEYOND I DID 

2194
01:23:16,468 --> 01:23:20,372
STANCES, TWO, FIVE ARE, OR 

2195
01:23:20,372 --> 01:23:21,473
TEN-MILE BUFFER ZONES. 

2196
01:23:21,473 --> 01:23:24,310
GOING BEYOND ANALYSES THAT ARE 

2197
01:23:24,310 --> 01:23:24,710
HELPFUL. 

2198
01:23:24,710 --> 01:23:34,486
BUT MOVING ON TO AN OF DIFFERENT

2199
01:23:34,486 --> 01:23:35,921
AREAS OF THE STATE OF THE HIGH 

2200
01:23:35,921 --> 01:23:38,357
AND LOW ACCESSIBILITY AND CAN 

2201
01:23:38,357 --> 01:23:40,626
HELP WITH OVERDOSE AND WHERE 

2202
01:23:40,626 --> 01:23:42,227
MORE PROVIDERS ARE NEEDED. 

2203
01:23:42,227 --> 01:23:44,663
FINALLY, I WILL TALK ABOUT OUR 

2204
01:23:44,663 --> 01:23:46,999
PREDICT TO PREVENT STUDY WHERE 

2205
01:23:46,999 --> 01:23:50,369
WE FOCUS ON DYNAMICS OF ANALYSES

2206
01:23:50,369 --> 01:23:53,439
OF OPIOID OVERDOSE TO GUIDE 

2207
01:23:53,439 --> 01:23:54,707
PREEMPTIVE PUBLIC HEALTH 

2208
01:23:54,707 --> 01:23:55,007
RESPONSES. 

2209
01:23:55,007 --> 01:23:56,208
WHAT DO I MEAN?

2210
01:23:56,208 --> 01:24:00,245
THINK OF WHAT METEOROLOGISTS DO 

2211
01:24:00,245 --> 01:24:01,680
REGULARLY DURING THE SUMMER 

2212
01:24:01,680 --> 01:24:03,449
MONTHS, RIGHT. 

2213
01:24:03,449 --> 01:24:07,353
PREDICTING WHERE FUTURE 

2214
01:24:07,353 --> 01:24:07,653
HURRICANES. 

2215
01:24:07,653 --> 01:24:09,722
THEY DEVELOP SPATIAL TEMPORAL 

2216
01:24:09,722 --> 01:24:12,057
MODELS BASED ON A WEALTH OF DATA

2217
01:24:12,057 --> 01:24:12,925
AND ABLE TO DETERMINE WHEN AND 

2218
01:24:12,925 --> 01:24:15,461
IF A HURRICANE WILL HIT AND HELP

2219
01:24:15,461 --> 01:24:17,162
INFORM DECISION-MAKING ON THE 

2220
01:24:17,162 --> 01:24:17,896
LOCAL LEVEL. 

2221
01:24:17,896 --> 01:24:19,631
WHO NEEDS TO GET TO THE GROCERY 

2222
01:24:19,631 --> 01:24:21,200
STORE BEFORE IT SHUTS DOWN. 

2223
01:24:21,200 --> 01:24:23,936
PEOPLE NEED TO BAT DOWN THE 

2224
01:24:23,936 --> 01:24:26,372
HATCHES, IF YOU WILL, TO OR 

2225
01:24:26,372 --> 01:24:28,073
EVACUATE THEIR HOME TO HIGHER 

2226
01:24:28,073 --> 01:24:28,307
YOURPD. 

2227
01:24:28,307 --> 01:24:36,048
WE WANT -- GROUND. 

2228
01:24:36,048 --> 01:24:37,583
HE WANT TO DO THE SAME OPIOID 

2229
01:24:37,583 --> 01:24:37,850
OVERDOSE. 

2230
01:24:37,850 --> 01:24:40,986
THIS IS WORK THAT I AM 

2231
01:24:40,986 --> 01:24:42,988
CO-LEADING WITH MY COLLEAGUE, 

2232
01:24:42,988 --> 01:24:45,691
DR. CC POWER. 

2233
01:24:45,691 --> 01:24:47,960
A STELLAR INVESTIGATIVE TIME 

2234
01:24:47,960 --> 01:24:52,464
FROM TUFTS, UMASS LOWELL. 

2235
01:24:52,464 --> 01:24:53,098
AND THE MASSACHUSETTS DEPARTMENT

2236
01:24:53,098 --> 01:24:55,100
OF PUBLIC HEALTH AND KEEN ON 

2237
01:24:55,100 --> 01:24:56,068
COMMUNITY ENGAGED RESOURCE. 

2238
01:24:56,068 --> 01:24:57,669
YES THIS IS SECONDARY ANALYSIS 

2239
01:24:57,669 --> 01:24:59,505
OF EXIST CAN DATA. 

2240
01:24:59,505 --> 01:25:01,540
WE SAY THAT COMMUNITY ENGAGED 

2241
01:25:01,540 --> 01:25:03,609
RESEARCH IS PARAMOUNT IN ORDER 

2242
01:25:03,609 --> 01:25:05,544
TO ENSURE THAT OUR MODEL INPUTS 

2243
01:25:05,544 --> 01:25:06,812
ARE RIGHT. 

2244
01:25:06,812 --> 01:25:09,715
OUR MODEL OUTPUTS ARE CORRECTLY 

2245
01:25:09,715 --> 01:25:10,049
INTERPRETED. 

2246
01:25:10,049 --> 01:25:12,017
AND THAT THE DATA ULTIMATELY CAN

2247
01:25:12,017 --> 01:25:14,787
HELP TO INFORM DECISION MAKING. 

2248
01:25:14,787 --> 01:25:17,689
AND OUR CAB INCLUDES PEOPLE WHO 

2249
01:25:17,689 --> 01:25:18,957
WORK AT LOCAL HEALTH 

2250
01:25:18,957 --> 01:25:20,125
DEPARTMENTS, HEALTH AGENCIES AND

2251
01:25:20,125 --> 01:25:22,828
PEOPLE WITH LIVED EXPERIENCES. 

2252
01:25:22,828 --> 01:25:24,663
WE USE THE SOCIAL ECOLOGICAL 

2253
01:25:24,663 --> 01:25:27,099
MODEL TO INFORM OUR ANALYSES, 

2254
01:25:27,099 --> 01:25:29,501
THICK OF THE MULTIPLE LEVELS OF 

2255
01:25:29,501 --> 01:25:31,503
FACTORS THAT CAN IMPACT RISKS 

2256
01:25:31,503 --> 01:25:33,672
RELATED TO OVERDOSE. 

2257
01:25:33,672 --> 01:25:34,706
WE HAVE AGREE OPPORTUNITY HERE 

2258
01:25:34,706 --> 01:25:36,542
IN MASSACHUSETTS TO WORK WITH 

2259
01:25:36,542 --> 01:25:39,178
THE PUBLIC HEALTH DATA 

2260
01:25:39,178 --> 01:25:39,478
WAREHOUSE. 

2261
01:25:39,478 --> 01:25:41,814
THIS IS CREATED BY THE 

2262
01:25:41,814 --> 01:25:44,149
MASSACHUSETTS DEPARTMENT OF 

2263
01:25:44,149 --> 01:25:44,516
PUBLIC HEALTH. 

2264
01:25:44,516 --> 01:25:48,787
IT INCLUDES AS ITS SPINE, ALL 

2265
01:25:48,787 --> 01:25:51,824
PAIR CLAIMS DATA AND A WEALTH OF

2266
01:25:51,824 --> 01:25:52,858
PUBLIC HEALTH, PUBLIC SAFETY, 

2267
01:25:52,858 --> 01:25:55,894
CRIMINAL, LEGAL, HEALTH CARE, 

2268
01:25:55,894 --> 01:25:57,229
COMMUNITY-LEVEL DATA THAT LET'S 

2269
01:25:57,229 --> 01:25:58,964
US LOOK AT THE VIRTUAL CENSUS OF

2270
01:25:58,964 --> 01:26:00,699
THE MASSACHUSETTS POPULATION AND

2271
01:26:00,699 --> 01:26:05,337
THEIR RISKS AS IT RELATES TO 

2272
01:26:05,337 --> 01:26:05,671
OVERDOSE. 

2273
01:26:05,671 --> 01:26:08,407
WE CAN EMPLOY SPATIAL AND 

2274
01:26:08,407 --> 01:26:10,609
TEMPORAL MODELING AND TAKING 

2275
01:26:10,609 --> 01:26:12,010
STEPS TO DEVELOP THESE MODELS 

2276
01:26:12,010 --> 01:26:13,679
AND A LIKELY OF FUNCTIONS TO 

2277
01:26:13,679 --> 01:26:15,581
CALCULATE DISTRIBUTIONS 

2278
01:26:15,581 --> 01:26:18,450
INCLUDING TIME IN GEE YAFK AREA 

2279
01:26:18,450 --> 01:26:20,419
AND ADDITIONAL INFORMATION OF 

2280
01:26:20,419 --> 01:26:21,687
SOUTHBOUNDING AREAS AND 

2281
01:26:21,687 --> 01:26:24,823
CONTINUING TIMES AND OU

2282
01:26:24,823 --> 01:26:28,794
OUR BAYESIAN SPATIOTEMPORAL WILL

2283
01:26:28,794 --> 01:26:31,130
HAVE EFFECTS AND CORRELATION, 

2284
01:26:31,130 --> 01:26:32,364
TIME EFFECTS. 

2285
01:26:32,364 --> 01:26:36,568
TIME DURING CO-VARIANTS AND 

2286
01:26:36,568 --> 01:26:37,603
SPACE-TIME INTERACTION EFFECTS. 

2287
01:26:37,603 --> 01:26:40,172
ONE OF THE EARLY STUDIES FOR OUR

2288
01:26:40,172 --> 01:26:40,372
TEAM. 

2289
01:26:40,372 --> 01:26:43,275
WE LOOKED AT OVERDOSE DATA ABOUT

2290
01:26:43,275 --> 01:26:46,345
15 TO 20 YEARS OF DATA ACROSS 

2291
01:26:46,345 --> 01:26:48,347
MASSACHUSETTS ZIP CODES. 

2292
01:26:48,347 --> 01:26:51,750
AND WE TRAINED OUR PREDICTIVE 

2293
01:26:51,750 --> 01:26:53,685
MODEL ON ABOUT 15 YEARS OF DATA 

2294
01:26:53,685 --> 01:26:55,754
TO THEN DETERMINE WHEN AND WHERE

2295
01:26:55,754 --> 01:26:57,689
FUTURE SPIKES IN OVERDOSE WOULD 

2296
01:26:57,689 --> 01:26:59,892
TAKE PLACE. 

2297
01:26:59,892 --> 01:27:01,660
THE SPAGHETTI PLOT AT THE TOP OF

2298
01:27:01,660 --> 01:27:04,830
THE SLIDE REPRESENT THE 540 ZIP 

2299
01:27:04,830 --> 01:27:07,232
CODES ACROSS MASSACHUSETTS, 

2300
01:27:07,232 --> 01:27:08,400
CHARACTERIZED AS RURAL OR URBAN.

2301
01:27:08,400 --> 01:27:12,304
THE MAPS SHOW THE LOCATIONS OF 

2302
01:27:12,304 --> 01:27:13,672
PREDICTED FATAL OVERDOSE RATES 

2303
01:27:13,672 --> 01:27:17,376
AND COUNTS ACROSS MASSACHUSETTS.

2304
01:27:17,376 --> 01:27:18,911
WE HAVE ALSO LOOKED AT OPIOID 

2305
01:27:18,911 --> 01:27:21,680
RELATED MORTALITY THROUGH 

2306
01:27:21,680 --> 01:27:23,448
DYNAMIC TEMPORAL AND SPATIAL 

2307
01:27:23,448 --> 01:27:25,684
TRENDS BY DRUG TYPE AND 

2308
01:27:25,684 --> 01:27:27,319
DEMOGRAPHIC POPULATIONS. 

2309
01:27:27,319 --> 01:27:29,488
AND THROUGH THESE ANALYSES, WE 

2310
01:27:29,488 --> 01:27:33,525
UNCOVERED NEW TIME VARYING A

2311
01:27:33,525 --> 01:27:37,963
AND SPACIOTEMPORAL PATTERNS THAT

2312
01:27:37,963 --> 01:27:39,064
WERE NOT PREVIOUSLY REPORTED. 

2313
01:27:39,064 --> 01:27:42,501
TO TAKE A CLOSER LOOK AT 

2314
01:27:42,501 --> 01:27:43,135
FENTANYL-RELATED OVERDOSES. 

2315
01:27:43,135 --> 01:27:46,538
YOU CAN SEE ON THE UPPER-LEFT 

2316
01:27:46,538 --> 01:27:48,774
HAND CORNER THE TREND OF 

2317
01:27:48,774 --> 01:27:51,176
REDUCING OPIOID DEATHS ACROSS 

2318
01:27:51,176 --> 01:27:51,810
TOWN. 

2319
01:27:51,810 --> 01:27:54,846
YOU CAN SEE THAT MALE OVERDOSES 

2320
01:27:54,846 --> 01:27:55,581
RELATED TO FENTANYL LARGELY 

2321
01:27:55,581 --> 01:27:56,448
DROVE THOSE TRENDS. 

2322
01:27:56,448 --> 01:28:00,085
BUT YOU CAN SEE THAT BY RACE AND

2323
01:28:00,085 --> 01:28:01,954
ETHNICITY, THE TRAJECTORIES ARE 

2324
01:28:01,954 --> 01:28:04,256
A BIT DIFFERENT ACROSS WHITE, 

2325
01:28:04,256 --> 01:28:07,426
BLACK AND HISPANIC COMMUNITY 

2326
01:28:07,426 --> 01:28:08,427
MEMBERS. 

2327
01:28:08,427 --> 01:28:12,297
SEEING A BISMULDMORDAL AGE 

2328
01:28:12,297 --> 01:28:13,432
DISTRIBUTION OF INCREASED 

2329
01:28:13,432 --> 01:28:17,102
OVERDOSE AMONG BLACK DECEDENTS 

2330
01:28:17,102 --> 01:28:19,771
AND THAT WAS CLOSELY MIRRORED 

2331
01:28:19,771 --> 01:28:20,739
WITH STIMULATED OVERDOSES.

2332
01:28:20,739 --> 01:28:22,674
WE LOOK AT URBAN AND RURAL 

2333
01:28:22,674 --> 01:28:24,977
DIFFERENCES IN THE TRAJECTORY AS

2334
01:28:24,977 --> 01:28:25,310
WELL. 

2335
01:28:25,310 --> 01:28:27,813
AND THEN CAN LOOK AT SPATIAL 

2336
01:28:27,813 --> 01:28:34,019
DISTRIBUTION AND SPACIOTEMPORAL 

2337
01:28:34,019 --> 01:28:36,288
OF OVERDOSE OF HEROIN, SYNTHETIC

2338
01:28:36,288 --> 01:28:41,560
OPIOID AND STIMULANTS. 

2339
01:28:41,560 --> 01:28:43,962
WE ARE TAKING DATA-TO-ACTION 

2340
01:28:43,962 --> 01:28:44,429
APPROACH. 

2341
01:28:44,429 --> 01:28:45,664
DATA DASHBOARDS THAT WERE 

2342
01:28:45,664 --> 01:28:46,898
DISTRICT MODELS AND SIMULATION 

2343
01:28:46,898 --> 01:28:48,934
MODELS OF THE EFFECTS OF AN 

2344
01:28:48,934 --> 01:28:50,969
INDIVIDUAL AND COMBINED 

2345
01:28:50,969 --> 01:28:51,837
INTERVENTIONS THAT CAN BEND THE 

2346
01:28:51,837 --> 01:28:55,073
CURVE IN LOCAL PUBLIC HEALTH 

2347
01:28:55,073 --> 01:28:55,540
COMMUNITIES AND LOCAL 

2348
01:28:55,540 --> 01:28:56,241
POLICYM

2349
01:28:56,241 --> 01:28:56,575
POLICYMAKERS. 

2350
01:28:56,575 --> 01:29:01,513
TO RECAP, WE TALKED OF SPATIAL 

2351
01:29:01,513 --> 01:29:02,447
EPIDEMIOLOGY CONCEPTS AND 

2352
01:29:02,447 --> 01:29:03,715
APPLICATIONS. 

2353
01:29:03,715 --> 01:29:05,050
SPATIAL PREVENTION HIGHLIGHTED 

2354
01:29:05,050 --> 01:29:07,519
IN OUR NIDA. 

2355
01:29:07,519 --> 01:29:11,123
AND RELOOK AT THIS QUESTION OF 

2356
01:29:11,123 --> 01:29:13,659
SPATIAL AND CAN AFFECT DISEASE 

2357
01:29:13,659 --> 01:29:13,959
PREVENTION. 

2358
01:29:13,959 --> 01:29:16,995
YES IT CAN, MONITOR PREVENTION 

2359
01:29:16,995 --> 01:29:17,429
INTERVENTIONS. 

2360
01:29:17,429 --> 01:29:19,398
GUIDE HEALTH COMMUNITY AND 

2361
01:29:19,398 --> 01:29:20,465
ECONOMIC REQUIREMENTS. 

2362
01:29:20,465 --> 01:29:22,167
TARGET LOCATIONS FOR NEW HEALTH 

2363
01:29:22,167 --> 01:29:22,634
SERVICES. 

2364
01:29:22,634 --> 01:29:25,070
INFORM LOCAL COMMUNITIES AND 

2365
01:29:25,070 --> 01:29:25,671
POLICYMAKERS. 

2366
01:29:25,671 --> 01:29:29,041
AND ALLOW US TO USE SPATIAL AN 

2367
01:29:29,041 --> 01:29:29,675
LIT TALL SCHOOLS FOR 

2368
01:29:29,675 --> 01:29:30,709
SURVEILLANCE. 

2369
01:29:30,709 --> 01:29:31,877
I THANK YOU VERY MUCH FOR YOUR 

2370
01:29:31,877 --> 01:29:34,379
TIME AND LOOK FORWARD TO THE 

2371
01:29:34,379 --> 01:29:36,915
QUESTION AND ANSWER SESSION. 

2372
01:29:36,915 --> 01:29:38,450
>> GREAT. 

2373
01:29:38,450 --> 01:29:42,354
THANK YOU SO MUCH, HAVE STOPKA. 

2374
01:29:42,354 --> 01:29:44,056
THAT WAS WONDERFUL AND I AM 

2375
01:29:44,056 --> 01:29:45,691
HAVING A HARD TIME ABSORBING IT 

2376
01:29:45,691 --> 01:29:47,592
ALL BECAUSE SO MUCH THAT YOU 

2377
01:29:47,592 --> 01:29:49,094
EXPERTLY PUNT INTO SUCH A SHORT 

2378
01:29:49,094 --> 01:29:49,294
TIME. 

2379
01:29:49,294 --> 01:29:50,996
I WILL START WITH SOME 

2380
01:29:50,996 --> 01:29:51,330
QUESTIONS. 

2381
01:29:51,330 --> 01:29:53,398
AND I WILL TRY TO FOCUS ON THE 

2382
01:29:53,398 --> 01:29:54,266
ONES THAT OTHER PEOPLE WROTE 

2383
01:29:54,266 --> 01:29:55,901
INSTEAD OF ALL THE ONES I WROTE 

2384
01:29:55,901 --> 01:29:56,468
DOWN. 

2385
01:29:56,468 --> 01:29:58,970
BECAUSE I HAVE A LOT OF 

2386
01:29:58,970 --> 01:30:00,072
QUESTIONS TOO. 

2387
01:30:00,072 --> 01:30:02,074
BUT IT IS JUST EXCITING. FIRST 

2388
01:30:02,074 --> 01:30:03,775
OF ALL, WE ARE GOING TO START --

2389
01:30:03,775 --> 01:30:05,610
WE HAVE ABOUT TEN MINUTES HERE. 

2390
01:30:05,610 --> 01:30:07,045
START WITH QUESTIONS FOR DR. 

2391
01:30:07,045 --> 01:30:07,346
WALLER. 

2392
01:30:07,346 --> 01:30:08,447
WE ALSO HAVE QUESTIONS FOR BOTH 

2393
01:30:08,447 --> 01:30:08,680
PEOPLE. 

2394
01:30:08,680 --> 01:30:11,483
I AM GETTING THEM FROM DIFFERENT

2395
01:30:11,483 --> 01:30:11,750
SOURCES. 

2396
01:30:11,750 --> 01:30:15,220
SO TIME JUGGLING HERE A LITTLE 

2397
01:30:15,220 --> 01:30:17,289
BIT. 

2398
01:30:17,289 --> 01:30:18,590
SO LET'S SEE. 

2399
01:30:18,590 --> 01:30:22,094
THESE DON'T HAVE NAMES ON THEM. 

2400
01:30:22,094 --> 01:30:26,331
OKAY. SO FOR DR. WALLER, YOU 

2401
01:30:26,331 --> 01:30:28,667
SPOKE ABOUT THE ECOLOGY AND 

2402
01:30:28,667 --> 01:30:30,435
CATCHMENT FOR DATA TO UNDERSTAND

2403
01:30:30,435 --> 01:30:32,471
THE SYSTEMS AND ENVIRONMENTS OF 

2404
01:30:32,471 --> 01:30:34,339
SUBSTANCE ABUSE. 

2405
01:30:34,339 --> 01:30:39,177
HOW ARE THOSE TOOLS AND THE 

2406
01:30:39,177 --> 01:30:39,945
DATA. 

2407
01:30:39,945 --> 01:30:42,614
AND ALONGSIDE OTHER METHODS WITH

2408
01:30:42,614 --> 01:30:43,515
STAKEHOLDERS OF COMMUNITY 

2409
01:30:43,515 --> 01:30:45,417
ENGAGEMENT AND POTENTIALLY 

2410
01:30:45,417 --> 01:30:48,120
INCREASE THE RICHNESS OF THAT 

2411
01:30:48,120 --> 01:30:49,187
DATA CATCHMENT THROUGH THAT 

2412
01:30:49,187 --> 01:30:51,189
ENGAGEMENT PROCESS. 

2413
01:30:51,189 --> 01:30:51,923
>> THANKS. 

2414
01:30:51,923 --> 01:30:53,658
I THINK THAT IS A VERY GOOD 

2415
01:30:53,658 --> 01:30:53,925
QUESTION. 

2416
01:30:53,925 --> 01:30:56,495
TOWARD THE END OF INTEREST 

2417
01:30:56,495 --> 01:30:58,430
STOPKA'S PRESENTATION, THE 

2418
01:30:58,430 --> 01:31:00,332
DASHBOARDING AND THOSE KIND OF 

2419
01:31:00,332 --> 01:31:00,732
ACCESS. 

2420
01:31:00,732 --> 01:31:02,901
MORE DATA SETS AVAILABLE NOW AND

2421
01:31:02,901 --> 01:31:04,169
IF YOU HAVE A COMMON PLATFORM 

2422
01:31:04,169 --> 01:31:06,371
FOR PEOPLE OBSERVING THEM, I 

2423
01:31:06,371 --> 01:31:09,040
THINK YOU CAN GET MORE FEEDBACK 

2424
01:31:09,040 --> 01:31:10,542
FROM COMMUNITY MEMBERS, THE 

2425
01:31:10,542 --> 01:31:11,977
COMMUNITY ENGAGEMENT. 

2426
01:31:11,977 --> 01:31:14,546
I WILL SAY ON OUR ENVIRONMENTAL 

2427
01:31:14,546 --> 01:31:16,515
STATISTIC SLIDE, WE DID A PUBLIC

2428
01:31:16,515 --> 01:31:20,352
USE DATA COURSE FOR COMMUNITY 

2429
01:31:20,352 --> 01:31:21,686
GROUPS WORKING ON ENVIRONMENTAL 

2430
01:31:21,686 --> 01:31:23,021
JUSTICE ISSUES IN THE 

2431
01:31:23,021 --> 01:31:23,922
METROPOLITAN ATLANTA AREA. 

2432
01:31:23,922 --> 01:31:25,657
AND I THINK A LOT OF US A THAT 

2433
01:31:25,657 --> 01:31:28,326
ARE DOING STATISTICS FOR A LONG 

2434
01:31:28,326 --> 01:31:30,362
TIME, YOU DON'T YOU HAVE TO LOOK

2435
01:31:30,362 --> 01:31:31,530
AT EIGHT YEARS OF STATISTICS 

2436
01:31:31,530 --> 01:31:33,665
BEFORE YOU LOOK AT DATASETS. 

2437
01:31:33,665 --> 01:31:35,434
PEOPLE CAN ACCESS THE SOCIAL 

2438
01:31:35,434 --> 01:31:37,302
VULNERABILITY INDEX. 

2439
01:31:37,302 --> 01:31:38,170
THE MAPS ARE POWERFUL 

2440
01:31:38,170 --> 01:31:39,237
INFORMATION BECAUSE THE 

2441
01:31:39,237 --> 01:31:41,106
COMMUNITY MEMBERS AND THOSE WHO 

2442
01:31:41,106 --> 01:31:42,407
LIVED CONCERNS ABOUT ARE 

2443
01:31:42,407 --> 01:31:43,875
BRINGING THEIR INSIGHT TO THE 

2444
01:31:43,875 --> 01:31:45,343
PATTERNS AS WELL. 

2445
01:31:45,343 --> 01:31:47,279
SO THE NUMBERS, BUT I THINK AS 

2446
01:31:47,279 --> 01:31:48,747
-- IT IS PUT VERY WELL AT THE 

2447
01:31:48,747 --> 01:31:49,681
BEGINNING OF THE LAST 

2448
01:31:49,681 --> 01:31:50,515
PRESENTATION, THERE ARE PEOPLE. 

2449
01:31:50,515 --> 01:31:52,317
THESE ARE PEOPLE WE ARE TALKING 

2450
01:31:52,317 --> 01:31:52,551
ABOUT. 

2451
01:31:52,551 --> 01:31:56,521
AND THAT CONTEXT, A LOT OF THAT 

2452
01:31:56,521 --> 01:31:57,856
IS NOT MEASURED. 

2453
01:31:57,856 --> 01:31:59,357
SO I WILL STOP THERE. 

2454
01:31:59,357 --> 01:32:01,493
>> OKAY. 

2455
01:32:01,493 --> 01:32:02,527
THANK YOU. 

2456
01:32:02,527 --> 01:32:04,896
GREAT RESPONSE. 

2457
01:32:04,896 --> 01:32:07,132
SO I AM GOING TO SWITCH BACK AND

2458
01:32:07,132 --> 01:32:07,732
FOR THE. 

2459
01:32:07,732 --> 01:32:09,734
A QUESTION FOR DR. STOPKA, GIVEN

2460
01:32:09,734 --> 01:32:11,136
THE LARGE PORTION OF THE 

2461
01:32:11,136 --> 01:32:12,404
POPULATION OF PEOPLE WHO USE 

2462
01:32:12,404 --> 01:32:13,505
DRUGS HAVE UNSTABLE OR 

2463
01:32:13,505 --> 01:32:14,973
TRANSITIONAL HOUSING, HOW DO YOU

2464
01:32:14,973 --> 01:32:16,741
THINK THIS AFFECTED YOUR 

2465
01:32:16,741 --> 01:32:21,213
ANALYSES THAT RELY ON DECEDENTS'

2466
01:32:21,213 --> 01:32:22,614
HOME ADDRESSES?

2467
01:32:22,614 --> 01:32:23,615
>>Tom Stopka: THAT IS A
GREAT 

2468
01:32:23,615 --> 01:32:23,882
QUESTION. 

2469
01:32:23,882 --> 01:32:26,251
WE HAVE ACCESS TO TWO ADDRESSES 

2470
01:32:26,251 --> 01:32:28,386
-- WE HAVE ACCESS TO THREE 

2471
01:32:28,386 --> 01:32:28,687
ADDRESSES. 

2472
01:32:28,687 --> 01:32:30,121
PLACE OF RESIDENCE, PLACE OF 

2473
01:32:30,121 --> 01:32:31,990
INJURY, AND A PLACE OF DEATH. 

2474
01:32:31,990 --> 01:32:33,959
THE MOST COMPLETE DATA ARE THE 

2475
01:32:33,959 --> 01:32:38,463
PLACE OF RESIDENCE AT TIME OF 

2476
01:32:38,463 --> 01:32:39,598
THE FATAL OVERDOSE. 

2477
01:32:39,598 --> 01:32:41,666
PLACE OF INJURY DATA IS ONLY 

2478
01:32:41,666 --> 01:32:43,468
ABOUT 50% COMPLETE. 

2479
01:32:43,468 --> 01:32:46,738
A LOT MISSING TO THAT DATA. 

2480
01:32:46,738 --> 01:32:49,040
PLACE OF DEATH IS HIGHLY BIASED 

2481
01:32:49,040 --> 01:32:51,610
PAUSE RELEGATED TO A HOSPITAL 

2482
01:32:51,610 --> 01:32:52,978
WHERE THE DEATH IS DECLARED. 

2483
01:32:52,978 --> 01:32:55,113
THE INJURY OR THE ACCIDENT, THE 

2484
01:32:55,113 --> 01:32:58,817
OVERDOSE REALLY HAPPENED AT A 

2485
01:32:58,817 --> 01:32:59,484
LOCAL COMMUNITY OR SOMEONE'S 

2486
01:32:59,484 --> 01:32:59,885
HOME. 

2487
01:32:59,885 --> 01:33:03,688
ONE OF THE PAPERS THAT WE 

2488
01:33:03,688 --> 01:33:05,557
HIGHLIGHTED TRYING TO TEASE THIS

2489
01:33:05,557 --> 01:33:05,790
APART. 

2490
01:33:05,790 --> 01:33:06,892
THERE ARE CERTAINLY LIMITATIONS 

2491
01:33:06,892 --> 01:33:08,960
BUT WE TRIED TO LOOK VERY 

2492
01:33:08,960 --> 01:33:10,095
CLOSELY AT DIFFERENCES BETWEEN 

2493
01:33:10,095 --> 01:33:11,930
PLACE OF RESENSE, PLACE OF 

2494
01:33:11,930 --> 01:33:12,163
INJURY. 

2495
01:33:12,163 --> 01:33:13,198
PLACE OF DEATH. 

2496
01:33:13,198 --> 01:33:16,535
AND TO LOOK AT THE DISTANCE OF 

2497
01:33:16,535 --> 01:33:17,235
SPATIAL DISTANCE BETWEEN POLICE 

2498
01:33:17,235 --> 01:33:19,304
OF RESIDENCE AND PLACE WHERE THE

2499
01:33:19,304 --> 01:33:20,672
INJURY TOOK PLACE AND PLACE 

2500
01:33:20,672 --> 01:33:24,342
WHERE THE DEATH WAS RECORDED. WE

2501
01:33:24,342 --> 01:33:25,977
-- YOU KNOW, THERE ARE -- THERE 

2502
01:33:25,977 --> 01:33:27,779
ARE CHALLENGES. 

2503
01:33:27,779 --> 01:33:28,914
AND WE ACKNOWLEDGE THOSE. 

2504
01:33:28,914 --> 01:33:31,883
BUT WE TRY TO REALLY TEASE APART

2505
01:33:31,883 --> 01:33:33,351
ALL THESE DIFFERENT ADDRESSES TO

2506
01:33:33,351 --> 01:33:35,620
GIVE THE BEST PICTURE OF THE 

2507
01:33:35,620 --> 01:33:38,523
RISK LANDSCAPE AS IT PERTAINS TO

2508
01:33:38,523 --> 01:33:39,090
FATAL OVERDOSE. 

2509
01:33:39,090 --> 01:33:41,259
WE ARE TRYING TO DO THE SAME 

2510
01:33:41,259 --> 01:33:44,195
WITH NONFATAL OVERDOSE BASED ON 

2511
01:33:44,195 --> 01:33:47,432
AMBULANCE TRIP DATA AS WELL. 

2512
01:33:47,432 --> 01:33:48,133
>>Courte Van Voorhees:
GREAT. 

2513
01:33:48,133 --> 01:33:49,267
THANK YOU. 

2514
01:33:49,267 --> 01:33:51,102
IN QUESTION CAME IN EARLIER, BUT

2515
01:33:51,102 --> 01:33:53,238
I THINK EITHER OF YOU COULD 

2516
01:33:53,238 --> 01:33:54,506
ANSWER THIS ONE. 

2517
01:33:54,506 --> 01:33:56,041
WHAT RECOMMENDATIONS DO YOU HAVE

2518
01:33:56,041 --> 01:33:58,743
FOR EARLY CAREERS OR TRAINEES 

2519
01:33:58,743 --> 01:34:01,680
WHO ARE INTERESTED IN PURSUING 

2520
01:34:01,680 --> 01:34:07,118
THIS FIELD OF RESEARCH?

2521
01:34:07,118 --> 01:34:08,186
>> I WOULD SAY, FIRST OF
ALL, 

2522
01:34:08,186 --> 01:34:08,954
JUST READ. 

2523
01:34:08,954 --> 01:34:12,691
YOU SAW A LIST OF PAPERS -- 

2524
01:34:12,691 --> 01:34:13,658
THOMAS'S GROUP HAS A WIDE 

2525
01:34:13,658 --> 01:34:14,526
SELECTION OF THEM. 

2526
01:34:14,526 --> 01:34:15,927
SEE WHAT PEOPLE DO. 

2527
01:34:15,927 --> 01:34:18,697
A LOT OF TIMES WHEN YOU START, 

2528
01:34:18,697 --> 01:34:19,631
YOU JUST THINK IT IS THE MAP 

2529
01:34:19,631 --> 01:34:21,666
WITH THE RATES ON IT. 

2530
01:34:21,666 --> 01:34:24,502
AS YOU SAW EACH ONE HAD MAPS OF 

2531
01:34:24,502 --> 01:34:26,538
ACCESS, ATTRIBUTION. 

2532
01:34:26,538 --> 01:34:28,373
DIFFERENT TYPES OF MEASUREMENT. 

2533
01:34:28,373 --> 01:34:29,674
IF YOU READ -- I THINK READING 

2534
01:34:29,674 --> 01:34:31,910
AS MUCH AS YOU CAN IS ALWAYS A 

2535
01:34:31,910 --> 01:34:32,344
GOOD THING. 

2536
01:34:32,344 --> 01:34:33,678
SOME AUTHORS WILL SPEAK TO YOU A

2537
01:34:33,678 --> 01:34:35,246
LITTLE BETTER. 

2538
01:34:35,246 --> 01:34:37,115
ALL HAVE DIFFERENT LEARNS STYLES

2539
01:34:37,115 --> 01:34:39,117
AND DIFFERENT TEACHING STYLES. 

2540
01:34:39,117 --> 01:34:40,752
THAT IS THE GOOD WAY. 

2541
01:34:40,752 --> 01:34:42,621
FIND WHAT COURSES OR SHORT 

2542
01:34:42,621 --> 01:34:44,522
COURSES ARE AVAILABLE. 

2543
01:34:44,522 --> 01:34:47,092
HONEST RECOMMENDATIONS YOU MIGHT

2544
01:34:47,092 --> 01:34:47,292
HAVE?

2545
01:34:47,292 --> 01:34:49,361
>> THOSE ARE GREAT 

2546
01:34:49,361 --> 01:34:49,761
RECOMMENDATIONS. 

2547
01:34:49,761 --> 01:34:51,496
I TRY TO GIVE MY STUDENTS THE 

2548
01:34:51,496 --> 01:34:53,331
OPPORTUNITY TO WORK WITH LIVE 

2549
01:34:53,331 --> 01:34:53,632
DATA. 

2550
01:34:53,632 --> 01:34:55,400
I TYPICALLY SEND OUT E-MAILS TO 

2551
01:34:55,400 --> 01:34:57,102
COLLEAGUES NEAR AND FAR A COUPLE

2552
01:34:57,102 --> 01:35:00,672
OF WEEKS BEFORE THE CLASS STARTS

2553
01:35:00,672 --> 01:35:02,507
IN THE CRETE TO YOU HAVE 

2554
01:35:02,507 --> 01:35:03,541
SPATIALLY ORIENTED DATA YOU 

2555
01:35:03,541 --> 01:35:04,576
WOULD LIKE TO HAVE MAPPED?

2556
01:35:04,576 --> 01:35:10,048
BECAUSE THIS IS A WIN-WIN 

2557
01:35:10,048 --> 01:35:12,017
OPPORTUNITY TO GET YOUR DATA 

2558
01:35:12,017 --> 01:35:13,385
MAPPED AND WOULDN'T HAPPEN 

2559
01:35:13,385 --> 01:35:15,520
OTHERWISE AND A STUDENT FOR 

2560
01:35:15,520 --> 01:35:16,821
PRODUCTS THAT WILL HELP INFORM 

2561
01:35:16,821 --> 01:35:17,622
DECISION MAKING. 

2562
01:35:17,622 --> 01:35:19,591
I WILL LOOK FOR CLASSES THAT 

2563
01:35:19,591 --> 01:35:23,228
ALLOW FOR THAT HANDS ON APPLIED 

2564
01:35:23,228 --> 01:35:25,664
OPPORTUNITY TO WORK WITH LOCAL 

2565
01:35:25,664 --> 01:35:26,364
DATA. 

2566
01:35:26,364 --> 01:35:28,566
HERE AT TUFTS, WE HAVE 

2567
01:35:28,566 --> 01:35:29,668
RESIDENTIAL CLASS. 

2568
01:35:29,668 --> 01:35:32,337
WE HAVE ONLINE CLASS IN SPATIAL 

2569
01:35:32,337 --> 01:35:32,671
EPIDEMIOLOGY. 

2570
01:35:32,671 --> 01:35:34,305
A LOT OF OFFERING AROUND THE 

2571
01:35:34,305 --> 01:35:35,507
COUNTRY THROUGH UNIVERSITIES, 

2572
01:35:35,507 --> 01:35:38,410
THROUGH COMPANIES THAT MAKE THE 

2573
01:35:38,410 --> 01:35:39,077
SOFTWARE. 

2574
01:35:39,077 --> 01:35:41,713
AND -- AND READING AND ALSO 

2575
01:35:41,713 --> 01:35:44,549
LOOKING AT ONLINE TUTORIALS CAN 

2576
01:35:44,549 --> 01:35:45,684
BE USEFUL AND STUDENTS COME TO 

2577
01:35:45,684 --> 01:35:47,986
ME AND SAY I WANT TO DEVELOP A 

2578
01:35:47,986 --> 01:35:50,622
MAP OR DO SOME SPATIAL ANALYSES 

2579
01:35:50,622 --> 01:35:53,158
FOR MY CAPSTONE PROJECT. 

2580
01:35:53,158 --> 01:35:54,259
THE FIRST QUESTION, HAVE YOU 

2581
01:35:54,259 --> 01:35:55,126
TAKEN A CLASS?

2582
01:35:55,126 --> 01:35:57,262
TAKE A CLASS FIRST, BECAUSE MANY

2583
01:35:57,262 --> 01:35:58,596
DIFFERENT CONSIDERATIONS AS DR. 

2584
01:35:58,596 --> 01:35:59,597
WALLER HIGHLIGHTED IN HIS 

2585
01:35:59,597 --> 01:36:00,999
PRESENTATION AND I HIGHLIGHTED 

2586
01:36:00,999 --> 01:36:02,567
AND AS WE WILL HEAR THROUGH THE 

2587
01:36:02,567 --> 01:36:05,670
REST OF THE AFTERNOON. 

2588
01:36:05,670 --> 01:36:06,371
>>Courte Van Voorhees:
GREAT. 

2589
01:36:06,371 --> 01:36:07,839
THANK YOU, BOTH, VERY MUCH. 

2590
01:36:07,839 --> 01:36:09,174
THIS QUESTION CAME IN AND CAN BE

2591
01:36:09,174 --> 01:36:11,109
FOR ANYBODY, BUT I WILL ASK IT. 

2592
01:36:11,109 --> 01:36:13,678
AND IT IS A GOOD ONE. 

2593
01:36:13,678 --> 01:36:16,081
PERHAPS ANOTHER CHALLENGE IN 

2594
01:36:16,081 --> 01:36:17,348
GEOSPATIAL DATA IS TO SHARE THE 

2595
01:36:17,348 --> 01:36:19,684
DATA WITH THE COMMUNITY IN 

2596
01:36:19,684 --> 01:36:21,086
IDENTIFYING THE GEOSPATIAL DATA.

2597
01:36:21,086 --> 01:36:22,620
HOW SHOULD WE ADDRESS THIS 

2598
01:36:22,620 --> 01:36:22,821
ISSUE?

2599
01:36:22,821 --> 01:36:25,190
I SEE THIS AS BEING TO A CERTAIN

2600
01:36:25,190 --> 01:36:27,225
DEGREE PART OF SOME LARGER 

2601
01:36:27,225 --> 01:36:30,195
ISSUES OF ACCESS AND ETHICS 

2602
01:36:30,195 --> 01:36:31,062
WHICH BOTH OF YOU TOUCHED ON, 

2603
01:36:31,062 --> 01:36:32,564
BUT WOULD LOVE TO HEAR YOUR 

2604
01:36:32,564 --> 01:36:34,099
DIRECT RESPONSE TO THAT. 

2605
01:36:34,099 --> 01:36:35,033
>> YES. 

2606
01:36:35,033 --> 01:36:37,168
I SAW ANOTHER QUESTION IN THE 

2607
01:36:37,168 --> 01:36:38,703
CHAT ALONG THIS LINE TOO. 

2608
01:36:38,703 --> 01:36:46,911
YOU KNOW, WE GEO MASK OUR DATA 

2609
01:36:46,911 --> 01:36:50,582
IN A RANDOM DIRECTION AND RANDOM

2610
01:36:50,582 --> 01:36:50,849
DISTANCE. 

2611
01:36:50,849 --> 01:36:56,788
WE USE THE BIMODALITY GALION 

2612
01:36:56,788 --> 01:36:59,591
APPROACH TO RAMP OUR DATA THAT 

2613
01:36:59,591 --> 01:37:01,259
THEY ARE RANDOMLY DISPLACED SO 

2614
01:37:01,259 --> 01:37:04,162
DON'T IDENTIFY THE EXACT HOME OR

2615
01:37:04,162 --> 01:37:05,563
RESIDENCE, BUT IN THE VICINITY, 

2616
01:37:05,563 --> 01:37:06,731
BECAUSE THE NUMBERS ARE 

2617
01:37:06,731 --> 01:37:07,799
RELATIVELY LARGE OVER A NUMBER 

2618
01:37:07,799 --> 01:37:10,034
OF YEARS, WE ARE ABLE TO SEE 

2619
01:37:10,034 --> 01:37:12,170
MEANINGFUL PATTERNS. 

2620
01:37:12,170 --> 01:37:13,438
I THINK THAT IS SUPER IMPORTANT.

2621
01:37:13,438 --> 01:37:15,940
ONE, TO PROTECT THE CONFIDENTIAL

2622
01:37:15,940 --> 01:37:17,675
OF FAMILY MEMBERS AND FRIENDS 

2623
01:37:17,675 --> 01:37:21,479
AND NEIGHBORS AND COMMUNITIES. 

2624
01:37:21,479 --> 01:37:22,180
I THINK THAT -- I THINK THAT THE

2625
01:37:22,180 --> 01:37:30,555
COMMUNITY EN GAEN /*GAGEG -- 

2626
01:37:30,555 --> 01:37:32,323
ENGAGE IT PARAMOUNT TO ENSURE WE

2627
01:37:32,323 --> 01:37:34,559
ARE GETTING THINGS RIGHT AND THE

2628
01:37:34,559 --> 01:37:36,895
GROUND TRUTH AND WHAT ARE WE 

2629
01:37:36,895 --> 01:37:38,730
MISSING AND NOT CONSIDERED IN 

2630
01:37:38,730 --> 01:37:42,734
OUR SPATIAL ANALYTICS AND OUR 

2631
01:37:42,734 --> 01:37:42,967
MODELS?

2632
01:37:42,967 --> 01:37:43,301
>> THANK YOU. 

2633
01:37:43,301 --> 01:37:44,903
>> I THINK THAT IS A GREAT

2634
01:37:44,903 --> 01:37:45,203
RERESPONSE. 

2635
01:37:45,203 --> 01:37:46,704
I THINK ALSO WE SHOULD KEEP IN 

2636
01:37:46,704 --> 01:37:51,409
MIND WE PROBABLY CAN'T GUARANTEE

2637
01:37:51,409 --> 01:37:51,709
PROTECTING. 

2638
01:37:51,709 --> 01:37:54,712
SO YOU ALWAYS NEED -- IF SOMEONE

2639
01:37:54,712 --> 01:37:56,347
SAYS IS THIS ETHICAL ENOUGH?

2640
01:37:56,347 --> 01:37:58,950
PROBABLY A GOOD TIP IT IS NOT. 

2641
01:37:58,950 --> 01:38:01,653
FOR ANY DATA ETHICS QUESTION. 

2642
01:38:01,653 --> 01:38:04,088
I DO THINK IT IS A VERY 

2643
01:38:04,088 --> 01:38:05,056
CHALLENGING ASPECT BECAUSE WE 

2644
01:38:05,056 --> 01:38:08,560
WILL -- WE ADD ENOUGH NOISE TO 

2645
01:38:08,560 --> 01:38:11,663
PROT

2646
01:38:11,663 --> 01:38:15,166
PROTECT MIGHT HIDE A SIGNAL AT A

2647
01:38:15,166 --> 01:38:15,600
LOWER SCALE. 

2648
01:38:15,600 --> 01:38:19,504
I THINK IT IS -- NOT IS A WARY 

2649
01:38:19,504 --> 01:38:20,438
CONSUMER BUT A INFORMED CONS

2650
01:38:20,438 --> 01:38:23,441
CONSUMERS OF THE TOOLS YOU HAVE 

2651
01:38:23,441 --> 01:38:24,375
TO PROTECT IDENTITY AND WHAT 

2652
01:38:24,375 --> 01:38:26,578
REMAINS DETECTABLE. 

2653
01:38:26,578 --> 01:38:29,180
SO I THINK WE SAW A REALLY GOOD 

2654
01:38:29,180 --> 01:38:32,550
BALANCE OF THOSE AND DR. 

2655
01:38:32,550 --> 01:38:33,651
STOPKA'S PRESENTATION, BUT IT IS

2656
01:38:33,651 --> 01:38:35,086
AN ONGOING CHALLENGE AND 

2657
01:38:35,086 --> 01:38:37,488
SOMETHING TO KEEP IN MIND AS A 

2658
01:38:37,488 --> 01:38:39,390
USER OF GEOSPATIAL DATA. 

2659
01:38:39,390 --> 01:38:40,825
>> CERTAINLY. 

2660
01:38:40,825 --> 01:38:42,961
SO WE DON'T HAVE A TON OF TIME. 

2661
01:38:42,961 --> 01:38:43,795
I DON'T KNOW IF WE WILL GET TO 

2662
01:38:43,795 --> 01:38:45,597
ALL OF THEM, BUT THIS IS ANOTHER

2663
01:38:45,597 --> 01:38:48,132
ONE FOR BOTH OF YOU WHICH IS 

2664
01:38:48,132 --> 01:38:49,000
WORKING SO PAR. 

2665
01:38:49,000 --> 01:38:52,170
HI, DR. STOPKA AND WALLER. 

2666
01:38:52,170 --> 01:38:54,439
TALK ABOUT SPATIAL SCALE AND ANY

2667
01:38:54,439 --> 01:38:56,374
CONSIDERATIONS FOR LOW DENSITY 

2668
01:38:56,374 --> 01:38:58,576
POPULATION AREA OR WHERE THE 

2669
01:38:58,576 --> 01:39:00,311
SAMPLING SHOW LOW INCIDENCE OR 

2670
01:39:00,311 --> 01:39:01,679
DATA GAPS?

2671
01:39:01,679 --> 01:39:05,183
>> THIS IS AN ISSUE WE ARE

2672
01:39:05,183 --> 01:39:06,184
GRAPPLING WITH ALWAYS. 

2673
01:39:06,184 --> 01:39:07,785
SOMETIMES WE ARE RELEGATED TO 

2674
01:39:07,785 --> 01:39:11,155
THE SOURCE THAT THE DATA COME 

2675
01:39:11,155 --> 01:39:11,522
FROM. 

2676
01:39:11,522 --> 01:39:17,028
WITH DECEDENTT DATA AND 

2677
01:39:17,028 --> 01:39:17,462
NONOVERDOSE DATA. 

2678
01:39:17,462 --> 01:39:19,030
WE CAN MAKE DECISIONS. 

2679
01:39:19,030 --> 01:39:21,666
NOT ONLY DEPEND ON POLITICAL 

2680
01:39:21,666 --> 01:39:26,537
BOUNDARIES SUCH AS ZIP CODES, 

2681
01:39:26,537 --> 01:39:27,472
CENSUS TRACTS, BLOCK GROUPS. 

2682
01:39:27,472 --> 01:39:32,577
WE ARE LOOKING AT EXPLORING 

2683
01:39:32,577 --> 01:39:33,678
FISHNET-BASED ANALYSES. 

2684
01:39:33,678 --> 01:39:35,113
THROW A FISHNET OVER YOUR 

2685
01:39:35,113 --> 01:39:39,550
CATCHMENT STUDY AREA AND VARYING

2686
01:39:39,550 --> 01:39:40,818
SIZES TO AGGREGATE THE DATA AT 

2687
01:39:40,818 --> 01:39:44,389
THOSE LEVELS AND SEE WHAT THAT 

2688
01:39:44,389 --> 01:39:44,923
DOES IN IMPLICATIONS WITH 

2689
01:39:44,923 --> 01:39:48,192
CLUSTER ANALYSES AND WHAT 

2690
01:39:48,192 --> 01:39:50,061
INDICATION WITH ANALYTIC 

2691
01:39:50,061 --> 01:39:50,361
APPROACHES. 

2692
01:39:50,361 --> 01:39:51,629
>> YEAH, I THINK IT IS
IMPORTANT

2693
01:39:51,629 --> 01:39:53,665
TO KEEP IN MIND THAT THERE IS 

2694
01:39:53,665 --> 01:39:56,434
NOT -- THERE IS NOT A SINGLE 

2695
01:39:56,434 --> 01:39:57,135
SCALE. 

2696
01:39:57,135 --> 01:39:58,436
YOU KNOW THINGS HAT AN DIFFERENT

2697
01:39:58,436 --> 01:39:58,670
SCALES. 

2698
01:39:58,670 --> 01:40:00,204
ONE OF THE THINGS THAT IS HARD, 

2699
01:40:00,204 --> 01:40:01,606
WE OBSERVE SOMETHING AT A 

2700
01:40:01,606 --> 01:40:03,107
DIFFERENT SCALE THAN THE 

2701
01:40:03,107 --> 01:40:03,875
PROCESSES OPERATING IT. 

2702
01:40:03,875 --> 01:40:05,276
SOMETHING IS VERY LOCAL AND WE 

2703
01:40:05,276 --> 01:40:06,811
LOOK AT A BIG AGGREGATION. 

2704
01:40:06,811 --> 01:40:09,080
WE CAN MISS IT BECAUSE IT GETS 

2705
01:40:09,080 --> 01:40:10,448
WASHED OUT. 

2706
01:40:10,448 --> 01:40:12,483
AND I HAD SMALLER ESTIMATION IN 

2707
01:40:12,483 --> 01:40:15,553
MY TITLE AND DIDN'T DO A LOT OF 

2708
01:40:15,553 --> 01:40:17,021
THAT BUT THE MODELS THAT WERE 

2709
01:40:17,021 --> 01:40:18,923
MENTIONED CATCHING THE TENSION 

2710
01:40:18,923 --> 01:40:20,925
BETWEEN GEOGRAPHIC PRECISION, 

2711
01:40:20,925 --> 01:40:24,329
REALLY LOCAL SCALES, AND 

2712
01:40:24,329 --> 01:40:25,663
STATISTICAL AND BIG SAMPLE 

2713
01:40:25,663 --> 01:40:25,964
SIZES. 

2714
01:40:25,964 --> 01:40:28,833
YOU TRY TO GET STATISTICAL 

2715
01:40:28,833 --> 01:40:32,437
PREVISION YOU LOSE GEOGRAPHIC. 

2716
01:40:32,437 --> 01:40:33,972
AND THE RANDOM EFFECTS IS TO 

2717
01:40:33,972 --> 01:40:37,675
JUST RIGHT BORROWING OF 

2718
01:40:37,675 --> 01:40:38,443
INFORMATION FROM NEARBY 

2719
01:40:38,443 --> 01:40:39,277
OBSERVATIONS. 

2720
01:40:39,277 --> 01:40:41,679
AND THE THIRD TENSION AND MAKE A

2721
01:40:41,679 --> 01:40:42,447
TRIANGLE. 

2722
01:40:42,447 --> 01:40:43,147
PRIVACY. 

2723
01:40:43,147 --> 01:40:48,252
THE MORE NOISE THE MORE PRIVACY.

2724
01:40:48,252 --> 01:40:55,960
TO SEE HOW YOU I HAVE VAT. 

2725
01:40:55,960 --> 01:40:57,161
CONFIDENTIAL AND GEOGRAPHIC 

2726
01:40:57,161 --> 01:40:58,363
PRECISION AND A CHALLENGE. 

2727
01:40:58,363 --> 01:41:01,366
TOOLS TO HELP WITH THAT. 

2728
01:41:01,366 --> 01:41:03,701
BUT THINGS DO HAPPEN AT 

2729
01:41:03,701 --> 01:41:04,702
DIFFERENT SCALES. 

2730
01:41:04,702 --> 01:41:06,137
AND I THINK YOU WANT TO KEEP 

2731
01:41:06,137 --> 01:41:07,238
THAT IN MIND. 

2732
01:41:07,238 --> 01:41:08,506
>> THANK YOU SO MUCH. 

2733
01:41:08,506 --> 01:41:10,408
SO, UNFORTUNATELY, WE ARE OUT OF

2734
01:41:10,408 --> 01:41:13,044
TIME FOR QUESTIONS. 

2735
01:41:13,044 --> 01:41:14,412
THANK YOU, BOTH, SO MUCH THIS IS

2736
01:41:14,412 --> 01:41:14,979
VERY INFORMATIVE. 

2737
01:41:14,979 --> 01:41:15,536
WE HAVE A FIVE-MINUTE BREAK NOW 

2738
01:41:15,536 --> 01:41:16,938
AND LOOK FORWARD TO SEEK YOU ON 

2739
01:41:16,938 --> 01:41:19,140
THE OTHER SIDE OF THE BREAK.

2740
01:41:19,140 --> 01:41:19,975
HELLO, EVERYONE. 

2741
01:41:19,975 --> 01:41:21,009
WELCOME BACK FROM THE BREAK THAT

2742
01:41:21,009 --> 01:41:21,776
WE HAVE. 

2743
01:41:21,776 --> 01:41:25,013
I WOULD LIKE TO INTRODUCE OUR 

2744
01:41:25,013 --> 01:41:27,282
MODERATOR FOR THE NEXT SESSION 

2745
01:41:27,282 --> 01:41:29,451
TAMARA HAEGERICH WHO WILL BE 

2746
01:41:29,451 --> 01:41:32,687
ANNOUNCING THE SPEAKERS FOR THE 

2747
01:41:32,687 --> 01:41:33,388
RESEARCH SECTION. 

2748
01:41:33,388 --> 01:41:36,758
THANK VERY MUCH. 

2749
01:41:36,758 --> 01:41:38,860
>> THANK YOU, JANET. 

2750
01:41:38,860 --> 01:41:40,695
WE HAVE TWO PRESENTERS, FROM 

2751
01:41:40,695 --> 01:41:41,763
MARYNIA KOLAK AND DR. DEVIN 

2752
01:41:41,763 --> 01:41:42,263
BANKS. 

2753
01:41:42,263 --> 01:41:43,498
I AM GOING TO INTRODUCE THEM 

2754
01:41:43,498 --> 01:41:45,767
BOTH AND THEN WE WILL HAVE EACH 

2755
01:41:45,767 --> 01:41:46,701
PRESENT IN SEQUENCE. 

2756
01:41:46,701 --> 01:41:49,104
AND THEN THEY WILL BE ABLE TO 

2757
01:41:49,104 --> 01:41:50,338
ANSWER QUESTIONS AT THE END. 

2758
01:41:50,338 --> 01:41:54,743
AS A REMINDER, USE THE Q&A
BOX 

2759
01:41:54,743 --> 01:41:57,312
TO POSE QUESTIONS TO THOSE 

2760
01:41:57,312 --> 01:41:57,779
SPECIFIC PRESENTER. 

2761
01:41:57,779 --> 01:41:59,848
FIRST OFF DR. MARYNIA KOLAK. 

2762
01:41:59,848 --> 01:42:01,616
SHE IS AN ASSISTANT PROFESSOR AT

2763
01:42:01,616 --> 01:42:04,619
THE DEPARTMENT OF GEOGRAPHY 

2764
01:42:04,619 --> 01:42:08,590
AND GI SCIENCE AT THE UNIVERSITY

2765
01:42:08,590 --> 01:42:10,759
OF ILLINOIS IN CHANNEL N 

2766
01:42:10,759 --> 01:42:11,659
 CHAMPAIGN. 

2767
01:42:11,659 --> 01:42:13,895
A GI AND FELLOW OF THE DATA 

2768
01:42:13,895 --> 01:42:16,731
SCIENCE FOR THE UNIVERSITY OF 

2769
01:42:16,731 --> 01:42:20,068
CHICAGO. 

2770
01:42:20,068 --> 01:42:20,368
D

2771
01:42:20,368 --> 01:42:26,274
KOLAK IS A BIOGRAPHER AND 

2772
01:42:26,274 --> 01:42:28,410
HEALTH, SPATIAL DATA SCIENCE AND

2773
01:42:28,410 --> 01:42:29,244
HEALTH EQUITY. 

2774
01:42:29,244 --> 01:42:31,212
HER PRIMARY AREA INTEREST IS 

2775
01:42:31,212 --> 01:42:32,280
UNDERSTANDING HOW PLACE IMPACTS 

2776
01:42:32,280 --> 01:42:34,416
HEALTH OUTCOMES IN DIFFERENT 

2777
01:42:34,416 --> 01:42:36,518
WAYS FOR DIFFERENT PEOPLE WITHIN

2778
01:42:36,518 --> 01:42:37,352
OPIOID RISK ENVIRONMENTS. 

2779
01:42:37,352 --> 01:42:41,456
DR. KOLAK PLACE AS STRONG 

2780
01:42:41,456 --> 01:42:43,792
EMPHASIS ON SOCIAL SPATIAL 

2781
01:42:43,792 --> 01:42:44,893
DETERMINANTS OF HEALTH AND 

2782
01:42:44,893 --> 01:42:45,760
BUILDING COMMUNITIES OF PRACTICE

2783
01:42:45,760 --> 01:42:48,363
TO MOVE THE SCIENCE AND POLICIES

2784
01:42:48,363 --> 01:42:50,098
FORWARDSHE WILL SPEAK ON 

2785
01:42:50,098 --> 01:42:50,832
MEASURING THE SPATIAL 

2786
01:42:50,832 --> 01:42:56,304
AVAILABILITY OF MEDICATIONS FOR 

2787
01:42:56,304 --> 01:42:57,038
OPIOID-RELATED ABUSE DISORDER. 

2788
01:42:57,038 --> 01:43:00,108
AND DR. DEVIN BANKS ARE A 

2789
01:43:00,108 --> 01:43:04,079
LICENSED CLINICAL SIGH KOLG AND 

2790
01:43:04,079 --> 01:43:05,780
ASSISTANT DIRECTOR OF THE 

2791
01:43:05,780 --> 01:43:07,115
DEPARTMENT OF PSYCHOLOGY. 

2792
01:43:07,115 --> 01:43:09,317
DR. BANKS RESEARCH IS EQUITY 

2793
01:43:09,317 --> 01:43:09,951
PRESIDENT RESEARCH AND TREATMENT

2794
01:43:09,951 --> 01:43:13,321
OF SUBSTANCE ABUSE AND BE 

2795
01:43:13,321 --> 01:43:14,856
BEHAVIORAL HEALTH PARTICULARLY 

2796
01:43:14,856 --> 01:43:16,024
AMONG BLACK AMERICANS. 

2797
01:43:16,024 --> 01:43:18,560
EXAMINES THE IMPACT OF RACISM OF

2798
01:43:18,560 --> 01:43:19,694
SUBSTANCE ABUSE AT MULTIPLE 

2799
01:43:19,694 --> 01:43:21,763
LEVELS AIMING AT MITIGATING A 

2800
01:43:21,763 --> 01:43:23,465
SOCIAL DETERMINANCE OF 

2801
01:43:23,465 --> 01:43:24,899
BEHAVIORAL HEALTH. 

2802
01:43:24,899 --> 01:43:27,435
HER WORK USES MIXED KWA 

2803
01:43:27,435 --> 01:43:29,304
QUALITATIVE AND QUANTITATIVE 

2804
01:43:29,304 --> 01:43:31,172
METHODS AND COMMUNITY-ENGAGED 

2805
01:43:31,172 --> 01:43:33,174
METHODS INTO RESEARCH DESIGN. 

2806
01:43:33,174 --> 01:43:35,977
DR. BANKS WILL BE SPEAKING ON 

2807
01:43:35,977 --> 01:43:37,779
INTEGRATING COMMUNITY ENGAGEMENT

2808
01:43:37,779 --> 01:43:40,949
AND GEOSPATIAL DATA FOR METHODS 

2809
01:43:40,949 --> 01:43:43,017
TO ADDRESS EQUITIES. 

2810
01:43:43,017 --> 01:43:47,689
AND LET ME KICK IT OFF TO DR. KO

2811
01:43:47,689 --> 01:43:47,956
WILL,AK. 

2812
01:43:47,956 --> 01:43:48,790
>> THANK YOU VERY MUCH FOR

2813
01:43:48,790 --> 01:43:49,591
HAVING ME HERE. 

2814
01:43:49,591 --> 01:43:52,193
AND GREAT TO HEAR THE OTHER 

2815
01:43:52,193 --> 01:43:53,761
FOLKS AS WELL AND LOOKING 

2816
01:43:53,761 --> 01:43:56,998
FORWARD WITH OTHER 

2817
01:43:56,998 --> 01:43:57,365
CONVERSATIONS. 

2818
01:43:57,365 --> 01:44:03,037
I WILL BE CHATTING ABOUT MESH 

2819
01:44:03,037 --> 01:44:07,275
THE SPATIAL AVATE OF MEDICATIONS

2820
01:44:07,275 --> 01:44:07,876
FOR OPIOID USE DISORDERS. 

2821
01:44:07,876 --> 01:44:09,177
NEXT SHIED. 

2822
01:44:09,177 --> 01:44:11,746
WHILE WE KNOW THERE ARE MULTIPLE

2823
01:44:11,746 --> 01:44:13,581
EVIDENCE-BASED MEDICATIONS 

2824
01:44:13,581 --> 01:44:14,182
AVAILABLE FOR PERSONS WITH 

2825
01:44:14,182 --> 01:44:15,950
OPIOID USE DISORDER. 

2826
01:44:15,950 --> 01:44:17,452
I WILL BE CALLING THAT OUD FOR A

2827
01:44:17,452 --> 01:44:19,020
BIT THROUGH THE REST OF THE 

2828
01:44:19,020 --> 01:44:19,654
TALK. 

2829
01:44:19,654 --> 01:44:22,157
ON AVERAGE, ONLY ABOUT 20% OF 

2830
01:44:22,157 --> 01:44:24,559
PERSONS WITH OUD ARE ACTUALLY 

2831
01:44:24,559 --> 01:44:28,396
ABLE TO ACCESS THAT -- IF THAT. 

2832
01:44:28,396 --> 01:44:30,198
SO THERE IS ACTUALLY A HUGE 

2833
01:44:30,198 --> 01:44:32,433
VARIABILITY IN THAT NUMBER AND 

2834
01:44:32,433 --> 01:44:34,736
ONLY A SMALL PROPORTION OF 

2835
01:44:34,736 --> 01:44:36,404
PATIENTS SUCCESSFULLY MAKE IT 

2836
01:44:36,404 --> 01:44:39,274
THROUGH THE OPIOID TREATMENT 

2837
01:44:39,274 --> 01:44:39,807
CASCADES TOWARD TREATMENT 

2838
01:44:39,807 --> 01:44:40,408
RETENTION AND REMISSION. 

2839
01:44:40,408 --> 01:44:42,577
SO THE THREE MEDICATIONS IN 

2840
01:44:42,577 --> 01:44:45,780
PARTICULAR ARE METHADONE, 

2841
01:44:45,780 --> 01:44:52,287
FULL AGONIST. 

2842
01:44:52,287 --> 01:44:55,156
BUPRENORP HINE PARTIAL A 

2843
01:44:55,156 --> 01:45:01,196
GO,ONISN AND NALTREXONE. 

2844
01:45:01,196 --> 01:45:03,131
EFFICACY CAN VARY AND EACH 

2845
01:45:03,131 --> 01:45:04,699
PERSON OF OUD WITH REFERENCE 

2846
01:45:04,699 --> 01:45:05,767
THEIR MEDICATION OF PRESENCE 

2847
01:45:05,767 --> 01:45:09,170
WHICH IS KIND OF THE GOLD 

2848
01:45:09,170 --> 01:45:09,771
STANDA

2849
01:45:09,771 --> 01:45:10,371
STANDARD. ALL RIGHT. 

2850
01:45:10,371 --> 01:45:11,940
NEXT SLIDE. 

2851
01:45:11,940 --> 01:45:13,775
SO UNFORTUNATELY, THERE ARE 

2852
01:45:13,775 --> 01:45:16,578
MULTIPLE BARRIERS TO ACCESSING 

2853
01:45:16,578 --> 01:45:16,778
OUDS. 

2854
01:45:16,778 --> 01:45:19,280
AND IT TURNS OUT THAT A LOT OF 

2855
01:45:19,280 --> 01:45:21,783
RESEARCH HAS SHOWN THAT LOWER 

2856
01:45:21,783 --> 01:45:25,653
BARRIER M.O.U.D.s INCREASE 

2857
01:45:25,653 --> 01:45:27,622
ENROLLMENT OF HIGH RISK. 

2858
01:45:27,622 --> 01:45:30,858
HIGH BARRIER M OUDS. 

2859
01:45:30,858 --> 01:45:33,728
IN A REVIEW BY SHARMA ET AL IN 

2860
01:45:33,728 --> 01:45:36,064
2020 GARRIERS THAT THEY 

2861
01:45:36,064 --> 01:45:38,833
IDENTIFIED WERE SPECIFICALLY 

2862
01:45:38,833 --> 01:45:40,768
REGULATORY, LOGISTICAL, 

2863
01:45:40,768 --> 01:45:42,470
GEOGRAPHIC, FINANCIAL AND 

2864
01:45:42,470 --> 01:45:43,037
ATTITUDINAL. 

2865
01:45:43,037 --> 01:45:45,707
ANOTHER GREAT REVIEW BY 

2866
01:45:45,707 --> 01:45:49,344
HUTCHINSON IN 2023 ON BUT 

2867
01:45:49,344 --> 01:45:50,345
FINANCIAL BARRIERS ARE 

2868
01:45:50,345 --> 01:45:53,781
CONSISTENT ACROSS ALL THREE 

2869
01:45:53,781 --> 01:45:54,482
MEDICATIONS. 

2870
01:45:54,482 --> 01:45:57,185
LOGISTICALLY -- OH, I AM GETTING

2871
01:45:57,185 --> 01:45:59,254
A MESSAGE HERE. 

2872
01:45:59,254 --> 01:46:00,755
OH, OKAY. 

2873
01:46:00,755 --> 01:46:01,756
I CAN ADVANCE THE -- OKAY. 

2874
01:46:01,756 --> 01:46:03,291
I WILL DO THAT. 

2875
01:46:03,291 --> 01:46:03,825
OKAY. 

2876
01:46:03,825 --> 01:46:05,326
SORRY ABOUT THAT. 

2877
01:46:05,326 --> 01:46:07,428
SO LOGISTICALLY AND 

2878
01:46:07,428 --> 01:46:08,463
GEOGRAPHICALLY. 

2879
01:46:08,463 --> 01:46:09,797
WHILE FINANCIAL BARRIERS ARE 

2880
01:46:09,797 --> 01:46:10,999
KIND OF CONSISTENT ACROSS ALL 

2881
01:46:10,999 --> 01:46:13,768
THREE MEDICATIONS, LOGISTICALLY 

2882
01:46:13,768 --> 01:46:15,570
AND GEOGRAPHICALLY TO ACCESS 

2883
01:46:15,570 --> 01:46:17,805
MEDICATION ON A DAILY, WEEKLY OR

2884
01:46:17,805 --> 01:46:20,008
MONTHLY BASES REQUIRES PRETTY 

2885
01:46:20,008 --> 01:46:22,644
CONSISTENT TRANSPORTATION AND 

2886
01:46:22,644 --> 01:46:23,745
AFFORDABLE AND CONVENIENT 

2887
01:46:23,745 --> 01:46:25,780
TRANSPORTATION, RIGHT. 

2888
01:46:25,780 --> 01:46:27,582
SO REGULATORY CHALLENGES TO 

2889
01:46:27,582 --> 01:46:28,249
METHADONE, FOR EXAMPLE, HAVE 

2890
01:46:28,249 --> 01:46:30,451
LONG CHALLENGED ACCESS AND THEY 

2891
01:46:30,451 --> 01:46:33,288
ALSO ARE LINKED WITH STIGMA 

2892
01:46:33,288 --> 01:46:35,290
AGAINST OUDS AS WELL AS 

2893
01:46:35,290 --> 01:46:38,926
MEDICATIONS FOR OPIOID ABUSE 

2894
01:46:38,926 --> 01:46:40,762
DISORDER, ESPECIALLY IN -- AS --

2895
01:46:40,762 --> 01:46:42,864
THE OTHER OPTION BEING 

2896
01:46:42,864 --> 01:46:44,132
ABSTINENCE WHICH, UNFORTUNATELY,

2897
01:46:44,132 --> 01:46:45,333
HAS BEEN LINKED WITH HIGHER 

2898
01:46:45,333 --> 01:46:48,136
MORTALITY IN MANY CASES. 

2899
01:46:48,136 --> 01:46:50,238
SO WHILE SPATIAL AVAILABILITY OF

2900
01:46:50,238 --> 01:46:52,373
MEDICATION IS LINKED AS AGREE 

2901
01:46:52,373 --> 01:46:54,776
GRAPHIC FACTOR IN A LOT OF 

2902
01:46:54,776 --> 01:46:55,843
EXISTING RESEARCH, I ARGUE THAT,

2903
01:46:55,843 --> 01:46:57,779
ACTUALLY ALL OF THESE BARRIERS 

2904
01:46:57,779 --> 01:47:00,548
HAVE A PRETTY STRONG SPATIAL 

2905
01:47:00,548 --> 01:47:04,385
FOOTPRINT AND SPATIALLY SPECIFIC

2906
01:47:04,385 --> 01:47:04,752
DIMENSIONS. 

2907
01:47:04,752 --> 01:47:07,288
THEY VARY THROUGHOUT REGIONS. 

2908
01:47:07,288 --> 01:47:08,456
TRANSPORTATION, INFRASTRUCTURE, 

2909
01:47:08,456 --> 01:47:09,557
ECONOMIC OPPORTUNITIES AND 

2910
01:47:09,557 --> 01:47:11,559
SOCIAL PATTERNS EMERGE AT LOCAL 

2911
01:47:11,559 --> 01:47:13,361
AND REGIONAL SCALES AND CAN BE 

2912
01:47:13,361 --> 01:47:17,699
AND HAVE BEEN MEASURED BY GEE 

2913
01:47:17,699 --> 01:47:17,999
A

2914
01:47:17,999 --> 01:47:22,270
GEE GEOGRAPHERS FOR DECADES. 

2915
01:47:22,270 --> 01:47:24,906
OUR STUDY TEAM EXPLORE THIS 

2916
01:47:24,906 --> 01:47:26,407
INTERSECTION ACROSS BARRIERS. 

2917
01:47:26,407 --> 01:47:29,510
IN ONE STUDY ATTITUDINAL 

2918
01:47:29,510 --> 01:47:32,613
PERSPECTIVES, SIGMA, WAS 

2919
01:47:32,613 --> 01:47:34,649
CORRELATED ACROSS MANY DIFFERENT

2920
01:47:34,649 --> 01:47:36,084
SEGMENTS, PERSONAL, 

2921
01:47:36,084 --> 01:47:37,719
INTERPERSONAL, EVEN 

2922
01:47:37,719 --> 01:47:38,252
ORGANIZATIONAL, WITH THE 

2923
01:47:38,252 --> 01:47:41,756
PRESENCE OF MOUDs NEARBY. 

2924
01:47:41,756 --> 01:47:44,625
MORE RESOURCES WERE TOO LYLE 

2925
01:47:44,625 --> 01:47:46,761
LINKED TO LESS STIGMA AGAINST 

2926
01:47:46,761 --> 01:47:48,062
ALL THESE DIFFERENT SCALES WHICH

2927
01:47:48,062 --> 01:47:49,397
IS VERY INTERESTING AND RESEARCH

2928
01:47:49,397 --> 01:47:51,532
HE IS FOUND THAT STIGMA IS 

2929
01:47:51,532 --> 01:47:52,300
LETHAL. 

2930
01:47:52,300 --> 01:47:55,236
BEING TREATED POORLY AT HEALTH 

2931
01:47:55,236 --> 01:47:56,337
PROVIDER MEDICAL SPACE LEADS TO 

2932
01:47:56,337 --> 01:47:57,872
WORSE OUTCOMES. 

2933
01:47:57,872 --> 01:47:59,140
SOMETIMES THIS OCCURS BECAUSE OF

2934
01:47:59,140 --> 01:48:02,677
LACK OF UNDERSTANDING OF MOUD ON

2935
01:48:02,677 --> 01:48:04,278
PROVIDER SETTINGS AND FOCUS ON 

2936
01:48:04,278 --> 01:48:05,780
DRUG-FREE OUTCOMES. 

2937
01:48:05,780 --> 01:48:08,116
SOME POPULATIONS AND SOCIAL 

2938
01:48:08,116 --> 01:48:10,752
GROUPS HAVE HIGHER STIGMA 

2939
01:48:10,752 --> 01:48:17,792
AGAINST OUDS ORMOUDs AND IN 

2940
01:48:17,792 --> 01:48:19,694
CRIMINAL RESPONSE TO OUD VERSUS 

2941
01:48:19,694 --> 01:48:20,895
PUBLIC HEALTH RESPONSES.

2942
01:48:20,895 --> 01:48:22,730
I CAN GO ON FOR STIGMA FOR DAYS,

2943
01:48:22,730 --> 01:48:24,298
BUT I WANTED TO HIGHLIGHT THIS 

2944
01:48:24,298 --> 01:48:25,767
AS A VERY IMPORTANT TOPIC, AND 

2945
01:48:25,767 --> 01:48:27,301
MAYBE NOT THE MAIN FOCUS THAT I 

2946
01:48:27,301 --> 01:48:28,636
WILL TALK ABOUT TODAY, BUT 

2947
01:48:28,636 --> 01:48:29,637
SOMETHING THAT WE WILL BE 

2948
01:48:29,637 --> 01:48:32,540
LOOKING AT IN THE FUTURE. 

2949
01:48:32,540 --> 01:48:35,576
SO WHILE REFINING OUR 

2950
01:48:35,576 --> 01:48:37,011
UNDERSTANDING OF ALL THE 

2951
01:48:37,011 --> 01:48:39,814
DIFFERENT BARRIERS OF MOUD IS 

2952
01:48:39,814 --> 01:48:41,249
UNDER WAY ACROSS MULTIPLE 

2953
01:48:41,249 --> 01:48:41,749
RESEARCH GROUP. 

2954
01:48:41,749 --> 01:48:44,619
OUR TEAM WANTS TO FOCUS ON THE 

2955
01:48:44,619 --> 01:48:46,320
GEOGRAPHIC FLOOR OF THIS WORK 

2956
01:48:46,320 --> 01:48:48,556
BEFORE ADVANCING TO OTHER 

2957
01:48:48,556 --> 01:48:48,856
DIMENSIONS. 

2958
01:48:48,856 --> 01:48:49,757
CONFLICTING EVIDENCE OF HOW 

2959
01:48:49,757 --> 01:48:53,327
SPATIAL ACCESS TO MOUDs IMPACT 

2960
01:48:53,327 --> 01:48:53,761
FINDINGS. 

2961
01:48:53,761 --> 01:48:55,930
BEFORE WE CAN TEST THAT IN A 

2962
01:48:55,930 --> 01:48:57,765
QUASI EXPERIMENTAL WAY, WE NEED 

2963
01:48:57,765 --> 01:49:00,701
TO SEE HOW WE ARE MEASURING 

2964
01:49:00,701 --> 01:49:02,437
SPATIAL ACCESS IN ITSELF NOT 

2965
01:49:02,437 --> 01:49:04,639
INTRODUCING BIAS TO THE STUDY. 

2966
01:49:04,639 --> 01:49:06,974
SO MULTIPLE DIFFERENT APPROACHES

2967
01:49:06,974 --> 01:49:09,744
BEING USED, OFTEN DIVERGING 

2968
01:49:09,744 --> 01:49:13,347
ACROSS CLINICAL AND GEOGRAPHIC 

2969
01:49:13,347 --> 01:49:15,283
HEALTH RESEARCHES. CLINICAL 

2970
01:49:15,283 --> 01:49:17,785
SPACES OF TRAVEL TIMES AND 

2971
01:49:17,785 --> 01:49:20,054
RESOURCE DISTANCES BECAUSE ABLE 

2972
01:49:20,054 --> 01:49:20,955
TO INTERPRET. 

2973
01:49:20,955 --> 01:49:23,624
AND GRAVITY MODELS DOMINATE 

2974
01:49:23,624 --> 01:49:24,926
THE GI SCIENCE WORK THAT COMES 

2975
01:49:24,926 --> 01:49:27,128
OUT IN SCORES. 

2976
01:49:27,128 --> 01:49:29,330
AND THAT SCORE MAY BE DIFFICULT 

2977
01:49:29,330 --> 01:49:31,666
TO INTERPRET IN CLINICAL 

2978
01:49:31,666 --> 01:49:33,768
SETTINGS. 

2979
01:49:33,768 --> 01:49:40,775
SO TOM LOGAN OF CANTERBURY 

2980
01:49:40,775 --> 01:49:42,743
UNIVERSITY LIKES TO SPECIFY 

2981
01:49:42,743 --> 01:49:43,344
DISTIC

2982
01:49:43,344 --> 01:49:45,746
DISTINCTION WITH SPATIAL. 

2983
01:49:45,746 --> 01:49:47,715
SPATIAL, TEMPORAL, THE DISTANCE 

2984
01:49:47,715 --> 01:49:49,750
MEASURE YOU USE AS WELL AS THE 

2985
01:49:49,750 --> 01:49:50,184
ACCESS MEASURES. 

2986
01:49:50,184 --> 01:49:52,620
OUR TEAMS' WORK, WE FOUND THAT 

2987
01:49:52,620 --> 01:49:54,121
BOUNDARY CONDITIONS AND THE 

2988
01:49:54,121 --> 01:49:57,758
DEGREE OF URBANICITY CAN 

2989
01:49:57,758 --> 01:50:00,228
INFLUENCE OUTCOMES. 

2990
01:50:00,228 --> 01:50:01,028
FOR EXAMPLE, A JAIL 

2991
01:50:01,028 --> 01:50:03,464
OFFERING MOUDs FOR THEIR INMATES

2992
01:50:03,464 --> 01:50:05,166
MAY NOT BE ABLE TO TRANSPORT 

2993
01:50:05,166 --> 01:50:07,368
FOLKS ACROSS STATE BORDERS. 

2994
01:50:07,368 --> 01:50:09,904
IN SOME CASES, THERE MAY BE 

2995
01:50:09,904 --> 01:50:10,571
INSURANCE THAT CHALLENGES AND 

2996
01:50:10,571 --> 01:50:12,206
THOSE TYPES OF THIS I THINK SO. 

2997
01:50:12,206 --> 01:50:13,641
AN EXAMPLE OF BOUNDARY 

2998
01:50:13,641 --> 01:50:13,941
CONDITION. 

2999
01:50:13,941 --> 01:50:16,477
CHANGES ACROSS EACH OF THESE 

3000
01:50:16,477 --> 01:50:17,612
FACTORS CAN INFLUENCE RESULTS. 

3001
01:50:17,612 --> 01:50:20,348
SO TO SEE EVALUATE SPATIAL 

3002
01:50:20,348 --> 01:50:21,182
ACCESS CONSISTENTLY WILL HOLD 

3003
01:50:21,182 --> 01:50:24,719
SOME OF THESE MEASURES CONSTANT 

3004
01:50:24,719 --> 01:50:25,753
FOR AN ENVIRONMENTAL SETTING. 

3005
01:50:25,753 --> 01:50:28,289
SPECIFICALLY FOR THIS STUDY, WE 

3006
01:50:28,289 --> 01:50:33,561
LOOKED AT SPATIAL ACCESS AT 

3007
01:50:33,561 --> 01:50:35,363
CENSUS TRACT LEVELS, BOUNDARY 

3008
01:50:35,363 --> 01:50:36,697
CONDITIONS AND WE TWEAK THE 

3009
01:50:36,697 --> 01:50:38,032
DISTANCE AND ACCESS MEASURES AND

3010
01:50:38,032 --> 01:50:40,801
LOOK AT THE RESULTS ACROSS 

3011
01:50:40,801 --> 01:50:43,471
DIFFERENT DEGREES OF URBAN IS 

3012
01:50:43,471 --> 01:50:49,143
TEASE IN -- AND THE URBANICITY 

3013
01:50:49,143 --> 01:50:51,045
IS PART IS IMPORTANT BECAUSE 

3014
01:50:51,045 --> 01:50:52,647
DIFFERENT BEHAVIORS OF URBAN, 

3015
01:50:52,647 --> 01:50:54,782
SUBURBAN AND RURAL REGIMES. 

3016
01:50:54,782 --> 01:50:58,586
SO OUR STUDY OBJECTIVE IS TO 

3017
01:50:58,586 --> 01:50:59,353
CALCULATE AND COMPARE 

3018
01:50:59,353 --> 01:51:00,087
NEIGHBORHOOD LEVEL ASSOCIATIONS 

3019
01:51:00,087 --> 01:51:03,357
OF SPATIAL AVAILABILITY METRICS,

3020
01:51:03,357 --> 01:51:05,293
AND CONTEXT WISE THAT WITH 

3021
01:51:05,293 --> 01:51:07,528
ADDITIONAL DIMENSIONS OF ACCESS 

3022
01:51:07,528 --> 01:51:08,596
AT COMMUNITY SCALE. 

3023
01:51:08,596 --> 01:51:10,665
WE WILL LOOK AT ACCESS METRICS 

3024
01:51:10,665 --> 01:51:13,768
LIKE TRAVEL TIME AND GRAVITY 

3025
01:51:13,768 --> 01:51:15,303
MODELS, MULTIPLE TRANSIT MOVES, 

3026
01:51:15,303 --> 01:51:17,805
AND EXPLORE THE RESULTS ACROSS 

3027
01:51:17,805 --> 01:51:18,973
DIFFERENT MORALITIES. 

3028
01:51:18,973 --> 01:51:21,642
AND, AGAIN, ACROSS DIFFERENT 

3029
01:51:21,642 --> 01:51:23,778
TYPE OLTS OF THE SOCIAL 

3030
01:51:23,778 --> 01:51:24,645
DETERMINANCE OF HEALTH TO BRING 

3031
01:51:24,645 --> 01:51:26,547
THAT -- THOSE ADDITIONAL 

3032
01:51:26,547 --> 01:51:27,782
DIMENSIONS OF ACCESS IN. 

3033
01:51:27,782 --> 01:51:29,817
AND THEN FINALLY, BECAUSE WE ARE

3034
01:51:29,817 --> 01:51:32,119
INTERESTED IN REFINING A MEASURE

3035
01:51:32,119 --> 01:51:34,288
OR MEASURES FOR FUTURE ANALYSIS 

3036
01:51:34,288 --> 01:51:36,157
AND EXPERIMENTS, IT WILL BE 

3037
01:51:36,157 --> 01:51:37,758
REALLY IMPORTANT TO IDENTIFY AND

3038
01:51:37,758 --> 01:51:40,728
MEASURE THAT IS MEANINGFUL, 

3039
01:51:40,728 --> 01:51:41,796
CONSISTENT, AND HAS SUFFICIENT 

3040
01:51:41,796 --> 01:51:45,766
VARIABILITY ACROSS STATES. OKAY.

3041
01:51:45,766 --> 01:51:47,501
SO LET'S TALK ABOUT THOSE 

3042
01:51:47,501 --> 01:51:47,768
METHODS. 

3043
01:51:47,768 --> 01:51:49,637
WHO IS THE STUDY POPULATION?

3044
01:51:49,637 --> 01:51:52,707
SO WE ARE LOOKING AT ALL 

3045
01:51:52,707 --> 01:51:57,044
POPULATED AREAS IN THE 

3046
01:51:57,044 --> 01:51:58,546
CONTINENTAL CENSUS. 

3047
01:51:58,546 --> 01:52:00,615
FOCUS ON CENSUS TRACKS AND 

3048
01:52:00,615 --> 01:52:04,051
BECAUSE WE ARE INTERESTED IN 

3049
01:52:04,051 --> 01:52:06,654
DYNAMICS ACROSS CENSUS TRACT 

3050
01:52:06,654 --> 01:52:07,555
BORDERS AND STATE BORDER, IN 

3051
01:52:07,555 --> 01:52:09,757
THIS KIND OF ANALYSIS FOCUSING 

3052
01:52:09,757 --> 01:52:12,126
ON THE CONTINENTAL STATES, 

3053
01:52:12,126 --> 01:52:14,028
HAWAII AND ALASKA BRING NEW 

3054
01:52:14,028 --> 01:52:15,830
CHALLENGES AND WOULD BETTER WORK

3055
01:52:15,830 --> 01:52:19,233
AS A SEPARATE TYPE OF ANALYSIS 

3056
01:52:19,233 --> 01:52:24,338
ALL TOGETHER. WE USED DATA THAT 

3057
01:52:24,338 --> 01:52:27,074
OUR TEAM COLLECTED WITH THE 

3058
01:52:27,074 --> 01:52:28,809
ENVIRONMENTAL POLICY SCAM 

3059
01:52:28,809 --> 01:52:31,946
OR OEPS. 

3060
01:52:31,946 --> 01:52:33,314
METHADONE WERE EXTRACTED 

3061
01:52:33,314 --> 01:52:35,750
FROM SAMSHA. 

3062
01:52:35,750 --> 01:52:39,920
AND BUPRENORP HINE. 

3063
01:52:39,920 --> 01:52:42,790
AND VIVITROL WEB SCRAPING 

3064
01:52:42,790 --> 01:52:46,560
FOR NALTREXONE. 

3065
01:52:46,560 --> 01:52:48,362
WE DID THIS AT YALE, AND NOW 

3066
01:52:48,362 --> 01:52:49,764
AT PITT. 

3067
01:52:49,764 --> 01:52:51,866
WE ARE AWARE OF ALL THE EXISTING

3068
01:52:51,866 --> 01:52:53,768
LIMITATIONS AMONG ALL OF THESE 

3069
01:52:53,768 --> 01:52:54,669
RESOURCES. 

3070
01:52:54,669 --> 01:52:57,772
I KNOW. 

3071
01:52:57,772 --> 01:53:01,742
BUPLENORP HINE WILL BE AN 

3072
01:53:01,742 --> 01:53:04,945
OVERESTIMATED MANY CAN PRESCRIBE

3073
01:53:04,945 --> 01:53:07,548
IT BUT DON'T. 

3074
01:53:07,548 --> 01:53:09,750
AND ARE NOT ACCEPTING NEW 

3075
01:53:09,750 --> 01:53:10,818
PATIENTS, BUT A THE COMPLETE 

3076
01:53:10,818 --> 01:53:13,621
LIST WHAT IS PUBLICLY ON VIEW IN

3077
01:53:13,621 --> 01:53:15,923
A SNAPSHOT IN TIME OF MOW 

3078
01:53:15,923 --> 01:53:21,062
PENSION MOUD RESOURCES ON 

3079
01:53:21,062 --> 01:53:24,098
GOVERNMENT WEB SITES. 

3080
01:53:24,098 --> 01:53:25,366
AS FOLKS WILL TRAVEL TO 

3081
01:53:25,366 --> 01:53:28,836
RESOURCES IN DIFFERENT WAYS, WE 

3082
01:53:28,836 --> 01:53:30,171
NEED TO CAPTURE DIFFERENT 

3083
01:53:30,171 --> 01:53:31,739
TRANSIT. 

3084
01:53:31,739 --> 01:53:34,141
DRIVING, WALKING, BIKING, OPEN 

3085
01:53:34,141 --> 01:53:37,044
STREET MAPS, ROAD NETWORKS. 

3086
01:53:37,044 --> 01:53:38,479
DISTANCE FROM EACH CENSUS TRACT 

3087
01:53:38,479 --> 01:53:43,350
TO ANOTHER CENTER USING ROAD 

3088
01:53:43,350 --> 01:53:45,319
NETWORKS AND THE TRACK CENTER TO

3089
01:53:45,319 --> 01:53:47,822
TRACK CENTER IS NOT IDEA, BUT 

3090
01:53:47,822 --> 01:53:53,227
FOR THE SCALE OF OUR. 

3091
01:53:53,227 --> 01:53:55,429
WE ALSO HAVE PROPORTIONS OF 

3092
01:53:55,429 --> 01:53:57,131
HOUSEHOLDS WITHOUT A VEHICLE AND

3093
01:53:57,131 --> 01:53:58,566
COMMUTERS USING TRANSIT AND 

3094
01:53:58,566 --> 01:54:00,935
WALKING TIMES OR COMMUTERS USING

3095
01:54:00,935 --> 01:54:02,570
TRANSIT AND WALKING MODES AS 

3096
01:54:02,570 --> 01:54:04,572
MADE AVAILABLE FROM THE CENSUS. 

3097
01:54:04,572 --> 01:54:08,008
WE REALLY WANTED TO HAVE PUBLIC 

3098
01:54:08,008 --> 01:54:10,511
TRANSIT METRICS FOR THE COUNTRY;

3099
01:54:10,511 --> 01:54:15,049
HOWEVER, AT THE TIME THAT THESE 

3100
01:54:15,049 --> 01:54:15,649
OTHER 

3101
01:54:15,649 --> 01:54:19,453
 MATRICES WERE GENERATED WE 

3102
01:54:19,453 --> 01:54:20,921
DIDN'T HAVE CLEAN FEEDS AT THE 

3103
01:54:20,921 --> 01:54:22,523
COUNTRY LEVEL, 245 HAS CHANGED 

3104
01:54:22,523 --> 01:54:24,525
IN THE PAST FEW MONTHS AND THAT 

3105
01:54:24,525 --> 01:54:26,627
MAY CHANGE AS WELL FOR FUTURE 

3106
01:54:26,627 --> 01:54:26,927
ANALYSIS. 

3107
01:54:26,927 --> 01:54:29,163
TO MEASURE SPATIAL ACCESS, WE 

3108
01:54:29,163 --> 01:54:32,133
CALCULATE SUPPLY ONLY MODELS. 

3109
01:54:32,133 --> 01:54:33,968
MINIMUM DISTANCE. 

3110
01:54:33,968 --> 01:54:35,636
IN OTHER WORDS, AS THE CROW 

3111
01:54:35,636 --> 01:54:40,708
FLIES, RIGHT, FOR THE GISERS AND

3112
01:54:40,708 --> 01:54:42,743
EUCLIDIAN, POINT A TO POINT B. 

3113
01:54:42,743 --> 01:54:44,545
WHAT IS THE NEAREST OR SHORTEST 

3114
01:54:44,545 --> 01:54:45,179
LINE. 

3115
01:54:45,179 --> 01:54:46,247
TRAVEL TIMES FOR EACH TRAVEL 

3116
01:54:46,247 --> 01:54:46,447
MODE. 

3117
01:54:46,447 --> 01:54:49,150
THERE IS A LOT, A LOT, A LOT IN 

3118
01:54:49,150 --> 01:54:51,318
THE LITERATURE SPECIFICALLY FOES

3119
01:54:51,318 --> 01:54:53,754
CUSSING ON HOW TRAVEL IS TIME IS

3120
01:54:53,754 --> 01:54:55,523
SUPERIOR TO MINIMUM DISTANCE 

3121
01:54:55,523 --> 01:54:57,758
ESPECIALLY IN URBAN SPACES. 

3122
01:54:57,758 --> 01:54:59,326
TOM LOGAN'S WORK SHOWED YOU CAN 

3123
01:54:59,326 --> 01:55:01,228
BE OFF BY A COUPLE OF MILES IF 

3124
01:55:01,228 --> 01:55:02,263
YOU ARE NOT USING THE RIGHT 

3125
01:55:02,263 --> 01:55:03,964
TRAVEL TIME APPROACH OR THAT 

3126
01:55:03,964 --> 01:55:04,799
SORT OF THING. 

3127
01:55:04,799 --> 01:55:07,234
NOTE THAT FOR OUR ANALYSIS, A 

3128
01:55:07,234 --> 01:55:10,538
COUPLE OF MILES MIGHT BE A -- 

3129
01:55:10,538 --> 01:55:13,741
THAT MIGHT BE WITHIN OUR ERROR 

3130
01:55:13,741 --> 01:55:16,811
OF SENTENCE ZONE AND LOOKING AT 

3131
01:55:16,811 --> 01:55:19,013
THINGS ACROSS THE COUNTRY AND 

3132
01:55:19,013 --> 01:55:21,081
YOU WILL SEE IN A LITTLE BIT THE

3133
01:55:21,081 --> 01:55:23,484
VARIATION IS SO SUBSTANTIAL -- 

3134
01:55:23,484 --> 01:55:25,753
THE LACK OF ACCESS MAY BE SO 

3135
01:55:25,753 --> 01:55:27,888
SUBSTANTIAL THAT A COUPLE OF 

3136
01:55:27,888 --> 01:55:29,757
MILES MAY NOT BE A DEAL BREAKER.

3137
01:55:29,757 --> 01:55:31,192
FINALLY ACCOUNTED RESOURCES 

3138
01:55:31,192 --> 01:55:33,227
WITHIN 30-MINUTE TRAVEL TIME. 

3139
01:55:33,227 --> 01:55:36,197
AND NEXT WE HAVE OUR SUPPLY 

3140
01:55:36,197 --> 01:55:40,868
DEMAND MODEL. AND. 

3141
01:55:40,868 --> 01:55:43,003
THIS THIS ANALYSIS, WE ARE USING

3142
01:55:43,003 --> 01:55:46,841
TOTAL POPULATION AS A BASIS OF 

3143
01:55:46,841 --> 01:55:49,710
NEED NOT PERFECT, BUT A 

3144
01:55:49,710 --> 01:55:50,811
REASONABLE ESTIMATE. 

3145
01:55:50,811 --> 01:55:52,112
SOME OF OUR PREVIOUS WORK HAS 

3146
01:55:52,112 --> 01:55:55,950
SHOWN THAT USING JUST TOTAL 

3147
01:55:55,950 --> 01:55:58,052
POPULATION IS REASONABLE IN LIEU

3148
01:55:58,052 --> 01:56:00,754
OF HAVING THE ACTUAL ACTIVE 

3149
01:56:00,754 --> 01:56:02,623
POPULATION WITH OUD. 

3150
01:56:02,623 --> 01:56:03,724
AGAIN, BECAUSE WE ARE TRYING TO 

3151
01:56:03,724 --> 01:56:06,527
TAKE A HUMAN-CENTER AID 

3152
01:56:06,527 --> 01:56:06,794
APPROACH. 

3153
01:56:06,794 --> 01:56:11,999
HUMAN LED CENTERED APPROACH TO 

3154
01:56:11,999 --> 01:56:13,767
HAVE ACCESS IN A REASONABLE WAY.

3155
01:56:13,767 --> 01:56:18,639
WE FELT THAT THE PTOTAL 

3156
01:56:18,639 --> 01:56:19,373
POPULATION WAS REASONABLE AND 

3157
01:56:19,373 --> 01:56:22,376
PER CAPITA AS AN APPENDIX LEVEL 

3158
01:56:22,376 --> 01:56:24,345
MEASURE, BUT MORE IMPORTANTLY, 

3159
01:56:24,345 --> 01:56:26,013
WE HAVE THESE CLASSICAL GRAVITY 

3160
01:56:26,013 --> 01:56:28,048
NOVELS, WELL LOVED BY THE GEO 

3161
01:56:28,048 --> 01:56:29,750
SCIENCE COMMUNITY. 

3162
01:56:29,750 --> 01:56:32,186
FLOATING CATCHMENT AREAS WILL 

3163
01:56:32,186 --> 01:56:33,420
MEASURE THE RATIO OF CLIENTS TO 

3164
01:56:33,420 --> 01:56:34,822
THE TRAVEL TIME. 

3165
01:56:34,822 --> 01:56:36,056
ENHANCED VERSIONS ARE GOING TO 

3166
01:56:36,056 --> 01:56:37,591
REFINE THIS FURTHER. 

3167
01:56:37,591 --> 01:56:40,828
SO THE RATIONAL AGENT ACCESS 

3168
01:56:40,828 --> 01:56:42,463
MODEL IS A NEWER VERSION OF 

3169
01:56:42,463 --> 01:56:44,999
THESE GRAVITY MODELS THAT 

3170
01:56:44,999 --> 01:56:46,600
ATTEMPTS TO EQUALIZE CONGESTION 

3171
01:56:46,600 --> 01:56:48,702
AND MINIMIZE COST. 

3172
01:56:48,702 --> 01:56:51,105
SO IF THERE IS RESEARCH FURTHER 

3173
01:56:51,105 --> 01:56:54,975
AWAY WITH LESS CONGESTION, THAT 

3174
01:56:54,975 --> 01:56:55,643
WOULD BE PREFERRED ESSENTIALLY. 

3175
01:56:55,643 --> 01:56:57,478
BECAUSE WE KNOW THIS IS WHAT 

3176
01:56:57,478 --> 01:57:01,348
PEOPLE DO, THIS WAS KIND OF AN 

3177
01:57:01,348 --> 01:57:03,884
EXCITE SOMETHING MODEL TO TEST 

3178
01:57:03,884 --> 01:57:04,451
AS WELL. 

3179
01:57:04,451 --> 01:57:06,754
THE RAM OF THE COST TO TRAVEL 

3180
01:57:06,754 --> 01:57:07,388
FOR EACH TRACT. 

3181
01:57:07,388 --> 01:57:10,824
LOWER IS BETTER AND TH

3182
01:57:10,824 --> 01:57:14,094
THE FCA-BASED METHOD OF 

3183
01:57:14,094 --> 01:57:14,595
POPULATION. 

3184
01:57:14,595 --> 01:57:15,462
SO HIGHER IS BETTER. 

3185
01:57:15,462 --> 01:57:17,364
WE FLIPPED THE COLOR OF THE MAPS

3186
01:57:17,364 --> 01:57:20,534
LATER ON JUST -- FOR THESE TWO 

3187
01:57:20,534 --> 01:57:23,470
SO THAT ACCESSION IS BETTER -- 

3188
01:57:23,470 --> 01:57:24,738
LOWER ACCESS IN THE SAME 

3189
01:57:24,738 --> 01:57:25,172
DIRECTION. 

3190
01:57:25,172 --> 01:57:27,274
BUT IN SOME OF THE SUMMARY 

3191
01:57:27,274 --> 01:57:28,776
STATISTICS, WE OBVIOUSLY DON'T 

3192
01:57:28,776 --> 01:57:30,844
DO THAT AND TAKES JUST KNOWING 

3193
01:57:30,844 --> 01:57:33,747
THAT ENDS UP BEING IMPORTANT. 

3194
01:57:33,747 --> 01:57:36,884
AND SO WE DID A PRETTY MASSIVE 

3195
01:57:36,884 --> 01:57:38,085
COMPUTATIONAL FRAMEWORK TO 

3196
01:57:38,085 --> 01:57:39,386
ACCOMPLISH ALL OF THIS. 

3197
01:57:39,386 --> 01:57:42,022
WE USED PRECOMPUTED TRAVEL 

3198
01:57:42,022 --> 01:57:46,026
TIME MATRICES AND PRIOR 

3199
01:57:46,026 --> 01:57:46,293
RESEARCH. 

3200
01:57:46,293 --> 01:57:47,094
THIS IS ALSO AVAILABLE FOR 

3201
01:57:47,094 --> 01:57:48,529
OTHERS TO USE. 

3202
01:57:48,529 --> 01:57:52,132
ALSO AVAILABLE ON THAT OEPS 

3203
01:57:52,132 --> 01:57:52,399
WEBSITE. 

3204
01:57:52,399 --> 01:57:55,269
WE HAVE -- FOR ALL THE DIFFERENT

3205
01:57:55,269 --> 01:57:56,136
CALCULATIONS, THEY WERE EITHER 

3206
01:57:56,136 --> 01:57:58,706
DONE IN OUR PYTHON. 

3207
01:57:58,706 --> 01:58:01,742
AND WE HAVE OUR R OR PYTHON CODE

3208
01:58:01,742 --> 01:58:03,811
MADE AVAILABLE TO OTHERS MADE 

3209
01:58:03,811 --> 01:58:06,847
AVAILABLE SO OTHERS CAN DO THIS.

3210
01:58:06,847 --> 01:58:08,782
OENZ ENVIRONMENT TOOL KIT THAT 

3211
01:58:08,782 --> 01:58:09,183
CLAIMS RESEARCH. 

3212
01:58:09,183 --> 01:58:12,653
AND WE HAVE A GOOGLE PYTHON 

3213
01:58:12,653 --> 01:58:13,654
NETWORKING TO CALCULATE TRAVEL 

3214
01:58:13,654 --> 01:58:15,189
TIME WITH THE TRAVEL TIM

3215
01:58:15,189 --> 01:58:17,725
TIME MATRICES. 

3216
01:58:17,725 --> 01:58:20,427
THE GRAVITY MODELS WITH THE RAM 

3217
01:58:20,427 --> 01:58:22,830
MODEL USING 90-MINUTE THRESHOLDS

3218
01:58:22,830 --> 01:58:27,434
WAS QUITE A COMPUTATIONALLY 

3219
01:58:27,434 --> 01:58:29,770
INTENSIVE AND WOULDN'T WORK IN A

3220
01:58:29,770 --> 01:58:32,339
CLASSIC SETTING AND A HIGH 

3221
01:58:32,339 --> 01:58:32,840
PERFORMANCE COMPUTING 

3222
01:58:32,840 --> 01:58:33,741
ENVIRONMENT FOR THAT WHICH WAS 

3223
01:58:33,741 --> 01:58:36,910
MADE AVAILABLE AT U OF I. 

3224
01:58:36,910 --> 01:58:39,146
I KNOW THAT IS NOT A 

3225
01:58:39,146 --> 01:58:39,747
STRAIGHTFORWARD THING FOR 

3226
01:58:39,747 --> 01:58:40,848
EVERYONE AND CURRENTLY LOOKING 

3227
01:58:40,848 --> 01:58:44,685
FOR A GROUP AT THE U OF I TO 

3228
01:58:44,685 --> 01:58:46,854
MAKE THAT AVAILABLE AS 

3229
01:58:46,854 --> 01:58:48,956
COMPUTATIONAL NETWORKING TO 

3230
01:58:48,956 --> 01:58:52,459
ACCESS THE SAME COMPUTING 

3231
01:58:52,459 --> 01:58:55,129
ENVIRONMENT. OKAY. AND SO LET'S 

3232
01:58:55,129 --> 01:58:56,864
TALK MORE ABOUT NEEDS. 

3233
01:58:56,864 --> 01:58:58,832
THERE IS POPULATION, BUT HERE IT

3234
01:58:58,832 --> 01:59:02,236
IS LIKE DEFINING NEED IN THE 

3235
01:59:02,236 --> 01:59:03,871
WORLD OF LOOKING AT THE 

3236
01:59:03,871 --> 01:59:05,739
DIFFERENT DIMENSIONS OF ACCESS. 

3237
01:59:05,739 --> 01:59:07,107
WHAT ARE THOSE FACTOR. 

3238
01:59:07,107 --> 01:59:09,777
SO WE DEFINED URBAN, SUBURBAN 

3239
01:59:09,777 --> 01:59:12,212
AND RURAL AREAS USING DIFFERENT 

3240
01:59:12,212 --> 01:59:16,850
CATEGORIES OF THE RURAL, URBAN 

3241
01:59:16,850 --> 01:59:20,954
COMMUTING OR RURAL, URBAN 

3242
01:59:20,954 --> 01:59:21,355
CONTINUUM CODES. 

3243
01:59:21,355 --> 01:59:22,689
AND YOU CAN CHECK OUT OUR 

3244
01:59:22,689 --> 01:59:25,092
RESEARCH BRIEF FOR MORE DETAILS 

3245
01:59:25,092 --> 01:59:29,763
HERE, BUT ESSENTIALLY WE USE 

3246
01:59:29,763 --> 01:59:31,765
COMMUTING FLOWS FOR URBAN, 

3247
01:59:31,765 --> 01:59:33,767
SUBURBAN AND RURAL AND VIR PHI 

3248
01:59:33,767 --> 01:59:37,304
USING EXTENSIVE EXPLORATORY DATA

3249
01:59:37,304 --> 01:59:39,373
ANALYSIS, A LOT OF MAPPING, 

3250
01:59:39,373 --> 01:59:40,841
DISCUSSIONS, AND VERIFY AREAS 

3251
01:59:40,841 --> 01:59:45,746
WITH POPULATION DENSITY 

3252
01:59:45,746 --> 01:59:47,314
SUMMARIES TO MAKE THEIR THAT WAS

3253
01:59:47,314 --> 01:59:47,614
CONSISTENT. 

3254
01:59:47,614 --> 01:59:50,818
OKAY, TO DEFINE VARYING NEED AND

3255
01:59:50,818 --> 01:59:52,352
APPROXIMATE THOSE DIMENSIONS OF 

3256
01:59:52,352 --> 01:59:54,354
ACCESS IN A STANDARDIZED WAY, WE

3257
01:59:54,354 --> 02:00:01,195
USE PRE-EXISTING CLUSTERS OR 

3258
02:00:01,195 --> 02:00:01,762
TYPOLOGIES. 

3259
02:00:01,762 --> 02:00:04,398
THE SOCIAL DETERMINANT, HEALTH 

3260
02:00:04,398 --> 02:00:06,700
OUTCOMES AND INTERSECTING 

3261
02:00:06,700 --> 02:00:14,341
COMMUNITY CONTEXTS AT VARIABLE 

3262
02:00:14,341 --> 02:00:14,575
SCALES. 

3263
02:00:14,575 --> 02:00:19,680
OUR WORK PREVIOUSLY IDENTIFIED 

3264
02:00:19,680 --> 02:00:21,748
FOUR DISTINCT INDICES AND THOSE 

3265
02:00:21,748 --> 02:00:25,752
FOUR INDICES THEN WERE USED AS 

3266
02:00:25,752 --> 02:00:28,822
INPUT TO GENERATE SEVEN DISTINCT

3267
02:00:28,822 --> 02:00:31,258
CLUSTERS CHARACTERIZING SDOH. 

3268
02:00:31,258 --> 02:00:33,527
IS MOVING BEYOND THE CLASSICAL 

3269
02:00:33,527 --> 02:00:36,663
SOCIO ECONOMIC LEVEL ALONE. 

3270
02:00:36,663 --> 02:00:37,764
SOCIOECONOMIC ADVANTAGE, THE 

3271
02:00:37,764 --> 02:00:40,100
FIRST COMPONENT IS STRONGLY 

3272
02:00:40,100 --> 02:00:42,836
COORDINATED WITH THE AVI AND 

3273
02:00:42,836 --> 02:00:46,073
THE SBI AND THE MEASURE IN 

3274
02:00:46,073 --> 02:00:46,807
RELATED RESEARCH. 

3275
02:00:46,807 --> 02:00:49,009
WE ALSO IDENTIFIED ADDITIONAL 

3276
02:00:49,009 --> 02:00:49,943
MEASURES IN THIS CASE WOULD BE 

3277
02:00:49,943 --> 02:00:51,612
IMPORTANT TO CAPTURING 

3278
02:00:51,612 --> 02:00:52,613
DIMENSIONS OF THE OPIOID RISK 

3279
02:00:52,613 --> 02:00:55,315
ENVIRONMENT FOR THIS ANALYSIS. 

3280
02:00:55,315 --> 02:01:03,891
SOME LIKE AIR OF HIGH MOBILITY 

3281
02:01:03,891 --> 02:01:05,626
AND PERSONS AND FAMILIES, FOR 

3282
02:01:05,626 --> 02:01:05,893
EXAMPLE. 

3283
02:01:05,893 --> 02:01:08,195
OF NOTE IN THE ANALYSIS, SO 

3284
02:01:08,195 --> 02:01:10,364
SPECIFICALLY -- BECAUSE IT IS A 

3285
02:01:10,364 --> 02:01:13,167
VERY -- THE TALK TODAY, I AM NOT

3286
02:01:13,167 --> 02:01:15,569
GOING TO BE ABLE TO GO THROUGH 

3287
02:01:15,569 --> 02:01:18,572
ALL THE RESULTS, BUT HIGHLIGHT 

3288
02:01:18,572 --> 02:01:20,140
THE SUBURBAN AFFLUENT GROUP AND 

3289
02:01:20,140 --> 02:01:22,009
EXTREME POVERTY GROUP. 

3290
02:01:22,009 --> 02:01:25,345
THESE ARE -- THEY HAVE VERY, YOU

3291
02:01:25,345 --> 02:01:27,814
KNOW, STRONGLY DIVERGING 

3292
02:01:27,814 --> 02:01:29,383
ADVANTAGES AS WELL AS 

3293
02:01:29,383 --> 02:01:29,783
VULNERABILITIES. 

3294
02:01:29,783 --> 02:01:37,758
SO EXTREME POVERTY HAS VERY HIGH

3295
02:01:37,758 --> 02:01:40,861
SOCIOECONOMIC DISADVANTAGES, AND

3296
02:01:40,861 --> 02:01:42,996
SUBAFFLUENT GROUP HAS EXTENSIVE 

3297
02:01:42,996 --> 02:01:45,766
ADVANTAGE ACROSS ALL THOSE 

3298
02:01:45,766 --> 02:01:53,540
DIFFERENT CATEGORIES. 

3299
02:01:53,540 --> 02:01:56,743
FOR HERE FOR MORE DETAILS. 

3300
02:01:56,743 --> 02:02:00,647
DATA DRIVING THE MODELS AND SDOH

3301
02:02:00,647 --> 02:02:00,981
CLUSTERS. 

3302
02:02:00,981 --> 02:02:02,149
AND WE ARE ALWAYS TRYING TO COME

3303
02:02:02,149 --> 02:02:05,352
BACK TO THAT IN SOME WAYS. OKAY.

3304
02:02:05,352 --> 02:02:08,388
SO WHAT DO WE DO WITH ALL THAT?

3305
02:02:08,388 --> 02:02:11,592
SO SOME GEOSPATIAL DATA SCIENCE.

3306
02:02:11,592 --> 02:02:15,829
WE CREATED CORRELATION MATRICES 

3307
02:02:15,829 --> 02:02:18,899
USING SPEARMAN RANKED 

3308
02:02:18,899 --> 02:02:19,333
CORRELATION. 

3309
02:02:19,333 --> 02:02:20,234
MEASURES ARE SKEWED AND 

3310
02:02:20,234 --> 02:02:23,737
NONLINEAR SO WE NEEDED TO U

3311
02:02:23,737 --> 02:02:27,207
USE THERAN FOR THIS FOR OVERALL 

3312
02:02:27,207 --> 02:02:28,842
SPATIAL, ACCESSIBILITY MEASURES 

3313
02:02:28,842 --> 02:02:31,511
TO EACH TREATMENT TIME FOR ALL 

3314
02:02:31,511 --> 02:02:33,480
THE CENSUS TRACTS WITHIN EACH 

3315
02:02:33,480 --> 02:02:34,514
URBAN, RURAL CATEGORY. 

3316
02:02:34,514 --> 02:02:36,416
TO FURTHER UNDERSTAND THE 

3317
02:02:36,416 --> 02:02:40,854
SPATIAL ACCESS, WE CREATED BOX 

3318
02:02:40,854 --> 02:02:44,992
BLOCKS AND MAPPED SPATIAL 

3319
02:02:44,992 --> 02:02:45,225
ACCESS. 

3320
02:02:45,225 --> 02:02:48,762
BOX PLOTS TO MEASURE 

3321
02:02:48,762 --> 02:02:51,298
APPLES-TO-APPLES AND RANGES AND 

3322
02:02:51,298 --> 02:02:52,566
OUTLIERS BETWEEN EACH MEASURE. 

3323
02:02:52,566 --> 02:02:55,168
AND WE USED SUMMARY STATISTICS 

3324
02:02:55,168 --> 02:02:59,172
OF THE CO-VARIATE DATA AND 

3325
02:02:59,172 --> 02:03:03,210
ACCESS METRICS STRATIFIED BY ALL

3326
02:03:03,210 --> 02:03:03,944
THESE DIFFERENCE ASPECTS. 

3327
02:03:03,944 --> 02:03:05,112
I DON'T HAVE A CHANCE TO SHOW 

3328
02:03:05,112 --> 02:03:09,416
ALL THE PIECES TODAY, BUT JUST 

3329
02:03:09,416 --> 02:03:09,916
SOME OF THE HIGHLIGHTS 

3330
02:03:09,916 --> 02:03:10,851
APPROXIMATELY. 

3331
02:03:10,851 --> 02:03:13,220
AND THEN FINALLY, IT WAS VERY 

3332
02:03:13,220 --> 02:03:18,325
IMPORTANT THAT WE IDENTIFIED 

3333
02:03:18,325 --> 02:03:21,061
PARTS OF THE COUNTRY WITH BETTER

3334
02:03:21,061 --> 02:03:23,497
CONSISTENCY OR LESS CONSISTENCY.

3335
02:03:23,497 --> 02:03:25,766
MEASURING INTERNAL CONSISTENCY. 

3336
02:03:25,766 --> 02:03:27,968
WE REPEATED STANDARD DEVIATIONS 

3337
02:03:27,968 --> 02:03:30,971
AMONG THE SPATIAL ACCESS AMONG 

3338
02:03:30,971 --> 02:03:32,239
EACH TREATMENT TYPE. 

3339
02:03:32,239 --> 02:03:35,342
CENSUS TRACT WITH HIGH INTERNAL 

3340
02:03:35,342 --> 02:03:36,777
CONSISTENCY SHOW LOW VARIANCE. 

3341
02:03:36,777 --> 02:03:38,178
THAT IS A GOOD THING. 

3342
02:03:38,178 --> 02:03:39,546
WE WANT CONSISTENT MEASURES. 

3343
02:03:39,546 --> 02:03:41,748
ON THE OTHER HAND -- WELL, I 

3344
02:03:41,748 --> 02:03:42,749
GUESS IT DEPEND. 

3345
02:03:42,749 --> 02:03:44,251
CONSISTENT MEASURE IT IS DOESN'T

3346
02:03:44,251 --> 02:03:45,752
MATTER WHICH MEASURE YOU USE. 

3347
02:03:45,752 --> 02:03:46,853
FROM THAT PERSPECTIVE, YOU ARE 

3348
02:03:46,853 --> 02:03:48,388
-- YOU KNOW, THAT MIGHT BE A 

3349
02:03:48,388 --> 02:03:49,756
GOOD THING. 

3350
02:03:49,756 --> 02:03:53,360
ON THE OTHER HAND, ONES OF LOW 

3351
02:03:53,360 --> 02:03:54,394
CONSISTENCY SHOW HIGH VARIANCE. 

3352
02:03:54,394 --> 02:03:55,996
WE MAP IT OUT BECAUSE ONE OF THE

3353
02:03:55,996 --> 02:04:05,072
GOALS IS TO SEE, AGAIN, WHERE 

3354
02:04:05,072 --> 02:04:06,807
SELECTING THE RIGHT SPATIAL IS 

3355
02:04:06,807 --> 02:04:08,442
NECESSARY FOR POLICYMAKERS AND 

3356
02:04:08,442 --> 02:04:10,110
THAT SORT OF THING. 

3357
02:04:10,110 --> 02:04:11,778
LET'S GET TO SOME OF THE 

3358
02:04:11,778 --> 02:04:12,112
RESULTS. 

3359
02:04:12,112 --> 02:04:14,448
TRAVEL TIME TO NEAREST RESOURCE.

3360
02:04:14,448 --> 02:04:18,885
HERE WE SEE THAT FOR ALL THREE 

3361
02:04:18,885 --> 02:04:19,286
MEDICATIONS. 

3362
02:04:19,286 --> 02:04:20,287
VARIES ACROSS MEDICATION TYPE. 

3363
02:04:20,287 --> 02:04:22,255
THIS IS CONSISTENT WITH OUR 

3364
02:04:22,255 --> 02:04:24,324
PRIOR WORK, OTHER FOLKS' PRIOR 

3365
02:04:24,324 --> 02:04:24,524
WORK. 

3366
02:04:24,524 --> 02:04:25,659
MANY OF THE FOLKS ARE EITHER 

3367
02:04:25,659 --> 02:04:27,994
TALKING HERE TODAY OR IN THE 

3368
02:04:27,994 --> 02:04:28,261
AUDIENCE. 

3369
02:04:28,261 --> 02:04:31,098
NOTE THAT THE LACK OF RESOURCES 

3370
02:04:31,098 --> 02:04:33,734
FOR METHADONE AND RURAL AREAS, 

3371
02:04:33,734 --> 02:04:34,701
AS WELL AS ACROSS OTHER PARTS OF

3372
02:04:34,701 --> 02:04:37,738
THE U.S., YOU KNOW, IT'S REALLY 

3373
02:04:37,738 --> 02:04:39,172
NOT JUSTIFIED, ESPECIALLY 

3374
02:04:39,172 --> 02:04:40,874
COMPARED TO THE WEALTH OF 

3375
02:04:40,874 --> 02:04:44,311
POTENTIAL RESOURCES OF

3376
02:04:44,311 --> 02:04:47,714
OF  BUPRENORP HINE AND 

3377
02:04:47,714 --> 02:04:48,014
METHADONE. 

3378
02:04:48,014 --> 02:04:51,685
AND NALTREXONE IN PREVENTING 

3379
02:04:51,685 --> 02:04:54,287
OVERDOSES AND THE HIGHEST POLICY

3380
02:04:54,287 --> 02:04:56,156
ROAD BLOCKS AS WELL AS STIGMA. 

3381
02:04:56,156 --> 02:04:57,758
SO THE LACK OF METHADONE 

3382
02:04:57,758 --> 02:05:03,497
RESEARCH SPECIFICALLY MAY A 

3383
02:05:03,497 --> 02:05:04,464
SIGNIFICANC 

3384
02:05:04,464 --> 02:05:06,733
SIGNAL FOR OTHER BARRIERS LIKE 

3385
02:05:06,733 --> 02:05:07,501
ATTITUDINAL AND, ETC. 

3386
02:05:07,501 --> 02:05:09,736
ALL RIGHT, LET'S LOOK AT ONE 

3387
02:05:09,736 --> 02:05:13,306
MEASURE LOOKING AT MULTIPLE 

3388
02:05:13,306 --> 02:05:15,008
DIFFERENT METHODS. 

3389
02:05:15,008 --> 02:05:17,010
WE LOOK AT A BOX PLOT CATEGORY 

3390
02:05:17,010 --> 02:05:20,947
TO CHARACTERIZE ALL DIFFERENT 

3391
02:05:20,947 --> 02:05:21,248
APPROACHES. 

3392
02:05:21,248 --> 02:05:22,883
RED IS ESSENTIALLY AN OUTLIER. 

3393
02:05:22,883 --> 02:05:25,852
AND SO THE APPROACH WILL DEPEND 

3394
02:05:25,852 --> 02:05:29,356
ON WHICH -- WHICH METRIC YOU ARE

3395
02:05:29,356 --> 02:05:36,029
LOOKING AT. SO RED TO OUTLIERS. 

3396
02:05:36,029 --> 02:05:40,400
BLYTHE BLUE TO PEACH OF THE CORE

3397
02:05:40,400 --> 02:05:42,502
TELL RANGE AND TOP THREE 

3398
02:05:42,502 --> 02:05:43,303
RESOURCES ARE SIMILAR MAINLY 

3399
02:05:43,303 --> 02:05:45,439
BECAUSE OF THE ACCUMULATION OF 

3400
02:05:45,439 --> 02:05:49,075
RESOURCES AND POPULATION-LOADED 

3401
02:05:49,075 --> 02:05:51,244
SUBURBS AND CITY CENTER. 

3402
02:05:51,244 --> 02:05:52,279
HOWEVER, POPULATION IS NOT THE 

3403
02:05:52,279 --> 02:05:52,879
ONLY THING. 

3404
02:05:52,879 --> 02:05:56,016
BOTTOM THREE WHEN YOU TAKE INTO 

3405
02:05:56,016 --> 02:05:57,651
ACCOUNT POPULATION IN OTHER WAYS

3406
02:05:57,651 --> 02:05:59,419
AGAINST THE BOTTOM RIGHT TWO, 

3407
02:05:59,419 --> 02:06:01,555
THAT THE RAM MODEL, FOR EXAMPLE,

3408
02:06:01,555 --> 02:06:03,256
EVEN THOUGH THE TWO-STEP 

3409
02:06:03,256 --> 02:06:05,158
FLOATING CATCHMENT AREA AND THE 

3410
02:06:05,158 --> 02:06:07,494
RAM MODEL BOTH USE SUPPLY AND 

3411
02:06:07,494 --> 02:06:09,763
DEMAND, THERE IS VERY CLEARLY 

3412
02:06:09,763 --> 02:06:10,764
DIFFERENT VARIABILITY DEPENDING 

3413
02:06:10,764 --> 02:06:13,233
ON THE TYPE OF MEASURE THAT YOU 

3414
02:06:13,233 --> 02:06:13,733
USE. 

3415
02:06:13,733 --> 02:06:16,002
TEXAS AND THE ROCKIES HAVE 

3416
02:06:16,002 --> 02:06:21,741
DRAMATICALLY LESS ACCESS IN THAT

3417
02:06:21,741 --> 02:06:25,779
EXAMPLE. 

3418
02:06:25,779 --> 02:06:31,084
HERE WE ARE LOOKING AT SPATIAL 

3419
02:06:31,084 --> 02:06:31,852
ORLATION. 

3420
02:06:31,852 --> 02:06:33,086
AND BASICALLY IF TWO THINGS ARE 

3421
02:06:33,086 --> 02:06:34,721
STRONGLY CORRELATED WITH EACH 

3422
02:06:34,721 --> 02:06:36,323
OTHER, IT MIGHT NOT MATTER WHICH

3423
02:06:36,323 --> 02:06:37,757
ONE YOU USE. 

3424
02:06:37,757 --> 02:06:39,960
WHILE A LOT OF THE -- US 

3425
02:06:39,960 --> 02:06:40,794
RESEARCHERS HAVE BEEN DEBATING 

3426
02:06:40,794 --> 02:06:43,163
ON IS -- YOU KNOW, NEAREST 

3427
02:06:43,163 --> 02:06:44,097
DISTANCE OR TRAVEL TIME BETTER 

3428
02:06:44,097 --> 02:06:46,233
OR WORSE WHEN YOU ARE LOOKING AT

3429
02:06:46,233 --> 02:06:48,201
THIS AT A NATIONAL SCALE. 

3430
02:06:48,201 --> 02:06:51,171
AND SOME CASES, THAT -- THOSE --

3431
02:06:51,171 --> 02:06:52,873
THOSE -- THAT DEBATE BECOMES 

3432
02:06:52,873 --> 02:06:54,341
LESS IMPORTANT. 

3433
02:06:54,341 --> 02:07:01,748
ESPECIALLY IS A HUGE VARIETY IN 

3434
02:07:01,748 --> 02:07:04,885
WHAT YOU ARE LOOKING AT. 

3435
02:07:04,885 --> 02:07:06,319
SPATIAL MATTERS ARE DISTINCT. 

3436
02:07:06,319 --> 02:07:10,524
EXAMINE THE TO SEE LIGHTER 

3437
02:07:10,524 --> 02:07:12,125
COMBARS. 

3438
02:07:12,125 --> 02:07:15,095
BUPONORP HINE AND THEY PERFORM 

3439
02:07:15,095 --> 02:07:16,897
SIMILAR TO EACH OTHER WITH HIGH 

3440
02:07:16,897 --> 02:07:17,764
CORRELATIONS. 

3441
02:07:17,764 --> 02:07:21,735
FOR EXAMPLE, IN THIS CAS

3442
02:07:21,735 --> 02:07:24,070
CASE, BUPRENORP HINE I WOULD 

3443
02:07:24,070 --> 02:07:25,672
RECOMMEND USING A GRAVITY MODEL 

3444
02:07:25,672 --> 02:07:28,174
AND WILL ACCOUNT FOR THE 

3445
02:07:28,174 --> 02:07:29,743
POPULATION IN A DISTINCTLY 

3446
02:07:29,743 --> 02:07:30,677
DIFFERENT WAY DOESN'T MATTER 

3447
02:07:30,677 --> 02:07:32,846
WHICH GRAVITY MODEL AND DOESN'T 

3448
02:07:32,846 --> 02:07:34,881
MATTER ACROSS THE URBAN, 

3449
02:07:34,881 --> 02:07:36,349
SUBURBAN RURAL AREAS. 

3450
02:07:36,349 --> 02:07:37,083
IN CONTRAST. 

3451
02:07:37,083 --> 02:07:38,418
LET'S LOOK AT METHADONE. 

3452
02:07:38,418 --> 02:07:40,353
WHILE URBAN AREAS HAVE LESS 

3453
02:07:40,353 --> 02:07:41,755
CORRELATION BECAUSE WE SEE A 

3454
02:07:41,755 --> 02:07:43,823
LITTLE BIT MORE OF THOSE LIGHT 

3455
02:07:43,823 --> 02:07:45,392
AREAS. 

3456
02:07:45,392 --> 02:07:46,560
SEVERAL ACCESS METRICS IN 

3457
02:07:46,560 --> 02:07:47,794
SUBURBAN AND ESPECIALLY RURAL 

3458
02:07:47,794 --> 02:07:49,462
AREAS ARE STRONGLY CORRELATED 

3459
02:07:49,462 --> 02:07:50,964
WITH EACH OTHER. 

3460
02:07:50,964 --> 02:07:53,199
DRIVING TIME AND NEAREST 

3461
02:07:53,199 --> 02:07:54,801
RESOURCE IS ALMOST 

3462
02:07:54,801 --> 02:07:55,235
INDISTINGUISHABLE. 

3463
02:07:55,235 --> 02:07:56,736
THE LACK -- AND SO HERE -- WHY 

3464
02:07:56,736 --> 02:07:58,905
IS THIS HAPPENING?

3465
02:07:58,905 --> 02:08:01,741
WELL, A HUGE LACK OF RESOURCES 

3466
02:08:01,741 --> 02:08:04,411
AND VERY DIFFICULT TO HAVE 

3467
02:08:04,411 --> 02:08:06,546
VARLGS IN ALMOST ZERO ACCESS. 

3468
02:08:06,546 --> 02:08:09,382
I CONTEND THIS IS WHY WE 

3469
02:08:09,382 --> 02:08:12,385
SOMETIMES SEE THAT METHADONE 

3470
02:08:12,385 --> 02:08:16,590
SPATIAL ACCESS IS NOT A 

3471
02:08:16,590 --> 02:08:17,090
SIGNIFICANT VARIABLE IN 

3472
02:08:17,090 --> 02:08:18,291
DIFFERENT ANALYSES BECAUSE THERE

3473
02:08:18,291 --> 02:08:20,694
IS VERY -- IF YOU DON'T HAVE 

3474
02:08:20,694 --> 02:08:21,761
SPECIFIC VARIATION, YOU ARE 

3475
02:08:21,761 --> 02:08:23,296
MISSING THAT. 

3476
02:08:23,296 --> 02:08:25,265
SO HERE TO KIND OF MAKE IT MORE 

3477
02:08:25,265 --> 02:08:27,300
COMPLEX, WE ARE ONLY SHOWING 

3478
02:08:27,300 --> 02:08:29,235
AREAS THAT WERE WITHIN 90-MINUTE

3479
02:08:29,235 --> 02:08:30,704
DRIVING TIME OF METHADONE AND 

3480
02:08:30,704 --> 02:08:32,739
EVEN WHOLE OTHER SWATHS OF THE 

3481
02:08:32,739 --> 02:08:34,874
COUNTRY THAT HAVE ZERO ACCESS 

3482
02:08:34,874 --> 02:08:40,447
CONSISTEN

3483
02:08:40,447 --> 02:08:41,748
CONSISTENTLY WE ARE RECALLING 

3484
02:08:41,748 --> 02:08:45,752
ANY MINUTES REASONABLE. 

3485
02:08:45,752 --> 02:08:46,920
AND HIGHLIGHT THE VERY DRAMATIC 

3486
02:08:46,920 --> 02:08:48,855
CHANGE OF URBAN, SUBURBAN AND 

3487
02:08:48,855 --> 02:08:50,991
RURAL AREAS AND VERY IMPORTANT 

3488
02:08:50,991 --> 02:08:53,660
TO STRATIFY BY URBANICITY IN 

3489
02:08:53,660 --> 02:08:54,961
DOING THIS KIND OF WORK. 

3490
02:08:54,961 --> 02:08:56,663
ANOTHER WAY TO LOOK AT THIS IS 

3491
02:08:56,663 --> 02:08:58,798
LOOKING AT BOX PLOTS AS A WAY OF

3492
02:08:58,798 --> 02:09:00,767
KIND OF AGAIN -- THE BOX PLOTS 

3493
02:09:00,767 --> 02:09:02,168
IS HOW WE ARE MAPPING IT BUT 

3494
02:09:02,168 --> 02:09:04,638
LOOKING AT THE BOX PLOT ON A 

3495
02:09:04,638 --> 02:09:06,873
TRADITIONAL WAY AND SO ON AND SO

3496
02:09:06,873 --> 02:09:07,107
FORTH. 

3497
02:09:07,107 --> 02:09:09,609
SO I AM GOING TO JUMP TO THE 

3498
02:09:09,609 --> 02:09:11,544
LAST SCREEN HERE. 

3499
02:09:11,544 --> 02:09:13,747
ESSENTIALLY WHEN WE PUT THIS ALL

3500
02:09:13,747 --> 02:09:21,755
TOGETHER WHICH METRIC WAS FAST, 

3501
02:09:21,755 --> 02:09:23,823
THE RAM MODEL HAD SUFFICIENT 

3502
02:09:23,823 --> 02:09:25,925
VARIABILITY AND VERY EFFICIENT; 

3503
02:09:25,925 --> 02:09:27,193
HOWEVER, IT ACTUALLY DIDN'T 

3504
02:09:27,193 --> 02:09:29,062
MATTER FOR METHADONE. 

3505
02:09:29,062 --> 02:09:30,597
METHADONE -- WE ACTUALLY FOUND 

3506
02:09:30,597 --> 02:09:34,868
THAT FOR RESOURCES THAT ARE V

3507
02:09:34,868 --> 02:09:39,773
VERY SCARCE LIKE METHADONE, 

3508
02:09:39,773 --> 02:09:40,640
MINIMUM DISTANCE MAY BE 

3509
02:09:40,640 --> 02:09:41,574
CONSISTENT. 

3510
02:09:41,574 --> 02:09:44,344
THAT IS A BIG SAY, BUT A BIG 

3511
02:09:44,344 --> 02:09:44,678
FINDING. 

3512
02:09:44,678 --> 02:09:45,645
THESE ARE SOME OF THE HIGH 

3513
02:09:45,645 --> 02:09:46,079
MODELS. 

3514
02:09:46,079 --> 02:09:47,847
WE FOUND THAT THE CONSISTENCY 

3515
02:09:47,847 --> 02:09:50,417
BETWEEN SPATIAL -- MEASUREMENTS 

3516
02:09:50,417 --> 02:09:53,453
WERE HETEROGENEOUS. 

3517
02:09:53,453 --> 02:09:56,956
RESOURCES HAVE LESS CONSISTENCY 

3518
02:09:56,956 --> 02:09:59,392
IN SUBURBAN AND RURAL AREA. 

3519
02:09:59,392 --> 02:10:00,427
MATTERS WHAT YOU USE MEASURING 

3520
02:10:00,427 --> 02:10:03,697
IN THOSE PLACES. 

3521
02:10:03,697 --> 02:10:04,964
HOW POPULATION IS ACCOUNTED FOR 

3522
02:10:04,964 --> 02:10:09,736
OR NOT CAN GENERATE INCONSISTENT

3523
02:10:09,736 --> 02:10:09,936
VIS. 

3524
02:10:09,936 --> 02:10:11,771
IN THE END, RECOMMEND USING RAM 

3525
02:10:11,771 --> 02:10:13,239
AND MINIMUM DISTANCE OR TRAVEL 

3526
02:10:13,239 --> 02:10:14,774
TIME JUST TO BETTER COMMUNICATE 

3527
02:10:14,774 --> 02:10:15,408
YOUR FINDINGS. 

3528
02:10:15,408 --> 02:10:19,879
AND I ALSO MENTIONED SOME OF THE

3529
02:10:19,879 --> 02:10:20,580
COMPUTATIONAL NOTEBOOKS AND 

3530
02:10:20,580 --> 02:10:22,315
THINGS BEING MADE AVAILABLE SO 

3531
02:10:22,315 --> 02:10:23,383
OTHERS CAN DO THIS AS WELL. 

3532
02:10:23,383 --> 02:10:24,851
THANK YOU, GUYS. 

3533
02:10:24,851 --> 02:10:26,119
I THINK THE FIRST FEW MINUTES 

3534
02:10:26,119 --> 02:10:27,654
THREW ME UP. 

3535
02:10:27,654 --> 02:10:28,755
I POLL SIZE FOR RUNNING A MINUTE

3536
02:10:28,755 --> 02:10:29,989
OR TWO OVER. 

3537
02:10:29,989 --> 02:10:31,558
>> THANK YOU SO MUCH FOR
THAT 

3538
02:10:31,558 --> 02:10:32,058
GREAT PRESENTATION. 

3539
02:10:32,058 --> 02:10:34,160
I LOVED HEARING ALL THE NUANCE 

3540
02:10:34,160 --> 02:10:35,261
ABOUT THE DIFFERENT MEASUREMENT 

3541
02:10:35,261 --> 02:10:37,163
APPROACHES AND HOW THAT CAN 

3542
02:10:37,163 --> 02:10:38,698
IMPACT -- IMPACT THE ABILITY TO 

3543
02:10:38,698 --> 02:10:39,099
HAVE INSIGHTS. 

3544
02:10:39,099 --> 02:10:39,799
THAT WAS GREAT. 

3545
02:10:39,799 --> 02:10:41,735
JUST A REMINDER TO FOLKS WHILE 

3546
02:10:41,735 --> 02:10:44,270
THE NEXT PRESENTATION IS GOING, 

3547
02:10:44,270 --> 02:10:47,907
IF YOU HAVE QUESTIONS FOR 

3548
02:10:47,907 --> 02:10:50,577
MARYNIA, PUT THEM IN THE Q AND A

3549
02:10:50,577 --> 02:10:52,178
AND WE WILL GET TO THEM AT THE 

3550
02:10:52,178 --> 02:10:53,580
END OF THE SESSION. 

3551
02:10:53,580 --> 02:10:56,116
HAND IT OVER TO DR. BANK. 

3552
02:10:56,116 --> 02:11:05,725
>> THANK YOU. 

3553
02:11:05,725 --> 02:11:06,159
OKAY. 

3554
02:11:06,159 --> 02:11:10,096
I CAN'T SEE MYSELF BUT I ASSUME 

3555
02:11:10,096 --> 02:11:12,465
YOU SHALL MARILY. 

3556
02:11:12,465 --> 02:11:17,804
DEVIN BANKS, AND MY SESSION IS 

3557
02:11:17,804 --> 02:11:19,739
INTEGRATING COMMUNITY ENGAGEMENT

3558
02:11:19,739 --> 02:11:22,876
AND GEO SPATIAL METHODS TO 

3559
02:11:22,876 --> 02:11:26,746
ADDRESS RACIAL INEQUITIES. 

3560
02:11:26,746 --> 02:11:28,715
SWITCH GEARS FROM ANALYTIC 

3561
02:11:28,715 --> 02:11:30,650
METHODS AND COMMUNITY ENGAGEMENT

3562
02:11:30,650 --> 02:11:32,819
AS MENTIONED BY MY COLLEAGUE DR.

3563
02:11:32,819 --> 02:11:34,420
STOPKA EARLIER WITH THE GOAL OF 

3564
02:11:34,420 --> 02:11:37,357
GETTING AT SOME OF THOSE USER 

3565
02:11:37,357 --> 02:11:40,627
APPLICATIONS THAT -- THAT D

3566
02:11:40,627 --> 02:11:42,128
DR. BLANCO TALKED ABOUT IN THE 

3567
02:11:42,128 --> 02:11:44,664
VERY -- IN HIS OPENING REMARKS. 

3568
02:11:44,664 --> 02:11:46,733
AND ESPECIALLY AS THEY RELATE TO

3569
02:11:46,733 --> 02:11:48,034
RACIAL INEQUITIES. 

3570
02:11:48,034 --> 02:11:49,235
I WOULD LIKE TO START WITH THE 

3571
02:11:49,235 --> 02:11:52,505
PROBLEM SO WE ALL START FROM THE

3572
02:11:52,505 --> 02:11:53,039
SAME PLACE. 

3573
02:11:53,039 --> 02:11:57,710
SINCE THE MID 2010s, FATAL DRUG 

3574
02:11:57,710 --> 02:11:58,878
OVERDOSES HAVE INCREASED 

3575
02:11:58,878 --> 02:12:01,748
DRASTICALLY OF PEOPLE 

3576
02:12:01,748 --> 02:12:04,050
FROM MINORITY AND RACIAL AND 

3577
02:12:04,050 --> 02:12:08,221
ETHNIC GROUPS ACROSS THE UNITED 

3578
02:12:08,221 --> 02:12:10,256
STATES MANUFACTURE OF FENTANYL 

3579
02:12:10,256 --> 02:12:12,025
IN THE DRUG SUPPLY AND 

3580
02:12:12,025 --> 02:12:13,760
DISPROPORTION ALLEY IMPACTED 

3581
02:12:13,760 --> 02:12:16,896
BLACK MEN IN PARTICULAR THATCH 

3582
02:12:16,896 --> 02:12:19,465
-- KINDS OF THE SHARPEST SLOPE 

3583
02:12:19,465 --> 02:12:22,168
OF INCREASE THERE FROM 2015 TO 

3584
02:12:22,168 --> 02:12:25,738
20 

3585
02:12:25,738 --> 02:12:29,742
2020 THIS LED A LOT OF 

3586
02:12:29,742 --> 02:12:33,012
STAKEHOLDER INCLUDING NIDA THAT 

3587
02:12:33,012 --> 02:12:34,714
PREVENTION AND TREATMENT EFFORTS

3588
02:12:34,714 --> 02:12:39,352
WERE NOT BENEFITING RACIAL 

3589
02:12:39,352 --> 02:12:40,019
ETHNIC GROUPS. 

3590
02:12:40,019 --> 02:12:42,555
EVEN RECENTLY, THE DATA SUGGESTS

3591
02:12:42,555 --> 02:12:44,958
THAT -- EVEN MORE RECENTLY AND 

3592
02:12:44,958 --> 02:12:47,994
INTO THIS DECADE, THE CURRENT 

3593
02:12:47,994 --> 02:12:49,963
DECADE, SUGGESTS THAT ALL KNOW 

3594
02:12:49,963 --> 02:12:52,899
DEATHS ARE FALLING, THEY 

3595
02:12:52,899 --> 02:12:55,168
CERTAINLY ARE NOT FALLING 

3596
02:12:55,168 --> 02:12:57,704
EQUALLY AMONG RACIAL GROUPS. 

3597
02:12:57,704 --> 02:13:00,139
WHILE RATES HAVE STABILIZED AND 

3598
02:13:00,139 --> 02:13:02,075
TOTAL DEATHSES HAVE FALLEN 

3599
02:13:02,075 --> 02:13:03,309
SIGNIFICANTLY AMONG WHITE 

3600
02:13:03,309 --> 02:13:04,744
INDIVIDUALS, THAT IS NOT 

3601
02:13:04,744 --> 02:13:05,845
NECESSARILY THE CASE THAT YOU 

3602
02:13:05,845 --> 02:13:08,548
CAN SEE AMONG OTHER RACIAL ETHIC

3603
02:13:08,548 --> 02:13:10,483
GROUPS IN THE UNITED STATES. 

3604
02:13:10,483 --> 02:13:12,919
SO IT IS WELL ESTABLISHED THAT 

3605
02:13:12,919 --> 02:13:17,290
THIS HAS NOTHING TO DO WITH RACE

3606
02:13:17,290 --> 02:13:18,524
WITH YOU WITH SOCIAL 

3607
02:13:18,524 --> 02:13:19,859
DETERMINANTS OF HEALTH THAT WE 

3608
02:13:19,859 --> 02:13:26,699
HEARD A LOT ABOUT ALREADY TODAY.

3609
02:13:26,699 --> 02:13:29,736
FOR EXAMPLE, NO 022, INCOME 

3610
02:13:29,736 --> 02:13:31,938
INEQUALITY WAS ASSOCIATED WITH 

3611
02:13:31,938 --> 02:13:33,373
DRUG OVERDOSE. 

3612
02:13:33,373 --> 02:13:35,441
BUT PARTICULARLY AMONG BLACK 

3613
02:13:35,441 --> 02:13:39,412
AMERICANS, SUCH AS THE HIGHEST 

3614
02:13:39,412 --> 02:13:41,447
PER TILE OF INCOME INEQUALITY 

3615
02:13:41,447 --> 02:13:43,449
WAS ASSOCIATED WITH FATAL 

3616
02:13:43,449 --> 02:13:45,752
OVERDOSE TWO TIMES AS HIGH AS 

3617
02:13:45,752 --> 02:13:50,189
THE LOWEST. 

3618
02:13:50,189 --> 02:13:53,626
WE DIDN'T SEE THAT DRASTIC OF A 

3619
02:13:53,626 --> 02:13:56,062
DOSE RESPONSE RATE AMONG OTHER 

3620
02:13:56,062 --> 02:13:56,296
GROUPS. 

3621
02:13:56,296 --> 02:13:57,730
AS YOU MITE IMAGINE SOCIAL 

3622
02:13:57,730 --> 02:13:59,465
DETERMINANTS OF HEALTH VARY BY 

3623
02:13:59,465 --> 02:14:02,402
REGION AND SO DO INEQUITIES. 

3624
02:14:02,402 --> 02:14:04,904
THIS IS THE RATE OF OVERDOSE 

3625
02:14:04,904 --> 02:14:07,941
AMONG BLACK INDIVIDUALS IN THE 

3626
02:14:07,941 --> 02:14:09,742
UNITED STATES. 

3627
02:14:09,742 --> 02:14:11,544
WHERE I LIVE IN MISSOURI. 

3628
02:14:11,544 --> 02:14:17,450
THE DARK BLUE SPOT IN THE MIDDLE

3629
02:14:17,450 --> 02:14:18,751
LOWEST RATE OF BLACK OVERDOSES 

3630
02:14:18,751 --> 02:14:22,188
IN THE COUNTRY BETWEEN 2019 AND 

3631
02:14:22,188 --> 02:14:25,692
202

3632
02:14:25,692 --> 02:14:28,494
2022 AND WHAT WE SEE IN MISSOURI

3633
02:14:28,494 --> 02:14:30,430
IS REFLECTING A LOT OF THE 

3634
02:14:30,430 --> 02:14:33,733
TRENDS WE ARE SEEING NATIONALLY 

3635
02:14:33,733 --> 02:14:40,173
AS WELL IN PARTICULAR HIGH RATE 

3636
02:14:40,173 --> 02:14:41,741
BELONG BLACK MEN. 

3637
02:14:41,741 --> 02:14:44,477
THE HIGH RATE AMONG BLACK MEN IN

3638
02:14:44,477 --> 02:14:45,878
MISSOURI IS DRIVEN LARGELY BY 

3639
02:14:45,878 --> 02:14:48,314
THE ST. LOUIS METROPOLITAN AREA 

3640
02:14:48,314 --> 02:14:52,051
WHICH ACCOUNTS FOR 45% OF STATE 

3641
02:14:52,051 --> 02:14:57,156
DRUG INVOLVED DEATHS AND 75% OF 

3642
02:14:57,156 --> 02:15:04,430
STATE -- STATE INVOLVED DEATH. 

3643
02:15:04,430 --> 02:15:09,736
AND VERY SUB EPIDEMIC BLACK 

3644
02:15:09,736 --> 02:15:12,372
RESIDENTS. 

3645
02:15:12,372 --> 02:15:15,641
LIKE I SAID, THIS IS NOT DRIVEN 

3646
02:15:15,641 --> 02:15:17,276
NECESSARILY BY RACE BY 

3647
02:15:17,276 --> 02:15:22,815
RACIALIZED DETERMINANCE OF 

3648
02:15:22,815 --> 02:15:23,049
HEALTH. 

3649
02:15:23,049 --> 02:15:26,285
THIS -- THIS ENVIRONMENTAL 

3650
02:15:26,285 --> 02:15:27,854
EXPOSURE DRIVES RACIAL 

3651
02:15:27,854 --> 02:15:28,154
INEQUITIES. 

3652
02:15:28,154 --> 02:15:30,056
IN ST. LOUIS, THE IMPACT OF 

3653
02:15:30,056 --> 02:15:32,125
SOCIAL DETERMINANTS HAVE BEEN 

3654
02:15:32,125 --> 02:15:33,326
DEMONSTRATED THROUGH DATA 

3655
02:15:33,326 --> 02:15:35,395
VISUALIZATION AND GIS. 

3656
02:15:35,395 --> 02:15:37,463
THESE ARE JUST MAPS THAT SHOW 

3657
02:15:37,463 --> 02:15:40,133
THE CONCENTRATION OF AFRICAN 

3658
02:15:40,133 --> 02:15:43,002
AMERICAN POPULATION, POVERTY, 

3659
02:15:43,002 --> 02:15:45,405
RELATIVE TO THE CAUSE OF HEART 

3660
02:15:45,405 --> 02:15:46,439
DISEASE AND CANCER. 

3661
02:15:46,439 --> 02:15:48,708
THESE WERE ALL THE WAY BACK IN 

3662
02:15:48,708 --> 02:15:48,908
2013. 

3663
02:15:48,908 --> 02:15:51,144
AND THIS IS ST. LOUIS CITY. 

3664
02:15:51,144 --> 02:15:52,211
AND ST. LOUIS COUNTY. 

3665
02:15:52,211 --> 02:15:54,680
AND WHAT THEY ARE TRYING TO 

3666
02:15:54,680 --> 02:16:01,788
DEMONSTRATE OR HOP CREATED THESE

3667
02:16:01,788 --> 02:16:03,022
MATCHES WERE TRYING TO 

3668
02:16:03,022 --> 02:16:04,724
DEMONSTRATE POVERTY AND THE 

3669
02:16:04,724 --> 02:16:05,458
PERCENTAGE OF AFRICAN AMERICAN 

3670
02:16:05,458 --> 02:16:09,028
WAS ASSOCIATED WITH HEALTH 

3671
02:16:09,028 --> 02:16:11,697
INEQUITIES. SO CERTAINLY RACE 

3672
02:16:11,697 --> 02:16:14,467
AND POVERTY IS RELATED TO 

3673
02:16:14,467 --> 02:16:16,502
OVERDOSE, BUT WE DO KNOW THIS IS

3674
02:16:16,502 --> 02:16:19,505
MORE COMPLEX BECAUSE IN THE 

3675
02:16:19,505 --> 02:16:21,340
COMPLEX OF THE FENTANYL ERA, 

3676
02:16:21,340 --> 02:16:24,544
ENVIRONMENTAL EXPOSURES ARE MORE

3677
02:16:24,544 --> 02:16:24,977
PROMINENT. 

3678
02:16:24,977 --> 02:16:26,279
BLURRIER THAN IT LOOKED ON MY 

3679
02:16:26,279 --> 02:16:26,979
COMPUTER. 

3680
02:16:26,979 --> 02:16:28,548
I APOLOGIZE FOR THAT. 

3681
02:16:28,548 --> 02:16:30,450
BUT THIS WAS SOME WORK WE DID A 

3682
02:16:30,450 --> 02:16:31,951
COUPLE OF YEARS AGO. 

3683
02:16:31,951 --> 02:16:33,119
BASE AND WORKING THAT 

3684
02:16:33,119 --> 02:16:36,622
ELIZABETH NESOF DID AND OTHERS 

3685
02:16:36,622 --> 02:16:39,358
THAT SHOWED THAT IN THE FENTANYL

3686
02:16:39,358 --> 02:16:41,461
ERA, FENTANYL INVOLVED DEATHS 

3687
02:16:41,461 --> 02:16:43,663
CLUSTER MORE DENSELY THAN OTHER 

3688
02:16:43,663 --> 02:16:46,299
TYPES OF DRUG-INVOLVED -- OR 

3689
02:16:46,299 --> 02:16:47,533
OVERDOSE DEATHS. 

3690
02:16:47,533 --> 02:16:49,769
IN ST. LOUIS, WE FOUND THAT DRUG

3691
02:16:49,769 --> 02:16:52,939
OVERDOSE CLUSTERED NOT ONLY MORE

3692
02:16:52,939 --> 02:16:54,841
DENSELY IN THE FENTANYL AREA BUT

3693
02:16:54,841 --> 02:16:57,443
CLUSTERED MORE DENSELY IN NORTH 

3694
02:16:57,443 --> 02:16:58,945
CITY ST. LOUIS. 

3695
02:16:58,945 --> 02:17:07,153
THIS THE READ AIR AREA IN THE 

3696
02:17:07,153 --> 02:17:08,087
TOP LEFT-HAND SIDE. 

3697
02:17:08,087 --> 02:17:09,088
BLACK NEIGHBORHOOD THAT HAVE 

3698
02:17:09,088 --> 02:17:10,957
BEEN DIVESTED IN. 

3699
02:17:10,957 --> 02:17:16,963
AND THAT WAS EXPECTED AMONG THE 

3700
02:17:16,963 --> 02:17:22,702
BLACK DECEDENENTS. 

3701
02:17:22,702 --> 02:17:24,170
WHITE RESIDENTS WERE MORE 

3702
02:17:24,170 --> 02:17:25,438
CLUSTERED IN THOSE PREDOMINANTLY

3703
02:17:25,438 --> 02:17:26,939
BLACK NEIGHBORHOODS. 

3704
02:17:26,939 --> 02:17:28,941
SO THAT LED US, YOU KNOW, TO THE

3705
02:17:28,941 --> 02:17:31,611
QUESTION, WHAT ARE THE SPECIFIC 

3706
02:17:31,611 --> 02:17:32,478
SOCIAL DETERMINANTS DRIVING 

3707
02:17:32,478 --> 02:17:33,379
OVERDOSE IN THESE AREAS?

3708
02:17:33,379 --> 02:17:42,288
IT IS NOT JUST RACE. ONE OF THE 

3709
02:17:42,288 --> 02:17:44,056
THINGS THAT HAVE BEEN POINTED TO

3710
02:17:44,056 --> 02:17:45,024
IS ACCESS TO TREATMENT. 

3711
02:17:45,024 --> 02:17:46,559
I SHOWED THIS MAP TO DEMOCRAT 

3712
02:17:46,559 --> 02:17:49,428
STRAIGHT AS AN EXAMPLE THAT GIS 

3713
02:17:49,428 --> 02:17:51,697
IS NOT ONLY EASILY TRANSLETABLE 

3714
02:17:51,697 --> 02:17:53,399
TO COMMUNITY SETTINGS BUT ALSO 

3715
02:17:53,399 --> 02:17:54,834
SOMETHING THAT WE FOUND THAT 

3716
02:17:54,834 --> 02:17:58,871
COMMUNITIES ARE INTERESTED IN. 

3717
02:17:58,871 --> 02:18:02,508
AT THIS TIME, IN 2021, OUR 

3718
02:18:02,508 --> 02:18:03,242
COMMUNITY PARTNERS WERE 

3719
02:18:03,242 --> 02:18:05,378
INTERESTED IN MAPPING, TREATMENT

3720
02:18:05,378 --> 02:18:07,280
ACCESS AND OTHER DETERMINANTS OF

3721
02:18:07,280 --> 02:18:09,749
HEALTH AND SOMETHING THAT ONE OF

3722
02:18:09,749 --> 02:18:11,651
OUR PARTNERS PUT TOGETHER AS A 

3723
02:18:11,651 --> 02:18:14,754
RUDIMENTARY ATTEMPT AT GIS. 

3724
02:18:14,754 --> 02:18:17,690
SO THIS TOLD ME THAT GIS HAD 

3725
02:18:17,690 --> 02:18:20,626
SIGNIFICANT POTENTIAL FOR 

3726
02:18:20,626 --> 02:18:22,662
TRANSLATION TO COMMUNITY 

3727
02:18:22,662 --> 02:18:22,929
SETTINGS. 

3728
02:18:22,929 --> 02:18:24,130
BUT AS FAR AS I COULD TELL, IT 

3729
02:18:24,130 --> 02:18:26,299
WASN'T REALLY BEING APPLIED OR 

3730
02:18:26,299 --> 02:18:28,634
TRANSLATED TO THE COMMUNITY IN 

3731
02:18:28,634 --> 02:18:32,238
OUR REGION DESPITE THE INTEREST 

3732
02:18:32,238 --> 02:18:33,773
AND EASE OF INTERPRETATION. 

3733
02:18:33,773 --> 02:18:35,274
AND THAT IS A SHAME, BECAUSE A 

3734
02:18:35,274 --> 02:18:37,376
LOT OF GIS RESEARCH HAS BEEN 

3735
02:18:37,376 --> 02:18:38,244
APPLIED TO OVERDOSE. 

3736
02:18:38,244 --> 02:18:41,681
THIS IS A PAPER PUSH IN 2022 

3737
02:18:41,681 --> 02:18:45,585
THAT FOUND THAT OVER 231 

3738
02:18:45,585 --> 02:18:47,420
ARTICLES ARE -- THAT 231 

3739
02:18:47,420 --> 02:18:51,290
ARTICLES USING GIS 2 

3740
02:18:51,290 --> 02:18:52,758
CHARACTERIZED OPIOID OVERDOSE 

3741
02:18:52,758 --> 02:18:54,427
SPECIFIC LOW AND OVER 3/4 OF 

3742
02:18:54,427 --> 02:19:03,302
THOSE WERE PUBLISHED IN THE LAST

3743
02:19:03,302 --> 02:19:04,870
FIVE YEARS SINCE 2017. 

3744
02:19:04,870 --> 02:19:07,473
MOST OCCURRED AT THE LOCAL LEVEL

3745
02:19:07,473 --> 02:19:09,108
DEMONSTRATING THAT POTENTIAL FOR

3746
02:19:09,108 --> 02:19:11,844
ENGAGEMENT WITH THE LOCAL 

3747
02:19:11,844 --> 02:19:13,946
COMMUNITY. BUT WHAT -- WHAT TYPE

3748
02:19:13,946 --> 02:19:16,315
OF COMMUNITY?

3749
02:19:16,315 --> 02:19:20,052
WELL FOR ME, I WAS PARTICULARLY 

3750
02:19:20,052 --> 02:19:24,824
INTERESTED IN -- IN -- MY WORK 

3751
02:19:24,824 --> 02:19:27,426
IN RACIAL INEQUITIES. 

3752
02:19:27,426 --> 02:19:29,362
THE DETERMINANCE OF HEALTH AND 

3753
02:19:29,362 --> 02:19:31,998
ACCESS TO TREATMENT IN 

3754
02:19:31,998 --> 02:19:32,965
PREDOMINANTLY BLACK 

3755
02:19:32,965 --> 02:19:34,267
NEIGHBORHOODS, SOME MOBILE 

3756
02:19:34,267 --> 02:19:34,967
APPROACHES HAVE POPPED UP. 

3757
02:19:34,967 --> 02:19:36,602
I KNOW IT POPPED UP IN OUR CITY 

3758
02:19:36,602 --> 02:19:40,706
IN ST. LOUIS, BUT ALL OVER THE 

3759
02:19:40,706 --> 02:19:40,973
COUNTRY. 

3760
02:19:40,973 --> 02:19:48,281
IT CAN LOOK LIKE GRASS-ROOTS 

3761
02:19:48,281 --> 02:19:52,051
ORGANIZATIONS THAT RETROFIT 

3762
02:19:52,051 --> 02:19:52,451
MOBILE VEHICLES. 

3763
02:19:52,451 --> 02:19:53,019
IT CAN LOOK LIKE BRICK AND 

3764
02:19:53,019 --> 02:19:54,487
MORTAR ORGANIZATIONS THAT SEND 

3765
02:19:54,487 --> 02:19:56,722
OUTREACH WORKERS. 

3766
02:19:56,722 --> 02:20:02,228
IT CAN LOOK LIKE PEERS -- PEER 

3767
02:20:02,228 --> 02:20:03,696
OUTREACH PROGRAMS. 

3768
02:20:03,696 --> 02:20:06,165
BUT BASICALLY PEOPLE ARE 

3769
02:20:06,165 --> 02:20:07,600
DISPATCHING -- LAY HEALTH 

3770
02:20:07,600 --> 02:20:10,803
WORKERS, PEERS, COMMUNITY WORK 

3771
02:20:10,803 --> 02:20:13,272
ARES TO UNDERSERVED COMMUNITIES 

3772
02:20:13,272 --> 02:20:14,573
TO MITIGATE SOCIAL DETERMINANTS.

3773
02:20:14,573 --> 02:20:16,742
WE KNOW OUTREACH THAT CAN 

3774
02:20:16,742 --> 02:20:19,178
IMPROVE TRUST AND ACCESS IF 

3775
02:20:19,178 --> 02:20:20,379
PEOPLE KEEP SHOWING UP TO 

3776
02:20:20,379 --> 02:20:22,548
NEIGHBORHOODS AND PROVIDING 

3777
02:20:22,548 --> 02:20:25,017
SERVICES WHERE THERE WERE NOT 

3778
02:20:25,017 --> 02:20:25,785
PREVIOUSLY SERVICED. 

3779
02:20:25,785 --> 02:20:27,286
SERVICES RANGE FROM BASIC NEEDS 

3780
02:20:27,286 --> 02:20:32,425
NO NALOXONE TO WOUND CARE TO 

3781
02:20:32,425 --> 02:20:38,464
EVEN  BUPRENORP HINE PRODUCTION 

3782
02:20:38,464 --> 02:20:40,633
AND RELIANCE ON CONVENIENCE OR 

3783
02:20:40,633 --> 02:20:42,268
ARBITRARY METHODS LIKE WORD OF 

3784
02:20:42,268 --> 02:20:44,136
MOUTH, FUNDING, AGENCY POLICY, 

3785
02:20:44,136 --> 02:20:46,972
AND THEN, OF COURSE, SIGMA, WHO 

3786
02:20:46,972 --> 02:20:48,941
WILL ALLOW YOU TO PARK THEIR 

3787
02:20:48,941 --> 02:20:51,210
MOBILE VAN IN THEIR PARKING LOT,

3788
02:20:51,210 --> 02:20:51,677
FOR EXAMPLE. 

3789
02:20:51,677 --> 02:20:56,382
SO MY QUESTION IS, CAN DATA 

3790
02:20:56,382 --> 02:20:58,984
DRIVEN OUTREACH, CAN WE USE GIS 

3791
02:20:58,984 --> 02:21:01,253
AND MAPS TO IMPROVE SERVICE 

3792
02:21:01,253 --> 02:21:03,189
IMPACT AND ENVELOPE 

3793
02:21:03,189 --> 02:21:04,757
INTERVENTION?

3794
02:21:04,757 --> 02:21:09,495
BASICALLY RAPIDLY TRANSLATE 

3795
02:21:09,495 --> 02:21:11,797
OPIOID OVERDOSE SURVEILLANCE TO 

3796
02:21:11,797 --> 02:21:14,333
MOBILE OUTREACH. 

3797
02:21:14,333 --> 02:21:16,969
BUT GIVEN WE ARE TALKING OF 

3798
02:21:16,969 --> 02:21:19,105
COMMUNITIES THAT HAVE BEEN 

3799
02:21:19,105 --> 02:21:19,538
INVESTED IN. 

3800
02:21:19,538 --> 02:21:21,140
THE QUESTION END SPIRALED BY 

3801
02:21:21,140 --> 02:21:21,707
COMMUNITIES THEMSELVES. 

3802
02:21:21,707 --> 02:21:25,177
I COULDN'T BEGIN TO ANSWER THEIR

3803
02:21:25,177 --> 02:21:25,778
QUESTION INPUT. 

3804
02:21:25,778 --> 02:21:27,847
WE DID A FOCUS GROUP. 

3805
02:21:27,847 --> 02:21:31,317
WE ENGAGED -- BASICALLY EXISTING

3806
02:21:31,317 --> 02:21:32,318
PARTNERS THAT WE KNEW WE WERE 

3807
02:21:32,318 --> 02:21:34,320
DOING OUTREACH IN BLACK 

3808
02:21:34,320 --> 02:21:37,256
NEIGHBORHOODS IN NORTH ST. 

3809
02:21:37,256 --> 02:21:37,757
LOUIS. 

3810
02:21:37,757 --> 02:21:39,358
THEY REPRESENTED ORGANIZATIONS 

3811
02:21:39,358 --> 02:21:41,761
FROM GRASS-ROOTS NONPROFITS TO 

3812
02:21:41,761 --> 02:21:43,062
LARGE TREATMENT AND SERVICE 

3813
02:21:43,062 --> 02:21:43,429
AGENCIES. 

3814
02:21:43,429 --> 02:21:47,400
THEY ALL HAD OPERATIONAL AND 

3815
02:21:47,400 --> 02:21:48,334
SUPERVISING ROLE. 

3816
02:21:48,334 --> 02:21:50,269
MEANING THEY -- THEY EITHER WERE

3817
02:21:50,269 --> 02:21:51,437
GOING OUT ON -- ON OUTREACH 

3818
02:21:51,437 --> 02:21:52,571
EVERY DAY. 

3819
02:21:52,571 --> 02:21:53,773
AND THAT WAS THEIR MAIN JOB. 

3820
02:21:53,773 --> 02:21:57,109
SO THEY DECIDED WHERE THEY WERE 

3821
02:21:57,109 --> 02:21:57,543
GOING. 

3822
02:21:57,543 --> 02:21:59,612
OR MAYBE THEY RAN AN OUTREACH 

3823
02:21:59,612 --> 02:22:03,416
TEAM OF PEERS OR THE ONLY PERSON

3824
02:22:03,416 --> 02:22:05,551
AT THEIR ORGANIZATION WHO WAS 

3825
02:22:05,551 --> 02:22:07,086
RESPONSIBLE FOR OUTREACH. 

3826
02:22:07,086 --> 02:22:08,087
THEY WORKED FOR THE BRICK AND 

3827
02:22:08,087 --> 02:22:08,988
MORTAR AND THEY WERE THE 

3828
02:22:08,988 --> 02:22:13,592
COMMUNITY OUTREACH COORDINATOR. 

3829
02:22:13,592 --> 02:22:15,761
SO DURING THE FOCUS GROUP, 

3830
02:22:15,761 --> 02:22:18,397
PARTICIPANTS WERE ASKED OF THEIR

3831
02:22:18,397 --> 02:22:19,598
CURRENT OUTREACH EFFORTS AND 

3832
02:22:19,598 --> 02:22:21,767
THEIR ATTITUDE TOWARD MAPPING 

3833
02:22:21,767 --> 02:22:23,002
EFFORTS IN ST. LOUIS THAT WERE 

3834
02:22:23,002 --> 02:22:24,770
ALREADY GOING ON. 

3835
02:22:24,770 --> 02:22:27,606
WE CREATED SOME BASIC MAPS IN 

3836
02:22:27,606 --> 02:22:30,976
OUR GIS, DEMONSTRATING OVERDOSE 

3837
02:22:30,976 --> 02:22:33,779
LIKE IN A HEAT MAP, OVERLAID 

3838
02:22:33,779 --> 02:22:34,713
WITH SUBSTANCE ABUSE TREATMENT 

3839
02:22:34,713 --> 02:22:36,315
AND SERVICES THAT EXIST WHICH 

3840
02:22:36,315 --> 02:22:37,817
YOU CAN SEE KIND OF ON THE 

3841
02:22:37,817 --> 02:22:40,786
LEFT-HAND SIDE, AND THEN WE -- 

3842
02:22:40,786 --> 02:22:42,388
WE SHOWED THEM SOME POINT MAPS 

3843
02:22:42,388 --> 02:22:45,291
AND HOW THE FILTERS WORK. 

3844
02:22:45,291 --> 02:22:49,528
AND SO ON THE RIGHT HAND JOB, 

3845
02:22:49,528 --> 02:22:51,297
THERE IS A MAP FILTER BY YEAR 

3846
02:22:51,297 --> 02:22:54,567
AND RACE. 

3847
02:22:54,567 --> 02:22:57,002
BUT MOSTLY, WE WERE INTERESTED 

3848
02:22:57,002 --> 02:22:59,705
ON ACCESSIBILITY OF MAPS LIKE 

3849
02:22:59,705 --> 02:23:01,774
THIS. 

3850
02:23:01,774 --> 02:23:04,877
AND PREADOPTION AND 

3851
02:23:04,877 --> 02:23:06,078
IMPLEMENTATION QUESTIONS. 

3852
02:23:06,078 --> 02:23:07,112
THESE ARE THE THEMES WE 

3853
02:23:07,112 --> 02:23:12,351
EXTRACTED FROM THE DATA. I WILL 

3854
02:23:12,351 --> 02:23:13,686
GO WITH EACH OF THEM 

3855
02:23:13,686 --> 02:23:14,019
INDIVIDUALLY. 

3856
02:23:14,019 --> 02:23:15,821
THE FIRST ONE IS IMPORTANCE OF 

3857
02:23:15,821 --> 02:23:16,956
CONSIDERING BROADER COMMUNITY 

3858
02:23:16,956 --> 02:23:17,223
CONTEXT. 

3859
02:23:17,223 --> 02:23:21,026
SO OUR INTENT WAS TO DISCUSS THE

3860
02:23:21,026 --> 02:23:24,463
MAPPING TOOL AND IMPLEMENTATION 

3861
02:23:24,463 --> 02:23:25,798
QUESTIONS AND QUESTIONS OF THE 

3862
02:23:25,798 --> 02:23:28,634
SIZE OF THE CONTEXT UNDERLYING 

3863
02:23:28,634 --> 02:23:31,537
RACIAL SOCIAL DETERMINANCE. 

3864
02:23:31,537 --> 02:23:36,108
THEY ARE FOCUSED OUT CURRENT AND

3865
02:23:36,108 --> 02:23:37,209
HISTORICAL POLICIES WERE 

3866
02:23:37,209 --> 02:23:38,244
IMPACTING BLACK COMMUNITIES 

3867
02:23:38,244 --> 02:23:41,447
LEADING TO BASICALLY REALLY 

3868
02:23:41,447 --> 02:23:43,349
VISIBILITY BLACK, WHITE 

3869
02:23:43,349 --> 02:23:45,251
DISPARITIES IN OUR COMMUNITY. 

3870
02:23:45,251 --> 02:23:47,520
AND THIS DERIVED -- PART FROM MY

3871
02:23:47,520 --> 02:23:48,888
PREVIOUS CONCERNS ABOUT WITH 

3872
02:23:48,888 --> 02:23:51,357
INITIATIVES THAT USE MAPPING TO 

3873
02:23:51,357 --> 02:23:57,696
MAP THINGS LIKE HIV AND STI 

3874
02:23:57,696 --> 02:23:58,964
DISPARITIES THAT INSTALLED 

3875
02:23:58,964 --> 02:24:00,599
LIMITED IMPACT AND IT NO SOCIAL 

3876
02:24:00,599 --> 02:24:05,004
DETERMINANTS WERE REALLY 

3877
02:24:05,004 --> 02:24:05,771
ADDRESSED IT. 

3878
02:24:05,771 --> 02:24:09,341
OR THE SOCIAL DETERMINANCE 

3879
02:24:09,341 --> 02:24:10,976
BARRIERS WERE MADE HARDER TO 

3880
02:24:10,976 --> 02:24:11,510
IMPLEMENT. 

3881
02:24:11,510 --> 02:24:13,145
AND APPEAR MAPPING TOOL WILL NOT

3882
02:24:13,145 --> 02:24:15,514
ONLY SHOW OVERDOSE BUT SHOW THE 

3883
02:24:15,514 --> 02:24:16,415
SOCIAL DETERMINANTS OF HEALTH 

3884
02:24:16,415 --> 02:24:18,150
THAT HAVE TO IT BE MITIGATED IN 

3885
02:24:18,150 --> 02:24:21,153
ORDER TO EFFECTIVELY REDRESS 

3886
02:24:21,153 --> 02:24:25,190
OVERD

3887
02:24:25,190 --> 02:24:25,758
OVERD

3888
02:24:25,758 --> 02:24:27,826
OVERDOSE I AM JUST LEAVING THIS 

3889
02:24:27,826 --> 02:24:30,496
UP FOR YOU FOR A SECOND TO READ 

3890
02:24:30,496 --> 02:24:39,405
THE QUOTE. THE SECOND THEME WAS 

3891
02:24:39,405 --> 02:24:42,775
DATA MANIPULATION AND VALIDITY 

3892
02:24:42,775 --> 02:24:43,409
CONCERNS. 

3893
02:24:43,409 --> 02:24:45,778
SO NOT UNEXPECTEDLY PARTICIPANTS

3894
02:24:45,778 --> 02:24:47,780
WERE APPREHENSIVE OF THE 

3895
02:24:47,780 --> 02:24:49,048
VALIDITY OF THE OVERDOSE DATA 

3896
02:24:49,048 --> 02:24:51,050
THAT THE TOOL WOULD DISPLAY THAT

3897
02:24:51,050 --> 02:24:52,985
WE GET FROM THE MEDICAL 

3898
02:24:52,985 --> 02:24:54,153
EXAMINER'S OFFICE OF ST. LOUIS 

3899
02:24:54,153 --> 02:24:55,321
CITY AND COUNTY. 

3900
02:24:55,321 --> 02:24:57,256
THEY DOUBTED WHETHER THE DATA 

3901
02:24:57,256 --> 02:24:58,190
COULD ACCURATELY REPRESENT THE 

3902
02:24:58,190 --> 02:25:00,626
PEOPLE WHO USE DRUGS THAT THEY 

3903
02:25:00,626 --> 02:25:02,761
WORK WITH MANY OF WHOM WERE 

3904
02:25:02,761 --> 02:25:04,997
UNHOUSED AND FACED STRUCTURAL 

3905
02:25:04,997 --> 02:25:08,000
BARRIERS THAT LED THEM, QUOTE, 

3906
02:25:08,000 --> 02:25:09,602
"INVISIBLE TO THE SYSTEM."

3907
02:25:09,602 --> 02:25:11,003
AND THAT HAS BEEN SPOKEN ABOUT 

3908
02:25:11,003 --> 02:25:13,105
QUITE A BIT. 

3909
02:25:13,105 --> 02:25:18,177
AND IT IS A FAIR CRITICISM BUT 

3910
02:25:18,177 --> 02:25:20,546
WE KNOW THERE ARE RACIAL 

3911
02:25:20,546 --> 02:25:22,982
DISPARITIES IN HOW THESE DATA 

3912
02:25:22,982 --> 02:25:26,318
ARE PROCESSED AND COLLECTED. 

3913
02:25:26,318 --> 02:25:31,290
NOT ONLY ABOUT BASIC DATA 

3914
02:25:31,290 --> 02:25:33,258
VALIDITY BUT ALSO MANIPULATION 

3915
02:25:33,258 --> 02:25:33,525
CONCERNS. 

3916
02:25:33,525 --> 02:25:34,994
SKEPTICISM OF HOW THE DATA WILL 

3917
02:25:34,994 --> 02:25:38,030
BE USED AND WHO IT WILL ATTRACT.

3918
02:25:38,030 --> 02:25:39,898
IN PARTICULAR BAD ACTORS. 

3919
02:25:39,898 --> 02:25:41,367
PARTICIPANTS WERE CONCERNED THAT

3920
02:25:41,367 --> 02:25:43,302
A MAP HIGHLIGHTING MAJORITY 

3921
02:25:43,302 --> 02:25:45,304
BLACK AREA AS HIGH CRIME, HIGH 

3922
02:25:45,304 --> 02:25:48,173
OVERDOSE COULD LEAD TO FURTHER 

3923
02:25:48,173 --> 02:25:49,775
DISINVESTMENT OF THOSE 

3924
02:25:49,775 --> 02:25:50,442
NEIGHBORHOODS, INCREASED LAW 

3925
02:25:50,442 --> 02:25:52,878
ENFORCEMENT PRESENCE, AND CAN BE

3926
02:25:52,878 --> 02:25:55,247
USED TO JUSTIFY AND ENCOURAGE 

3927
02:25:55,247 --> 02:25:56,782
GENTRIFICATION AND DISPLACEMENT 

3928
02:25:56,782 --> 02:25:58,984
OF BLACK RESIDENTS RATHER THAN 

3929
02:25:58,984 --> 02:26:03,455
IMPROVING THEIR CIRCUMSTANCES. 

3930
02:26:03,455 --> 02:26:05,324
THIS FIRST CODE KIND OF CITES A 

3931
02:26:05,324 --> 02:26:06,692
PREVIOUS INSTANCE THAT 

3932
02:26:06,692 --> 02:26:07,326
PARTICIPANTS COULD REMEMBER THAT

3933
02:26:07,326 --> 02:26:17,870
HAPPENING IN THEIR OWN LIFETIME.

3934
02:26:21,073 --> 02:26:23,008
>> THE THIRD -- I WILL SAY

3935
02:26:23,008 --> 02:26:24,877
DESPITE THAT, THERE WERE SOME 

3936
02:26:24,877 --> 02:26:27,713
BENEFITS WITHIN THE DATA HAVE I 

3937
02:26:27,713 --> 02:26:30,182
LID CONCERNS. 

3938
02:26:30,182 --> 02:26:31,383
A QUOTE FROM A PARTICIPANT WHO 

3939
02:26:31,383 --> 02:26:33,285
TALKED ABOUT HOW HE ALREADY USED

3940
02:26:33,285 --> 02:26:36,221
THE DATA THAT WERE AVAILABLE BY 

3941
02:26:36,221 --> 02:26:37,856
ZIP CODE TO CHECK OUT SPECIFIC 

3942
02:26:37,856 --> 02:26:38,390
NEIGHBORHOODS. 

3943
02:26:38,390 --> 02:26:40,292
AND HE DIDN'T TAKE IT FOR FACE 

3944
02:26:40,292 --> 02:26:42,761
VALUE, BUT, YOU KNOW, HE USED IT

3945
02:26:42,761 --> 02:26:53,305
AS ONE DATA POINT. THE NEXT INTO

3946
02:26:53,605 --> 02:26:56,008
EMWAS POTENTIAL FOR AWARENESS, 

3947
02:26:56,008 --> 02:26:58,711
ENGAGEMENT AND COMMUNITY 

3948
02:26:58,711 --> 02:26:59,078
COLLABORATION. 

3949
02:26:59,078 --> 02:27:01,013
DESPITE CONCERNS, PARTICIPATE 

3950
02:27:01,013 --> 02:27:02,481
TONIGHTS ENDORSED THE 

3951
02:27:02,481 --> 02:27:04,783
COMPATIBILITY OF AN OVERDOSE 

3952
02:27:04,783 --> 02:27:06,085
VISUALIZATION TOOL WITH CURRENT 

3953
02:27:06,085 --> 02:27:07,820
SERVICE AND COMMUNITY NEEDS. 

3954
02:27:07,820 --> 02:27:10,289
THEY TALKED OF HOW A MAP WILL 

3955
02:27:10,289 --> 02:27:12,024
HELP THEM WITH OUTREACH AND 

3956
02:27:12,024 --> 02:27:13,759
SPECIFIC TARGET RESOURCES. 

3957
02:27:13,759 --> 02:27:16,795
FOR EXAMPLE FOR PEOPLE WHO USE 

3958
02:27:16,795 --> 02:27:20,165
STIMULANTS, WHO WERE -- WHO WERE

3959
02:27:20,165 --> 02:27:21,767
FACING -- PEOPLE THAT THOUGHT 

3960
02:27:21,767 --> 02:27:23,736
THEY WERE ONLY USING STIMULANTS 

3961
02:27:23,736 --> 02:27:26,171
WHO THEY FELT COULD BE AT 

3962
02:27:26,171 --> 02:27:26,805
SPECIFIC RISKS AND WEREN'T 

3963
02:27:26,805 --> 02:27:30,509
GETTING THE RESOURCES THEY NEED.

3964
02:27:30,509 --> 02:27:32,211
SO, HOWEVER, PARTICIPANTS MOST 

3965
02:27:32,211 --> 02:27:35,013
STRONGLY VIEWED A TOOL LIKE THIS

3966
02:27:35,013 --> 02:27:37,716
AS AN ADVOCACY TOOL. 

3967
02:27:37,716 --> 02:27:38,884
AT THE INDIVIDUAL LEVEL, THEY 

3968
02:27:38,884 --> 02:27:40,652
TALKED OF WHO YOU IT WILL 

3969
02:27:40,652 --> 02:27:41,653
INCREASE GENERAL AWARENESS OF 

3970
02:27:41,653 --> 02:27:42,521
OVERDOSE IN THE NEIGHBORHOODS 

3971
02:27:42,521 --> 02:27:44,423
THEY WORK WITH AND REDUCE STIGMA

3972
02:27:44,423 --> 02:27:46,992
TO HAVE SOMETHING ON A PHONE OR 

3973
02:27:46,992 --> 02:27:49,561
AN iPAD, AND TALK OF THE 

3974
02:27:49,561 --> 02:27:51,430
OVERDOSES THAT HAPPEN IN THIS 

3975
02:27:51,430 --> 02:27:53,031
NEIGHBORHOOD OR THIS COMMUNITY 

3976
02:27:53,031 --> 02:27:55,701
TO INCREASE AWARENESS TO 

3977
02:27:55,701 --> 02:27:57,770
ENCOURAGE RESIDENTS TO CAR

3978
02:27:57,770 --> 02:28:01,440
CARRY NALOXONE, THINGS LIKE 

3979
02:28:01,440 --> 02:28:01,740
THAT. 

3980
02:28:01,740 --> 02:28:03,342
AND COLLABORATION AND REFERRAL 

3981
02:28:03,342 --> 02:28:03,976
ACROSS ORGANIZATIONS. 

3982
02:28:03,976 --> 02:28:04,843
AND CAN SEE ORGANIZATIONS DOING 

3983
02:28:04,843 --> 02:28:06,445
THIS WORK ON THE MAP. 

3984
02:28:06,445 --> 02:28:08,580
AND THEN AT THE POLICY LEVEL, 

3985
02:28:08,580 --> 02:28:11,016
THEY THOUGHT IT COULD BE A GREAT

3986
02:28:11,016 --> 02:28:13,385
STRATEGY TO ADVOCATE FOR 

3987
02:28:13,385 --> 02:28:14,753
INCREASED FUNDING AND ENGAGEMENT

3988
02:28:14,753 --> 02:28:17,022
WITHIN THEIR COMMUNITIES AND FOR

3989
02:28:17,022 --> 02:28:21,760
THEIR ORGANIZATIONS 

3990
02:28:21,760 --> 02:28:32,004
SPECIFICA

3991
02:28:36,809 --> 02:28:37,075
SPECIFICALLY. 

3992
02:28:37,075 --> 02:28:41,013
FINAL THEME WAS ENSURE DATA 

3993
02:28:41,013 --> 02:28:41,680
RELEVANCE TO THE AFFECTED 

3994
02:28:41,680 --> 02:28:41,980
COMMUNITY. 

3995
02:28:41,980 --> 02:28:43,782
PARTICIPANTS STRESS THE 

3996
02:28:43,782 --> 02:28:45,751
IMPORTANCE OF PEOPLE WITH LIVED 

3997
02:28:45,751 --> 02:28:47,252
EXPERIENCE WITH THE DEVELOPMENT 

3998
02:28:47,252 --> 02:28:49,054
OF ANY OVERDOSE MAPPING TOOL. 

3999
02:28:49,054 --> 02:28:51,423
THEY -- ALTHOUGH THEY VALUED 

4000
02:28:51,423 --> 02:28:53,759
SPATIAL DATA, THEY BELIEVED IT 

4001
02:28:53,759 --> 02:28:56,295
SHOULD BE PAIRED WITH DATA AND 

4002
02:28:56,295 --> 02:28:58,330
NARRATIVE AND STORYTELLING AND 

4003
02:28:58,330 --> 02:29:03,869
VITAL FOR FRAMING THE MAPS SO 

4004
02:29:03,869 --> 02:29:04,369
THEY DIDN'T CONTINUE TO 

4005
02:29:04,369 --> 02:29:05,904
PERPETUATE STIGMA FOR PEOPLE WHO

4006
02:29:05,904 --> 02:29:07,873
USE DRUGS OR BAD ACTORS TO 

4007
02:29:07,873 --> 02:29:11,009
FURTHER DISINVEST IN BLACK 

4008
02:29:11,009 --> 02:29:13,645
MAJORITY AREAS WITH HIGH 

4009
02:29:13,645 --> 02:29:23,021
OVERDOSE RATES. AND THEN I WILL 

4010
02:29:23,021 --> 02:29:25,123
SEND WITH THIS QUOTE JUST TO 

4011
02:29:25,123 --> 02:29:27,726
HIGHLIGHT TOWARD THE END OF THE 

4012
02:29:27,726 --> 02:29:30,128
FOCUS GROUP. 

4013
02:29:30,128 --> 02:29:31,964
DEFENSE STATION OF THE OVERDOSE 

4014
02:29:31,964 --> 02:29:32,764
CRISIS IN BLACK COMMUNITIES WAS 

4015
02:29:32,764 --> 02:29:34,867
SO SEVERE THAT BETTER TO USE THE

4016
02:29:34,867 --> 02:29:36,768
DATA IN HOPES OF ATTRACTING MORE

4017
02:29:36,768 --> 02:29:39,605
AWARENESS AND RESOURCES AND TO 

4018
02:29:39,605 --> 02:29:42,341
IMPROVE THEIR WORK. 

4019
02:29:42,341 --> 02:29:43,208
THE POTENTIAL BARRIERS AND 

4020
02:29:43,208 --> 02:29:53,018
CONCERNS ABOUT IT. SO WE HAVE 

4021
02:29:53,018 --> 02:29:54,152
THESE FOUR THEMES. 

4022
02:29:54,152 --> 02:29:58,290
AND WE HAVE THESE FOUR THEMES, 

4023
02:29:58,290 --> 02:30:01,526
VALIDITY, COMPLEX, POTENTIAL AND

4024
02:30:01,526 --> 02:30:02,828
COMMUNITY RELEVANCE. 

4025
02:30:02,828 --> 02:30:05,430
AND WE HAD THIS DATA. 

4026
02:30:05,430 --> 02:30:08,066
WE HAVE DATA THAT WE -- LOCATION

4027
02:30:08,066 --> 02:30:13,238
OF INJURY THAT WE CAREFUL LY 

4028
02:30:13,238 --> 02:30:15,007
GEOCODED FROM THE MEDICAL 

4029
02:30:15,007 --> 02:30:23,015
EXAMINER'S OFFICE. 

4030
02:30:23,015 --> 02:30:27,986
AND I REALLY WAS HAVE HAD -- 

4031
02:30:27,986 --> 02:30:31,623
INTERESTED IN HOW TO GET THIS 

4032
02:30:31,623 --> 02:30:33,759
DATA ON THE STREETS WITH THE 

4033
02:30:33,759 --> 02:30:34,960
OVERDOSE PREVENTION AND TO HELP 

4034
02:30:34,960 --> 02:30:35,761
THEIR WORK. 

4035
02:30:35,761 --> 02:30:37,763
FROM THAT FOCUS GROUP, PROJECT 

4036
02:30:37,763 --> 02:30:39,364
MOST WAS BORN. 

4037
02:30:39,364 --> 02:30:45,137
WHICH IS WHAT WE CALL MY CAREER 

4038
02:30:45,137 --> 02:30:45,904
DEVELOPMENT AWARD PROJECT FR

4039
02:30:45,904 --> 02:30:46,538
FROM NIDA. 

4040
02:30:46,538 --> 02:30:47,906
IT IS NOT THE NAME -- NOT THE 

4041
02:30:47,906 --> 02:30:50,309
NAME OF THE PROJECT, BUT I FOUND

4042
02:30:50,309 --> 02:30:52,811
THAT IN COMMUNITY ENGAGEMENT 

4043
02:30:52,811 --> 02:30:56,915
WORK. 

4044
02:30:56,915 --> 02:30:58,450
YOU NEED A CATCHY TITLE SO 

4045
02:30:58,450 --> 02:30:59,718
PEOPLE CAN IDENTIFY WHAT YOU ARE

4046
02:30:59,718 --> 02:31:02,754
DOING. AND THE IDEA FOR AT 

4047
02:31:02,754 --> 02:31:07,326
PROJECT "MOST" IS TO CREATE A 

4048
02:31:07,326 --> 02:31:09,161
COMMUNITY-INFORMED INDEX. 

4049
02:31:09,161 --> 02:31:14,232
THAT TRANSLATES DATA TO OUTREACH

4050
02:31:14,232 --> 02:31:15,200
PREVENTION SERVICES WHILE -- TO 

4051
02:31:15,200 --> 02:31:18,804
ACHIEVE THE AWARENESS AND 

4052
02:31:18,804 --> 02:31:23,675
ENGAGEMENT POTENTIAL THAT THE 

4053
02:31:23,675 --> 02:31:25,110
COMMUNITY SAW THROUGH SOCIAL 

4054
02:31:25,110 --> 02:31:27,579
DETERMINANTS OF HEALTH AND DATA 

4055
02:31:27,579 --> 02:31:29,748
RELEVANCE TO THE COMMUNITY FROM 

4056
02:31:29,748 --> 02:31:31,516
COMMUNITY PARTNERS. 

4057
02:31:31,516 --> 02:31:38,757
I HAVE SEVEN CONSULTANTS AND 

4058
02:31:38,757 --> 02:31:43,195
ENGAGED IN PARTICIPATORY PROCESS

4059
02:31:43,195 --> 02:31:43,829
WITH SCIENCE AND GEOGRAPHY AND 

4060
02:31:43,829 --> 02:31:44,963
APPLYING IT TO HEALTH. 

4061
02:31:44,963 --> 02:31:47,232
THE IDEA IS THAT THEY BRAINSTORM

4062
02:31:47,232 --> 02:31:49,768
AND RANK SOCIAL DETERMINANTS OF 

4063
02:31:49,768 --> 02:31:52,471
HEALTH VARIABLES IN AN 

4064
02:31:52,471 --> 02:31:53,772
ANALYTICAL HIERARCHY PROCESS 

4065
02:31:53,772 --> 02:31:56,475
TOWARD THIS COMMUNITY ARRIVED 

4066
02:31:56,475 --> 02:32:02,347
SPATIAL INDEX. I HAVE TO SAY I 

4067
02:32:02,347 --> 02:32:04,316
DID NOT COME UP WITH THIS. 

4068
02:32:04,316 --> 02:32:06,818
THIS HAS MORE RECENTLY STARTED 

4069
02:32:06,818 --> 02:32:08,887
TO BE APPLIED TO THE HEALTH 

4070
02:32:08,887 --> 02:32:13,759
SCIENCES RICHARD SADDLER AND 

4071
02:32:13,759 --> 02:32:15,727
COLLEAGUES IN MICHIGAN HAVE USED

4072
02:32:15,727 --> 02:32:17,796
THIS PROCESS AND AN EXAMPLE OF 

4073
02:32:17,796 --> 02:32:20,999
WHAT AN POLITICAL HIERARCHY 

4074
02:32:20,999 --> 02:32:23,168
PROCESS MIGHT LOOK LIKE. 

4075
02:32:23,168 --> 02:32:29,775
TO USING A -- SEVERAL COMMUNITY 

4076
02:32:29,775 --> 02:32:31,510
STAKESHOULDERS WITH DIFFERENT 

4077
02:32:31,510 --> 02:32:38,450
ROLES THE FLINT GEOSPATIAL 

4078
02:32:38,450 --> 02:32:39,551
HEALTH INDEX. 

4079
02:32:39,551 --> 02:32:43,021
AND THIS PAPER IS FROM 2019, BUT

4080
02:32:43,021 --> 02:32:45,524
MORE RECENTLY A VALIDATION OF 

4081
02:32:45,524 --> 02:32:49,761
THEIR INDEX AND FOUND THAT THEIR

4082
02:32:49,761 --> 02:32:52,364
COMMUNITY DERIVED HELPFUL SCORES

4083
02:32:52,364 --> 02:32:55,600
IS RELATED TO THINGS LIKE BLOOD 

4084
02:32:55,600 --> 02:32:56,501
PRESSURE. 

4085
02:32:56,501 --> 02:32:59,137
NOT CONDITIONS OR SPECIFIC, SO 

4086
02:32:59,137 --> 02:33:00,205
WE ARE TRYING TO REPLICATE THIS 

4087
02:33:00,205 --> 02:33:03,909
AND MAKE IT CONDITION SPECIFIC. 

4088
02:33:03,909 --> 02:33:08,513
AND FRANKLY, INEQUITY LOOKING AT

4089
02:33:08,513 --> 02:33:09,614
RACIAL DETERMINANCE OF HEALTH 

4090
02:33:09,614 --> 02:33:12,117
AND THE IDEA THAT THAT INDEX CAN

4091
02:33:12,117 --> 02:33:16,321
BE USED FOR ADVOCACY AND STIGMA 

4092
02:33:16,321 --> 02:33:17,789
AND INTERVENTION AS WELL AS 

4093
02:33:17,789 --> 02:33:20,559
SERVICE PRIORITIZATION FOR LAY 

4094
02:33:20,559 --> 02:33:23,895
HEALTH CARE WORKERS AND MODEL 

4095
02:33:23,895 --> 02:33:30,669
REP POLICE THE CA-- REPLICATED  

4096
02:33:30,669 --> 02:33:34,639
OTHER AREAS WITH HAY SHALL SUB 

4097
02:33:34,639 --> 02:33:34,940
EPIDEMICS. 

4098
02:33:34,940 --> 02:33:36,775
SO I HAVE JUST A LITTLE BIT OF 

4099
02:33:36,775 --> 02:33:38,810
DATA TO SHOW YOU. 

4100
02:33:38,810 --> 02:33:41,012
SO I WILL SAY THIS. 

4101
02:33:41,012 --> 02:33:42,981
THIS PARTICIPATORY GIS PROCESS, 

4102
02:33:42,981 --> 02:33:46,418
THE STAGES ARE CONVENING, 

4103
02:33:46,418 --> 02:33:48,186
DELIBERATION AND OUTCOMES. 

4104
02:33:48,186 --> 02:33:50,922
CONVENING IS THE BRAINSTORMING, 

4105
02:33:50,922 --> 02:33:51,556
ANALYTICAL HIERARCHY AND 

4106
02:33:51,556 --> 02:33:54,392
OUTCOMES YOU DO THE VALIDATION. 

4107
02:33:54,392 --> 02:33:57,462
SO IN CONVENING OUR CONSULTANTS 

4108
02:33:57,462 --> 02:34:01,766
WERE INTRODUCED TO PROJECT 

4109
02:34:01,766 --> 02:34:02,000
GOALS. 

4110
02:34:02,000 --> 02:34:02,801
SUSTAINED MEMORANDUMS OF 

4111
02:34:02,801 --> 02:34:05,070
AGREEMENT. 

4112
02:34:05,070 --> 02:34:09,441
AND INTRODUCTION ON GIS AND SOME

4113
02:34:09,441 --> 02:34:11,076
TRAINING ON IT. 

4114
02:34:11,076 --> 02:34:13,445
LITERATURE REVIEW THAT WE SHOWED

4115
02:34:13,445 --> 02:34:15,313
GEOSPATIALLY BASED ON THE 

4116
02:34:15,313 --> 02:34:16,014
LITERATURE. 

4117
02:34:16,014 --> 02:34:17,782
AND BASED ON THEIR LIVED 

4118
02:34:17,782 --> 02:34:19,584
EXPERIENCE AND THEY BRAINSTORMED

4119
02:34:19,584 --> 02:34:21,086
THEY FELT WERE MOST RELEVANT TO 

4120
02:34:21,086 --> 02:34:23,388
BLACK OVERDOSE IN ST. LOUIS. AND

4121
02:34:23,388 --> 02:34:25,757
YOU WILL SEE A LOT OF THE THINGS

4122
02:34:25,757 --> 02:34:28,059
THAT CONSULTANTS CAME UNDER WITH

4123
02:34:28,059 --> 02:34:29,594
MATCHED UP WITH THE LITERATURE 

4124
02:34:29,594 --> 02:34:31,396
REVIEW AND ADDED A FEW AND TOOK 

4125
02:34:31,396 --> 02:34:33,498
AWAY A FEW. 

4126
02:34:33,498 --> 02:34:34,833
AND A LOT OF THEM HAVE ASTERISKS

4127
02:34:34,833 --> 02:34:37,769
BY THEM AND ADDED A LOT MORE 

4128
02:34:37,769 --> 02:34:38,837
COLOR. 

4129
02:34:38,837 --> 02:34:41,239
THEN WHAT IS -- THEN OUR 

4130
02:34:41,239 --> 02:34:45,744
PREVIOUS DEFINITIONS. ARE YOU 

4131
02:34:45,744 --> 02:34:48,280
ABLE TO ADVANCE THE SLIDES FOR 

4132
02:34:48,280 --> 02:34:48,446
ME?

4133
02:34:48,446 --> 02:34:53,752
THEY STOPPED ADVANCING. 

4134
02:34:53,752 --> 02:34:56,288
FORECAST, HOUSING QUALITY AND 

4135
02:34:56,288 --> 02:34:57,822
STABILITY, THAT IS GREAT, BUT 

4136
02:34:57,822 --> 02:35:00,792
ALSO CAN WE PRESSURE 

4137
02:35:00,792 --> 02:35:02,928
GENTRIFICATION AND DISPLACEMENT.

4138
02:35:02,928 --> 02:35:04,596
PREDATORY LENDING. 

4139
02:35:04,596 --> 02:35:05,330
EXCLUSIONARY ZONING PRACTICES 

4140
02:35:05,330 --> 02:35:08,833
THAT ONLY ALLOW CERTAIN TYPES OF

4141
02:35:08,833 --> 02:35:09,134
BUILDINGS. 

4142
02:35:09,134 --> 02:35:13,538
FOR EXAMPLE, THEY HIGHLIGHTED 

4143
02:35:13,538 --> 02:35:15,507
NOT ONLY INSURANCE STATUS AND 

4144
02:35:15,507 --> 02:35:19,044
TYPE, BUT ALSO INSURANCE 

4145
02:35:19,044 --> 02:35:24,616
UTILIZATION. NEXT SLIDE. 

4146
02:35:24,616 --> 02:35:25,450
OVER TWO THIRD OF DETERMINANCE 

4147
02:35:25,450 --> 02:35:27,185
WERE NEW AND NOT IN THE 

4148
02:35:27,185 --> 02:35:28,687
LITERATURE THAT HIGHLIGHTS THE 

4149
02:35:28,687 --> 02:35:29,921
BENEFITS OF PARTICIPATORY 

4150
02:35:29,921 --> 02:35:31,756
MAPPING HERE. 

4151
02:35:31,756 --> 02:35:41,066
NEXT SLIDE. AREA OF THE 

4152
02:35:41,066 --> 02:35:42,534
DEPRAVATION INDEX AND THE DOME 

4153
02:35:42,534 --> 02:35:43,802
INDEX AND THEY ARE VARIABLES 

4154
02:35:43,802 --> 02:35:45,537
JUST TO SHOW -- NEXT SLIDE, 

4155
02:35:45,537 --> 02:35:47,672
PLEASE -- THESE ARE THE DOMAINS 

4156
02:35:47,672 --> 02:35:48,873
THAT OUR CONSULTANTS HAVE COME 

4157
02:35:48,873 --> 02:35:51,309
UP WITH THAT WE ARE WORKING ON 

4158
02:35:51,309 --> 02:35:53,745
GETTING THE INDIVIDUAL VARIABLES

4159
02:35:53,745 --> 02:35:55,146
INTO EACH OF THOSE DOMAINS. 

4160
02:35:55,146 --> 02:35:56,047
YOU CAN SEE HOW DIFFERENT THEY 

4161
02:35:56,047 --> 02:35:57,349
ARE THAN SOMETHING LIKE A AHTRA 

4162
02:35:57,349 --> 02:36:05,724
ELNASHAR DI-- A TRADITIONALLY 

4163
02:36:05,724 --> 02:36:08,460
DERIVED INDEX. 

4164
02:36:08,460 --> 02:36:10,428
GIS HAS MATERIALS OF THE BLACK 

4165
02:36:10,428 --> 02:36:12,397
COMMUNITY AND UNDERRESOURCED 

4166
02:36:12,397 --> 02:36:14,699
INCLUDING INFORMING 

4167
02:36:14,699 --> 02:36:17,068
LOCATION-BASED TARGET. 

4168
02:36:17,068 --> 02:36:18,770
APPROVING AWARENESS AND STIGMA 

4169
02:36:18,770 --> 02:36:19,371
AND COLLABORATION. 

4170
02:36:19,371 --> 02:36:20,939
DESPITE BENEFIT, WE HAVE TO 

4171
02:36:20,939 --> 02:36:23,074
RECOGNIZE THE CHALLENGES AND 

4172
02:36:23,074 --> 02:36:25,610
SKEPTICISM REMAIN DUE TO 

4173
02:36:25,610 --> 02:36:27,846
INEQUITIES IN DATA VALIDITY AND 

4174
02:36:27,846 --> 02:36:29,080
DATA USE. 

4175
02:36:29,080 --> 02:36:32,484
COMMUNITY-EN GAMED GEOSPATIAL 

4176
02:36:32,484 --> 02:36:34,352
REQUIREMENTS CAN MITIGATE 

4177
02:36:34,352 --> 02:36:36,955
CHALLENGES AND ILLUMINATE NO 

4178
02:36:36,955 --> 02:36:38,089
SOCIAL DETERMINANCE OF OVERDOSE 

4179
02:36:38,089 --> 02:36:39,758
TO ADVANCE THE SCIENCE OF HEALTH

4180
02:36:39,758 --> 02:36:40,091
EQUITY. 

4181
02:36:40,091 --> 02:36:43,361
THAT'S ALL I HAVE FOR YOU. 

4182
02:36:43,361 --> 02:36:43,662
THANK YOU. 

4183
02:36:43,662 --> 02:36:44,896
>> THANK YOU, DR. BANKS
FOR THAT

4184
02:36:44,896 --> 02:36:45,497
GREAT PRESENTATION. 

4185
02:36:45,497 --> 02:36:47,065
AND HIGHLIGHTING THE IMPORTANCE 

4186
02:36:47,065 --> 02:36:49,768
OF ENGAGING PARTNERS TO 

4187
02:36:49,768 --> 02:36:50,769
INTERPRET DATA, AS WELL AS EVEN 

4188
02:36:50,769 --> 02:36:52,570
IDENTIFY WHAT DATA ARE THE MOST 

4189
02:36:52,570 --> 02:36:55,040
IMPORTANT TO BE CONSIDERING IN 

4190
02:36:55,040 --> 02:36:55,607
THE FIRST PLACE. 

4191
02:36:55,607 --> 02:36:59,811
THANK YOU FOR THAT. 

4192
02:36:59,811 --> 02:37:01,746
I NOTICED ONE QUESTION THAT CAME

4193
02:37:01,746 --> 02:37:05,083
IN THROUGH THE Q ANDA AND SHE 

4194
02:37:05,083 --> 02:37:07,185
ANSWER IT RELATED TO RESOURCES 

4195
02:37:07,185 --> 02:37:08,119
OF CONGESTION DATA. 

4196
02:37:08,119 --> 02:37:09,688
AND THERE IS A LINK IN THERE TO 

4197
02:37:09,688 --> 02:37:11,890
ACCESS WITH A NOTE THAT THERE 

4198
02:37:11,890 --> 02:37:13,258
WILL BE SOME NOTEBOOKS COMING 

4199
02:37:13,258 --> 02:37:15,327
OUT SOON AND THERE WILL BE MORE 

4200
02:37:15,327 --> 02:37:16,928
DETAILS FOR INDIVIDUALS 

4201
02:37:16,928 --> 02:37:17,796
INTERESTED IN THAT. 

4202
02:37:17,796 --> 02:37:19,097
I DIDN'T SEE ANY OTHER QUESTIONS

4203
02:37:19,097 --> 02:37:20,265
COME IN. 

4204
02:37:20,265 --> 02:37:23,034
I DO HAVE A COUPLE THAT I CAN 

4205
02:37:23,034 --> 02:37:26,705
START WITH WHILE WE WAIT FOR 

4206
02:37:26,705 --> 02:37:27,172
OTHERS. 

4207
02:37:27,172 --> 02:37:28,340
SO DR. BANKS, I WILL JUST START 

4208
02:37:28,340 --> 02:37:29,774
WITH YOU. 

4209
02:37:29,774 --> 02:37:32,277
YOU TALKED OF THE IMPORTANCE OF 

4210
02:37:32,277 --> 02:37:38,016
TRUST IN DATA AND HOW THAT TRUST

4211
02:37:38,016 --> 02:37:41,086
HAVEN'T BEEN BY RESEARCHERS OR 

4212
02:37:41,086 --> 02:37:41,753
COMMUNITY LEADERS. 

4213
02:37:41,753 --> 02:37:44,522
AND SOME POINT, PEOPLE HAVE 

4214
02:37:44,522 --> 02:37:45,457
BROKEN TRUST. 

4215
02:37:45,457 --> 02:37:46,858
AND MANY IN THE COMMUNITY MAY 

4216
02:37:46,858 --> 02:37:48,827
NOT SEE THEMSELVES REFLECTED IN 

4217
02:37:48,827 --> 02:37:50,562
THE DATA OR HELPED WITH DATA 

4218
02:37:50,562 --> 02:37:50,762
USE. 

4219
02:37:50,762 --> 02:37:52,530
I AM JUST WONDER WHAT KIND OF 

4220
02:37:52,530 --> 02:37:53,431
CAPACITY BUILDING OR TRAINING 

4221
02:37:53,431 --> 02:37:55,233
YOU THINK MIGHT BE NEEDED FOR 

4222
02:37:55,233 --> 02:37:57,502
THE RESEARCH COMMUNITY TO BETTER

4223
02:37:57,502 --> 02:37:59,704
SUPPORT THIS MEANINGFUL 

4224
02:37:59,704 --> 02:38:01,573
ENGAGEMENT IN THE RELATIONSHIPS 

4225
02:38:01,573 --> 02:38:02,941
WITH THE APPROACHES YOU ARE 

4226
02:38:02,941 --> 02:38:04,676
MODELING OF TRUST AND DATA BY 

4227
02:38:04,676 --> 02:38:06,378
THE COMMUNITY AND CAN BE USED 

4228
02:38:06,378 --> 02:38:07,345
FOR BENEFITS. 

4229
02:38:07,345 --> 02:38:09,581
ARE THERE SPECIFIC TYPES OF 

4230
02:38:09,581 --> 02:38:11,516
RESOURCES REFUNDED OR SUPPORTED 

4231
02:38:11,516 --> 02:38:13,385
TO HELP THE FIELD?

4232
02:38:13,385 --> 02:38:15,353
>> YEAH, YOU KNOW, I THINK
IT IS

4233
02:38:15,353 --> 02:38:17,789
BEST FOR RESEARCHERS TO HEAR 

4234
02:38:17,789 --> 02:38:19,190
DIRECTLY FROM COMMUNITY PARSERS 

4235
02:38:19,190 --> 02:38:19,357
IN. 

4236
02:38:19,357 --> 02:38:22,093
THAT IS WHERE I LEARN THE BEST. 

4237
02:38:22,093 --> 02:38:25,563
SO ANYTHING THAT IS EMPOWERING 

4238
02:38:25,563 --> 02:38:27,632
OR EMBOLDENING COMMUNITY MEMBERS

4239
02:38:27,632 --> 02:38:31,002
WHO HAVE GOTTEN ENGAGED IN A 

4240
02:38:31,002 --> 02:38:33,238
MEANINGFUL WAY WITH A COMMUNITY 

4241
02:38:33,238 --> 02:38:35,974
ADVISORY BOARD OR CONSULTANT TO 

4242
02:38:35,974 --> 02:38:36,574
SHARE THEIR EXPERIENCE AND 

4243
02:38:36,574 --> 02:38:39,711
LEARNINGS AND RESOURCES FOR 

4244
02:38:39,711 --> 02:38:42,680
RESEARCHERS, RIGHT. 

4245
02:38:42,680 --> 02:38:44,215
THEY HAVE GOTTEN INVOLVED IN 

4246
02:38:44,215 --> 02:38:45,750
RESEARCH AND LEARNED OF THE 

4247
02:38:45,750 --> 02:38:49,754
RESEARCH PROCESS AND TAKEN IT 

4248
02:38:49,754 --> 02:38:54,225
BACK WHO WANTED TO ENGAGE MORE 

4249
02:38:54,225 --> 02:38:55,560
IN COMMUNITY. 

4250
02:38:55,560 --> 02:38:56,494
HEARING WHAT WE THINK 

4251
02:38:56,494 --> 02:38:57,562
COMMUNITIES WILL BE INTERESTED. 

4252
02:38:57,562 --> 02:38:59,063
I LEARNED THIS EVERY TWO WEEKS 

4253
02:38:59,063 --> 02:39:00,965
WHEN I HAVE MEETING WITH 

4254
02:39:00,965 --> 02:39:02,133
CONSULTANTS THAT THING THEY WILL

4255
02:39:02,133 --> 02:39:03,301
BE INTERESTED IN EVEN THOUGH 

4256
02:39:03,301 --> 02:39:04,068
DEVELOPED RELATIONSHIPS WITH 

4257
02:39:04,068 --> 02:39:05,703
THEM OF WHAT THEY ARE ACTUALLY 

4258
02:39:05,703 --> 02:39:08,139
ARE INTERESTED IN ARE ALWAYS 

4259
02:39:08,139 --> 02:39:12,177
VERY DIFFERENT. 

4260
02:39:12,177 --> 02:39:14,312
I GIVE TALKS ALL THE TIME AND 

4261
02:39:14,312 --> 02:39:16,347
HAPPY TO TELL PEOPLE WHAT I 

4262
02:39:16,347 --> 02:39:17,315
LEARNED AND HEARING FROM 

4263
02:39:17,315 --> 02:39:19,017
COMMUNITY MEMBERS TO HAVE BEEN 

4264
02:39:19,017 --> 02:39:20,285
ENGAGED IN THIS RESEARCH AND 

4265
02:39:20,285 --> 02:39:25,757
WHAT THEIR CONCERNS ARE THE MOST

4266
02:39:25,757 --> 02:39:29,961
IMPACTF

4267
02:39:29,961 --> 02:39:30,261
IMPACTFUL. 

4268
02:39:30,261 --> 02:39:32,030
>> ANOTHER QUESTION CAME
IN 

4269
02:39:32,030 --> 02:39:33,431
THROUGH Q&A. 

4270
02:39:33,431 --> 02:39:35,066
AND MEASUREMENT OF TREATMENT 

4271
02:39:35,066 --> 02:39:35,500
ACCESS. 

4272
02:39:35,500 --> 02:39:36,634
WE KNOW THERE IS DIFFERENCE IN 

4273
02:39:36,634 --> 02:39:41,773
DOSING FOR BUPRENORP HINE AND 

4274
02:39:41,773 --> 02:39:42,340
ACCESSIBLE. 

4275
02:39:42,340 --> 02:39:43,741
AND I AM WONDERING HOW THAT WILL

4276
02:39:43,741 --> 02:39:45,743
BE INCLUDED IN MEASURES OF 

4277
02:39:45,743 --> 02:39:45,977
ACCESS. 

4278
02:39:45,977 --> 02:39:48,213
NOT JUST ACCESS OF THE 

4279
02:39:48,213 --> 02:39:49,481
MEDICATION BUT HIGHER DOSE WHERE

4280
02:39:49,481 --> 02:39:52,417
IS IT IS NEEDEDED WITH 

4281
02:39:52,417 --> 02:39:54,385
PREDOMINANCE OF FENTANYL, FOR 

4282
02:39:54,385 --> 02:39:54,719
EXAMPLE. 

4283
02:39:54,719 --> 02:39:57,956
WONDER IF YOU CAN SPEAK TO THAT.

4284
02:39:57,956 --> 02:39:59,591
>> I THINK CHALLENGE THERE
IS 

4285
02:39:59,591 --> 02:40:01,759
DATA THAT EXISTS FOR THE WHOLE 

4286
02:40:01,759 --> 02:40:02,727
COUNTRY AT SCALE. 

4287
02:40:02,727 --> 02:40:04,229
OFTENTIMES, THAT IS NOT THE 

4288
02:40:04,229 --> 02:40:05,063
CASE. 

4289
02:40:05,063 --> 02:40:09,801
AND OUR APPROACH HAS BEEN WHAT 

4290
02:40:09,801 --> 02:40:11,736
WE FIGURE OUT AT SCALE FOR THE 

4291
02:40:11,736 --> 02:40:13,137
COUNTRY AND THAT IS THE INITIAL 

4292
02:40:13,137 --> 02:40:14,472
VIEW AND WORK WITH THE COMMUNITY

4293
02:40:14,472 --> 02:40:17,075
AND A LOT OF OUR COLLABORATORS 

4294
02:40:17,075 --> 02:40:19,310
ON THIS -- ON THIS SERIES OF 

4295
02:40:19,310 --> 02:40:21,746
PROJECTS ARE ACROSS THE COUNTRY.

4296
02:40:21,746 --> 02:40:24,849
SO A BIG PART OF IT IS -- 

4297
02:40:24,849 --> 02:40:26,484
ACTUALLY WHAT DR. BANKS SAID AS 

4298
02:40:26,484 --> 02:40:27,452
WELL. 

4299
02:40:27,452 --> 02:40:29,087
GOING TO THOSE AREAS IN 

4300
02:40:29,087 --> 02:40:31,222
COMMUNITIES AND KIND OF 

4301
02:40:31,222 --> 02:40:33,758
CONNECTING ON THAT LEVEL TO SEE 

4302
02:40:33,758 --> 02:40:39,664
WHAT -- NOT JUST TO SEE WHAT IS 

4303
02:40:39,664 --> 02:40:41,766
AVAILABLE, BUT WHAT HIGHEST 

4304
02:40:41,766 --> 02:40:44,569
TOPICS OF CONCERNS ARE IN THOSE 

4305
02:40:44,569 --> 02:40:45,136
AREAS. 

4306
02:40:45,136 --> 02:40:48,339
FOR EXAMPLE, MEDICATION DOSES. 

4307
02:40:48,339 --> 02:40:52,377
HIPPA SPECIFIC -- HIPPA SPECIFIC

4308
02:40:52,377 --> 02:40:53,111
TOPIC. 

4309
02:40:53,111 --> 02:41:00,718
AND THIS WILL BE KIND OF LIKE A 

4310
02:41:00,718 --> 02:41:04,756
SUB NATIONAL ANALYSIS, TO 

4311
02:41:04,756 --> 02:41:07,025
VALIDATE A COMPONENT OF IT. 

4312
02:41:07,025 --> 02:41:08,259
THAT IS WITH A LOT OF THE WORK 

4313
02:41:08,259 --> 02:41:11,829
WE DO, WE ARE TRYING TO UNDER 

4314
02:41:11,829 --> 02:41:13,097
BETTER UNDERSTAND HOW THESE 

4315
02:41:13,097 --> 02:41:13,798
PROCESSES WORK. 

4316
02:41:13,798 --> 02:41:16,668
AND WE ARE TRYING TO ADVANCE 

4317
02:41:16,668 --> 02:41:18,236
ANALYSIS, AND MAKE AN IMPACT 

4318
02:41:18,236 --> 02:41:19,370
RIGHT NOW. 

4319
02:41:19,370 --> 02:41:20,038
CONSTANT TENSION WHAT WE CAN -- 

4320
02:41:20,038 --> 02:41:24,576
WHAT CAN WE DO WITH ALL THE 

4321
02:41:24,576 --> 02:41:25,176
LIMITATIONS THAT WE HAVE AND 

4322
02:41:25,176 --> 02:41:27,879
WHAT CAN WE PROVIDE TO 

4323
02:41:27,879 --> 02:41:29,681
POLICYMAKERS, COMMUNITY GROUPS, 

4324
02:41:29,681 --> 02:41:32,150
RESEARCHERS TO IMPACT THINGS. 

4325
02:41:32,150 --> 02:41:36,988
I THINK THAT IS MAYBE A 

4326
02:41:36,988 --> 02:41:37,755
NONANSWER. 

4327
02:41:37,755 --> 02:41:39,524
JUST DEPENDS. 

4328
02:41:39,524 --> 02:41:41,492
>> GREAT, THANKS. 

4329
02:41:41,492 --> 02:41:42,594
I DIDN'T SEE ANYTHING ELSE COME 

4330
02:41:42,594 --> 02:41:44,862
IN, SO I HAVE ANOTHER ONE. 

4331
02:41:44,862 --> 02:41:47,865
I THINK -- DR. KOLAK. 

4332
02:41:47,865 --> 02:41:52,270
YOU TALK A LOT OF FACTORS THAT 

4333
02:41:52,270 --> 02:41:55,006
INFLUENCE SPATIAL FACTORS, 

4334
02:41:55,006 --> 02:41:57,575
DISTANCE, BORDERS, URBANICITY, 

4335
02:41:57,575 --> 02:41:59,143
AS THEY RELATE TO LOCATION OF 

4336
02:41:59,143 --> 02:41:59,410
SERVICES. 

4337
02:41:59,410 --> 02:42:02,947
I AM WONDERING HOW WE MIGHT 

4338
02:42:02,947 --> 02:42:05,383
AFFECT OTHER FACTORS SPATIALLY. 

4339
02:42:05,383 --> 02:42:06,117
EARLIER IN YOUR PRESENTATION YOU

4340
02:42:06,117 --> 02:42:08,219
STALKED OF STIGMA AND INTERESTED

4341
02:42:08,219 --> 02:42:09,420
IN LEARNING THAT. 

4342
02:42:09,420 --> 02:42:12,523
I THINK OF COMMUNICATION AROUND 

4343
02:42:12,523 --> 02:42:13,625
RESOU

4344
02:42:13,625 --> 02:42:14,125
RESOURCE AVAILABILITY. 

4345
02:42:14,125 --> 02:42:15,493
IN MY COMMUNITY, WE HAVE A 

4346
02:42:15,493 --> 02:42:15,994
PROGRAM THAT THE POLICE 

4347
02:42:15,994 --> 02:42:17,795
DEPARTMENT IS FOCUSING ON 

4348
02:42:17,795 --> 02:42:19,197
REFERRING DIRECTLY TO TREATMENT 

4349
02:42:19,197 --> 02:42:20,765
AND TRYING TO AVOID ENTRY INTO 

4350
02:42:20,765 --> 02:42:21,899
THE JUSTICE SYSTEM. 

4351
02:42:21,899 --> 02:42:24,702
AND THEY TALK A LOT ABOUT IT IN 

4352
02:42:24,702 --> 02:42:26,037
COMMUNITY NEWSLETTERS AND 

4353
02:42:26,037 --> 02:42:27,538
PROMOTE IT. 

4354
02:42:27,538 --> 02:42:28,573
A GOOD SOURCE OF PRIDE. 

4355
02:42:28,573 --> 02:42:29,374
EVERYBODY IN THE COMMUNITY KNOWS

4356
02:42:29,374 --> 02:42:32,276
OF THIS ACCESS TO THIS PROGRAM, 

4357
02:42:32,276 --> 02:42:32,510
RIGHT. 

4358
02:42:32,510 --> 02:42:34,212
BUT THAT MAY NOT BE THE CASE IN 

4359
02:42:34,212 --> 02:42:35,747
A LOT OF AREAS, AND EVEN IF A 

4360
02:42:35,747 --> 02:42:37,482
PROGRAM IS AVAILABLE PEOPLE MAY 

4361
02:42:37,482 --> 02:42:39,183
NOT KNOW ABOUT IT. 

4362
02:42:39,183 --> 02:42:40,652
WONDERING HOW WE MIGHT MAP THESE

4363
02:42:40,652 --> 02:42:42,787
OTHER KIND OF SOFTER ACCESS 

4364
02:42:42,787 --> 02:42:43,888
MEASURES AND MAYBE YOU CAN 

4365
02:42:43,888 --> 02:42:44,122
SPEAK. 

4366
02:42:44,122 --> 02:42:45,757
AND DR. BANKS, YOU MOO IT HAVE 

4367
02:42:45,757 --> 02:42:50,561
INSIDES ON THIS TOO. 

4368
02:42:50,862 --> 02:42:50,995
>>. 

4369
02:42:50,995 --> 02:42:52,363
>> WELL, I WILL SAY AT
THIS 

4370
02:42:52,363 --> 02:42:55,633
PARTICULAR STUDY -- ONE OF THE 

4371
02:42:55,633 --> 02:42:56,567
FINDINGS THAT I WASN'T ABLE TO 

4372
02:42:56,567 --> 02:42:58,269
TALK ABOUT IN TOO MUCH DETAIL 

4373
02:42:58,269 --> 02:42:59,370
IS, FOR EXAMPLE, I MOAN, THERE 

4374
02:42:59,370 --> 02:43:01,005
ARE SOME AREAS THAT CLEARLY HAVE

4375
02:43:01,005 --> 02:43:02,907
POOR ACCESS. 

4376
02:43:02,907 --> 02:43:06,210
RURAL -- CERTAIN TYPES OF RULES 

4377
02:43:06,210 --> 02:43:07,045
AREAS, SPARSE AREAS NEAR 

4378
02:43:07,045 --> 02:43:08,446
NATIONAL PARKS AND THAT KIND OF 

4379
02:43:08,446 --> 02:43:09,113
THING. 

4380
02:43:09,113 --> 02:43:09,447
GOT IT. 

4381
02:43:09,447 --> 02:43:10,348
ANOTHER INTERESTING THING CAME 

4382
02:43:10,348 --> 02:43:12,917
OUT WHEN WE STRATIFIED BY THE 

4383
02:43:12,917 --> 02:43:14,686
SOCIAL DETERMINANT HEALTH 

4384
02:43:14,686 --> 02:43:15,853
CLUSTERS, AS WELL AS THOSE 

4385
02:43:15,853 --> 02:43:18,956
DIFFERENT, LIKE, CENSUS-BASED, 

4386
02:43:18,956 --> 02:43:20,925
LIKE, PUBLIC TRANSPORTATION, 

4387
02:43:20,925 --> 02:43:22,527
COMMUTING MEASURES .SO WE FOUND 

4388
02:43:22,527 --> 02:43:23,861
THAT SUBURBAN AFFLUENT PLACES 

4389
02:43:23,861 --> 02:43:26,364
AND PLACES EXTREME POVERTY 

4390
02:43:26,364 --> 02:43:27,598
ACTUALLY HAD SIMILAR SPATIAL 

4391
02:43:27,598 --> 02:43:29,734
ACCESS TO RESOURCES. 

4392
02:43:29,734 --> 02:43:31,703
AND THAT ACTUALLY MAKES -- YOU 

4393
02:43:31,703 --> 02:43:35,673
KNOW, A LOT OF PLACES OF THIS --

4394
02:43:35,673 --> 02:43:37,975
LIKE EXTREME POVERTY WOULD EXIST

4395
02:43:37,975 --> 02:43:41,145
IN URBAN ENVIRONMENTS AND 

4396
02:43:41,145 --> 02:43:43,715
RESOURCES NEARBY. 

4397
02:43:43,715 --> 02:43:46,117
HOWEVER, THE NUMBERS ARE ALMOST 

4398
02:43:46,117 --> 02:43:48,086
INDISTINGUISHABLE AND SDOH AND A

4399
02:43:48,086 --> 02:43:50,588
COMPLETELY DIFFERENT STORY. 

4400
02:43:50,588 --> 02:43:54,959
FOLKS ARE WALKING FOLKS ARE 

4401
02:43:54,959 --> 02:43:55,760
WALKING TO WORK. 

4402
02:43:55,760 --> 02:43:56,961
USING PUBLIC TRANSPORTATION TO 

4403
02:43:56,961 --> 02:43:57,395
WORK. 

4404
02:43:57,395 --> 02:43:59,530
THEY DON'T HAVE ACCESS TO 

4405
02:43:59,530 --> 02:44:03,634
VEHICLES EVEN THOUGH NUMBERS ARE

4406
02:44:03,634 --> 02:44:05,336
THE SAME, A DIFFERENT EXPERIENCE

4407
02:44:05,336 --> 02:44:07,705
AND DIFFERENT BARRIERS THAT 

4408
02:44:07,705 --> 02:44:09,741
DIDN'T EXIST BEFORE AND LOOKING 

4409
02:44:09,741 --> 02:44:11,142
AT ONE DIMENSION AND YOU CAN 

4410
02:44:11,142 --> 02:44:13,044
FOLD IN ALL THE OTHER -- SORT 

4411
02:44:13,044 --> 02:44:15,079
OF SDOH AND STRUCTURAL DRIVERS 

4412
02:44:15,079 --> 02:44:16,748
THAT GO WITH THAT. 

4413
02:44:16,748 --> 02:44:18,116
SO, YEAH, I THINK I WILL GIVE 

4414
02:44:18,116 --> 02:44:19,951
THAT AS A SHORT ANSWER, BUT, 

4415
02:44:19,951 --> 02:44:21,986
AGAIN, WE CAN TALK FOR ANOTHER 

4416
02:44:21,986 --> 02:44:26,557
HOUR ABOUT THIS. 

4417
02:44:26,557 --> 02:44:27,725
>>ALL RIGHT, LOOKS LIKE WE
ARE 

4418
02:44:27,725 --> 02:44:28,793
AT TIME THEN. 

4419
02:44:28,793 --> 02:44:35,666
SO THANK YOU VERY MUCH FOR YOUR 

4420
02:44:35,666 --> 02:44:36,033
PRESENTATIONS. 

4421
02:44:36,033 --> 02:44:37,168
THEY WERE VERY

4422
02:44:37,168 --> 02:44:37,535
VERY INSIGHT. 

4423
02:44:37,535 --> 02:44:39,270
MOVE TO EPIDEMIOLOGY RESEARCH 

4424
02:44:39,270 --> 02:44:41,205
AND TAKE IT BACK TO JANET. 

4425
02:44:41,205 --> 02:44:44,809
>> THANK YOU SO MUCH,
TAMARA AND

4426
02:44:44,809 --> 02:44:47,011
THE VERY INFORM SIEVE SESSION OF

4427
02:44:47,011 --> 02:44:47,612
TREATMENT RESEARCH. 

4428
02:44:47,612 --> 02:44:49,347
IT IS MY PLEASURE TO MODERATE 

4429
02:44:49,347 --> 02:44:51,415
THE LAST SESSION OF TODAY'S 

4430
02:44:51,415 --> 02:44:53,317
WORKSHOP ON EPIDEMIOLOGY 

4431
02:44:53,317 --> 02:44:53,684
RESEARCH. 

4432
02:44:53,684 --> 02:44:55,486
AND IT IS MY PLEASURE TO 

4433
02:44:55,486 --> 02:44:58,156
INTRODUCE TWO OF OUR LAST 

4434
02:44:58,156 --> 02:45:00,224
SPEAKERS, DR. JOHANNES 

4435
02:45:00,224 --> 02:45:04,929
EICHSTAEDT IS AN ASSISTANT 

4436
02:45:04,929 --> 02:45:06,297
PROFESSOR IN STANFORD, AND OF 

4437
02:45:06,297 --> 02:45:09,500
HUMAN CENTERED AI WHERE HE 

4438
02:45:09,500 --> 02:45:11,669
FOCUSES ON RESEARCH THAT HAS A 

4439
02:45:11,669 --> 02:45:14,172
POSITIVE SOCIETAL IMPACT ONLINE 

4440
02:45:14,172 --> 02:45:16,707
TEXT DATA FOR PSYCHOLOGY, HEALTH

4441
02:45:16,707 --> 02:45:18,743
AND WELL BEING FOR INDIVIDUALS 

4442
02:45:18,743 --> 02:45:24,015
IN THE COMMUNITY, HELPING MENTAL

4443
02:45:24,015 --> 02:45:25,750
HEALTH WITH LARGE LANGUAGE 

4444
02:45:25,750 --> 02:45:26,450
MODELS. 

4445
02:45:26,450 --> 02:45:28,653
KWO FOUNDED A PROJECT, A 

4446
02:45:28,653 --> 02:45:32,924
CONSORTIUM OF PSYCHOLOGY AND 

4447
02:45:32,924 --> 02:45:35,126
COMPUTER SCIENCE LABS ACROSS 

4448
02:45:35,126 --> 02:45:35,560
FIVE UNIVERSITIES. 

4449
02:45:35,560 --> 02:45:37,595
TRAINED AS A PHYSICIST. 

4450
02:45:37,595 --> 02:45:38,930
Ph.d. OF CLINICAL TRAINING AT 

4451
02:45:38,930 --> 02:45:41,132
THE UNIVERSITY OF PENNSYLVANIA. 

4452
02:45:41,132 --> 02:45:45,002
AND DR. JOHANNES EICHSTAEDT WAS 

4453
02:45:45,002 --> 02:45:47,738
ELECTED A RISING STAR BY THREE 

4454
02:45:47,738 --> 02:45:50,842
ORGANIZATIONS AND PUBLISH 

4455
02:45:50,842 --> 02:45:51,943
$85-PLUS ARTICLES AND EXPERT FOR

4456
02:45:51,943 --> 02:45:55,246
THE UNITED NATIONS AND FEDERAL 

4457
02:45:55,246 --> 02:45:55,546
GOVERNMENT. 

4458
02:45:55,546 --> 02:45:57,515
FOLLOWING DR. JOHANNES 

4459
02:45:57,515 --> 02:45:57,815
EICHSTAEDT. 

4460
02:45:57,815 --> 02:46:03,120
WE HAVE DR. CHERYL SEE SHOVER 

4461
02:46:03,120 --> 02:46:07,558
AT UCLA DIRECTS THE EPIDEMIOLOGY

4462
02:46:07,558 --> 02:46:16,334
AND POLICY LAB DATA ANALYSIS 

4463
02:46:16,334 --> 02:46:17,501
WITH PARTICIPATORY OF RESEARCH 

4464
02:46:17,501 --> 02:46:22,273
AND INFECTIOUS DISEASES AND 

4465
02:46:22,273 --> 02:46:22,607
HOMELESSNESS. 

4466
02:46:22,607 --> 02:46:25,943
HAVE SLOFR COMPETED HER 

4467
02:46:25,943 --> 02:46:28,279
EPIDEMIOLOGY AND POST DOCTORAL 

4468
02:46:28,279 --> 02:46:30,081
OF PSYCHIATRY AND BEHAVIORAL 

4469
02:46:30,081 --> 02:46:33,751
SCIENCE AT STANFORD UNIVERSITY 

4470
02:46:33,751 --> 02:46:35,019
SCHOOL OF MEDICINE. 

4471
02:46:35,019 --> 02:46:39,490
DR. SHOVER'S WORK. 

4472
02:46:39,490 --> 02:46:41,092
AND OPERATES A PROGRAM AND 

4473
02:46:41,092 --> 02:46:42,627
SYRINGE SERVICES PROGRAMS. 

4474
02:46:42,627 --> 02:46:45,763
CO-AUTHOR OF A REPORT PUBLISHED 

4475
02:46:45,763 --> 02:46:48,332
2022 AS A MEMBER OF THE NORTH 

4476
02:46:48,332 --> 02:46:49,734
AMERICAN OVERDOSE CRISIS. 

4477
02:46:49,734 --> 02:46:52,570
AND IN 2023, SHE WAS INVITED TO 

4478
02:46:52,570 --> 02:46:55,406
JOIN A WORKING GROUP OF THE 

4479
02:46:55,406 --> 02:46:56,073
UNITED KINGDOM ADVISORY COUNCIL 

4480
02:46:56,073 --> 02:46:58,643
ON THE MISUSE OF DRUGS TO C IBT 

4481
02:46:58,643 --> 02:46:59,977
TO A REPORT MAKING 

4482
02:46:59,977 --> 02:47:01,779
RECOMMENDATIONS TO PREVENT 

4483
02:47:01,779 --> 02:47:03,180
PUBLIC HEALTH HARMS ASSOCIATED 

4484
02:47:03,180 --> 02:47:07,985
WITH IT. WITHOUT FURTHER ADO, 

4485
02:47:07,985 --> 02:47:08,586
DR. JOHANNES EICHSTAEDT. 

4486
02:47:08,586 --> 02:47:09,553
LOOKING FORWARD TO YOUR 

4487
02:47:09,553 --> 02:47:09,887
PRESENTATION. 

4488
02:47:09,887 --> 02:47:11,122
THANK YOU FOR JOINING US. 

4489
02:47:11,122 --> 02:47:13,591
>> HELLO, EVERYONE, AND
THANK 

4490
02:47:13,591 --> 02:47:15,393
YOU TO ALL OF THE PARTICIPANTS 

4491
02:47:15,393 --> 02:47:15,893
AND ORGANIZERS. 

4492
02:47:15,893 --> 02:47:17,628
I KNOW WE ARE ALL VERY BUSY AND 

4493
02:47:17,628 --> 02:47:19,263
TO PUT SOMETHING LIKE THIS ON IS

4494
02:47:19,263 --> 02:47:20,765
A BIG CONTRIBUTION FOR EVERYONE.

4495
02:47:20,765 --> 02:47:22,233
THANK YOU FOR YOUR ATTENTION. 

4496
02:47:22,233 --> 02:47:25,136
I AM GOING TO TRY TO MAKE THIS 

4497
02:47:25,136 --> 02:47:27,271
AS PAINLESS AS I POSSIBLY -- AS 

4498
02:47:27,271 --> 02:47:28,839
I POSSIBLY CAN DO. 

4499
02:47:28,839 --> 02:47:29,040
OKAY. 

4500
02:47:29,040 --> 02:47:30,675
SO SUPER HIGH LEVEL. 

4501
02:47:30,675 --> 02:47:32,710
I AM GOING TO TALK A LITTLE BIT 

4502
02:47:32,710 --> 02:47:35,246
HOW WE USE SOCIAL MEDIA IN THE 

4503
02:47:35,246 --> 02:47:37,648
OPIOID EPIDEMIC. 

4504
02:47:37,648 --> 02:47:39,517
THERE YOU GO. 

4505
02:47:39,517 --> 02:47:41,719
AND I -- MORE THAN ANYTHING, I 

4506
02:47:41,719 --> 02:47:43,421
WANT TO ORIENT, AND I WANT TO 

4507
02:47:43,421 --> 02:47:45,022
GIVE YOU MENTAL MODELS TO MAKE 

4508
02:47:45,022 --> 02:47:45,923
ACCEPTS OF THE SPACE. 

4509
02:47:45,923 --> 02:47:49,293
I WANT TO TALK A LITTLE BIT OF 

4510
02:47:49,293 --> 02:47:50,127
DATA SOURCES. 

4511
02:47:50,127 --> 02:47:53,164
ONCE YOU HAVE TWEETS OR REDDIT 

4512
02:47:53,164 --> 02:47:54,298
POSTS, HOW DO YOU DETERMINE THAT

4513
02:47:54,298 --> 02:47:54,932
INTO ESTIMATES. 

4514
02:47:54,932 --> 02:47:56,734
AND I WILL WALK YOU THROUGH A 

4515
02:47:56,734 --> 02:47:58,502
FEW EXAMPLE RESULTS AND TALK 

4516
02:47:58,502 --> 02:48:00,338
ABOUT SOME OUR COLLABORATIONS 

4517
02:48:00,338 --> 02:48:02,173
THAT TRY TO USE THE SOCIAL MEDIA

4518
02:48:02,173 --> 02:48:05,142
DATA FEED AS PART OF EXISTING 

4519
02:48:05,142 --> 02:48:07,511
SURVEILLANCE PLATFORM IN 

4520
02:48:07,511 --> 02:48:07,778
KENTUCKY. 

4521
02:48:07,778 --> 02:48:11,115
AND I WILL ALSO FOREGROUND SOME 

4522
02:48:11,115 --> 02:48:12,950
TOPICS AROUND DATA LINKAGE AND 

4523
02:48:12,950 --> 02:48:14,952
ETHICS STUFF. 

4524
02:48:14,952 --> 02:48:19,357
SO -- SO WITH THAT  -- SO WE JUT

4525
02:48:19,357 --> 02:48:21,759
HAD A LOOK -- OUR RESEARCH TEAM 

4526
02:48:21,759 --> 02:48:27,198
AT STANFORD HAD A LOOK AT 

4527
02:48:27,198 --> 02:48:27,865
DIFFERENT TYPES OF SOCIAL MEDIA 

4528
02:48:27,865 --> 02:48:28,766
PLATFORMS USE FOR OPIOID 

4529
02:48:28,766 --> 02:48:29,166
SURVEILLANCE. 

4530
02:48:29,166 --> 02:48:32,336
AND A BIG CONCERN OR BIG 

4531
02:48:32,336 --> 02:48:33,404
CONSTRAINT ON USING THESE 

4532
02:48:33,404 --> 02:48:35,139
DIFFERENT PLATFORMS ARE TWO 

4533
02:48:35,139 --> 02:48:35,373
THINGS. 

4534
02:48:35,373 --> 02:48:38,009
DOES IT CONTAIN LANGUAGE ABOUT 

4535
02:48:38,009 --> 02:48:39,510
OPIOID USE AND DRUG USE?

4536
02:48:39,510 --> 02:48:41,746
AND CAN YOU GEOLOCATE IT. 

4537
02:48:41,746 --> 02:48:44,882
SO THAT IS ACTUALLY QUITE HARD A

4538
02:48:44,882 --> 02:48:48,019
LOT OF THESE PLATFORMS. 

4539
02:48:48,019 --> 02:48:52,623
THE BEST PLATFORM TO GEO-LOCATE 

4540
02:48:52,623 --> 02:48:56,060
IS TWITTER, BUT BY ELON MUSK, 

4541
02:48:56,060 --> 02:48:57,428
USED TO BE TWITTER. 

4542
02:48:57,428 --> 02:49:00,231
AND YOU HAVE GPS TAGS YOU CAN 

4543
02:49:00,231 --> 02:49:01,098
USE AND PROFILING INFORMATION 

4544
02:49:01,098 --> 02:49:02,833
THAT INCLUDES THE LOCATION FIELD

4545
02:49:02,833 --> 02:49:05,036
THAT WE HAVE USED TO GEO-LOCATE 

4546
02:49:05,036 --> 02:49:07,304
A FEW MILLION TWITTER USERS WE 

4547
02:49:07,304 --> 02:49:09,273
ARE NOW FOLLOWING OVER TIME. 

4548
02:49:09,273 --> 02:49:12,109
THERE ARE OTHER GEO-LOCATION 

4549
02:49:12,109 --> 02:49:13,044
METHOD AT OTHER PLATFORMS. 

4550
02:49:13,044 --> 02:49:17,148
SAY ON REDDIT, EXPLOIT THE FACT 

4551
02:49:17,148 --> 02:49:19,850
SOMEBODY MAY POST IN A SUB 

4552
02:49:19,850 --> 02:49:21,052
REDDIT BUT ALSO IN THE 

4553
02:49:21,052 --> 02:49:25,723
PHILADELPHIA SUB REDDIT AND YOU 

4554
02:49:25,723 --> 02:49:27,391
MAKE INFERENCES THAT THIS PERSON

4555
02:49:27,391 --> 02:49:29,160
IS FROM PHILADELPHIA. 

4556
02:49:29,160 --> 02:49:34,265
WHERE TWIPT TT /* TWITTER AT TH 

4557
02:49:34,265 --> 02:49:37,668
COUNTY LEVEL, WITH REDDIT STATE 

4558
02:49:37,668 --> 02:49:37,902
LEVEL. 

4559
02:49:37,902 --> 02:49:39,970
AND EXPLORED OTHER LOCATIONS. 

4560
02:49:39,970 --> 02:49:42,173
WITH THE OTHER FORMS, DATA 

4561
02:49:42,173 --> 02:49:43,941
ACCESS IS A CONSTRAINT. 

4562
02:49:43,941 --> 02:49:45,743
TWITTER AT LEAST HISTORICALLY 

4563
02:49:45,743 --> 02:49:48,379
YOU CAN COLLECT TO THE ORDER OF 

4564
02:49:48,379 --> 02:49:49,713
BILLION OF TWEETS PER YEAR AND 

4565
02:49:49,713 --> 02:49:51,348
HAVE BECOME MORE DIFFICULT NOW. 

4566
02:49:51,348 --> 02:49:52,850
AND THERE IS NOTHING LIKE IT, 

4567
02:49:52,850 --> 02:49:54,652
SAY, ON FACEBOOK WHERE YOU USED 

4568
02:49:54,652 --> 02:49:57,755
TO BE ABLE TO COLLECT FACEBOOK 

4569
02:49:57,755 --> 02:49:59,623
WITH INDIVIDUAL LEVEL AND 

4570
02:49:59,623 --> 02:50:04,528
INFORMED CONSENT FROM PEOPLE BUT

4571
02:50:04,528 --> 02:50:06,831
LATE LAST YEAR, FACEBOOK HAS 

4572
02:50:06,831 --> 02:50:08,399
STOPPED THAT OPPORTUNITY TO 

4573
02:50:08,399 --> 02:50:10,634
COLLECT DATA WITH RESEARCH APPS 

4574
02:50:10,634 --> 02:50:12,303
FOR LARGER POLITICAL REASONS 

4575
02:50:12,303 --> 02:50:14,338
THAT ARE ABOVE MY ACADEMIC PAY 

4576
02:50:14,338 --> 02:50:14,872
GRADE. 

4577
02:50:14,872 --> 02:50:16,407
OKAY, SO LET'S ASSUME WE HAVE 

4578
02:50:16,407 --> 02:50:17,775
LANGUAGE DATA. 

4579
02:50:17,775 --> 02:50:20,077
LET'S ASSUME WE COLLECTED 

4580
02:50:20,077 --> 02:50:22,079
TWEETS, REDDIT POSTS THAT I WILL

4581
02:50:22,079 --> 02:50:23,581
FOCUS ON AND NOW WE NEED TO MAKE

4582
02:50:23,581 --> 02:50:26,617
SOME SORT OF CHOICE OF HOW TO 

4583
02:50:26,617 --> 02:50:28,486
TURN INTO THAT ESTIMATES ABOUT 

4584
02:50:28,486 --> 02:50:30,454
DRUG USE. 

4585
02:50:30,454 --> 02:50:32,423
SO THIS IS WHERE NATURAL 

4586
02:50:32,423 --> 02:50:33,757
LANGUAGE PROCESSING METHODS COME

4587
02:50:33,757 --> 02:50:34,058
IN. 

4588
02:50:34,058 --> 02:50:36,393
TWO DIFFERENT OPTIONS AT A HIGH 

4589
02:50:36,393 --> 02:50:36,627
LEVEL. 

4590
02:50:36,627 --> 02:50:38,729
SUPER SIMPLE THING WHERE WE 

4591
02:50:38,729 --> 02:50:41,732
COUNT KEY WORDS, SO THIS IS THE 

4592
02:50:41,732 --> 02:50:43,334
GENERALIZED ASSUMPTION THAT 

4593
02:50:43,334 --> 02:50:45,636
PEOPLE WANTED -- ARE MORE LIKELY

4594
02:50:45,636 --> 02:50:48,639
TO USE DRUGS IN AN AREA THAN 

4595
02:50:48,639 --> 02:50:51,942
USING FENTANYL OR FENTY OR ALL 

4596
02:50:51,942 --> 02:50:53,277
THESE SORT OF SLANG WORDS. 

4597
02:50:53,277 --> 02:50:55,779
THAT WORKS TO SOME EXTENT. 

4598
02:50:55,779 --> 02:51:01,752
SEEMS TO WORK ON REDDIT. 

4599
02:51:01,752 --> 02:51:04,622
DOES NOT WORK ON TWITTER. 

4600
02:51:04,622 --> 02:51:05,489
SIMPLE AYE APPROACH TO DO THIS 

4601
02:51:05,489 --> 02:51:06,891
KIND OF INFERENCE. 

4602
02:51:06,891 --> 02:51:07,858
WE HAVE LEARNED IN PRIOR WORKS 

4603
02:51:07,858 --> 02:51:09,627
AND SOME OF WHICH WE WILL SHOW 

4604
02:51:09,627 --> 02:51:11,061
NEW A SECOND THAT YOU DON'T 

4605
02:51:11,061 --> 02:51:12,997
ACTUALLY WANT TO DO THIS FOR 

4606
02:51:12,997 --> 02:51:14,798
PUBLIC HEALTH APPLICATIONS. 

4607
02:51:14,798 --> 02:51:17,168
YOU WANT TO PROBABLY INGEST THE 

4608
02:51:17,168 --> 02:51:19,570
ENTIRE VOCABULARY AND CREATE 

4609
02:51:19,570 --> 02:51:23,641
THIS OVERALL SMITH ODD THIS OF 

4610
02:51:23,641 --> 02:51:27,278
PAIN AND ASSOCIATED WITH THESE 

4611
02:51:27,278 --> 02:51:29,046
MORTALITY END POINTS OR USE END 

4612
02:51:29,046 --> 02:51:29,280
POINTS. 

4613
02:51:29,280 --> 02:51:31,148
WE BUILT THIS ON TWITTER AN 

4614
02:51:31,148 --> 02:51:33,417
BENCHMARK THIS ON TWITTER. 

4615
02:51:33,417 --> 02:51:35,085
SO YOU EITHER LEARN THE LANGUAGE

4616
02:51:35,085 --> 02:51:36,954
PATTERNS DIRECTLY FROM THE DATA.

4617
02:51:36,954 --> 02:51:38,422
LET'S SAY YOU HAVE COUNTY 

4618
02:51:38,422 --> 02:51:39,256
MORTALITY AND THE LANGUAGE 

4619
02:51:39,256 --> 02:51:41,592
STATISTICS AND TOLD THE MACHINE 

4620
02:51:41,592 --> 02:51:43,294
LEARNING FIND THE LANGUAGE THAT 

4621
02:51:43,294 --> 02:51:44,562
PREDICTS THE MORTALITY 

4622
02:51:44,562 --> 02:51:46,430
STATISTICS ACROSS COUNTIES OR 

4623
02:51:46,430 --> 02:51:49,366
YOU GO TO SUPERVISED SMALLER 

4624
02:51:49,366 --> 02:51:51,869
INDIVIDUAL LEVEL TRAINING DATA 

4625
02:51:51,869 --> 02:51:52,403
SETS. 

4626
02:51:52,403 --> 02:51:53,537
A SET OF LANGUAGE DATA FROM 

4627
02:51:53,537 --> 02:51:54,605
SOCIAL MEDIA AND THEY HAVE ALL 

4628
02:51:54,605 --> 02:51:58,108
TAKEN A SURVEY OF PSYCHOLOGICAL 

4629
02:51:58,108 --> 02:52:00,611
DISTRESS, AND YOU CAN EXPLOIT 

4630
02:52:00,611 --> 02:52:02,046
CO-VARIANCE TO MAP THE LANGUAGE 

4631
02:52:02,046 --> 02:52:03,280
TO THE DISTRESS. 

4632
02:52:03,280 --> 02:52:05,816
ONCE YOU BUILD THAT MODEL, YOU 

4633
02:52:05,816 --> 02:52:10,521
CAN APPLY IT TO SCALE OF THE 

4634
02:52:10,521 --> 02:52:11,155
GEO-AGGREGATED TWEETS. 

4635
02:52:11,155 --> 02:52:13,757
RUN YOU THROUGH AN EXAMPLE HERE.

4636
02:52:13,757 --> 02:52:16,493
WE HAVE GEO-LOCATED -- OKAY, SO 

4637
02:52:16,493 --> 02:52:21,165
I AM A LITTLE BIT OUT OF SYNC, 

4638
02:52:21,165 --> 02:52:25,769
GEO-LOCATED TWITTER OF GPS 

4639
02:52:25,769 --> 02:52:27,571
TEXTS. 

4640
02:52:27,571 --> 02:52:27,871
REDDIT. 

4641
02:52:27,871 --> 02:52:28,339
REDDIT. 

4642
02:52:28,339 --> 02:52:29,540
I ALREADY TALKED ABOUT. 

4643
02:52:29,540 --> 02:52:30,274
AND PARTICULATE HAS A 

4644
02:52:30,274 --> 02:52:33,210
RESEARCH API, BUT IT IS ACTUALLY

4645
02:52:33,210 --> 02:52:36,780
QUITE TRICKY TO INTERACT WITH. 

4646
02:52:36,780 --> 02:52:37,381
AND IT IS NOT CLEAR ALSO HOW 

4647
02:52:37,381 --> 02:52:38,382
MUCH DATA YOU CAN ACTUALLY GET 

4648
02:52:38,382 --> 02:52:40,351
WITH THE RESEARCH API. 

4649
02:52:40,351 --> 02:52:42,353
LEAPT ME TALK ABOUT TWITTER. 

4650
02:52:42,353 --> 02:52:44,655
THIS IS -- THIS TOOK TEN YEARS 

4651
02:52:44,655 --> 02:52:46,624
AND OUR CONSORTIUM AND DOING 

4652
02:52:46,624 --> 02:52:47,925
THAT ACROSS. 

4653
02:52:47,925 --> 02:52:50,728
WE HAVE RESEARCHERS, GEORGIE 

4654
02:52:50,728 --> 02:52:53,264
AT NIDA. 

4655
02:52:53,264 --> 02:52:59,803
WE HAVE A GROUP AT PENN AND MY 

4656
02:52:59,803 --> 02:53:01,405
LAB AT STANFORD. 

4657
02:53:01,405 --> 02:53:02,906
WE HAVE COMPUTER CHESTERS 

4658
02:53:02,906 --> 02:53:04,775
TOGETHER AND WHAT THE PIPELINES 

4659
02:53:04,775 --> 02:53:05,075
LOOK LIKE. 

4660
02:53:05,075 --> 02:53:06,343
YOU GET THESE TWEETS. 

4661
02:53:06,343 --> 02:53:08,345
FEE YO-LOCATE TWEETS. 

4662
02:53:08,345 --> 02:53:10,614
THROW OUT RETWEETS AND REPLIES. 

4663
02:53:10,614 --> 02:53:12,650
YOU ARE TRYING TO GET TO THE 

4664
02:53:12,650 --> 02:53:15,586
MOST DIRECT SELF-DISCLOSURE THAT

4665
02:53:15,586 --> 02:53:19,290
GIVES YOU A QUARTER OF THE DATA 

4666
02:53:19,290 --> 02:53:19,623
SET. 

4667
02:53:19,623 --> 02:53:21,759
WE GO THROUGH THESE PIPELINES 

4668
02:53:21,759 --> 02:53:22,793
AND NEST WITHIN USERS THAT TURNS

4669
02:53:22,793 --> 02:53:25,529
OUT TO BE A VERY, VERY IMPORTANT

4670
02:53:25,529 --> 02:53:26,930
PROCESSING STEP BECAUSE IT 

4671
02:53:26,930 --> 02:53:28,666
PROTECTS AGAINST BOTS AND OTHER 

4672
02:53:28,666 --> 02:53:30,734
ACCOUNTS THAT POST A LOT OF 

4673
02:53:30,734 --> 02:53:34,071
LANGUAGE TO SKEW YOUR LANGUAGE 

4674
02:53:34,071 --> 02:53:35,139
MODEL. 

4675
02:53:35,139 --> 02:53:41,145
ANDING A G-- AND AGGREGATE ACROS

4676
02:53:41,145 --> 02:53:43,180
THESE AREAS AND LINGUISTIC 

4677
02:53:43,180 --> 02:53:44,148
PATTERNS WITH LANGUAGE 

4678
02:53:44,148 --> 02:53:44,448
PROCESSING. 

4679
02:53:44,448 --> 02:53:46,283
WE COUNT THE FREQUENCY OF WORDS 

4680
02:53:46,283 --> 02:53:48,285
OR SOMETHING A LITTLE BIT MORE 

4681
02:53:48,285 --> 02:53:49,520
INTELLIGENT A TODAY USE THESE 

4682
02:53:49,520 --> 02:53:51,622
SORT OF TOPIC MODELS WHICH IS A 

4683
02:53:51,622 --> 02:53:53,457
TYPE OF DIMENSION AT REDUCTION 

4684
02:53:53,457 --> 02:53:55,025
IN THE LANGUAGE FACE. 

4685
02:53:55,025 --> 02:53:57,127
AND ONCE YOU HAVE -- LET'S HE 

4686
02:53:57,127 --> 02:53:58,629
SAY YOU HAVE 1,000 COUNTIES. 

4687
02:53:58,629 --> 02:54:01,298
AND NOW YOU HAVE 2,000 

4688
02:54:01,298 --> 02:54:01,832
DIMENSIONAL VECTOR THAT 

4689
02:54:01,832 --> 02:54:03,100
DESCRIBES THE LANGUAGE, NOW YOU 

4690
02:54:03,100 --> 02:54:05,602
CAN USE THAT AS INPUT AND 

4691
02:54:05,602 --> 02:54:07,504
MACHINE LEARNING MODEL. 

4692
02:54:07,504 --> 02:54:09,440
AND IN THIS CASE, WE HAVE A 

4693
02:54:09,440 --> 02:54:11,408
PRETRAINED MODEL AT THE 

4694
02:54:11,408 --> 02:54:12,376
INDIVIDUAL LEVEL. 

4695
02:54:12,376 --> 02:54:13,711
WE ESTIMATE DEPRESSION AND 

4696
02:54:13,711 --> 02:54:14,511
ANXIETY. 

4697
02:54:14,511 --> 02:54:16,947
AND WE GO TO THE PIPELINE WHERE 

4698
02:54:16,947 --> 02:54:18,882
FOR EVERY GIVEN PERSON, SO IN 

4699
02:54:18,882 --> 02:54:24,188
OUR DATA SETS NOW, OVER '21, 

4700
02:54:24,188 --> 02:54:25,756
'22, FIVE MILLION AMERICANS 

4701
02:54:25,756 --> 02:54:29,293
OUIJA 

4702
02:54:29,293 --> 02:54:33,364
OUIJA -- WE HAVE GEO-LOCATED 

4703
02:54:33,364 --> 02:54:35,165
OVER TIME AND WE ESTIMATE THEIR 

4704
02:54:35,165 --> 02:54:37,267
AGE, GENDER, EDUCATION AND 

4705
02:54:37,267 --> 02:54:40,671
INCOME AND COMPARE THAT AGAINST 

4706
02:54:40,671 --> 02:54:42,106
CENSUS STATISTICS AND 

4707
02:54:42,106 --> 02:54:42,773
POST-STRATIFY THE EXAMPLE WHAT 

4708
02:54:42,773 --> 02:54:44,875
YOU WOULD DO IN A REPRESENTATIVE

4709
02:54:44,875 --> 02:54:45,709
PHONE SURVEY. 

4710
02:54:45,709 --> 02:54:47,611
WE ASSIGN WEIGHTS TO PEOPLE TO 

4711
02:54:47,611 --> 02:54:49,947
BIAS THE DISTRIBUTION TOWARD THE

4712
02:54:49,947 --> 02:54:51,382
-- THE UNDERLYING DISTRIBUTIONS 

4713
02:54:51,382 --> 02:54:52,950
AND THE POPULATIONS. 

4714
02:54:52,950 --> 02:54:54,852
WE FOLLOW THESE PEOPLE OVER 

4715
02:54:54,852 --> 02:54:57,254
TIME, AND NOW WE HAVE THESE POST

4716
02:54:57,254 --> 02:54:58,722
STRATIFIED DEMOGRAPHICALLY 

4717
02:54:58,722 --> 02:55:05,929
CONTROLLED PERSON-LEVEL WEIGHTED

4718
02:55:05,929 --> 02:55:08,265
T

4719
02:55:08,265 --> 02:55:08,832
TEMPO

4720
02:55:08,832 --> 02:55:10,801
TEMPORAL ESTIMATES OVER TIME. 

4721
02:55:10,801 --> 02:55:12,069
WE ARE PRODUCING ALL THAT DATA 

4722
02:55:12,069 --> 02:55:14,104
AS A COMMON GOOD. 

4723
02:55:14,104 --> 02:55:15,906
THE ONES THAT FUND US, IT IS OUR

4724
02:55:15,906 --> 02:55:17,608
GOAL TO PUT ALL OF THIS IN THE 

4725
02:55:17,608 --> 02:55:23,147
PUBLIC DES MOINES AND THE 

4726
02:55:23,147 --> 02:55:25,282
RESEARCH DOMAIN. 

4727
02:55:25,282 --> 02:55:26,850
OUTDATING IT AT THE COUNTY WEEKS

4728
02:55:26,850 --> 02:55:29,086
AND MONTH LEVEL AND OUTPUTTING 

4729
02:55:29,086 --> 02:55:30,454
UNDER AGGREGATION. 

4730
02:55:30,454 --> 02:55:32,956
NOT INDIVIDUAL LEVEL PEOPLE, BUT

4731
02:55:32,956 --> 02:55:36,460
COUNTY LEVELS SCORE THA

4732
02:55:36,460 --> 02:55:38,395
THAT ANNOMIZE AWAY FROM THE 

4733
02:55:38,395 --> 02:55:40,097
INDIVIDUALS AND MAKES IT 

4734
02:55:40,097 --> 02:55:40,931
UNPROBLEMATIC TO SHARE. 

4735
02:55:40,931 --> 02:55:44,468
JUST TO GIVE YOU A SENSE THIS IS

4736
02:55:44,468 --> 02:55:45,736
LANGUAGE-BASED MENTAL HEALTH 

4737
02:55:45,736 --> 02:55:47,604
ASSESSMENT, DEPRESSION, ANXIETY 

4738
02:55:47,604 --> 02:55:48,205
MODELS OF COUNTIES. 

4739
02:55:48,205 --> 02:55:51,475
AT THE TOP THERE, YOU CAN SEE 

4740
02:55:51,475 --> 02:55:54,912
SORT OF THEIR RANGE OF HOW MUCH 

4741
02:55:54,912 --> 02:55:55,446
WE CAN THRESHOLD ACROSS 

4742
02:55:55,446 --> 02:55:57,481
DIFFERENT UNITS OF ANALYSIS. 

4743
02:55:57,481 --> 02:55:59,349
AND AT THE BOTTOM, YOU SEE WHAT 

4744
02:55:59,349 --> 02:56:02,186
YOU CAN DO WITH SURVEYS -- WITH 

4745
02:56:02,186 --> 02:56:04,087
2.1 MILLION SURVEY RESPONSES. 

4746
02:56:04,087 --> 02:56:05,155
AND THE HIGH LEVEL -- NEVER MIND

4747
02:56:05,155 --> 02:56:07,791
THE DETAILS, THE HIGH-LEVEL 

4748
02:56:07,791 --> 02:56:09,993
TAKEAWAY IS THE KIND OF DATA YOU

4749
02:56:09,993 --> 02:56:11,161
GET FROM SOCIAL MEDIA DOMINATES 

4750
02:56:11,161 --> 02:56:13,363
EVEN THE LARGEST POPULATION 

4751
02:56:13,363 --> 02:56:14,498
HEALTH INSURANCE EFFORTS LIKE 

4752
02:56:14,498 --> 02:56:18,635
THE BRFSS OR GALLOP OR WHATEVER 

4753
02:56:18,635 --> 02:56:25,476
IT IS. 

4754
02:56:25,476 --> 02:56:26,143
WE THINK THAT THE SWEET SPOT AT 

4755
02:56:26,143 --> 02:56:27,611
THE COUNTY LEVEL. 

4756
02:56:27,611 --> 02:56:31,582
AND DATA AGGREGATION. 

4757
02:56:31,582 --> 02:56:34,051
SPATIAL VERSUS TEMPORAL. 

4758
02:56:34,051 --> 02:56:35,152
YOU HAVE TO LUMP THEM. 

4759
02:56:35,152 --> 02:56:37,688
INTO DAILY TOWNSHIPS, 

4760
02:56:37,688 --> 02:56:38,622
RELIABILITY TANKS. 

4761
02:56:38,622 --> 02:56:41,291
SO LET ME GIVE YOU AN EXAMPLE 

4762
02:56:41,291 --> 02:56:45,729
WHAT IT LOOKS LIKE TO GIVE YOU 

4763
02:56:45,729 --> 02:56:46,530
AN INTUITION. 

4764
02:56:46,530 --> 02:56:50,267
IN THE BOTTOM SADNESS OVER TIME 

4765
02:56:50,267 --> 02:56:54,805
OF THE GALLOP SURVEY OF SAY. 

4766
02:56:54,805 --> 02:56:56,173
PART OF THE COVID SURVEY. 

4767
02:56:56,173 --> 02:56:58,742
THE PEAK IS THE MURDER OF GEORGE

4768
02:56:58,742 --> 02:56:59,142
FLOYD. 

4769
02:56:59,142 --> 02:57:01,411
THE MOST STRONGEST NEGATIVE 

4770
02:57:01,411 --> 02:57:02,312
AFFECT OR SOCIAL MEDIA DATA. 

4771
02:57:02,312 --> 02:57:05,148
AT THE TOP YOU SEE OUR ESTIMATES

4772
02:57:05,148 --> 02:57:07,384
OF NATIONAL DEPRESSION BASE AND 

4773
02:57:07,384 --> 02:57:11,021
TWIPT TWIT. 

4774
02:57:11,021 --> 02:57:13,156
YOU CAN SEE THEY HAVE BECOME 

4775
02:57:13,156 --> 02:57:14,191
VERY STABLE BECAUSE WE ARE 

4776
02:57:14,191 --> 02:57:15,592
FOLLOWING THE SAME PEOPLE OVER 

4777
02:57:15,592 --> 02:57:15,859
TIME. 

4778
02:57:15,859 --> 02:57:17,761
SOME WE ARE BUILDING A DIGITAL 

4779
02:57:17,761 --> 02:57:22,833
PANEL SURVEY IF YOU WILL. 

4780
02:57:22,833 --> 02:57:23,800
WE ARE TAKING RANDOM SLICES 

4781
02:57:23,800 --> 02:57:25,202
TWITTER HOPING THEY LINE UP. 

4782
02:57:25,202 --> 02:57:27,771
SO HERE IS THE SET-UP. 

4783
02:57:27,771 --> 02:57:28,005
RIGHT. 

4784
02:57:28,005 --> 02:57:29,506
WE HAVE COUNTIES FROM THE 

4785
02:57:29,506 --> 02:57:29,773
COUNTIES. 

4786
02:57:29,773 --> 02:57:32,476
OPIOID MORTALITIES AND THE 

4787
02:57:32,476 --> 02:57:33,343
TWEETS. 

4788
02:57:33,343 --> 02:57:34,478
X POSTS. 

4789
02:57:34,478 --> 02:57:35,345
FUTURE EXTRACTION. 

4790
02:57:35,345 --> 02:57:37,347
I TALKED OF IT LIKE A DIMENSION 

4791
02:57:37,347 --> 02:57:37,648
AT. 

4792
02:57:37,648 --> 02:57:39,550
THINK OF IT AS A CLUSTER 

4793
02:57:39,550 --> 02:57:41,151
ANALYSIS IN THE LANGUAGE SPACE. 

4794
02:57:41,151 --> 02:57:43,186
FACTOR ANALYSIS IS A LITTLE 

4795
02:57:43,186 --> 02:57:44,154
DIFFERENT BECAUSE STATISTICS ARE

4796
02:57:44,154 --> 02:57:46,390
A LITTLE BIT DIFFERENT. 

4797
02:57:46,390 --> 02:57:49,560
WITH THE DISTRIBUTION OF ROUTES 

4798
02:57:49,560 --> 02:57:52,629
AND FREQUENCIES, TRAIN A MACHINE

4799
02:57:52,629 --> 02:57:54,164
LEARNING MODEL THAT PREDICTS THE

4800
02:57:54,164 --> 02:57:57,834
OPIOID MORTALITY AND USE SIMPLE 

4801
02:57:57,834 --> 02:57:58,135
AGGRESSION. 

4802
02:57:58,135 --> 02:58:00,571
AND JUST TO BENCHMARK IT ACROSS 

4803
02:58:00,571 --> 02:58:03,040
600, 700 COUNTIES, YOU SEE HOW 

4804
02:58:03,040 --> 02:58:05,375
WELL DIFFERENT CO-VARIATES OF 

4805
02:58:05,375 --> 02:58:08,545
THE COUNTY LEVEL PREDICT OPIOID 

4806
02:58:08,545 --> 02:58:08,845
MORTALITY. 

4807
02:58:08,845 --> 02:58:10,948
WELL BEING ARE THOSE GALLOP 

4808
02:58:10,948 --> 02:58:11,815
RESPONSES INDICATING STRESS, 

4809
02:58:11,815 --> 02:58:15,352
PAIN, ALL THESE DIFFERENT THINGS

4810
02:58:15,352 --> 02:58:16,386
AND DEPRESSION AS WELL FROM 

4811
02:58:16,386 --> 02:58:16,620
GALLOP. 

4812
02:58:16,620 --> 02:58:19,456
A SORT OF STANDARD MODEL THAT 

4813
02:58:19,456 --> 02:58:22,593
COMBINES EVERY ECONOMIC AND 

4814
02:58:22,593 --> 02:58:24,428
DEMOGRAPHIC AND SURVEY ASSESSED 

4815
02:58:24,428 --> 02:58:26,597
VARIABLE THAT WE CAN FIND AND 

4816
02:58:26,597 --> 02:58:29,733
HOW WELL TWITTER DOES OF 

4817
02:58:29,733 --> 02:58:31,668
PREDICTING OPIOID MORTALITY. 

4818
02:58:31,668 --> 02:58:33,503
THE WAY WE THINK OF TWITTER, 

4819
02:58:33,503 --> 02:58:36,840
CAPTURES OTHER VARIABLES, SOCIAL

4820
02:58:36,840 --> 02:58:38,609
ECONOMIC AND BEHAVIORS AND ADD A

4821
02:58:38,609 --> 02:58:41,144
SLIVER OF UNIQUELY PSYCHOLOGICAL

4822
02:58:41,144 --> 02:58:44,581
SIGNAL THAT YOU CAN ONLY REALLY 

4823
02:58:44,581 --> 02:58:45,983
SEEM TO GET THROUGH THE SOCIAL 

4824
02:58:45,983 --> 02:58:47,217
MEDIA OF SOCIAL MEDIA EFFORTS. 

4825
02:58:47,217 --> 02:58:48,585
WE ARE WORKING WITH AN EFFORTS 

4826
02:58:48,585 --> 02:58:50,721
OUT OF THE UNIVERSITY OF 

4827
02:58:50,721 --> 02:58:54,124
KENTUCKY CALLED "REDORKY."

4828
02:58:54,124 --> 02:58:57,928
WHICH IS BASICALLY A 

4829
02:58:57,928 --> 02:58:59,529
BENCHMARKING OF DIFFERENT DATA 

4830
02:58:59,529 --> 02:59:05,369
FEEDS TO PREDICT OPIOID HOT 

4831
02:59:05,369 --> 02:59:06,770
SPOTS. 

4832
02:59:06,770 --> 02:59:08,939
HOSPITAL REPORTS, CORONER 

4833
02:59:08,939 --> 02:59:10,173
REPORTS COME WITH DIFFERENT 

4834
02:59:10,173 --> 02:59:11,008
LEGS. 

4835
02:59:11,008 --> 02:59:13,043
AND THE HOPE OF SOCHI THAT YOU 

4836
02:59:13,043 --> 02:59:17,681
CAN IN PRINCIPLE GET A END-TIME 

4837
02:59:17,681 --> 02:59:19,616
INDICATE THEIR CAN FRONT SOME OF

4838
02:59:19,616 --> 02:59:21,018
THOSE OTHER INDICATORS. 

4839
02:59:21,018 --> 02:59:22,185
WHAT WE ARE DOING FOR THE FIRST 

4840
02:59:22,185 --> 02:59:24,688
TIME AND HANDING OVER A DATA 

4841
02:59:24,688 --> 02:59:26,523
PRODUCT TO THIS CONSORTIUM AND 

4842
02:59:26,523 --> 02:59:28,959
SAY HERE IS OUR BEST ESTIMATE OF

4843
02:59:28,959 --> 02:59:31,395
MONTHLY COUNTY LEVEL, LEVELS OF 

4844
02:59:31,395 --> 02:59:33,730
DISTRESS ON THE POPULATION. 

4845
02:59:33,730 --> 02:59:36,299
DOES IT ADD PREDICTIVE 

4846
02:59:36,299 --> 02:59:37,534
INCREMENTAL VALUE TO YOUR 

4847
02:59:37,534 --> 02:59:38,235
PREDICTION MODELS?

4848
02:59:38,235 --> 02:59:40,337
SO HERE -- JUST TO GIVE YOU A 

4849
02:59:40,337 --> 02:59:42,873
SENSE WHAT THIS LOOKS LIKE, LIKE

4850
02:59:42,873 --> 02:59:44,574
ALL DISTRIBUTION THIS WAS KIND, 

4851
02:59:44,574 --> 02:59:46,443
POWER LAW DISTRIBUTIONS WHERE 

4852
02:59:46,443 --> 02:59:48,979
YOU HAVE THE COUNTIES THAT HAVE 

4853
02:59:48,979 --> 02:59:51,448
THE CITIES HAVE, AND MOST OF THE

4854
02:59:51,448 --> 02:59:52,349
POPULATION, EVERYTHING ELSE 

4855
02:59:52,349 --> 02:59:52,849
PETERS OUT AFTER THAT. 

4856
02:59:52,849 --> 02:59:56,353
20 1-2022. 

4857
02:59:56,353 --> 02:59:58,922
AN ORDER OF MAGNITUDE IDEA, WE 

4858
02:59:58,922 --> 03:00:00,490
ARE LOOKING JUST AT KENTUCKY. 

4859
03:00:00,490 --> 03:00:03,226
WHICH -- IT IS ONE OF OUR LEAST 

4860
03:00:03,226 --> 03:00:05,495
SAMPLED STATE IN THE U.S. IN 

4861
03:00:05,495 --> 03:00:07,931
TERMS OF TWITTER USERS. 

4862
03:00:07,931 --> 03:00:11,835
IN 2021, WE HAD 20,000 -- 21,000

4863
03:00:11,835 --> 03:00:13,737
GEO-LOCATED TWITTER USERS IN 

4864
03:00:13,737 --> 03:00:14,604
KENTUCKY. 

4865
03:00:14,604 --> 03:00:15,639
PRODUCED SEVEN MILLION TWEETS OF

4866
03:00:15,639 --> 03:00:17,774
WHICH THREE MILLION OR SO WERE 

4867
03:00:17,774 --> 03:00:18,041
RELEVANT. 

4868
03:00:18,041 --> 03:00:21,678
AS ALWAYS, YOU HAVE THIS HUGE 

4869
03:00:21,678 --> 03:00:23,280
DISTRIBUTION WHERE -- WHERE SOME

4870
03:00:23,280 --> 03:00:25,749
PEOPLE POST A LOT AND MOST 

4871
03:00:25,749 --> 03:00:27,350
PEOPLE JUST POST ONCE OR TWICE. 

4872
03:00:27,350 --> 03:00:30,320
BUT TO BE INCLUDED IN OUR DATA 

4873
03:00:30,320 --> 03:00:31,455
SET, THEY HAVE ACTUALLY BEEN 

4874
03:00:31,455 --> 03:00:33,724
SHORT LIFTED AND POSTED AT LEAST

4875
03:00:33,724 --> 03:00:35,225
30 TIMES THIS YEAR AND SO FORTH.

4876
03:00:35,225 --> 03:00:37,728
THERE IS REFERENCES IN THE BACK 

4877
03:00:37,728 --> 03:00:41,164
IF YOU CARE ABOUT THE GNARLY 

4878
03:00:41,164 --> 03:00:41,465
DETAILS. 

4879
03:00:41,465 --> 03:00:45,368
THEN IN 2022, SIMILAR SIZED DATA

4880
03:00:45,368 --> 03:00:46,103
SET. 

4881
03:00:46,103 --> 03:00:46,703
THAT IS VERY FRESH. 

4882
03:00:46,703 --> 03:00:49,740
THAT HAVEN'T BEEN EVALUATED. 

4883
03:00:49,740 --> 03:00:51,241
THAT IS WHAT WE JUST HANDED 

4884
03:00:51,241 --> 03:00:51,441
OVER. 

4885
03:00:51,441 --> 03:00:52,542
THIS GIVES YOU A SENSE, I HOPE, 

4886
03:00:52,542 --> 03:00:54,945
OF THE POWER OF THE TWITTER 

4887
03:00:54,945 --> 03:01:00,617
METHODS JUST TO RECAP, THEY USE 

4888
03:01:00,617 --> 03:01:01,084
THE WHOLE VOCABULARY. 

4889
03:01:01,084 --> 03:01:01,752
THEY USE MACHINE LEARNING TO 

4890
03:01:01,752 --> 03:01:03,320
DEFINE PATTERNS AND 

4891
03:01:03,320 --> 03:01:04,421
DISTRIBUTIONS AND THOUSANDS OF 

4892
03:01:04,421 --> 03:01:07,958
WORDS SAID LESS OR MORE THAT 

4893
03:01:07,958 --> 03:01:08,825
INDEX TO OPIOID MORTALITY. 

4894
03:01:08,825 --> 03:01:10,927
SO WE ARE NOT COUNTING KEY 

4895
03:01:10,927 --> 03:01:11,161
WORDS. 

4896
03:01:11,161 --> 03:01:14,397
IN -- IN THIS WORK HERE, IN THIS

4897
03:01:14,397 --> 03:01:16,900
REDDIT WORK, EARLIER WORK, WE 

4898
03:01:16,900 --> 03:01:18,435
ARE DOING KEY WORDS. 

4899
03:01:18,435 --> 03:01:21,104
THIS WORK IS UNDER REVIEW, AND 

4900
03:01:21,104 --> 03:01:24,474
SO HERE WE ARE EXPLOITING WHAT I

4901
03:01:24,474 --> 03:01:27,043
ALREADY TOLD YOU A LITTLE BIT 

4902
03:01:27,043 --> 03:01:28,345
ABOUT WHERE SOMEBODY POINTS IN 

4903
03:01:28,345 --> 03:01:31,581
THE LOS ANGELES SUB REDDIT THIS 

4904
03:01:31,581 --> 03:01:32,582
PERSON IT FROM LOS ANGELES. 

4905
03:01:32,582 --> 03:01:34,818
IF THEY POSTED IN MULTIPLE 

4906
03:01:34,818 --> 03:01:36,753
CITIES, WE DISREGARD HIM. 

4907
03:01:36,753 --> 03:01:39,456
VERY CRUDE WAY OF GEO-LOCATING. 

4908
03:01:39,456 --> 03:01:41,158
IT DOVETAILS ROUGHLY TO THE 

4909
03:01:41,158 --> 03:01:44,060
STATE POPULATION OF THE STATE 

4910
03:01:44,060 --> 03:01:45,929
REDDIT USER POPULATION ACROSS 

4911
03:01:45,929 --> 03:01:47,164
THE DIFFERENT STATES. 

4912
03:01:47,164 --> 03:01:48,265
SEEM TO GO TOGETHER SOMEWHAT, 

4913
03:01:48,265 --> 03:01:50,967
AND THIS IS SORT OF A HIGH LEVEL

4914
03:01:50,967 --> 03:01:52,035
VIEW OF THE DATA. 

4915
03:01:52,035 --> 03:01:53,603
YOU CAN SEE THE DIFFERENT PHASES

4916
03:01:53,603 --> 03:01:55,972
IF NOT ELSE, YOU CAN SEE THE 

4917
03:01:55,972 --> 03:01:58,275
DIFFERENT PHASES OF THE OPIOID 

4918
03:01:58,275 --> 03:01:58,775
EPIDEMIC. 

4919
03:01:58,775 --> 03:02:00,977
YOU SEE HEROIN AND THE -- THE 

4920
03:02:00,977 --> 03:02:02,546
GROWTH OF SYNTHETIC OPIOID ALL 

4921
03:02:02,546 --> 03:02:03,914
THE WAY NOW TO FENTANYL WHICH 

4922
03:02:03,914 --> 03:02:06,149
HAS BEEN STRIKING AS YOU SEE 

4923
03:02:06,149 --> 03:02:07,818
THERE ON THE RIGHT. 

4924
03:02:07,818 --> 03:02:10,253
THIS IS JUST THE PURE OCCURRENCE

4925
03:02:10,253 --> 03:02:11,922
OF KEY WORDS THAT INDEXES 

4926
03:02:11,922 --> 03:02:13,723
DIFFERENT CONSTRUCTS. 

4927
03:02:13,723 --> 03:02:15,859
ONE THING WE HAVE DONE. 

4928
03:02:15,859 --> 03:02:18,328
WE HAVE USED EMBEDDINGS WHICH IS

4929
03:02:18,328 --> 03:02:20,430
SORT OF THE CLEVER WAY OF 

4930
03:02:20,430 --> 03:02:22,833
MAPPING LANGUAGE INTO NUMERICAL 

4931
03:02:22,833 --> 03:02:24,000
SPACES AND SEEING WHICH OTHER 

4932
03:02:24,000 --> 03:02:25,202
WORDS MAP TO AREAS. 

4933
03:02:25,202 --> 03:02:29,039
SO THIS WAS AN EARLY NEURO 

4934
03:02:29,039 --> 03:02:30,140
NETWORK WAY OF THINKING OF 

4935
03:02:30,140 --> 03:02:32,609
LANGUAGE AND USING THE SYNTHETIC

4936
03:02:32,609 --> 03:02:34,678
MODELS TO FIND ALL THE WORDS 

4937
03:02:34,678 --> 03:02:35,912
THAT MEAN HEROIN BUT ARE SOME 

4938
03:02:35,912 --> 03:02:37,113
SORT OF SLANG. 

4939
03:02:37,113 --> 03:02:40,884
AND WE ALSO HAD GOOD SUCCESS 

4940
03:02:40,884 --> 03:02:44,721
USING CHAT GPT 3 AND 4 TO DITCH 

4941
03:02:44,721 --> 03:02:46,456
NARY EXTENSIONS, AS THEY ARE 

4942
03:02:46,456 --> 03:02:46,890
CALLED. 

4943
03:02:46,890 --> 03:02:49,192
EVEN IF YOU USE KEYWORDS, CLEVER

4944
03:02:49,192 --> 03:02:51,161
WAYS TO DO THAT TO GIVE YOU AN 

4945
03:02:51,161 --> 03:02:53,363
EASIER WAY TO EXTEND YOUR KEY 

4946
03:02:53,363 --> 03:02:54,831
WORDS TO GET THE SPEAK. 

4947
03:02:54,831 --> 03:02:57,300
AND THIS SORT OF SLANG. 

4948
03:02:57,300 --> 03:02:57,500
OKAY. 

4949
03:02:57,500 --> 03:02:58,902
SO IF YOU GROUP THIS INTO -- 

4950
03:02:58,902 --> 03:03:00,871
INTO DIFFERENT CATEGORIES, YOU 

4951
03:03:00,871 --> 03:03:03,473
SEE SORT OF A SIMILAR PATTERN 

4952
03:03:03,473 --> 03:03:03,673
HERE. 

4953
03:03:03,673 --> 03:03:06,509
THEN AT THE TOP HERE, YOU SEE 

4954
03:03:06,509 --> 03:03:10,347
THE CDC DEATHS PER 1,000. 

4955
03:03:10,347 --> 03:03:11,481
AS REPORTED PROBABLY THE 

4956
03:03:11,481 --> 03:03:14,317
UNDERLYING CAUSE OF DEATH BY CDC

4957
03:03:14,317 --> 03:03:16,152
WONDER AND AT BOTTOM, YOU SEE 

4958
03:03:16,152 --> 03:03:18,455
THE REDDIT RATES. 

4959
03:03:18,455 --> 03:03:20,657
TAMPA ROUGHLY DOVETAILS. 

4960
03:03:20,657 --> 03:03:22,125
NOT A PERFECT FIT. 

4961
03:03:22,125 --> 03:03:25,262
NOT A PERFECT FIT DOING COVID-19

4962
03:03:25,262 --> 03:03:26,162
WHERE THE POSTING BEHAVIOR 

4963
03:03:26,162 --> 03:03:30,433
ONLINE REALLY CHANGED AS DID THE

4964
03:03:30,433 --> 03:03:32,235
OPIOID MORTALITY IN THE REAL 

4965
03:03:32,235 --> 03:03:33,069
WORLD. 

4966
03:03:33,069 --> 03:03:34,537
WE TESTED DIFFERENT OFFSETS, YOU

4967
03:03:34,537 --> 03:03:35,972
SEE ON THE RIGHT AND WE GOT THE 

4968
03:03:35,972 --> 03:03:37,641
SENSE THAT IF YOU OVERLIE THE 

4969
03:03:37,641 --> 03:03:40,110
TIME SERIES EXACTLY, YOU GET THE

4970
03:03:40,110 --> 03:03:41,278
HIGHEST TIME SERIES COURSE. 

4971
03:03:41,278 --> 03:03:41,745
>> SO DENSE. 

4972
03:03:41,745 --> 03:03:44,180
IF YOU WERE TO SHIFT IT BY JUST 

4973
03:03:44,180 --> 03:03:45,982
A MONTH OR TWO THAT CORRELATION 

4974
03:03:45,982 --> 03:03:48,184
WOULD DECAY AND GIVES US 

4975
03:03:48,184 --> 03:03:48,785
ADDITIONAL INFORMATION THAT 

4976
03:03:48,785 --> 03:03:50,687
THESE THINGS MAY BE TRACKING. 

4977
03:03:50,687 --> 03:03:52,389
SO THIS IS THE COURSE. 

4978
03:03:52,389 --> 03:03:54,958
>> SO DENSE WITH THE CDC. 

4979
03:03:54,958 --> 03:03:58,061
WE USE THE DIFFERENT DRUG 

4980
03:03:58,061 --> 03:04:00,030
REPORTING, THE LABORATORY 

4981
03:04:00,030 --> 03:04:00,897
INFORMATION SYSTEM. 

4982
03:04:00,897 --> 03:04:03,833
AND YOU CAN SEE WE SEE SIMILAR 

4983
03:04:03,833 --> 03:04:04,134
COURSE. 

4984
03:04:04,134 --> 03:04:05,168
>> SO DENSE FOR FENTANYL
ACROSS 

4985
03:04:05,168 --> 03:04:07,270
DIFFERENT AREAS OF THE U.S.

4986
03:04:07,270 --> 03:04:10,473
AND THEN WE WANTED TO BE MORE 

4987
03:04:10,473 --> 03:04:13,009
PRINCIPLED AND TESTED THIS IN AN

4988
03:04:13,009 --> 03:04:14,978
ARENA, SO AN AUTO REGRESSIVE 

4989
03:04:14,978 --> 03:04:17,147
MODEL. 

4990
03:04:17,147 --> 03:04:19,482
AND WE LOOKED AT HOW THE 

4991
03:04:19,482 --> 03:04:20,684
PREDICTION ERA CHANGES AS A 

4992
03:04:20,684 --> 03:04:25,622
FUNCTION OF PRECLUDING REALTIME 

4993
03:04:25,622 --> 03:04:27,691
SOCIAL MEDIA IN IF THE 

4994
03:04:27,691 --> 03:04:29,159
CO-VARIANCE. 

4995
03:04:29,159 --> 03:04:31,628
AND NORMALLY THIS HAS LAG CDC 

4996
03:04:31,628 --> 03:04:32,162
DATA. 

4997
03:04:32,162 --> 03:04:35,165
AND HAS SIX-MONTH -- SIX-MONTH 

4998
03:04:35,165 --> 03:04:35,365
LAG. 

4999
03:04:35,365 --> 03:04:39,035
AND THIS -- WE FIND STATISTICAL 

5000
03:04:39,035 --> 03:04:40,236
SIGNIFICANCE AT LEAST SHOWING 

5001
03:04:40,236 --> 03:04:44,107
THERE IS I BELIEVE CEMENTAL 

5002
03:04:44,107 --> 03:04:45,742
PREDICTIVE VALUE USING CREW 

5003
03:04:45,742 --> 03:04:47,143
ALLEGATIONS STRATEGIES. 

5004
03:04:47,143 --> 03:04:49,279
SO CERTAINLY VERY PROMISE. 

5005
03:04:49,279 --> 03:04:50,313
THANK YOU FOR YOUR ATTENTION AND

5006
03:04:50,313 --> 03:04:52,749
HERE ARE THE REFERENCES IF YOU 

5007
03:04:52,749 --> 03:04:55,685
ARE INTERESTED. 

5008
03:04:55,685 --> 03:05:00,724
>> THANK YOU VERY MUCH,
DJOHANNS

5009
03:05:00,724 --> 03:05:01,024
EICHSTAEDT. 

5010
03:05:01,024 --> 03:05:04,394
USE OF NONTRADITIONAL DATA 

5011
03:05:04,394 --> 03:05:05,729
SOURCES IN RESEARCH THROUGH 

5012
03:05:05,729 --> 03:05:07,530
SOCIAL MEDIA PLATFORM DATA. 

5013
03:05:07,530 --> 03:05:09,265
REALLY APPRECIATE THAT 

5014
03:05:09,265 --> 03:05:09,666
INFORMATION. 

5015
03:05:09,666 --> 03:05:13,737
NEXT WE HAVE DR. CHELSEA STOVER 

5016
03:05:13,737 --> 03:05:16,906
WHO WILL BE SPEAKING OF THE HARM

5017
03:05:16,906 --> 03:05:17,173
RESEARCH. 

5018
03:05:17,173 --> 03:05:17,774
>> THANK YOU SO MUCH. 

5019
03:05:17,774 --> 03:05:19,409
HI, EVERYBODY. 

5020
03:05:19,409 --> 03:05:20,543
HAPPY TO BE HERE. 

5021
03:05:20,543 --> 03:05:21,878
AND ALWAYS FUN TO TALK OF SOCIAL

5022
03:05:21,878 --> 03:05:24,280
MEDIA AND REALIZE THAT THE ONLY 

5023
03:05:24,280 --> 03:05:25,281
SOCIAL MEDIA PLATFORM I AM 

5024
03:05:25,281 --> 03:05:27,417
REFERENCING ON MINE IS NOT ON 

5025
03:05:27,417 --> 03:05:28,718
THAT LIST YET. 

5026
03:05:28,718 --> 03:05:30,687
NEW AREAS FOR THE TEAM TO STUDY 

5027
03:05:30,687 --> 03:05:33,023
AS SO MANY SCIENTISTS MOVE OVER 

5028
03:05:33,023 --> 03:05:34,724
TO BLUE SKY. 

5029
03:05:34,724 --> 03:05:35,992
ANYWAY, TODAY I WILL BE TALKING 

5030
03:05:35,992 --> 03:05:37,027
ABOUT A PROJECT THAT GROWS OUT 

5031
03:05:37,027 --> 03:05:43,099
YOU HAVE AN  RO 1 AND MPI. 

5032
03:05:43,099 --> 03:05:44,034
IT IS FOCUSED ON MAPPING 

5033
03:05:44,034 --> 03:05:48,238
OVERDOSE IN TERMS OF FATAL AND 

5034
03:05:48,238 --> 03:05:49,439
NONFATAL OVERDOSE IN LOS ANGELES

5035
03:05:49,439 --> 03:05:52,509
COUNTY AS IT RELATES OF HOW WE 

5036
03:05:52,509 --> 03:05:54,277
MIGHT BETTER ALLOCATE TREATMENT 

5037
03:05:54,277 --> 03:05:57,113
AND HARM REDUCTION SERVICES. 

5038
03:05:57,113 --> 03:05:57,414
SORRY. 

5039
03:05:57,414 --> 03:05:58,915
LET ME ADVANCE -- DO I CONTROL 

5040
03:05:58,915 --> 03:06:00,050
MY SLIDE?

5041
03:06:00,050 --> 03:06:01,751
YES, I DO. 

5042
03:06:01,751 --> 03:06:01,985
GREAT. 

5043
03:06:01,985 --> 03:06:03,586
OKAY. 

5044
03:06:03,586 --> 03:06:05,021
I WANT TO START BY THANKING ALL 

5045
03:06:05,021 --> 03:06:07,791
THE PEOPLE THAT REALLY DID THIS 

5046
03:06:07,791 --> 03:06:08,258
WORK. 

5047
03:06:08,258 --> 03:06:13,329
MY MPI IS DR. GOODMAN-MESA, THE 

5048
03:06:13,329 --> 03:06:17,167
RARE COMBINATION OF ADDICTION 

5049
03:06:17,167 --> 03:06:17,967
MEDICINE AND DISEASE PHYSICIAN 

5050
03:06:17,967 --> 03:06:19,803
MEDICINE AND EXPERTISE IN 

5051
03:06:19,803 --> 03:06:21,438
NATURAL LANGUAGE PROCESSING AND 

5052
03:06:21,438 --> 03:06:22,906
OTHER MACHINE LEARNING, AND 

5053
03:06:22,906 --> 03:06:24,207
REALLY IS KIND OF THE DRIVING 

5054
03:06:24,207 --> 03:06:25,942
FORCE BETWEEN -- BEHIND A LOT OF

5055
03:06:25,942 --> 03:06:28,344
THE DATA SCIENCE ASPECTS OF OUR 

5056
03:06:28,344 --> 03:06:28,545
WORK. 

5057
03:06:28,545 --> 03:06:33,750
DR. MICHAEL SCIN, A PROFESSOR IN

5058
03:06:33,750 --> 03:06:35,485
THE GEOGRAPHY DEPARTMENT AND OUR

5059
03:06:35,485 --> 03:06:36,319
GEOSPATIAL EXPERT. 

5060
03:06:36,319 --> 03:06:37,754
HE IS MAKING ALL THESE MAPS. 

5061
03:06:37,754 --> 03:06:38,855
I SAY CAN YOU MAKE A MAP THAT 

5062
03:06:38,855 --> 03:06:39,956
DOES THIS. 

5063
03:06:39,956 --> 03:06:43,226
HE TELLS ME WHY IT IS NOT METH 

5064
03:06:43,226 --> 03:06:45,728
LOGICALLY RIGOROUS OR WHAT KIND 

5065
03:06:45,728 --> 03:06:48,398
OF ASSUMPTIONS WE ARE BAKING IN 

5066
03:06:48,398 --> 03:06:49,265
AND THE QUIRKS OF LOS ANGELES 

5067
03:06:49,265 --> 03:06:51,301
THAT I WILL TALK ABOUT AS I GO 

5068
03:06:51,301 --> 03:06:54,037
THROUGH THIS PRESENTATION. 

5069
03:06:54,037 --> 03:06:57,740
TUCKER AVRA, A CURRENT MEDICAL 

5070
03:06:57,740 --> 03:06:59,109
STUDENT AND ALSO A VETERINARIAN 

5071
03:06:59,109 --> 03:07:01,511
WHO HAS BEEN WORKING ON OUR 

5072
03:07:01,511 --> 03:07:04,147
PROJECT AND HIS IDEA ACTUALLY TO

5073
03:07:04,147 --> 03:07:07,951
LOOK AT THIS CONCEPT OF SYRINGE 

5074
03:07:07,951 --> 03:07:09,719
SERVICE DESERTS. 

5075
03:07:09,719 --> 03:07:13,723
AND LASTLY OUR PROJECT DIRECTOR 

5076
03:07:13,723 --> 03:07:15,592
RUBY ROMERO KEEPING US ALL ON 

5077
03:07:15,592 --> 03:07:17,193
TRACK TRYING TO KEEP DOING THIS.

5078
03:07:17,193 --> 03:07:19,062
WE WORK VERY CLOSELY WITH A 

5079
03:07:19,062 --> 03:07:21,464
NUMBER OF PARTNERS HERE IN LOS 

5080
03:07:21,464 --> 03:07:22,265
ANGELES AS FAR AS OUR COUNTY 

5081
03:07:22,265 --> 03:07:25,735
GOVERNMENT AND COMMUNITY-BASED 

5082
03:07:25,735 --> 03:07:26,202
ORGANIZATIONS. 

5083
03:07:26,202 --> 03:07:27,804
AND THAT'S KIND OF WHAT -- YOU 

5084
03:07:27,804 --> 03:07:30,440
KNOW, THAT SORT OF -- I GUESS 

5085
03:07:30,440 --> 03:07:31,007
STORYTELLING TIME. 

5086
03:07:31,007 --> 03:07:32,709
THAT IS KIND OF WHY WE ARE DOING

5087
03:07:32,709 --> 03:07:38,014
THIS PROJECT. YOU KNOW, DAVID 

5088
03:07:38,014 --> 03:07:39,716
AND I KNOWN EACH OTHER FOR A 

5089
03:07:39,716 --> 03:07:41,184
LONG TIME AND STARTED TALKING OF

5090
03:07:41,184 --> 03:07:46,456
THIS RO-1 WHEN WE WERE DOING 

5091
03:07:46,456 --> 03:07:48,024
FIELD-BASED WORK IN LOS ANGELES.

5092
03:07:48,024 --> 03:07:51,194
OUR IDEALIZED PICTURE OF LOS 

5093
03:07:51,194 --> 03:07:51,461
ANGELES. 

5094
03:07:51,461 --> 03:07:53,096
AT THE TIME WRITING THIS GRANT 

5095
03:07:53,096 --> 03:07:55,665
FROM EARLY 2021 AND EARLY 2022. 

5096
03:07:55,665 --> 03:07:58,868
I WAS RUNNING A PROGRAM THAT WAS

5097
03:07:58,868 --> 03:08:00,436
DOING COVID-19-VACCINE EVENTS 

5098
03:08:00,436 --> 03:08:01,971
PEOPLE EXPERIENCING HOMELESSNESS

5099
03:08:01,971 --> 03:08:05,975
AND LIVING IN ENCAMPMENTS. 

5100
03:08:05,975 --> 03:08:07,510
TAKING TEAMS FROM THE COUNTY G 

5101
03:08:07,510 --> 03:08:08,311
AROUND TO DIFFERENT PLACE TO 

5102
03:08:08,311 --> 03:08:13,750
FIND WHERE PEOPLE MAY BE LIVING 

5103
03:08:13,750 --> 03:08:17,954
AND GIVE THE COVID VACCINE. 

5104
03:08:17,954 --> 03:08:19,522
PEOPLE LIVING IN THE ENCAMPMENT 

5105
03:08:19,522 --> 03:08:22,692
AS COMMUNITY PEER AMBASSADORS.

5106
03:08:22,692 --> 03:08:23,426
WE WERE LOOKING AT WHY WHETHER 

5107
03:08:23,426 --> 03:08:25,728
PEOPLE MIGHT BE MISSED BY OTHER 

5108
03:08:25,728 --> 03:08:28,231
ASPECTS OF THE HEALTH CARE 

5109
03:08:28,231 --> 03:08:29,199
SYSTEM. 

5110
03:08:29,199 --> 03:08:30,133
AT THE SAME TIME, DAVID BECAME 

5111
03:08:30,133 --> 03:08:31,868
SITE PRINCIPAL INVESTIGATOR OF A

5112
03:08:31,868 --> 03:08:37,640
BIG NIH-FUNDED CLINICAL TRIAL 

5113
03:08:37,640 --> 03:08:42,612
ABOUT DELIVERING BUPRENORP HINE 

5114
03:08:42,612 --> 03:08:45,448
WITH CLEAR NAVIGATION AN WE WERE

5115
03:08:45,448 --> 03:08:46,816
TEXTING -- BECAUSE WE WERE 

5116
03:08:46,816 --> 03:08:48,785
FRIENDS WITH AND CO-FACULTY AND 

5117
03:08:48,785 --> 03:08:49,252
TEXTING. 

5118
03:08:49,252 --> 03:08:52,055
HEY, I WAS JUST BY THIS ONE 

5119
03:08:52,055 --> 03:08:53,189
LIBRARY AT THIS ONE 

5120
03:08:53,189 --> 03:08:53,523
INTERSECTION. 

5121
03:08:53,523 --> 03:08:56,392
A LOT OF NEEDLES ON THE GROUND. 

5122
03:08:56,392 --> 03:08:58,194
YOU SHOULD PROBABLY PARK YOUR 

5123
03:08:58,194 --> 03:09:00,296
BUS BECAUSE THERE MAY BE PEOPLE 

5124
03:09:00,296 --> 03:09:01,431
WHO WILL QUALIFY FOR YOUR 

5125
03:09:01,431 --> 03:09:01,731
STEADY. 

5126
03:09:01,731 --> 03:09:03,533
HE WOULD TELL ME, HEY, WE HAD 

5127
03:09:03,533 --> 03:09:06,502
THE BUS OUT AT THIS PLACE. 

5128
03:09:06,502 --> 03:09:08,238
AND ASK ABOUT THE COVID VACCINE.

5129
03:09:08,238 --> 03:09:11,641
AND SO THEN, WE SAID, WOW, LOS 

5130
03:09:11,641 --> 03:09:12,942
ANGELES IS SO BIG. 

5131
03:09:12,942 --> 03:09:14,244
SOME THIS IS OUR LITTLE 

5132
03:09:14,244 --> 03:09:16,246
IDEALIZED VERSION OF WHAT WE -- 

5133
03:09:16,246 --> 03:09:18,815
YOU KNOW, IF YOU DON'T LIVE 

5134
03:09:18,815 --> 03:09:20,316
IN L.A. YOU MIGHT IMAGINE 

5135
03:09:20,316 --> 03:09:22,352
WHAT L.A. IS LIKE. 

5136
03:09:22,352 --> 03:09:23,853
YOU MIGHT IMAGINE THIS WHICH IS 

5137
03:09:23,853 --> 03:09:27,690
WHAT L.A. IS LIKE SALIENT AND 

5138
03:09:27,690 --> 03:09:29,559
RELEVANT TO ANY GEOSPATIAL WORK.

5139
03:09:29,559 --> 03:09:31,060
ONE OF THE EARLIER TALKS HOW DO 

5140
03:09:31,060 --> 03:09:32,962
YOU DEAL WITH PEOPLE WALKING 

5141
03:09:32,962 --> 03:09:33,730
VERSUS DRIVING. 

5142
03:09:33,730 --> 03:09:35,231
AND SPOILER, THAT IS A MAJOR 

5143
03:09:35,231 --> 03:09:37,367
PART OF THE TYPE OF APPLIED WORK

5144
03:09:37,367 --> 03:09:40,536
WE ARE DOING. BUT ANYWAY, LOS 

5145
03:09:40,536 --> 03:09:40,803
ANGELES. 

5146
03:09:40,803 --> 03:09:42,171
FOR THOSE OF HOW HAVEN'T SPENT 

5147
03:09:42,171 --> 03:09:46,142
TEN YEAR OBSESSIONED WITH TH

5148
03:09:46,142 --> 03:09:49,112
THE DEMOGRAPHY AND THE 

5149
03:09:49,112 --> 03:09:51,080
POPULATION AND VARIOUS THINGS 

5150
03:09:51,080 --> 03:09:53,750
THAT MAKE L.A. A SPECIAL PLACE. 

5151
03:09:53,750 --> 03:09:56,653
POPULATION OVERVIEW. 

5152
03:09:56,653 --> 03:09:58,187
POPULATION IN 2023 WAS 9.7 

5153
03:09:58,187 --> 03:09:58,454
MILLION. 

5154
03:09:58,454 --> 03:10:00,089
IF IT WAS A STATE, IT WOULD BE 

5155
03:10:00,089 --> 03:10:03,426
THE 11th LARGEST STATE BY 

5156
03:10:03,426 --> 03:10:04,494
POPULATION. 

5157
03:10:04,494 --> 03:10:09,365
LAND AREA IS OVER 4,000 SQUARE 

5158
03:10:09,365 --> 03:10:09,599
MILES. 

5159
03:10:09,599 --> 03:10:11,367
TO BE RHODE ISLAND AND DELAWARE,

5160
03:10:11,367 --> 03:10:13,236
THE AREA AS LOS ANGELES. 

5161
03:10:13,236 --> 03:10:15,271
ONE OF MY FAVORITE EXPERIENCES 

5162
03:10:15,271 --> 03:10:16,539
WHEN I FIRST MOVED HERE -- 

5163
03:10:16,539 --> 03:10:18,708
BECAUSE I GREW UP ON THE EAST 

5164
03:10:18,708 --> 03:10:20,009
COAST IN A VERY SMALL TOWN. 

5165
03:10:20,009 --> 03:10:22,612
I MOVED TO LA AND I SAW A SIGN 

5166
03:10:22,612 --> 03:10:23,813
FOR ONE OF THE METROBUS SYSTEMS.

5167
03:10:23,813 --> 03:10:26,783
TAMPA SAID, HEY, THIS CARD IS 

5168
03:10:26,783 --> 03:10:29,018
GREAT BECAUSE WORKS ON 55 

5169
03:10:29,018 --> 03:10:30,086
DIFFERENT TRANSIT SYSTEMS 

5170
03:10:30,086 --> 03:10:31,421
WITHIN L.A. COUNTY. 

5171
03:10:31,421 --> 03:10:33,122
I SAID THAT IS NOT GOOD. 

5172
03:10:33,122 --> 03:10:35,058
IT IS NOT GOOD WE HAVE 55 

5173
03:10:35,058 --> 03:10:37,493
DIFFERENT TRANSIT SYSTEMS IN ONE

5174
03:10:37,493 --> 03:10:38,795
COUNTY. 

5175
03:10:38,795 --> 03:10:39,529
THAT IS ABSURD. 

5176
03:10:39,529 --> 03:10:42,165
88 CITIES AND IN MANY UNINCORPS 

5177
03:10:42,165 --> 03:10:44,467
RATED AREA. 

5178
03:10:44,467 --> 03:10:45,234
IT AFFECTED THE LARGE POPULATION

5179
03:10:45,234 --> 03:10:46,969
AND THE FACT WE GOT FENTANYL 

5180
03:10:46,969 --> 03:10:48,805
LATE, BUT ALSO HIT US VERY HARD 

5181
03:10:48,805 --> 03:10:51,407
IN TERMS OF TAKING OVER OUR 

5182
03:10:51,407 --> 03:10:54,510
ILLICIT DRUG SUPPLY AND NOT ONLY

5183
03:10:54,510 --> 03:10:56,145
REPLACING BUT DISPLACING 

5184
03:10:56,145 --> 03:10:59,182
EXPANDING THE POPULATION OF 

5185
03:10:59,182 --> 03:11:03,619
FOLKS USING ILLICIT OPIOIDS. 

5186
03:11:03,619 --> 03:11:05,722
WE LEAD THE COUNTRY IN PEOPLE 

5187
03:11:05,722 --> 03:11:07,323
DYING FROM OVERDOSE DEATHS IN 

5188
03:11:07,323 --> 03:11:08,191
THE LAST FEW YEARS. 

5189
03:11:08,191 --> 03:11:10,426
AND, YES, YOU KNOW, POPULATION 

5190
03:11:10,426 --> 03:11:12,061
IN THE COUNTRY, COUNTY -- THE 

5191
03:11:12,061 --> 03:11:13,730
COUNTY AND THE COUNTRY WHERE THE

5192
03:11:13,730 --> 03:11:14,530
LARGEST POPULATION. 

5193
03:11:14,530 --> 03:11:16,666
SO OUR POPULATION RATE IS A 

5194
03:11:16,666 --> 03:11:18,101
LITTLE BIT BELOW AVERAGE, BUT 

5195
03:11:18,101 --> 03:11:20,036
THE ACTUAL NUMBERS, YOU KNOW, IT

5196
03:11:20,036 --> 03:11:21,971
IS MULTIPLE THOUSANDS OF PEOPLE 

5197
03:11:21,971 --> 03:11:27,377
EVERY YEAR SO WHEN I THINK ABOUT

5198
03:11:27,377 --> 03:11:29,746
IT, WE HAVE A HUGE PROJECT AHEAD

5199
03:11:29,746 --> 03:11:30,613
OF US. 

5200
03:11:30,613 --> 03:11:32,014
IF WE CAN FIGURE IT OUT HERE, WE

5201
03:11:32,014 --> 03:11:33,149
CAN FIGURE IT OUT IN LOTS OF 

5202
03:11:33,149 --> 03:11:37,453
OTHER PLACES. SO, OKAY, SO OUR 

5203
03:11:37,453 --> 03:11:38,721
MOTIVATING QUESTION FOR THIS 

5204
03:11:38,721 --> 03:11:41,190
PARTICULAR ANALYSIS WAS, WELL, 

5205
03:11:41,190 --> 03:11:44,093
WHERE ARE HARM REDUCTION SERVICE

5206
03:11:44,093 --> 03:11:44,660
DESERTS IN LOS ANGELES?

5207
03:11:44,660 --> 03:11:46,929
SO IF YOU HAVE A PASSING 

5208
03:11:46,929 --> 03:11:48,197
FAMILIARITY WITH L.A., YOU 

5209
03:11:48,197 --> 03:11:50,533
PROBABLY HEARD OF SKID ROW. 

5210
03:11:50,533 --> 03:11:52,502
THAT IS LIKE THE OPPOSITE OF A 

5211
03:11:52,502 --> 03:11:54,370
HARM REDUCTION DESERT. 

5212
03:11:54,370 --> 03:11:56,506
IT IS VERY SERVICE-DENSE PLACE 

5213
03:11:56,506 --> 03:11:58,040
WHERE THERE IS A LOT OF 

5214
03:11:58,040 --> 03:11:58,307
OVERDOSE. 

5215
03:11:58,307 --> 03:11:59,876
BUT WHAT I KNOW, BECAUSE I -- I 

5216
03:11:59,876 --> 03:12:01,310
LIVED IN A DIFFERENT PART AND I 

5217
03:12:01,310 --> 03:12:03,913
HAVE SPENT ON THIS STUDY I WAS 

5218
03:12:03,913 --> 03:12:06,916
TALKING ABOUT GOING ALL OVER THE

5219
03:12:06,916 --> 03:12:07,150
PLACE. 

5220
03:12:07,150 --> 03:12:10,620
KNOW THAT THERE ARE LOTS OF 

5221
03:12:10,620 --> 03:12:13,156
SPOTS THAT ARE -- YOU KNOW, THAT

5222
03:12:13,156 --> 03:12:14,924
SEEM TO BE BASE ON THE MAPS HE 

5223
03:12:14,924 --> 03:12:16,192
WERE MAKING OF OVERDOSE 

5224
03:12:16,192 --> 03:12:20,129
MORTALITY AND LATER OF NONFATAL 

5225
03:12:20,129 --> 03:12:23,199
OVERDOSES MEASURED BY NALOXONE 

5226
03:12:23,199 --> 03:12:24,567
BY EMS. 

5227
03:12:24,567 --> 03:12:26,269
THERE SEEMS TO BE A HOT SPOT OF 

5228
03:12:26,269 --> 03:12:28,271
OVERDOSE HERE, BUT WE ARE NOT 

5229
03:12:28,271 --> 03:12:29,205
REALLY SURE HOW MUCH COVERAGE 

5230
03:12:29,205 --> 03:12:33,543
THERE ACTUALLY IS IN TERMS OF 

5231
03:12:33,543 --> 03:12:35,445
HARM REDUCTION RESOURCES. SO, 

5232
03:12:35,445 --> 03:12:38,748
YOU KNOW, TUCKER CAME TO US AND 

5233
03:12:38,748 --> 03:12:41,217
STARTED SAYING, WE SHOULD DO A 

5234
03:12:41,217 --> 03:12:43,319
PROJECT ABOUT HARM REDUCTION 

5235
03:12:43,319 --> 03:12:44,287
SERVICE DESERTS. 

5236
03:12:44,287 --> 03:12:47,223
SAID, OKAY, WHAT DOES THAT MEAN?

5237
03:12:47,223 --> 03:12:50,126
HOW DO YOU DEFINE A HARM 

5238
03:12:50,126 --> 03:12:51,627
REDUCTION SERVICE DESERT. 

5239
03:12:51,627 --> 03:12:55,064
BROUGHT IN MICHAEL, OUR G

5240
03:12:55,064 --> 03:12:55,698
GEOGRA

5241
03:12:55,698 --> 03:12:55,998
GEOGRAPHER. 

5242
03:12:55,998 --> 03:12:57,733
AND WE SAID THERE IS A LOT OF 

5243
03:12:57,733 --> 03:13:01,704
LITERATURE ON FOOD DESERTS AND 

5244
03:13:01,704 --> 03:13:03,573
PHARMACY DESERTS. 

5245
03:13:03,573 --> 03:13:05,174
A LOT OF DIFFERENT DESERTS. 

5246
03:13:05,174 --> 03:13:06,442
PEOPLE HAVE LESS ACCESS TO 

5247
03:13:06,442 --> 03:13:06,909
SERVICES. 

5248
03:13:06,909 --> 03:13:10,246
WHAT DOES THAT MEAN FOR HARM 

5249
03:13:10,246 --> 03:13:10,513
REDUCTION?

5250
03:13:10,513 --> 03:13:11,414
THAT IS THE QUESTION FOR THE 

5251
03:13:11,414 --> 03:13:12,181
MAIN THING. 

5252
03:13:12,181 --> 03:13:14,050
WE ESSENTIALLY WANTED TO KNOW 

5253
03:13:14,050 --> 03:13:18,221
WHAT PARTS OF LOS ANGELES HAD 

5254
03:13:18,221 --> 03:13:20,456
OVERDOSE MORTALITY AND NOT 

5255
03:13:20,456 --> 03:13:21,057
ENOUGH SERVICES. 

5256
03:13:21,057 --> 03:13:22,658
WE HAVE A SENSE -- YOU KNOW, 

5257
03:13:22,658 --> 03:13:24,494
JUST FROM WORKING HERE WHERE HAS

5258
03:13:24,494 --> 03:13:28,364
A LOT OF OVERDOSES AND A LOT OF 

5259
03:13:28,364 --> 03:13:30,566
SERVICES AND SINCE -- WE HAVE A 

5260
03:13:30,566 --> 03:13:32,702
SENSE OF -- WE SORT OF HAVE A 

5261
03:13:32,702 --> 03:13:35,738
SENSE OF -- WHERE THERE ANY 

5262
03:13:35,738 --> 03:13:37,006
OVERDOSES AND NOT MANY SERVICES 

5263
03:13:37,006 --> 03:13:39,742
BECAUSE A LOT OF L.A. SHOCKINGLY

5264
03:13:39,742 --> 03:13:42,245
IS LIKE FORESTS AND PARKS. 

5265
03:13:42,245 --> 03:13:44,247
AND THAT, YOU KNOW -- WE ARE 

5266
03:13:44,247 --> 03:13:46,649
TRYING TO GET THAT IN BETWEEN 

5267
03:13:46,649 --> 03:13:48,117
THAT AND UNDERSTAND AREAS WHERE 

5268
03:13:48,117 --> 03:13:50,319
THERE IS NEED AND THOSE NEEDS 

5269
03:13:50,319 --> 03:13:51,687
ARE NOT NECESSARILY BEING MEANT.

5270
03:13:51,687 --> 03:13:53,422
THIS GETS MORE COMPLICATED 

5271
03:13:53,422 --> 03:13:54,924
THOUGH AS MORE QUESTIONS -- AS 

5272
03:13:54,924 --> 03:13:58,261
MANY RESEARCHES PROCESS DO. THEY

5273
03:13:58,261 --> 03:13:59,161
GENERATE MORE QUESTIONS. 

5274
03:13:59,161 --> 03:14:01,564
THE FIRST IS WHERE ARE HARM 

5275
03:14:01,564 --> 03:14:05,735
REDUCTION SERVICES?

5276
03:14:05,735 --> 03:14:06,502
HARM REDUCTION IS SOMETHING THAT

5277
03:14:06,502 --> 03:14:08,538
HAS BEEN PRACTICED FOR A VERY 

5278
03:14:08,538 --> 03:14:10,606
LONG TIME. I THINK WHAT WE 

5279
03:14:10,606 --> 03:14:13,609
COMMONLY CALL "HARM REDUCTION."

5280
03:14:13,609 --> 03:14:22,151
IT GREW OUT OF THE HIV-AIDS ACT 

5281
03:14:22,151 --> 03:14:24,687
HIPS MOVEMENT AND CLEAN NEEDLES,

5282
03:14:24,687 --> 03:14:25,755
SYRINGE AND NEEDLE EXCHANGE HAVE

5283
03:14:25,755 --> 03:14:27,156
BEEN A PART OF IT. 

5284
03:14:27,156 --> 03:14:28,891
THAT IS WHERE WE STARTED. 

5285
03:14:28,891 --> 03:14:30,459
OKAY, NOW THERE IS -- WHAT 

5286
03:14:30,459 --> 03:14:32,528
PEOPLE CONSIDER HARM REDUCTION 

5287
03:14:32,528 --> 03:14:34,630
IS PROBABLY A BIGGER TENT, BUT 

5288
03:14:34,630 --> 03:14:37,533
LET'S KEEP IT FOCUSSED ON SORT 

5289
03:14:37,533 --> 03:14:41,571
OF THE ORIGINAL OF WHERE IS 

5290
03:14:41,571 --> 03:14:44,173
SYRINGE EXCHANGE HAPPENING. 

5291
03:14:44,173 --> 03:14:47,243
OKAY, THERE IS -- LET'S SEE. 

5292
03:14:47,243 --> 03:14:49,779
WE WORK CLOSELY WITH THE COUNTY 

5293
03:14:49,779 --> 03:14:51,314
GOVERNMENT AND A LIST OF WATCH 

5294
03:14:51,314 --> 03:14:53,382
IS FUNDED BY THE COUNTY 

5295
03:14:53,382 --> 03:14:53,683
GOVERNMENT. 

5296
03:14:53,683 --> 03:14:56,719
I THINK WE STARTED WITH 8. 

5297
03:14:56,719 --> 03:14:58,588
ANOTHER WAS ADDED AND IT WAS 9. 

5298
03:14:58,588 --> 03:15:00,189
MOST OF THEM HAVE MOBILE 

5299
03:15:00,189 --> 03:15:00,856
COMPONENTS. 

5300
03:15:00,856 --> 03:15:02,825
AND SO -- LOOK, OKAY, WHERE IS 

5301
03:15:02,825 --> 03:15:05,294
THAT -- FOR MAPPING, WHERE -- 

5302
03:15:05,294 --> 03:15:07,330
YOU KNOW, I -- IT SEEMED CLEAR 

5303
03:15:07,330 --> 03:15:10,833
TO ALL OF US CONCEPTUALLY, LIKE 

5304
03:15:10,833 --> 03:15:14,070
THIS EXAMPLE. 

5305
03:15:14,070 --> 03:15:15,438
ONE COUNTY SYRINGE EXCHANGE 

5306
03:15:15,438 --> 03:15:17,173
PROGRAMS I WORK WITH DRUG 

5307
03:15:17,173 --> 03:15:17,440
CHECKING. 

5308
03:15:17,440 --> 03:15:18,874
IN PHYSICAL BUILDING OBVIOUSLY 

5309
03:15:18,874 --> 03:15:20,509
THAT IS A LOCATION WHERE HARM 

5310
03:15:20,509 --> 03:15:22,144
REDUCTION SERVICES ARE. 

5311
03:15:22,144 --> 03:15:23,279
BUT SO IS THIS VAN. 

5312
03:15:23,279 --> 03:15:26,048
HOW DO YOU ACCOUNT FOR THIS VAN 

5313
03:15:26,048 --> 03:15:26,749
WHEN YOU ARE MAPPING?

5314
03:15:26,749 --> 03:15:30,353
SO THAT IS -- THAT IS OUR ONE 

5315
03:15:30,353 --> 03:15:31,087
QUESTION. 

5316
03:15:31,087 --> 03:15:31,287
OKAY. 

5317
03:15:31,287 --> 03:15:33,456
SO TO TRY TO FIGURE THAT OUT, WE

5318
03:15:33,456 --> 03:15:35,091
HAD TO DO A SURVEY -- BASICALLY 

5319
03:15:35,091 --> 03:15:38,260
WHAT I THINK OF AS A SURVEY OF 

5320
03:15:38,260 --> 03:15:38,561
SERVICE. 

5321
03:15:38,561 --> 03:15:42,832
AND RUBY TOOK THIS ON -- I MEAN 

5322
03:15:42,832 --> 03:15:44,600
TUCKER, AS WELL, FIGURING OUT --

5323
03:15:44,600 --> 03:15:45,668
HOW TO ACTUALLY MAP IT. 

5324
03:15:45,668 --> 03:15:48,137
PART OF IT, WELL, WE KNOW FROM 

5325
03:15:48,137 --> 03:15:49,171
LOCAL KNOWLEDGE THAT THERE IS 

5326
03:15:49,171 --> 03:15:53,976
SOME AREAS OF LOS ANGELES WHERE 

5327
03:15:53,976 --> 03:15:55,745
NEEDLES ARE NOT ALLOWED TO BE 

5328
03:15:55,745 --> 03:15:57,079
DISTRIBUTED AND OTHER TYPES OF 

5329
03:15:57,079 --> 03:16:01,584
HARM REDUCTION LIKE NALOXONE. 

5330
03:16:01,584 --> 03:16:05,588
WE SYSTEMATICALLY WENT TO COUNTY

5331
03:16:05,588 --> 03:16:08,691
SYRINGE PROGRAMS AND SURVEY -- 

5332
03:16:08,691 --> 03:16:10,726
SEMI STRUCTURED INTERVIEW 

5333
03:16:10,726 --> 03:16:11,027
BASICALLY. 

5334
03:16:11,027 --> 03:16:13,162
WHAT DO OFFER, WHERE DO YOU 

5335
03:16:13,162 --> 03:16:14,296
OFFER IT AND WHEN?

5336
03:16:14,296 --> 03:16:16,465
WE WERE INTERESTED IN THE BROAD 

5337
03:16:16,465 --> 03:16:18,768
RANGE INCLUDING, OF COURSE, 

5338
03:16:18,768 --> 03:16:20,569
INJECTING SUPPLIES. 

5339
03:16:20,569 --> 03:16:23,939
BUT AS -- AS THE FENTANYL USE IN

5340
03:16:23,939 --> 03:16:25,341
THE WEST COAST AND INCREASINGLY 

5341
03:16:25,341 --> 03:16:27,410
MORE OF THE COUNTRY HAS SHIFTED 

5342
03:16:27,410 --> 03:16:30,680
TO SMOKING, IT WAS LIKE, OH, 

5343
03:16:30,680 --> 03:16:32,615
SAFER INJECTION EQUIPMENT IS 

5344
03:16:32,615 --> 03:16:33,049
IMPORTANT. 

5345
03:16:33,049 --> 03:16:34,884
IN LOS ANGELES, PEOPLE EN JECT 

5346
03:16:34,884 --> 03:16:37,353
METH AND SMOKE THEIR FENTANYL. 

5347
03:16:37,353 --> 03:16:39,155
WE WANT TO KNOW ABOUT SAFER 

5348
03:16:39,155 --> 03:16:45,761
SMOKING KITS. 

5349
03:16:45,761 --> 03:16:46,729
NALOXONE. 

5350
03:16:46,729 --> 03:16:49,598
DIFFERENTIATE OF NASAL SPRAY AND

5351
03:16:49,598 --> 03:16:51,167
INJECTABLE. 

5352
03:16:51,167 --> 03:16:53,002
HIV PREVENTION LIKE PREP, 

5353
03:16:53,002 --> 03:16:55,471
CONDOMS AND SOME ON AND GET A 

5354
03:16:55,471 --> 03:16:57,473
SORT OF BROAD RANGE. 

5355
03:16:57,473 --> 03:16:58,808
WHAT I WAS PERSONALLY INTERESTED

5356
03:16:58,808 --> 03:17:01,510
IN IS THE WHERE AND WHEN THIS 

5357
03:17:01,510 --> 03:17:06,582
TERMS OF HOW IT IS MAPPED OUT. 

5358
03:17:06,582 --> 03:17:07,249
ANIMATED CHATS. 

5359
03:17:07,249 --> 03:17:09,685
TO YOU DO YOU DEFINE HARM 

5360
03:17:09,685 --> 03:17:10,920
REDUCTION SERVICE DESERT?

5361
03:17:10,920 --> 03:17:13,122
IN THE OTHER TYPES OF DESERTS 

5362
03:17:13,122 --> 03:17:16,058
THEY THINK ABOUT IN PUBLIC 

5363
03:17:16,058 --> 03:17:16,659
HEALTH, THERE ARE SORT OF 

5364
03:17:16,659 --> 03:17:17,727
STANDARD DEFINITIONS. 

5365
03:17:17,727 --> 03:17:20,529
BUT WE WEREN'T ABLE TO FIND ONE 

5366
03:17:20,529 --> 03:17:21,731
FOR HARM REDUCTION SERVICES. 

5367
03:17:21,731 --> 03:17:23,432
AND NOT THAT I THINK IT IS A NEW

5368
03:17:23,432 --> 03:17:26,302
IDEA THAT WE THOUGHT OF, JUST 

5369
03:17:26,302 --> 03:17:29,004
THIS ISN'T SOMETHING THAT IS 

5370
03:17:29,004 --> 03:17:29,739
ROBUSTLY DOCUMENTED IN THE 

5371
03:17:29,739 --> 03:17:32,908
SCIENTIFIC LITERATURE. 

5372
03:17:32,908 --> 03:17:37,546
SO WE USED A COUPLE OF DIFFERENT

5373
03:17:37,546 --> 03:17:38,380
POSSIBLE DEFINITIONS. 

5374
03:17:38,380 --> 03:17:39,682
ESSENTIALLY, YOU KNOW, WE 

5375
03:17:39,682 --> 03:17:43,786
THOUGHT LIKE A VERY -- LIKE VERY

5376
03:17:43,786 --> 03:17:46,522
NARROW WOULD BE LIKE WITHIN ONE 

5377
03:17:46,522 --> 03:17:46,722
MILE. 

5378
03:17:46,722 --> 03:17:47,890
THINKING OF IT BOTH IN TERMS OF 

5379
03:17:47,890 --> 03:17:49,592
DRY TIME AND WALKING TIMES. 

5380
03:17:49,592 --> 03:17:52,628
LOS ANGELES IS SUPER CAR-BASED 

5381
03:17:52,628 --> 03:17:57,700
AND TWO, A LOT OF PEOPLE WHO ARE

5382
03:17:57,700 --> 03:17:59,135
ACCESSING SYRINGE SERVICES 

5383
03:17:59,135 --> 03:17:59,635
PROG

5384
03:17:59,635 --> 03:18:00,870
PROGRAMS DON'T HAVE CARS. 

5385
03:18:00,870 --> 03:18:03,539
AREN'T DRIVING ARE NOT USING 

5386
03:18:03,539 --> 03:18:06,809
PUBLIC SIT OR WALKING AND 

5387
03:18:06,809 --> 03:18:07,042
BIKING. 

5388
03:18:07,042 --> 03:18:12,348
SO WE HAD TO KIND INCLUDE BOTH. 

5389
03:18:12,348 --> 03:18:15,251
WHAT DO THE MAPS LOOK LIKE?

5390
03:18:15,251 --> 03:18:19,155
I APOLOGIZE SHOWING YOU OLD 

5391
03:18:19,155 --> 03:18:19,755
OVERDOSE DATA. 

5392
03:18:19,755 --> 03:18:21,757
WHEN WE STARTED DOING THIS 

5393
03:18:21,757 --> 03:18:23,659
PROCESS -- WE STARTED TO DOING 

5394
03:18:23,659 --> 03:18:24,460
IN 2022. 

5395
03:18:24,460 --> 03:18:26,529
WE WANTED TO LOOK BACK AT THE 

5396
03:18:26,529 --> 03:18:28,631
MOST RECENT COMPLETE YEAR OF 

5397
03:18:28,631 --> 03:18:32,201
WHEN WE HAD DATA AS A WAY TO 

5398
03:18:32,201 --> 03:18:33,769
LOOK AT THIS IN TERMS OF WHERE 

5399
03:18:33,769 --> 03:18:36,605
THE SERVICES WORK. AND SO THIS 

5400
03:18:36,605 --> 03:18:39,775
IS LOS ANGELES COUNTY. 

5401
03:18:39,775 --> 03:18:42,645
IT IS -- IT IS BASICALLY A HEAT 

5402
03:18:42,645 --> 03:18:42,845
MAP. 

5403
03:18:42,845 --> 03:18:45,014
ALL THE LITTLE DOTS REPRESENT A 

5404
03:18:45,014 --> 03:18:46,582
OVERDOSE DEATH. 

5405
03:18:46,582 --> 03:18:49,752
THE PURPLE REPRESENTS A WARMER 

5406
03:18:49,752 --> 03:18:51,987
CONCENTRATION AND KIND OF MOVES 

5407
03:18:51,987 --> 03:18:55,224
ON THE INGREDIENT FROM PURPLE TO

5408
03:18:55,224 --> 03:18:55,624
ORANGE. 

5409
03:18:55,624 --> 03:18:58,661
AND IN THIS DOWNTOWN L.A. AREA 

5410
03:18:58,661 --> 03:19:00,663
WITH SKID ROW AND DOWNTOWN. 

5411
03:19:00,663 --> 03:19:02,331
AND THEN THE LIGHTER PURPLE, YOU

5412
03:19:02,331 --> 03:19:04,500
CAN GET IN YOUR HOLLYWOOD, YOUR 

5413
03:19:04,500 --> 03:19:07,903
SOUTH L.A. AND COUPLE OTHER HOT 

5414
03:19:07,903 --> 03:19:09,872
SPOTS LIKE UP IN THE SAN 

5415
03:19:09,872 --> 03:19:12,041
FERNANDO VALLEY AND DOWN IN LONG

5416
03:19:12,041 --> 03:19:12,274
BEACH. 

5417
03:19:12,274 --> 03:19:15,244
SOME THAT'S PRETTY -- THIS IS 

5418
03:19:15,244 --> 03:19:17,079
ACROSS ALL KINDS OF DRUGS. 

5419
03:19:17,079 --> 03:19:19,949
WE ARE WORKING ON WRITING IT UP,

5420
03:19:19,949 --> 03:19:21,483
YOU KNOW, AS IT DIFFERS BY TYPE 

5421
03:19:21,483 --> 03:19:22,718
OF DRUG IMPLICATED. 

5422
03:19:22,718 --> 03:19:24,920
I THINK THE OTHER THING THAT IS 

5423
03:19:24,920 --> 03:19:26,255
WORTH MENTIONS THAT LOS ANGELES 

5424
03:19:26,255 --> 03:19:29,191
HAD HISTORICALLY HAD SUCH A HUGE

5425
03:19:29,191 --> 03:19:32,494
METH PROBLEM IN THAT UNTIL JUST 

5426
03:19:32,494 --> 03:19:34,897
A -- JUST A -- JUST TWO OR THREE

5427
03:19:34,897 --> 03:19:37,333
YEARS AGO, MORE 

5428
03:19:37,333 --> 03:19:38,167
METHAMPHETAMINE-RELATED DEATHS 

5429
03:19:38,167 --> 03:19:39,935
THAN OPIOID-RELATED DEATHS. 

5430
03:19:39,935 --> 03:19:41,770
THIS IS JUST DRUG-RELATED 

5431
03:19:41,770 --> 03:19:44,607
DEATHS, SORRY, NOT SPECIFICALLY 

5432
03:19:44,607 --> 03:19:46,508
OVERDOSES. 

5433
03:19:46,508 --> 03:19:47,610
DRUG-RELATED DEATHS THAT WE 

5434
03:19:47,610 --> 03:19:49,712
DEFINE DRUGS IN THE HAD CAUSE 

5435
03:19:49,712 --> 03:19:51,280
AND CONTRIBUTING FACT ARE OF THE

5436
03:19:51,280 --> 03:19:52,348
DEATHER IS TESTIFY CAT. 

5437
03:19:52,348 --> 03:19:54,016
IT DOESN'T JUST MEAN THAT DRUGS 

5438
03:19:54,016 --> 03:19:55,684
WERE FOUND ONLY BOARD, BUT MEANS

5439
03:19:55,684 --> 03:19:58,153
THAT THE MEDICAL EXAMINER DURING

5440
03:19:58,153 --> 03:19:59,154
THIS PERIOD WAS THE PERIOD WE 

5441
03:19:59,154 --> 03:20:00,189
ARE LOOKED AFFIDAVIT THIS. 

5442
03:20:00,189 --> 03:20:02,858
YOU KNOW THIS MAP IS ONLY 2021, 

5443
03:20:02,858 --> 03:20:04,960
BUT WE WERE LOOKING AT IT 

5444
03:20:04,960 --> 03:20:08,063
STARTING IN 2012, THE SAME 

5445
03:20:08,063 --> 03:20:09,365
MEDICAL EXAMINER FOR A LONG TIME

5446
03:20:09,365 --> 03:20:11,433
OPERATING ON THE SAME GENERAL 

5447
03:20:11,433 --> 03:20:13,769
FRAMEWORK IN TERMS OF MAKING 

5448
03:20:13,769 --> 03:20:16,605
THOSE DETERMINATIONS. OKAY. 

5449
03:20:16,605 --> 03:20:18,507
SO TAKING THOSE -- TAKING THAT 

5450
03:20:18,507 --> 03:20:21,510
MAP OF OVERDOSE MORTALITY AND 

5451
03:20:21,510 --> 03:20:23,612
ADDING IN THE BE 5 AND 15-MINUTE

5452
03:20:23,612 --> 03:20:26,548
DRIVE TIMES TO SYRINGE SERVICES 

5453
03:20:26,548 --> 03:20:26,815
PROGRAMS. 

5454
03:20:26,815 --> 03:20:30,452
IN VERSION OF IT, THE BRIGHT 

5455
03:20:30,452 --> 03:20:35,624
PURPLE DOTS ARE THE SSPs, WHICH 

5456
03:20:35,624 --> 03:20:37,326
INCLUDE FIXED SITES AS WELL AS 

5457
03:20:37,326 --> 03:20:38,327
MOBILE SITES. 

5458
03:20:38,327 --> 03:20:40,462
I WILL GET INTO WHY THAT IS A 

5459
03:20:40,462 --> 03:20:42,364
LITTLE COMPLICATED AND RED DOTS 

5460
03:20:42,364 --> 03:20:45,067
IN HERE ARE THE OVERDOSE DEATHS.

5461
03:20:45,067 --> 03:20:53,776
THE, LIKE, FAINT PURPLY LINE IS 

5462
03:20:53,776 --> 03:20:55,844
SUPPOSEDLY A TVOF A FIVE-MINUTE 

5463
03:20:55,844 --> 03:20:57,513
AND THE OTHER ONE SEASON A 

5464
03:20:57,513 --> 03:20:59,381
30-MINUTE DRIVE. 

5465
03:20:59,381 --> 03:21:01,750
THAT IS MOST OF L.A. 

5466
03:21:01,750 --> 03:21:04,620
MAYBE NOT SERVICE DESERTS. 

5467
03:21:04,620 --> 03:21:07,222
SOMEBODY SHOWED ME THAT MAP, BUT

5468
03:21:07,222 --> 03:21:09,191
WHAT ABOUT TRAFFIC?

5469
03:21:09,191 --> 03:21:10,559
NO RURAL -- DISTANCE JUMPING 

5470
03:21:10,559 --> 03:21:13,896
BACK FOR A SECOND, THE TIME TO 

5471
03:21:13,896 --> 03:21:15,464
GET FROM -- THOSE CENTER POINTS 

5472
03:21:15,464 --> 03:21:18,233
TO THE OUTER EDGE OF THE LITTLE 

5473
03:21:18,233 --> 03:21:20,336
-- THE LITTLE SURROUNDING FOR 

5474
03:21:20,336 --> 03:21:22,638
EACH POINT IS FIVE MINUTES. 

5475
03:21:22,638 --> 03:21:24,039
LIKE, YEAH, MAYBE IN THE MIDDLE 

5476
03:21:24,039 --> 03:21:25,774
OF THE NIGHT OR SOMETHING LIKE 

5477
03:21:25,774 --> 03:21:26,008
THAT. 

5478
03:21:26,008 --> 03:21:27,076
THAT IS NOT HOW IT IS MOST OF 

5479
03:21:27,076 --> 03:21:27,977
THE TIME. 

5480
03:21:27,977 --> 03:21:29,244
SOME HOW DO WE ACTUALLY ACCOUNT 

5481
03:21:29,244 --> 03:21:30,079
FOR THAT?

5482
03:21:30,079 --> 03:21:32,181
THAT IS SORT OF WHERE I GET TO A

5483
03:21:32,181 --> 03:21:33,315
SPOILER OF OURS THAT WICK NOT 

5484
03:21:33,315 --> 03:21:34,483
FIRST DEGREE THIS OUT OF HOW TO 

5485
03:21:34,483 --> 03:21:36,585
DO THIS YET. 

5486
03:21:36,585 --> 03:21:38,253
ONE THING -- ONE THING YOU CAN 

5487
03:21:38,253 --> 03:21:39,989
TAKE BE AWAY FROM THIS. 

5488
03:21:39,989 --> 03:21:41,190
LOS ANGELES HAS A LOT OF THE 

5489
03:21:41,190 --> 03:21:41,457
SERVICES. 

5490
03:21:41,457 --> 03:21:43,559
WE DON'T REALLY HAVE THAT MUCH 

5491
03:21:43,559 --> 03:21:44,393
OF A DESERT. 

5492
03:21:44,393 --> 03:21:46,228
WHICH, YOU KNOW, MAYBE. 

5493
03:21:46,228 --> 03:21:49,765
WALKING VERSUS DRIVING WHERE THE

5494
03:21:49,765 --> 03:21:51,433
SOLID LINES ARE FIVE-MINUTE 

5495
03:21:51,433 --> 03:21:53,135
WALKING AND 15-MINUTE WALKING. 

5496
03:21:53,135 --> 03:21:55,137
THAT I ACTUALLY FEEL GOOD OF 

5497
03:21:55,137 --> 03:21:56,739
BEING PRETTY ACCURATE IN TERMS 

5498
03:21:56,739 --> 03:21:59,775
OF -- YOU KNOW, WALKING IS GOING

5499
03:21:59,775 --> 03:22:00,642
TO PROBABLY TAKE ABOUT THE SAME 

5500
03:22:00,642 --> 03:22:03,445
AMOUNT OF TIME MOST OF THE TIME.

5501
03:22:03,445 --> 03:22:05,280
IT IS A SHORT ENOUGH DISTANCE 

5502
03:22:05,280 --> 03:22:08,250
THAT WOULD EVEN EXPECT YOUR 

5503
03:22:08,250 --> 03:22:09,918
PUBLIC TRANSIT ESTIMATES TO BE 

5504
03:22:09,918 --> 03:22:11,153
PRESENTEE EXTRAIBLE OF ACROSS 

5505
03:22:11,153 --> 03:22:12,087
TIME OF DAY. 

5506
03:22:12,087 --> 03:22:14,356
AND THE DRIVING IS RECOMMENDED 

5507
03:22:14,356 --> 03:22:15,758
FROM THE LANES THAT ARE THE 

5508
03:22:15,758 --> 03:22:18,160
THINNER LINES, THE GREEN, THE 

5509
03:22:18,160 --> 03:22:19,528
YELLOW AND RED. 

5510
03:22:19,528 --> 03:22:22,097
AND SO IF YOU WERE RESTRICTED TO

5511
03:22:22,097 --> 03:22:24,633
WALKING, YOU WOULD BE LIKE, WOW,

5512
03:22:24,633 --> 03:22:26,735
THERE IS A LOT OF DESERTS. 

5513
03:22:26,735 --> 03:22:28,037
THIS IS WHERE WE SORT OF RUN 

5514
03:22:28,037 --> 03:22:31,073
INTO THE LIMITS OF WHAT CAN WE 

5515
03:22:31,073 --> 03:22:33,675
DO THAT FITS SQUARELY WITHIN THE

5516
03:22:33,675 --> 03:22:37,780
PUBLISHED LITERATURE ON DESERTS 

5517
03:22:37,780 --> 03:22:39,081
IN THE SENSE THAT IT IS VERY 

5518
03:22:39,081 --> 03:22:41,417
COMPLICATED TO SAY, WELL, HOW 

5519
03:22:41,417 --> 03:22:44,820
ARE WE GOING TO SAY WHAT IS TOO 

5520
03:22:44,820 --> 03:22:45,020
FAR. 

5521
03:22:45,020 --> 03:22:47,990
AND SO I -- YOU KNOW, I AS WE 

5522
03:22:47,990 --> 03:22:51,026
ARE MOVING THIS PROJECT FORWARD,

5523
03:22:51,026 --> 03:22:54,363
WE WILL HAVE TO DO A LOT OF 

5524
03:22:54,363 --> 03:22:56,065
SENSITIVITY ACT MALL IN CEASE 

5525
03:22:56,065 --> 03:23:00,369
WHICH IS HELPFUL BECAUSE I AM AN

5526
03:23:00,369 --> 03:23:00,736
EPIDEMIOLOGIST. 

5527
03:23:00,736 --> 03:23:02,504
AND BUT PRESENTING IT TO 

5528
03:23:02,504 --> 03:23:04,573
COMMUNITY PARTNERS WE WORK WITH.

5529
03:23:04,573 --> 03:23:07,810
THEY ARE LIKE, WELL, IF YOU 

5530
03:23:07,810 --> 03:23:09,011
ASSUME EVERYONE WALKS OF PLACES 

5531
03:23:09,011 --> 03:23:10,712
LEFT OUT. 

5532
03:23:10,712 --> 03:23:12,114
YOU ASSUME SOMEONE DRIVES AND. 

5533
03:23:12,114 --> 03:23:14,116
NO TRAFFIC, WE ARE DOING VERY 

5534
03:23:14,116 --> 03:23:14,316
WELL. 

5535
03:23:14,316 --> 03:23:16,185
NONE OF THOSE ARE REASONABLE 

5536
03:23:16,185 --> 03:23:18,053
ASSUMPTION SO WE HAVE TO THINK 

5537
03:23:18,053 --> 03:23:18,954
LITTLE BIT BEYOND THAT. 

5538
03:23:18,954 --> 03:23:21,557
SO, RIGHT. 

5539
03:23:21,557 --> 03:23:22,791
THAT IS MY QUESTION THAT WE CAME

5540
03:23:22,791 --> 03:23:23,826
DOWN TO. 

5541
03:23:23,826 --> 03:23:25,861
DOING WELL AND AREN'T SERVICE 

5542
03:23:25,861 --> 03:23:26,195
DECISIONERS. 

5543
03:23:26,195 --> 03:23:27,096
THE REASON WE HAVE SEEN THIS 

5544
03:23:27,096 --> 03:23:31,433
GOING UP IS SOMETHING ELSE. 

5545
03:23:31,433 --> 03:23:33,836
I MEAN, I THINK THERE ARE 

5546
03:23:33,836 --> 03:23:35,971
SERVICE DESERTS, FIRST OF ALL. 

5547
03:23:35,971 --> 03:23:37,773
BUT -- BUT THEY ARE NOT ABLE TO 

5548
03:23:37,773 --> 03:23:38,740
BE CAPTURED IN THIS WAY. 

5549
03:23:38,740 --> 03:23:40,409
AND I AM ABOUT TO SHOW YOU, YOU 

5550
03:23:40,409 --> 03:23:42,077
KNOW, WHAT HI THINK MAKES THE 

5551
03:23:42,077 --> 03:23:43,212
STRONG EPPS CASE FOR THAT WHICH 

5552
03:23:43,212 --> 03:23:45,514
IS -- AND THAT'S WHY I AM GLAD 

5553
03:23:45,514 --> 03:23:47,449
WE DID THIS SURVEY -- WHAT IS 

5554
03:23:47,449 --> 03:23:50,352
OFFERED AND WHEN IS IT TO 

5555
03:23:50,352 --> 03:23:51,553
OFFERED?

5556
03:23:51,553 --> 03:23:53,689
I WILL SHOW YOU THE DAY-BY-DAY 

5557
03:23:53,689 --> 03:23:55,958
-- DAYS OF THE WEEK. 

5558
03:23:55,958 --> 03:23:58,527
WHERE SSPs ARE OPERATING. 

5559
03:23:58,527 --> 03:24:00,429
THIS IS A FIVE-MINUTE TO 

5560
03:24:00,429 --> 03:24:01,430
TEN-MINUTE DRIVE TIME. 

5561
03:24:01,430 --> 03:24:04,700
THIS IS, AGAIN, ASSUME NOTHING 

5562
03:24:04,700 --> 03:24:05,234
PROBLEM. 

5563
03:24:05,234 --> 03:24:06,135
UNREASONABLE ASSUMPTION. 

5564
03:24:06,135 --> 03:24:07,469
I THINK THE IMPORTANT THING TO 

5565
03:24:07,469 --> 03:24:08,470
REMEMBER THAT MOST PEOPLE 

5566
03:24:08,470 --> 03:24:10,739
IN L.A. WHO DRIVE HAVE A 

5567
03:24:10,739 --> 03:24:12,274
TOLERANCE FOR DRIVING LONGER 

5568
03:24:12,274 --> 03:24:14,143
THAN FIVE TO TEN MINUTES. 

5569
03:24:14,143 --> 03:24:16,145
WE EXPLICITLY INCLUDED THOSE AS 

5570
03:24:16,145 --> 03:24:18,881
SHORT TIMES TO KIND OF SPLIT THE

5571
03:24:18,881 --> 03:24:20,782
DISTANCE FOR WHAT PEOPLE MIGHT 

5572
03:24:20,782 --> 03:24:25,154
ACTUALLY DO. 

5573
03:24:25,154 --> 03:24:27,022
THERE ARE A LOT OF SYRINGE 

5574
03:24:27,022 --> 03:24:28,123
SERVICE PROGRAMS. 

5575
03:24:28,123 --> 03:24:29,525
THE LITTLE GREEN DOTS ARE ALL 

5576
03:24:29,525 --> 03:24:33,762
THE DIFFERENT SSPs THANK ARE 

5577
03:24:33,762 --> 03:24:34,630
OPERATING AND THESE ARE 

5578
03:24:34,630 --> 03:24:35,497
INCLUDED. 

5579
03:24:35,497 --> 03:24:36,932
-- SOME OF THEME ARE OPEN FOR 

5580
03:24:36,932 --> 03:24:38,033
TWO HOURS ON MONDAY. 

5581
03:24:38,033 --> 03:24:39,735
SOME OF THEM ARE OPEN ALL DAY. 

5582
03:24:39,735 --> 03:24:41,336
SOME ARE OPEN ALL DAY, EVERY 

5583
03:24:41,336 --> 03:24:42,437
DAY, THE WEEKDAY. 

5584
03:24:42,437 --> 03:24:43,438
SOME ARE OPEN AT NIGHT. 

5585
03:24:43,438 --> 03:24:45,107
ALL OVER THE PLACE. 

5586
03:24:45,107 --> 03:24:48,477
AND, YOU KNOW, URGENTING AN IDEA

5587
03:24:48,477 --> 03:24:50,812
THAT THERE IS REASONABLE 

5588
03:24:50,812 --> 03:24:52,915
COVERAGE AROUND ON MONDAY. 

5589
03:24:52,915 --> 03:24:54,349
HOW IS TUESDAY LOOK?

5590
03:24:54,349 --> 03:24:55,684
TUESDAY, LITTLE LESS. 

5591
03:24:55,684 --> 03:24:57,219
NOT AS MUCH HAPPENING ON 

5592
03:24:57,219 --> 03:24:57,486
TUESDAY. 

5593
03:24:57,486 --> 03:24:59,354
IF YOU WANT TO GO GENT YOUR 

5594
03:24:59,354 --> 03:25:01,757
STERILE SYRINGES ON TUESDAY, YOU

5595
03:25:01,757 --> 03:25:05,260
WON'T HAVE AS MANY CHOICES. 

5596
03:25:05,260 --> 03:25:08,430
WEDNESDAY, YOU SEA THIS BIG ONE 

5597
03:25:08,430 --> 03:25:14,736
OUT PAMONA WHICH IS IMPORTANT 

5598
03:25:14,736 --> 03:25:16,405
BECAUSE THE NEIGHBORING COUNTY 

5599
03:25:16,405 --> 03:25:21,310
DOES NOT CURRENTLY ALLOW FOR 

5600
03:25:21,310 --> 03:25:22,844
SYRINGE EXCHANGE AND PEOPLE 

5601
03:25:22,844 --> 03:25:25,380
DRIVE FROM ORANGE COUNTY TO GET 

5602
03:25:25,380 --> 03:25:25,747
SUPPLIES. 

5603
03:25:25,747 --> 03:25:27,449
THURSDAY, SAME DEAL. 

5604
03:25:27,449 --> 03:25:33,322
AND -- LIKE, YOU KNOW, IF I WERE

5605
03:25:33,322 --> 03:25:40,562
WAVING A MAGIC WAND. 

5606
03:25:40,562 --> 03:25:44,299
AND LOTS OF PEOPLE TO DO ALL OUR

5607
03:25:44,299 --> 03:25:47,402
TIME AND AGNOSTIC AND PEOPLE 

5608
03:25:47,402 --> 03:25:48,503
THAT PICK UP BEFORE WEEK 

5609
03:25:48,503 --> 03:25:50,205
JENNIFER AS WE THINK OF PEOPLE 

5610
03:25:50,205 --> 03:25:52,874
USING DRUGS IN DIFFERENT WAYS 

5611
03:25:52,874 --> 03:25:55,410
LIKE DAILY VERSUS EVENT-BASED OR

5612
03:25:55,410 --> 03:25:56,812
FOR PARTYING. 

5613
03:25:56,812 --> 03:25:58,347
I WOULD WANT TO HAVE MORE 

5614
03:25:58,347 --> 03:25:59,681
COVERAGE ON WEEKENDS. 

5615
03:25:59,681 --> 03:26:01,516
ALSO, IT IS HARD TO GET PEOPLE 

5616
03:26:01,516 --> 03:26:03,518
TO WORK THAT TIME. 

5617
03:26:03,518 --> 03:26:05,487
UH-OH, SATURDAY, NOT GREAT. 

5618
03:26:05,487 --> 03:26:09,291
SORRY, I FORGOT THE IMPORTANT 

5619
03:26:09,291 --> 03:26:09,524
NOTE. 

5620
03:26:09,524 --> 03:26:10,158
THE GREEN DOTS ARE WHERE 

5621
03:26:10,158 --> 03:26:13,195
THE SSPs ARE. 

5622
03:26:13,195 --> 03:26:15,430
THE ONES WITH NO RADIUS AROUND, 

5623
03:26:15,430 --> 03:26:18,300
THEY ARE NOT OPEN ON THAT DAY. 

5624
03:26:18,300 --> 03:26:20,402
SOME SATURDAY, NOT A WHOLE LOT 

5625
03:26:20,402 --> 03:26:21,270
GOING OBJECT. 

5626
03:26:21,270 --> 03:26:23,739
AND SUNDAY, ALSO NOT A LOT GOING

5627
03:26:23,739 --> 03:26:25,607
ON, BUT AT LEAST SOMETHING IN 

5628
03:26:25,607 --> 03:26:26,508
LONG BEACH. 

5629
03:26:26,508 --> 03:26:30,946
AND I KNOW R SOME MOBILE SITES. 

5630
03:26:30,946 --> 03:26:33,949
ALL THESE DISORDERS SAYS IT NOT 

5631
03:26:33,949 --> 03:26:37,753
JUST GEOSPATIAL ANALYSIS HERE. 

5632
03:26:37,753 --> 03:26:39,187
ONE OF THE EARLIER SPEAKERS WITH

5633
03:26:39,187 --> 03:26:41,256
AS TALKING ABOUT, IT IS NOT JUST

5634
03:26:41,256 --> 03:26:42,991
-- YOU KNOW WE HAVE TO THINK 

5635
03:26:42,991 --> 03:26:44,526
ABOUT -- NOT JUST THE SPAESHZ 

5636
03:26:44,526 --> 03:26:47,029
EVER SPATIAL PART WITH THE 

5637
03:26:47,029 --> 03:26:47,296
MAPPING. 

5638
03:26:47,296 --> 03:26:49,698
IT IS ALSO -- IT IS ALSO THE 

5639
03:26:49,698 --> 03:26:51,133
TIME HERE. 

5640
03:26:51,133 --> 03:26:52,934
SO IF -- I HAVE BEEN VERY 

5641
03:26:52,934 --> 03:26:54,770
CURIOUS OF ANY ATTENDEES THAT 

5642
03:26:54,770 --> 03:26:57,039
HAVE MORE EXPERTISE IN THE 

5643
03:26:57,039 --> 03:26:58,340
GEOGRAPHY ON THE MAPPING PART OF

5644
03:26:58,340 --> 03:27:00,876
THIS HAVE AN IDEA HOW TO HANDLE 

5645
03:27:00,876 --> 03:27:03,545
THIS WHERE THERE IS TIME VARYING

5646
03:27:03,545 --> 03:27:04,212
AVAILABILITY OF SERVICES. 

5647
03:27:04,212 --> 03:27:06,014
YOU KNOW WE HAVE BEEN TALKING OF

5648
03:27:06,014 --> 03:27:07,282
DIFFERENT THINGS SIN WE HAVE 

5649
03:27:07,282 --> 03:27:08,317
SEEN THESE RESULTS HOW TO 

5650
03:27:08,317 --> 03:27:11,420
PRESENT THIS IN A WAY THAT IS 

5651
03:27:11,420 --> 03:27:14,189
USABLE TO OUR PARTNERS BEYOND --

5652
03:27:14,189 --> 03:27:17,793
BEYOND THE MAPS AND SHOWING, 

5653
03:27:17,793 --> 03:27:21,563
HEY, IT IS HARD TO HAVE 

5654
03:27:21,563 --> 03:27:22,464
DECISIONS ON SATURDAY. 

5655
03:27:22,464 --> 03:27:23,265
COMMUNITY PARTIES KNOW THAT. 

5656
03:27:23,265 --> 03:27:25,667
AND THEY ARE ALL WORKING AND 

5657
03:27:25,667 --> 03:27:29,738
TAGS BIG -- BIG INTERCONNECTED 

5658
03:27:29,738 --> 03:27:31,506
CONVERSATION, OF COURSE, WHICH 

5659
03:27:31,506 --> 03:27:32,808
INCLUDE VALUING PEOPLE'S SKILLS 

5660
03:27:32,808 --> 03:27:34,309
AND EXPERIENCES AND COMPENSATING

5661
03:27:34,309 --> 03:27:37,312
THE KIND OF ROLES LIKE PASSING 

5662
03:27:37,312 --> 03:27:39,348
OUT CLEAN, STERILE SYRINGES THAT

5663
03:27:39,348 --> 03:27:44,119
IT IS -- YOU KNOW, HARDER TO GET

5664
03:27:44,119 --> 03:27:44,953
PEOPLE TO WORK ON WEEKS 

5665
03:27:44,953 --> 03:27:45,220
WEEKENDS. 

5666
03:27:45,220 --> 03:27:46,321
DOES YOU IT MAKE A DIFFERENCE?

5667
03:27:46,321 --> 03:27:47,255
WE ARE NOT SURE. 

5668
03:27:47,255 --> 03:27:49,758
I FEEL LIKE I AM MOSTLY RAISING 

5669
03:27:49,758 --> 03:27:51,326
QUESTIONS. 

5670
03:27:51,326 --> 03:27:53,729
BUT ALSO SHOWING THAT -- 

5671
03:27:53,729 --> 03:27:56,164
THINKING ABOUT IT THIS WAY IS --

5672
03:27:56,164 --> 03:27:59,735
HAS BEEN HELPFUL FOR US IN SORT 

5673
03:27:59,735 --> 03:28:01,770
OF MOVING BEYOND OUR ORIGINAL 

5674
03:28:01,770 --> 03:28:03,638
THING -- WHERE ARE SERVICES NOT 

5675
03:28:03,638 --> 03:28:04,873
BEING OFFERED. 

5676
03:28:04,873 --> 03:28:08,076
AND IT IS NOT JUST -- OKAY, 

5677
03:28:08,076 --> 03:28:09,745
WHERE IS THE BRICK AND MORTARS, 

5678
03:28:09,745 --> 03:28:12,214
BUT WHERE ARE MOBILE UNITS 

5679
03:28:12,214 --> 03:28:12,681
GOING. 

5680
03:28:12,681 --> 03:28:14,716
AND I GUESS A POLICY THING THAT 

5681
03:28:14,716 --> 03:28:17,319
MAKES IT MORE RELEVANT IN 

5682
03:28:17,319 --> 03:28:19,955
CALIFORNIA. 

5683
03:28:19,955 --> 03:28:22,023
IN THE LAST FEW YEARS AND 

5684
03:28:22,023 --> 03:28:24,926
INSURANCE BE IN MEDICAID, 

5685
03:28:24,926 --> 03:28:26,962
MEDICAL WILL BE TO REIMBURSEMENT

5686
03:28:26,962 --> 03:28:28,163
FOR MOBILE SERVICES. 

5687
03:28:28,163 --> 03:28:30,098
A LOT MORE NEW PROVIDERS HAVE 

5688
03:28:30,098 --> 03:28:31,099
ENTERED THIS AND THAT WAS PART 

5689
03:28:31,099 --> 03:28:33,135
OF THE REASON FOR TRYING TO DO 

5690
03:28:33,135 --> 03:28:33,335
THIS. 

5691
03:28:33,335 --> 03:28:38,573
OKAY, WE DO AS MUCH AS WE CAN 

5692
03:28:38,573 --> 03:28:45,347
AND I GUESS SERVICE AND TALK 

5693
03:28:45,347 --> 03:28:48,483
ABOUT IT IN LCHDA. SKID ROW IS 

5694
03:28:48,483 --> 03:28:49,584
SOMEWHERE THERE THERE IS AGREE 

5695
03:28:49,584 --> 03:28:51,286
AMOUNT OF NEED AND SERVICES AND 

5696
03:28:51,286 --> 03:28:52,387
WHEN PEOPLE -- WHEN NEW GROUPS 

5697
03:28:52,387 --> 03:28:54,423
ARE COMING IN, THEY SAY WHERE DO

5698
03:28:54,423 --> 03:28:55,190
I GO. 

5699
03:28:55,190 --> 03:28:56,458
I GO TO SKID ROW. 

5700
03:28:56,458 --> 03:28:57,993
LOOK, A BIG HOT SPOT IN THE 

5701
03:28:57,993 --> 03:29:00,796
VALLEY AND A BIG HOT SPOT IN 

5702
03:29:00,796 --> 03:29:01,997
LONG BEACH WHERE THERE AREN'T AS

5703
03:29:01,997 --> 03:29:04,065
MANY SERVICES. 

5704
03:29:04,065 --> 03:29:06,101
SO I THINK THAT AT THE RISK OF 

5705
03:29:06,101 --> 03:29:08,203
GETTING TOO LOST IN THE LITTLE, 

5706
03:29:08,203 --> 03:29:11,840
I GUESS, PROVENCIAL DETAILS OF 

5707
03:29:11,840 --> 03:29:12,774
MAPS OF LOS ANGELES. 

5708
03:29:12,774 --> 03:29:15,243
WHAT IT SORT OF SHOWS IS THAT, 

5709
03:29:15,243 --> 03:29:17,078
YOU KNOW, ZOOMING IN AND ZOOMING

5710
03:29:17,078 --> 03:29:19,481
OUT, YOU GET A DIFFERENT PICTURE

5711
03:29:19,481 --> 03:29:22,250
OF WHAT THE DIFFERENT ACCESS 

5712
03:29:22,250 --> 03:29:22,818
THINGS ARE. 

5713
03:29:22,818 --> 03:29:25,387
WE HAVEN'T TOUCHED ON ALL THE 

5714
03:29:25,387 --> 03:29:27,456
IMPORTANT QUALITATIVE THINGS 

5715
03:29:27,456 --> 03:29:31,927
RELATED TO SERVICE ACCESS THAT 

5716
03:29:31,927 --> 03:29:34,262
MIGHT MAKE SOMETHING OTHER 

5717
03:29:34,262 --> 03:29:36,765
BARRIERS WITH RAW, GEOGRAPHIC 

5718
03:29:36,765 --> 03:29:37,065
ASSISTANCE. 

5719
03:29:37,065 --> 03:29:38,800
AND WHERE DO WE GO FROM HERE?

5720
03:29:38,800 --> 03:29:40,001
I SHOULD HAVE SHOWED THIS 

5721
03:29:40,001 --> 03:29:42,270
QUESTION EARLIER BECAUSE I JUST 

5722
03:29:42,270 --> 03:29:43,772
TRIED TO ANSWER THAT. 

5723
03:29:43,772 --> 03:29:45,240
IN THE SENSE THAT WE ARE TRYING 

5724
03:29:45,240 --> 03:29:47,642
TO FIGURE OUT HOW TO 

5725
03:29:47,642 --> 03:29:51,480
SYSTEMATICALLY ACCOUNT FOR TIME 

5726
03:29:51,480 --> 03:29:53,281
VARYING AVAILABILITIES, AS WELL 

5727
03:29:53,281 --> 03:29:55,484
AS HOW DO WE PRESENT -- LIKE HOW

5728
03:29:55,484 --> 03:30:01,122
-- LIKE HOW MIGHT THIS 

5729
03:30:01,122 --> 03:30:02,591
INFORMATION GUIDE POLICY LOCALLY

5730
03:30:02,591 --> 03:30:04,759
AND ALSO GUIDE HOW WE THINK 

5731
03:30:04,759 --> 03:30:06,595
ABOUT IT IF WE ARE MACKING IN A 

5732
03:30:06,595 --> 03:30:07,929
LARGER OTHER AREA. 

5733
03:30:07,929 --> 03:30:09,431
THANK YOU, AGAIN, TO MY TEAM. 

5734
03:30:09,431 --> 03:30:11,233
ESPECIALLY THE FOLKS I MENTIONED

5735
03:30:11,233 --> 03:30:12,300
EARLIER BY NAME AS WELL AS OUR 

5736
03:30:12,300 --> 03:30:14,035
MUCH LARGER GROUP. 

5737
03:30:14,035 --> 03:30:15,370
THERE IS MAY E-MAIL. 

5738
03:30:15,370 --> 03:30:18,540
HAPPY TO TAKE QUESTIONS. 

5739
03:30:18,540 --> 03:30:21,643
>> THANK YOU, DR. SLOVER,
FOR A 

5740
03:30:21,643 --> 03:30:23,578
VERY INFORMATIVE SESSION, AND 

5741
03:30:23,578 --> 03:30:26,248
TALKING OF THE INTRICACIES AND 

5742
03:30:26,248 --> 03:30:30,552
COMPLEXITY OF GEOGRAPHY, TIMING,

5743
03:30:30,552 --> 03:30:34,656
OPERATIONALIZATION OF WHAT 

5744
03:30:34,656 --> 03:30:36,858
DESERT MEMBERS AND MANY OTHERS. 

5745
03:30:36,858 --> 03:30:38,126
SO AT THIS TIME, WE UP FOR 

5746
03:30:38,126 --> 03:30:38,426
DISCUSSION. 

5747
03:30:38,426 --> 03:30:39,661
WE ARE AHEAD OF TIME, BUT WE 

5748
03:30:39,661 --> 03:30:42,230
WILL -- WE WILL HAVE TEN MINUTES

5749
03:30:42,230 --> 03:30:43,565
OF DISCUSSION UNLESS THERE IS 

5750
03:30:43,565 --> 03:30:45,767
MORE QUESTIONS COMING IN THROUGH

5751
03:30:45,767 --> 03:30:47,702
THE AUDIENCES. 

5752
03:30:47,702 --> 03:30:52,941
SO -- I DO SEE ONE QUESTION HERE

5753
03:30:52,941 --> 03:30:53,542
OR TWO. 

5754
03:30:53,542 --> 03:31:01,750
FIRST ONE THAT I SEE IS WHY WAYS

5755
03:31:01,750 --> 03:31:04,319
TO TRANSPORT STK. 

5756
03:31:04,319 --> 03:31:07,622
THAT IS FOR DR. SHOVER. 

5757
03:31:07,622 --> 03:31:09,691
>> FUNNY, NONREGULAR RUSS
IDEAS 

5758
03:31:09,691 --> 03:31:11,793
OF HOW TO DEAL WITH THIS, PICK A

5759
03:31:11,793 --> 03:31:14,362
RANDOM TIME OF DAY AND USE 

5760
03:31:14,362 --> 03:31:15,530
GOOGLE MAPS AND SOME SORT OF APP

5761
03:31:15,530 --> 03:31:17,265
AND DO IT THAT WAY. 

5762
03:31:17,265 --> 03:31:19,100
THAT IS DEFINITELY SOMETHING WE 

5763
03:31:19,100 --> 03:31:21,403
ARE EXPLORING DURING -- DOING IT

5764
03:31:21,403 --> 03:31:21,970
THAT WAY. 

5765
03:31:21,970 --> 03:31:24,706
WE NEED TO FIGURE OUT HOW TO 

5766
03:31:24,706 --> 03:31:31,780
MAKE IT, LIKE PALATABLE TO 

5767
03:31:31,780 --> 03:31:33,715
PEOPLE WHO HAVE THE GEOSPATIAL 

5768
03:31:33,715 --> 03:31:36,952
MODELING EXPERTISE. 

5769
03:31:36,952 --> 03:31:38,853
>> THANK YOU SO MUCH. 

5770
03:31:38,853 --> 03:31:41,690
I SEE ANOTHER QUESTION ABOUT 

5771
03:31:41,690 --> 03:31:44,659
VERY INTERESTING ANALYSIS. 

5772
03:31:44,659 --> 03:31:47,195
DO YOU HAVE TIME OF DAY/NIGHT?

5773
03:31:47,195 --> 03:31:49,497
>> I DON'T HAVE THOSE MAPS

5774
03:31:49,497 --> 03:31:52,200
READY, BUT IT IS SOMETHING THAT 

5775
03:31:52,200 --> 03:31:55,303
WE HAVE LOOKED AT. 

5776
03:31:55,303 --> 03:31:57,072
SO, YES, I THINK THAT -- THANK 

5777
03:31:57,072 --> 03:31:58,373
YOU FOR ASKING THAT QUESTION. 

5778
03:31:58,373 --> 03:32:00,308
IT ADDS AMMUNITION TO MY POINT 

5779
03:32:00,308 --> 03:32:01,776
THAT I THINK WE REALLY SHOULD BE

5780
03:32:01,776 --> 03:32:04,613
SHOWING THAT, EVEN IF IT IS A 

5781
03:32:04,613 --> 03:32:06,247
LITTLE UNORTHODOX AS FAR AS 

5782
03:32:06,247 --> 03:32:07,315
MAPPING GOES. 

5783
03:32:07,315 --> 03:32:09,751
LIKE, HEY, IT IS 5:00. 

5784
03:32:09,751 --> 03:32:14,222
WHERE CAN I GEL A STERILE 

5785
03:32:14,222 --> 03:32:14,589
SYRINGE. 

5786
03:32:14,589 --> 03:32:16,558
>> THANK YOU SO MUCH. 

5787
03:32:16,558 --> 03:32:20,795
I DO HAVE A -- PERHAPS ONE FOR 

5788
03:32:20,795 --> 03:32:23,331
YOU QUESTIONS AS WE WAIT TO SEE 

5789
03:32:23,331 --> 03:32:24,699
IF THERE ARE OTHERS AS WELL. 

5790
03:32:24,699 --> 03:32:25,767
DR. JOHANNES EICHSTAEDT. 

5791
03:32:25,767 --> 03:32:26,768
CAN YOU SHARE WITH US THE 

5792
03:32:26,768 --> 03:32:30,171
COMPLEXITY OF THE DATA PROCESSES

5793
03:32:30,171 --> 03:32:30,639
OF SOCIAL MEDIA. 

5794
03:32:30,639 --> 03:32:33,475
AND I UNDERSTAND -- I'M CURIOUS 

5795
03:32:33,475 --> 03:32:37,212
TO SEE HOW THE MORE REALTIME THE

5796
03:32:37,212 --> 03:32:40,181
DAY AT THAT COMES IN AND HOW 

5797
03:32:40,181 --> 03:32:41,249
POTENTIALLY OPPORTUNITIES I 

5798
03:32:41,249 --> 03:32:42,784
GUESS ON UNDERSTANDING THAT 

5799
03:32:42,784 --> 03:32:45,720
MERGING LANDSCAPE, CHANGING 

5800
03:32:45,720 --> 03:32:46,955
AMOUNT OF DRUGS USING SOCIAL 

5801
03:32:46,955 --> 03:32:49,024
MEDIA DATA. 

5802
03:32:49,024 --> 03:32:53,762
>> YEAH, SO I WILL SAY
THAT, YOU

5803
03:32:53,762 --> 03:32:56,197
KNOW, IN PRINCIPLE REALTIME. 

5804
03:32:56,197 --> 03:32:59,167
AND -- [ LAUGHTER ] -- AND 

5805
03:32:59,167 --> 03:33:01,336
REALTIME IN THE REAL WORLD, 

5806
03:33:01,336 --> 03:33:03,805
THERE ARE MORE COMMERCIAL GRADE 

5807
03:33:03,805 --> 03:33:05,273
IMPLEMENTATIONS OF THIS. 

5808
03:33:05,273 --> 03:33:06,708
WE ARE SCIENTISTS AND 

5809
03:33:06,708 --> 03:33:08,543
BOOT-STRAPPING IT ON RELATIVELY 

5810
03:33:08,543 --> 03:33:09,210
INEXPENSIVE HARDWARE. 

5811
03:33:09,210 --> 03:33:11,212
ORDER OF MAGNITUDE ONE OF OUR 

5812
03:33:11,212 --> 03:33:13,014
SERVICES COST $50,000. 

5813
03:33:13,014 --> 03:33:14,516
CLUSTER COST $50,000. 

5814
03:33:14,516 --> 03:33:16,451
IF WE WERE TO DO THIS IN A 

5815
03:33:16,451 --> 03:33:18,219
COMMERCIAL WAY, YOU COULD DO 

5816
03:33:18,219 --> 03:33:19,421
WHAT IS CALLED STREAMING 

5817
03:33:19,421 --> 03:33:19,788
IMPLEMENTATION. 

5818
03:33:19,788 --> 03:33:21,690
YOU GET THE DATA AND PROCESS THE

5819
03:33:21,690 --> 03:33:23,491
DATA AND PROCESS THE DATA OUT. 

5820
03:33:23,491 --> 03:33:25,660
IN PRINCIPLE, THAT CAN RUN 

5821
03:33:25,660 --> 03:33:26,628
NIGHTLY. 

5822
03:33:26,628 --> 03:33:27,595
THERE IS NO REASON WHY YOU CAN'T

5823
03:33:27,595 --> 03:33:29,698
DO THIS WITH A DAY'S WORTH OF 

5824
03:33:29,698 --> 03:33:30,432
DEFENSE LAY. 

5825
03:33:30,432 --> 03:33:32,600
CONSTRAIN IS ACCESS TO DATA AT 

5826
03:33:32,600 --> 03:33:36,438
THE MOMENT. SO -- SO BOTH REDDIT

5827
03:33:36,438 --> 03:33:40,341
AND TWIPT TWIT HAS SHUT DOWN 

5828
03:33:40,341 --> 03:33:42,977
THE APIs FACE WHERE IS THE 

5829
03:33:42,977 --> 03:33:45,747
COMPUTERS CONNECT TO GET THE 

5830
03:33:45,747 --> 03:33:46,448
DATA. 

5831
03:33:46,448 --> 03:33:48,416
REDDIT DATA YOU CAN OBTAIN ON 

5832
03:33:48,416 --> 03:33:52,387
THE OPEN WEB AS OF AUGUST 2024. 

5833
03:33:52,387 --> 03:33:53,621
THERE ARE SOURCE FOR THIS KIND 

5834
03:33:53,621 --> 03:33:55,590
OF DATA THAT STILL WORKS AND 

5835
03:33:55,590 --> 03:33:58,293
WITH TWITTER IT IS EVOLVING. 

5836
03:33:58,293 --> 03:33:59,527
IN THE EUROPEAN UNION, LAWS HAVE

5837
03:33:59,527 --> 03:34:00,995
BEEN PASSED THAT RESEARCHERS 

5838
03:34:00,995 --> 03:34:02,530
NEED ACCESS TO THIS KIND OF 

5839
03:34:02,530 --> 03:34:03,031
DATA. 

5840
03:34:03,031 --> 03:34:04,065
I THINK THAT IS A GREAT STEP 

5841
03:34:04,065 --> 03:34:05,133
FORWARD AND MAYBE SOMETHING TO 

5842
03:34:05,133 --> 03:34:08,136
PACK THE -- OKAY, THAT WAS DATA 

5843
03:34:08,136 --> 03:34:08,403
REALTIME. 

5844
03:34:08,403 --> 03:34:09,604
YOUR SECOND QUESTION. 

5845
03:34:09,604 --> 03:34:11,039
YEAH, WE THINK THAT IS ACTUALLY 

5846
03:34:11,039 --> 03:34:13,141
ONE OF THE MOST PROMISING 

5847
03:34:13,141 --> 03:34:13,775
APPLICATIONS ARE SOCIAL MEDIA 

5848
03:34:13,775 --> 03:34:15,643
THAT YOU CAN GET AN EARLY 

5849
03:34:15,643 --> 03:34:18,012
WARNING SYSTEM FOR UPCOMING 

5850
03:34:18,012 --> 03:34:18,413
SUBSTANCES. 

5851
03:34:18,413 --> 03:34:21,049
SO WE -- WE SAW VERY GOOD 

5852
03:34:21,049 --> 03:34:23,218
RESOLUTION, FOR EXAMPLE, F

5853
03:34:23,218 --> 03:34:23,785
FOR CRATUM. 

5854
03:34:23,785 --> 03:34:27,789
IT WAS MEMEKING FOR A WHILE AND 

5855
03:34:27,789 --> 03:34:30,291
WE GOT A LOT OF SIGNAL AND YOU 

5856
03:34:30,291 --> 03:34:33,762
CAN MA'AM THAT NEAR REALTIME, 

5857
03:34:33,762 --> 03:34:35,163
YOU CAN MINE PARTICULARLY 

5858
03:34:35,163 --> 03:34:35,897
PARTICULATE HONESTLY AT THE 

5859
03:34:35,897 --> 03:34:40,135
MOMENT FOR THIS KIND OF 

5860
03:34:40,135 --> 03:34:40,468
INFORMATION. 

5861
03:34:40,468 --> 03:34:43,171
-- TIK TOK HONESTLY AT THE 

5862
03:34:43,171 --> 03:34:44,038
MOMENT FOR THIS INFORMATION. 

5863
03:34:44,038 --> 03:34:45,473
>> I HAVE A QUESTION
COMING IN. 

5864
03:34:45,473 --> 03:34:48,543
WHAT IS THE BENEFIT USING TWEETS

5865
03:34:48,543 --> 03:34:50,311
OVER GOOGLE SEARCH FOR TRENDS?

5866
03:34:50,311 --> 03:34:52,514
>> WELL, ALSO -- A GOOD 

5867
03:34:52,514 --> 03:34:53,414
QUESTION. 

5868
03:34:53,414 --> 03:34:56,151
AND WE HAVE A PAPER BAKING OFF 

5869
03:34:56,151 --> 03:34:58,520
TWEETS AGAINST GOOGLE SEARCH 

5870
03:34:58,520 --> 03:34:58,720
DATA. 

5871
03:34:58,720 --> 03:35:01,456
ONE THING TO KNOW OF GOOGLE 

5872
03:35:01,456 --> 03:35:02,157
SEARCH DATA. 

5873
03:35:02,157 --> 03:35:05,527
GOOGLE TRENDS AREA FROM THE DNA,

5874
03:35:05,527 --> 03:35:09,130
DESIGNATED MODEL AREA LIKE NSAs 

5875
03:35:09,130 --> 03:35:10,598
AND QUIRKY AND PURELY MARKETING 

5876
03:35:10,598 --> 03:35:12,667
-- MARKETING UNIT. 

5877
03:35:12,667 --> 03:35:13,768
SO THAT PRESENTS A CHALLENGE. 

5878
03:35:13,768 --> 03:35:18,573
SO IGNORING THAT SORT OF DATA 

5879
03:35:18,573 --> 03:35:19,340
LINKAGE STUFF IS PROBABLY GOING 

5880
03:35:19,340 --> 03:35:21,509
TO BE FAIRLY SIMILAR, HONESTLY. 

5881
03:35:21,509 --> 03:35:24,245
MORE OF THE KEYWORD THAN THE 

5882
03:35:24,245 --> 03:35:26,447
GENERAL DISTRESS ROUTE. 

5883
03:35:26,447 --> 03:35:30,418
PROBABLY MORE GOOGLE TRENDS, AND

5884
03:35:30,418 --> 03:35:31,853
PARAPHERNALIA, SOME SUCH PLY 

5885
03:35:31,853 --> 03:35:33,388
RATHER THAN -- RATHER THAN SORT 

5886
03:35:33,388 --> 03:35:36,424
OF THE GENERALIZED POPULATION 

5887
03:35:36,424 --> 03:35:38,393
DESPAIR THAT WE THINK TRANSLATES

5888
03:35:38,393 --> 03:35:39,794
INTO DRUG TAKING. 

5889
03:35:39,794 --> 03:35:41,162
BUT WORTH EXPLORING. 

5890
03:35:41,162 --> 03:35:44,098
HARD TO GET ACCESS TO THE DATA. 

5891
03:35:44,098 --> 03:35:45,366
>> ALL RIGHT. 

5892
03:35:45,366 --> 03:35:46,935
THANK YOU SO MUCH. 

5893
03:35:46,935 --> 03:35:48,102
DEALERSHIP HAVE ONE QUESTION FOR

5894
03:35:48,102 --> 03:35:50,471
DR. SHOVER. 

5895
03:35:50,471 --> 03:35:53,208
A COMMENT OF THE SENSITIVITY 

5896
03:35:53,208 --> 03:35:55,677
ANALYSIS, BUT THEN PRESENTING 

5897
03:35:55,677 --> 03:35:57,178
THOSE NUANCES TO THE 

5898
03:35:57,178 --> 03:35:59,280
DECISIONMAKERS OF THE DATA. 

5899
03:35:59,280 --> 03:35:59,881
AND THE CHALLENGE. 

5900
03:35:59,881 --> 03:36:01,749
I WOULD LIKE TO SEE IF YOU HAVE 

5901
03:36:01,749 --> 03:36:03,184
ANY FURTHER ELABORATION OF HOW 

5902
03:36:03,184 --> 03:36:05,720
THE PROCESS WORKS OR IF THERE 

5903
03:36:05,720 --> 03:36:09,424
ARE WAYS TO MAKE THE DATA KIND 

5904
03:36:09,424 --> 03:36:10,859
OF MORE DIGESTIBLE TO THE PEOPLE

5905
03:36:10,859 --> 03:36:14,662
WHO ARE MAKING THE DECISIONS. 

5906
03:36:14,662 --> 03:36:16,297
>> YEAH, THEIR IS A GREAT 

5907
03:36:16,297 --> 03:36:17,131
QUESTION. 

5908
03:36:17,131 --> 03:36:19,267
AND I SEE ANOTHER ONE IN THE 

5909
03:36:19,267 --> 03:36:21,002
CHAT THAT IS OF A PIECE OF THIS,

5910
03:36:21,002 --> 03:36:23,438
I THINK IT IS FOR ME. 

5911
03:36:23,438 --> 03:36:25,673
IT IS ABOUT -- SO -- YEAH, HOW 

5912
03:36:25,673 --> 03:36:29,277
DO YOU MAKE -- HOW DO YOU MAKE 

5913
03:36:29,277 --> 03:36:31,946
IT DIGESTIBLE?

5914
03:36:31,946 --> 03:36:37,752
WELL, I THINK -- YOU KNOW, I -- 

5915
03:36:37,752 --> 03:36:38,887
I THINK FOCUSED -- I THINK THERE

5916
03:36:38,887 --> 03:36:40,221
IS -- THERE IS A FEW DIFFERENT 

5917
03:36:40,221 --> 03:36:49,731
WAYS THAT I THOUGHT ABOUT IT. 

5918
03:36:49,731 --> 03:36:50,798
ONE WAY SERVICE BY SERVICE. 

5919
03:36:50,798 --> 03:36:52,467
THE REASON I WANTED TO TO THE 

5920
03:36:52,467 --> 03:36:54,502
SERVICE, WHEN WE SAY SRP, DOES 

5921
03:36:54,502 --> 03:36:56,404
THAT EVEN IN THE SAME THING 

5922
03:36:56,404 --> 03:36:56,804
ACROSS THE BOARD?

5923
03:36:56,804 --> 03:36:58,606
WITH THE EXCEPTION OF THE AREA 

5924
03:36:58,606 --> 03:37:00,308
THAT SPECIFICALLY PROHIBIT -- AT

5925
03:37:00,308 --> 03:37:02,744
LEAST AT THE TIME PASSING OUT 

5926
03:37:02,744 --> 03:37:03,645
SYRINGES AND INJECTING 

5927
03:37:03,645 --> 03:37:04,879
EQUIPMENT. 

5928
03:37:04,879 --> 03:37:09,951
IT WAS PRETTY CONSTANT FURTHER 

5929
03:37:09,951 --> 03:37:11,486
INTO THAT MAKING IT MORE 

5930
03:37:11,486 --> 03:37:12,020
COMPLICATED. 

5931
03:37:12,020 --> 03:37:13,221
SOME OF THE SERVICES THEY OFFER.

5932
03:37:13,221 --> 03:37:20,061
WE DO HAD HIV TESTING BUT ONLY 

5933
03:37:20,061 --> 03:37:21,763
THURSDAY NIGHT ONCE A MONTH. 

5934
03:37:21,763 --> 03:37:24,165
REASONABLE AMOUNT OF HIV TESTING

5935
03:37:24,165 --> 03:37:27,268
TO BE DONE MAYBE, BUT PRETTY 

5936
03:37:27,268 --> 03:37:28,236
DIFFERENT THAN IF IT WAS 

5937
03:37:28,236 --> 03:37:30,838
AVAILABLE ALL THE TIME AND I GET

5938
03:37:30,838 --> 03:37:32,473
WHY IT IS NOT IN TERM OF USING 

5939
03:37:32,473 --> 03:37:34,075
THE HIV TESTING COUNCIL THERE 

5940
03:37:34,075 --> 03:37:36,477
AND NEED ALL THE THE RESOURCES. 

5941
03:37:36,477 --> 03:37:38,346
SO SERVICE BY SERVICE IN TERMS 

5942
03:37:38,346 --> 03:37:42,884
OF WHERE YOU CAN GET, SAY SAFER 

5943
03:37:42,884 --> 03:37:43,818
SMOKING KITS. 

5944
03:37:43,818 --> 03:37:45,053
STERILE SYRINGES. 

5945
03:37:45,053 --> 03:37:51,025
WHY DO YOU DO RAPID START 

5946
03:37:51,025 --> 03:37:57,398
WITH BUPRENOPRINE. 

5947
03:37:57,398 --> 03:37:58,499
THINKING OF MAKING IT SERVICE BY

5948
03:37:58,499 --> 03:38:00,835
SERVICE IS A WAY TO MAKE IT 

5949
03:38:00,835 --> 03:38:02,103
EASIER TO UNDERSTAND IN TERMS OF

5950
03:38:02,103 --> 03:38:05,807
-- YOU KNOW, WHAT ARE THE GAP 

5951
03:38:05,807 --> 03:38:06,074
HERE. 

5952
03:38:06,074 --> 03:38:08,509
AND THEN THE QUESTION ABOUT THE 

5953
03:38:08,509 --> 03:38:12,680
GROWING POLITICAL ACT ABOUT HARM

5954
03:38:12,680 --> 03:38:13,748
REDUCTION SERVICES -- CONCERNS 

5955
03:38:13,748 --> 03:38:16,884
OF MAKING THESE MAPS PUBLICLY 

5956
03:38:16,884 --> 03:38:19,887
AVAILABLE FOR SSP LOCATIONS. 

5957
03:38:19,887 --> 03:38:27,095
YES THEY ARE NOT PUBLICLY 

5958
03:38:27,095 --> 03:38:27,395
AVAILABLE. 

5959
03:38:27,395 --> 03:38:28,596
YOU HAVE SEEN THEM BUT THEY ARE 

5960
03:38:28,596 --> 03:38:29,731
NOT OUTDATED. 

5961
03:38:29,731 --> 03:38:30,865
YOU ARE CERTAIN ABOUT THAT. 

5962
03:38:30,865 --> 03:38:39,507
THAT HAS BEEN A MAJOR -- 

5963
03:38:39,507 --> 03:38:40,508
SPECIFICALLY OF OVERDOSE DEATH 

5964
03:38:40,508 --> 03:38:43,244
AND NONFATAL OVERDOSE HAS BEEN 

5965
03:38:43,244 --> 03:38:44,645
TALK WITH THE DIFFERENT 

5966
03:38:44,645 --> 03:38:49,050
COMMUNITY MEMBERS AND HARM 

5967
03:38:49,050 --> 03:38:50,852
REDUCTION WORKERS AND GOVERNMENT

5968
03:38:50,852 --> 03:38:52,120
PUBLIC HEALTH PEOPLE. 

5969
03:38:52,120 --> 03:38:53,755
LIKE NO ONE WANTS -- NOBODY 

5970
03:38:53,755 --> 03:38:58,860
WANTS US TO PUT, HIKE, POI -- L 

5971
03:38:58,860 --> 03:39:01,029
POINTS ON THE MAP THAT YOU CAN 

5972
03:39:01,029 --> 03:39:01,696
ZOOM IN. 

5973
03:39:01,696 --> 03:39:03,698
I DON'T THINK I NEED TO EXPLAIN 

5974
03:39:03,698 --> 03:39:05,900
WHY NOBODY WANTS THAT. 

5975
03:39:05,900 --> 03:39:06,968
DISAGREEMENT IS HOW MUCH ZOOMING

5976
03:39:06,968 --> 03:39:08,102
OUT WE NEED TO DO. 

5977
03:39:08,102 --> 03:39:10,204
WE PROPOSED ZOOMING IT OUT TO 

5978
03:39:10,204 --> 03:39:11,939
THE CENSUS TRACT. 

5979
03:39:11,939 --> 03:39:14,308
I FEEL GOOD ABOUT THAT OF NOT 

5980
03:39:14,308 --> 03:39:15,043
ABOUT IDENTIFIABLE. 

5981
03:39:15,043 --> 03:39:17,011
BUT A LOT OF DATA IS ONLY AT 

5982
03:39:17,011 --> 03:39:17,512
THIS LEVEL. 

5983
03:39:17,512 --> 03:39:19,414
SO PROBABLY WHEN WE GET TO A 

5984
03:39:19,414 --> 03:39:23,017
PLACE OF MAKING SOME OF THIS 

5985
03:39:23,017 --> 03:39:24,385
PUBLIC, WE WILL HAVE MULTIPLE --

5986
03:39:24,385 --> 03:39:27,121
WE WILL TALK OF HAVING MULTIPLE 

5987
03:39:27,121 --> 03:39:29,057
LAYERS WHERE, YOU KNOW, SERVICE 

5988
03:39:29,057 --> 03:39:30,258
PROVIDERS MIGHT BE ABLE TO SEE, 

5989
03:39:30,258 --> 03:39:32,560
OKAY, THIS IS EXACTLY WHERE YOU 

5990
03:39:32,560 --> 03:39:34,195
CAN GET EXACTLY IN OR THAT. 

5991
03:39:34,195 --> 03:39:38,099
THIS IS EXACTLY WHERE PARK THEIR

5992
03:39:38,099 --> 03:39:39,300
VAN WITH THE VERSION OF PUBLIC 

5993
03:39:39,300 --> 03:39:42,870
TO SEE IT AT THE ZIP CODE LEVEL.

5994
03:39:42,870 --> 03:39:45,673
TWO SSPs THAT OFFER SERVICES IN 

5995
03:39:45,673 --> 03:39:48,076
THE ZIP CODE OR ONE IN THE 

5996
03:39:48,076 --> 03:39:48,943
ADJACENT ZIP CODE. 

5997
03:39:48,943 --> 03:39:50,311
COLOR CODE IT THAT WAY. 

5998
03:39:50,311 --> 03:39:52,413
NO, THAT IS REALLY IMPORTANT. 

5999
03:39:52,413 --> 03:39:54,348
LUCKILY IN LOS ANGELES -- IT IS 

6000
03:39:54,348 --> 03:39:56,551
ACTUALLY SHALL -- LOS ANGELES IS

6001
03:39:56,551 --> 03:39:58,086
SO BIG. 

6002
03:39:58,086 --> 03:40:05,293
A TON OF HETEROGENIETY OF 

6003
03:40:05,293 --> 03:40:07,395
WELCOME AND VERSUS ACTIVELY 

6004
03:40:07,395 --> 03:40:07,829
DESTRUCTIVE. 

6005
03:40:07,829 --> 03:40:10,665
LOCATION DEPENDENT EVEN IN L.A. 

6006
03:40:10,665 --> 03:40:12,767
SOME PLACES THAT I ABSOLUTELY 

6007
03:40:12,767 --> 03:40:13,501
DON'T SAY WHAT WE ARE DOING 

6008
03:40:13,501 --> 03:40:14,402
WHERE WE ARE DOING IT. 

6009
03:40:14,402 --> 03:40:16,270
OTHER PLACES WE PUT IT ON SOCIAL

6010
03:40:16,270 --> 03:40:17,805
MEDIA SAYING BRING YOUR DRUGS 

6011
03:40:17,805 --> 03:40:19,340
HERE. 

6012
03:40:19,340 --> 03:40:21,042
WE WILL CHECK THEM ON THIS TATE,

6013
03:40:21,042 --> 03:40:22,176
THIS TIME. 

6014
03:40:22,176 --> 03:40:23,044
SO, YEAH. 

6015
03:40:23,044 --> 03:40:23,711
>> GREAT. 

6016
03:40:23,711 --> 03:40:24,946
THANK YOU SO MUCH FOR THE 

6017
03:40:24,946 --> 03:40:26,848
RESPONSE TO THE QUESTION. 

6018
03:40:26,848 --> 03:40:29,517
I THINK I SEE A LITTLE 

6019
03:40:29,517 --> 03:40:30,384
BIT-RELATED IN TERMS OF 

6020
03:40:30,384 --> 03:40:32,653
CALIFORNIA LEGISLATION INVOLVING

6021
03:40:32,653 --> 03:40:35,223
THE UNHOUSED POPULATION. 

6022
03:40:35,223 --> 03:40:38,392
DO YOU HAVE ANY THOUGHTS OF HOW 

6023
03:40:38,392 --> 03:40:40,294
THAT CAN BE INVOLVED IN 

6024
03:40:40,294 --> 03:40:40,561
RESEARCH. 

6025
03:40:40,561 --> 03:40:41,963
>> HOW IT MIGHT HAVE
AFFECTED 

6026
03:40:41,963 --> 03:40:43,397
RECENT RESEARCH?

6027
03:40:43,397 --> 03:40:45,633
>> HOW THIS MIGHT EFFECT
THE 

6028
03:40:45,633 --> 03:40:48,002
FUTURE OF YOUR RESEARCH AND 

6029
03:40:48,002 --> 03:40:49,270
OTHER HARM REDUCTION EFFORTS?

6030
03:40:49,270 --> 03:40:51,839
>> YEAH, TOTALLY. 

6031
03:40:51,839 --> 03:40:56,277
I MEAN, SO PEOPLE EXPERIENCING 

6032
03:40:56,277 --> 03:41:01,749
HOMELESSNESS IN LOS ANGELES OVER

6033
03:41:01,749 --> 03:41:03,985
THE LAST FIVE YEARS ONE IN FOUR 

6034
03:41:03,985 --> 03:41:06,087
TO ONE IN FIVE OPIOID-RELATED 

6035
03:41:06,087 --> 03:41:07,355
DEATHS AND METHAMPHETAMINE 

6036
03:41:07,355 --> 03:41:09,190
RELATED DEATHS IT IS ONE IN 

6037
03:41:09,190 --> 03:41:09,423
THREE. 

6038
03:41:09,423 --> 03:41:12,393
THAT MEANS THIS IS A REALLY, 

6039
03:41:12,393 --> 03:41:13,761
REALLY IMPORTANT POPULATION TO 

6040
03:41:13,761 --> 03:41:14,262
FOCUS ON. 

6041
03:41:14,262 --> 03:41:17,298
IT ALSO MEANS THAT THE MAJORITY 

6042
03:41:17,298 --> 03:41:18,232
OF PEOPLE DYING FROM FENTANYL 

6043
03:41:18,232 --> 03:41:19,367
OVERDOSE ARE HOUSED. 

6044
03:41:19,367 --> 03:41:20,968
AND THAT IS ACTUALLY A MUCH 

6045
03:41:20,968 --> 03:41:23,938
HARDER POPULATION TO REACH. 

6046
03:41:23,938 --> 03:41:26,974
THE THING ABOUT, YOU KNOW -- ONE

6047
03:41:26,974 --> 03:41:28,376
THING THAT I THEORIZE IS BEHIND 

6048
03:41:28,376 --> 03:41:30,978
SOME OF THE LOCAL DECLINE. 

6049
03:41:30,978 --> 03:41:33,648
YOU KNOW -- IT MITOGEN RALIZE 

6050
03:41:33,648 --> 03:41:36,284
NATIONALLY WITH OVERDOSE WE ARE 

6051
03:41:36,284 --> 03:41:36,584
SEEING. 

6052
03:41:36,584 --> 03:41:39,820
EFFORTS TO GET NALOXONE IN THE 

6053
03:41:39,820 --> 03:41:41,656
HAND OF PEOPLE WHO WITNESS 

6054
03:41:41,656 --> 03:41:43,124
OVERDOSE IS SUCCESSFUL AND ALSO 

6055
03:41:43,124 --> 03:41:45,193
PEOPLE EXPERIENCING HOMELESSNESS

6056
03:41:45,193 --> 03:41:47,161
TONIGHT HAVE A CHOICES TO USE IT

6057
03:41:47,161 --> 03:41:48,062
A LOT OF THE TIMES. 

6058
03:41:48,062 --> 03:41:50,198
THEY ARE INHER TENTLY USING IT 

6059
03:41:50,198 --> 03:41:50,798
IN A WAY. 

6060
03:41:50,798 --> 03:41:52,900
NOW THAT THERE IS A TON O

6061
03:41:52,900 --> 03:41:56,437
OF NALOXONE ON THE STREETS. 

6062
03:41:56,437 --> 03:41:57,338
MULTIPLE MOBILE OVERDOSE 

6063
03:41:57,338 --> 03:41:58,406
RESPONSE TEAMS. 

6064
03:41:58,406 --> 03:42:02,543
LOTS OF JUST BYSTANDER WHO HAVE 

6065
03:42:02,543 --> 03:42:02,710
IT. 

6066
03:42:02,710 --> 03:42:04,045
MORE THAN ANY GIVEN OVERDOSE 

6067
03:42:04,045 --> 03:42:06,447
WILL BE WITNESS BY SOMEONE WHO 

6068
03:42:06,447 --> 03:42:08,916
HAS NALOXONE. 

6069
03:42:08,916 --> 03:42:10,318
THAT IS NOT TRUE FOR PEOPLE WHO 

6070
03:42:10,318 --> 03:42:12,553
ARE HOUSED AND USING FENTANYL IN

6071
03:42:12,553 --> 03:42:14,055
THEIR HOME. 

6072
03:42:14,055 --> 03:42:17,291
FOR WHOM THERE IS ALSO A MUCH 

6073
03:42:17,291 --> 03:42:20,661
HIGHER BARRIER TO DISCLOSURE. 

6074
03:42:20,661 --> 03:42:21,729
MORE STIGMATIZED. 

6075
03:42:21,729 --> 03:42:24,031
IT IS ALMOST LIKE -- YOU KNOW, 

6076
03:42:24,031 --> 03:42:25,566
TALKING TO PEOPLE IN THIS 

6077
03:42:25,566 --> 03:42:28,302
SITUATION, MY SENSE IS THAT THE 

6078
03:42:28,302 --> 03:42:33,107
MORE INSULATED YOU ARE FROM THE 

6079
03:42:33,107 --> 03:42:36,143
-- THE SORT OF VISIBLE 

6080
03:42:36,143 --> 03:42:37,445
CONSEQUENCES OF SEVERE OPIOID 

6081
03:42:37,445 --> 03:42:40,781
USE DISORDER, THE HARDER IT IS 

6082
03:42:40,781 --> 03:42:43,417
TO ENGAGE IN DIFFERENT KINDS OF 

6083
03:42:43,417 --> 03:42:44,518
SERVICES AND PUTS PEOPLE AT 

6084
03:42:44,518 --> 03:42:45,753
GREAT RISK. 

6085
03:42:45,753 --> 03:42:47,388
SO IN SHORT, HOMELESSNESS IS 

6086
03:42:47,388 --> 03:42:48,656
VERY IMPORTANT. 

6087
03:42:48,656 --> 03:42:50,558
HOUSED PEOPLE ALSO REALLY 

6088
03:42:50,558 --> 03:42:51,459
IMPORTANT. 

6089
03:42:51,459 --> 03:42:53,027
AND HONESTLY, MORE CHALLENGING 

6090
03:42:53,027 --> 03:42:54,528
THAN FOLKS WHO ARE LIVING OUT IN

6091
03:42:54,528 --> 03:42:57,398
THE OPEN OR IN CONGREGATE 

6092
03:42:57,398 --> 03:42:59,300
SETTING WITH THE INITIAL ACCESS 

6093
03:42:59,300 --> 03:42:59,834
PIECE. 

6094
03:42:59,834 --> 03:43:01,869
UPTAKE IS A DIFFERENT THING. 

6095
03:43:01,869 --> 03:43:04,071
THAT IS A SEPARATE QUESTION, 

6096
03:43:04,071 --> 03:43:05,139
BUT, YEAH. 

6097
03:43:05,139 --> 03:43:05,906
>> THANK YOU. 

6098
03:43:05,906 --> 03:43:08,409
TWO MORE QUESTIONS THAT I SEE. 

6099
03:43:08,409 --> 03:43:10,177
THEY ARE COMING IN. 

6100
03:43:10,177 --> 03:43:14,215
ONE IS, DO YOU HAVE DATA ON 

6101
03:43:14,215 --> 03:43:16,117
OVERDOSES OF DAYS/TIMES COMPARED

6102
03:43:16,117 --> 03:43:17,118
TO THE SYRINGE SERVICE PROVIDERS

6103
03:43:17,118 --> 03:43:18,352
ARE OPEN?

6104
03:43:18,352 --> 03:43:19,720
>> WE DO HAVE DATA. 

6105
03:43:19,720 --> 03:43:21,756
WE NEED TO FORMALLY ANALYZE 

6106
03:43:21,756 --> 03:43:22,790
THAT, STILL. 

6107
03:43:22,790 --> 03:43:25,126
YES, ONE OF THE MANY IDEA WE 

6108
03:43:25,126 --> 03:43:25,926
THROW OUT. 

6109
03:43:25,926 --> 03:43:28,329
NICE TO HEAR ANOTHER VOTE FOR 

6110
03:43:28,329 --> 03:43:28,796
THAT. 

6111
03:43:28,796 --> 03:43:28,996
YEAH. 

6112
03:43:28,996 --> 03:43:31,632
>> AND THE NEXT QUESTION
--

6113
03:43:31,632 --> 03:43:32,199
>>SPEAKER: RECENT --

6114
03:43:32,199 --> 03:43:33,534
>>SPEAKER: YOU ANSWERED
THIS ONE

6115
03:43:33,534 --> 03:43:34,268
ABOUT THE --

6116
03:43:34,268 --> 03:43:36,370
>>SPEAKER: OH, THE CHANGE
IN 

6117
03:43:36,370 --> 03:43:36,704
LEGISLATION. 

6118
03:43:36,704 --> 03:43:39,106
LIKE -- OH, RIGHT. 

6119
03:43:39,106 --> 03:43:41,008
YOU WERE ASKING -- I FORGOT, 

6120
03:43:41,008 --> 03:43:41,942
YES. 

6121
03:43:41,942 --> 03:43:46,147
I MEAN, ON THE ONE HAND, IF THIS

6122
03:43:46,147 --> 03:43:48,015
LAW LEADS TO MORE HOUSING AND 

6123
03:43:48,015 --> 03:43:49,183
MORE PEOPLE GETTING INTO 

6124
03:43:49,183 --> 03:43:51,352
HOUSING, I THINK THAT IS GOOD 

6125
03:43:51,352 --> 03:43:53,487
ACROSS MANY DIFFERENT HEALTH 

6126
03:43:53,487 --> 03:43:54,722
METRICS AND PROVIDE OPPORTUNITY 

6127
03:43:54,722 --> 03:43:57,391
TO OFFER HARM REDUCTION AND 

6128
03:43:57,391 --> 03:43:58,659
SUBSTANCE ABUSE TREATMENT 

6129
03:43:58,659 --> 03:43:59,193
SERVICES. 

6130
03:43:59,193 --> 03:44:00,294
IN PRACTICE, I AM DETERMINED IT 

6131
03:44:00,294 --> 03:44:01,462
IS MOVING PEOPLE AROUND AND 

6132
03:44:01,462 --> 03:44:03,531
FURTHER DISCONNECTING THEM FROM 

6133
03:44:03,531 --> 03:44:04,765
EXISTING SERVICES. 

6134
03:44:04,765 --> 03:44:06,934
THAT HAS BEEN -- THAT HAS BEEN 

6135
03:44:06,934 --> 03:44:09,570
KIND OF WHAT WE HAVE SEEN 

6136
03:44:09,570 --> 03:44:11,138
IN L.A. SINCE A SIMILAR LAW 

6137
03:44:11,138 --> 03:44:12,673
STARTED BEING ENFORCED A FEW 

6138
03:44:12,673 --> 03:44:14,108
YEARS AGO. 

6139
03:44:14,108 --> 03:44:15,643
SO THAT'S WHAT I AM MOSTLY 

6140
03:44:15,643 --> 03:44:17,645
CONCERNED ABOUT THERE. BUT, YOU 

6141
03:44:17,645 --> 03:44:20,114
KNOW, I AM -- YEAH. 

6142
03:44:20,114 --> 03:44:23,250
AND I SEE SOMEONE ALSO ASK, HOW 

6143
03:44:23,250 --> 03:44:24,852
TO GET A INVENTORY FACILITY 

6144
03:44:24,852 --> 03:44:29,323
FOR HIV EDUCATION TEST OR PREP. 

6145
03:44:29,323 --> 03:44:35,429
I MEAN, I CAN THINK OF A FEW 

6146
03:44:35,429 --> 03:44:37,431
DIFFERENCE WAYS .TO BE CLEAR, 

6147
03:44:37,431 --> 03:44:39,367
THERE ARE MANY, MANY OTHER PLACE

6148
03:44:39,367 --> 03:44:41,335
INFORMS L.A. THAT YOU CAN GET 

6149
03:44:41,335 --> 03:44:42,336
PREPPEDED THAT IS NOT ON THIS 

6150
03:44:42,336 --> 03:44:45,039
MAP AND NOT IN ANY OF OUR MAPS. 

6151
03:44:45,039 --> 03:44:47,108
WE DO NOT INCLUDE FEDERALLY 

6152
03:44:47,108 --> 03:44:49,677
QUALIFIED HEALTH CENTERS THAT 

6153
03:44:49,677 --> 03:44:51,379
ARE REQUIRED TO HAVE PREP IF 

6154
03:44:51,379 --> 03:44:53,547
DON'T HAVE A SSP. 

6155
03:44:53,547 --> 03:44:55,516
IF I WAS TRYING TO MAKE A MAP, 

6156
03:44:55,516 --> 03:44:56,984
LOCAL LAWS WHERE IT IS REQUIRED 

6157
03:44:56,984 --> 03:45:00,921
TO OFFER PREP AND COVER IT. 

6158
03:45:00,921 --> 03:45:04,191
I WOULD PROBABLY JUST BE DOING, 

6159
03:45:04,191 --> 03:45:04,892
LIKE, CALLING AROUND TO SOME OF 

6160
03:45:04,892 --> 03:45:07,094
THE OTHER PLACES TO GET A SENSE.

6161
03:45:07,094 --> 03:45:09,163
BUT THEY DO A LOT OF MAPPING. 

6162
03:45:09,163 --> 03:45:11,065
CURIOUS IF THEY HAD ALREADY DONE

6163
03:45:11,065 --> 03:45:11,298
THIS. 

6164
03:45:11,298 --> 03:45:13,934
BUT I ALSO KNOW JUST FROM 

6165
03:45:13,934 --> 03:45:20,741
WORKING IN THE FIELD THAT L.A. 

6166
03:45:20,741 --> 03:45:23,577
HAS A HISTORY OF HIV MOBILE 

6167
03:45:23,577 --> 03:45:24,245
VANS. 

6168
03:45:24,245 --> 03:45:25,346
AND STREETS WHERE YOU KNOW YOU 

6169
03:45:25,346 --> 03:45:27,281
WILL FIND A VAN TO HOP IN AND 

6170
03:45:27,281 --> 03:45:29,316
GET A HIV TEST ON FRIDAY AND 

6171
03:45:29,316 --> 03:45:31,752
SATURDAY NIGHT. 

6172
03:45:31,752 --> 03:45:34,422
>> AND -- THANK YOU SO
MUCH FOR 

6173
03:45:34,422 --> 03:45:37,758
BOTH OF THE SPEAKERS FOR THE 

6174
03:45:37,758 --> 03:45:38,692
EPIDEMIOLOGY SESSION. 

6175
03:45:38,692 --> 03:45:39,794
I BELIEVE THOSE ARE ALL THE 

6176
03:45:39,794 --> 03:45:42,329
QUESTIONS AND ANSWERS THAT I SEE

6177
03:45:42,329 --> 03:45:43,397
HERE. 

6178
03:45:43,397 --> 03:45:45,533
SO I WOULD LIKE TO NOW CLOSE THE

6179
03:45:45,533 --> 03:45:47,401
-- THE MEETING WITH A FEW 

6180
03:45:47,401 --> 03:45:50,104
CLOSING REMARKS. 

6181
03:45:50,104 --> 03:45:52,239
>> WELL, FIRST OF ALL, I
WOULD 

6182
03:45:52,239 --> 03:45:55,676
LIKE TO THANK THE NIDA LEADER 

6183
03:45:55,676 --> 03:45:57,545
PRESENTERS, THE TECHNICAL AND 

6184
03:45:57,545 --> 03:45:59,947
SUPPORT STAFF FOR MAKING THIS 

6185
03:45:59,947 --> 03:46:01,215
WORKSHOP POSSIBLE, AS WELL AS 

6186
03:46:01,215 --> 03:46:03,384
THE PARTICIPANTS AVAILABLE FOR 

6187
03:46:03,384 --> 03:46:05,453
THIS FOUR-HOUR VIRTUAL WORKSHOP.

6188
03:46:05,453 --> 03:46:09,256
WE APPRECIATE THE ACTIVE 

6189
03:46:09,256 --> 03:46:12,059
ENGAGEMENT AND Q&A BOX. 

6190
03:46:12,059 --> 03:46:16,697
WE APPRECIATE THE SPEAKERS ON 

6191
03:46:16,697 --> 03:46:18,399
GEOSPATIAL DATA SCIENCE AND HOW 

6192
03:46:18,399 --> 03:46:20,201
IT CAN USE FOR DRUG RESEARCH. 

6193
03:46:20,201 --> 03:46:24,772
AND USING ANALYSIS, AND 

6194
03:46:24,772 --> 03:46:25,139
INTERVENTIONS. 

6195
03:46:25,139 --> 03:46:29,176
HOW OF THE PRIVATE GEOGRAPHIC 

6196
03:46:29,176 --> 03:46:29,677
PRECISION. 

6197
03:46:29,677 --> 03:46:31,679
HOW CAN WE LEVERAGE THESE TO 

6198
03:46:31,679 --> 03:46:35,316
REALLY UNDERSTAND THE ACCESS TO 

6199
03:46:35,316 --> 03:46:36,484
TREATMENT, AS WELL AS THE 

6200
03:46:36,484 --> 03:46:38,018
INTRICACIES OF THE 

6201
03:46:38,018 --> 03:46:40,588
TRANSPORTATION MODALITY, TIME OF

6202
03:46:40,588 --> 03:46:41,689
THE DAY AND USING THE SOCIAL 

6203
03:46:41,689 --> 03:46:44,625
MEDIA DATA ON HOW IT WILL BE 

6204
03:46:44,625 --> 03:46:46,327
LEVERAGED USING THE GEOSPATIAL 

6205
03:46:46,327 --> 03:46:47,895
DATA THAT COMES FROM IT AS WELL.

6206
03:46:47,895 --> 03:46:50,764
LAST BUT NOT LEAST, ON HOW TO 

6207
03:46:50,764 --> 03:46:53,634
REALLY CONDUCT VISUAL SPATIAL 

6208
03:46:53,634 --> 03:46:56,103
WORK WITH COMMUNITY ENGAGEMENT 

6209
03:46:56,103 --> 03:46:57,137
WITH PARTNERSHIP SO THE DATA 

6210
03:46:57,137 --> 03:46:58,405
REACHES THE PEOPLE AND USEFUL 

6211
03:46:58,405 --> 03:47:01,542
FOR HOSE WHO CAN BENEFIT THE 

6212
03:47:01,542 --> 03:47:01,742
MOST. 

6213
03:47:01,742 --> 03:47:02,610
SO WE REALLY APPRECIATE HEARING 

6214
03:47:02,610 --> 03:47:07,081
FROM YOU AND TO HELP US FUTURE 

6215
03:47:07,081 --> 03:47:07,381
WORKSHOPS. 

6216
03:47:07,381 --> 03:47:09,283
QR CODE ON THE UPPER RIGHT. 

6217
03:47:09,283 --> 03:47:10,484
I BELIEVE, SUSAN, THANK YOU SO 

6218
03:47:10,484 --> 03:47:12,486
MUCH FOR PUTTING IN THE CHAT THE

6219
03:47:12,486 --> 03:47:13,754
LINK TO THE SURVEY AS WELL. 

6220
03:47:13,754 --> 03:47:16,023
WE REALLY APPRECIATE HEARING 

6221
03:47:16,023 --> 03:47:18,526
FROM YOU TO YOU HELP YOU CREATE 

6222
03:47:18,526 --> 03:47:20,060
FUTURE WORKSHOPS. 

6223
03:47:20,060 --> 03:47:23,297
AND AS A QUOTE SAYS, I HOPE THIS

6224
03:47:23,297 --> 03:47:26,400
WORKSHOP HAS INSPIRED YOU OF HOW

6225
03:47:26,400 --> 03:47:27,034
GEOSPATIAL DATA SCIENCE WILL 

6226
03:47:27,034 --> 03:47:29,169
HELP YOU WITH NEW DISCOVERED 

6227
03:47:29,169 --> 03:47:29,436
PATHWAYS. 

6228
03:47:29,436 --> 03:47:30,704
AND THANK YOU SO MUCH FOR 

6229
03:47:30,704 --> 03:47:32,039
ATTENDING AND ALL THE PRESENTERS

6230
03:47:32,039 --> 03:47:33,240
FOR THIS WORKSHOP. 

6231
03:47:33,240 --> 03:47:37,511
NOW I WOULD LIKE TO ADJOURN THE 

6232
03:47:37,511 --> 03:47:37,778
WORKSHOP. 

6233
03:47:37,778 --> 03:47:40,848
THANK YOU.