1 00:00:06,621 --> 00:00:07,021 >> GOOD MORNING. 2 00:00:07,021 --> 00:00:11,192 MY NAME IS ELISO PEREZ-STABLE 3 00:00:11,192 --> 00:00:16,264 THE DIRECTOR ON THE NATIONAL 4 00:00:16,264 --> 00:00:17,732 INSTITUTE OF MINORITY HEALTH AND 5 00:00:17,732 --> 00:00:19,267 HEALTH DISPARITIES. 6 00:00:19,267 --> 00:00:22,270 TODAY'S SESSION IS OPEN TO THE 7 00:00:22,270 --> 00:00:25,340 PUBLIC AND BEING BROADCAST ON 8 00:00:25,340 --> 00:00:30,912 THE NIH VIDEO NETWORK. 9 00:00:30,912 --> 00:00:31,679 COUNCIL MEMBERS PLEASE SPEAK 10 00:00:31,679 --> 00:00:32,814 SLOWLY AND DISTINCTLY WHEN 11 00:00:32,814 --> 00:00:33,581 REQUESTED TO SPEAK. 12 00:00:33,581 --> 00:00:35,850 I'LL TURN IT OVER TO DR. PAUL 13 00:00:35,850 --> 00:00:36,084 COTTON. 14 00:00:36,084 --> 00:00:41,556 THE EXECUTIVE SECRETARY OF OUR 15 00:00:41,556 --> 00:00:41,789 MEETING. 16 00:00:41,789 --> 00:00:45,960 >> WELCOME TO THE 66th MEETING 17 00:00:45,960 --> 00:00:48,563 OF ADVISORY COUNCIL. 18 00:00:48,563 --> 00:00:50,832 TODAY'S SESSION OF THIS MEETING 19 00:00:50,832 --> 00:00:53,434 IS OPEN TO THE PUBLIC AND 20 00:00:53,434 --> 00:00:55,270 BROADCASTED ON THE NIH VIDEO 21 00:00:55,270 --> 00:00:56,671 NETWORK. 22 00:00:56,671 --> 00:00:58,606 COUNCIL MEMBERS REPEATING WHAT 23 00:00:58,606 --> 00:01:01,176 YOU JUST HEARD, PLEASE BE SLOWLY 24 00:01:01,176 --> 00:01:03,144 AND DISTINCTLY WHEN REQUESTED OR 25 00:01:03,144 --> 00:01:06,047 CALLED UPON TO SPEAK. 26 00:01:06,047 --> 00:01:09,184 THE VIDEOCAST OBSERVERS, 27 00:01:09,184 --> 00:01:10,618 TECHNICAL STAFF AND NOTE TAKERS 28 00:01:10,618 --> 00:01:12,287 WILL BE LISTENING TO NOTE YOUR 29 00:01:12,287 --> 00:01:12,554 COMMENTS. 30 00:01:12,554 --> 00:01:19,961 I WILL BEGIN THE ROLL CALL. 31 00:01:19,961 --> 00:01:28,736 WHEN I CALL YOUR NAME GIVE A 32 00:01:28,736 --> 00:01:30,605 BRIEF OVERVIEW OF WHO YOU ARE 33 00:01:30,605 --> 00:01:38,012 AND WHAT YOU DO. 34 00:01:38,012 --> 00:01:48,489 >> I'M DR. AJILORE. 35 00:01:48,489 --> 00:01:51,859 DIRECT OF DEPARTMENT OF 36 00:01:51,859 --> 00:01:59,934 PSYCHIATRY. 37 00:01:59,934 --> 00:02:05,840 >> I'M AN ECONOMIST BY TRAINING 38 00:02:05,840 --> 00:02:09,811 AND I LOOK AT THE PROGRAMS THAT 39 00:02:09,811 --> 00:02:12,146 INCREASE ECONOMIC STATUS AND HOW 40 00:02:12,146 --> 00:02:16,718 TO IMPROVE HEALTH AND WELL BEING 41 00:02:16,718 --> 00:02:18,553 OF MINORITY POPULATION WITH A 42 00:02:18,553 --> 00:02:23,658 FOCUS ON HISPANIC POPULATION. 43 00:02:28,696 --> 00:02:30,164 >> GOOD MORNING I AM A PROFESSOR 44 00:02:30,164 --> 00:02:34,369 OF MEDICINE AND RURAL HEALTH AT 45 00:02:34,369 --> 00:02:36,604 OKLAHOMA STATE UNIVERSITY HEALTH 46 00:02:36,604 --> 00:02:39,140 SCIENCES WHERE I DIRECT THE 47 00:02:39,140 --> 00:02:40,608 CENTER FOR INDIGENOUS HEALTH 48 00:02:40,608 --> 00:02:42,410 POLICY AND AN INTERVENTION 49 00:02:42,410 --> 00:02:44,012 SCIENTIST FOCUSSED ON 50 00:02:44,012 --> 00:02:47,782 CARDIOVASCULAR DISEASE RISK 51 00:02:47,782 --> 00:02:51,286 REDUCTION PRIMARILY IN 52 00:02:51,286 --> 00:02:54,022 INDIGENOUS POPULATIONS. 53 00:02:54,022 --> 00:02:54,455 >> GOOD MORNING. 54 00:02:54,455 --> 00:02:58,226 I'M A PROFESSOR AND CHAIR OF 55 00:02:58,226 --> 00:02:59,827 NURSING AND COMMUNITY HEALTH. 56 00:02:59,827 --> 00:03:01,863 MY RESEARCH FOCUSSED ON 57 00:03:01,863 --> 00:03:02,730 MULTI-LEVEL STRATEGIES TO 58 00:03:02,730 --> 00:03:05,967 ADDRESS HIV DISPARITIES AND ONE 59 00:03:05,967 --> 00:03:12,974 OF THE MPIs FOR ELLISEO. 60 00:03:12,974 --> 00:03:15,710 >> I'M FROM THE UNIVERSITY OF 61 00:03:15,710 --> 00:03:18,446 NEW MEXICO A PROFESSOR OF HEALTH 62 00:03:18,446 --> 00:03:21,582 POLICY AND I'M AN NPI FOR THE 63 00:03:21,582 --> 00:03:22,283 SEAL PROJECT. 64 00:03:22,283 --> 00:03:25,086 OUR RESEARCH IS TRANS 65 00:03:25,086 --> 00:03:27,889 DISCIPLINARY TEAM SCIENCE WITH 66 00:03:27,889 --> 00:03:30,625 COMMUNITY BASED PARTICIPATORY 67 00:03:30,625 --> 00:03:30,892 RESEARCH. 68 00:03:30,892 --> 00:03:31,559 THANK YOU. 69 00:03:31,559 --> 00:03:35,063 >> REVEREND CURRY. 70 00:03:35,063 --> 00:03:37,265 >> GOOD MORNING. 71 00:03:37,265 --> 00:03:39,801 I'M THE PASTOR OF THE 72 00:03:39,801 --> 00:03:41,703 PENNSYLVANIA AVENUE BAPTIST 73 00:03:41,703 --> 00:03:43,237 CHURCH IN WASHINGTON, D.C. 74 00:03:43,237 --> 00:03:48,109 TRAINED AS A CHEMICAL ENGINEER 75 00:03:48,109 --> 00:03:53,114 AND THEOLOGIAN AND IN THE 76 00:03:53,114 --> 00:03:55,850 STEERING COMMITTEE FOR SEAL. 77 00:03:55,850 --> 00:03:58,553 >> I'M AT THE UNIVERSITY OF 78 00:03:58,553 --> 00:04:00,088 MIAMI A PROFESSOR OF 79 00:04:00,088 --> 00:04:02,256 PSYCHOLOPSYCHOLOGY 80 00:04:02,256 --> 00:04:03,958 MEDICINE AND MOST OF MY WORK 81 00:04:03,958 --> 00:04:06,627 FOCUSES ON UNDERSTANDING 82 00:04:06,627 --> 00:04:08,129 MECHANISMS THAT DRIVE QUALITY OF 83 00:04:08,129 --> 00:04:09,897 LIFE AND HEALTH OUTCOMES 84 00:04:09,897 --> 00:04:10,631 PARTICULARLY IN MINORITY 85 00:04:10,631 --> 00:04:17,472 POPULATIONS. 86 00:04:17,472 --> 00:04:18,373 >> GOOD MORNING. 87 00:04:18,373 --> 00:04:19,006 I AM PROFESSOR OF POPULATION 88 00:04:19,006 --> 00:04:22,677 HEALTH AND MEDICINE AT THE NYU 89 00:04:22,677 --> 00:04:26,614 SCHOOL OF MEDICINE AND SOCIAL 90 00:04:26,614 --> 00:04:30,885 EPIDEMIOLOGIST BY TRAINING AND 91 00:04:30,885 --> 00:04:35,089 FOCUSSED ON REDUCING CHRONIC 92 00:04:35,089 --> 00:04:36,457 DISEASE IN NEW YORK CITY 93 00:04:36,457 --> 00:04:38,159 MINORITIZED POPULATION AND NPI 94 00:04:38,159 --> 00:04:42,630 OF THE NEW YORK SEAL. 95 00:04:42,630 --> 00:04:48,736 >> DO WE HAVE EX-OFFICIO COUNCIL 96 00:04:48,736 --> 00:04:59,013 MEMBERS ONLINE? 97 00:05:00,148 --> 00:05:04,786 WE'LL COME BACK IF THEY APPEAR 98 00:05:04,786 --> 00:05:07,588 LATER UP OUR BROADCAST. 99 00:05:07,588 --> 00:05:09,791 WE'LL INTRODUCE NEXT OUR DEPUTY. 100 00:05:09,791 --> 00:05:13,027 >> I'M MONICA WEBB COOPER DEPUTY 101 00:05:13,027 --> 00:05:18,666 DIRECTOR OF NIMHD. 102 00:05:18,666 --> 00:05:24,639 WELCOME. 103 00:05:24,639 --> 00:05:26,774 >> I'M THE DIRECTOR AT THE 104 00:05:26,774 --> 00:05:27,675 HEALTH SERVICES RESEARCH AT 105 00:05:27,675 --> 00:05:33,347 NIMHD. 106 00:05:33,347 --> 00:05:36,984 >> AND I'M THE DIRECTOR MUCH 107 00:05:36,984 --> 00:05:37,852 COMMUNITY HEALTH AND POPULATION 108 00:05:37,852 --> 00:05:42,657 SCIENCE AT NIMHD. 109 00:05:42,657 --> 00:05:44,559 >> GOOD MORNING. 110 00:05:44,559 --> 00:05:47,128 I'M THE DIRECTOR FOR THE 111 00:05:47,128 --> 00:05:49,764 DIVISION OF INTEGRATIVE 112 00:05:49,764 --> 00:06:00,274 BIOLOGICAL SCIENCES AT NIMHD. 113 00:06:04,445 --> 00:06:08,382 >> I'M THE DIRECTOR OF THE 114 00:06:08,382 --> 00:06:10,885 OFFICE OF BIO SCIENCES RESEARCH. 115 00:06:10,885 --> 00:06:21,262 >> DID I MISS ANYONE? 116 00:06:23,898 --> 00:06:26,000 IF I DID WE'LL CIRCLE BACK AND 117 00:06:26,000 --> 00:06:28,035 YOU CAN INTRODUCE TO OUR LIVE 118 00:06:28,035 --> 00:06:30,071 STREAMING AUDIENCE. 119 00:06:30,071 --> 00:06:35,877 WE WILL NOW REVIEW THE FEBRUARY 120 00:06:35,877 --> 00:06:37,044 2024 COUNCIL MINUTES. 121 00:06:37,044 --> 00:06:43,284 THAT WILL BE VOTED ON BY OUR 122 00:06:43,284 --> 00:06:44,852 COUNCIL MEM 123 00:06:44,852 --> 00:06:46,621 COUNCIL MEMBERS THE MINUTES FOR 124 00:06:46,621 --> 00:06:47,755 THE FEBRUARY 2024 COUNCIL 125 00:06:47,755 --> 00:06:50,525 MEMBERS WERE POSTED IN THE 126 00:06:50,525 --> 00:06:51,526 ELECTRONIC COUNCIL BOOK AND 127 00:06:51,526 --> 00:06:53,227 HAVING REVIEWED THE MINUTES ARE 128 00:06:53,227 --> 00:06:54,729 THERE QUESTIONS, CONCERNS OR 129 00:06:54,729 --> 00:07:03,638 CORRECTIONS FOR THESE MINUTES? 130 00:07:03,638 --> 00:07:04,939 HEARING NONE MAY I RECEIVE A 131 00:07:04,939 --> 00:07:06,574 MOTION FOR ACCEPTANCE. 132 00:07:06,574 --> 00:07:08,843 >> I MOVE FOR THE ACCEPTANCE OF 133 00:07:08,843 --> 00:07:09,777 THE FEBRUARY COUNCIL MEETING. 134 00:07:09,777 --> 00:07:11,279 >> IS THERE A SECOND. 135 00:07:11,279 --> 00:07:15,316 >> I SECOND THE MOTION FOR 136 00:07:15,316 --> 00:07:15,750 ACCEPTANCE. 137 00:07:15,750 --> 00:07:21,322 >> ALL IN FAVOR PLEASE RAISE 138 00:07:21,322 --> 00:07:30,498 YOUR HAND THANK YOU VERY MUCH 139 00:07:30,498 --> 00:07:40,808 THE MOTION PASSES. 140 00:07:43,044 --> 00:07:45,313 I WANT TO NOW GIVE YOU THE 141 00:07:45,313 --> 00:07:48,849 FUTURE MEETING DATES TO PUT 142 00:07:48,849 --> 00:07:54,622 THESE IN THE CALENDARS. 143 00:07:54,622 --> 00:07:57,358 FEBRUARY 6, 2024. 144 00:07:57,358 --> 00:08:07,535 I'M SORRY. 145 00:08:13,541 --> 00:08:17,945 MAY 16, 2025, SEPTEMBER 5, 2025, 146 00:08:17,945 --> 00:08:28,456 FEBRUARY, 2026, MAY 19, 2026, 147 00:08:31,192 --> 00:08:36,230 AUGUST 11, 2026. 148 00:08:36,230 --> 00:08:39,333 THE FEBRUARY COUNCIL MEETINGS 149 00:08:39,333 --> 00:08:40,835 WILL BE VIRTUAL. 150 00:08:40,835 --> 00:08:43,871 THE OTHER MEETINGS WE WILL BE 151 00:08:43,871 --> 00:08:44,839 TOGETHER. 152 00:08:44,839 --> 00:08:46,907 PLEASE REMEMBER A COUNCIL MEMBER 153 00:08:46,907 --> 00:08:49,677 MAY HAVE ONE ABSENCE PER 154 00:08:49,677 --> 00:08:50,411 CALENDAR YEAR. 155 00:08:50,411 --> 00:08:53,447 AN INDIVIDUAL CANNOT SERVE ON 156 00:08:53,447 --> 00:08:57,051 THE NIH PEER REVIEW PANEL WHILE 157 00:08:57,051 --> 00:08:57,618 SERVING AS A COUNCIL MEMBER. 158 00:08:57,618 --> 00:09:01,222 I WILL NOW TURN THE MEETING BACK 159 00:09:01,222 --> 00:09:03,724 OVER TO DR. PEREZ-STABLE FOR THE 160 00:09:03,724 --> 00:09:14,035 DIRECTOR'S UPDATE. 161 00:09:38,325 --> 00:09:40,828 >> OKAY. 162 00:09:40,828 --> 00:09:43,397 WELL, GOOD MORNING EVERYONE. 163 00:09:43,397 --> 00:09:46,434 WE HAVE A GOOD SCHEDULE TODAY SO 164 00:09:46,434 --> 00:09:48,669 THERE'LL BE TIME FOR 165 00:09:48,669 --> 00:09:50,771 CONVERSATION AS YOU'RE SPEAKERS 166 00:09:50,771 --> 00:09:54,041 WERE RESTRICTED WHEN THEY'LL BE 167 00:09:54,041 --> 00:09:56,243 ABLE TO PRESENT AND WE SHOULDN'T 168 00:09:56,243 --> 00:10:02,616 END TOO LATE SO I'M GOING TO TRY 169 00:10:02,616 --> 00:10:05,052 AND PROVIDE A PERSPECTIVE ON 170 00:10:05,052 --> 00:10:07,922 WHAT NIH OR NIMHD SPECIFICALLY 171 00:10:07,922 --> 00:10:09,156 OVER THE LAST ALMOST FOUR MONTHS 172 00:10:09,156 --> 00:10:11,525 SINCE WE MET IN EARLY FEBRUARY 173 00:10:11,525 --> 00:10:15,730 AND WE'LL HAVE TIME TO ANSWER 174 00:10:15,730 --> 00:10:16,063 QUESTIONS. 175 00:10:16,063 --> 00:10:22,870 SO I'LL START WITH A NEW 176 00:10:22,870 --> 00:10:26,073 LEADERSHIP APPOINTMENT 177 00:10:26,073 --> 00:10:29,510 DR. KATHERINE NEZEL OF THE 178 00:10:29,510 --> 00:10:33,647 FOGARTY CENTER AND I HAPPED TO 179 00:10:33,647 --> 00:10:38,619 CO-CHAIR THE SEARCH WITH DR 180 00:10:38,619 --> 00:10:43,290 DR. D'SOUZA AND IS ALSO THE 181 00:10:43,290 --> 00:10:44,892 INTERNATIONAL RESEARCHER AT NIH 182 00:10:44,892 --> 00:10:46,827 AS PART OF HER FOGARTY POSITION 183 00:10:46,827 --> 00:10:48,829 AND FIRST WOMAN TO BE SELECTED 184 00:10:48,829 --> 00:10:50,598 TO BE DIRECTOR OF FOGARTY. 185 00:10:50,598 --> 00:10:54,635 PRIOR TO COMING TO NIH SHE WAS 186 00:10:54,635 --> 00:11:00,608 PROFESSOR IN VACCINOLOGY AND 187 00:11:00,608 --> 00:11:02,209 CHIEF OF THE DIVISION OF 188 00:11:02,209 --> 00:11:03,644 GEOGRAPHIC MEDICINE MARYLAND 189 00:11:03,644 --> 00:11:09,316 SCHOOL OF MEDICINE IN BALTIMORE. 190 00:11:09,316 --> 00:11:13,320 SHE HAS EXPERIENCE IN AFRICA AND 191 00:11:13,320 --> 00:11:16,257 SOUTH ASIA AND ALSO SPENT TIME 192 00:11:16,257 --> 00:11:19,660 IN INDUSTRY AND ACADEMICS BEFORE 193 00:11:19,660 --> 00:11:20,427 BEING IN HERE PREVIOUS POSITION 194 00:11:20,427 --> 00:11:23,030 AT THE UNIVERSITY OF MARYLAND. 195 00:11:23,030 --> 00:11:26,200 THERE'S ALSO A NEW DIRECTOR OF 196 00:11:26,200 --> 00:11:29,303 THE CENTER FOR INFORMATION 197 00:11:29,303 --> 00:11:32,406 TECHNOLOGY, DR. LOONEY. 198 00:11:32,406 --> 00:11:33,808 I DID MEET WITH HIM SINCE HE 199 00:11:33,808 --> 00:11:42,383 STARTED AND I THINK THIS IS EYE 200 00:11:42,383 --> 00:11:44,185 REFRESHING NEW DIRECTION. 201 00:11:44,185 --> 00:11:45,352 IT'S PART OF THE 27 INSTITUTES 202 00:11:45,352 --> 00:11:50,624 AND CENTERS WE TALK ABOUT ITS 203 00:11:50,624 --> 00:11:53,194 INFRASTRUCTURE AND EVERYONE'S 204 00:11:53,194 --> 00:11:54,528 AFFECTED BY IT WITH DESK STOP 205 00:11:54,528 --> 00:11:56,931 SUPPORT AND SYSTEMS ETCETERA. 206 00:11:56,931 --> 00:11:59,200 HE COMES FROM AN ACADEMIC 207 00:11:59,200 --> 00:12:00,668 CONTEXT FROM THE UNIVERSITY OF 208 00:12:00,668 --> 00:12:03,304 WASHINGTON SCHOOL OF MEDICINE AS 209 00:12:03,304 --> 00:12:05,072 PROFESSOR OF BIO MEDICAL 210 00:12:05,072 --> 00:12:06,006 INFORMATICS AND MEDICAL 211 00:12:06,006 --> 00:12:06,307 INFORMATION. 212 00:12:06,307 --> 00:12:14,815 HE OVERSAW THE ENTIRE CLINICAL 213 00:12:14,815 --> 00:12:16,350 DATA OPERATION INCLUDING SEVERAL 214 00:12:16,350 --> 00:12:20,855 HUNDRED CLINICAL SITES IN THE 215 00:12:20,855 --> 00:12:21,355 AREA. 216 00:12:21,355 --> 00:12:24,191 HE'S GOT AN ACADEMIC RESEARCH 217 00:12:24,191 --> 00:12:25,793 PERSPECTIVE ON THAT SIDE AS WELL 218 00:12:25,793 --> 00:12:29,163 AS KNOWLEDGEABLE ABOUT THE 219 00:12:29,163 --> 00:12:30,631 INFRASTRUCTURE AND SERVICE 220 00:12:30,631 --> 00:12:33,234 ORIENTATION C.I.T. NEEDS TO HAVE 221 00:12:33,234 --> 00:12:34,535 FOR IT TO THRIVE. 222 00:12:34,535 --> 00:12:38,606 HE WAS ALSO THE DIRECTOR FOR THE 223 00:12:38,606 --> 00:12:40,908 U.W. INSTITUTE FOR DATA SCIENCE 224 00:12:40,908 --> 00:12:43,110 AND DIRECTOR OF INFORMATICS. 225 00:12:43,110 --> 00:12:45,045 I THINK IT WILL BE A MOVE IN THE 226 00:12:45,045 --> 00:12:46,914 RIGHT DIRECTION AND ALREADY HAS 227 00:12:46,914 --> 00:12:49,950 HAD AN IMPACT IN THE INSTITUTE 228 00:12:49,950 --> 00:12:51,752 DIRECTOR MEETINGS AND LOOK 229 00:12:51,752 --> 00:12:53,654 FORWARD TO WORKING WITH HIM. 230 00:12:53,654 --> 00:12:57,091 HE ALSO SPENT SOME TIME AT 231 00:12:57,091 --> 00:12:58,025 UNIVERSITY OF CALIFORNIA SAN 232 00:12:58,025 --> 00:12:59,226 FRANCISCO IN HIS EARLIER PART OF 233 00:12:59,226 --> 00:13:03,831 HIS CAREER AS A POSTDOC AND 234 00:13:03,831 --> 00:13:05,799 EARLY FACULTY. 235 00:13:05,799 --> 00:13:08,836 THE NIH DIRECTOR, DR. MONICA 236 00:13:08,836 --> 00:13:14,608 BERTAGNOLLI HAS LAUNCHED THROUGH 237 00:13:14,608 --> 00:13:24,985 THE -- WHAT HAPPENED? 238 00:13:26,921 --> 00:13:29,189 ARE WE OKAY? 239 00:13:29,189 --> 00:13:30,224 OKAY. 240 00:13:30,224 --> 00:13:31,458 TWO OF THE COMMON FUND PROGRAMS 241 00:13:31,458 --> 00:13:35,796 TO SUPPORT CLINICAL RESEARCH AND 242 00:13:35,796 --> 00:13:38,432 PRIMARY CARE SETTINGS SHE HAS 243 00:13:38,432 --> 00:13:40,534 EMPHASIZED THIS SINCE SHE WAS 244 00:13:40,534 --> 00:13:42,569 CONFIRMED SHORTLY AFTER SHE WAS 245 00:13:42,569 --> 00:13:46,974 CONFIRMED AS THE NIH DIRECTOR 246 00:13:46,974 --> 00:13:49,043 AND SPOKE TO US ABOUT IT IN THE 247 00:13:49,043 --> 00:13:50,444 FEBRUARY COUNCIL WHEN SHE 248 00:13:50,444 --> 00:13:51,946 PRESENTED AT OUR NIMHD COUNCIL. 249 00:13:51,946 --> 00:13:53,647 A PRIMARY CARE FOCUS CLINICAL 250 00:13:53,647 --> 00:13:59,119 RESEARCH NETWORK STARTS WITH THE 251 00:13:59,119 --> 00:14:01,789 IDEA THAT SHE WANTS US TO DO 252 00:14:01,789 --> 00:14:02,656 MORE CLINICAL RESEARCH AND WANTS 253 00:14:02,656 --> 00:14:05,893 EVERY CLINICAL ENCOUNTER TO BE 254 00:14:05,893 --> 00:14:07,895 PART OF DATA TO BE USED TO 255 00:14:07,895 --> 00:14:10,431 ADVANCE KNOWLEDGE TO HAVE BETTER 256 00:14:10,431 --> 00:14:12,232 CARE FOR ALL AMERICANS. 257 00:14:12,232 --> 00:14:13,734 AND PARTICULARLY REACHING IN THE 258 00:14:13,734 --> 00:14:15,336 AREAS AND INTO POPULATIONS THAT 259 00:14:15,336 --> 00:14:20,107 HAVE NOT BENEFITTED FROM THE 260 00:14:20,107 --> 00:14:22,910 ADVANCES OF SCIENCE AND HEALTH 261 00:14:22,910 --> 00:14:23,544 CARE. 262 00:14:23,544 --> 00:14:26,613 SPECIFIC TARGET WOULD BE BOTH 263 00:14:26,613 --> 00:14:29,717 THE UNDER REPRESENTED 264 00:14:29,717 --> 00:14:30,718 POPULATIONS THAT NIMHD IS 265 00:14:30,718 --> 00:14:35,389 PARTICULARLY FOCUSSED ON AND 266 00:14:35,389 --> 00:14:37,424 WILL NOTE RURAL AREAS. 267 00:14:37,424 --> 00:14:42,129 IS A LONG TERM PROJECT THIS IS 268 00:14:42,129 --> 00:14:44,031 NOT INSTANTANEOUS AND THERE ARE 269 00:14:44,031 --> 00:14:48,669 NEW FUNDS FOR THIS IN FISCAL '24 270 00:14:48,669 --> 00:14:49,770 AND THE OFFICE OF THE DIRECTOR 271 00:14:49,770 --> 00:14:51,138 PROVIDED SOME FUNDS TO GET IT 272 00:14:51,138 --> 00:14:51,405 STARTED. 273 00:14:51,405 --> 00:14:53,173 THERE'S REQUEST FOR APPLICATIONS 274 00:14:53,173 --> 00:14:57,511 THAT IS DUE IN A COUPLE OF WEEKS 275 00:14:57,511 --> 00:15:01,815 AND TOE -- TO START A COUPLE 276 00:15:01,815 --> 00:15:04,318 PILOT STUDIES. 277 00:15:04,318 --> 00:15:06,653 MORE MONEY WILL BE AVAILABLE IN 278 00:15:06,653 --> 00:15:10,924 FISCAL '25 AND WE ANTICIPATE 279 00:15:10,924 --> 00:15:13,160 RAMPING UP WITH ADDITIONAL 280 00:15:13,160 --> 00:15:13,794 CONGRESSIONAL SUPPORT IN THE 281 00:15:13,794 --> 00:15:15,362 NEXT SEVERAL YEARS. 282 00:15:15,362 --> 00:15:18,599 STAY TUNED TO WHAT THIS WILL 283 00:15:18,599 --> 00:15:22,269 MEAN AS A FORMER PRIMARY CARE 284 00:15:22,269 --> 00:15:23,804 DOCTOR MYSELF, I THINK THIS 285 00:15:23,804 --> 00:15:27,941 APPEALS TO ME AND I THINK OUR 286 00:15:27,941 --> 00:15:29,810 STAFF AND SOME OF YOU HAVE HEARD 287 00:15:29,810 --> 00:15:31,612 ME SPEAK ABOUT EMPHASIS IN 288 00:15:31,612 --> 00:15:32,780 PRIMARY CARE. 289 00:15:32,780 --> 00:15:34,882 WE'LL HEAR MORE ABOUT THAT LATER 290 00:15:34,882 --> 00:15:37,551 THIS MORNING AND ALSO THROUGH 291 00:15:37,551 --> 00:15:39,286 THE RESEARCH CENTERS MINORITY 292 00:15:39,286 --> 00:15:40,354 INSTITUTIONS AND ALSO THROUGH 293 00:15:40,354 --> 00:15:42,423 OUR COMMUNITY ENGAGEMENT 294 00:15:42,423 --> 00:15:42,689 ALLIANCE. 295 00:15:42,689 --> 00:15:44,758 WE HAVE LAUNCHED INITIATIVES IN 296 00:15:44,758 --> 00:15:47,728 THIS DIRECTION SO WE'RE VERY 297 00:15:47,728 --> 00:15:52,099 EXCITED ABOUT THIS AND I'M 298 00:15:52,099 --> 00:15:54,668 INVOLVED WITH AT LEAST ADVISING 299 00:15:54,668 --> 00:15:58,172 THE GROUP THAT IS LEADING THIS 300 00:15:58,172 --> 00:16:02,342 OR PROVIDING OVERSIGHT FOR THIS. 301 00:16:02,342 --> 00:16:04,011 A REALLY IMPORTANT CHANGE 302 00:16:04,011 --> 00:16:07,548 OCCURRED IN MARCH AFTER 303 00:16:07,548 --> 00:16:11,819 CULMINATING PROBABLY 18 MONTHS 304 00:16:11,819 --> 00:16:16,723 OR SO REQUEST FOR COMMENTS AND 305 00:16:16,723 --> 00:16:17,024 PROCESSING. 306 00:16:17,024 --> 00:16:20,327 IT WAS LAST FALL THAT I WAS AT 307 00:16:20,327 --> 00:16:22,696 BRIEFINGS AT LEAST TWO TIMES I 308 00:16:22,696 --> 00:16:27,401 THINK OR MAYBE THREE WITH 309 00:16:27,401 --> 00:16:28,635 DR. WEBB COOPER AND OTHERS 310 00:16:28,635 --> 00:16:30,003 HEARING FROM THE DEPARTMENT OF 311 00:16:30,003 --> 00:16:32,072 HEALTH AND HUMAN SERVICES TEAM 312 00:16:32,072 --> 00:16:34,174 THAT WAS SOCIALIZING THIS WITHIN 313 00:16:34,174 --> 00:16:35,409 THE AGENCY. 314 00:16:35,409 --> 00:16:37,644 THERE WAS CLEARED AND MADE 315 00:16:37,644 --> 00:16:39,313 COMMENTS AND IT WAS OFFICIAL, 316 00:16:39,313 --> 00:16:40,948 THE CHIEF STATISTICIAN OF THE 317 00:16:40,948 --> 00:16:43,951 UNITED STATES WHO I BELIEVE SITS 318 00:16:43,951 --> 00:16:45,352 IN THE DEPARTMENT OF COMMERCE 319 00:16:45,352 --> 00:16:49,823 MADE THIS DECLARATION IN EARLY 320 00:16:49,823 --> 00:16:52,092 MARCH AND THE OMB DIRECTOR WAS 321 00:16:52,092 --> 00:16:53,727 CHANGED IN THE SUBSTANTIVE WAY 322 00:16:53,727 --> 00:16:55,996 FOR THE FIRST TIME SINCE 1997. 323 00:16:55,996 --> 00:16:58,198 SO THE TWO MAJOR CHANGES THAT 324 00:16:58,198 --> 00:17:01,301 EVERYONE WILL NOTICE IS FIRST, 325 00:17:01,301 --> 00:17:04,204 WE ARE ILLUMINATING THE TWO-PART 326 00:17:04,204 --> 00:17:07,007 QUESTION AND ASKING A SINGLE 327 00:17:07,007 --> 00:17:12,346 COMBINED RACE AND/OR ETHNICITY 328 00:17:12,346 --> 00:17:18,619 QUESTION THIS BURIES THE 329 00:17:18,619 --> 00:17:20,120 NON-HISPANIC PREFIX FOR 330 00:17:20,120 --> 00:17:21,788 EVERYTHING WE'VE SEEN 331 00:17:21,788 --> 00:17:22,990 POPULARIZED IN LITERATURE BUT I 332 00:17:22,990 --> 00:17:25,492 WILL SAY I HAVE NEVER ENDORSED 333 00:17:25,492 --> 00:17:27,861 THAT IF I HAD ANY CONTROL INTO 334 00:17:27,861 --> 00:17:30,731 WHAT WENT INTO TEXT, 335 00:17:30,731 --> 00:17:32,032 NON-HISPANIC, NON-LATINO. 336 00:17:32,032 --> 00:17:42,576 THAT ASIDE, THE GOAL IS THAT AND 337 00:17:51,652 --> 00:17:53,954 RACE AND ETHNICITY ARE DIFFERENT 338 00:17:53,954 --> 00:17:58,325 IN MANY WAYS BUT THE REALITY IS 339 00:17:58,325 --> 00:18:00,694 PEOPLE SEE THIS AS ONE CONSTRUCT 340 00:18:00,694 --> 00:18:11,238 AND IT'S AN IDENTITY CONSTRUCT 341 00:18:17,244 --> 00:18:20,914 AND THE BRITISH AND U.K. DO IT 342 00:18:20,914 --> 00:18:21,381 SLIGHTLY DIFFERENTLY. 343 00:18:21,381 --> 00:18:24,117 YOU SEE THE CATEGORIES ARE 344 00:18:24,117 --> 00:18:27,354 FAMILIAR, HISPANIC OR LATINO AND 345 00:18:27,354 --> 00:18:30,991 THE SECOND BIG CHANGE IS ADDING 346 00:18:30,991 --> 00:18:34,094 MIDDLE EASTERN OR NORTH AFRICAN. 347 00:18:34,094 --> 00:18:38,632 NATIVE HAWAIIAN OR PACIFIC 348 00:18:38,632 --> 00:18:39,800 ISLANDER EMPHASIZING DIFFERENT 349 00:18:39,800 --> 00:18:45,138 THAN ASIAN AND WHITE. 350 00:18:45,138 --> 00:18:48,408 THIS WAS PREVIOUSLY PROPOSED IN 351 00:18:48,408 --> 00:18:54,314 2015, 2016 AND WAS NOT IMPLEMENT 352 00:18:54,314 --> 00:18:57,718 ED IN 2017. 353 00:18:57,718 --> 00:18:58,986 THERE'S A SECOND LEVEL OF 354 00:18:58,986 --> 00:18:59,820 IMPORTANT DETAIL HERE. 355 00:18:59,820 --> 00:19:03,290 THESE ARE THE PRIMARY 356 00:19:03,290 --> 00:19:03,590 CATEGORIES. 357 00:19:03,590 --> 00:19:05,025 AND IT DOES SAY CHECK ALL THAT 358 00:19:05,025 --> 00:19:10,564 APPLY AND THE IDEA IS IF YOU 359 00:19:10,564 --> 00:19:14,601 CHECK MORE THAN ONE YOU'LL 360 00:19:14,601 --> 00:19:17,604 AUTOMATICALLY BE CONSIDERED 361 00:19:17,604 --> 00:19:18,572 MULTIRACIAL AND THAT BOX IS GONE 362 00:19:18,572 --> 00:19:20,340 AND THE OTHER RACE BOX IS NO 363 00:19:20,340 --> 00:19:21,575 LONGER AN OPTION. 364 00:19:21,575 --> 00:19:24,177 SO PEOPLE CAN'T JUST SAY I'M 365 00:19:24,177 --> 00:19:29,549 NONE OF THESE I'M SOMETHING 366 00:19:29,549 --> 00:19:29,850 ELSE. 367 00:19:29,850 --> 00:19:31,251 KEEP THAT IN MIND. 368 00:19:31,251 --> 00:19:34,621 THERE'S AN A SECOND LEVEL UNDER 369 00:19:34,621 --> 00:19:36,456 EACH CATEGORY THERE WILL BE 370 00:19:36,456 --> 00:19:38,191 GEOGRAPHIC HERITAGE, IF YOU 371 00:19:38,191 --> 00:19:39,960 WISH, TO DEFINE IT OFFERED. 372 00:19:39,960 --> 00:19:41,728 THE SIX MOST COMMON IN THE 373 00:19:41,728 --> 00:19:42,929 UNITED STATES. 374 00:19:42,929 --> 00:19:46,433 NOW, IT'S NOT EXACTLY THAT 375 00:19:46,433 --> 00:19:49,903 BECAUSE FOR AMERICAN INDIAN AND 376 00:19:49,903 --> 00:19:50,837 ALASKAN NATIVE IT'S MORE TRIBAL 377 00:19:50,837 --> 00:19:52,572 GROUPS OFFERED THE MOST LIKELY 378 00:19:52,572 --> 00:19:58,045 FOR THE MOST NUMEROUS AT LEAST 379 00:19:58,045 --> 00:20:08,555 BY THE CENSUS ASSESSMENT THEN 380 00:20:09,756 --> 00:20:12,225 THERE'S COUNTRIES BY AFRICA AND 381 00:20:12,225 --> 00:20:18,398 I BELIEVE THE CARIBBEAN AND 382 00:20:18,398 --> 00:20:21,068 SIMILARLY FOR LATINO AND FOR 383 00:20:21,068 --> 00:20:22,336 WHITE THERE'S COUNTRIES. 384 00:20:22,336 --> 00:20:26,573 THIS WAS IMPLEMENTED IN 2020. 385 00:20:26,573 --> 00:20:29,309 IT'S NOT SOMETHING PEOPLE NOTED 386 00:20:29,309 --> 00:20:30,644 ENOUGH OR HAVE SEEN MUCH 387 00:20:30,644 --> 00:20:33,046 ANALYSIS FROM THE CENSUS DATA. 388 00:20:33,046 --> 00:20:36,783 HAS ALWAYS EXISTED FOR AMERICAN 389 00:20:36,783 --> 00:20:39,353 INDIAN AND PACIFIC ISLANDER OR 390 00:20:39,353 --> 00:20:41,621 LATINO AND 2020 WAS THE FIRST 391 00:20:41,621 --> 00:20:43,256 TIME IMPLEMENTED FOR BLACK FOR 392 00:20:43,256 --> 00:20:44,791 AFRICAN AMERICAN. 393 00:20:44,791 --> 00:20:46,660 I BELIEVE FOR OUR COMMUNITY, ONE 394 00:20:46,660 --> 00:20:48,028 OF THE THINGS TO BE THINKING 395 00:20:48,028 --> 00:20:53,100 ABOUT AND WE WILL DO SOME OF 396 00:20:53,100 --> 00:20:55,202 THAT AT NIMHD AS WELL IS HOW 397 00:20:55,202 --> 00:20:58,605 DOES THIS OPERATIONALIZE ON A 398 00:20:58,605 --> 00:21:00,140 RESEARCH SPECTRUM BECAUSE THESE 399 00:21:00,140 --> 00:21:02,876 CATEGORIES AND THE SECOND-LEVEL 400 00:21:02,876 --> 00:21:04,344 CATEGORIES REQUIRED FOR FEDERAL 401 00:21:04,344 --> 00:21:07,247 AGENCIES TO COLLECT THIS DATA DO 402 00:21:07,247 --> 00:21:09,816 NOT NECESSARY MEET THE NEEDS OF 403 00:21:09,816 --> 00:21:11,318 ALL THE RESEARCH AREAS AND SO I 404 00:21:11,318 --> 00:21:12,953 THINK THAT THAT'S IMPORTANT FOR 405 00:21:12,953 --> 00:21:18,592 US TO THINK ABOUT AND HOW IT 406 00:21:18,592 --> 00:21:20,193 GETS OPERATIONALIZED. 407 00:21:20,193 --> 00:21:21,962 IT'S A CENSUS, IT'S NATIONAL AND 408 00:21:21,962 --> 00:21:24,131 EVEN THOUGH ALL THE OF US HAVE 409 00:21:24,131 --> 00:21:29,569 PROBLEMS WITH THE WAY IT'S 410 00:21:29,569 --> 00:21:33,173 DEFINED, I THINK HAVING 411 00:21:33,173 --> 00:21:34,040 STANDARDIZED COMMON WAYS TO 412 00:21:34,040 --> 00:21:38,412 COLLECT THE DATA IS IMPORTANT TO 413 00:21:38,412 --> 00:21:40,380 ASSESS THE RESEARCH AND PROVIDE 414 00:21:40,380 --> 00:21:41,548 BEST OPTIMAL CARE AND HEALTH FOR 415 00:21:41,548 --> 00:21:44,584 OUR COMMUNITIES. 416 00:21:44,584 --> 00:21:48,822 FOR EXAMPLE JUST TO GIVE YOU ONE 417 00:21:48,822 --> 00:21:49,856 IDEA UNDER HISPANIC OR LATINO IT 418 00:21:49,856 --> 00:21:53,493 WOULD BE IMPORTANT TO CAPTURE 419 00:21:53,493 --> 00:21:55,962 THE AFRO LATINO CATEGORY WHICH 420 00:21:55,962 --> 00:21:58,231 IS AN IMPORTANT SUBCATEGORY NOT 421 00:21:58,231 --> 00:21:58,732 CAPTURED CURRENTLY. 422 00:21:58,732 --> 00:22:01,301 IF YOU SAY I'M HISPANIC AND 423 00:22:01,301 --> 00:22:04,704 BLACK, THAT COULD BE ONE WAY OF 424 00:22:04,704 --> 00:22:09,376 CAPTURING IT BUT MANY LATINOS 425 00:22:09,376 --> 00:22:14,614 WHO HAVE MIXTURE WITH AFRICAN 426 00:22:14,614 --> 00:22:18,618 HERITAGE OR BLACK DO NOT 427 00:22:18,618 --> 00:22:20,220 IDENTIFY WITH BLACK BUT LATINO 428 00:22:20,220 --> 00:22:26,326 AND THIS IS RESEARCH DONE BY THE 429 00:22:26,326 --> 00:22:29,429 PUGH FOUNDATION. 430 00:22:29,429 --> 00:22:31,198 OTHER CATEGORIES ARE RELEVANT 431 00:22:31,198 --> 00:22:32,432 FOR OTHER GROUPS IN 432 00:22:32,432 --> 00:22:32,799 SUBPOPULATIONS. 433 00:22:32,799 --> 00:22:33,533 THAT'S THE KIND OF THING I'M 434 00:22:33,533 --> 00:22:38,905 CONSIDERING. 435 00:22:38,905 --> 00:22:40,907 NOW, THE DEPARTMENT ALSO 436 00:22:40,907 --> 00:22:46,279 PUBLISHED A 2023 EQUITY ACTION 437 00:22:46,279 --> 00:22:49,950 PLAN AS MOST OF YOU ARE AWARE 438 00:22:49,950 --> 00:22:51,017 THERE'S BEEN A STRONG EMPHASIS 439 00:22:51,017 --> 00:22:53,253 ON EQUITY WITHIN HEALTH AND 440 00:22:53,253 --> 00:22:55,555 HUMAN SERVICES OVER THE PAST 441 00:22:55,555 --> 00:22:58,492 THREE YEARS AND THESE WERE THE 442 00:22:58,492 --> 00:23:02,128 FIVE GENERAL PRIORITIES THAT 443 00:23:02,128 --> 00:23:03,763 WERE HIGHLIGHTED NEGLECT AND 444 00:23:03,763 --> 00:23:05,632 IMPROVE CARE TO HELP CHILDREN 445 00:23:05,632 --> 00:23:07,701 THRIVE AND THEIR FAMILIES AND 446 00:23:07,701 --> 00:23:09,035 COMMUNITIES. 447 00:23:09,035 --> 00:23:13,640 IT IS I THINK A CRITICAL PLACE. 448 00:23:13,640 --> 00:23:16,943 WE KNOW THE TREMENDOUS ADVERSITY 449 00:23:16,943 --> 00:23:19,546 THAT CREATE FOR A PERSON TO HAVE 450 00:23:19,546 --> 00:23:22,616 A DISADVANTAGED CHILDHOOD AND 451 00:23:22,616 --> 00:23:25,485 THE COUNTRY HAS MADE A 452 00:23:25,485 --> 00:23:27,787 SIGNIFICANT PROGRESS IN REDUCING 453 00:23:27,787 --> 00:23:29,489 CHILDHOOD POVERTY OVER THE LAST 454 00:23:29,489 --> 00:23:31,925 30 YEARS BUT IT'S OBVIOUSLY NOT 455 00:23:31,925 --> 00:23:32,492 ENOUGH. 456 00:23:32,492 --> 00:23:35,562 YOU STILL HAVE CHILDHOOD POVERTY 457 00:23:35,562 --> 00:23:37,297 AND THE UNITED STATES MAY DO 458 00:23:37,297 --> 00:23:39,366 WORSE THAN OTHER HIGH-INCOME 459 00:23:39,366 --> 00:23:41,101 COUNTRIES BUT IT'S NOT 460 00:23:41,101 --> 00:23:44,170 ACCEPTABLE TO SAY WE'RE NOT THAT 461 00:23:44,170 --> 00:23:49,109 BAD OFF BUT 30 YEARS AGO WAS 462 00:23:49,109 --> 00:23:50,377 TWICE AS BAD IN POVERTY AMONG 463 00:23:50,377 --> 00:23:52,946 ITS OWN CHILDREN HAS DECREASED 464 00:23:52,946 --> 00:23:55,015 AND IT'S MORE THAN POVERTY 465 00:23:55,015 --> 00:23:55,315 OBVIOUSLY. 466 00:23:55,315 --> 00:23:58,184 TO PROMOTE ACCESSIBLE AND 467 00:23:58,184 --> 00:23:59,319 WELCOMING HEALTH CARE AN ONGOING 468 00:23:59,319 --> 00:24:04,591 CHALLENGE PARTICULARLY IN THE 469 00:24:04,591 --> 00:24:05,926 CONTEXT OF THE INCREASING 470 00:24:05,926 --> 00:24:06,993 COMMERCIALIZATION OF HEALTH AND 471 00:24:06,993 --> 00:24:12,032 HEALTH CARE IN OUR COUNTRY. 472 00:24:12,032 --> 00:24:14,134 NOW IT'S AN IMPORTANT POINT AND 473 00:24:14,134 --> 00:24:18,238 OUTCOMES FOR RURAL AND ETHNIC 474 00:24:18,238 --> 00:24:22,609 MINORITY COMMUNITIES AN 475 00:24:22,609 --> 00:24:25,512 IMPORTANT ADDITIONAL POINT 476 00:24:25,512 --> 00:24:27,480 PRIORITIZE THE BEHAVIORAL HEALTH 477 00:24:27,480 --> 00:24:29,716 AND SEPARATION OF WHAT IS 478 00:24:29,716 --> 00:24:32,218 BEHAVIORAL HEALTH AND MENTAL 479 00:24:32,218 --> 00:24:38,625 HEALTH AND ROUTINE HEALTH CARE 480 00:24:38,625 --> 00:24:39,626 SOMETHINGS ARTIFICIAL AND 481 00:24:39,626 --> 00:24:40,860 CENTRAL TO NOT HOW ONE TAKES 482 00:24:40,860 --> 00:24:42,228 CARE OF PEOPLE IN PRIMARY CARE 483 00:24:42,228 --> 00:24:43,997 WE COULD NEVER DO THAT BECAUSE 484 00:24:43,997 --> 00:24:47,200 THAT'S NOT HOW WE TOOK CARE OF 485 00:24:47,200 --> 00:24:48,768 PATIENTS AND YET THE SYSTEM 486 00:24:48,768 --> 00:24:53,907 WASN'T SUPPORTING THAT. 487 00:24:53,907 --> 00:24:59,512 IT HAS GOTTEN BETTER BUT HAVE A 488 00:24:59,512 --> 00:25:03,350 LONG WAY TO GO LOU THE SYSTEM 489 00:25:03,350 --> 00:25:04,684 AND RESPONDS AND MANAGES HEALTH 490 00:25:04,684 --> 00:25:06,419 CARE AND RURAL HEALTH FOR THE 491 00:25:06,419 --> 00:25:09,322 MOST COMMON MENTAL HEALTH 492 00:25:09,322 --> 00:25:10,624 PROBLEMS WHICH RELATED TO 493 00:25:10,624 --> 00:25:12,659 DEPRESSIVE SYMPTOMS AND 494 00:25:12,659 --> 00:25:14,060 DEPRESSION AND ANXIETY. 495 00:25:14,060 --> 00:25:16,396 AND IN INCREASED DIVERSE IN 496 00:25:16,396 --> 00:25:16,963 TRIAL DIVERSITY TO SUPPORT 497 00:25:16,963 --> 00:25:20,600 INNOVATION. 498 00:25:20,600 --> 00:25:23,937 WE WERE CHARGED TO CREATE SAY 499 00:25:23,937 --> 00:25:25,271 HEALTH EQUITY FACT SHEET. 500 00:25:25,271 --> 00:25:26,940 EACH OF THE AGENCIES AT THE 501 00:25:26,940 --> 00:25:31,244 DEPARTMENT OF HEALTH AND HUMAN 502 00:25:31,244 --> 00:25:33,380 SERVICES THE NIH HEALTH EQUITY 503 00:25:33,380 --> 00:25:35,615 FACT SHEET AND NIMHD WAS MADE 504 00:25:35,615 --> 00:25:37,517 RESPONSIBLE FOR GENERATING THIS. 505 00:25:37,517 --> 00:25:41,755 THIS WAS FROM THE OFFICE OF THE 506 00:25:41,755 --> 00:25:44,357 NIH DIRECTOR AND STAFF WERE 507 00:25:44,357 --> 00:25:48,228 DILIGENTLY AT THIS BOTH IN OUR 508 00:25:48,228 --> 00:25:50,897 OFFICE OF PLANNING AND STRATEGIC 509 00:25:50,897 --> 00:25:51,798 ANALYSIS AS WELL AS 510 00:25:51,798 --> 00:25:52,165 COMMUNICATIONS. 511 00:25:52,165 --> 00:25:56,970 AND THIS IS AVAILABLE ON THE 512 00:25:56,970 --> 00:25:57,203 WEBSITE. 513 00:25:57,203 --> 00:26:04,010 IT WAS REVIEWED EXTENSIVELY BY 514 00:26:04,010 --> 00:26:14,487 DR. DR. WEBB-HOOPER AND THE 515 00:26:29,169 --> 00:26:32,205 OFFICE OF THE SURGEON GENERAL 516 00:26:32,205 --> 00:26:35,542 WAS CONTACT AND THERE WAS A 517 00:26:35,542 --> 00:26:39,045 FIRESIDE CHAT AND IT WAS 518 00:26:39,045 --> 00:26:43,750 CELEBRATED ON MAY 23 AND 519 00:26:43,750 --> 00:26:46,453 DR. MUTTI IS CELEBRATING PACIFIC 520 00:26:46,453 --> 00:26:47,620 ISLANDER NATIVE HAWAIIAN 521 00:26:47,620 --> 00:26:48,254 HERITAGE MONTH. 522 00:26:48,254 --> 00:26:51,324 THIS MONTH WAS WIDELY ENDORSED 523 00:26:51,324 --> 00:26:52,926 BY BOTH NIH THE OFFICE OF THE 524 00:26:52,926 --> 00:26:54,294 DIRECTOR AS WELL AS THE 525 00:26:54,294 --> 00:26:55,161 DEPARTMENT OF HEALTH AND HUMAN 526 00:26:55,161 --> 00:26:59,232 SERVICES. 527 00:26:59,232 --> 00:27:02,569 THE HOSTING AND ALL THE 528 00:27:02,569 --> 00:27:04,771 BACKGROUND WORK WAS DONE AT 529 00:27:04,771 --> 00:27:05,071 NIMHD. 530 00:27:05,071 --> 00:27:14,614 DR. MONICA WEBB-HOOPER WAS THE 531 00:27:14,614 --> 00:27:16,282 MODERA 532 00:27:16,282 --> 00:27:16,549 MODERATOR. 533 00:27:16,549 --> 00:27:17,917 I MISSED THIS EVENT BECAUSE I 534 00:27:17,917 --> 00:27:19,652 WAS IN NEW YORK CITY FOR AN 535 00:27:19,652 --> 00:27:21,488 EVENT THERE AND THE NEXT SPEAKER 536 00:27:21,488 --> 00:27:24,157 WAS PROFESSOR AND INAUGURAL 537 00:27:24,157 --> 00:27:25,992 DIRECTOR OF THE STAVROS 538 00:27:25,992 --> 00:27:31,698 FOUNDATION INSTITUTE AT JOHNS 539 00:27:31,698 --> 00:27:31,931 HOPKINS. 540 00:27:31,931 --> 00:27:37,971 IT IS DR. MUTI'S OFFICE THAT 541 00:27:37,971 --> 00:27:40,573 SELECTED THE DISTINGUISHED 542 00:27:40,573 --> 00:27:44,244 LECTURESHIP AND WANTED TO MAKE 543 00:27:44,244 --> 00:27:45,311 IT UP PERSON WHICH LOGISTICALLY 544 00:27:45,311 --> 00:27:47,881 WAS GOING TO BE CHALLENGING AND 545 00:27:47,881 --> 00:27:51,351 ENDED UP BEING ON VIDEOCAST AND 546 00:27:51,351 --> 00:27:53,419 I'M SURE THE EVENT WAS 547 00:27:53,419 --> 00:27:57,891 OUTSTANDING AND YOU CAN WATCH IT 548 00:27:57,891 --> 00:27:58,792 ON THE LINK THERE. 549 00:27:58,792 --> 00:28:03,263 I ALSO WANT TO CELEBRATE THE NIH 550 00:28:03,263 --> 00:28:04,664 MENTAL HEALTH NATIONAL YOUTH 551 00:28:04,664 --> 00:28:06,232 ESSAY CONTEST. 552 00:28:06,232 --> 00:28:10,603 IT'S BEEN A COLLABORATION OF 553 00:28:10,603 --> 00:28:12,305 NIMHD AND NIMHD AND NICHD SO 554 00:28:12,305 --> 00:28:14,607 MENTAL HEALTH, CHILD HEALTH AND 555 00:28:14,607 --> 00:28:15,975 HEALTH DISPARITIES. 556 00:28:15,975 --> 00:28:18,611 THE CONTEST CHALLENGES HIGH 557 00:28:18,611 --> 00:28:20,947 SCHOOL STUDENTS AGES 16 TO 18 TO 558 00:28:20,947 --> 00:28:23,383 RAISE AWARENESS OF MENTAL HEALTH 559 00:28:23,383 --> 00:28:23,616 ISSUES. 560 00:28:23,616 --> 00:28:28,354 AND PARTICULARLY RESONATES IN 561 00:28:28,354 --> 00:28:31,758 THE SETTING OF WHAT HAS 562 00:28:31,758 --> 00:28:32,692 INCREASINGLY BEEN RECOGNIZED AS 563 00:28:32,692 --> 00:28:34,861 A MENTAL HEALTH CRISIS FOR OUR 564 00:28:34,861 --> 00:28:35,094 YOUTH. 565 00:28:35,094 --> 00:28:38,598 IN PART EXACERBATED BY THE 566 00:28:38,598 --> 00:28:41,034 ISOLATION OF THE PANDEMIC, 567 00:28:41,034 --> 00:28:43,236 ISOLATION FROM SCHOOL, ISOLATION 568 00:28:43,236 --> 00:28:47,907 FROM FRIENDS AND THE AFFECTS 569 00:28:47,907 --> 00:28:50,376 SUBTLE OR OVERT OF CHANGES IN 570 00:28:50,376 --> 00:28:53,179 HOW WE COMMUNICATE PARTICULARLY 571 00:28:53,179 --> 00:28:54,614 THROUGH SOCIAL MEDIA AND OTHER 572 00:28:54,614 --> 00:28:55,882 DIGITAL MEANS OPPOSED TO IN 573 00:28:55,882 --> 00:28:58,384 PERSON INTERACTIONS. 574 00:28:58,384 --> 00:29:01,454 WE HAD A HUGE NUMBER OF 575 00:29:01,454 --> 00:29:02,622 SUBMISSIONS FROM ACROSS MOST OF 576 00:29:02,622 --> 00:29:05,158 THE COUNTRY. 577 00:29:05,158 --> 00:29:08,228 THE ESSAYS ADDRESS STIGMA AND 578 00:29:08,228 --> 00:29:10,363 TRAUMA AND RESILIENCE, EQUITY, 579 00:29:10,363 --> 00:29:10,663 ANXIETY. 580 00:29:10,663 --> 00:29:13,333 I HAD NOTHING TO DO WITH WHO WAS 581 00:29:13,333 --> 00:29:13,600 SELECTED. 582 00:29:13,600 --> 00:29:20,607 I JUST APPROVED IT. 583 00:29:20,607 --> 00:29:22,742 THERE ARE MODEST MONETARY AWARDS 584 00:29:22,742 --> 00:29:24,878 AND LABELLED AS GOLD, SILVER AND 585 00:29:24,878 --> 00:29:27,347 BRONZE AND THE ESSAYS I THINK 586 00:29:27,347 --> 00:29:31,384 ARE AVAILABLE, I ASSUME, FOR 587 00:29:31,384 --> 00:29:33,486 PEOPLE TO SEE. 588 00:29:33,486 --> 00:29:35,221 I DON'T KNOW IF THERE'S 589 00:29:35,221 --> 00:29:36,589 DESCRIPTIONS ON THE WEB LINK. 590 00:29:36,589 --> 00:29:38,691 SHOUT OUT TO STAFF FROM THE 591 00:29:38,691 --> 00:29:40,827 THREE INSTITUTES WHO HELPED 592 00:29:40,827 --> 00:29:41,728 COORDINATE AND ORGANIZE THIS FOR 593 00:29:41,728 --> 00:29:41,961 US. 594 00:29:41,961 --> 00:29:44,931 I DID READ THE WINNING ESSAYS BY 595 00:29:44,931 --> 00:29:46,432 THE WAY AND THEY'RE QUITE 596 00:29:46,432 --> 00:29:46,699 MOVING. 597 00:29:46,699 --> 00:29:48,668 I WANT TO ALSO POINT OUT THE ALL 598 00:29:48,668 --> 00:29:50,937 OF US RESEARCH PROGRAM. 599 00:29:50,937 --> 00:29:54,574 THE 27 INSTITUTES AND CENTER 600 00:29:54,574 --> 00:29:56,542 DIRECTORS CO-AUTHORED SIGNED ON 601 00:29:56,542 --> 00:30:02,282 TO AN ESSAY. 602 00:30:02,282 --> 00:30:09,756 DR. BIARTH -- DR. BIANCHI WAS AN 603 00:30:09,756 --> 00:30:11,724 AUTHOR BECAUSE HER NAME STARTS 604 00:30:11,724 --> 00:30:13,359 WITH A "B" AND LATER WE'LL HAVE 605 00:30:13,359 --> 00:30:14,794 THE SENIOR AUTHOR. 606 00:30:14,794 --> 00:30:18,398 IT'S BASICALLY A STATEMENT OF 607 00:30:18,398 --> 00:30:20,033 THIS PROGRAM. 608 00:30:20,033 --> 00:30:23,002 AND MANY WILL REMEMBER IN 2015 609 00:30:23,002 --> 00:30:24,704 THE YEAR THE PRECISION MEDICINE 610 00:30:24,704 --> 00:30:25,672 WAS LAUNCHED. 611 00:30:25,672 --> 00:30:27,373 I ARRIVED AT NIH JUST AS THAT 612 00:30:27,373 --> 00:30:32,111 WAS STARTING. 613 00:30:32,111 --> 00:30:42,689 IN FACT AND IT'S NOT ONLY 614 00:30:42,689 --> 00:30:44,490 LAURNLED OVER THE NEXT COUPLE 615 00:30:44,490 --> 00:30:47,727 YEARS BUT HAS NOW RECRUITED 616 00:30:47,727 --> 00:30:52,832 SOMEWHERE CLOSE TO 800,000 617 00:30:52,832 --> 00:30:54,634 INITIAL VOLUNTEERS WHO HAVE 618 00:30:54,634 --> 00:30:56,970 COMPLETED THE INITIAL DATA. 619 00:30:56,970 --> 00:30:59,739 MANY HAVE HAD THEIR GENETIC 620 00:30:59,739 --> 00:31:02,442 ANALYSIS DONE THE GWAS. 621 00:31:02,442 --> 00:31:04,110 THIS WAS DEEMED AS A GENETIC 622 00:31:04,110 --> 00:31:04,477 STUDY. 623 00:31:04,477 --> 00:31:08,881 THAT WAS THE IDEA TO BEGIN WITH 624 00:31:08,881 --> 00:31:10,650 AND STILL BEING PROMOTED AS SUCH 625 00:31:10,650 --> 00:31:14,587 BY MANY AND IT'S A LARGE COHORT 626 00:31:14,587 --> 00:31:16,689 STUDY OF DIVERSE AMERICA THAT 627 00:31:16,689 --> 00:31:19,892 WILL BE PROVIDING US WITH 628 00:31:19,892 --> 00:31:20,727 TREMENDOUS AMOUNT OF INFORMATION 629 00:31:20,727 --> 00:31:23,062 AND POSSIBILITIES FOR ANALYSIS 630 00:31:23,062 --> 00:31:25,498 FOR ADVANCING KNOWLEDGE FOR 631 00:31:25,498 --> 00:31:26,466 YEARS TO COME. 632 00:31:26,466 --> 00:31:28,468 THE VOLUNTEERS COMPLETE ALL 633 00:31:28,468 --> 00:31:30,737 SORTS OF QUESTIONNAIRES AND 634 00:31:30,737 --> 00:31:34,607 AGREE, MANY NOT ALL BUT MOST 635 00:31:34,607 --> 00:31:38,444 AGREE TO LINK TO THEIR 636 00:31:38,444 --> 00:31:39,078 ELECTRONIC HEALTH RECORD WHICH 637 00:31:39,078 --> 00:31:42,181 ARE HARMONIZED AND PROVIDED IN 638 00:31:42,181 --> 00:31:43,316 THE DATABASE AND THERE'S A 639 00:31:43,316 --> 00:31:44,817 DATABASE THAT EXIST AND PEOPLE 640 00:31:44,817 --> 00:31:49,522 ARE USING IT. 641 00:31:49,522 --> 00:31:52,291 THIS IS I THINK THE AN INFLEXION 642 00:31:52,291 --> 00:31:53,593 POINT TO SAY THIS IS REAL. 643 00:31:53,593 --> 00:31:54,927 THIS IS HAPPENING. 644 00:31:54,927 --> 00:31:57,663 WE HAVE THIS ENORMOUS RESOURCE 645 00:31:57,663 --> 00:32:01,234 AVAILABLE TO DO ANALYSIS. 646 00:32:01,234 --> 00:32:02,268 THERE ARE ISSUES AND I WON'T GO 647 00:32:02,268 --> 00:32:06,606 INTO THOSE RIGHT NOW BUT I THINK 648 00:32:06,606 --> 00:32:08,574 OVER ALL THIS COMMITMENT AND 649 00:32:08,574 --> 00:32:12,812 VISION INTRODUCED REALLY BY 650 00:32:12,812 --> 00:32:15,381 FRANCIS COLLINS AND MADE 651 00:32:15,381 --> 00:32:17,383 POSSIBLE BY CONGRESSIONAL 652 00:32:17,383 --> 00:32:19,052 SUPPORT AND BROAD NIH SUPPORT 653 00:32:19,052 --> 00:32:20,953 AND JOSH DENNY'S LEADERSHIP HAS 654 00:32:20,953 --> 00:32:21,788 MADE THIS REAL AND WE'LL HEAR 655 00:32:21,788 --> 00:32:30,630 MORE FROM HIM LATER. 656 00:32:30,630 --> 00:32:31,364 PROBABLY THE MOST IMPORTANT 657 00:32:31,364 --> 00:32:34,467 EVENT IS WE HAVE A BUDGET. 658 00:32:34,467 --> 00:32:37,837 TO MARCH 23 WE WERE OPERATING 659 00:32:37,837 --> 00:32:39,972 UNDER A CONTINUING RESOLUTION. 660 00:32:39,972 --> 00:32:45,111 THE BILL TO FUND NIH WAS SIGNED 661 00:32:45,111 --> 00:32:47,480 BY PRESIDENT BIDEN IN THE 662 00:32:47,480 --> 00:32:51,050 MORNING HOURS OF MARCH 23. 663 00:32:51,050 --> 00:32:52,952 IT WENT THROUGH CONGRESS AND THE 664 00:32:52,952 --> 00:32:59,092 C.R. WAS GOING TO END AT M 665 00:32:59,092 --> 00:33:03,696 MIDNIGHT ON MARCH 23 AND WE WERE 666 00:33:03,696 --> 00:33:07,400 PREPARED TO DEAL WITH IT AND 667 00:33:07,400 --> 00:33:14,240 OVER ALL THE NIH BUDGET WAS 668 00:33:14,240 --> 00:33:14,440 FLAT. 669 00:33:14,440 --> 00:33:15,374 DR. BERTAGNOLLI DEDICATED MANY 670 00:33:15,374 --> 00:33:19,645 VISIT TO SENATORS AND CONGRESS 671 00:33:19,645 --> 00:33:22,482 MEMBERS, CONGRESSIONAL MEMBERS 672 00:33:22,482 --> 00:33:27,353 TO ADVOCATE FOR THE NIH BUDGET 673 00:33:27,353 --> 00:33:30,590 SO WE WERE SPARED IMPORTANT 674 00:33:30,590 --> 00:33:33,392 REDUCTIONS AND PREPARED TO 675 00:33:33,392 --> 00:33:36,562 ABSORB UP TO A 5% TO 8% CUT AND 676 00:33:36,562 --> 00:33:42,135 WERE TOLD IT'S THE BEST POSSIBLE 677 00:33:42,135 --> 00:33:45,371 OUTCOME AND THAT'S SOMETHING I 678 00:33:45,371 --> 00:33:47,840 WANT TO MAKE SURE EVERYONE'S 679 00:33:47,840 --> 00:33:50,576 AWARE DR. BERTAGNOLLI STEPPED 680 00:33:50,576 --> 00:33:54,147 INTO THE FIRE AND DID A 681 00:33:54,147 --> 00:33:58,251 REMARKABLE JOB IN SUPPORTING THE 682 00:33:58,251 --> 00:33:59,318 AGENCY AS NIH DIRECTOR. 683 00:33:59,318 --> 00:34:01,254 THERE WERE SOME INCREASES. 684 00:34:01,254 --> 00:34:03,723 NIMHD GOT INCREASES FOR MENTAL 685 00:34:03,723 --> 00:34:04,891 HEALTH AMONG YOUTH. 686 00:34:04,891 --> 00:34:07,460 THERE WERE INCREASES ON CANCER 687 00:34:07,460 --> 00:34:09,829 AND THE MOONSHOT CATEGORY AND 688 00:34:09,829 --> 00:34:13,166 THERE WERE MODEST INCREASES FOR 689 00:34:13,166 --> 00:34:13,733 ALZHEIMER'S DISEASE FROM 690 00:34:13,733 --> 00:34:17,937 CONGRESS AS MORE THAN ANYTHING 691 00:34:17,937 --> 00:34:18,137 ELSE. 692 00:34:18,137 --> 00:34:21,641 A SLIGHT INCREASE IN NIDA AND 693 00:34:21,641 --> 00:34:24,010 THE HEAL INITIATIVE AND NIMHD 694 00:34:24,010 --> 00:34:26,612 ACTUALLY RECEIVED MODEST 695 00:34:26,612 --> 00:34:31,083 INCREASES IN TWO SPECIFIED 696 00:34:31,083 --> 00:34:31,450 CATEGORIES. 697 00:34:31,450 --> 00:34:37,190 I SEE THE INITIATIVE TO IMPROVE 698 00:34:37,190 --> 00:34:39,025 NATIVE AMERICAN WAS $6 MILLION 699 00:34:39,025 --> 00:34:40,927 NOT $10 MILLION. 700 00:34:40,927 --> 00:34:42,028 THAT THE AN ERROR. 701 00:34:42,028 --> 00:34:44,897 I APOLOGIZE FOR THAT. 702 00:34:44,897 --> 00:34:46,165 NO MATTER HOW MANY TIMES YOU GO 703 00:34:46,165 --> 00:34:46,899 OVER THE SLIDES THERE'S 704 00:34:46,899 --> 00:34:48,701 SOMETHING THAT ESCAPES YOU. 705 00:34:48,701 --> 00:34:51,437 MAYBE IT WAS WISHFUL THINKING 706 00:34:51,437 --> 00:34:53,673 MAYBE IT WAS THE SIX PLUS FOUR 707 00:34:53,673 --> 00:34:55,908 THAT GOT CONFUSED THERE. 708 00:34:55,908 --> 00:34:58,477 THIS WAS AN INITIATIVE WE WERE 709 00:34:58,477 --> 00:35:03,382 NOT EXPECTING. 710 00:35:03,382 --> 00:35:06,686 IT IS BASED IN NIMHD WE HAVE 711 00:35:06,686 --> 00:35:08,187 DONE ALL THE GROUND WORK TO 712 00:35:08,187 --> 00:35:11,724 PREPARE FOR THIS INCLUDING 713 00:35:11,724 --> 00:35:17,129 SPEAKING WITH COLLEAGUES AT NCI 714 00:35:17,129 --> 00:35:20,199 AND HAVE TALKED TO DOUG LOWEY 715 00:35:20,199 --> 00:35:21,167 WITH THIS AND BEEN IN DISCUSSION 716 00:35:21,167 --> 00:35:23,936 WITH THE DRASHTH -- 717 00:35:25,972 --> 00:35:28,040 DIRECTOR OF THE TRIBAL HEALTH 718 00:35:28,040 --> 00:35:28,908 RESEARCH AND WE'RE EXCITED ABOUT 719 00:35:28,908 --> 00:35:30,076 THE POSSIBILITIES. 720 00:35:30,076 --> 00:35:34,580 I THINK IT'S MUCH NEEDED 721 00:35:34,580 --> 00:35:39,418 INVESTMENT AND WE WILL SEE HOW 722 00:35:39,418 --> 00:35:41,954 THIS EVOLVES. 723 00:35:41,954 --> 00:35:45,191 OUR INTENTION IS TO PUBLISH AN 724 00:35:45,191 --> 00:35:46,158 IN THE FOR FUNDING OPPORTUNITY 725 00:35:46,158 --> 00:35:48,694 IN A COMPETITION LINKED TO THE 726 00:35:48,694 --> 00:35:54,066 NCI FUNDED CANCER CENTERS AS 727 00:35:54,066 --> 00:35:55,601 DIRECTED BY THE LEGISLATION SOME 728 00:35:55,601 --> 00:35:57,570 TIME BY MID JUNE. 729 00:35:57,570 --> 00:35:58,537 THAT'S OUR GOAL. 730 00:35:58,537 --> 00:36:06,612 WE WILL MAKE THIS HAP JPEN THIS 731 00:36:06,612 --> 00:36:08,781 FISCAL YEAR AND EXPECT 732 00:36:08,781 --> 00:36:09,515 ADDITIONAL SUPPORT IF CONGRESS 733 00:36:09,515 --> 00:36:10,583 IS SO INCLINED. 734 00:36:10,583 --> 00:36:12,752 WE WERE DIRECTED TO ESTABLISH AN 735 00:36:12,752 --> 00:36:14,787 OFFICE ON NATIVE HAWAIIAN AND 736 00:36:14,787 --> 00:36:15,921 PACIFIC ISLANDER HEALTH 737 00:36:15,921 --> 00:36:16,188 RESEARCH. 738 00:36:16,188 --> 00:36:19,625 THERE HAD BEEN BACK AND FORM 739 00:36:19,625 --> 00:36:24,630 DISCUSSIONS FROM CONGRESSIONAL 740 00:36:24,630 --> 00:36:29,969 STAFF. 741 00:36:29,969 --> 00:36:32,238 THIS WAS NOT AS MUCH OF A 742 00:36:32,238 --> 00:36:33,639 SURPRISE AND WE LAD A PLAN IN 743 00:36:33,639 --> 00:36:37,209 PLACE AND DEVELOPING IT TO 744 00:36:37,209 --> 00:36:38,577 ESTABLISH AN OFFICE WITHIN 745 00:36:38,577 --> 00:36:41,514 PROGRAM THAT WILL BE FUNDING 746 00:36:41,514 --> 00:36:43,616 RESEARCH CONDUCTING OUTREACH TO 747 00:36:43,616 --> 00:36:48,387 THE COMMUNITY, WORK WITH 748 00:36:48,387 --> 00:36:50,189 COMMUNITY GROUPS AND LEVERAGE 749 00:36:50,189 --> 00:36:52,792 EXISTING PROGRAMS TO IMPLEMENT 750 00:36:52,792 --> 00:36:54,927 THIS IN A ROBUST WAY. 751 00:36:54,927 --> 00:36:57,830 WE'RE EXCITED ABOUT THESE ARE 752 00:36:57,830 --> 00:36:58,597 THE TWO POPULATIONS IN THE 753 00:36:58,597 --> 00:37:01,067 CENSUS IF YOU LOOK AT THE CENSUS 754 00:37:01,067 --> 00:37:03,903 WE THINK THOUGH WE DON'T KNOW 755 00:37:03,903 --> 00:37:09,375 HOW MANY PEOPLE WILL IDENTIFY 756 00:37:09,375 --> 00:37:12,445 ADDS MIDDLE EASTERN OR AFRICAN 757 00:37:12,445 --> 00:37:14,046 WERE LEFT OUT OF NATIONAL DATA 758 00:37:14,046 --> 00:37:16,115 BECAUSE THERE WERE NOT SAMPLING 759 00:37:16,115 --> 00:37:17,216 STRATEGIES. 760 00:37:17,216 --> 00:37:19,985 WE'VE DONE BETTER WITH AMERICAN 761 00:37:19,985 --> 00:37:23,556 INDIAN AND ALASKAN NATIVE AND 762 00:37:23,556 --> 00:37:25,691 NOT THE CASE FOR NATIVE PACIFIC 763 00:37:25,691 --> 00:37:26,592 ISLANDER AND THE SMALL 764 00:37:26,592 --> 00:37:28,994 POPULATIONS END UP WITH NOT 765 00:37:28,994 --> 00:37:30,196 ENOUGH AND EMPHASIZE WITH 766 00:37:30,196 --> 00:37:33,399 DIFFERENT METHODS IS IMPORTANT 767 00:37:33,399 --> 00:37:39,605 TO ADVANCE RESEARCH. 768 00:37:39,605 --> 00:37:42,708 THIS IS A SNAPSHOT OF THE NIMHD 769 00:37:42,708 --> 00:37:43,609 BUDGET SINCE 2016. 770 00:37:43,609 --> 00:37:51,083 OUR GROWTH OVER THE NOT QUITE 771 00:37:51,083 --> 00:37:53,753 10, NINE YEARS HAS BEEN ALMOST 772 00:37:53,753 --> 00:37:54,086 DOUBLE. 773 00:37:54,086 --> 00:37:56,389 THE FISCAL '24 DID NOT GO DOWN 774 00:37:56,389 --> 00:37:57,056 THOUGH WAS AT RISK. 775 00:37:57,056 --> 00:38:07,600 I WENT UP SLIGHTLY, $10 MILLION. 776 00:38:07,933 --> 00:38:11,303 AND HOPE IT'S LAID A SOLID 777 00:38:11,303 --> 00:38:12,104 FOUNDATION FOR CONTINUING 778 00:38:12,104 --> 00:38:13,005 SCIENCE IN MINORITY HEALTH AND 779 00:38:13,005 --> 00:38:14,440 HEALTH DISPARITIES. 780 00:38:14,440 --> 00:38:16,008 ILLUSTRATION OF WHERE WE HAVE 781 00:38:16,008 --> 00:38:26,552 BEEN WITH R01 APPLICATIONS AND 782 00:38:27,453 --> 00:38:31,123 '24 IS FAR FROM OVER THROUGH '23 783 00:38:31,123 --> 00:38:32,992 YOU SEE IN 2015 THE YEAR I WAS 784 00:38:32,992 --> 00:38:36,629 HERE FOR JUST THE LAST MONTH OF 785 00:38:36,629 --> 00:38:38,931 THAT FISCAL YEAR, NIMHD HAD 786 00:38:38,931 --> 00:38:45,237 LAUNCHED AN RFA, A SET ASIDE FOR 787 00:38:45,237 --> 00:38:48,207 R01s AND THE APPLICATIONS HAD 788 00:38:48,207 --> 00:38:52,211 GONE DOWN IN FISCAL '16 WHERE WE 789 00:38:52,211 --> 00:38:54,613 DOESN'T HAVE SET ASIDES AND 790 00:38:54,613 --> 00:38:57,383 ACCEPTING APPLICATIONS FROM THE 791 00:38:57,383 --> 00:38:59,151 PARENT R01 MECHANISM. 792 00:38:59,151 --> 00:39:03,656 THAT WAS IN MY FIRST YEAR HERE 793 00:39:03,656 --> 00:39:06,425 WHEN STAFF BEGAN TO GENERATE 794 00:39:06,425 --> 00:39:08,494 IDEAS AND CONCEPTS AND OF COURSE 795 00:39:08,494 --> 00:39:11,931 THOSE WERE NOT IMPLEMENTED OR 796 00:39:11,931 --> 00:39:14,500 OPERATIONALIZED UNTIL LATER. 797 00:39:14,500 --> 00:39:16,268 THE SHIFT IN R01 SCIENCE AS YOU 798 00:39:16,268 --> 00:39:20,439 SEE BEGAN TO BE NOTED IN FISCAL 799 00:39:20,439 --> 00:39:22,808 '17 WITH INCREASING NUMBER OF 800 00:39:22,808 --> 00:39:25,144 APPLICATIONS UNTIL '23 WHEN WE 801 00:39:25,144 --> 00:39:27,746 HAD A SLIGHT DECREASE FROM '22 802 00:39:27,746 --> 00:39:29,181 TO '23. 803 00:39:29,181 --> 00:39:31,283 THE SUCCESS RATE HAS VARIED 804 00:39:31,283 --> 00:39:34,487 BECAUSE AGAIN WE HAVE A SMALLER 805 00:39:34,487 --> 00:39:38,457 SAMPLE SIZE AND ALSO WITH 806 00:39:38,457 --> 00:39:41,827 SHIFTING FUNDING FROM CENTERS TO 807 00:39:41,827 --> 00:39:44,897 R01s AND AGAIN VARYING YEAR TO 808 00:39:44,897 --> 00:39:45,898 YEAR DEPENDING ON WHAT CONGRESS 809 00:39:45,898 --> 00:39:47,500 ASKS US TO DO. 810 00:39:47,500 --> 00:39:54,974 WE BOTTOMED OUT IN 2020 AND 811 00:39:54,974 --> 00:39:57,977 MOVED BACK UP TO 18% IN 2022 AND 812 00:39:57,977 --> 00:39:59,478 2023 AND PROBABLY GO DOWN THIS 813 00:39:59,478 --> 00:40:01,280 YEAR GIVEN THE RESTRICTION ON 814 00:40:01,280 --> 00:40:01,881 THE BUDGET. 815 00:40:01,881 --> 00:40:05,351 BUT WE HOPE TO KEEP IT IN THAT 816 00:40:05,351 --> 00:40:08,153 RANGE AND KEEP INCHING IT UP AS 817 00:40:08,153 --> 00:40:09,855 MUCH AS POSSIBLE AND WE'LL FIND 818 00:40:09,855 --> 00:40:13,259 THE RIGHT BALANCE OF THE BUDGET. 819 00:40:13,259 --> 00:40:17,396 SO I WANTED TO SHARE THE 820 00:40:17,396 --> 00:40:17,630 NUMBERS. 821 00:40:17,630 --> 00:40:20,132 THIS IS AN ILLUSTRATION OF 822 00:40:20,132 --> 00:40:21,500 AWARDS AND SUCCESS RATES AGAIN. 823 00:40:21,500 --> 00:40:24,503 AGAIN SHOWING THE NUMBER OF 824 00:40:24,503 --> 00:40:26,605 APPLICATIONS, NUMBER OF AWARDS 825 00:40:26,605 --> 00:40:28,274 AND SUCCESS RATE. 826 00:40:28,274 --> 00:40:29,875 AGAIN, YOU CAN SEE THIS LINE 827 00:40:29,875 --> 00:40:33,946 THAT WE'RE LOOKING AT HERE IS 828 00:40:33,946 --> 00:40:35,681 REALLY WHAT MANY INSTITUTES -- 829 00:40:35,681 --> 00:40:38,584 YOU SAY WHERE DO OTHER 830 00:40:38,584 --> 00:40:40,419 INSTITUTES SIT? 831 00:40:40,419 --> 00:40:44,256 SOME INSTITUTES ARE BELOW 10% 832 00:40:44,256 --> 00:40:44,490 SUCCESS. 833 00:40:44,490 --> 00:40:47,293 SOME OF THE LARGE INSTITUTES ARE 834 00:40:47,293 --> 00:40:49,662 AT THAT LEVEL. 835 00:40:49,662 --> 00:40:52,965 SOME OF THE SMALLER OR LARGE OF 836 00:40:52,965 --> 00:40:56,335 LARGE INSTITUTES, EYE INSTITUTE 837 00:40:56,335 --> 00:41:00,105 IN THE MID TO HIGH 20th PERCENT. 838 00:41:00,105 --> 00:41:01,006 TRADITIONALLY THAT'S WHERE NIMHD 839 00:41:01,006 --> 00:41:02,875 USED TO BE MANY YEARS AGO AND 840 00:41:02,875 --> 00:41:04,510 SOME INSTITUTES LIKE AGING FOR 841 00:41:04,510 --> 00:41:09,682 EXAMPLE HAS ONE PAY LINE FOR 842 00:41:09,682 --> 00:41:11,016 NON-ALZHEIMER'S DISEASE RELATED 843 00:41:11,016 --> 00:41:13,619 AND HIGHER PAY LINE FOR 844 00:41:13,619 --> 00:41:15,754 ALZHEIMER'S DISEASE RELATED 845 00:41:15,754 --> 00:41:16,789 STUDIES. 846 00:41:16,789 --> 00:41:17,856 SO ALL OF THE INSTITUTE 847 00:41:17,856 --> 00:41:21,794 DIRECTORS FOCUS ON THIS. 848 00:41:21,794 --> 00:41:26,865 IT'S R01 IS THE COMMON CURRENCY 849 00:41:26,865 --> 00:41:28,667 THOUGH VARIES BY INSTITUTES. 850 00:41:28,667 --> 00:41:33,772 SOME ARE MORE LIKELY AND WE 851 00:41:33,772 --> 00:41:36,141 DON'T -- WE HAVE A LITTLE LESS 852 00:41:36,141 --> 00:41:38,844 THAN HALF OF OUR BUDGET GOES TO 853 00:41:38,844 --> 00:41:43,749 R01 SCIENCE OR RPGs COMPARED TO 854 00:41:43,749 --> 00:41:46,752 OTHER INSTITUTES IT'S 80%. 855 00:41:46,752 --> 00:41:48,988 SO WE'RE KIND OF IN THAT RANGE 856 00:41:48,988 --> 00:41:52,925 AND I DON'T THINK GIVEN OUR 857 00:41:52,925 --> 00:41:53,559 OTHER MANDATES THAT'S GOING TO 858 00:41:53,559 --> 00:41:58,797 CHANGE SUBSTANTIALLY. 859 00:41:58,797 --> 00:42:00,566 WE LIKE TO LOOK AT HOW WE'RE 860 00:42:00,566 --> 00:42:01,934 DOING WITH EARLY STAGE 861 00:42:01,934 --> 00:42:02,267 INVESTIGATORS. 862 00:42:02,267 --> 00:42:06,572 THE EMPHASIS ON THIS RECENTLY 863 00:42:06,572 --> 00:42:09,041 HAS BEEN REEMPHASIZED BY BOTH 864 00:42:09,041 --> 00:42:12,878 DR. TABAK AND DR. BERTAGNOLLI. 865 00:42:12,878 --> 00:42:15,414 THE LAST TIME NIH BUDGET GREW 866 00:42:15,414 --> 00:42:18,283 RAPIDLY THE DOUBLING AND THEN 867 00:42:18,283 --> 00:42:20,653 FLATTENED AND EVEN DECREASED 868 00:42:20,653 --> 00:42:22,454 DURING THE SEQUESTER THE BIGGEST 869 00:42:22,454 --> 00:42:26,592 GROUP THAT SUFFERED WERE EARLY 870 00:42:26,592 --> 00:42:27,159 CAREER SCIENTISTS. 871 00:42:27,159 --> 00:42:28,794 SO THE ESTABLISHED SCIENTISTS 872 00:42:28,794 --> 00:42:30,362 WERE ABLE TO SUCCEED OR STAY 873 00:42:30,362 --> 00:42:32,364 ALIVE OR MANAGE BUT IT WAS THE 874 00:42:32,364 --> 00:42:35,034 EARLY CAREER PEOPLE THAT REALLY 875 00:42:35,034 --> 00:42:35,300 SUFFERED. 876 00:42:35,300 --> 00:42:37,169 SO WE'VE BEEN TOLD IN NO 877 00:42:37,169 --> 00:42:38,604 UNCERTAIN TERMS AND I THINK ALL 878 00:42:38,604 --> 00:42:40,339 THE DIRECTORS AGREE WE NEED TO 879 00:42:40,339 --> 00:42:43,776 FIND WAYS TO PROTECT EARLY STAGE 880 00:42:43,776 --> 00:42:44,410 INVESTIGATORS. 881 00:42:44,410 --> 00:42:46,445 THERE'S A VARIETY OF WAYS TO DO 882 00:42:46,445 --> 00:42:48,814 THIS PRIMARILY THROUGH OUR 883 00:42:48,814 --> 00:42:50,949 FUNDING DECISIONS IS THE PRIMARY 884 00:42:50,949 --> 00:42:52,084 WAY TO DO IT. 885 00:42:52,084 --> 00:42:55,421 OTHER THINGS HAVE CHANGED SINCE 886 00:42:55,421 --> 00:42:56,055 THAT TIME. 887 00:42:56,055 --> 00:43:02,995 THERE WAS A THIRD OF NIH R01 888 00:43:02,995 --> 00:43:04,229 APPLICATIONS AND MULTI-P.I. 889 00:43:04,229 --> 00:43:05,364 OPPOSED TO A SING AT P.I. AND 890 00:43:05,364 --> 00:43:08,233 THAT COULD BE A BENEFIT OR NOT 891 00:43:08,233 --> 00:43:10,502 DEPENDING ON THE CONTEXT AND WHO 892 00:43:10,502 --> 00:43:11,804 THE P.I.s ARE. 893 00:43:11,804 --> 00:43:18,077 THIS IS NIMHD DATA. 894 00:43:18,077 --> 00:43:20,112 AGAIN, GROUPING THE 2022 THROUGH 895 00:43:20,112 --> 00:43:22,181 FISCAL YEARS SEPARATELY SEE THE 896 00:43:22,181 --> 00:43:25,184 SUCCESS AWARD RATE FOR EARLY 897 00:43:25,184 --> 00:43:27,553 STAGE INVESTIGATORS IMPROVED IN 898 00:43:27,553 --> 00:43:31,557 THAT TIME BUT IS STILL SLIGHTLY 899 00:43:31,557 --> 00:43:34,593 BELOW WHAT WE'RE CALLING 900 00:43:34,593 --> 00:43:35,260 ESTABLISHED INVESTIGATORS. 901 00:43:35,260 --> 00:43:36,895 THERE'S A GROUP I'M NOT SHOWING 902 00:43:36,895 --> 00:43:43,135 YOU WHICH IS MID YEAR -- 903 00:43:43,135 --> 00:43:44,336 MIDCAREER PEOPLE AND A 904 00:43:44,336 --> 00:43:46,138 COMPARISON AND TRYING TO KEEP 905 00:43:46,138 --> 00:43:47,406 THIS BALANCED IN IMPLEMENTING 906 00:43:47,406 --> 00:43:50,843 TOOLS AT OUR DISPOSAL INTERNALLY 907 00:43:50,843 --> 00:43:53,479 THAT CAN ALSO PROTECT EARLY 908 00:43:53,479 --> 00:43:54,179 STAGE INVESTIGATORS. 909 00:43:54,179 --> 00:43:58,817 JUST TO REMIND EVERYBODY THIS IS 910 00:43:58,817 --> 00:44:00,252 INDIVIDUALS NOT HAVING R01 BUT 911 00:44:00,252 --> 00:44:03,555 WITHIN A 10 YEAR WINDOW OF THEIR 912 00:44:03,555 --> 00:44:07,192 TERMINAL DEGREE OR RESEARCH 913 00:44:07,192 --> 00:44:07,459 TRAINING. 914 00:44:07,459 --> 00:44:09,228 SO THAT'S THE OPERATIONAL 915 00:44:09,228 --> 00:44:11,396 DEFINITION WE USED. 916 00:44:11,396 --> 00:44:15,100 SO SHIFTING BACK TO LEGISLATIVE 917 00:44:15,100 --> 00:44:18,270 UPDATES, SOMETIMES IT COMES IN 918 00:44:18,270 --> 00:44:18,537 SPURTS. 919 00:44:18,537 --> 00:44:22,608 THE REQUEST FOR BRIEFINGS IN 920 00:44:22,608 --> 00:44:26,178 FEBRUARY I WAS ASKED TO BRIEF 921 00:44:26,178 --> 00:44:29,248 STAFF FROM THE SENATE HEALTH, 922 00:44:29,248 --> 00:44:31,917 EDUCATION, LABOR AND PENSION 923 00:44:31,917 --> 00:44:33,152 COMMITTEE SENATOR SANDERS' STAFF 924 00:44:33,152 --> 00:44:38,590 AND THE AGING SENATE COMMITTEE 925 00:44:38,590 --> 00:44:42,594 ON THE IMPLEMENTATION OF PEOPLE 926 00:44:42,594 --> 00:44:44,797 WITH DISPARITIES AND DR. TABAK 927 00:44:44,797 --> 00:44:45,631 ACCOMPANIED ME THOUGH I DID ALL 928 00:44:45,631 --> 00:44:48,801 THE TALKING AND THEY WANTED 929 00:44:48,801 --> 00:44:50,736 CLARIFICATION ON QUESTIONS AND I 930 00:44:50,736 --> 00:44:54,106 THINK THEY WERE SATISFIED WITH 931 00:44:54,106 --> 00:44:56,975 WHAT NIMHD'S PLAN AND WHAT NIH'S 932 00:44:56,975 --> 00:45:02,481 PLANS WERE IN THIS CONTEXT. 933 00:45:02,481 --> 00:45:03,849 THERE WAS ALSO AN IMPLEMENTATION 934 00:45:03,849 --> 00:45:06,885 OF A PROJECT THAT HAD BEEN 935 00:45:06,885 --> 00:45:10,255 DEVELOPED AND CONDUCTED OVER THE 936 00:45:10,255 --> 00:45:16,061 LAST THREE YEARS LED BY THE 937 00:45:16,061 --> 00:45:21,767 UNITE COMMITTEE WHICH HAS BEEN 938 00:45:21,767 --> 00:45:27,039 CO-CHAIRED BY DR. WEBB HOOPER TO 939 00:45:27,039 --> 00:45:29,074 LOOK AT THE DISEASE 940 00:45:29,074 --> 00:45:31,643 CATEGORIZATION WE CALL RCDC AT 941 00:45:31,643 --> 00:45:33,045 NIH. 942 00:45:33,045 --> 00:45:36,315 BRIEFINGS ON THESE CHANGES TO 943 00:45:36,315 --> 00:45:36,982 MINORITY HEALTH AND HEALTH 944 00:45:36,982 --> 00:45:41,687 DISPARITIES CATEGORIES. 945 00:45:41,687 --> 00:45:44,723 THIS IS WAS DEVELOPED THROUGH 946 00:45:44,723 --> 00:45:46,225 MACHINE LEARNING ALGORITHM TO 947 00:45:46,225 --> 00:45:47,759 IMPROVE WHAT WE DO AND 948 00:45:47,759 --> 00:45:50,128 CATEGORIZE GRANTS. 949 00:45:50,128 --> 00:45:54,433 PRIOR TO THIS, THIS WAS DONE 950 00:45:54,433 --> 00:45:57,402 MANUALLY THOUGH THERE WAS 951 00:45:57,402 --> 00:45:58,871 REASONABLE INTERCODER 952 00:45:58,871 --> 00:46:01,473 RELIABILITY THERE WERE STILL 953 00:46:01,473 --> 00:46:03,408 ERRORS PARTICULARLY THAT WERE 954 00:46:03,408 --> 00:46:08,080 NOT ABLE TO FULLY CONTROL SOME 955 00:46:08,080 --> 00:46:09,481 INSTITUTE CODERS WOULD BE OFF IN 956 00:46:09,481 --> 00:46:12,484 A DIRECTION WE COULDN'T MANAGE. 957 00:46:12,484 --> 00:46:14,586 IT WAS ALSO TREMENDOUS AMOUNT OF 958 00:46:14,586 --> 00:46:16,521 STAFF BURDEN WITH THIS AND ONE 959 00:46:16,521 --> 00:46:20,225 OF THE FEW CATEGORIES IN RCDC 960 00:46:20,225 --> 00:46:21,126 DONE MANUALLY. 961 00:46:21,126 --> 00:46:22,594 THERE ARE STILL OTHERS. 962 00:46:22,594 --> 00:46:29,334 THIS I THINK WAS AN ADVANCE IN 963 00:46:29,334 --> 00:46:33,772 MANY WAYS MULTIPLE DATA 964 00:46:33,772 --> 00:46:35,440 DEMONSTRATIONS SHOWED WE WERE AT 965 00:46:35,440 --> 00:46:37,943 LEAST AS GOOD AS MANUAL CODING. 966 00:46:37,943 --> 00:46:39,845 AT THIS MINIMUM AND MUCH LESS 967 00:46:39,845 --> 00:46:45,083 EFFORT AND WORK TO GET THERE. 968 00:46:45,083 --> 00:46:45,984 IT PROBABLY WAS DISTINGUISHED 969 00:46:45,984 --> 00:46:51,423 AND TOOK THINGS OUT THAT WERE 970 00:46:51,423 --> 00:46:54,092 PREVIOUSLY COUNTED AS WELL AS 971 00:46:54,092 --> 00:46:56,395 COUNT THE THINGS PREVIOUSLY NOT 972 00:46:56,395 --> 00:46:56,662 COUNTED. 973 00:46:56,662 --> 00:46:58,263 THE OTHER THING IT DID WAS 974 00:46:58,263 --> 00:47:01,833 SOMETHING I TRIED TO PROMOTE 975 00:47:01,833 --> 00:47:07,072 SINCE ARRIVING AT NIH WAS TO 976 00:47:07,072 --> 00:47:14,046 HAVE A CLEAR SEPARATION OF WHAT 977 00:47:14,046 --> 00:47:16,348 PEOPLE CALLED MINORITY HEALTH SO 978 00:47:16,348 --> 00:47:18,350 IT CREATE A COMBINED MINORITY 979 00:47:18,350 --> 00:47:20,852 MUTUALLY EXCLUSIVE. 980 00:47:20,852 --> 00:47:23,221 IT ELIMINATES WHAT CALL DOUBLE 981 00:47:23,221 --> 00:47:24,589 COUNTING THOUGH WE DON'T TALK 982 00:47:24,589 --> 00:47:25,958 ABOUT THAT USUALLY PARTICULARLY 983 00:47:25,958 --> 00:47:34,533 TO OUR CONGRESSIONAL STAFF. 984 00:47:34,533 --> 00:47:36,168 IT HAPPENS ALL THE TIME BUT WAS 985 00:47:36,168 --> 00:47:40,105 FRUSTRATING AT TIMES TO NOT SEE 986 00:47:40,105 --> 00:47:42,641 WHAT WE WERE ABLE TO DIVIDE WITH 987 00:47:42,641 --> 00:47:46,812 MANUAL METHODS BUT THIS IS A 988 00:47:46,812 --> 00:47:48,046 MUCH MORE EFFICIENT WAY TO GET 989 00:47:48,046 --> 00:47:50,248 AT WHAT WE'RE INTERESTED IN. 990 00:47:50,248 --> 00:47:51,683 THE AMOUNT OF INVESTMENT IN 991 00:47:51,683 --> 00:47:57,055 MINORITY HEALTH AND HEALTH 992 00:47:57,055 --> 00:48:07,566 DISPARITIES IS NOW AVAILABLE 993 00:48:12,304 --> 00:48:14,006 IT'S ACROSS THE AGENCY AND WILL 994 00:48:14,006 --> 00:48:16,942 GIVE A BETTER BASELINE FOR THE 995 00:48:16,942 --> 00:48:17,576 FUTURE. 996 00:48:17,576 --> 00:48:20,212 WE ALSO SPOKE TO THE SAME SENATE 997 00:48:20,212 --> 00:48:22,247 HOUSE AND ENERGY COMMITTEE AND 998 00:48:22,247 --> 00:48:23,548 DR. TABAK AND DR. BERNARD 999 00:48:23,548 --> 00:48:25,884 ACCOMPANIED ME ON THIS. 1000 00:48:25,884 --> 00:48:28,553 AGAIN, I LED THE DISCUSSION BOTH 1001 00:48:28,553 --> 00:48:30,589 DR. TABAK AND DR. BERNARD ADDED 1002 00:48:30,589 --> 00:48:40,766 COMMENTS. 1003 00:48:52,477 --> 00:48:54,613 THE COMMUNICATION STATEMENT IS 1004 00:48:54,613 --> 00:48:55,147 NOW AVAILABLE. 1005 00:48:55,147 --> 00:49:01,153 EVERY YEAR WE PRODUCE A 1006 00:49:01,153 --> 00:49:01,653 CONGRESSIONAL BUDGET 1007 00:49:01,653 --> 00:49:02,287 JUSTIFICATION AND SEE THE LINK 1008 00:49:02,287 --> 00:49:09,694 ON THE WEBSITE. 1009 00:49:09,694 --> 00:49:12,030 THIS IS PART OF THE PROCESS FOR 1010 00:49:12,030 --> 00:49:14,232 FISCAL '25 AND THIS WAS 1011 00:49:14,232 --> 00:49:15,734 PUBLISHED IN MARCH AND A SUMMARY 1012 00:49:15,734 --> 00:49:19,371 OF SOME OF THE MAJOR HIGHLIGHTS 1013 00:49:19,371 --> 00:49:21,440 OF ACCOMPLISHMENTS AND 1014 00:49:21,440 --> 00:49:24,709 EXPECTATIONS FOR THE FUTURE. 1015 00:49:24,709 --> 00:49:26,211 STRATEGIC PRIORITIES AND 1016 00:49:26,211 --> 00:49:28,447 ANTICIPATED IMPACT OF OUR 1017 00:49:28,447 --> 00:49:28,747 PRIORITIES. 1018 00:49:28,747 --> 00:49:32,651 I ENCOURAGE IF YOU'RE INTERESTED 1019 00:49:32,651 --> 00:49:36,521 TO READ IT OR REVIEW IT. 1020 00:49:36,521 --> 00:49:39,291 IT IS REALLY A PUBLIC DOCUMENT 1021 00:49:39,291 --> 00:49:43,028 MEANT FOR OUR CONGRESSIONAL 1022 00:49:43,028 --> 00:49:44,062 PARTNERS AND FUNDERS BUT IT'S 1023 00:49:44,062 --> 00:49:46,598 REALLY FOR ALL OF YOU TO ALSO 1024 00:49:46,598 --> 00:49:50,068 REACT TO. 1025 00:49:50,068 --> 00:49:51,903 WE'RE ALWAYS BUSY SEEING HOW WE 1026 00:49:51,903 --> 00:49:56,641 CAN PROMOTE OUR SCIENCE AND WHAT 1027 00:49:56,641 --> 00:50:01,012 WE DO BOTH TO OUR SCIENTIFIC 1028 00:50:01,012 --> 00:50:01,680 COMMUNITY AS WELL AS POTENTIAL 1029 00:50:01,680 --> 00:50:03,682 ORGANIZATIONS THAT WOULD BE 1030 00:50:03,682 --> 00:50:05,650 INTERESTED IN WHAT NIMHD DOES. 1031 00:50:05,650 --> 00:50:11,223 IN FEBRUARY I SPENT A COUPLE 1032 00:50:11,223 --> 00:50:16,061 HOURS AT THE OFFICES HERE IN 1033 00:50:16,061 --> 00:50:22,033 WASHINGTON AT A SYMPOSIUM ON 1034 00:50:22,033 --> 00:50:23,001 HEALTH SOME COLLEAGUES WERE 1035 00:50:23,001 --> 00:50:23,869 THERE AND PRESIDENT OF THE 1036 00:50:23,869 --> 00:50:25,203 UNIVERSITY AND THERE WAS A 1037 00:50:25,203 --> 00:50:30,308 CONGRESSIONAL MEMBER FROM 1038 00:50:30,308 --> 00:50:32,444 FLORIDA AND ALSO A 1039 00:50:32,444 --> 00:50:32,978 REPRESENTATIVE FROM THE 1040 00:50:32,978 --> 00:50:33,678 UNIVERSITY OF WASHINGTON HAD 1041 00:50:33,678 --> 00:50:35,213 ALSO BEEN INVITED. 1042 00:50:35,213 --> 00:50:40,519 I DID MEETING AT THE LEAGUE OF 1043 00:50:40,519 --> 00:50:41,753 UNITED LATIN AMERICAN CITIZENS 1044 00:50:41,753 --> 00:50:46,958 WHICH WAS MORE OF A PANEL 1045 00:50:46,958 --> 00:50:47,259 DISCUSSION. 1046 00:50:47,259 --> 00:50:52,998 WE DISCUSSED ISSUES AROUND 1047 00:50:52,998 --> 00:50:55,867 OBESITY. 1048 00:50:55,867 --> 00:50:59,504 IT'S THE OLDEST AND LARGEST 1049 00:50:59,504 --> 00:51:00,605 ORGANIZATION FOCUSSED ON 1050 00:51:00,605 --> 00:51:03,275 HISPANIC AND LATIN ISSUES. 1051 00:51:03,275 --> 00:51:05,010 THEY'RE NOT AS INVOLVED IN 1052 00:51:05,010 --> 00:51:09,047 ISSUES AROUND HEALTH AS OTHERS 1053 00:51:09,047 --> 00:51:10,615 BUT VERY IMPORTANT PUBLIC 1054 00:51:10,615 --> 00:51:11,116 ADVOCACY ORGANIZATION. 1055 00:51:11,116 --> 00:51:14,052 I THINK IT STARTED IN TEXAS AND 1056 00:51:14,052 --> 00:51:16,955 IS HEAVILY LED BY 1057 00:51:16,955 --> 00:51:20,559 MEXICAN-AMERICANS BUT REALLY AN 1058 00:51:20,559 --> 00:51:21,426 IMPORTANT CIVIL RIGHTS 1059 00:51:21,426 --> 00:51:25,530 ORGANIZATION AND IT'S GOOD TO 1060 00:51:25,530 --> 00:51:27,666 HAVE A PLACE OF OTHER 1061 00:51:27,666 --> 00:51:30,602 INDIVIDUALS IN THE PANEL AND THE 1062 00:51:30,602 --> 00:51:32,537 DISCUSSION WAS QUITE GOOD. 1063 00:51:32,537 --> 00:51:41,079 MONICA WEBB-HOOPER ATTENDED. 1064 00:51:41,079 --> 00:51:45,584 IB MARCH I WAS INVITED TO GO TO 1065 00:51:45,584 --> 00:51:47,452 THE BROD INSTITUTE IN BOSTON. 1066 00:51:47,452 --> 00:51:51,122 WHAT IS THE NIH DOING AT THE 1067 00:51:51,122 --> 00:51:54,593 BRODE A HIGH GENETICS THINK TANK 1068 00:51:54,593 --> 00:51:58,597 THAT WORKS CLOSELY WITH THE 1069 00:51:58,597 --> 00:52:00,966 HARVARD INSTITUTION AT BRIGHAM 1070 00:52:00,966 --> 00:52:03,435 AND MASS GENERAL AND RELATES TO 1071 00:52:03,435 --> 00:52:08,306 A FORMER MENTEE AND FRIEND RENE 1072 00:52:08,306 --> 00:52:16,014 SAL AZAR WHO HAD GONE TO THE THE 1073 00:52:16,014 --> 00:52:17,816 BROAD AS A CHIEF REQUEST OFFICER 1074 00:52:17,816 --> 00:52:20,752 AND HAD A ROLE IN THE DELL 1075 00:52:20,752 --> 00:52:24,623 SCHOOL OF MEDICINE AND MOVED TO 1076 00:52:24,623 --> 00:52:31,263 THE BROAD AND DECIDE -- DIED 1077 00:52:31,263 --> 00:52:32,530 UNEXPECTEDLY. 1078 00:52:32,530 --> 00:52:35,033 I HAD BEEN INVOLVED IN THE 1079 00:52:35,033 --> 00:52:37,068 MEMORIALS FOR HIM THE PERSON WHO 1080 00:52:37,068 --> 00:52:42,474 INVITED ME A WOMAN OF WHO IS 1081 00:52:42,474 --> 00:52:43,141 AFGHANI IMMIGRANT AND RUNS EIGHT 1082 00:52:43,141 --> 00:52:44,542 OF THE DIVERSITY PROGRAMS AT THE 1083 00:52:44,542 --> 00:52:47,412 BROAD INVITED ME AND IT WAS A 1084 00:52:47,412 --> 00:52:47,812 GOOD EXPERIENCE. 1085 00:52:47,812 --> 00:52:50,615 I THINK I MET WITH THE DIRECTOR 1086 00:52:50,615 --> 00:52:53,151 OF THE BROAD FOR ALMOST AN HOUR 1087 00:52:53,151 --> 00:52:54,619 AND DID A TALK AND MET WITH 1088 00:52:54,619 --> 00:52:57,088 OTHER SCIENTISTS THERE AND HAD 1089 00:52:57,088 --> 00:52:58,256 AN APPRECIATION FOR THE WORK 1090 00:52:58,256 --> 00:52:58,723 THEY DO. 1091 00:52:58,723 --> 00:53:01,326 BY THE WAY, THEY RUN ALL THE 1092 00:53:01,326 --> 00:53:02,761 GWAS FOR ALL OF US. 1093 00:53:02,761 --> 00:53:03,995 THAT'S THROUGH A CONTRACT JUST 1094 00:53:03,995 --> 00:53:09,034 TO GIVE YOU A SENSE OF THE SIZE 1095 00:53:09,034 --> 00:53:09,668 OF THE OPERATION. 1096 00:53:09,668 --> 00:53:11,569 IN MARCH I VISITED THE 1097 00:53:11,569 --> 00:53:14,706 UNIVERSITY OF MICHIGAN INSTITUTE 1098 00:53:14,706 --> 00:53:17,309 FOR HEALTH CARE POLICY AND 1099 00:53:17,309 --> 00:53:21,780 INNOVATION A COLLEAGUE FROM THE 1100 00:53:21,780 --> 00:53:25,116 MEDICINE GROUP SOCIETY INVITED 1101 00:53:25,116 --> 00:53:25,383 ME. 1102 00:53:25,383 --> 00:53:27,852 OUR FORMER COUNCIL MEMBER WAS 1103 00:53:27,852 --> 00:53:30,088 THERE AS WELL AS OTHER 1104 00:53:30,088 --> 00:53:31,690 COLLEAGUES I'VE KNOWN AND IT WAS 1105 00:53:31,690 --> 00:53:35,627 AGAIN SET UP AS AN INFORMAL 1106 00:53:35,627 --> 00:53:36,728 CONVERSATION. 1107 00:53:36,728 --> 00:53:39,431 I DID MEET WITH FELLOWS AND 1108 00:53:39,431 --> 00:53:40,999 ASSISTANT PROFESSORS AS WELL AS 1109 00:53:40,999 --> 00:53:44,402 THEIR LEADERSHIP WHICH WERE VERY 1110 00:53:44,402 --> 00:53:47,072 GOOD AND ALSO ATTENDED THE 1111 00:53:47,072 --> 00:53:51,409 RECORDS HEALTH SYMPOSIUM AT THE 1112 00:53:51,409 --> 00:53:55,013 RUTGERS BIOLOGICAL AND HEALTH 1113 00:53:55,013 --> 00:53:56,581 SCIENCES INSTITUTION WITH THEIR 1114 00:53:56,581 --> 00:54:00,618 DEAN AND OTHER FACULTY THERE AND 1115 00:54:00,618 --> 00:54:02,354 I SPOKE THERE. 1116 00:54:02,354 --> 00:54:08,993 OTHER ENGAGEMENTS IN MY CASE AT 1117 00:54:08,993 --> 00:54:12,864 THE NATIONAL MEDICAL ASSOCIATION 1118 00:54:12,864 --> 00:54:15,500 HEALTH POLICY AND THE INSTITUTE 1119 00:54:15,500 --> 00:54:16,968 AS A HILL BRIEFING AND THE PHOTO 1120 00:54:16,968 --> 00:54:22,040 WAS ON THE PRIOR SLIDE AND 1121 00:54:22,040 --> 00:54:25,243 MONICA WEBB-HOOPER ATTENDED THE 1122 00:54:25,243 --> 00:54:28,480 ACT FOR NIH FOUNDATION WHICH IS 1123 00:54:28,480 --> 00:54:33,385 ALWAYS A GREAT -- WAS IN THE 1124 00:54:33,385 --> 00:54:36,621 LIBRARY OF CONGRESS WHICH IS A 1125 00:54:36,621 --> 00:54:38,890 BEAUTIFUL SETTING AND I'VE BEEN 1126 00:54:38,890 --> 00:54:42,026 IN THE PAST AND IT'S A GREAT 1127 00:54:42,026 --> 00:54:43,495 OPPORTUNITY TO SPEAK WITH 1128 00:54:43,495 --> 00:54:45,830 CONGRESSIONAL MEMBERS AS WELL AS 1129 00:54:45,830 --> 00:54:47,098 CELEBRATE NIH. 1130 00:54:47,098 --> 00:54:51,603 IT'S SUPPORTED BY THIS ACT FOR 1131 00:54:51,603 --> 00:54:55,206 NIH. 1132 00:54:55,206 --> 00:54:58,610 MONICA WEBB HOOPER ALSO AT THE 1133 00:54:58,610 --> 00:55:08,520 OMAHA CARES DELTA SIGMA THETA 1134 00:55:08,520 --> 00:55:10,488 SORORITY FROM UNIVERSITY OF 1135 00:55:10,488 --> 00:55:12,123 NEBRASKA THE PHOTO AT THE TOP 1136 00:55:12,123 --> 00:55:13,758 AND SPEAKING AT THAT PART OF THE 1137 00:55:13,758 --> 00:55:14,592 COUNTRY WHICH DIFFERENT THAN 1138 00:55:14,592 --> 00:55:20,532 WHERE WE ARE. 1139 00:55:20,532 --> 00:55:27,939 AND ALISA LASANTA ATTENDED THE 1140 00:55:27,939 --> 00:55:32,877 MANA AND LATINO MAGAZINE ON LA 1141 00:55:32,877 --> 00:55:35,413 TINA HEALTH AND IT WAS A GREAT 1142 00:55:35,413 --> 00:55:40,518 OPPORTUNITY TO TALK ABOUT NIMHD 1143 00:55:40,518 --> 00:55:45,256 AND OUR WORK. 1144 00:55:45,256 --> 00:55:47,692 I WAS AT THE WHITE HOUSE 1145 00:55:47,692 --> 00:55:51,429 EISENHOWER OFFICE BUILDING OF 1146 00:55:51,429 --> 00:55:57,535 THE HOST WAS THE OFFICE OF 1147 00:55:57,535 --> 00:55:58,503 MINORITY HEALTH AND THE 1148 00:55:58,503 --> 00:55:59,437 SECRETARY MADE CLOSING COMMENTS 1149 00:55:59,437 --> 00:56:02,640 AND THE OSTP DIRECTOR OPENED THE 1150 00:56:02,640 --> 00:56:05,176 SESSION. 1151 00:56:05,176 --> 00:56:08,746 THERE WAS A BUNCH OF SMALL BREAK 1152 00:56:08,746 --> 00:56:12,350 OUT SESSIONS AND LIVE VIDEOCAST 1153 00:56:12,350 --> 00:56:15,186 PANEL THAT WAS AND I WAS PART OF 1154 00:56:15,186 --> 00:56:16,154 ONE OF THOSE. 1155 00:56:16,154 --> 00:56:20,758 THERE WERE TWO OR THREE PANELS 1156 00:56:20,758 --> 00:56:21,025 PRESENTED. 1157 00:56:21,025 --> 00:56:26,431 THIS PHOTO -- THREES ARE THE 1158 00:56:26,431 --> 00:56:29,868 NAVY STEPS THE EISENHOWER OFFICE 1159 00:56:29,868 --> 00:56:31,102 BUILDING FACE THE REAL WHITE 1160 00:56:31,102 --> 00:56:32,270 HOUSE AND THESE ARE THE STEPS 1161 00:56:32,270 --> 00:56:33,605 AND I'M LOST IN THE BACKGROUND 1162 00:56:33,605 --> 00:56:37,775 BUT IN THE PHOTO. 1163 00:56:37,775 --> 00:56:42,380 AND I THINK IT WAS A GOOD EVENT. 1164 00:56:42,380 --> 00:56:43,181 THERE WERE A LOT OF EXTRAMURAL 1165 00:56:43,181 --> 00:56:45,416 SCIENTIST AND ADVOCATES AND 1166 00:56:45,416 --> 00:56:45,650 LEADERS. 1167 00:56:45,650 --> 00:56:49,387 SEVERAL PEOPLE I KNOW I'M NOT 1168 00:56:49,387 --> 00:56:50,522 GOING TO REMEMBER ALL THE PEOPLE 1169 00:56:50,522 --> 00:56:56,261 I TALKED TO THERE BUT IT WAS A 1170 00:56:56,261 --> 00:56:56,928 BROAD REPRESENTATION OF DIVERSE 1171 00:56:56,928 --> 00:56:58,630 AMERICANS PRESENT. 1172 00:56:58,630 --> 00:57:02,634 WE WERE VERY PROUD TO AGAIN DO A 1173 00:57:02,634 --> 00:57:07,539 WEBINAR WITH THE CHILDREN'S INN 1174 00:57:07,539 --> 00:57:11,276 AT NIH APRIL 17 IN COLLABORATION 1175 00:57:11,276 --> 00:57:12,410 WITH NATIONAL INSTITUTE ON 1176 00:57:12,410 --> 00:57:12,944 MENTAL HEALTH. 1177 00:57:12,944 --> 00:57:16,047 WE SETTLED ON THE THEME OF 1178 00:57:16,047 --> 00:57:17,081 MENTAL HEALTH. 1179 00:57:17,081 --> 00:57:19,751 THE CHILDREN'S INN IS AN 1180 00:57:19,751 --> 00:57:23,888 AUTONOMOUS RESIDENTIAL PLACE FOR 1181 00:57:23,888 --> 00:57:28,059 FAMILIES OF CHILDREN WHO ARE AT 1182 00:57:28,059 --> 00:57:29,861 NIH FOR CLINICAL CARE. 1183 00:57:29,861 --> 00:57:34,632 KEEP IN MIND MANY OF THESE ARE 1184 00:57:34,632 --> 00:57:38,303 CHILDREN WITH SEVERE DISEASE 1185 00:57:38,303 --> 00:57:42,106 THAT IS NOT POSSIBLE TO TREAT 1186 00:57:42,106 --> 00:57:44,442 ANYWHERE ELSE AND AT NIH AS A 1187 00:57:44,442 --> 00:57:52,350 LAST RESORT WITH DISORDERS ONLY 1188 00:57:52,350 --> 00:57:53,518 POSSIBLE TO MANAGE AT NIH AND IF 1189 00:57:53,518 --> 00:57:55,720 YOU'RE ACCEPTED TO OUR PROTOCOL 1190 00:57:55,720 --> 00:57:58,690 AT NIH YOU DON'T PAY A PENNY. 1191 00:57:58,690 --> 00:58:01,859 THE SERVICE IS IMPECCABLE AT ALL 1192 00:58:01,859 --> 00:58:02,093 LEVELS. 1193 00:58:02,093 --> 00:58:03,928 AND THESE ARE INDIVIDUALS THAT 1194 00:58:03,928 --> 00:58:08,933 COME FROM ALL OVER THE WORLD 1195 00:58:08,933 --> 00:58:10,501 INDEPENDENT OF WHAT THEIR 1196 00:58:10,501 --> 00:58:11,669 BACKGROUND OR INSURANCE OR 1197 00:58:11,669 --> 00:58:14,639 ISSUES ARE ON. 1198 00:58:14,639 --> 00:58:18,276 THIS IS A GOOD EXCHANGE, A 1199 00:58:18,276 --> 00:58:20,612 CONVERSATION. 1200 00:58:20,612 --> 00:58:23,081 I MADE A SHORT PRESENTATION AND 1201 00:58:23,081 --> 00:58:25,083 THE DEPUTY DIRECTOR AND ASSUMED 1202 00:58:25,083 --> 00:58:30,521 TO BE ACTING DIRECTOR OF NIMHD 1203 00:58:30,521 --> 00:58:30,955 ALSO SPOKE. 1204 00:58:30,955 --> 00:58:41,399 IT WAS MODERATED BY ONE OF THE 1205 00:58:41,399 --> 00:58:46,137 MAIN SUPPORTER, PHILIPIA HILLMAN 1206 00:58:46,137 --> 00:58:49,374 AND IT'S SPONSORED MOSTLY 1207 00:58:49,374 --> 00:58:53,277 THROUGH PHILANTHROPY AND WE HAD 1208 00:58:53,277 --> 00:58:56,447 THE CEO OF CHILDREN'S INN AND 1209 00:58:56,447 --> 00:59:06,824 REPRESENTATIVE ROBIN. 1210 00:59:10,261 --> 00:59:15,900 APRIL WAS A BUSY MONTH AND WE 1211 00:59:15,900 --> 00:59:18,336 HAD TREMENDOUS OPPORTUNITY TO 1212 00:59:18,336 --> 00:59:21,773 HOST DR. SULLIVAN APRIL 22. 1213 00:59:21,773 --> 00:59:24,208 THIS WAS TO GENERATE ORAL 1214 00:59:24,208 --> 00:59:26,978 HISTORY FOR THE ARCHIVES. 1215 00:59:26,978 --> 00:59:34,852 DR. SULLIVAN WAS THE LAST THE 1216 00:59:34,852 --> 00:59:35,853 PHYSICIAN THE LAST SECRETARY OF 1217 00:59:35,853 --> 00:59:38,156 HEALTH AND HUMAN SERVICES THAT 1218 00:59:38,156 --> 00:59:38,856 LASTED A YEAR. 1219 00:59:38,856 --> 00:59:47,765 AND HE'S A REMARKABLE INDIVIDUAL 1220 00:59:47,765 --> 00:59:50,401 I'VE GOTTEN TO KNOW HIM SINCE 1221 00:59:50,401 --> 00:59:51,536 BECOMING DIRECT AT NIMHD AND WAS 1222 00:59:51,536 --> 00:59:54,272 THE FIRST PERSON TO CALL ME AND 1223 00:59:54,272 --> 00:59:55,573 CONGRATULATE ME WITH THE 1224 00:59:55,573 --> 00:59:57,108 THREE-HOUR TIME DIFFERENCE WAS 1225 00:59:57,108 --> 00:59:58,776 IN THE MORNING IN SAN FRANCISCO 1226 00:59:58,776 --> 01:00:02,280 AND IT WAS MY SON WHO BROUGHT ME 1227 01:00:02,280 --> 01:00:04,382 THE CELL PHONE AND SAID THERE'S 1228 01:00:04,382 --> 01:00:05,383 A DR. SULLIVAN THAT WANTS TO 1229 01:00:05,383 --> 01:00:06,084 TALK TO YOU. 1230 01:00:06,084 --> 01:00:16,594 I WAS ON THE EXERCISE MACHINE. 1231 01:00:18,696 --> 01:00:23,735 WE INVITED HIM TO CELEBRATE AND 1232 01:00:23,735 --> 01:00:26,637 HEAR WHAT HE COULD REPORT TO US. 1233 01:00:26,637 --> 01:00:29,240 KEEP IN MIND DR. SULLIVAN IS 90 1234 01:00:29,240 --> 01:00:30,742 OR 91 YEARS OLD. 1235 01:00:30,742 --> 01:00:34,579 HE IS REMARKABLE FOR HIS 1236 01:00:34,579 --> 01:00:38,716 PRESENCE AND MEMORY. 1237 01:00:38,716 --> 01:00:41,319 WE DID A FIRESIDE CHAT AND MAYBE 1238 01:00:41,319 --> 01:00:43,121 NOT REPRESENTED IN THE PHOTO 1239 01:00:43,121 --> 01:00:48,926 COMPLETELY BUT THERE WERE HALF A 1240 01:00:48,926 --> 01:00:54,599 DOZEN INSTITUTE DIRECTORS 1241 01:00:54,599 --> 01:00:59,103 PRESENT AS WELL AS A COUPLE 1242 01:00:59,103 --> 01:01:01,172 DEPUTIES AND IT'S ARCHIVED AT 1243 01:01:01,172 --> 01:01:03,908 THE NIH VIDEOCAST. 1244 01:01:03,908 --> 01:01:07,211 I WANT TO POINT PEOPLE TO THIS 1245 01:01:07,211 --> 01:01:11,382 IF YOU HAVE TIME OR WANT TO HEAR 1246 01:01:11,382 --> 01:01:13,518 FROM HOW HE REMEMBERS AND 1247 01:01:13,518 --> 01:01:14,619 RELATES THE ISSUES OF THOSE 1248 01:01:14,619 --> 01:01:16,354 DAYS. 1249 01:01:16,354 --> 01:01:18,422 AT THE END OF APRIL, BEGINNING 1250 01:01:18,422 --> 01:01:19,891 OF MAY THERE WAS OUR MANUAL 1251 01:01:19,891 --> 01:01:21,993 MEETING OF THE RESEARCH CENTERS 1252 01:01:21,993 --> 01:01:25,163 AND MINORITY INSTITUTIONS OR 1253 01:01:25,163 --> 01:01:28,699 RCMI PROGRAM WE TALK ABOUT NOT 1254 01:01:28,699 --> 01:01:31,435 INFREQUENTLY AT THE COUNCIL 1255 01:01:31,435 --> 01:01:31,669 MEMBERS. 1256 01:01:31,669 --> 01:01:35,873 BEING TOGETHER THE 22RCMIs 1257 01:01:35,873 --> 01:01:39,343 PRINCIPAL INVESTIGATORS OR 1258 01:01:39,343 --> 01:01:41,279 PROGRAM DIRECTORS AS WELL AS 1259 01:01:41,279 --> 01:01:43,981 OTHER SENIOR SCIENTIST AN ASKED 1260 01:01:43,981 --> 01:01:46,651 MANY PRESIDENTS OF THE 1261 01:01:46,651 --> 01:01:51,289 INSTITUTIONS TO ATTEND. 1262 01:01:51,289 --> 01:01:52,590 I SPENT TIME THERE THE FIRST DAY 1263 01:01:52,590 --> 01:01:55,726 AND HAD REPRESENTATIONS FROM THE 1264 01:01:55,726 --> 01:02:02,633 DIRECTOR OF NIGMS AND DR. LORSCH 1265 01:02:02,633 --> 01:02:09,207 AND DOUG LOWEY WAS THERE AND AND 1266 01:02:09,207 --> 01:02:12,710 MARIE BERNARD THE CHIEF OFFICER 1267 01:02:12,710 --> 01:02:14,779 FOR WORKFORCE DIVERSITY. 1268 01:02:14,779 --> 01:02:16,047 THERE WAS A LOT OF SCIENCE IN 1269 01:02:16,047 --> 01:02:17,014 THE POSTERS. 1270 01:02:17,014 --> 01:02:19,483 I WAS ABLE TO WALK THROUGH THE 1271 01:02:19,483 --> 01:02:22,153 POSTER SESSION IN THE AFTERNOON. 1272 01:02:22,153 --> 01:02:25,089 WE HAD A SEPARATE MEETING WITH 1273 01:02:25,089 --> 01:02:26,357 THE UNIVERSITY PRESIDENTS AND 1274 01:02:26,357 --> 01:02:27,792 UNIVERSITY INVESTIGATORS AND 1275 01:02:27,792 --> 01:02:30,595 OVER ALL A HIGH LEVEL, HIGH 1276 01:02:30,595 --> 01:02:32,363 QUALITY SCIENTIFIC MEETING AS WE 1277 01:02:32,363 --> 01:02:36,400 HAD MOVED THIS PROGRAM REALLY TO 1278 01:02:36,400 --> 01:02:41,706 A DIFFERENT LEVEL THEN 10 YEARS 1279 01:02:41,706 --> 01:02:41,873 AGO. 1280 01:02:41,873 --> 01:02:45,109 I COULD AN UNEQUIVOCALLY. 1281 01:02:45,109 --> 01:02:46,244 AND MOST MY INSTITUTIONS WOULD 1282 01:02:46,244 --> 01:02:46,944 AGREE AT THIS POINT AFTER A FEW 1283 01:02:46,944 --> 01:02:51,983 YEARS. 1284 01:02:51,983 --> 01:02:55,586 WE ALSO HAD A MEETING I ATTENDED 1285 01:02:55,586 --> 01:02:57,588 VIRTUALLY THE CENTERS FOR 1286 01:02:57,588 --> 01:02:59,257 EXCELLENCE AND ENVIRONMENTAL 1287 01:02:59,257 --> 01:03:01,325 HEALTH DISPARITIES ANNUAL 1288 01:03:01,325 --> 01:03:06,597 GRANTEE MEETING IN FEBRUARY HELD 1289 01:03:06,597 --> 01:03:17,141 IN NORTH CAROLINA ON THE NIEHS 1290 01:03:17,341 --> 01:03:20,278 CAMPUS AND WAS HOSTED BY THE 1291 01:03:20,278 --> 01:03:22,580 BAYLOR INSTITUTE AND BROUGHT 1292 01:03:22,580 --> 01:03:24,081 TOGETHER AGAIN THE GRANT 1293 01:03:24,081 --> 01:03:24,782 RECIPIENTS AND DISCUSSED 1294 01:03:24,782 --> 01:03:28,052 DIFFERENT WAYS OF REDUCING 1295 01:03:28,052 --> 01:03:31,489 HEALTH DISPARITIES RELATED TO 1296 01:03:31,489 --> 01:03:35,159 ENVIRONMENTAL HARMS. 1297 01:03:35,159 --> 01:03:37,662 THERE'S A THREE CENTERS LOOKING 1298 01:03:37,662 --> 01:03:38,663 TO WRITE REQUEST FOR 1299 01:03:38,663 --> 01:03:41,098 APPLICATIONS FOR FUTURE CENTERS. 1300 01:03:41,098 --> 01:03:43,501 WE'RE HOPING TO GROW THIS 1301 01:03:43,501 --> 01:03:46,203 PROGRAM MODESTLY WITH SUPPORT 1302 01:03:46,203 --> 01:03:48,406 FROM OTHER INSTITUTES AND WE'LL 1303 01:03:48,406 --> 01:03:51,242 SEE HOW THAT EVOLVES FOR FISCAL 1304 01:03:51,242 --> 01:03:55,513 '25 AS WE GET READY TO PUBLISH A 1305 01:03:55,513 --> 01:04:00,651 NEW RFA. 1306 01:04:00,651 --> 01:04:03,187 WE HAVE SCIENTIFIC WORKSHOP ON 1307 01:04:03,187 --> 01:04:06,590 RESEARCH ON NATIVE HAWAIIAN AND 1308 01:04:06,590 --> 01:04:07,959 PACIFIC ISLANDER HEALTH. 1309 01:04:07,959 --> 01:04:13,931 NOTED EARLIER WE HAD A $4 1310 01:04:13,931 --> 01:04:18,035 MILLION FOR THE RESEARCH ON 1311 01:04:18,035 --> 01:04:19,804 NATIVE HAWAIIAN AND PACIFIC 1312 01:04:19,804 --> 01:04:22,640 ISLANDER HEALTH AND AT THE TIME 1313 01:04:22,640 --> 01:04:25,343 WE RECOMMENDED WE DO WORKSHOP 1314 01:04:25,343 --> 01:04:28,312 FIRST BEFORE THE NOTICE IS 1315 01:04:28,312 --> 01:04:28,579 PUBLISHED. 1316 01:04:28,579 --> 01:04:33,417 THIS IS FEBRUARY THE NOFO IS 1317 01:04:33,417 --> 01:04:34,618 BEING DEVELOPED. 1318 01:04:34,618 --> 01:04:37,989 THIS MEETING WAS ROBUST AND 1319 01:04:37,989 --> 01:04:38,456 VIBRANT. 1320 01:04:38,456 --> 01:04:40,691 THE RESEARCHERS AND COMMUNITY 1321 01:04:40,691 --> 01:04:41,659 ADVOCATES WERE PRESENT. 1322 01:04:41,659 --> 01:04:43,661 LOTS OF CRITICAL HEALTH TOPICS 1323 01:04:43,661 --> 01:04:48,833 AND NEEDS, GAPS IN KNOWLEDGE 1324 01:04:48,833 --> 01:04:56,674 WERE IDENTIFIED AND HAD 1325 01:04:56,674 --> 01:04:59,310 DETERMINATES OF NHLBI HEALTH AND 1326 01:04:59,310 --> 01:05:00,811 METHODOLOGICAL APPROACHES AND 1327 01:05:00,811 --> 01:05:05,149 INTERVENTIONS TO IMPROVE HEALTH. 1328 01:05:05,149 --> 01:05:07,785 SEVERAL POINTS ABOUT SOCIAL 1329 01:05:07,785 --> 01:05:09,854 DETERMINATE OF HEALTH AND 1330 01:05:09,854 --> 01:05:11,088 CULTURALLY VALID ASSESSMENT 1331 01:05:11,088 --> 01:05:12,623 TOOLS AND COMMUNITY 1332 01:05:12,623 --> 01:05:16,727 PARTICIPATION FOR SUCCESSFUL 1333 01:05:16,727 --> 01:05:19,630 PARTNERSHIPS. 1334 01:05:19,630 --> 01:05:22,566 AND THE NIH POPULATION IS 1335 01:05:22,566 --> 01:05:23,501 DISSEMINATED ACROSS THE 1336 01:05:23,501 --> 01:05:25,369 TERRITORIES OF THE UNITED STATES 1337 01:05:25,369 --> 01:05:29,073 AND CONCENTRATED IN HAWAI'I, 1338 01:05:29,073 --> 01:05:32,276 CALIFORNIA, UTAH AND 1339 01:05:32,276 --> 01:05:35,346 INTERESTINGLY ENOUGH, ARKANSAS. 1340 01:05:35,346 --> 01:05:39,683 THE PACIFIC TERRITORIES ALSO ARE 1341 01:05:39,683 --> 01:05:42,453 INCLUDED THOUGH THE REACH IS 1342 01:05:42,453 --> 01:05:43,454 CHALLENGING. 1343 01:05:43,454 --> 01:05:45,489 WE'VE HAD PREVIOUS PROGRAMS IN 1344 01:05:45,489 --> 01:05:46,257 THE PACIFIC TERRITORIES. 1345 01:05:46,257 --> 01:05:48,726 SO I LOOK FORWARD TO SEEING THIS 1346 01:05:48,726 --> 01:05:49,160 DEVELOP. 1347 01:05:49,160 --> 01:05:52,596 NOW, WE HAVE THE MANDATE IN 1348 01:05:52,596 --> 01:05:56,567 OFFICE TO I SEE THIS RESEARCH 1349 01:05:56,567 --> 01:05:59,170 WILL ADVANCE UP CARING FOR THIS 1350 01:05:59,170 --> 01:06:01,072 GENERALLY UNDER REPRESENTED, 1351 01:06:01,072 --> 01:06:04,775 UNDER STUDIED POPULATION WHERE 1352 01:06:04,775 --> 01:06:08,245 MULTIPLE INDICATORS OF HEALTH 1353 01:06:08,245 --> 01:06:12,216 DISPARITIES THAT MAKE IT VERY 1354 01:06:12,216 --> 01:06:16,320 DIFFERENT FROM THE HETEROGENEOUS 1355 01:06:16,320 --> 01:06:17,822 GROUP OF ASIAN AMERICANS. 1356 01:06:17,822 --> 01:06:21,025 AND SHOUT OUT TO THE UPCOMING 1357 01:06:21,025 --> 01:06:24,295 HEALTH DISPARITIES RESEARCH 1358 01:06:24,295 --> 01:06:26,597 INSTITUTE IN AUGUST. 1359 01:06:26,597 --> 01:06:35,840 THIS YEAR AS A WEEK LONG 1360 01:06:35,840 --> 01:06:36,507 TRAINING EXPERIENCE TO HAVE 1361 01:06:36,507 --> 01:06:39,376 SENIOR INVESTIGATORS AND 1362 01:06:39,376 --> 01:06:42,613 POSTDOCS AND ASSISTANT PROFESSOR 1363 01:06:42,613 --> 01:06:43,948 LEVEL PROFESSION COME TO NIH AND 1364 01:06:43,948 --> 01:06:45,816 LEARN FROM NIH AND INTERACT WITH 1365 01:06:45,816 --> 01:06:48,519 STAFF AND OTHER INSTITUTES AND 1366 01:06:48,519 --> 01:06:52,756 BE EXPOSED TO SOME SCIENTIFIC 1367 01:06:52,756 --> 01:06:56,026 LECTURES, GRANT WRITING SESSION 1368 01:06:56,026 --> 01:06:58,996 AND GRANT REVIEW MOCK REVIEW 1369 01:06:58,996 --> 01:07:01,265 WITH REAL GRANTS AND REALLY 1370 01:07:01,265 --> 01:07:02,833 INTERACT WITH EACH OTHER AND 1371 01:07:02,833 --> 01:07:05,503 NETWORK WITH EACH OTHER. 1372 01:07:05,503 --> 01:07:06,637 WE HOPE WE CONTINUE TO BUILD 1373 01:07:06,637 --> 01:07:09,740 COMMUNITY THROUGH THIS. 1374 01:07:09,740 --> 01:07:13,010 WE HAD OVER 500 SCHOLARS ATTEND 1375 01:07:13,010 --> 01:07:15,646 OUR HGRIs IN THE SUMMER. 1376 01:07:15,646 --> 01:07:17,882 WE HAD THREE CONSECUTIVE YEARS 1377 01:07:17,882 --> 01:07:21,452 OF VIRTUAL MEETINGS AND 2021 AND 1378 01:07:21,452 --> 01:07:23,354 2022 AND 2023 WE RESTARTED IN 1379 01:07:23,354 --> 01:07:24,021 PERSON. 1380 01:07:24,021 --> 01:07:28,025 SO IT LIMITS OUR NUMBERS TO 1381 01:07:28,025 --> 01:07:29,660 ABOUT 50 BUT IT'S A HUGE 1382 01:07:29,660 --> 01:07:33,297 ADVANTAGE TO DO IT IN PERSON. 1383 01:07:33,297 --> 01:07:36,467 SHIFTING TO DATA, I WANTED TO 1384 01:07:36,467 --> 01:07:40,938 START WITH THIS SOBERING 1385 01:07:40,938 --> 01:07:43,874 STATISTIC FROM THE AMERICAN 1386 01:07:43,874 --> 01:07:45,509 ASSOCIATION OF MEDICAL COLLEGES. 1387 01:07:45,509 --> 01:07:47,578 MEDICAL SCHOOL ENROLLMENT AND 1388 01:07:47,578 --> 01:07:49,380 GRADUATES BY RACE AND ETHNICITY. 1389 01:07:49,380 --> 01:07:54,752 WITH ALL THE ADVERSITY WE FACE 1390 01:07:54,752 --> 01:07:59,890 ABOUT HOW TO SELECT AND PROMOTE 1391 01:07:59,890 --> 01:08:01,258 DIVERSITY IN THE WORKFORCE AND 1392 01:08:01,258 --> 01:08:04,195 BY THE WAY THEY'RE SIMILAR 1393 01:08:04,195 --> 01:08:07,932 INFORMATION ON S.T.E.M. Ph.D.s 1394 01:08:07,932 --> 01:08:09,867 IN THE U.S. WITH U.S.-BASED 1395 01:08:09,867 --> 01:08:10,501 DEGREES IN S.T.E.M. INCLUDING 1396 01:08:10,501 --> 01:08:12,536 SOCIAL SCIENCES. 1397 01:08:12,536 --> 01:08:13,771 THIS IS NOT ANY DIFFERENT IN 1398 01:08:13,771 --> 01:08:14,672 THAT REALM. 1399 01:08:14,672 --> 01:08:17,441 SOME OF THESE PHYSICIANS OF 1400 01:08:17,441 --> 01:08:19,076 COURSE GO ON TO DO SCIENCE, THE 1401 01:08:19,076 --> 01:08:19,677 MAJORITY DON'T. 1402 01:08:19,677 --> 01:08:21,545 THE MAJORITY DO CLINICAL CARE 1403 01:08:21,545 --> 01:08:24,415 WHICH IS EQUALLY IMPORTANT FOR 1404 01:08:24,415 --> 01:08:26,450 US TO PROMOTE THE HEALTH OF OUR 1405 01:08:26,450 --> 01:08:27,384 COMMUNITIES. 1406 01:08:27,384 --> 01:08:30,921 BUT AGAIN, I HIGHLIGHTED THE 1407 01:08:30,921 --> 01:08:33,557 AREAS WHERE WE ARE MOST 1408 01:08:33,557 --> 01:08:34,024 EFFICIENT. 1409 01:08:34,024 --> 01:08:34,992 YOU CAN SEE THAT. 1410 01:08:34,992 --> 01:08:38,929 LESS THAN 1% OF OUR MEDICAL 1411 01:08:38,929 --> 01:08:46,203 SCHOOL GRADUATE IN '22 WERE 1412 01:08:46,203 --> 01:08:48,339 AMERICAN INDIAN AND ALASKAN 1413 01:08:48,339 --> 01:08:50,541 NATIVE AND THE NUMBERS HAVE 1414 01:08:50,541 --> 01:08:52,576 DECREASED OF THE POSITIONS TO 1415 01:08:52,576 --> 01:08:54,078 PUT IN TERMS OF SOBERING 1416 01:08:54,078 --> 01:08:54,311 NUMBERS. 1417 01:08:54,311 --> 01:09:00,251 LESS THAN 1% ARE NATIVE HAWAIIAN 1418 01:09:00,251 --> 01:09:05,256 PACIFIC ISLANDERS AND LESS THAN 1419 01:09:05,256 --> 01:09:07,391 1% AND FOR BLACK AFRICAN 1420 01:09:07,391 --> 01:09:08,559 AMERICAN AND LATINO HISPANIC THE 1421 01:09:08,559 --> 01:09:11,662 TOTAL ADDS UP TO ABOUT 13%. 1422 01:09:11,662 --> 01:09:13,364 SO, IT HAS INCHED UP SLIGHTLY. 1423 01:09:13,364 --> 01:09:17,201 YOU LOOK AT MEDICAL SCHOOL 1424 01:09:17,201 --> 01:09:19,069 ENROLLMENT IS SLIGHTLY HIGHER. 1425 01:09:19,069 --> 01:09:24,775 THIS IS WHEN WE INCLUDE THE FACT 1426 01:09:24,775 --> 01:09:30,281 THAT THERE ARE FOUR HBCU MEDICAL 1427 01:09:30,281 --> 01:09:33,183 SCHOOLS THAT ARE MAJORITY BLACK 1428 01:09:33,183 --> 01:09:34,551 AFRICAN AMERICAN AND RECENTLY 1429 01:09:34,551 --> 01:09:37,988 LEARNED THERE MAY BE A FIFTH ONE 1430 01:09:37,988 --> 01:09:38,656 IN LOUISIANA WITH XAVIER 1431 01:09:38,656 --> 01:09:41,292 PLANNING TO START A MEDICAL 1432 01:09:41,292 --> 01:09:42,092 SCHOOL. 1433 01:09:42,092 --> 01:09:46,330 THE FOUR MEDICAL SCHOOLS IN 1434 01:09:46,330 --> 01:09:48,465 PUERTO RICO AND THEY THE 1435 01:09:48,465 --> 01:09:50,634 MAJORITY LATINO. 1436 01:09:50,634 --> 01:09:52,703 SO IF YOU TAKE THOSE AWAY, WHAT 1437 01:09:52,703 --> 01:09:55,205 WOULD THE STATUS BE? 1438 01:09:55,205 --> 01:09:58,475 THIS IS A CHALLENGE. 1439 01:09:58,475 --> 01:10:02,446 ONLY MADE MORE CHALLENGING BY 1440 01:10:02,446 --> 01:10:03,480 THE SUPREME COURT DECISION LAST 1441 01:10:03,480 --> 01:10:04,481 YEAR. 1442 01:10:04,481 --> 01:10:06,483 JUST A REMINDER BECAUSE WE'RE 1443 01:10:06,483 --> 01:10:07,651 NOT GOING TO SOLVE THIS 1444 01:10:07,651 --> 01:10:07,985 OVERNIGHT. 1445 01:10:07,985 --> 01:10:09,820 WE'RE NOT GOING TO SOLVE THIS IN 1446 01:10:09,820 --> 01:10:13,290 MY LIFE TIME BUT WE'VE GOT TO 1447 01:10:13,290 --> 01:10:18,862 KEEP THIS FRONT AND CENTER IN 1448 01:10:18,862 --> 01:10:21,365 PROMOTING TO DECREASE HEALTH 1449 01:10:21,365 --> 01:10:24,435 DISPARITIES AND EMPIRICAL 1450 01:10:24,435 --> 01:10:26,370 EVERYDAY SAYS IF WE TRAIN MORE 1451 01:10:26,370 --> 01:10:27,404 UNDER REPRESENTED CLINICIAN US 1452 01:10:27,404 --> 01:10:28,305 DECREASE HEALTH DISPARITIES 1453 01:10:28,305 --> 01:10:29,573 BECAUSE THEY'RE MORE LIKELY TO 1454 01:10:29,573 --> 01:10:33,243 TAKE CARE OF PATIENTS OF NOT 1455 01:10:33,243 --> 01:10:34,712 ONLY THEIR GROUP BUT PEOPLE WHO 1456 01:10:34,712 --> 01:10:39,783 ARE POOR AND UNINSURED AND 1457 01:10:39,783 --> 01:10:41,852 MEDICAID AND YET WE DON'T DO 1458 01:10:41,852 --> 01:10:42,386 THIS. 1459 01:10:42,386 --> 01:10:44,955 MY OPPORTUNITY TO KEEP REMINDING 1460 01:10:44,955 --> 01:10:46,357 US. 1461 01:10:46,357 --> 01:10:47,658 LET ME TURN TO RESEARCH ADVANCES 1462 01:10:47,658 --> 01:10:51,228 OVER THE LAST FEW MONTHS. 1463 01:10:51,228 --> 01:10:52,930 I WANT TO HIGHLIGHT THIS NOT 1464 01:10:52,930 --> 01:10:55,833 FUNDED BY NIMHD BUT WANTED TO 1465 01:10:55,833 --> 01:11:01,372 EMPHASIS A RANDOMIZED TRIAL. 1466 01:11:01,372 --> 01:11:06,276 AND THE DIRECTED MEDICAL AND IN 1467 01:11:06,276 --> 01:11:10,414 THE NAVAJO THERAPY PUBLISHED IN 1468 01:11:10,414 --> 01:11:18,088 JAMA AND INTERNAL MEDICINE AND 1469 01:11:18,088 --> 01:11:19,289 MILE AN HOUR INDIAN PATIENTS 1470 01:11:19,289 --> 01:11:22,393 WITH REDUCED EJECTION FRACTION 1471 01:11:22,393 --> 01:11:27,197 HEART FAILURE 24% TO 36% AND 1472 01:11:27,197 --> 01:11:28,632 THOUGH IT'S BECOME LESS AND LESS 1473 01:11:28,632 --> 01:11:30,367 COMMON IN THE EVOLUTION OF HEART 1474 01:11:30,367 --> 01:11:35,072 FAILURE AS A CONDITION WE HAVE 1475 01:11:35,072 --> 01:11:37,708 SEEN MUCH MORE DIASTOLIC 1476 01:11:37,708 --> 01:11:41,512 DYSFUNCTION WHERE THE MUSCLE IS 1477 01:11:41,512 --> 01:11:45,949 STIFF OPPOSED TO LOSING PUMP 1478 01:11:45,949 --> 01:11:46,216 ABILITY. 1479 01:11:46,216 --> 01:11:48,585 MOST COMES FROM PRIOR HEART 1480 01:11:48,585 --> 01:11:49,920 ATTACKS WHERE YOU LOSE TISSUE 1481 01:11:49,920 --> 01:11:52,322 AND YOUR PUMP FUNCTION GOES 1482 01:11:52,322 --> 01:11:53,824 DOWN. 1483 01:11:53,824 --> 01:11:55,926 THERE ARE LITERALLY DOZENS OF 1484 01:11:55,926 --> 01:11:57,428 STUDIES THAT SHOW THIS IS THE 1485 01:11:57,428 --> 01:11:58,796 WAY YOU TREAT IT AND THE 1486 01:11:58,796 --> 01:12:01,799 MEDICATIONS YOU SHOULD BE ON AND 1487 01:12:01,799 --> 01:12:02,366 PROLONGS LIFE. 1488 01:12:02,366 --> 01:12:10,641 I WITNESSED THAT AS A CLINICIAN 1489 01:12:10,641 --> 01:12:12,976 WITH PEOPLE WITH REDUCED 1490 01:12:12,976 --> 01:12:16,313 EJECTION FRACTION AND LIVING 20 1491 01:12:16,313 --> 01:12:18,749 PLUS YEARS AND THIS WAS A STEP 1492 01:12:18,749 --> 01:12:22,986 WEDGE PRAGMATIC EFFECTIVENESS 1493 01:12:22,986 --> 01:12:24,755 TRIAL AND A TELEHEALTH MODEL 1494 01:12:24,755 --> 01:12:26,690 SERVICE US USUAL CARE AND THE 1495 01:12:26,690 --> 01:12:30,461 SAMPLE SIZE IS RELATIVELY SMALL, 1496 01:12:30,461 --> 01:12:33,430 103 PHONE BASED METHOD AND 1497 01:12:33,430 --> 01:12:34,031 TELEMONITORING AND THERE ARE 1498 01:12:34,031 --> 01:12:34,431 WAYS TO DO THIS. 1499 01:12:34,431 --> 01:12:37,434 YOU CAN GET PEOPLE'S WEIGHT, YOU 1500 01:12:37,434 --> 01:12:39,336 CAN MONITOR THEIR BLOOD PRESSURE 1501 01:12:39,336 --> 01:12:40,637 AND HEART RATE. 1502 01:12:40,637 --> 01:12:42,539 THERE'S A VARIETY OF METHODS 1503 01:12:42,539 --> 01:12:46,376 AVAILABLE OR EASY TO DO FROM A 1504 01:12:46,376 --> 01:12:46,977 REMOTE PERSPECTIVE. 1505 01:12:46,977 --> 01:12:50,414 OF COURSE IF YOU GET SYMPTOMS 1506 01:12:50,414 --> 01:12:53,817 AND THE OUTCOME OF INTEREST WAS 1507 01:12:53,817 --> 01:12:55,252 INCREASED CLASSES OF DRUGS WHICH 1508 01:12:55,252 --> 01:12:56,887 ARE MULTIPLE. 1509 01:12:56,887 --> 01:13:00,224 BOTH ARE SYMPTOMS AND PROLONGING 1510 01:13:00,224 --> 01:13:00,457 LIFE. 1511 01:13:00,457 --> 01:13:04,328 THE INTERVENTION WAS REMARKABLY 1512 01:13:04,328 --> 01:13:14,505 EFFECTIVE IN 66% WITH AN ODDS 1513 01:13:14,505 --> 01:13:16,840 RATIO AND TO IMPROVE AT 30 DAYS 1514 01:13:16,840 --> 01:13:17,608 WAS LESS THAN 2. 1515 01:13:17,608 --> 01:13:20,077 THIS WAS CONDUCTED AGAIN IN 1516 01:13:20,077 --> 01:13:29,319 NAVAJO NATION. 1517 01:13:29,319 --> 01:13:31,922 AND HIS WAS PARTIALLY FUNDED BY 1518 01:13:31,922 --> 01:13:34,858 NIMHD AND ANALYZED THE IMPACT OF 1519 01:13:34,858 --> 01:13:37,227 STRUCTURAL RACISM ON DIABETES 1520 01:13:37,227 --> 01:13:40,330 PREVALENCE AND USED A DATA SET 1521 01:13:40,330 --> 01:13:44,401 LOOKING AT OVER 11,000 1522 01:13:44,401 --> 01:13:46,837 U.S. CENSUS TRACKS LINKING THE 1523 01:13:46,837 --> 01:13:50,340 CDC PLACES DATA ON DIABETES 1524 01:13:50,340 --> 01:13:53,410 PREVALENCE, THE HOMEOWNERS LOAN 1525 01:13:53,410 --> 01:13:57,848 AND RED LINING DATA AND 1526 01:13:57,848 --> 01:13:58,649 OPPORTUNITY INSIGHT ON SOCIAL 1527 01:13:58,649 --> 01:14:02,953 DETERMINATES OF HEALTH. 1528 01:14:02,953 --> 01:14:05,389 AND CONDUCTING EQUATION 1529 01:14:05,389 --> 01:14:07,124 MODELLING SHOWED A DIRECT 1530 01:14:07,124 --> 01:14:07,791 ASSOCIATION BETWEEN RED LINING 1531 01:14:07,791 --> 01:14:10,227 AND DIABETES PREVALENCE AND 1532 01:14:10,227 --> 01:14:10,961 INDIRECT ASSOCIATION THAT 1533 01:14:10,961 --> 01:14:13,997 INVOLVED THE CONSTRUCTS OF 1534 01:14:13,997 --> 01:14:16,567 HISTORY OF INCARCERATION, LEVEL 1535 01:14:16,567 --> 01:14:18,936 OF POVERTY IN THE AREA AND LEVEL 1536 01:14:18,936 --> 01:14:22,606 OF DISCRIMINATION AND SUBSTANCE 1537 01:14:22,606 --> 01:14:28,979 USE, HOUSING, QUALITY OF HOUSING 1538 01:14:28,979 --> 01:14:30,581 AND EDUCATION AND FOOD SECURITY. 1539 01:14:30,581 --> 01:14:36,687 AND TREATMENT OF UNCONTROLLED SO 1540 01:14:36,687 --> 01:14:38,422 HYPERTENSION TREATMENT IS WELL 1541 01:14:38,422 --> 01:14:40,857 ESTABLISHED A GOOD WAY TO 1542 01:14:40,857 --> 01:14:42,626 PREVENT ADVERSE CARDIOVASCULAR 1543 01:14:42,626 --> 01:14:42,893 OUTCOMES. 1544 01:14:42,893 --> 01:14:46,363 BACK IN THE 1960s THE TERM 1545 01:14:46,363 --> 01:14:48,899 SILENT KILLER WAS COINED BECAUSE 1546 01:14:48,899 --> 01:14:50,567 PEOPLE DON'T HAVE SYMPTOMS FROM 1547 01:14:50,567 --> 01:14:50,901 HYPERTENSION. 1548 01:14:50,901 --> 01:14:52,302 IN MANY WAYS IT'S A RISK FACTOR 1549 01:14:52,302 --> 01:14:54,871 AND NOT A DISEASE. 1550 01:14:54,871 --> 01:14:56,607 YOU DON'T TREAT THE RISK FACTOR 1551 01:14:56,607 --> 01:14:58,809 YOU GET DISEASE AND STROKES AND 1552 01:14:58,809 --> 01:15:00,644 HEART FAILURE AND HEART ATTACKS. 1553 01:15:00,644 --> 01:15:02,613 WE MOSTLY CONSIDER IT A DISEASE 1554 01:15:02,613 --> 01:15:05,215 NOW. 1555 01:15:05,215 --> 01:15:10,053 UNCONTROLLED HYPERTENSION AT A 1556 01:15:10,053 --> 01:15:18,195 LEVEL ABOVE 140 OVER 90 AND SOME 1557 01:15:18,195 --> 01:15:21,365 CONSIDER IT 130 OVER 85 AND USE 1558 01:15:21,365 --> 01:15:24,434 140 OVER 90 UP THIS STUDY. 1559 01:15:24,434 --> 01:15:26,103 THIS FOCUSSED ON AFRICAN 1560 01:15:26,103 --> 01:15:29,206 AMERICAN OR BLACK ADULTS WITH 1561 01:15:29,206 --> 01:15:30,507 PERSISTENT HYPERTENSION 1562 01:15:30,507 --> 01:15:32,409 ATTENDING RURAL PRIMARY CARE 1563 01:15:32,409 --> 01:15:34,578 CLINICS IN ALABAMA AND NORTH 1564 01:15:34,578 --> 01:15:35,245 CAROLINA. 1565 01:15:35,245 --> 01:15:37,314 THE MAJORITY FEMALE AND YOU SEE 1566 01:15:37,314 --> 01:15:42,986 THE MEAN AGE IN THE LATE '50s. 1567 01:15:42,986 --> 01:15:45,322 IT'S ADVERSE OUTCOME FOR AN 1568 01:15:45,322 --> 01:15:48,258 INDIVIDUAL, FAMILY AND SOCIETY 1569 01:15:48,258 --> 01:15:49,426 TO HAVE A MAJOR STROKE IN 1570 01:15:49,426 --> 01:15:55,232 THE 'EM -- 50s AND LEADS TO 1571 01:15:55,232 --> 01:15:56,967 DISABILITY AND DYSFUNCTION FOR 1572 01:15:56,967 --> 01:15:57,401 THE INDIVIDUAL. 1573 01:15:57,401 --> 01:16:04,574 SO THIS IS AN IMPORTANT TIME TO 1574 01:16:04,574 --> 01:16:04,808 PREVENT. 1575 01:16:04,808 --> 01:16:06,076 SO PEER COACHING, PRACTICE 1576 01:16:06,076 --> 01:16:09,146 FACILITATION AND ENHANCE USUAL 1577 01:16:09,146 --> 01:16:10,080 CARE AND COMPARING THESE THREE 1578 01:16:10,080 --> 01:16:12,182 ARMS ESSENTIALLY THE STUDY WAS A 1579 01:16:12,182 --> 01:16:14,885 NEGATIVE STUDY AND CLUSTERED 1580 01:16:14,885 --> 01:16:20,023 RANDOMIZED TRIAL AND THE OVER 1581 01:16:20,023 --> 01:16:26,630 ALL RESULTS DID NOT AFFECT BLOOD 1582 01:16:26,630 --> 01:16:29,866 PRESSURE CONTROL BUT THE INTENT 1583 01:16:29,866 --> 01:16:33,503 TO PREVENT AND IN ANALYSES UNDER 1584 01:16:33,503 --> 01:16:37,474 THE AGE OF 60 THE PEER COACHING 1585 01:16:37,474 --> 01:16:42,612 AND PRACTICE FACILITATION 1586 01:16:42,612 --> 01:16:44,081 INTERVENTIONS WERE BETTER THAN 1587 01:16:44,081 --> 01:16:46,783 ENHANCED USUAL CARE AND LED TO A 1588 01:16:46,783 --> 01:16:50,620 5 MILLIMETER REDUCTION IN 1589 01:16:50,620 --> 01:16:51,421 SYSTOLIC BLOOD PRESSURE 1590 01:16:51,421 --> 01:16:54,891 CLINICALLY AND STATISTICALLY 1591 01:16:54,891 --> 01:16:55,225 SIGNIFICANT. 1592 01:16:55,225 --> 01:16:58,595 NOW, TURNING TO NIMHD FUNDED 1593 01:16:58,595 --> 01:17:02,299 RESULTS, THIS IS A STUDY ON 1594 01:17:02,299 --> 01:17:10,240 REPORTED SELF-ESTEEM LINKED TO 1595 01:17:10,240 --> 01:17:12,109 IMMUNOMETABOLISM FROM AN R01 1596 01:17:12,109 --> 01:17:13,477 GRANT FROM OUR INSTITUTE AND 1597 01:17:13,477 --> 01:17:15,312 MECHANISTIC IN LOOKING AT 1598 01:17:15,312 --> 01:17:19,983 RELATIONSHIPS BETWEEN THE GUT 1599 01:17:19,983 --> 01:17:29,226 MICROBIOME IN A GROUP OF HAWAI'I 1600 01:17:29,226 --> 01:17:32,896 AND MOSTLY USING STOOL SAMPLES 1601 01:17:32,896 --> 01:17:34,431 AND BIOMARKERS OF INFLAMMATORY 1602 01:17:34,431 --> 01:17:35,398 DISEASE WERE FOUND DIFFERENCES 1603 01:17:35,398 --> 01:17:40,270 IN ABUNDANCE OF GUT BACTERIA AND 1604 01:17:40,270 --> 01:17:42,205 DNA METHYLATION. 1605 01:17:42,205 --> 01:17:43,540 WHAT THE FINDINGS MEAN IN THE 1606 01:17:43,540 --> 01:17:44,941 LONG RUN IS UNKNOWN. 1607 01:17:44,941 --> 01:17:45,709 THIS IS WHAT DISCOVERY SCIENCE 1608 01:17:45,709 --> 01:17:47,878 IS ABOUT. 1609 01:17:47,878 --> 01:17:51,381 AND I THINK USING THE FRAMEWORK 1610 01:17:51,381 --> 01:17:54,317 OF KNOWING THE POPULATION, 1611 01:17:54,317 --> 01:17:56,386 KNOWING YOUR RACE AND ETHNICITY 1612 01:17:56,386 --> 01:18:00,056 AND SOCIO ECONOMIC STAT US AND 1613 01:18:00,056 --> 01:18:01,458 WHAT DISEASE OUTCOMES ARE MORE 1614 01:18:01,458 --> 01:18:05,128 OR LESS PREVALENT IN THOSE 1615 01:18:05,128 --> 01:18:09,132 GROUPS ALLOWS US THEN TO TRY TO 1616 01:18:09,132 --> 01:18:12,102 IDENTIFY IN THIS CASE BIOLOGICAL 1617 01:18:12,102 --> 01:18:13,637 MECHANISMS TO HELP IDENTIFY 1618 01:18:13,637 --> 01:18:14,604 BEHAVIORAL MECHANISMS OF 1619 01:18:14,604 --> 01:18:17,841 OUTCOMES. 1620 01:18:17,841 --> 01:18:21,211 GREAT MINDFULNESS AS A 1621 01:18:21,211 --> 01:18:23,480 PROTECTIVE FACTOR FOR TRAUMA. 1622 01:18:23,480 --> 01:18:29,586 AGAIN, MORE IN A MECHANISTIC 1623 01:18:29,586 --> 01:18:31,655 STUDY AMONG GULF COAST RESIDENTS 1624 01:18:31,655 --> 01:18:34,991 EXPOSED TO WEATHER EVENTS, 1625 01:18:34,991 --> 01:18:37,494 CATASTROPHIC HURRICANES AND 1626 01:18:37,494 --> 01:18:38,328 SURVEYED TWICE DURING THE 1627 01:18:38,328 --> 01:18:40,030 COVID-19 PANDEMIC. 1628 01:18:40,030 --> 01:18:43,867 THE MORE SEVERE POSTTRAUMATIC 1629 01:18:43,867 --> 01:18:48,939 STRESS SYMPTOMS RELATED TO 1630 01:18:48,939 --> 01:18:50,073 TRAINED MINDFULNESS AND COVID-19 1631 01:18:50,073 --> 01:18:51,842 EXPOSURE AND HISTORY OF ANXIETY 1632 01:18:51,842 --> 01:18:53,543 AND DEPRESSION IN LATINO 1633 01:18:53,543 --> 01:18:55,278 ETHNICITY AND LOWER INCOME AND 1634 01:18:55,278 --> 01:18:59,316 OLDER AGE. 1635 01:18:59,316 --> 01:19:04,721 SO THIS IS A FACTOR THAT COULD 1636 01:19:04,721 --> 01:19:05,488 IMPROVE RESILIENCE AND MAY 1637 01:19:05,488 --> 01:19:08,258 INFORM INTERVENTIONS AND THIS 1638 01:19:08,258 --> 01:19:10,627 WAS A PROJECT CONDUCTED BY K 1639 01:19:10,627 --> 01:19:16,633 AWARD RECIPIENT. 1640 01:19:16,633 --> 01:19:19,069 MATERNAL ADVANCES RELATED TO DNA 1641 01:19:19,069 --> 01:19:19,369 METHYLATION. 1642 01:19:19,369 --> 01:19:22,272 THIS IS AN AREA NIMHD HAS BEEN 1643 01:19:22,272 --> 01:19:24,441 FUNDING NOW FOR THE LAST SEVEN 1644 01:19:24,441 --> 01:19:28,778 OR EIGHT YEARS UNDER THE SOCIAL 1645 01:19:28,778 --> 01:19:29,846 EPIGENOMICS INITIATIVE. 1646 01:19:29,846 --> 01:19:32,582 THE STUDY LOOKED AT MATERNAL 1647 01:19:32,582 --> 01:19:35,886 ADVERSE CHILDHOOD EXPERIENCES 1648 01:19:35,886 --> 01:19:38,989 OUR ACES AMONG PREGNANT WOMEN 1649 01:19:38,989 --> 01:19:42,726 WITH SELF-REPORTED 1650 01:19:42,726 --> 01:19:44,828 DISCRIMINATION AND STRESS AND 1651 01:19:44,828 --> 01:19:46,630 DISCRIMINATION WAS ASSOCIATED 1652 01:19:46,630 --> 01:19:53,670 WITH HYPOMETHYLATION AND PROTEO 1653 01:19:53,670 --> 01:19:57,007 LIPID IMPORTANT FOR 1654 01:19:57,007 --> 01:19:58,708 DIFFERENTIATION IN LATINO 1655 01:19:58,708 --> 01:20:04,014 NEWBORNS WITH HYPER METHYLATION 1656 01:20:04,014 --> 01:20:08,852 OF THIS GENE AND HOW DO THE 1657 01:20:08,852 --> 01:20:10,520 MEASURES IN BEHAVIORAL RESEARCH 1658 01:20:10,520 --> 01:20:15,091 PARTICULARLY IN THIS CASE 1659 01:20:15,091 --> 01:20:17,327 FINANCIAL STRESS DISCRIMINATION 1660 01:20:17,327 --> 01:20:21,131 WHAT DOES IT DO IN TERMS OF 1661 01:20:21,131 --> 01:20:29,773 CHANGES IN EPI GENGENOMICS AND 1662 01:20:29,773 --> 01:20:30,674 METHYLATION AND THE STRESSORS 1663 01:20:30,674 --> 01:20:32,108 MAY INFLUENCE METHYLATION IN A 1664 01:20:32,108 --> 01:20:37,113 WAY THAT AFFECT THE NEWBORN 1665 01:20:37,113 --> 01:20:39,516 IMPRINTING THEIR GENES AND 1666 01:20:39,516 --> 01:20:40,884 FURTHER EXPRESSION OF THE GENE 1667 01:20:40,884 --> 01:20:43,520 AND TO BE CLEAR THESE ARE NOT 1668 01:20:43,520 --> 01:20:44,087 PERMANENT CHANGES THEY'RE 1669 01:20:44,087 --> 01:20:46,356 POTENTIALLY MODIFIABLE AS TIME 1670 01:20:46,356 --> 01:20:48,625 EVOLVES SO AS NOT TO BE 1671 01:20:48,625 --> 01:20:52,295 FATALISTIC ABOUT THESE OUTCOMES. 1672 01:20:52,295 --> 01:20:54,297 I HAVE TO LOVE THIS ONE 1673 01:20:54,297 --> 01:20:59,836 TRADITIONAL DIET RELATES TO 1674 01:20:59,836 --> 01:21:10,313 LOWER HEPATIC STEATOSIS AND 1675 01:21:12,582 --> 01:21:15,585 BEANS ARE AN IMPORTANT PART OF 1676 01:21:15,585 --> 01:21:18,154 MUCH OF CENTRAL AMERICA AND 1677 01:21:18,154 --> 01:21:21,725 MEXICO THE CARIBBEAN AND 1678 01:21:21,725 --> 01:21:22,892 NORTHERN, SOUTH AMERICA AND 1679 01:21:22,892 --> 01:21:27,130 BEANS ARE PULSES, LENTILS WHICH 1680 01:21:27,130 --> 01:21:32,035 ALSO ARE COMMON IN OTHER 1681 01:21:32,035 --> 01:21:35,171 GEOGRAPHIC AREAS OF THE WORLD 1682 01:21:35,171 --> 01:21:36,740 HAVE A POSITIVE EFFECT ON 1683 01:21:36,740 --> 01:21:38,274 METABOLIC FUNCTION IN OUR BODY 1684 01:21:38,274 --> 01:21:40,643 AND YET THE PRACTICE OF 1685 01:21:40,643 --> 01:21:42,479 CONSUMING THIS IN THE DIET WANES 1686 01:21:42,479 --> 01:21:45,315 WITH GENERATIONS IN THE U.S. AND 1687 01:21:45,315 --> 01:21:47,751 WE'RE LOOKING AT THIS IN MY OWN 1688 01:21:47,751 --> 01:21:54,190 RESEARCH LAB THANKS TO A POSTDOC 1689 01:21:54,190 --> 01:21:57,460 WHO'S A NUTRITIONIST AND LOOKING 1690 01:21:57,460 --> 01:22:00,163 AT ACCULTURATION SO I'M LEARNING 1691 01:22:00,163 --> 01:22:01,698 MORE ABOUT THIS AND THINKING 1692 01:22:01,698 --> 01:22:03,333 MAYBE I SHOULD BE EATING MORE 1693 01:22:03,333 --> 01:22:09,739 BEANS AS A WAY TO BALANCE OTHER 1694 01:22:09,739 --> 01:22:15,578 THINGS EITHER WAY LOOKING AT 1695 01:22:15,578 --> 01:22:18,948 HEPATIC STEATOSIS AND THE 1696 01:22:18,948 --> 01:22:23,720 APPRECIATIVE MECHANISM OF WHAT 1697 01:22:23,720 --> 01:22:25,989 PEOPLE END UP WITH FATTY 1698 01:22:25,989 --> 01:22:27,624 INFILTRATION OF THE LIVER 1699 01:22:27,624 --> 01:22:29,893 LEADING TO CHRONIC INFLAMMATION 1700 01:22:29,893 --> 01:22:32,128 IN ADDITION TO CAUSING DISEASE 1701 01:22:32,128 --> 01:22:35,265 AND SYMPTOMS AND PEOPLE GET SICK 1702 01:22:35,265 --> 01:22:38,601 WITH THIS IT RESULTS AS ONE OF 1703 01:22:38,601 --> 01:22:40,670 THE MECHANISMS BY WHICH 1704 01:22:40,670 --> 01:22:41,371 INDIVIDUALS GET CANCER AND LIVER 1705 01:22:41,371 --> 01:22:44,207 CANCER CAN BE CAUSED BY OTHER 1706 01:22:44,207 --> 01:22:45,608 THINGS AS WELL. 1707 01:22:45,608 --> 01:22:48,778 THIS IS DISPROPORTIONATELY MORE 1708 01:22:48,778 --> 01:22:50,680 COMMON AMONG LATINOS 1709 01:22:50,680 --> 01:22:52,615 PARTICULARLY THOSE OF MEXICAN 1710 01:22:52,615 --> 01:22:53,616 AMERICAN HERITAGE. 1711 01:22:53,616 --> 01:22:59,956 LOOKING AT THIS AS A WAY TO 1712 01:22:59,956 --> 01:23:01,424 DECREASE HEPATIC STEATOSIS AND 1713 01:23:01,424 --> 01:23:05,795 THIS IS A PUBLICATION BY A K 1714 01:23:05,795 --> 01:23:06,329 AWARDEE TO NIMHD. 1715 01:23:06,329 --> 01:23:08,665 THIS IS A STUDY COMING AGAIN 1716 01:23:08,665 --> 01:23:14,471 FROM A K AWARDEE OF MANAGING 1717 01:23:14,471 --> 01:23:16,639 HYPERTENSION IN SOUTH ASIANS 1718 01:23:16,639 --> 01:23:17,173 WITH DIABETES. 1719 01:23:17,173 --> 01:23:20,176 SOUTH ASIANS DESPITE NOT 1720 01:23:20,176 --> 01:23:27,183 NECESSARILY HAVING ACCESS, HIGH 1721 01:23:27,183 --> 01:23:36,326 BMI MAINLY MALES HAVE A 1722 01:23:36,326 --> 01:23:37,961 DISPROPORTIONATE RISK OF 1723 01:23:37,961 --> 01:23:40,630 DIABETES AS A METABOLIC 1724 01:23:40,630 --> 01:23:41,297 DYSFUNCTION AND CARDIOVASCULAR 1725 01:23:41,297 --> 01:23:41,531 DISEASE. 1726 01:23:41,531 --> 01:23:45,568 THIS STUDY WAS TO TRY TO FOCUS 1727 01:23:45,568 --> 01:23:46,636 ON UNCONTROLLED BLOOD PRESSURE 1728 01:23:46,636 --> 01:23:48,238 USING A COMMUNITY HEALTH WORKER 1729 01:23:48,238 --> 01:23:51,574 MODEL AND INTERVENTION AND 1730 01:23:51,574 --> 01:23:55,411 FEASIBILITY TRIAL THAN THE K23 1731 01:23:55,411 --> 01:23:57,113 AWARDEE AND 190 PARTICIPANTS 1732 01:23:57,113 --> 01:23:59,649 WITH DIABETES TO EMPHASIZE IT'S 1733 01:23:59,649 --> 01:24:01,184 NOT JUST GENERAL TREATMENT OF 1734 01:24:01,184 --> 01:24:02,685 HYPERTENSION BUT FOCUSSING ON 1735 01:24:02,685 --> 01:24:04,721 PEOPLE WITH DIABETES AND 1736 01:24:04,721 --> 01:24:06,055 CONTROLLING THEIR BLOOD PRESSURE 1737 01:24:06,055 --> 01:24:10,226 WHICH MAGNIFIES THE POTENTIAL 1738 01:24:10,226 --> 01:24:12,362 BENEFIT OF WHATEVER INTERVENTION 1739 01:24:12,362 --> 01:24:18,334 WORKS AND SHOWING ED CONTROL AND 1740 01:24:18,334 --> 01:24:20,103 TWICE AS COMMON OF THE CONTROL 1741 01:24:20,103 --> 01:24:21,204 ARMS. 1742 01:24:21,204 --> 01:24:22,939 THE COMMUNITY HEALTH WORKER 1743 01:24:22,939 --> 01:24:24,841 MODEL WORKS IN THIS POPULATION 1744 01:24:24,841 --> 01:24:27,744 FOR A PARTICULAR OUTCOME THAT IS 1745 01:24:27,744 --> 01:24:30,046 HIGHLY SIGNIFICANT IN SOUTH 1746 01:24:30,046 --> 01:24:32,916 ASIANS AS WELL AS IN THE 1747 01:24:32,916 --> 01:24:34,784 COMMUNITY IN GENERAL. 1748 01:24:34,784 --> 01:24:37,820 THIS IS AN OUTCOME PAPER FROM 1749 01:24:37,820 --> 01:24:39,756 ONE OF THE R01s WE FUNDED. 1750 01:24:39,756 --> 01:24:44,627 I THINK IN 2020 WHEN WE FIRST 1751 01:24:44,627 --> 01:24:46,462 DELVED INTO THE MATERNAL HEALTH 1752 01:24:46,462 --> 01:24:48,531 ISSUES WHEN THIS BECAME A 1753 01:24:48,531 --> 01:24:52,068 HIGHLIGHT OF U.S. IS HIDING 1754 01:24:52,068 --> 01:24:56,105 MATERNAL MORTALITY AND 30 OTHER 1755 01:24:56,105 --> 01:24:58,274 COUNTRIES ARE OF COMPARABLE HIGH 1756 01:24:58,274 --> 01:24:59,309 INCOME AND WHAT'S GOING ON. 1757 01:24:59,309 --> 01:25:02,045 WE LAUNCHED THE SMALL INITIATIVE 1758 01:25:02,045 --> 01:25:05,148 AND FUNDED FIVE R01s PARTNERING 1759 01:25:05,148 --> 01:25:09,185 WITH A COUPLE OF THEIR I.C.s. 1760 01:25:09,185 --> 01:25:10,520 THIS EXAMINED HOSPITAL, 1761 01:25:10,520 --> 01:25:14,924 RESIDENTIAL AND OTHER FACTORS IN 1762 01:25:14,924 --> 01:25:21,064 GEORGIA IN FETAL DEATH RECORDS 1763 01:25:21,064 --> 01:25:25,501 AND THE AND THE DISCHARGE WAS 1764 01:25:25,501 --> 01:25:26,936 HIGHER AMONG BLACK NOT QUITE 1765 01:25:26,936 --> 01:25:29,205 DOUBLE THE RISK. 1766 01:25:29,205 --> 01:25:30,974 THERE WERE HOSPITAL FIXED 1767 01:25:30,974 --> 01:25:33,476 EFFECTS EXPLAINING THE LARGEST 1768 01:25:33,476 --> 01:25:34,010 PORTION. 1769 01:25:34,010 --> 01:25:35,478 THIS CONSISTENT WITH DATA THAT 1770 01:25:35,478 --> 01:25:38,548 HAD BEEN GENERATED ALSO IN NEW 1771 01:25:38,548 --> 01:25:39,482 YORK CITY PREVIOUS TO THIS 1772 01:25:39,482 --> 01:25:43,186 INITIATIVE WHERE IF YOU WENT TO 1773 01:25:43,186 --> 01:25:46,723 A HOSPITAL WHERE THE MAJORITY OF 1774 01:25:46,723 --> 01:25:50,593 PATIENTS WERE DISPROPORTIONATELY 1775 01:25:50,593 --> 01:25:53,229 CARED FOR BLACK WOMEN IN THE LB 1776 01:25:53,229 --> 01:25:55,765 CONTEXT THE OUTCOMES WERE WORSE 1777 01:25:55,765 --> 01:25:58,468 AND IF YOUR WHITE YOUR OUTCOME 1778 01:25:58,468 --> 01:26:02,205 WAS WORSE THAN IF YOU GO TO A 1779 01:26:02,205 --> 01:26:03,406 HOSPITAL AS A BLACK WOMAN WHERE 1780 01:26:03,406 --> 01:26:05,808 THE MAJORITY ARE WHITE. 1781 01:26:05,808 --> 01:26:10,880 AND DELVING IN THE DETAILS IS 1782 01:26:10,880 --> 01:26:16,286 IT'S NOT WHAT'S WRONG WITH BLACK 1783 01:26:16,286 --> 01:26:19,055 MOMS AND IT MIGHT BE BUT IT'S 1784 01:26:19,055 --> 01:26:20,423 MORE OF A SYSTEM ISSUE RELATING 1785 01:26:20,423 --> 01:26:23,960 TO THE QUALITY OF CARE NOT JUST 1786 01:26:23,960 --> 01:26:25,528 INTRAHOSPITAL BUT ALSO 1787 01:26:25,528 --> 01:26:26,095 POSTPARTUM. 1788 01:26:26,095 --> 01:26:29,565 WE'LL CONTINUE TO PURSUE THIS 1789 01:26:29,565 --> 01:26:31,200 WITH AN INITIATIVE WE WERE 1790 01:26:31,200 --> 01:26:32,535 EXPECTING TO FUND SOME GRANTS 1791 01:26:32,535 --> 01:26:34,003 LATER THIS FISCAL YEAR. 1792 01:26:34,003 --> 01:26:37,040 THE RACIAL DIFFERENCES IN CARE 1793 01:26:37,040 --> 01:26:38,441 PROCESS AND OTHER FACTORS WITHIN 1794 01:26:38,441 --> 01:26:41,744 THE SAME HOSPITAL TRANSLATE TO 1795 01:26:41,744 --> 01:26:42,045 DISPARITIES. 1796 01:26:42,045 --> 01:26:48,017 KEEP IN MIND ALSO THE DATA ON 1797 01:26:48,017 --> 01:26:49,419 SEVERE MATERNAL MORBIDITY IS THE 1798 01:26:49,419 --> 01:26:50,620 PATHWAY TO DEATH. 1799 01:26:50,620 --> 01:26:55,058 WE HAVE 1,000 MATERNAL DEATHS A 1800 01:26:55,058 --> 01:26:58,728 YEAR IS FAIRLY UNCOMMON OR 1801 01:26:58,728 --> 01:27:00,730 ALMOST A RARE EVENT THOUGH IT 1802 01:27:00,730 --> 01:27:01,631 GETS A LOT OF ATTENTION BECAUSE 1803 01:27:01,631 --> 01:27:02,832 IT SHOULDN'T HAPPEN. 1804 01:27:02,832 --> 01:27:05,668 THERE'S ABOUT 50,000 AT LEAST 1805 01:27:05,668 --> 01:27:08,538 CASES OF SEVERE MATERNAL 1806 01:27:08,538 --> 01:27:09,238 MORBIDITY. 1807 01:27:09,238 --> 01:27:12,108 THIS IS I THINK YOU LOOK AT 1808 01:27:12,108 --> 01:27:13,209 HYPERTENSION AND STROKE AND WE 1809 01:27:13,209 --> 01:27:16,946 FOCUS ON THAT AND THIS IS 1810 01:27:16,946 --> 01:27:18,581 MORBIDITY LEADING TO MORTALITY. 1811 01:27:18,581 --> 01:27:21,117 IN GEORGIA IS PARTICULARLY 1812 01:27:21,117 --> 01:27:21,751 CHALLENGING. 1813 01:27:21,751 --> 01:27:23,486 WE LOOK AT THE GEOGRAPHIC 1814 01:27:23,486 --> 01:27:26,255 DISTRIBUTION OF MATERNAL DEATHS. 1815 01:27:26,255 --> 01:27:28,257 THERE'S HOT SPOTS IN THE 1816 01:27:28,257 --> 01:27:29,726 SOUTHEAST AND GEORGIA IN 1817 01:27:29,726 --> 01:27:30,326 PARTICULAR. 1818 01:27:30,326 --> 01:27:35,298 THIS IS I THINK A PARTICULARLY 1819 01:27:35,298 --> 01:27:39,869 RELEVANT ANALYSIS T TO FIND WAY 1820 01:27:39,869 --> 01:27:40,837 TO ADDRESS THE ISSUE. 1821 01:27:40,837 --> 01:27:43,373 IT CANNOT COME FROM JUST A 1822 01:27:43,373 --> 01:27:44,374 GLOBAL PROGRAM ACROSS THE 1823 01:27:44,374 --> 01:27:46,542 COUNTRY BECAUSE MOST THE PLACES 1824 01:27:46,542 --> 01:27:47,243 ARE DOING MUCH BETTER. 1825 01:27:47,243 --> 01:27:50,213 WE HAVE TO FIND WHERE WE HAVE 1826 01:27:50,213 --> 01:27:54,450 THE BIGGEST PROBLEMS AND THEN 1827 01:27:54,450 --> 01:27:56,252 INTERVENE THERE MORE 1828 01:27:56,252 --> 01:27:58,421 AGGRESSIVELY PARALLELED WITH 1829 01:27:58,421 --> 01:28:01,290 OTHER THINGS LIKE HIV INFECTION. 1830 01:28:01,290 --> 01:28:03,593 THE HOT SPOTS BOTH STATES AND 1831 01:28:03,593 --> 01:28:06,229 REGIONAL AREAS. 1832 01:28:06,229 --> 01:28:08,464 THIS IS A PUBLICATION THAT CAME 1833 01:28:08,464 --> 01:28:09,065 FROM THE HISPANIC COMMUNITY 1834 01:28:09,065 --> 01:28:15,438 HEALTH STUDY LOOKING AT ECHO 1835 01:28:15,438 --> 01:28:20,910 CARDIO GRAPHIC MEASUREMENTS IN 1836 01:28:20,910 --> 01:28:22,478 LATINAS WITH A HISTORY OF 1837 01:28:22,478 --> 01:28:26,549 HYPERTENSION AND WOMEN WITH THIS 1838 01:28:26,549 --> 01:28:28,418 HISTORY OF HYPERTENSIVE 1839 01:28:28,418 --> 01:28:29,986 DISORDERS OF PREGNANCY. 1840 01:28:29,986 --> 01:28:34,023 IT'S BECOMING MORE CLEAR THE 1841 01:28:34,023 --> 01:28:39,228 PERIOD OF PREGNANCY HAS YOU'LL 1842 01:28:39,228 --> 01:28:42,131 THIS BEAUTY AND WONDER AND 1843 01:28:42,131 --> 01:28:44,567 REPRODUCTION AND HAVING THE NEXT 1844 01:28:44,567 --> 01:28:47,670 GENERATION BUT IT'S ALSO A 1845 01:28:47,670 --> 01:28:51,107 PERIOD OF RISK FOR THE PREGNANT 1846 01:28:51,107 --> 01:28:55,111 PERSON AND IT'S NOT SO MUCH YES, 1847 01:28:55,111 --> 01:28:55,978 SEVERE MORBIDITY AND MORTALITY 1848 01:28:55,978 --> 01:28:57,246 BUT THERE'S EVENTS THAT CAN 1849 01:28:57,246 --> 01:28:59,315 HAPPEN WITH HYPERTENSION AND 1850 01:28:59,315 --> 01:28:59,582 DIABETES. 1851 01:28:59,582 --> 01:29:01,284 WE'VE KNOWN THIS AND I'VE 1852 01:29:01,284 --> 01:29:04,320 LEARNED ABOUT THIS IN MEDICAL 1853 01:29:04,320 --> 01:29:04,554 SCHOOL. 1854 01:29:04,554 --> 01:29:08,191 WE'VE KNOWN THIS MANY YEARS AND 1855 01:29:08,191 --> 01:29:10,126 WHAT THE CONSEQUENCES ARE 1856 01:29:10,126 --> 01:29:14,030 LONG-TERM IS WHAT THESE ANALYSES 1857 01:29:14,030 --> 01:29:14,464 ARE ABOUT. 1858 01:29:14,464 --> 01:29:17,266 THE HYPERTENSION USED OFTEN AS 1859 01:29:17,266 --> 01:29:19,902 MANAGED OR RESOLVES. 1860 01:29:19,902 --> 01:29:21,070 IT'S GESTATIONAL DIABETES IN 1861 01:29:21,070 --> 01:29:23,840 PARALLEL SIMILARLY GETS BETTER 1862 01:29:23,840 --> 01:29:25,374 BUT IT DOES INCREASE RISK FOR 1863 01:29:25,374 --> 01:29:27,210 LATER CONSEQUENCES AND THAT'S 1864 01:29:27,210 --> 01:29:30,146 WHAT THE STUDY WAS FOCUSSED ON. 1865 01:29:30,146 --> 01:29:34,050 LOOKING AT MECHANISMS WITH 1866 01:29:34,050 --> 01:29:36,786 STRUCTURAL ABNORMALITIES IN THE 1867 01:29:36,786 --> 01:29:38,821 LEFT VENTRICLE COULD PREDICT 1868 01:29:38,821 --> 01:29:39,789 HEART FAILURE AND CARDIOVASCULAR 1869 01:29:39,789 --> 01:29:45,995 DISEASE AND DEATH IN THE FUTURE. 1870 01:29:45,995 --> 01:29:49,265 ALMOST INVARIABLY BY PHYSIOLOGY 1871 01:29:49,265 --> 01:29:52,168 PREGNANCY OCCURS AT AN AGE YOU 1872 01:29:52,168 --> 01:29:54,203 DON'T EXPECT THESE CONDITIONS TO 1873 01:29:54,203 --> 01:29:55,538 MANIFEST HEART DISEASE BUT 1874 01:29:55,538 --> 01:29:56,105 REFERRING TO WHAT HAPPENED 1875 01:29:56,105 --> 01:29:58,074 AFTERWARDS AND HOW THIS COULD BE 1876 01:29:58,074 --> 01:30:00,977 INTERCEPTED ON AND TREATED IN A 1877 01:30:00,977 --> 01:30:03,679 WAY THE ADVERSE EFFECTS ARE NOT 1878 01:30:03,679 --> 01:30:07,750 MANIFESTED YEARS LATER. 1879 01:30:07,750 --> 01:30:12,121 THIS IS MENTAL HEALTH CARE USED 1880 01:30:12,121 --> 01:30:16,726 BY LATINO PATIENTS IN A CENTER 1881 01:30:16,726 --> 01:30:19,462 AND RETROSPECTIVE CARE WHERE WE 1882 01:30:19,462 --> 01:30:21,464 SEE CARE OVER MANY YEARS AND THE 1883 01:30:21,464 --> 01:30:23,432 ESTIMATED LIKELIHOOD OF 1884 01:30:23,432 --> 01:30:25,501 RECEIVING MENTAL HEALTH 1885 01:30:25,501 --> 01:30:26,602 SERVICES. 1886 01:30:26,602 --> 01:30:30,239 ABOUT 14% RECEIVE THESE MENTAL 1887 01:30:30,239 --> 01:30:33,342 HEALTH SERVICES IN SPANISH 1888 01:30:33,342 --> 01:30:35,912 PREFERRING LATINO PATIENTS HAVE 1889 01:30:35,912 --> 01:30:37,480 SIGNIFICANTLY LOWER RATE THAN 1890 01:30:37,480 --> 01:30:42,151 WHITE PATIENTS AT AN ESTIMATED 1891 01:30:42,151 --> 01:30:44,053 RATE OF .59. 1892 01:30:44,053 --> 01:30:49,859 SO IT'S HUMBLING TO THINK IF YOU 1893 01:30:49,859 --> 01:30:54,730 NEED HEALTH CARE THAT YOU AREN'T 1894 01:30:54,730 --> 01:30:56,165 ABLE TO TALK TO A HEALTH CARE 1895 01:30:56,165 --> 01:30:57,900 PROFESSIONAL IN THE LANGUAGE YOU 1896 01:30:57,900 --> 01:30:58,100 SPEAK. 1897 01:30:58,100 --> 01:31:02,538 ONE ATTITUDE MAY BE WELL, GO 1898 01:31:02,538 --> 01:31:05,641 LEARN ENGLISH AS I HEARD FROM 1899 01:31:05,641 --> 01:31:08,110 SOME PEOPLE MANY YEARS AGO, WHY 1900 01:31:08,110 --> 01:31:10,379 DON'T THEY JUST LEARN ENGLISH 1901 01:31:10,379 --> 01:31:11,314 AND THAT'S NOT GOING TO ALWAYS 1902 01:31:11,314 --> 01:31:13,316 BE POSSIBLE, RIGHT. 1903 01:31:13,316 --> 01:31:15,284 WE HAVE A CERTAIN PROPORTION OF 1904 01:31:15,284 --> 01:31:17,320 THE U.S. POPULATION THAT DOESN'T 1905 01:31:17,320 --> 01:31:19,088 SPEAK ENGLISH WELL CALLED 1906 01:31:19,088 --> 01:31:20,723 LIMITED ENGLISH PROFICIENCY. 1907 01:31:20,723 --> 01:31:22,925 THE MAJORITY OF THE INDIVIDUALS 1908 01:31:22,925 --> 01:31:25,194 IN THE COUNTRY SPEAK SPANISH. 1909 01:31:25,194 --> 01:31:25,861 NOT ALL. 1910 01:31:25,861 --> 01:31:34,971 THERE'S MANDARIN, CHINESE, 1911 01:31:34,971 --> 01:31:36,906 CANTONESE AND CREOLE AND ALMOST 1912 01:31:36,906 --> 01:31:39,875 TWO OF THIS THIRDS OF THOSE WHO 1913 01:31:39,875 --> 01:31:42,912 HAD LIMITED PROFICIENCY IN THE 1914 01:31:42,912 --> 01:31:53,456 COUNTRY PREFER SPEAKING SPANISH. 1915 01:31:53,656 --> 01:31:54,724 KNOW WE GET A PROFESSIONAL 1916 01:31:54,724 --> 01:31:58,260 INTERPRETER AND NOT DOING 1917 01:31:58,260 --> 01:32:02,898 CLINICAL CARE WITH TOTAL JUST 1918 01:32:02,898 --> 01:32:05,568 BARRIERS OF COMMUNICATION BUT IN 1919 01:32:05,568 --> 01:32:08,170 MENTAL HEALTH IT'S AN ALMOST 1920 01:32:08,170 --> 01:32:11,674 LIKE WHERE DO YOU START WHEN THE 1921 01:32:11,674 --> 01:32:17,113 OBSERVATION AND PHYSICAL EXAM 1922 01:32:17,113 --> 01:32:18,481 ARE THE MAIN THERAPEUTIC 1923 01:32:18,481 --> 01:32:20,750 APPROACHES IN MENTAL HEALTH. 1924 01:32:20,750 --> 01:32:23,819 THIS IS OF GREAT RELEVANCE AND 1925 01:32:23,819 --> 01:32:26,188 THE OTHER CHALLENGE IS HOW MANY 1926 01:32:26,188 --> 01:32:29,025 CLINICIANS SPEAK SPANISH. 1927 01:32:29,025 --> 01:32:32,261 SAY THEY HAVE COVERAGE AND 1928 01:32:32,261 --> 01:32:34,630 ACCESS AND RESOURCES TO PAY FOR 1929 01:32:34,630 --> 01:32:37,433 MENTAL HEALTH VISIT, HOW MANY OF 1930 01:32:37,433 --> 01:32:40,870 THOSE CLINICIANS SPEAK THEIR 1931 01:32:40,870 --> 01:32:41,137 LANGUAGE? 1932 01:32:41,137 --> 01:32:45,541 BELIEVE ME IT'S VERY FEW. 1933 01:32:45,541 --> 01:32:50,279 IN THE DMB AREA WHERE MAYBE 18% 1934 01:32:50,279 --> 01:32:52,682 OF THE POPULATION IS LATINO AND 1935 01:32:52,682 --> 01:32:54,116 10% OF THEM SPEAK SPANISH YOU 1936 01:32:54,116 --> 01:32:55,918 CAN DO THE MATH. 1937 01:32:55,918 --> 01:32:57,153 IT'S A LOT OF PEOPLE AND SAN 1938 01:32:57,153 --> 01:32:58,854 FRANCISCO THERE WAS A CHALLENGE. 1939 01:32:58,854 --> 01:33:03,526 I COULDN'T FIND A SPANISH 1940 01:33:03,526 --> 01:33:04,260 SPEAKING CLINICIAN PARTICULARLY 1941 01:33:04,260 --> 01:33:06,495 COVERED BY INSURANCE. 1942 01:33:06,495 --> 01:33:10,566 THIS IS A MAJOR CHALLENGE AND 1943 01:33:10,566 --> 01:33:15,538 NOW MORE SO FOR LESS FREQUENTLY 1944 01:33:15,538 --> 01:33:18,607 SPOKEN LANGUAGE AND RESEARCH IN 1945 01:33:18,607 --> 01:33:20,843 THIS AREA IS OF SPECIAL 1946 01:33:20,843 --> 01:33:23,179 IMPORTANCE AND WHETHER THE 1947 01:33:23,179 --> 01:33:25,848 DIAGNOSIS IS THE SAME OR 1948 01:33:25,848 --> 01:33:28,484 DIFFERENT THERE'S NO 1949 01:33:28,484 --> 01:33:29,985 EPIDEMIOLOGICAL MAJOR 1950 01:33:29,985 --> 01:33:31,253 DIFFERENCES IN RATES OF 1951 01:33:31,253 --> 01:33:32,822 DEPRESSION AND ANXIETY BY RACE 1952 01:33:32,822 --> 01:33:34,323 AND ETHNICITY. 1953 01:33:34,323 --> 01:33:37,560 MOST THE ISSUES IN MENTAL HEALTH 1954 01:33:37,560 --> 01:33:38,828 DIAGNOSIS RELATE TO CARE. 1955 01:33:38,828 --> 01:33:41,464 ACCESS TO CARE AND MANAGEMENT 1956 01:33:41,464 --> 01:33:42,331 AFTER DIAGNOSIS. 1957 01:33:42,331 --> 01:33:44,133 SO UNLIKE SOME OTHER CONDITIONS 1958 01:33:44,133 --> 01:33:46,168 LIKE SAY DIABETES WHERE WE SEE 1959 01:33:46,168 --> 01:33:48,738 BIG DIFFERENCES BY RACE AND 1960 01:33:48,738 --> 01:33:52,775 ETHNICITY IN TERMS OF INCIDENTS 1961 01:33:52,775 --> 01:33:54,643 WE DON'T SEE MUCH LOWER 1962 01:33:54,643 --> 01:33:56,712 DIFFERENCES BY RACE AND 1963 01:33:56,712 --> 01:33:59,849 ETHNICITY IN MENTAL HEALTH 1964 01:33:59,849 --> 01:34:00,483 DIAGNOSIS. 1965 01:34:00,483 --> 01:34:03,486 THE IMPACT OF MEDICAID EXPANSION 1966 01:34:03,486 --> 01:34:09,759 AND THE K AWARDEE PUBLICATION 1967 01:34:09,759 --> 01:34:11,060 RECENT PUBLICATION IN EXAMINING 1968 01:34:11,060 --> 01:34:15,064 WHAT'S IT'S LIKE TO HAVE ACCESS 1969 01:34:15,064 --> 01:34:19,401 TO CARE WHICH IS A BLUNT 1970 01:34:19,401 --> 01:34:19,869 MEASURE. 1971 01:34:19,869 --> 01:34:21,303 YOU SAY I HAVE EXPANDED MEDICAID 1972 01:34:21,303 --> 01:34:24,507 AND NOW CAN SEE SOME DOCTOR 1973 01:34:24,507 --> 01:34:29,245 DEPENDING ON WHERE YOU LIVE AND 1974 01:34:29,245 --> 01:34:32,515 MEDICAID BUT THERE ARE NOWADAYS 1975 01:34:32,515 --> 01:34:33,849 MAYBE LESS THAN 10 STATES THAT 1976 01:34:33,849 --> 01:34:37,286 DON'T HAVE AN EXPANDED MEDICAID 1977 01:34:37,286 --> 01:34:43,526 AND ALL THIS DOES IS RAISES THE 1978 01:34:43,526 --> 01:34:45,327 ELIGIBILITY FOR MEDICAID FROM 1979 01:34:45,327 --> 01:34:50,366 POVERTY OVER 60% OF POVERTY TO 1980 01:34:50,366 --> 01:34:53,335 140, 150, 200 PERCENT OF 1981 01:34:53,335 --> 01:34:53,803 POVERTY. 1982 01:34:53,803 --> 01:34:55,738 IT MAKES WORKING POOR ELIGIBLE. 1983 01:34:55,738 --> 01:34:58,874 IT'S NOT A GIVE AWAY IT'S MAKING 1984 01:34:58,874 --> 01:35:03,579 PEOPLE PEOPLE WORKING A 1985 01:35:03,579 --> 01:35:07,316 RESTAURANT, DOING CONSTRUCTION 1986 01:35:07,316 --> 01:35:08,517 DO NOT GET EMPLOYER PROVIDED 1987 01:35:08,517 --> 01:35:11,787 INSURANCE TO GET MEDICAID UP TO 1988 01:35:11,787 --> 01:35:15,424 A CERTAIN STATE WHAT POLICIES 1989 01:35:15,424 --> 01:35:16,292 ARE. 1990 01:35:16,292 --> 01:35:19,895 IT PROVIDES COVERAGE FOR WOMEN 1991 01:35:19,895 --> 01:35:25,267 WHO ARE PREGNANT AND IT FILLS 1992 01:35:25,267 --> 01:35:28,437 THIS GAP OF CHILDREN COVERED BY 1993 01:35:28,437 --> 01:35:36,712 CHIP ADULTS OVER 65 AND THIS IS 1994 01:35:36,712 --> 01:35:39,281 THE GAP 18 TO 64 AGE RANGE. 1995 01:35:39,281 --> 01:35:42,952 LATINOS HAVE THE HIGHEST RATE OF 1996 01:35:42,952 --> 01:35:45,654 UNINSURED AND AFTER THE ACA 1997 01:35:45,654 --> 01:35:49,124 BEING MORE THAN DOUBLE WHAT THE 1998 01:35:49,124 --> 01:35:54,063 RATE IS FOR WHITE AMERICANS BUT 1999 01:35:54,063 --> 01:35:57,199 IN THIS ANALYSIS THERE WAS 2000 01:35:57,199 --> 01:35:59,535 IMPACT OF MEDICAID EXPANSION 2001 01:35:59,535 --> 01:36:00,302 WITH REDUCTION IN CARDIOVASCULAR 2002 01:36:00,302 --> 01:36:04,406 DISEASE MORTALITY OVER ALL AND 2003 01:36:04,406 --> 01:36:06,709 IN ALL POPULATIONS. 2004 01:36:06,709 --> 01:36:09,044 NO DIFFERENCE ACROSS RACE. 2005 01:36:09,044 --> 01:36:11,146 WE HAVE SEEN AN UPTAKE OF 2006 01:36:11,146 --> 01:36:12,948 MEDICAID EXPANSION IN MORE AND 2007 01:36:12,948 --> 01:36:14,083 MORE STATES. 2008 01:36:14,083 --> 01:36:16,285 THE MOST RECENT ONE I READ ABOUT 2009 01:36:16,285 --> 01:36:18,420 WAS MISSISSIPPI. 2010 01:36:18,420 --> 01:36:21,090 THERE ARE HOLDOUTS AT A 2011 01:36:21,090 --> 01:36:21,991 POPULATION POLICY LEVEL. 2012 01:36:21,991 --> 01:36:24,059 THIS IS SOMETHING THAT WE SHOULD 2013 01:36:24,059 --> 01:36:25,728 CONTINUE TO PROMOTE. 2014 01:36:25,728 --> 01:36:28,430 IT'S NOT THE ANSWER BUT IT IS A 2015 01:36:28,430 --> 01:36:29,565 MAJOR STEP IN THE RIGHT 2016 01:36:29,565 --> 01:36:29,832 DIRECTION. 2017 01:36:29,832 --> 01:36:32,668 I WON'T GO OVER THIS IN DETAIL 2018 01:36:32,668 --> 01:36:36,105 BUT THESE ARE MEASURES FOR HIV 2019 01:36:36,105 --> 01:36:38,674 TESTING AND PREP AMONG LATINO 2020 01:36:38,674 --> 01:36:39,775 SEXUAL MINORITY MEN. 2021 01:36:39,775 --> 01:36:45,614 A VARIETY OF TOOLS AND BARRIERS 2022 01:36:45,614 --> 01:36:47,082 TO IMPLEMENT PREP IN USE HIV 2023 01:36:47,082 --> 01:36:47,316 TESTING. 2024 01:36:47,316 --> 01:36:50,319 WE'RE BEGINNING TO SEE MORE 2025 01:36:50,319 --> 01:36:54,456 IMPACT OF THE AVAILABILITY OF 2026 01:36:54,456 --> 01:36:56,025 THE MANAGEMENT OF BOTH 2027 01:36:56,025 --> 01:36:58,594 PREVENTING HIV INFECTION THROUGH 2028 01:36:58,594 --> 01:37:02,531 PREP IN POPULATIONS AT RISK AND 2029 01:37:02,531 --> 01:37:05,734 ALSO THE TREATMENT AND 2030 01:37:05,734 --> 01:37:06,702 SUPPRESSION OF VIRAL PRESENCE IN 2031 01:37:06,702 --> 01:37:07,736 INDIVIDUALS INFECTED. 2032 01:37:07,736 --> 01:37:13,542 WE HAVE THE TOOLS TO HAVE 2033 01:37:13,542 --> 01:37:14,877 INFECTION WITH HIV AND YOU'RE 2034 01:37:14,877 --> 01:37:22,918 PROBABILITY OF A NORMAL LIFE 2035 01:37:22,918 --> 01:37:23,519 EXPECTANCY WITH VIRAL 2036 01:37:23,519 --> 01:37:25,354 SUPPRESSION. 2037 01:37:25,354 --> 01:37:28,457 AND THE FACT THAT WE EVENT BEEN 2038 01:37:28,457 --> 01:37:30,726 ABLE TO DO THIS WE SHOULD BE 2039 01:37:30,726 --> 01:37:31,460 ABLE TO IMPLEMENT THIS MORE 2040 01:37:31,460 --> 01:37:34,563 BROADLY IN OUR COUNTRY. 2041 01:37:34,563 --> 01:37:35,798 WHO SUFFERS FROM THIS? 2042 01:37:35,798 --> 01:37:38,500 MEN WHO HAVE SEX WITH MEN WHO 2043 01:37:38,500 --> 01:37:40,936 ARE BLACK OR LATINO MAKE UP 2044 01:37:40,936 --> 01:37:42,504 THREE-QUARTERS OF THE 2045 01:37:42,504 --> 01:37:47,409 INDIVIDUALS IN THIS CATEGORY. 2046 01:37:47,409 --> 01:37:49,311 AND ANOTHER IMPORTANT GROUP ARE 2047 01:37:49,311 --> 01:37:52,781 FEMALES WHO ARE PARTNERS OF 2048 01:37:52,781 --> 01:37:53,782 THESE INDIVIDUALS. 2049 01:37:53,782 --> 01:38:00,356 THIS IS A HIGH PRIORITY FOR NIH, 2050 01:38:00,356 --> 01:38:02,992 NIAID AND US AT NIMHD AND ARE 2051 01:38:02,992 --> 01:38:04,226 ALWAYS LOOKING FOR BETTER 2052 01:38:04,226 --> 01:38:06,028 APPLICATIONS YOU, GOOD 2053 01:38:06,028 --> 01:38:11,100 APPLICATIONS THAT FOCUS ON HIV 2054 01:38:11,100 --> 01:38:18,040 AREAS THIS IS A PROJECT FROM OUR 2055 01:38:18,040 --> 01:38:23,979 INTRAMURAL DIVISION. 2056 01:38:23,979 --> 01:38:26,782 THIS IS JAMA NETWORK OPEN AND 2057 01:38:26,782 --> 01:38:29,485 COVID-19 TREATMENT OF PUBLIC 2058 01:38:29,485 --> 01:38:31,387 HEALTH CARE SITES FROM COVID-19 2059 01:38:31,387 --> 01:38:32,488 SPATIAL CLUSTERS OF COUNTIES AND 2060 01:38:32,488 --> 01:38:35,290 SO LESS ACCESS TO TREATMENT IN 2061 01:38:35,290 --> 01:38:37,726 COUNTIES WITH HIGH POVERTY AND 2062 01:38:37,726 --> 01:38:47,069 IN UNINSURED RATES AND WE SERVE 2063 01:38:47,069 --> 01:38:49,605 THE COLLECTIVE IN WANTING TO 2064 01:38:49,605 --> 01:38:50,773 FORGET WHAT HAPPENED THE LAST 2065 01:38:50,773 --> 01:38:53,609 THREE YEARS BECAUSE NOBODY WANTS 2066 01:38:53,609 --> 01:38:55,077 TO TALK ABOUT COVID ANYMORE BUT 2067 01:38:55,077 --> 01:39:01,116 HAVE TO KEEP REMINDING OURSELVES 2068 01:39:01,116 --> 01:39:11,660 THIS IS A MAJOR LIFE EVENT AND 2069 01:39:15,664 --> 01:39:18,434 WE HAVE SCIENTIFIC TOOLS TO BE 2070 01:39:18,434 --> 01:39:20,502 ABLE TO ADDRESS THIS. 2071 01:39:20,502 --> 01:39:23,672 WE HAVE A VACCINE EFFECTIVE AT 2072 01:39:23,672 --> 01:39:25,307 PREVENTING SEVERE DISEASE AND 2073 01:39:25,307 --> 01:39:26,341 MORTALITY PARTICULARLY AND 2074 01:39:26,341 --> 01:39:29,945 PERHAPS PRIMARILY IN OLDER 2075 01:39:29,945 --> 01:39:31,447 ADULTS AND PEOPLE WITH CERTAIN 2076 01:39:31,447 --> 01:39:31,747 CONDITIONS. 2077 01:39:31,747 --> 01:39:34,149 WE HAVE EFFECTIVE THERAPY IF 2078 01:39:34,149 --> 01:39:36,351 YOU'RE INFECTED PARTICULARLY 2079 01:39:36,351 --> 01:39:39,321 AGAIN IN THE SAME GROUPS IF YOU 2080 01:39:39,321 --> 01:39:42,124 START TREATMENT EARLY YOU 2081 01:39:42,124 --> 01:39:44,493 CLEARLY PREVENT SEVERE DISEASE 2082 01:39:44,493 --> 01:39:46,028 HOSPITALIZATION AND 2083 01:39:46,028 --> 01:39:46,795 COMPLICATIONS LEADING TO 2084 01:39:46,795 --> 01:39:47,396 POTENTIAL DEATH. 2085 01:39:47,396 --> 01:39:50,632 THIS INFECTION IS NOT GOING TO 2086 01:39:50,632 --> 01:39:51,266 GO AWAY. 2087 01:39:51,266 --> 01:39:55,637 IT WILL CONTINUE TO BE PART OF 2088 01:39:55,637 --> 01:39:57,739 OUR ANNUAL REQUEST FOR BOOSTERS. 2089 01:39:57,739 --> 01:40:01,543 AND ADDRESSING AND MAKING SURE 2090 01:40:01,543 --> 01:40:04,279 THAT AREAS THAT ARE 2091 01:40:04,279 --> 01:40:06,281 DISADVANTAGED SOCIO ECONOMICALLY 2092 01:40:06,281 --> 01:40:10,519 AND PERHAPS THERE'S NO ACCESS TO 2093 01:40:10,519 --> 01:40:16,558 PHARMACIES OR MORE UNINSURED 2094 01:40:16,558 --> 01:40:20,395 PEOPLE WHO GOT ACCESS TO THE 2095 01:40:20,395 --> 01:40:23,532 TREATMENT PAY TO THE $8 OR $9 2096 01:40:23,532 --> 01:40:25,601 FOR THE HOME TEST TO MAKE I 2097 01:40:25,601 --> 01:40:27,202 DIAGNOSIS WE'RE CONTINUING TO 2098 01:40:27,202 --> 01:40:30,706 ADDRESS THIS. 2099 01:40:30,706 --> 01:40:39,982 DR. ALTUCCI LOOKS AT THE SMOKING 2100 01:40:39,982 --> 01:40:42,050 CESSATION TREATMENT. 2101 01:40:42,050 --> 01:40:44,553 SHE'S FOCUSSED ON PRIMARY DATA 2102 01:40:44,553 --> 01:40:47,656 AND USING THE SMOKE-FREE DOT-GOV 2103 01:40:47,656 --> 01:40:49,658 TEXT MESSAGING DATABASE. 2104 01:40:49,658 --> 01:40:57,900 IN THIS CASE WITH LATINO USERS 2105 01:40:57,900 --> 01:41:05,941 IN ESPANOL AND USING THE SPANISH 2106 01:41:05,941 --> 01:41:09,745 VERSION IMPROVED RETENTION AND 2107 01:41:09,745 --> 01:41:11,747 ENGAGEMENT AMONG LATINO USERS 2108 01:41:11,747 --> 01:41:14,650 BUT NOT ENGAGE ABSTINENCE. 2109 01:41:14,650 --> 01:41:16,385 PERHAPS WITH A LARGER SAMPLE 2110 01:41:16,385 --> 01:41:17,953 THAT COULD BE OBTAINED OR 2111 01:41:17,953 --> 01:41:20,055 TWEAKING THE CONTENT OF THE 2112 01:41:20,055 --> 01:41:20,389 INTERVENTION. 2113 01:41:20,389 --> 01:41:28,630 AND SMOKING CESSATION IS NOT A 2114 01:41:28,630 --> 01:41:29,731 SHORT TERM ISSUE. 2115 01:41:29,731 --> 01:41:33,835 I EXPERIENCED WITH PATIENTS OF 2116 01:41:33,835 --> 01:41:35,003 ANY ETHNIC RACIAL GROUP EVERY 2117 01:41:35,003 --> 01:41:37,105 TIME YOU SMOKE AND IT SEEMS LIKE 2118 01:41:37,105 --> 01:41:39,875 YEARS LATER THEY SAY, DOCTOR, I 2119 01:41:39,875 --> 01:41:44,213 QUIT, I FINALLY DID IT AND 2120 01:41:44,213 --> 01:41:46,348 FOCUSSING ON IT IS NOT A 2121 01:41:46,348 --> 01:41:47,316 ONE-TIME THING TO DO. 2122 01:41:47,316 --> 01:41:50,519 SO I THINK ENGAGEMENT AND 2123 01:41:50,519 --> 01:41:51,253 RETENTION IS AN IMPORTANT 2124 01:41:51,253 --> 01:41:54,623 PROCESS OUTCOME TO KEEP IN MIND 2125 01:41:54,623 --> 01:41:58,126 HERE. 2126 01:41:58,126 --> 01:42:02,364 THIS IS FROM A LAB LOOKING AT 2127 01:42:02,364 --> 01:42:04,466 TRENDS IN ADOLESCENT SUICIDE BY 2128 01:42:04,466 --> 01:42:04,833 METHOD. 2129 01:42:04,833 --> 01:42:09,204 AGAIN, THE FIREARM IS THE MOST 2130 01:42:09,204 --> 01:42:12,140 EFFECTIVE AND UNFORTUNATELY USED 2131 01:42:12,140 --> 01:42:14,476 EVEN AMONG ADOLESCENTS AND ALSO 2132 01:42:14,476 --> 01:42:16,979 USE OTHER METHODS AS HIGHLIGHTED 2133 01:42:16,979 --> 01:42:17,179 HERE. 2134 01:42:17,179 --> 01:42:19,081 AND THE INCREASE IN SUICIDES 2135 01:42:19,081 --> 01:42:21,950 OVER THE DECADE FROM 2011 TO 2136 01:42:21,950 --> 01:42:25,821 2020 AND IT WAS PARTICULARLY 2137 01:42:25,821 --> 01:42:28,724 STARK AMONG FEMALES THE DATA FOR 2138 01:42:28,724 --> 01:42:30,592 ADULTS FEMALES MAKE MORE 2139 01:42:30,592 --> 01:42:34,463 ATTEMPTS, MALES ARE MORE 2140 01:42:34,463 --> 01:42:39,334 SUCCESSFUL AND THAT'S THE 2141 01:42:39,334 --> 01:42:41,069 GENERALITY RELATED TO THE MODE 2142 01:42:41,069 --> 01:42:43,905 OF USE BECAUSE FIREARMS ARE MORE 2143 01:42:43,905 --> 01:42:44,172 EFFECTIVE. 2144 01:42:44,172 --> 01:42:47,075 AN AREA OF EFFECTIVENESS IN 2145 01:42:47,075 --> 01:42:49,845 MENTAL HEALTH CRISIS AND IN A 2146 01:42:49,845 --> 01:42:52,481 ADOLESCENTS AND WE TALKED ABOUT 2147 01:42:52,481 --> 01:42:54,049 THIS IN COUNCIL AT DIFFERENT 2148 01:42:54,049 --> 01:42:56,084 TIMES AND I'LL END WITH A 2149 01:42:56,084 --> 01:43:01,089 CELEBRATION OF AWARDS. 2150 01:43:01,089 --> 01:43:08,363 IN THIS CASE AND WE SHARE THE 2151 01:43:08,363 --> 01:43:09,931 POST-BAC POSTER DAY FACES FROM 2152 01:43:09,931 --> 01:43:13,835 OUR TRAINEES IN THE INTRAMURAL 2153 01:43:13,835 --> 01:43:16,972 PROGRAMS AND NIH HAS A VIBRANT 2154 01:43:16,972 --> 01:43:18,240 EDUCATIONAL ENVIRONMENT AND 2155 01:43:18,240 --> 01:43:21,043 NIMHD IS ONE OF THE INTRAMURAL 2156 01:43:21,043 --> 01:43:24,146 PROGRAMS THAT FOCUSES ON 2157 01:43:24,146 --> 01:43:25,881 POPULATION AND SOCIAL BEHAVIORAL 2158 01:43:25,881 --> 01:43:26,948 ISSUES AND ISSUES AROUND 2159 01:43:26,948 --> 01:43:29,584 MINORITY HEALTH AND HEALTH 2160 01:43:29,584 --> 01:43:29,885 DISPARITIES. 2161 01:43:29,885 --> 01:43:33,288 WE'RE IN THE ONLY ONE BUT WE'RE 2162 01:43:33,288 --> 01:43:36,325 PROUD OF WHAT WE CONTRIBUTE TO 2163 01:43:36,325 --> 01:43:38,527 THE AGENCY IN THIS ASPECT AND TO 2164 01:43:38,527 --> 01:43:42,397 THE FUTURE OF SCIENTISTS. 2165 01:43:42,397 --> 01:43:43,899 SO AGAIN, FOR ALL OUT THERE, 2166 01:43:43,899 --> 01:43:46,001 CONSIDER COMING TO WORK FOR 2167 01:43:46,001 --> 01:43:46,968 NIMHD. 2168 01:43:46,968 --> 01:43:50,339 WE'RE ALWAYS LOOKING FOR GREAT 2169 01:43:50,339 --> 01:43:55,277 PEOPLE TO FOCUS ON SCIENCE AT 2170 01:43:55,277 --> 01:43:58,613 NIMHD AND NIH AND THANK YOU 2171 01:43:58,613 --> 01:43:59,348 AGAIN FOR YOUR ATTENTION. 2172 01:43:59,348 --> 01:44:01,216 WE'RE OPEN FOR CONVERSATION FROM 2173 01:44:01,216 --> 01:44:01,683 THE COUNCIL MEMBERS. 2174 01:44:01,683 --> 01:44:11,860 THANK YOU. 2175 01:44:25,374 --> 01:44:32,914 A 2176 01:44:34,716 --> 01:44:37,486 >> IS THERE A GENERAL OFFICE AND 2177 01:44:37,486 --> 01:44:39,821 WONDERING WHAT THAT LOOKS LIKE. 2178 01:44:39,821 --> 01:44:43,091 >> THANK YOU FOR THE QUESTION. 2179 01:44:43,091 --> 01:44:45,761 THE TERMINOLOGY IS RELATIVE. 2180 01:44:45,761 --> 01:44:47,829 IT'S NOT AN OFFICE IN THE 2181 01:44:47,829 --> 01:44:50,599 CONTEXT OF THE OFFICE YOU DIRECT 2182 01:44:50,599 --> 01:44:52,801 WITHIN THE OFFICE OF THE 2183 01:44:52,801 --> 01:44:53,068 DIRECTOR. 2184 01:44:53,068 --> 01:44:55,570 BUT OPERATIONALLY WE WILL CALL 2185 01:44:55,570 --> 01:44:59,007 IT AN OFFICE. 2186 01:44:59,007 --> 01:45:04,312 WE'LL SIT IN PROGRAM SO UNDER 2187 01:45:04,312 --> 01:45:06,982 THE DIVISION OF BIOLOGICAL AND 2188 01:45:06,982 --> 01:45:08,450 BEHAVIORAL AND ENVIRONMENTAL 2189 01:45:08,450 --> 01:45:11,186 SCIENCES YOU CAN THOUGH YOU LOSE 2190 01:45:11,186 --> 01:45:15,590 YOUR ACRONYM. 2191 01:45:15,590 --> 01:45:19,761 LED BY DR. RENA DAS. 2192 01:45:19,761 --> 01:45:20,162 THAT'S HOW WE'RE 2193 01:45:20,162 --> 01:45:22,798 OPERATIONALIZING IT AND THERE'LL 2194 01:45:22,798 --> 01:45:26,635 BE A DIRECTOR AND THERE WILL BE 2195 01:45:26,635 --> 01:45:29,004 A SUPERVISORY ROLE AND WILL 2196 01:45:29,004 --> 01:45:30,105 STAFF APPROPRIATELY. 2197 01:45:30,105 --> 01:45:33,074 KEEP UNMIND IT'S A $4 MILLION 2198 01:45:33,074 --> 01:45:39,147 BUDGET AND ONE RCMI GRANT. 2199 01:45:39,147 --> 01:45:41,316 SO, WE DO NEED TO REALLY FOCUS 2200 01:45:41,316 --> 01:45:43,685 ON THIS, GET IT SET UP. 2201 01:45:43,685 --> 01:45:47,689 THIS FISCAL YEAR AND SEE HOW IT 2202 01:45:47,689 --> 01:45:53,929 GETS IMPLEMENTED. 2203 01:45:53,929 --> 01:45:56,598 EVENTUALLY RELATING ACROSS THE 2204 01:45:56,598 --> 01:46:01,169 AGENCY ONCE WE ESTABLISH IT. 2205 01:46:01,169 --> 01:46:04,906 WE HAVE A GOOD PLAN SET UP WE 2206 01:46:04,906 --> 01:46:07,776 WILL SHARE AT THE APPROPRIATE 2207 01:46:07,776 --> 01:46:12,914 TIME AS WE MAKE FUNDING 2208 01:46:12,914 --> 01:46:13,982 DECISIONS AND FORTUNATELY WE HAD 2209 01:46:13,982 --> 01:46:17,552 A CONCEPT A YEAR AGO THAT WE 2210 01:46:17,552 --> 01:46:18,186 CLEARED. 2211 01:46:18,186 --> 01:46:23,458 WE'LL HAVE A NOFO, NOTICE OF 2212 01:46:23,458 --> 01:46:24,559 FUNDING OPPORTUNITY AVAILABLE 2213 01:46:24,559 --> 01:46:26,895 THIS FISCAL YEAR TO FUND GRANTS 2214 01:46:26,895 --> 01:46:30,866 FOR '25 AND WE HAD THIS TERRIFIC 2215 01:46:30,866 --> 01:46:32,167 WORKSHOP IN FEBRUARY. 2216 01:46:32,167 --> 01:46:36,137 I THINK WE'RE WELL POISED TO 2217 01:46:36,137 --> 01:46:37,339 WE'RE NOT STARTING FROM SCRATCH. 2218 01:46:37,339 --> 01:46:40,275 WE'VE BEEN THINKING ABOUT THIS 2219 01:46:40,275 --> 01:46:42,077 FOR SOME TIME BECAUSE NATIVE 2220 01:46:42,077 --> 01:46:45,680 HAWAIIAN PACIFIC ISLANDER 2221 01:46:45,680 --> 01:46:46,781 POPULATIONS HAVE NOT BEEN EASY 2222 01:46:46,781 --> 01:46:50,585 TO FOCUS ON AND UNTIL 2017 2223 01:46:50,585 --> 01:46:52,287 NATIONAL DATA ON MORTALITY WERE 2224 01:46:52,287 --> 01:46:54,456 NOT EVEN AVAILABLE ACROSS THE 2225 01:46:54,456 --> 01:47:01,696 COUNTRY. 2226 01:47:01,696 --> 01:47:04,099 EVERY AGENCY NOW REPORTS OUT 2227 01:47:04,099 --> 01:47:04,933 MORTALITY DIFFERENTLY. 2228 01:47:04,933 --> 01:47:06,134 THERE HAVE BEEN DIFFERENT 2229 01:47:06,134 --> 01:47:08,236 PUBLICATIONS LOOKING AT CANCER 2230 01:47:08,236 --> 01:47:09,905 AND MORTALITY FOR EXAMPLE, 2231 01:47:09,905 --> 01:47:15,911 SHOWING THOUGH CANCER INCIDENS 2232 01:47:15,911 --> 01:47:17,279 MAY NOT BE THAT DIFFERENT AND 2233 01:47:17,279 --> 01:47:18,346 MORTALITY WAS DIFFERENT MALES 2234 01:47:18,346 --> 01:47:18,713 AND FEMALES. 2235 01:47:18,713 --> 01:47:22,784 WE'VE KNOWN FROM LOCAL STUDIES 2236 01:47:22,784 --> 01:47:25,186 THAT METABOLIC ISSUES RELATING 2237 01:47:25,186 --> 01:47:27,589 TO DIABETES IN PARTICULAR ARE 2238 01:47:27,589 --> 01:47:30,559 MORE FREQUENT IN NATIVE HAWAIIAN 2239 01:47:30,559 --> 01:47:31,159 PACIFIC ISLANDERS. 2240 01:47:31,159 --> 01:47:34,596 SO I THINK THIS WILL PROVIDE AN 2241 01:47:34,596 --> 01:47:37,566 OPPORTUNITY TO ADVANCE THE 2242 01:47:37,566 --> 01:47:39,034 KNOWLEDGE IN THIS POPULATION. 2243 01:47:39,034 --> 01:47:42,837 >> THAT WAS FOR 2024 FISCAL 2244 01:47:42,837 --> 01:47:45,807 YEAR. 2245 01:47:45,807 --> 01:47:46,141 >> OF COURSE. 2246 01:47:46,141 --> 01:47:47,042 >> I'M SORRY. 2247 01:47:47,042 --> 01:47:49,511 >> YOU HAVE TO SPEND IT BEFORE 2248 01:47:49,511 --> 01:47:49,744 OCTOBER. 2249 01:47:49,744 --> 01:47:51,780 >> WELL, WE DON'T WANT TO LEAVE 2250 01:47:51,780 --> 01:47:53,181 MONEY ON THE TABLE. 2251 01:47:53,181 --> 01:48:03,325 >> OKAY. 2252 01:48:09,497 --> 01:48:11,533 >> IT'S GREAT TO SEE ALL THE 2253 01:48:11,533 --> 01:48:13,935 DIFFERENT TYPES OF ANNUAL 2254 01:48:13,935 --> 01:48:15,470 MEETINGS YOU'RE HAVING FOR THE 2255 01:48:15,470 --> 01:48:16,438 CENTERS OF EXCELLENCE AND 2256 01:48:16,438 --> 01:48:18,573 ENVIRONMENTAL HEALTH DISPARITIES 2257 01:48:18,573 --> 01:48:20,208 AND OTHER GROUPS. 2258 01:48:20,208 --> 01:48:24,679 SO I'M JUST THINKING BECAUSE I'M 2259 01:48:24,679 --> 01:48:27,549 INVOLVED IN THE NIEHS CHILDREN'S 2260 01:48:27,549 --> 01:48:28,316 COLLABORATIVE ENVIRONMENTAL 2261 01:48:28,316 --> 01:48:31,486 HEALTH CENTERS AND THEY DO 2262 01:48:31,486 --> 01:48:33,488 INVESTIGATOR DEVELOPMENT AND ONE 2263 01:48:33,488 --> 01:48:44,032 OF THE CHALLENGES IS SUPPORTING 2264 01:48:45,734 --> 01:48:49,571 A NETWORK AND WONDERING IF 2265 01:48:49,571 --> 01:48:51,072 THERE'S OPPORTUNITY TO 2266 01:48:51,072 --> 01:48:51,373 COLLABORATE. 2267 01:48:51,373 --> 01:48:54,609 YOU ALREADY HAVE THE 2268 01:48:54,609 --> 01:48:58,546 COLLABORATIONS WITH NIEHS TO 2269 01:48:58,546 --> 01:49:00,949 HAVE THE CONVENING OF OTHER 2270 01:49:00,949 --> 01:49:05,387 GRANTEE NETWORKS TACKLING 2271 01:49:05,387 --> 01:49:06,688 ENVIRONMENTAL HEALTH 2272 01:49:06,688 --> 01:49:07,322 DISPARITIES. 2273 01:49:07,322 --> 01:49:08,823 >> THAT'S A GOOD SUGGESTION. 2274 01:49:08,823 --> 01:49:10,225 DEBBIE, IF YOU'RE STILL IN THE 2275 01:49:10,225 --> 01:49:11,393 ROOM -- THERE SHE IS. 2276 01:49:11,393 --> 01:49:16,231 TAKE NOTE. 2277 01:49:16,231 --> 01:49:26,775 IT'S SOMETHING WE CAN ADD TO 2278 01:49:27,909 --> 01:49:31,813 OUR -- I'LL MAKE A COMMENT. 2279 01:49:31,813 --> 01:49:34,182 OUR COLLABORATION BEFORE I 2280 01:49:34,182 --> 01:49:40,288 ARRIVED AT NIMHD HAS BEEN ROBUST 2281 01:49:40,288 --> 01:49:50,498 HAS EVOLVED. 2282 01:49:56,237 --> 01:49:58,506 I THINK CLIMATE CHANGE IN THE 2283 01:49:58,506 --> 01:50:00,942 SPECTRUM AND ENVIRONMENTAL 2284 01:50:00,942 --> 01:50:02,110 DISPARITIES AND THERE'S 2285 01:50:02,110 --> 01:50:04,913 DISCUSSION ABOUT ENVIRONMENTAL 2286 01:50:04,913 --> 01:50:05,880 JUSTICE ISSUES IN RESEARCH 2287 01:50:05,880 --> 01:50:06,981 COMING FROM THE DEPARTMENT OF 2288 01:50:06,981 --> 01:50:10,618 HEALTH AND HUMAN SERVICE AND 2289 01:50:10,618 --> 01:50:11,419 APPROPRIATELY SO. 2290 01:50:11,419 --> 01:50:14,889 SO I THINK THAT'S WHERE 2291 01:50:14,889 --> 01:50:15,890 LEVERAGING THESE OPPORTUNITIES 2292 01:50:15,890 --> 01:50:20,195 TO CREATE MORE NETWORKING ACROSS 2293 01:50:20,195 --> 01:50:23,765 THESE DIFFERENT PROGRAMS IS I 2294 01:50:23,765 --> 01:50:24,566 THINK AN IMPORTANT SO THANK YOU 2295 01:50:24,566 --> 01:50:34,743 FOR THAT. 2296 01:50:37,078 --> 01:50:38,613 OKAY, ANY OTHER COMMENTS OR 2297 01:50:38,613 --> 01:50:40,849 QUESTIONS FROM COUNCIL? 2298 01:50:40,849 --> 01:50:42,217 >> DR. STONE DO YOU HAVE A 2299 01:50:42,217 --> 01:50:42,917 QUESTION OR COMMENT? 2300 01:50:42,917 --> 01:50:52,627 >> YES, THANK YOU. 2301 01:50:52,627 --> 01:50:53,962 I APPRECIATE WHAT YOU PRESENT 2302 01:50:53,962 --> 01:50:54,829 EACH MEETING. 2303 01:50:54,829 --> 01:51:01,002 I AGREE IT'S SOBERING TO SEE THE 2304 01:51:01,002 --> 01:51:05,707 DATA FROM THE AMERICAN MEDICAL 2305 01:51:05,707 --> 01:51:07,208 ASSOCIATION AND THE UNDERMINING 2306 01:51:07,208 --> 01:51:09,177 DUE TO THE SUPREME COURT 2307 01:51:09,177 --> 01:51:10,779 DECISION AND WONDERING IF 2308 01:51:10,779 --> 01:51:13,581 NIMHD'S THINKING AHEAD ON THE 2309 01:51:13,581 --> 01:51:15,817 PORTFOLIO AND THE POSSIBLE 2310 01:51:15,817 --> 01:51:16,785 REDUCTION OF UNDER REPRESENTED 2311 01:51:16,785 --> 01:51:20,889 MINORITY SCHOLARS IN THE 2312 01:51:20,889 --> 01:51:22,323 PIPELINE AS WELL AS URM FACULTY 2313 01:51:22,323 --> 01:51:23,992 AND HOW YOU MIGHT THINK OF 2314 01:51:23,992 --> 01:51:25,326 MITIGATING THAT OR MAYBE 2315 01:51:25,326 --> 01:51:30,598 BOOSTING OR INCENTIVIZING THE 2316 01:51:30,598 --> 01:51:34,502 PIPELINE WITH THE RESEARCH. 2317 01:51:34,502 --> 01:51:38,573 >> SO, I WANT TO JUST BE CLEAR. 2318 01:51:38,573 --> 01:51:42,343 OUR OBJECTIVES ARE UNCHANGED. 2319 01:51:42,343 --> 01:51:48,183 BUT WE HAVE TO BE EXTREMELY 2320 01:51:48,183 --> 01:51:50,618 CAUTIOUS ABOUT BEING CLEAR THAT 2321 01:51:50,618 --> 01:51:52,821 WE DO NOT MAKE FUNDING DECISIONS 2322 01:51:52,821 --> 01:51:57,525 OR SELECTION OF APPLICANTS ON 2323 01:51:57,525 --> 01:51:59,994 THE BASIS OF IDENTITY 2324 01:51:59,994 --> 01:52:01,062 CHARACTERISTIC AND THIS GOES FOR 2325 01:52:01,062 --> 01:52:04,632 RACE AND ETHNICITY AND FOR 2326 01:52:04,632 --> 01:52:06,034 GENDER OR SEX. 2327 01:52:06,034 --> 01:52:06,935 THIS IS THE LAW. 2328 01:52:06,935 --> 01:52:08,837 WHETHER WE AGREE WITH IT OR NOT 2329 01:52:08,837 --> 01:52:13,641 THIS IS THE INTERPRETATION OF 2330 01:52:13,641 --> 01:52:16,878 THE LAW AND WE NEED TO BE VERY 2331 01:52:16,878 --> 01:52:22,517 IMPORTANT THAT BE THE MESSAGE 2332 01:52:22,517 --> 01:52:24,018 AND OUR COMMUNITY DO NOT 2333 01:52:24,018 --> 01:52:27,222 INTERPRET WHAT WE WANT TO SEE 2334 01:52:27,222 --> 01:52:28,590 HAPPEN AS ANOTHER WAY OF MAKING 2335 01:52:28,590 --> 01:52:37,265 CHOICES ON THAT BASIS. 2336 01:52:37,265 --> 01:52:40,235 SO, THIS IS A SOCIETAL ISSUE WE 2337 01:52:40,235 --> 01:52:41,536 THINK IS IMPORTANT. 2338 01:52:41,536 --> 01:52:43,204 OTHERS DON'T -- WE DO SEE THIS 2339 01:52:43,204 --> 01:52:49,244 AS A WAY OF IMPROVING NOT JUST 2340 01:52:49,244 --> 01:52:54,883 HEALTH CARE BUT ALSO SCIENCE AND 2341 01:52:54,883 --> 01:52:59,420 IT'S A LONG GAME. 2342 01:52:59,420 --> 01:53:02,757 THERE'S BEEN PROGRESS SINCE I 2343 01:53:02,757 --> 01:53:06,694 STARTED BUT CERTAINLY 14% IS NOT 2344 01:53:06,694 --> 01:53:09,764 WHERE WE SHOULD BE IN THE LONG 2345 01:53:09,764 --> 01:53:13,368 RUN. 2346 01:53:13,368 --> 01:53:14,702 SO, I DO THINK WE'LL CONTINUE TO 2347 01:53:14,702 --> 01:53:18,873 DO EVERYTHING WE CAN TO ADVANCE 2348 01:53:18,873 --> 01:53:21,542 TO APPROACH OUR GOALS WITHIN THE 2349 01:53:21,542 --> 01:53:26,481 LIMITATIONS THAT WE HAVE. 2350 01:53:26,481 --> 01:53:31,152 I WILL SAY THAT USING SOCIO 2351 01:53:31,152 --> 01:53:34,789 ECONOMIC CRITERIA THOUGH PERHAPS 2352 01:53:34,789 --> 01:53:40,328 MORE BLUNT EXCLUDES THE LIVED 2353 01:53:40,328 --> 01:53:42,497 EXPERIENCE OF RACISM THAT OCCURS 2354 01:53:42,497 --> 01:53:45,900 WITH UNDER REPRESENTED GROUPS. 2355 01:53:45,900 --> 01:53:51,139 DOES HAVE AN EFFECT IN THE 2356 01:53:51,139 --> 01:53:53,608 DESIRED DIRECTION. 2357 01:53:53,608 --> 01:53:56,811 WE'VE SEEN THAT IN CALIFORNIA 2358 01:53:56,811 --> 01:54:00,715 WHERE AFFIRMATIVE ACTION WAS 2359 01:54:00,715 --> 01:54:02,717 OUTLAWED BY A REFERENDUM OF THE 2360 01:54:02,717 --> 01:54:06,721 VOTING PUBLIC IN 1997 I THINK 2361 01:54:06,721 --> 01:54:10,091 AND CONFIRMED IN A SECOND EFFORT 2362 01:54:10,091 --> 01:54:12,060 TO CHANGE THAT AND THERE ARE 2363 01:54:12,060 --> 01:54:14,128 WAYS OF IMPROVING THE PIPELINE 2364 01:54:14,128 --> 01:54:19,500 AS YOU SAY IN CALIFORNIA 2365 01:54:19,500 --> 01:54:20,635 PRIMARILY THROUGH GREATER ACCESS 2366 01:54:20,635 --> 01:54:25,373 TO HIGHER EDUCATION AND ROBUST 2367 01:54:25,373 --> 01:54:28,977 COMMUNITY COLLEGE NETWORK WHERE 2368 01:54:28,977 --> 01:54:33,548 STUDENTS FROM UNDER PRIVILEGED 2369 01:54:33,548 --> 01:54:36,584 BACKGROUNDS ARE ABLE TO ATTEND, 2370 01:54:36,584 --> 01:54:38,953 GET A QUALITY EDUCATION AND BE 2371 01:54:38,953 --> 01:54:43,224 ACCEPTED TO UNIVERSITY OF 2372 01:54:43,224 --> 01:54:46,461 CALIFORNIA WHICH IS IN THE SAME 2373 01:54:46,461 --> 01:54:47,595 BETTER OR WORSE BUT SAME LEAGUE 2374 01:54:47,595 --> 01:54:50,598 AS THE IVY LEAGUE IN TERMS OF 2375 01:54:50,598 --> 01:54:56,137 QUALITY EDUCATION. 2376 01:54:56,137 --> 01:55:00,308 IT'S STATE SUPPORTED OR 2377 01:55:00,308 --> 01:55:02,610 AFFORDABLE TUITION AND ALMOST 2378 01:55:02,610 --> 01:55:04,712 HALF THE STUDENTS UNDERGRADUATE 2379 01:55:04,712 --> 01:55:07,582 STUDENTS, MIND YOU, IN THE U.C. 2380 01:55:07,582 --> 01:55:08,483 SYSTEM ATTEND CAMPUSES ARE FIRST 2381 01:55:08,483 --> 01:55:09,517 IN THEIR FAMILY TO ATTEND 2382 01:55:09,517 --> 01:55:13,388 COLLEGE. 2383 01:55:13,388 --> 01:55:15,390 THERE IS A WAY TO DO THIS. 2384 01:55:15,390 --> 01:55:18,593 IT'S JUST NOT UNIVERSALLY 2385 01:55:18,593 --> 01:55:27,368 IMPLEMENTED. 2386 01:55:27,368 --> 01:55:30,405 THE OTHER TOOL IS GEOGRAPHIC. 2387 01:55:30,405 --> 01:55:34,275 WE CAN SAY THIS IS WHAT THE IDEA 2388 01:55:34,275 --> 01:55:37,678 STATES PROGRAM IS ABOUT AND 2389 01:55:37,678 --> 01:55:37,945 NIGMS. 2390 01:55:37,945 --> 01:55:40,648 WE CAN ALSO IMPLEMENT. 2391 01:55:40,648 --> 01:55:44,519 THIS IS WHAT WE DO IN PART WITH 2392 01:55:44,519 --> 01:55:46,387 RESEARCH ACTIVE INSTITUTIONS OR 2393 01:55:46,387 --> 01:55:50,658 THE LESS RESOURCED INSTITUTIONS. 2394 01:55:50,658 --> 01:55:54,429 THIS IS WHERE WE'RE TRYING TO 2395 01:55:54,429 --> 01:55:55,129 DEAL WITH THE TRIBAL 2396 01:55:55,129 --> 01:55:57,665 EPIDEMIOLOGY CENTERS AND WHAT WE 2397 01:55:57,665 --> 01:55:59,767 WILL CONTINUE TO DO AS MUCH AS 2398 01:55:59,767 --> 01:56:04,439 WE CAN IN OUR OWN LIMITED SCOPE 2399 01:56:04,439 --> 01:56:08,810 AND PROMOTE AND THERE IS I THINK 2400 01:56:08,810 --> 01:56:14,315 GENERAL SUPPORT FOR THIS ACROSS 2401 01:56:14,315 --> 01:56:18,052 NIMH AND THIS IS NOT ONLY NIGMS 2402 01:56:18,052 --> 01:56:19,387 AND A COUPLE OTHERS, THIS IS 2403 01:56:19,387 --> 01:56:20,855 GENERALLY SUPPORTED AND KEEP 2404 01:56:20,855 --> 01:56:25,359 BRINGING THIS UP AND PROMOTING 2405 01:56:25,359 --> 01:56:28,229 IT. 2406 01:56:28,229 --> 01:56:30,598 THERE ARE OTHER THINGS AT WORK 2407 01:56:30,598 --> 01:56:32,633 THE HOLISTIC ADMISSION 2408 01:56:32,633 --> 01:56:34,235 PERSPECTIVE OPPOSED TO A PURE 2409 01:56:34,235 --> 01:56:39,073 DID YOU GET A TEST SCORE OR ARE 2410 01:56:39,073 --> 01:56:41,776 A GPA OR GO TO A SCHOOL THAT 2411 01:56:41,776 --> 01:56:47,081 PREPARED YOU TO GET A GOOD SCORE 2412 01:56:47,081 --> 01:56:49,150 ON YOUR TEST. 2413 01:56:49,150 --> 01:56:51,419 CERTAINLY IN THE MEDICAL 2414 01:56:51,419 --> 01:56:53,721 PROFESSION IT'S DEFENSIBLE IT'S 2415 01:56:53,721 --> 01:56:56,524 NOT HOW GOOD YOU ARE TAKING TEST 2416 01:56:56,524 --> 01:56:59,560 BUT A DIFFERENT SET OF QUALITIES 2417 01:56:59,560 --> 01:57:02,096 THAT MAKE YOU A GOOD CLINICIAN 2418 01:57:02,096 --> 01:57:04,432 AND SO HOLISTIC ADMISSION IS 2419 01:57:04,432 --> 01:57:07,335 MUCH MORE CONSISTENT IN THAT 2420 01:57:07,335 --> 01:57:08,769 CONTEXT THOUGH ONE CAN ARGUE IT 2421 01:57:08,769 --> 01:57:10,505 YOU'D BE CONSIDERED FOR ALL OF 2422 01:57:10,505 --> 01:57:11,005 THIS. 2423 01:57:11,005 --> 01:57:14,075 IT'S HARD TO DO THIS WHEN 2424 01:57:14,075 --> 01:57:16,110 THOUSAND AND THOUSANDS OF PEOPLE 2425 01:57:16,110 --> 01:57:18,846 ARE ON BUT WE HAVE TO FIND THESE 2426 01:57:18,846 --> 01:57:25,086 ALTERNATIVE APPROACHES GIVEN THE 2427 01:57:25,086 --> 01:57:26,387 CURRENT RULINGS ON THAT. 2428 01:57:26,387 --> 01:57:29,857 RACE CONSCIOUS, RACE AWARENESS 2429 01:57:29,857 --> 01:57:32,860 ADMISSIONS ARE NOW NOT 2430 01:57:32,860 --> 01:57:36,364 ACCEPTABLE IN THE COUNTRY. 2431 01:57:36,364 --> 01:57:38,599 HOPE THAT HELPS, LISA. 2432 01:57:38,599 --> 01:57:42,603 >> THANK YOU SO MUCH. 2433 01:57:42,603 --> 01:57:44,338 >> THANK YOU. 2434 01:57:44,338 --> 01:57:49,010 SO I HAVE A QUESTION. 2435 01:57:49,010 --> 01:57:55,082 ONE OF THE STUDIES YOU DISCUSSED 2436 01:57:55,082 --> 01:58:00,855 INDICATED THAT MENTAL HEALTH 2437 01:58:00,855 --> 01:58:06,494 AMONG LATINOS IS LESS TREATED 2438 01:58:06,494 --> 01:58:11,032 AND WHAT ARE THE FUNDS TO 2439 01:58:11,032 --> 01:58:14,168 ADDRESS SOME OF THOSE. 2440 01:58:14,168 --> 01:58:16,437 >> SO, I DON'T REMEMBER THE 2441 01:58:16,437 --> 01:58:19,574 DETAILS OF WHAT I SAID BEFORE 2442 01:58:19,574 --> 01:58:23,811 BUT WILL TRY TO REITERATE WHAT I 2443 01:58:23,811 --> 01:58:26,814 THINK IS THE ISSUE. 2444 01:58:26,814 --> 01:58:30,985 MAJOR MENTAL HEALTH ISSUES ARE 2445 01:58:30,985 --> 01:58:32,520 SIMILAR ACROSS GROUPS. 2446 01:58:32,520 --> 01:58:34,755 I DON'T THINK THERE'S BEEN MAJOR 2447 01:58:34,755 --> 01:58:37,325 DIFFERENCES SAY WITH 2448 01:58:37,325 --> 01:58:38,993 SCHIZOPHRENIA, PSYCHOSIS AND 2449 01:58:38,993 --> 01:58:40,061 BIPOLAR DISORDERS. 2450 01:58:40,061 --> 01:58:45,333 THERE ARE SOME DIFFERENCES IN 2451 01:58:45,333 --> 01:58:45,967 THINGS LIKE AUTISM AND ATTENTION 2452 01:58:45,967 --> 01:58:47,235 DEFICIT DISORDERS WRITTEN ABOUT 2453 01:58:47,235 --> 01:58:49,570 BUT IN THE CLINICAL CONTEXT, 2454 01:58:49,570 --> 01:58:53,007 THIS WAS PRIMARILY REFERRING TO 2455 01:58:53,007 --> 01:58:55,209 DEPRESSION, DEPRESSIVE SYMPTOMS 2456 01:58:55,209 --> 01:58:58,879 AND ANXIETY AND SEVERE ANXIETY. 2457 01:58:58,879 --> 01:59:02,216 PEOPLE FROM LATIN AMERICAN 2458 01:59:02,216 --> 01:59:05,786 BACKGROUND IN GENERAL, THIS IS 2459 01:59:05,786 --> 01:59:07,521 GENERALIZED TO MIND-BODY 2460 01:59:07,521 --> 01:59:08,623 CONNECTIONS. 2461 01:59:08,623 --> 01:59:10,591 IF I TELL A PATIENT, WELL, THIS 2462 01:59:10,591 --> 01:59:12,593 IS REALLY PSYCHOLOGICAL PROBLEM 2463 01:59:12,593 --> 01:59:15,296 OR A STRESS ISSUE OR SOMETHING 2464 01:59:15,296 --> 01:59:18,032 RELATED TO EVENTS OPPOSED TO A 2465 01:59:18,032 --> 01:59:20,401 PHYSICAL PROBLEM THAT I NEED TO 2466 01:59:20,401 --> 01:59:25,673 FIND THE RIGHT TEST AND 2467 01:59:25,673 --> 01:59:27,241 MEDICATION TO GIVE YOU, THEY 2468 01:59:27,241 --> 01:59:29,210 GENERALLY ARE RESPONSIVE TO THAT 2469 01:59:29,210 --> 01:59:31,712 AND IN THAT CONTEXT CHEMICAL 2470 01:59:31,712 --> 01:59:34,615 IMBALANCE THAT LEADS TO YOUR 2471 01:59:34,615 --> 01:59:35,583 SEVERE DEPRESSIVE SYMPTOMS CAN 2472 01:59:35,583 --> 01:59:37,318 BE TREATED IN PART WITH THIS 2473 01:59:37,318 --> 01:59:38,619 MEDICATION AND PEOPLE HAVE 2474 01:59:38,619 --> 01:59:41,289 ACCEPTED THAT. 2475 01:59:41,289 --> 01:59:46,594 OTHER CULTURES HAVE A DIFFERENT 2476 01:59:46,594 --> 01:59:50,197 ACCEPTANCE AND PEOPLE HAVE 2477 01:59:50,197 --> 01:59:55,436 WRITTEN ABOUT THIS FOR DECADES, 2478 01:59:55,436 --> 01:59:57,972 BOTH MEDICAL ANTHROPOLOGISTS AND 2479 01:59:57,972 --> 01:59:58,272 CLINICIANS. 2480 01:59:58,272 --> 02:00:00,841 THE PROBLEM IS IN ACCESSING 2481 02:00:00,841 --> 02:00:01,742 MEDICAL HEALTH CARE. 2482 02:00:01,742 --> 02:00:06,480 BECAUSE THE WAY THE SYSTEM 2483 02:00:06,480 --> 02:00:11,419 SEPARATED OUT MENTAL HEALTH CARE 2484 02:00:11,419 --> 02:00:15,589 FROM CLINICAL CARE AS A PRIMARY 2485 02:00:15,589 --> 02:00:17,391 CARE DOCTOR WE COULDN'T DO THAT 2486 02:00:17,391 --> 02:00:20,161 BECAUSE PATIENTS CAME TO US WITH 2487 02:00:20,161 --> 02:00:25,800 WHATEVER THEY HAD AND I DID 2488 02:00:25,800 --> 02:00:29,003 RESEARCH ON MEDICAL DEPRESSION 2489 02:00:29,003 --> 02:00:31,539 AS A FELLOW WITH PSYCHOLOGISTS 2490 02:00:31,539 --> 02:00:34,608 AND SHOWED IT WAS COMMON AND 2491 02:00:34,608 --> 02:00:36,510 UNDER RECOGNIZED AND UNDER 2492 02:00:36,510 --> 02:00:39,780 TREATED INTERVENTIONS DO WORK. 2493 02:00:39,780 --> 02:00:44,852 SO THIS HAS EVOLVED ENORMOUSLY 2494 02:00:44,852 --> 02:00:46,787 AND CLINGS SAY WE SCREENED FOR 2495 02:00:46,787 --> 02:00:47,088 DEPRESSION. 2496 02:00:47,088 --> 02:00:48,356 YOU CAN ASK FOR ONE OR TWO 2497 02:00:48,356 --> 02:00:50,224 QUESTIONS AND GET A SENSE OF 2498 02:00:50,224 --> 02:00:51,692 SOMEONE NEEDS FURTHER 2499 02:00:51,692 --> 02:00:52,460 VALIDATION. 2500 02:00:52,460 --> 02:00:57,765 WE CAN DO THE PHQ 9 THE 2501 02:00:57,765 --> 02:00:58,999 DIAGNOSTIC TOOL AND SAY SOMEONE 2502 02:00:58,999 --> 02:00:59,800 NEEDS TO BE CONSIDERED FOR A 2503 02:00:59,800 --> 02:01:01,235 THERAPEUTIC TRIAL. 2504 02:01:01,235 --> 02:01:02,536 I THINK THE DATA HAVE INFORMED 2505 02:01:02,536 --> 02:01:09,377 US IN WHAT TO DO AND AS A 2506 02:01:09,377 --> 02:01:11,979 CLINICIAN AND IF YOU HAVE ACCESS 2507 02:01:11,979 --> 02:01:13,514 TO ME I CAN DO A LOT OF THAT. 2508 02:01:13,514 --> 02:01:15,282 BUT IF I THINK THE PATIENT NEEDS 2509 02:01:15,282 --> 02:01:18,886 ONCE A WEEK COUNSELLING WITH A 2510 02:01:18,886 --> 02:01:20,755 MENTAL HEALTH PROFESSIONAL, 2511 02:01:20,755 --> 02:01:24,225 ACCESS TO THAT IS CHALLENGING 2512 02:01:24,225 --> 02:01:25,893 BECAUSE A LOT OF INSURANCES 2513 02:01:25,893 --> 02:01:26,494 DON'T COVER IT. 2514 02:01:26,494 --> 02:01:27,995 OR YOU DON'T HAVE ACCESS TO 2515 02:01:27,995 --> 02:01:30,731 SOMEONE WHO SPEAKS YOUR LANGUAGE 2516 02:01:30,731 --> 02:01:32,066 IN THIS CASE WHAT'S THE USE OF 2517 02:01:32,066 --> 02:01:34,502 GOING TO A COUNSELLING SESSION 2518 02:01:34,502 --> 02:01:35,836 TO AN INTERPRETER. 2519 02:01:35,836 --> 02:01:38,973 YOU CAN DO IT THROUGH AN 2520 02:01:38,973 --> 02:01:41,041 INTERPRETER AND IT'S BETTER THAN 2521 02:01:41,041 --> 02:01:42,576 NOTHING BUT REALLY BECOMES MORE 2522 02:01:42,576 --> 02:01:44,445 AND MORE CHALLENGING. 2523 02:01:44,445 --> 02:01:47,982 I FOUND THAT FREQUENTLY TO BE A 2524 02:01:47,982 --> 02:01:48,215 PROBLEM. 2525 02:01:48,215 --> 02:01:48,983 THERE'S A LIST OF AVAILABLE 2526 02:01:48,983 --> 02:01:52,052 PEOPLE WHO ARE PART OF THIS PLAN 2527 02:01:52,052 --> 02:01:54,989 WHO WOULD DO BEHAVIORAL THERAPY, 2528 02:01:54,989 --> 02:02:00,261 BEHAVIORAL HEALTH CARE FOR YOUR 2529 02:02:00,261 --> 02:02:00,528 PATIENTS. 2530 02:02:00,528 --> 02:02:02,463 90% WERE NOT TAKING NEW PATIENTS 2531 02:02:02,463 --> 02:02:03,397 FOR EXAMPLE. 2532 02:02:03,397 --> 02:02:05,166 THAT WASN'T UNCOMMON. 2533 02:02:05,166 --> 02:02:09,703 AND FINDING MODELS WHERE WE 2534 02:02:09,703 --> 02:02:13,507 INTEGRATED THE BEHAVIORAL HEALTH 2535 02:02:13,507 --> 02:02:16,710 THERAPY INTO HEALTH CARE WAS A 2536 02:02:16,710 --> 02:02:20,114 DIRECTION I THINK SOME SYSTEMS 2537 02:02:20,114 --> 02:02:22,917 HAVE MOVED TO INCORPORATING THAT 2538 02:02:22,917 --> 02:02:24,618 INTO THE PRACTICE SETTING OR 2539 02:02:24,618 --> 02:02:28,255 INTO THE PRIMARY CARE SETTING 2540 02:02:28,255 --> 02:02:31,492 OPPOSED TO BEING SPUN OFF TO A 2541 02:02:31,492 --> 02:02:32,893 SEPARATE ENTITY AND SO I THINK 2542 02:02:32,893 --> 02:02:40,067 THOSE ARE THE CHALLENGES. 2543 02:02:40,067 --> 02:02:42,002 SOMEONE WHO DOESN'T SPEAK 2544 02:02:42,002 --> 02:02:44,305 ENGLISH WELL THE BARRIERS ARE 2545 02:02:44,305 --> 02:02:54,515 MULTIPLIED. 2546 02:02:55,649 --> 02:02:57,618 >> THANK YOU FOR YOUR GREAT 2547 02:02:57,618 --> 02:02:57,952 PRESENTATION. 2548 02:02:57,952 --> 02:03:03,891 I WAS VERY MUCH INTERESTED IN 2549 02:03:03,891 --> 02:03:05,059 THE STRUCTURAL RACISM 2550 02:03:05,059 --> 02:03:06,427 CORRELATION THAT YOU MENTIONED 2551 02:03:06,427 --> 02:03:07,595 WITH DIABETES. 2552 02:03:07,595 --> 02:03:11,832 AND I'M WONDERING IF YOU COULD 2553 02:03:11,832 --> 02:03:17,671 SPEAK TO OR SPECULATE ON ANY OF 2554 02:03:17,671 --> 02:03:19,440 THE DOWN STREAM SOCIAL 2555 02:03:19,440 --> 02:03:20,674 DETERMINATE AND THEIR 2556 02:03:20,674 --> 02:03:23,077 CORRELATIONS WITH STRUCTURAL 2557 02:03:23,077 --> 02:03:23,844 RACISM. 2558 02:03:23,844 --> 02:03:26,680 PARTICULARLY AROUND MAYBE 2559 02:03:26,680 --> 02:03:32,887 HYPERTENSION, OTHER TRAUMATIC 2560 02:03:32,887 --> 02:03:33,220 MATTERS. 2561 02:03:33,220 --> 02:03:36,123 >> NOT SURE WHAT YOU'RE ASKING. 2562 02:03:36,123 --> 02:03:37,791 >> OKAY. 2563 02:03:37,791 --> 02:03:42,363 SO, IF STRUCTURAL RACISM 2564 02:03:42,363 --> 02:03:43,030 CORRELATES WITH DIABETES, RIGHT, 2565 02:03:43,030 --> 02:03:47,301 THEN CAN WE THINK OF OTHER 2566 02:03:47,301 --> 02:03:53,173 COMORBIDITIES OR OTHER SOCIAL 2567 02:03:53,173 --> 02:03:53,941 DETERMINATES WHERE YOU MIGHT 2568 02:03:53,941 --> 02:03:57,244 FIND SIMILAR CORRELATIONS. 2569 02:03:57,244 --> 02:03:58,712 >> DEFINITELY. 2570 02:03:58,712 --> 02:04:00,481 LEONARD'S PUBLICATION WAS 2571 02:04:00,481 --> 02:04:01,649 FOCUSSING ON THINGS WE PUBLISHED 2572 02:04:01,649 --> 02:04:07,721 IN THE LAST SEVERAL MONTHS. 2573 02:04:07,721 --> 02:04:16,630 THERE'S A MAP OF THE DISTRICT OF 2574 02:04:16,630 --> 02:04:19,533 COLUMBIA SHOWING THE EFFECTS OF 2575 02:04:19,533 --> 02:04:23,003 RED LINING AND SEGREGATION IN 2576 02:04:23,003 --> 02:04:23,571 THE DISTRICT. 2577 02:04:23,571 --> 02:04:27,374 THE AREA EAST OF THE RIVER 2578 02:04:27,374 --> 02:04:30,678 COMPARED TO NORTHWEST SHOWING 2579 02:04:30,678 --> 02:04:35,916 NOT JUST THE USUAL LIFE 2580 02:04:35,916 --> 02:04:36,884 EXPECTANCY DIFFERENCES BUT 2581 02:04:36,884 --> 02:04:37,685 CARDIOVASCULAR DISEASE AND 2582 02:04:37,685 --> 02:04:40,688 MECHANISTIC DIFFERENCES IN TERMS 2583 02:04:40,688 --> 02:04:42,590 OF BLOOD PRESSURE, INFLAMMATORY 2584 02:04:42,590 --> 02:04:51,231 MARKERS AND EVENTS. 2585 02:04:51,231 --> 02:04:54,401 THIS WHOLE RED LINING POLICY 2586 02:04:54,401 --> 02:04:59,773 WHICH WAS A POLICY WAS AN 2587 02:04:59,773 --> 02:05:06,013 INTENTIONAL PLAN THAT 2588 02:05:06,013 --> 02:05:06,614 MARGINALIZED AFRICAN AMERICAN 2589 02:05:06,614 --> 02:05:10,150 BLACK AMERICANS IN MOST CITIES 2590 02:05:10,150 --> 02:05:14,955 IN THE U.S., MOST LARGE URBAN 2591 02:05:14,955 --> 02:05:17,458 CITIES AND SUBSEQUENTLY OR 2592 02:05:17,458 --> 02:05:18,592 CONSEQUENTLY LATINO POPULATIONS 2593 02:05:18,592 --> 02:05:24,732 AS WELL BY CREATING NOT ONLY 2594 02:05:24,732 --> 02:05:26,767 SEGREGATED COMMUNITIES BUT 2595 02:05:26,767 --> 02:05:31,872 CREATING ENORMOUS BARRIERS TO 2596 02:05:31,872 --> 02:05:34,875 ACCESS AFFORDABLE LOANS TO GROW 2597 02:05:34,875 --> 02:05:36,477 EQUITY. 2598 02:05:36,477 --> 02:05:42,583 WHICH IS HOW AMERICAN FAMILIES 2599 02:05:42,583 --> 02:05:46,186 BUILD WEALTH. 2600 02:05:46,186 --> 02:05:51,091 IT WAS A IMPLEMENTED AND USED BY 2601 02:05:51,091 --> 02:05:54,628 THE APARTHEID REGIME AS A MODEL 2602 02:05:54,628 --> 02:05:57,698 AND CITED BY THE NAZI REGIME IN 2603 02:05:57,698 --> 02:05:59,266 GERMANY AS A SUCCESSFUL MODEL OF 2604 02:05:59,266 --> 02:06:04,672 HOW TO DO THESE THINGS AND POST 2605 02:06:04,672 --> 02:06:06,607 WORLD WAR II WHEN THE 2606 02:06:06,607 --> 02:06:14,381 U.S. EMBARKED ON A 25, 30-YEAR 2607 02:06:14,381 --> 02:06:16,517 ECONOMIC BOOM THAT BUILT ON 2608 02:06:16,517 --> 02:06:17,251 PARTLY ON PURCHASING PROPERTY AS 2609 02:06:17,251 --> 02:06:22,589 A WAY OF ENHANCING HEALTH AMONG 2610 02:06:22,589 --> 02:06:23,424 FAMILIES BLACK AMERICANS AND 2611 02:06:23,424 --> 02:06:29,763 LATINO AMERICANS TO A LESSER 2612 02:06:29,763 --> 02:06:40,307 EXTENT WERE DISENFRANCHISED AND 2613 02:06:41,608 --> 02:06:42,443 THERE ARE MAPS HISTORICALLY 2614 02:06:42,443 --> 02:06:44,912 ARCHIVED IN MOST URBAN CITIES 2615 02:06:44,912 --> 02:06:48,916 SOMEWHAT ATTENUATED AS YOU MOVE 2616 02:06:48,916 --> 02:06:51,852 WEST BECAUSE OF THE LACK OF 2617 02:06:51,852 --> 02:06:54,354 POPULATION AND DIFFERENCES IN 2618 02:06:54,354 --> 02:06:56,490 POPULATION BUT NOT ABSENT BY ANY 2619 02:06:56,490 --> 02:06:58,525 STRETCH OF THE IMAGINATION. 2620 02:06:58,525 --> 02:06:59,727 AND AS OTHERS HAVE SAID AND I 2621 02:06:59,727 --> 02:07:03,997 HAVE SAID, THIS IS LIKE OH, YOU 2622 02:07:03,997 --> 02:07:05,032 START A MONOPOLY GAME WHERE YOU 2623 02:07:05,032 --> 02:07:05,365 CAN'T PLAY. 2624 02:07:05,365 --> 02:07:10,604 YOU HAVE TO WAIT AN HOUR BEFORE 2625 02:07:10,604 --> 02:07:13,707 YOU CAN START PLAYING AND THEN 2626 02:07:13,707 --> 02:07:16,110 BY THEN EVERYONE HAS HOTEL, SIX 2627 02:07:16,110 --> 02:07:22,483 PROPERTIES OR HOUSES AND WHAT 2628 02:07:22,483 --> 02:07:27,788 THIS PROMOTED WAS THE STRUCTURAL 2629 02:07:27,788 --> 02:07:30,190 BARRIERS WE STILL WITNESS TODAY. 2630 02:07:30,190 --> 02:07:35,028 EFFORTS TO DISMANTLE THIS HAVE 2631 02:07:35,028 --> 02:07:37,631 MADE SOME PROGRESS IN SOME AREAS 2632 02:07:37,631 --> 02:07:42,603 BUT STOPPED FOR POLITICAL 2633 02:07:42,603 --> 02:07:43,871 REASONS PRIMARILY AND THERE IS 2634 02:07:43,871 --> 02:07:47,241 STILL A CONCEPT THAT I THINK IS 2635 02:07:47,241 --> 02:07:50,878 TRUE THAT THE IDEA OF HAVING A 2636 02:07:50,878 --> 02:07:54,515 COMMUNITY AND URBAN SETTING IN 2637 02:07:54,515 --> 02:07:56,617 RURAL AREAS BE DIFFERENT HOW YOU 2638 02:07:56,617 --> 02:07:58,385 OPERATIONALIZE THIS THAT'S NOT 2639 02:07:58,385 --> 02:07:58,619 UNIFORM. 2640 02:07:58,619 --> 02:08:02,389 IT'S GOOD FOR THE COMMUNITY'S 2641 02:08:02,389 --> 02:08:04,691 HEALTH AND BY UNIFORMITY I DON'T 2642 02:08:04,691 --> 02:08:07,795 REFER TO RACE AND ETHNICITY 2643 02:08:07,795 --> 02:08:09,863 BECAUSE THAT'S ACCORDING TO WHO 2644 02:08:09,863 --> 02:08:13,767 IS IN THE AREA BUT SOCIO 2645 02:08:13,767 --> 02:08:16,804 ECONOMIC SO WEALTHY PEOPLE WILL 2646 02:08:16,804 --> 02:08:17,304 ALWAYS BE SEPARATE. 2647 02:08:17,304 --> 02:08:20,073 THE 1% ASIDE BECAUSE THEY WON'T 2648 02:08:20,073 --> 02:08:22,676 BE INTEGRATED BUT A COMMUNITY 2649 02:08:22,676 --> 02:08:25,045 HAS WORKING PEOPLE AND PEOPLE 2650 02:08:25,045 --> 02:08:32,486 WHO ARE PROFESSIONALS, PEOPLE 2651 02:08:32,486 --> 02:08:34,154 BETWEEN PROFESSIONAL, I THINK 2652 02:08:34,154 --> 02:08:38,525 THAT HAS POTENTIAL TO BE 2653 02:08:38,525 --> 02:08:41,528 HEALTHIER AND I'VE ALWAYS SEEN 2654 02:08:41,528 --> 02:08:42,596 SOME EMPIRICAL EVIDENCE TO 2655 02:08:42,596 --> 02:08:46,567 SUPPORT THAT BUT YOU CAN'T DO 2656 02:08:46,567 --> 02:08:47,968 THIS IN A RANDOMIZED TRIAL AND 2657 02:08:47,968 --> 02:08:49,736 HOW DO YOU MOVE IN THAT 2658 02:08:49,736 --> 02:08:50,003 DIRECTION? 2659 02:08:50,003 --> 02:08:52,306 PART OF THE UNDERLYING THEME I 2660 02:08:52,306 --> 02:08:55,275 WOULD SAY THE CAMPUS INITIATIVE 2661 02:08:55,275 --> 02:08:59,046 WE LAUNCHED IS HOPEFULLY 2662 02:08:59,046 --> 02:09:03,417 SOMETHING WE CAN WORK TOWARDS IN 2663 02:09:03,417 --> 02:09:07,654 SEAL EVENTUALLY BUT WOULD MEAN 2664 02:09:07,654 --> 02:09:10,057 FOR HEALTH RESEARCHERS TO WORK 2665 02:09:10,057 --> 02:09:11,458 WITH PEOPLE IN HOUSING AND 2666 02:09:11,458 --> 02:09:15,262 PEOPLE IN LOCAL GOVERNMENT AND 2667 02:09:15,262 --> 02:09:20,234 PEOPLE IN EDUCATIONAL HIERARCHY 2668 02:09:20,234 --> 02:09:20,968 AND IN COMMERCIAL SECTOR ABOUT 2669 02:09:20,968 --> 02:09:21,869 FOOD ACCESS AND THINGS OF THAT 2670 02:09:21,869 --> 02:09:24,872 TYPE. 2671 02:09:24,872 --> 02:09:29,776 SO ONE IS NOT SORT OF 2672 02:09:29,776 --> 02:09:30,510 CATEGORIZED. 2673 02:09:30,510 --> 02:09:34,248 I THINK -- YOU MUST KNOW THIS, 2674 02:09:34,248 --> 02:09:37,117 KENDRICK, THERE WERE NO 2675 02:09:37,117 --> 02:09:39,853 FULL-SERVICE SUPER MARKETS EAST 2676 02:09:39,853 --> 02:09:41,021 OF THE RIVER UNTIL TWO OR THREE 2677 02:09:41,021 --> 02:09:45,392 YEARS AGO THEY OPENED THAT ONE. 2678 02:09:45,392 --> 02:09:50,631 >> CURRENTLY THERE ARE FOUR EAST 2679 02:09:50,631 --> 02:09:54,067 OF THE RIVER FOR APPROXIMATELY 2680 02:09:54,067 --> 02:09:56,837 160,000 PEOPLE. 2681 02:09:56,837 --> 02:09:58,138 MUCH OF THAT HAS HAPPENED AS A 2682 02:09:58,138 --> 02:10:00,207 RESULT OF WHAT YOU TALKED ABOUT 2683 02:10:00,207 --> 02:10:02,142 IN TERMS OF THE STRUCTURAL 2684 02:10:02,142 --> 02:10:05,746 RACISM PARTICULARLY AROUND THE 2685 02:10:05,746 --> 02:10:06,947 RED LINING COMPONENT. 2686 02:10:06,947 --> 02:10:12,452 IT CREATES FOOD DESERT AND FOOD 2687 02:10:12,452 --> 02:10:12,653 SWAMP. 2688 02:10:12,653 --> 02:10:14,655 YOU MAY CALL IT FOOD APARTHEID 2689 02:10:14,655 --> 02:10:15,756 IN SOME REGARD. 2690 02:10:15,756 --> 02:10:19,660 AS YOU CONTEND AND DEAL WITH 2691 02:10:19,660 --> 02:10:22,930 THOSE ISSUES WE'RE ALSO SEEING 2692 02:10:22,930 --> 02:10:24,798 CORRESPONDINGLY ISSUES WITH 2693 02:10:24,798 --> 02:10:26,466 HIGHEST INCIDENTS OF KIDNEY 2694 02:10:26,466 --> 02:10:28,869 DISEASES AND MORTALITY 2695 02:10:28,869 --> 02:10:31,705 ASSOCIATES WITH CANCER, HIGHEST 2696 02:10:31,705 --> 02:10:33,473 INCIDENTS OF SUICIDE, HIGHEST 2697 02:10:33,473 --> 02:10:38,612 INCIDENCES OF OTHER SORT OF 2698 02:10:38,612 --> 02:10:41,148 TRAUMA AS A RESULT ALL THESE 2699 02:10:41,148 --> 02:10:41,481 THINGS. 2700 02:10:41,481 --> 02:10:45,352 SO, I AM CURIOUS IN YOUR 2701 02:10:45,352 --> 02:10:47,187 COMMENTS WITH REGARD TO THIS 2702 02:10:47,187 --> 02:10:49,156 CORRELATION BECAUSE I THINK THE 2703 02:10:49,156 --> 02:10:52,225 PAPER IS SEMINOLE IN THE FACT IT 2704 02:10:52,225 --> 02:10:55,896 POINTS OUT STRUCTURAL RACISM AND 2705 02:10:55,896 --> 02:10:58,465 DIABETES, BUT WE CAN CORRELATE 2706 02:10:58,465 --> 02:11:00,934 THAT WITH PERHAPS OTHER 2707 02:11:00,934 --> 02:11:03,570 COMORBIDITIES. 2708 02:11:03,570 --> 02:11:05,305 AND PSYCHOSOCIAL ISSUES AS WELL. 2709 02:11:05,305 --> 02:11:07,541 THANK YOU. 2710 02:11:07,541 --> 02:11:16,316 >> THANK YOU FOR THAT. 2711 02:11:16,316 --> 02:11:16,717 OKAY, PAUL. 2712 02:11:16,717 --> 02:11:18,418 >> OKAY, WE'RE GOING TO TAKE OUR 2713 02:11:18,418 --> 02:11:22,222 BREAK AND RESUME AT 11:00 a.m. 2714 02:11:22,222 --> 02:11:22,823 THANK YOU VAECH. 2715 02:11:22,823 --> 02:11:22,889 THANK YOU VERY MUCH. 2716 02:11:28,624 --> 02:11:32,060 >> I'LL PRESENT ON RESEARCH ON 2717 02:11:32,060 --> 02:11:33,829 PRIMARY CARE FOR POPULATIONS 2718 02:11:33,829 --> 02:11:37,533 THAT EXPERIENCE HEALTH 2719 02:11:37,533 --> 02:11:39,701 DISPARITIES COMPARED TO WHITE 2720 02:11:39,701 --> 02:11:43,605 COUNTERPARTS, RACIAL OR ETHNIC 2721 02:11:43,605 --> 02:11:46,175 MINORITY GROUP WERE MORE LIKE TO 2722 02:11:46,175 --> 02:11:48,677 REPORT FAIR HEALTH STAT AND MORE 2723 02:11:48,677 --> 02:11:50,345 LIKELY TO DIE OF DIABETES AND 2724 02:11:50,345 --> 02:11:54,550 HEART DISEASE, MORE LIKELY TO 2725 02:11:54,550 --> 02:11:55,150 REPORT GOING WITHOUT MEDICAL 2726 02:11:55,150 --> 02:11:59,288 CARE AND LIKELY TO REPORT NOT 2727 02:11:59,288 --> 02:12:04,693 HAVING A USUAL MEDICAL PROVIDER. 2728 02:12:04,693 --> 02:12:09,064 PRIMARY MAY BE A WAY TO ADVANCE 2729 02:12:09,064 --> 02:12:11,400 HEALTH EQUITY BECAUSE IN 2730 02:12:11,400 --> 02:12:12,067 COMPREHENSIVE HEALTH CARE THAT 2731 02:12:12,067 --> 02:12:15,904 COVERS PREVENTION, WELLNESS, 2732 02:12:15,904 --> 02:12:16,772 MANAGEMENT OF ACUTE AND CHRONIC 2733 02:12:16,772 --> 02:12:18,440 CONDITION AND TREATMENT FOR 2734 02:12:18,440 --> 02:12:19,441 VARIETY OF HEALTH CONCERNS 2735 02:12:19,441 --> 02:12:21,543 INCLUDING PHYSICAL, BEHAVIORAL 2736 02:12:21,543 --> 02:12:24,980 AND SOCIAL. 2737 02:12:24,980 --> 02:12:26,782 THE PURPOSE OF THE INITIATIVE IS 2738 02:12:26,782 --> 02:12:29,518 TO SUPPORT RESEARCH ON PRIMARY 2739 02:12:29,518 --> 02:12:30,385 CARE FOR POPULATIONS THAT 2740 02:12:30,385 --> 02:12:33,822 EXPERIENCE HEALTH DISPARITIES TO 2741 02:12:33,822 --> 02:12:34,623 UNDERSTAND THE ASSOCIATION 2742 02:12:34,623 --> 02:12:37,025 BETWEEN RECEIPT OF PRIMARY CARE, 2743 02:12:37,025 --> 02:12:39,928 HEALTH DISPARITIES AND HEALTH 2744 02:12:39,928 --> 02:12:42,464 EQUITY, TO EVALUATE FACTORS AND 2745 02:12:42,464 --> 02:12:44,433 MECHANISMS THAT INFLUENCE THE 2746 02:12:44,433 --> 02:12:46,335 EFFECTIVENESS OF PRIMARY CARE 2747 02:12:46,335 --> 02:12:49,805 AND TO DEVELOP INNOVATIVE 2748 02:12:49,805 --> 02:12:51,740 SUSTAINABLE INTERVENTIONS WITHIN 2749 02:12:51,740 --> 02:12:55,677 PRIMARY CARE TO IMPROVE HEALTH 2750 02:12:55,677 --> 02:12:56,111 AND HEALTH OUTCOMES. 2751 02:12:56,111 --> 02:12:58,747 ACCESS TO PRIMARY CARE HEALTH 2752 02:12:58,747 --> 02:13:04,653 SERVICES HAS INCREASED LARGELY 2753 02:13:04,653 --> 02:13:08,957 DUE TO HEALTH CARE REFORM 2754 02:13:08,957 --> 02:13:11,360 DESPITE IMPROVED ACCESS HEALTH 2755 02:13:11,360 --> 02:13:12,461 DISPARITIES PERSIST. 2756 02:13:12,461 --> 02:13:13,996 POPULATIONS THAT EXPERIENCE 2757 02:13:13,996 --> 02:13:17,766 HEALTH DISPARITIES ARE LIKELY TO 2758 02:13:17,766 --> 02:13:20,636 RECEIVE SCREENING, STATINS FOR 2759 02:13:20,636 --> 02:13:21,637 PRIMARY PREVENTION OF HEART 2760 02:13:21,637 --> 02:13:23,805 DISEASE, CANCER SCREENING, 2761 02:13:23,805 --> 02:13:26,708 EXCUSE ME, AND RETINAL SCREENING 2762 02:13:26,708 --> 02:13:28,310 FOR DIABETES. 2763 02:13:28,310 --> 02:13:30,479 THEY'RE ALSO LESS LIKELY TO 2764 02:13:30,479 --> 02:13:31,179 RECEIVE EVIDENCE-BASED TREATMENT 2765 02:13:31,179 --> 02:13:32,781 FOR A VARIETY OF HEALTH 2766 02:13:32,781 --> 02:13:33,081 CONDITIONS. 2767 02:13:33,081 --> 02:13:35,717 THESE POPULATIONS ARE MORE 2768 02:13:35,717 --> 02:13:38,287 LIKELY TO RECEIVE LOW VALUE CARE 2769 02:13:38,287 --> 02:13:42,291 WHICH MAY INCLUDE NON-EVIDENCE 2770 02:13:42,291 --> 02:13:45,527 BASED CANCER SCREENING AND 2771 02:13:45,527 --> 02:13:49,531 TREATMENT OF MIGRAINES AND HAVE 2772 02:13:49,531 --> 02:13:53,535 HIGH BLOOD PRESSURE AND GLUCOSE 2773 02:13:53,535 --> 02:13:56,071 LEVELS ABOVE THE STANDARDS 2774 02:13:56,071 --> 02:13:57,806 RECOMMENDED FOR OPTIMAL 2775 02:13:57,806 --> 02:14:03,645 OUTCOMES. 2776 02:14:03,645 --> 02:14:08,517 A RECENT STUDY FOUND A 2777 02:14:08,517 --> 02:14:10,352 CORRELATION BETWEEN PHYSICIANS 2778 02:14:10,352 --> 02:14:11,019 AND LIFE EXPECTANCY AND THERE'S 2779 02:14:11,019 --> 02:14:19,394 BEEN A STEADY DECLINE IN THE 2780 02:14:19,394 --> 02:14:20,062 PRIMARY CLINICIAN WORKFORCE DUE 2781 02:14:20,062 --> 02:14:22,064 TO THE RISE IN SPECIALIZATION 2782 02:14:22,064 --> 02:14:24,866 AND NURSE PRACTITIONERS AND 2783 02:14:24,866 --> 02:14:26,969 PHYSICIAN ASSISTANTS. 2784 02:14:26,969 --> 02:14:31,106 HIGH QUALITY PRIMARY CARE AS 2785 02:14:31,106 --> 02:14:33,308 DEFINED BY THE NATIONAL 2786 02:14:33,308 --> 02:14:33,942 ACADEMIES SCIENCES ENGINEERING 2787 02:14:33,942 --> 02:14:37,079 MEDICINE AS WHOLE PERSON 2788 02:14:37,079 --> 02:14:39,047 INTEGRATED ACCESSIBLE AND 2789 02:14:39,047 --> 02:14:40,582 EQUITABLE HEALTH CARE PROVIDED 2790 02:14:40,582 --> 02:14:41,883 BY INTERPROFESSIONAL TEAMS 2791 02:14:41,883 --> 02:14:44,453 ACCOUNTABLE FOR ADDRESSING THE 2792 02:14:44,453 --> 02:14:46,855 MAJORITY OF AN INDIVIDUAL'S 2793 02:14:46,855 --> 02:14:48,924 HEALTH AND WELLNESS NEEDS ACROSS 2794 02:14:48,924 --> 02:14:54,196 SETTINGS AND THROUGH SUSTAINED 2795 02:14:54,196 --> 02:14:58,967 RELATIONSHIPS MAY REDUCE 2796 02:14:58,967 --> 02:15:05,007 DISPARITY AND MORE RESEARCH IS 2797 02:15:05,007 --> 02:15:05,440 NEED. 2798 02:15:05,440 --> 02:15:07,576 AN PORTFOLIO FOUND INVESTMENT OF 2799 02:15:07,576 --> 02:15:12,014 2% OF THE NIH BUDGET AND 15% OF 2800 02:15:12,014 --> 02:15:15,884 THE NIMHD BUDGET IN FISCAL YEAR 2801 02:15:15,884 --> 02:15:17,853 2023 TAKEN TOGETHER THE 2802 02:15:17,853 --> 02:15:19,588 PERSISTENT DISPARITIES IN HEALTH 2803 02:15:19,588 --> 02:15:22,124 AND HEALTH OUTCOMES DESPITE 2804 02:15:22,124 --> 02:15:24,993 IMPROVED ACCESS THE POTENTIAL 2805 02:15:24,993 --> 02:15:27,129 FOR HIGH QUALITY PRIMARY CARE TO 2806 02:15:27,129 --> 02:15:30,465 MOVE THE NEEDLE ON REDUCING 2807 02:15:30,465 --> 02:15:31,299 DISPARITIES AND HEALTH EQUITY 2808 02:15:31,299 --> 02:15:36,538 AND THE LIMITED PRIMARY HEALTH 2809 02:15:36,538 --> 02:15:37,539 CARE RESEARCH PORTFOLIO WITHIN 2810 02:15:37,539 --> 02:15:40,308 NIH PROVIDE THE BACKGROUND FOR 2811 02:15:40,308 --> 02:15:41,543 INCREASING THE INVESTMENT IN 2812 02:15:41,543 --> 02:15:44,246 RESEARCH ON PRIMARY CARE THAT 2813 02:15:44,246 --> 02:15:45,547 PRIORITIZES POPULATIONS THAT 2814 02:15:45,547 --> 02:15:50,252 EXPERIENCE HEALTH DISPARITIES. 2815 02:15:50,252 --> 02:15:52,387 THE INITIATIVE WILL SUPPORT 2816 02:15:52,387 --> 02:15:53,789 RESEARCH USING A VARIETY OF 2817 02:15:53,789 --> 02:15:56,491 STUDY METHODS TO INVESTIGATE THE 2818 02:15:56,491 --> 02:15:57,659 EFFECTIVENESS OF PRIMARY CARE IN 2819 02:15:57,659 --> 02:16:00,462 ADDRESSING THE HEALTH CARE NEEDS 2820 02:16:00,462 --> 02:16:01,096 OF POPULATIONS THAT EXPERIENCE 2821 02:16:01,096 --> 02:16:04,232 HEALTH DISPARITIES OR STUDIES 2822 02:16:04,232 --> 02:16:06,902 THAT PROPOSE TO DEVELOP AND 2823 02:16:06,902 --> 02:16:10,272 TEST, IMPLEMENT AND/OR EVALUATE 2824 02:16:10,272 --> 02:16:11,073 SUSTAINABLE INTERVENTIONS WITHIN 2825 02:16:11,073 --> 02:16:13,575 PRIMARY CARE TO REDUCE 2826 02:16:13,575 --> 02:16:15,977 DISPARITIES AND ADVANCE HEALTH 2827 02:16:15,977 --> 02:16:16,311 EQUITY. 2828 02:16:16,311 --> 02:16:18,747 THERE'S A VARIETY OF TOPICS THAT 2829 02:16:18,747 --> 02:16:21,049 SHOULD BE EXPLORED IN THIS AREA 2830 02:16:21,049 --> 02:16:21,883 TO FULFILL THE OBJECTIVES OF 2831 02:16:21,883 --> 02:16:25,220 THIS INITIATIVE. 2832 02:16:25,220 --> 02:16:28,056 RESEARCH ON THE PROVISION OF 2833 02:16:28,056 --> 02:16:29,925 HIGH-QUALITY PRIMARY CARE TO 2834 02:16:29,925 --> 02:16:31,293 IMPROVE HEALTH OUTCOMES MIGHT 2835 02:16:31,293 --> 02:16:33,528 EXAMINE FACTORS AND MECHANISMS 2836 02:16:33,528 --> 02:16:35,464 AT MULTIPLE LEVELS THAT ARE 2837 02:16:35,464 --> 02:16:38,733 ASSOCIATED WITH ACCESS, QUALITY 2838 02:16:38,733 --> 02:16:41,369 AND HEALTH OUTCOMES OR DEVELOP 2839 02:16:41,369 --> 02:16:43,071 AND TEST, IMPLEMENT AND/OR 2840 02:16:43,071 --> 02:16:45,540 EVALUATE INNOVATIVE STRATEGIES 2841 02:16:45,540 --> 02:16:50,879 TO OPTIMIZE TIMELY RECEIPT OF 2842 02:16:50,879 --> 02:16:52,814 DIAGNOSTIC AND TREATMENT 2843 02:16:52,814 --> 02:16:53,548 SERVICES AND TIMELY REFERRAL TO 2844 02:16:53,548 --> 02:16:56,852 SPECIALISTS. 2845 02:16:56,852 --> 02:16:58,954 RESEARCH ON THE COORDINATION OF 2846 02:16:58,954 --> 02:16:59,955 CARE THROUGH INTERPROFESSIONAL 2847 02:16:59,955 --> 02:17:05,427 TEAMS TO IMPROVE CARE QUALITY 2848 02:17:05,427 --> 02:17:07,095 AND IMPROVE HEALTH OUTCOMES MAY 2849 02:17:07,095 --> 02:17:08,296 EXAMINE MULTI-LEVEL FACTORS AND 2850 02:17:08,296 --> 02:17:09,598 MECHANISMS FOCUSSED ON THE 2851 02:17:09,598 --> 02:17:15,337 FUNCTIONING AND EFFECTIVENESS OF 2852 02:17:15,337 --> 02:17:21,009 CARE TEAMS AND IMPLEMENT AND 2853 02:17:21,009 --> 02:17:23,612 EVALUATE AND ADDRESS CHALLENGES 2854 02:17:23,612 --> 02:17:24,546 IN CARE COORDINATION. 2855 02:17:24,546 --> 02:17:26,047 RESEARCH ON THE ROLE, STRUCTURE 2856 02:17:26,047 --> 02:17:28,817 AND EFFECTIVENESS OF PRIMARY 2857 02:17:28,817 --> 02:17:31,786 CARE AND UNIQUE POPULATIONS 2858 02:17:31,786 --> 02:17:35,123 AND/OR SETTINGS MIGHT FOCUS ON 2859 02:17:35,123 --> 02:17:36,758 UNIQUE CARE TO PRIMARY CARE 2860 02:17:36,758 --> 02:17:38,660 STRUCTURE AND WORK FLOW AND THE 2861 02:17:38,660 --> 02:17:40,662 RESULT ON HEALTH OUTCOMES OR 2862 02:17:40,662 --> 02:17:43,198 PARTNER WITH THE COMMUNITY TO 2863 02:17:43,198 --> 02:17:44,499 CODESIGN INNOVATIVE STRATEGIES 2864 02:17:44,499 --> 02:17:46,735 TO IMPROVE ACCESS AND 2865 02:17:46,735 --> 02:17:48,470 UTILIZATION OF CARE FOR 2866 02:17:48,470 --> 02:17:50,205 POPULATIONS WHO MAY AVOID 2867 02:17:50,205 --> 02:17:52,807 TRADITIONAL CARE SETTINGS DUE TO 2868 02:17:52,807 --> 02:17:53,542 STIGMA OR OTHER SOCIAL 2869 02:17:53,542 --> 02:17:56,678 CIRCUMSTANCES. 2870 02:17:56,678 --> 02:17:58,480 FOR THIS PARTICULAR PRIORITY, 2871 02:17:58,480 --> 02:18:02,984 PROPOSALS SHOULD IDENTIFY WHY 2872 02:18:02,984 --> 02:18:05,287 THE POPULATION OR SETTING IS 2873 02:18:05,287 --> 02:18:07,022 UNIQUE. 2874 02:18:07,022 --> 02:18:08,690 UNIQUE SETTINGS MAY INCLUDE 2875 02:18:08,690 --> 02:18:12,294 PLACES OF WORSHIP, BARBERSHOPS 2876 02:18:12,294 --> 02:18:12,694 OR CLINICS. 2877 02:18:12,694 --> 02:18:14,296 RESEARCH ON THE ROLE OF THE 2878 02:18:14,296 --> 02:18:15,730 PRIMARY CARE WORKFORCE IN 2879 02:18:15,730 --> 02:18:17,933 FACILITATING OR CHALLENGING THE 2880 02:18:17,933 --> 02:18:19,968 EFFECTIVENESS OF PRIMARY CARE 2881 02:18:19,968 --> 02:18:21,970 MAY EXAMINE THE ROLE OF 2882 02:18:21,970 --> 02:18:22,938 SPECIALIZATION WITHIN PRIMARY 2883 02:18:22,938 --> 02:18:26,007 CARE ON ACCESS, QUALITY AND 2884 02:18:26,007 --> 02:18:27,909 OUTCOMES OR CLINICIAN-LEVEL 2885 02:18:27,909 --> 02:18:28,877 FACTORS THAT INFLUENCE MEDICAL 2886 02:18:28,877 --> 02:18:32,147 DECISION MAKING. 2887 02:18:32,147 --> 02:18:34,115 IN SUMMARY, MORE RESEARCH IS 2888 02:18:34,115 --> 02:18:37,519 NEEDED ON PRIMARY CARE FOR 2889 02:18:37,519 --> 02:18:41,122 POPULATIONS THAT EXPERIENCE 2890 02:18:41,122 --> 02:18:44,626 HEALTH DISPARITYIES AND THE 2891 02:18:44,626 --> 02:18:45,627 PRIORITIES THAT HIGHLIGHT KEY 2892 02:18:45,627 --> 02:18:47,262 GAPS IN KNOWLEDGE THAT SHOULD BE 2893 02:18:47,262 --> 02:18:48,930 ADDRESSED TO ADVANCE THE SCIENCE 2894 02:18:48,930 --> 02:18:49,631 IN THIS AREA. 2895 02:18:49,631 --> 02:18:50,465 THANK YOU AND I WELCOME FEEDBACK 2896 02:18:50,465 --> 02:18:55,103 AND QUESTIONS. 2897 02:18:55,103 --> 02:19:00,175 >> THANK YOU SO VERY MUCH FOR AN 2898 02:19:00,175 --> 02:19:03,345 OUTSTANDING PRESENTATION OF A 2899 02:19:03,345 --> 02:19:03,578 CONCEPT. 2900 02:19:03,578 --> 02:19:09,517 THIS CONCEPT IS INCREDIBLY 2901 02:19:09,517 --> 02:19:10,719 IMPORTANT BECAUSE OF AN AREA 2902 02:19:10,719 --> 02:19:14,055 VERY MUCH NEEDED IN TERMS OF 2903 02:19:14,055 --> 02:19:16,758 RESEARCH AROUND PRIMARY CARE I 2904 02:19:16,758 --> 02:19:24,833 LIVE AND WORK AS A POS -- 2905 02:19:24,833 --> 02:19:28,270 PASTOR IN A NEIGHBORHOOD WHY 2906 02:19:28,270 --> 02:19:29,371 MOST PEOPLE USE THE EMERGENCY 2907 02:19:29,371 --> 02:19:31,172 ROOM FOR PRIMARY CARE INSTEAD OF 2908 02:19:31,172 --> 02:19:33,842 HAVING PRIMARY CARE DOCTORS. 2909 02:19:33,842 --> 02:19:36,111 I'M VERY CURIOUS ABOUT AS WE GO 2910 02:19:36,111 --> 02:19:38,313 THROUGH LOOKING AT THE 2911 02:19:38,313 --> 02:19:39,714 PROVISIONS FOR HIGH QUALITY 2912 02:19:39,714 --> 02:19:42,083 PRIMARY CARE TO IMPROVE THE 2913 02:19:42,083 --> 02:19:46,354 HEALTH OUTCOMES HOW WE'RE GOING 2914 02:19:46,354 --> 02:19:48,723 TO CONSIDER THE CULTURAL 2915 02:19:48,723 --> 02:19:52,027 LITERACY OR COMPETENCY WITH 2916 02:19:52,027 --> 02:19:56,264 REGARD TO MAKING SURE PHYSICIANS 2917 02:19:56,264 --> 02:19:57,732 HAVE SUCH AND ALSO CONSIDERING 2918 02:19:57,732 --> 02:20:00,101 LITERACY IN GENERAL WITH REGARD 2919 02:20:00,101 --> 02:20:06,041 TO THOSE PATIENTS THAT HAVE 2920 02:20:06,041 --> 02:20:07,409 WOULD NORMALLY SEEN PRIMARY 2921 02:20:07,409 --> 02:20:09,010 CARE. 2922 02:20:09,010 --> 02:20:10,111 THOSE THAT CURRENTLY IN THE 2923 02:20:10,111 --> 02:20:12,380 NEIGHBORHOOD WHO I SERVE HAVE 2924 02:20:12,380 --> 02:20:15,250 LOW LITERACY RATES AND OFTEN 2925 02:20:15,250 --> 02:20:17,686 TIMES THOSE WHO ARE PHYSICIANS 2926 02:20:17,686 --> 02:20:19,888 ARE NOT NECESSARILY CULTURALLY 2927 02:20:19,888 --> 02:20:20,155 COMPETENT. 2928 02:20:20,155 --> 02:20:22,757 SO HOW ARE WE GOING TO BEGIN TO 2929 02:20:22,757 --> 02:20:26,895 START TO THINK ABOUT CULTURAL 2930 02:20:26,895 --> 02:20:29,197 COMPETENCY AS WELL AS LITERACY 2931 02:20:29,197 --> 02:20:33,435 AND ALL THAT GOES INTO 2932 02:20:33,435 --> 02:20:35,337 UNDERSTANDING HOW WE MAKE AND 2933 02:20:35,337 --> 02:20:38,506 PROVIDE FOR HIGH-QUALITY AND I 2934 02:20:38,506 --> 02:20:41,409 WOULD ADD LOW COST PRIMARY CARE? 2935 02:20:41,409 --> 02:20:43,378 >> THANK YOU FOR THE QUESTION. 2936 02:20:43,378 --> 02:20:47,415 I THINK CULTURAL COMPETENCY AND 2937 02:20:47,415 --> 02:20:50,418 HEALTH LITERATURE AND CULTURAL 2938 02:20:50,418 --> 02:20:52,120 LITERACY ARE VERY IMPORTANT 2939 02:20:52,120 --> 02:20:53,555 TOPICS AND ALL REQUIRE 2940 02:20:53,555 --> 02:20:54,956 ADDITIONAL RESEARCH. 2941 02:20:54,956 --> 02:20:58,727 SO THERE IS AN OPPORTUNITY WITH 2942 02:20:58,727 --> 02:21:01,529 THIS INITIATIVE FOR MORE 2943 02:21:01,529 --> 02:21:04,065 RESEARCH SPECIFICALLY THERE'S AN 2944 02:21:04,065 --> 02:21:05,467 INTEREST IN THE 2945 02:21:05,467 --> 02:21:07,435 PATIENT-CLINICIAN CONCORDANCE 2946 02:21:07,435 --> 02:21:09,971 AND HOW THIS EFFECTS HEALTH 2947 02:21:09,971 --> 02:21:10,605 EQUITY. 2948 02:21:10,605 --> 02:21:12,841 MUCH OF RESEARCH ALREADY DONE IS 2949 02:21:12,841 --> 02:21:14,776 CROSS-SECTIONAL SO THERE'S A 2950 02:21:14,776 --> 02:21:15,477 NEED FOR MORE RESEARCH TO 2951 02:21:15,477 --> 02:21:16,678 UNDERSTAND CAUSE AND EFFECT AND 2952 02:21:16,678 --> 02:21:19,280 THAT TYPE OF RESEARCH OR 2953 02:21:19,280 --> 02:21:22,250 PROPOSALS WOULD BE APPROPRIATELY 2954 02:21:22,250 --> 02:21:24,953 SUBMITTED IN RESPONSE TO THIS 2955 02:21:24,953 --> 02:21:28,857 INITIATIVE. 2956 02:21:28,857 --> 02:21:31,292 >> THANK YOU SO MUCH. 2957 02:21:31,292 --> 02:21:35,463 WHEN YOU TALK ABOUT THIS WHOLE 2958 02:21:35,463 --> 02:21:37,665 PART AROUND ACCESS AND WE NOTED 2959 02:21:37,665 --> 02:21:39,834 CULTURAL COMPETENCY AND THOSE 2960 02:21:39,834 --> 02:21:42,871 SORTS OF THINGS AND YOU HAVE 2961 02:21:42,871 --> 02:21:45,840 CONCORDANCE AS WELL OR HARMONY, 2962 02:21:45,840 --> 02:21:47,075 HOW DO WE START TO HAVE 2963 02:21:47,075 --> 02:21:49,544 CONVERSATION AROUND 2964 02:21:49,544 --> 02:21:51,479 TRUSTWORTHINESS OF PRIMARY CARE 2965 02:21:51,479 --> 02:21:53,948 PHYSICIANS PARTICULARLY WHEN YOU 2966 02:21:53,948 --> 02:21:56,418 START TO TALK ABOUT LEARNING 2967 02:21:56,418 --> 02:21:58,286 WHAT MAKES A PATIENT 2968 02:21:58,286 --> 02:21:58,586 COMFORTABLE. 2969 02:21:58,586 --> 02:22:01,456 HOW DOES THAT TIE TO QUALITY AND 2970 02:22:01,456 --> 02:22:09,531 HOW DOES THAT IMPACT THE 2971 02:22:09,531 --> 02:22:11,065 CONTINUITY OF CARE? 2972 02:22:11,065 --> 02:22:14,903 >> I'LL ANSWER THAT IN TWO WAYS. 2973 02:22:14,903 --> 02:22:15,970 FIRST, THERE'S A CURRENT 2974 02:22:15,970 --> 02:22:17,305 ANALYSTS OF FUNDING OPPORTUNITY 2975 02:22:17,305 --> 02:22:22,877 FOCUSSED ON THE 2976 02:22:22,877 --> 02:22:23,912 PATIENT-CLINICIAN RELATIONSHIP 2977 02:22:23,912 --> 02:22:24,846 GOING TO THE COMMENT YOU MADE. 2978 02:22:24,846 --> 02:22:26,548 IN DEVELOPING THE CONCEPT FOR 2979 02:22:26,548 --> 02:22:27,482 CONSIDERATION IS THAT PRIMARY 2980 02:22:27,482 --> 02:22:30,151 CARE IS REALLY AN OVER ARCHING 2981 02:22:30,151 --> 02:22:36,224 THEME THAT WE SEE MOVING IN MANY 2982 02:22:36,224 --> 02:22:38,860 THAT ARE ALREADY ESTABLISHED AND 2983 02:22:38,860 --> 02:22:43,198 TRY TO CARVE OUT UNIQUE AREAS 2984 02:22:43,198 --> 02:22:44,365 WHERE THERE WASN'T SIGNIFICANT 2985 02:22:44,365 --> 02:22:45,133 OVERLAP. 2986 02:22:45,133 --> 02:22:47,402 SPEAKING TO THIS PARTICULAR NOFO 2987 02:22:47,402 --> 02:22:50,038 CALLED FOR ADDITIONAL 2988 02:22:50,038 --> 02:22:51,539 CO-DESIGNING OF PARTICULAR 2989 02:22:51,539 --> 02:22:52,540 INTERVENTIONS OR STRATEGIES. 2990 02:22:52,540 --> 02:22:56,444 SO IN THAT WAY TRUST CAN BE 2991 02:22:56,444 --> 02:22:59,681 BUILT BETWEEN THE MEDICAL FIELD 2992 02:22:59,681 --> 02:23:00,482 RESEARCHERS AS WELL AS THE 2993 02:23:00,482 --> 02:23:02,150 COMMUNITY IN DESIGNING SOME 2994 02:23:02,150 --> 02:23:04,953 INTERVENTIONS TO IMPROVE ACCESS 2995 02:23:04,953 --> 02:23:06,221 AND UTILIZATION AND HOPEFULLY 2996 02:23:06,221 --> 02:23:07,589 TRUST AS WELL AS IN THE PROCESS. 2997 02:23:07,589 --> 02:23:13,094 >> SO AS YOU THINK ABOUT DESIGN, 2998 02:23:13,094 --> 02:23:15,263 ARE YOU ALSO CONSULTING PART OF 2999 02:23:15,263 --> 02:23:16,498 COMMUNITY-BASED ORGANIZATIONS 3000 02:23:16,498 --> 02:23:19,667 AND THOSE WHO WOULD BE 3001 02:23:19,667 --> 02:23:22,270 CAREGIVERS IN DEVELOPING SUCH AN 3002 02:23:22,270 --> 02:23:25,406 INTERVENTION THAT WOULD BE 3003 02:23:25,406 --> 02:23:25,940 SUITABLE FOR A COMMUNITY. 3004 02:23:25,940 --> 02:23:30,345 >> YES, ALL THE ABOVE. 3005 02:23:30,345 --> 02:23:31,579 IDEALLY CO-DESIGN DOES INVOLVE 3006 02:23:31,579 --> 02:23:32,547 THE LIVED EXPERIENCE AND 3007 02:23:32,547 --> 02:23:33,481 INDIVIDUALS FROM THIS COMMUNITY 3008 02:23:33,481 --> 02:23:36,084 AND COMMUNITY-BASED 3009 02:23:36,084 --> 02:23:39,554 ORGANIZATIONS, RESEARCHERS AND 3010 02:23:39,554 --> 02:23:40,989 MEDICAL CLINICIANS AS WELL 3011 02:23:40,989 --> 02:23:41,656 WORKING TOGETHER. 3012 02:23:41,656 --> 02:23:44,392 >> WITH THAT IN MIND COULD YOU 3013 02:23:44,392 --> 02:23:45,593 SPEAK TO THE INTERSECTIONALITY 3014 02:23:45,593 --> 02:23:52,133 FRAMEWORK AS IT RELATES TO SEX 3015 02:23:52,133 --> 02:23:53,334 AND GENDER AND ALL THAT INCLUDED 3016 02:23:53,334 --> 02:23:54,969 IN THE WHOLE INTERVENTION AND 3017 02:23:54,969 --> 02:23:57,739 DESIGN PROCESS? 3018 02:23:57,739 --> 02:23:59,541 >> YES, NIMHD SUPPORTS RESEARCH 3019 02:23:59,541 --> 02:24:01,376 ESPECIALLY LOOKING AT THE 3020 02:24:01,376 --> 02:24:04,212 INTERSECTION OF SOCIO ECONOMIC 3021 02:24:04,212 --> 02:24:06,014 STATUS AND RACIAL ETHNIC 3022 02:24:06,014 --> 02:24:07,482 MINORITY WHILE OTHER 3023 02:24:07,482 --> 02:24:08,016 INTERSECTIONS. 3024 02:24:08,016 --> 02:24:10,585 SO IT IS VERY IMPORTANT FOR 3025 02:24:10,585 --> 02:24:13,521 PROPOSALS TO CONSIDER 3026 02:24:13,521 --> 02:24:14,088 INTERSECTIONAL LENS IN THE 3027 02:24:14,088 --> 02:24:16,124 DESIGN. 3028 02:24:16,124 --> 02:24:21,629 >> IF WE WERE TO GO FURTHER WITH 3029 02:24:21,629 --> 02:24:31,506 REGARD TO COORDINATION OF 3030 02:24:31,506 --> 02:24:33,374 PROFESSIONAL TEAMS AND WHO IS 3031 02:24:33,374 --> 02:24:34,509 THAT IN MIND? 3032 02:24:34,509 --> 02:24:36,110 WOULD THAT CRUD NOT ONLY THE 3033 02:24:36,110 --> 02:24:38,713 SOCIAL WORKERS BUT HOW ABOUT 3034 02:24:38,713 --> 02:24:40,481 INCLUDING THOSE LIKE COMMUNITY 3035 02:24:40,481 --> 02:24:45,320 ADVOCATES OR CHAPLAINS OR OTHERS 3036 02:24:45,320 --> 02:24:48,256 THAT ARE PART OF PERSONAL 3037 02:24:48,256 --> 02:24:49,591 NETWORKS AND PART OF THE SOCIAL 3038 02:24:49,591 --> 02:24:53,328 CAPITAL THAT WOULD BE PART OF 3039 02:24:53,328 --> 02:24:54,062 THIS INTERPROFESSIONAL TEAM. 3040 02:24:54,062 --> 02:24:58,566 >> THE MAKEUP OF THE 3041 02:24:58,566 --> 02:25:00,034 INTERPROFESSIONAL TEAM SHOULD BE 3042 02:25:00,034 --> 02:25:01,636 TAILORED SO THE ORGANIZATION AND 3043 02:25:01,636 --> 02:25:02,337 COMMUNITY. 3044 02:25:02,337 --> 02:25:05,607 HOW THAT TEAM LOOKS MAY VARY BY 3045 02:25:05,607 --> 02:25:05,873 PROPOSAL. 3046 02:25:05,873 --> 02:25:06,674 HOWEVER THERE'S A WIDE BREADTH 3047 02:25:06,674 --> 02:25:08,576 OF WHO COULD BE INCLUDED IN THE 3048 02:25:08,576 --> 02:25:12,447 TEAM DEPENDING ON WHAT THE NEEDS 3049 02:25:12,447 --> 02:25:15,183 OF THE PATIENTS ARE AND THE 3050 02:25:15,183 --> 02:25:15,516 ORGANIZATION. 3051 02:25:15,516 --> 02:25:17,418 COMMUNITY HEALTH WORKERS YOU, 3052 02:25:17,418 --> 02:25:20,288 PATIENTS, SOCIAL WORKERS, 3053 02:25:20,288 --> 02:25:22,690 CLINICIANS SHOULD ALL BE 3054 02:25:22,690 --> 02:25:23,324 CONSIDERED IN INTERPROFESSIONAL 3055 02:25:23,324 --> 02:25:24,392 TEAMS. 3056 02:25:24,392 --> 02:25:28,196 >> YOU MENTIONED EARLIER THAT 3057 02:25:28,196 --> 02:25:29,430 WILL YOU CONSIDER 3058 02:25:29,430 --> 02:25:30,331 NON-TRADITIONAL HEALTH CARE 3059 02:25:30,331 --> 02:25:33,334 OPTIONS LIKE BARBERSHOPS AND 3060 02:25:33,334 --> 02:25:35,903 HOUSES OF WORSHIP. 3061 02:25:35,903 --> 02:25:39,474 I'M WONDERING IF YOU WOULD 3062 02:25:39,474 --> 02:25:41,142 CONSIDER OR HAVE YOU CONSIDERED 3063 02:25:41,142 --> 02:25:42,310 WITH REGARD TO THE ROLE, 3064 02:25:42,310 --> 02:25:45,747 STRUCTURE AND EFFECTIVENESS OF 3065 02:25:45,747 --> 02:25:48,583 PRIMARY CARE FOR UNIQUE 3066 02:25:48,583 --> 02:25:53,421 POPULATIONS, LET'S SAY, THOSE 3067 02:25:53,421 --> 02:25:54,389 NON-TRADITIONAL HOURS 3068 02:25:54,389 --> 02:25:55,590 PARTICULARLY SINCE THE JOB 3069 02:25:55,590 --> 02:25:58,192 MARKET HAS CHANGED SIGNIFICANTLY 3070 02:25:58,192 --> 02:26:02,163 SINCE THE PANDEMIC, DOES THIS 3071 02:26:02,163 --> 02:26:04,198 ALLOW FOR THE CONSIDERATION OF 3072 02:26:04,198 --> 02:26:06,067 THOSE WHO ARE PART OF THE GIG 3073 02:26:06,067 --> 02:26:06,734 ECONOMY? 3074 02:26:06,734 --> 02:26:09,337 THOSE WHO ARE PART OF OTHER 3075 02:26:09,337 --> 02:26:10,304 SORTS OF WORK FRAMEWORKS THAT 3076 02:26:10,304 --> 02:26:12,874 HAVE EMERGED SINCE THE PANDEMIC? 3077 02:26:12,874 --> 02:26:14,575 >> IT DEFINITELY DOES. 3078 02:26:14,575 --> 02:26:16,244 ONE OF THE CONSIDERATIONS THAT 3079 02:26:16,244 --> 02:26:19,947 WE THOUGHT OF WITH THAT UNIQUE 3080 02:26:19,947 --> 02:26:21,115 SOCIAL CIRCUMSTANCES WAS PEOPLE 3081 02:26:21,115 --> 02:26:22,583 WHO HAVE WORK HOURS THAT DO NOT 3082 02:26:22,583 --> 02:26:27,188 ALLOW FOR GOING TO CLINICS NOR 3083 02:26:27,188 --> 02:26:28,589 TRADITIONAL 9:00 TO 5:00 HOURS 3084 02:26:28,589 --> 02:26:31,259 AND THOSE WHO MAY HAVE 3085 02:26:31,259 --> 02:26:31,893 CAREGIVING ROLES. 3086 02:26:31,893 --> 02:26:33,528 THAT PARTICULAR PRIORITY 3087 02:26:33,528 --> 02:26:38,166 DEFINITELY DOES ALLOW FOR 3088 02:26:38,166 --> 02:26:42,537 STRATEGIES AS YOU MENTIONED AS 3089 02:26:42,537 --> 02:26:43,905 HAVING UNIQUE HOURS FOR 3090 02:26:43,905 --> 02:26:45,106 PROVIDING CLINICAL CARE. 3091 02:26:45,106 --> 02:26:47,775 BUT I THINK THE IMPORTANCE OF 3092 02:26:47,775 --> 02:26:49,477 THAT PARTICULAR NOTE AS WELL THE 3093 02:26:49,477 --> 02:26:49,844 CO-DESIGN. 3094 02:26:49,844 --> 02:26:51,179 TRYING TO DETERMINE WHAT IS BEST 3095 02:26:51,179 --> 02:26:53,514 FOR THE COMMUNITY BY INCLUDING 3096 02:26:53,514 --> 02:26:54,382 THE COMMUNITY AND MAKING THE 3097 02:26:54,382 --> 02:26:58,586 DECISIONS. 3098 02:26:58,586 --> 02:26:59,487 >> THANK YOU VERY MUCH. 3099 02:26:59,487 --> 02:27:00,722 INCLUDING THE COMMUNITY I WANTED 3100 02:27:00,722 --> 02:27:05,927 TO BROADEN THE SCOPE TO BEGIN TO 3101 02:27:05,927 --> 02:27:08,062 LOOK AT IF SOCIETY'S DEVELOPED 3102 02:27:08,062 --> 02:27:09,797 BASED ON THREE PRIMARY 3103 02:27:09,797 --> 02:27:12,934 STRUCTURES, YOUR GOVERNMENTAL 3104 02:27:12,934 --> 02:27:13,901 STRUCTURE, YOUR NONPROFIT 3105 02:27:13,901 --> 02:27:15,303 STRUCTURE INCLUDING ACADEMIC 3106 02:27:15,303 --> 02:27:16,137 INSTITUTIONS AS WELL AS 3107 02:27:16,137 --> 02:27:17,739 COMMUNITY THEN YOU HAVE THE 3108 02:27:17,739 --> 02:27:21,709 PRIVATE SECTOR, HOW CAN THOSE 3109 02:27:21,709 --> 02:27:23,478 THREE COME TOGETHER TO HELP 3110 02:27:23,478 --> 02:27:26,748 PROVIDE THIS WHOLE IDEA OF 3111 02:27:26,748 --> 02:27:28,983 RE-IMAGINING OF PRIMARY CARE? 3112 02:27:28,983 --> 02:27:32,286 >> IT'S VERY IMPORTANT FOR ALL 3113 02:27:32,286 --> 02:27:33,054 OF THOSE TEAMS TO COME TO THE 3114 02:27:33,054 --> 02:27:35,623 TABLE BUT I THINK IT'S IMPORTANT 3115 02:27:35,623 --> 02:27:37,258 TO NOTE THAT THEY -- ALL THOSE 3116 02:27:37,258 --> 02:27:39,060 GROUPS SHOULD BE AT THE TABLE 3117 02:27:39,060 --> 02:27:40,528 FROM THE BEGINNING AGAIN TO HELP 3118 02:27:40,528 --> 02:27:41,496 WITH THE CO-DESIGN. 3119 02:27:41,496 --> 02:27:44,999 IT'S NOT DESIGNING AND THEN 3120 02:27:44,999 --> 02:27:48,236 ENFORCING WITHOUT INPUT FROM ALL 3121 02:27:48,236 --> 02:27:49,103 OF THE IMPORTANT KEY PERSONS 3122 02:27:49,103 --> 02:27:56,144 THAT SHOULD BE AT THE TABLE. 3123 02:27:56,144 --> 02:27:59,814 >> THANK YOU. 3124 02:27:59,814 --> 02:28:03,384 >> AS THE SECOND REVIEWER DO YOU 3125 02:28:03,384 --> 02:28:04,318 HAVE ADDITIONAL COMMENTS? 3126 02:28:04,318 --> 02:28:06,220 >> THANK YOU TO YOU AND YOUR 3127 02:28:06,220 --> 02:28:06,888 COLLEAGUES FOR PUTTING TOGETHER 3128 02:28:06,888 --> 02:28:09,590 A STRONG CONCEPT. 3129 02:28:09,590 --> 02:28:11,559 IT'S DOCUMENTED THERE'S A 3130 02:28:11,559 --> 02:28:13,628 MULTIPLE CHALLENGES IN PRIMARY 3131 02:28:13,628 --> 02:28:17,532 CARE NOT ONLY ABOUT PROVIDER 3132 02:28:17,532 --> 02:28:23,504 SHORTAGES BUT REACTIVE RATHER 3133 02:28:23,504 --> 02:28:26,040 THAN PREVENTIVE CARE AND LACKS 3134 02:28:26,040 --> 02:28:27,308 GROUNDING AND EVIDENCE-BASED 3135 02:28:27,308 --> 02:28:28,976 STRATEGIES AND VALUE-BASED 3136 02:28:28,976 --> 02:28:29,343 APPROACHES. 3137 02:28:29,343 --> 02:28:32,880 I THINK ANOTHER PHENOMENON THAT 3138 02:28:32,880 --> 02:28:35,449 WE'RE WITNESSING IS THERE'S ALSO 3139 02:28:35,449 --> 02:28:36,884 A SHORTAGE OF SPECIALTY WITH 3140 02:28:36,884 --> 02:28:38,219 SPECIALISTS IN OUR COMMUNITY, 3141 02:28:38,219 --> 02:28:39,387 PRIMARY CARE SETTINGS ARE MORE 3142 02:28:39,387 --> 02:28:42,523 AND MORE BURDENED WITH DEALING 3143 02:28:42,523 --> 02:28:44,692 WITH COMPLEX MANAGEMENT AND 3144 02:28:44,692 --> 02:28:47,662 FOLLOW-UP CARE FOR CONDITIONS 3145 02:28:47,662 --> 02:28:49,130 LIKE CANCER AND CARDIOVASCULAR 3146 02:28:49,130 --> 02:28:49,564 DISEASE. 3147 02:28:49,564 --> 02:28:52,333 I FELT THIS WAS A VERY MUCH 3148 02:28:52,333 --> 02:28:54,735 NEEDED INITIATIVE THAT TAKES THE 3149 02:28:54,735 --> 02:28:56,671 RIGHT STEPS TO ADDRESS THESE 3150 02:28:56,671 --> 02:28:57,171 CHALLENGES. 3151 02:28:57,171 --> 02:28:59,407 I HAD A FEW ADDITIONAL COMMENTS 3152 02:28:59,407 --> 02:29:03,511 AND THANK YOU TO MY COLLEAGUE 3153 02:29:03,511 --> 02:29:04,846 FOR RAISING ALL THE IMPORTANT 3154 02:29:04,846 --> 02:29:05,246 ISSUES. 3155 02:29:05,246 --> 02:29:08,015 ONE OF THE COMMENTS WAS THAT WE 3156 02:29:08,015 --> 02:29:12,553 HAVE A PRETTY WELL ESTABLISHED 3157 02:29:12,553 --> 02:29:13,387 RRT THAT DOCUMENTS 3158 02:29:13,387 --> 02:29:17,458 EVIDENCE-BASED STRATEGIES THAT 3159 02:29:17,458 --> 02:29:20,061 DOCUMENT MULTIPLE CHRONIC 3160 02:29:20,061 --> 02:29:21,996 DISEASES LIKE DIABETES AND 3161 02:29:21,996 --> 02:29:22,964 OTHERS IMPACT SPECIFIC 3162 02:29:22,964 --> 02:29:25,366 COMMUNITIES BUT CAN BE PREVENTED 3163 02:29:25,366 --> 02:29:28,102 AND WELL MANAGED IF DELIVERED IN 3164 02:29:28,102 --> 02:29:29,403 THESE SETTINGS. 3165 02:29:29,403 --> 02:29:31,839 I WONDER OF STRATEGIES YOU WOULD 3166 02:29:31,839 --> 02:29:34,408 PROMOTE OR REQUEST TO IMPLEMENT 3167 02:29:34,408 --> 02:29:35,276 THOSE EVIDENCE-BASED STRATEGIES 3168 02:29:35,276 --> 02:29:38,346 WITHIN THE PRIMARY CARE 3169 02:29:38,346 --> 02:29:38,613 SETTINGS. 3170 02:29:38,613 --> 02:29:40,281 >> SO FOR MULTIPLE CHRONIC 3171 02:29:40,281 --> 02:29:42,750 CONDITIONS IS AN AREA WHERE WE 3172 02:29:42,750 --> 02:29:43,651 HAVE NOTICE OF FUNDING 3173 02:29:43,651 --> 02:29:45,620 OPPORTUNITIES SPECIFICALLY 3174 02:29:45,620 --> 02:29:48,956 FOCUSSED ON MODELS FOR CARE FOR 3175 02:29:48,956 --> 02:29:51,559 INDIVIDUALS WITH MULTIPLE 3176 02:29:51,559 --> 02:29:52,560 CHRONIC CONDITIONS WHICH WOULD 3177 02:29:52,560 --> 02:29:54,862 INCLUDE WITHIN PRIMARY CARE AND 3178 02:29:54,862 --> 02:29:57,765 TO YOUR POINT, WE DEFINITELY 3179 02:29:57,765 --> 02:29:59,600 MANY OF THE RESEARCH OR SOME 3180 02:29:59,600 --> 02:30:02,837 RESEARCH DONE TO DEVELOP MODELS 3181 02:30:02,837 --> 02:30:07,241 IS NOT DIVERSE SO TAILORING SOME 3182 02:30:07,241 --> 02:30:10,244 OF THESE EVIDENCE-BASED 3183 02:30:10,244 --> 02:30:12,046 STRATEGIES TO THE COMMUNITY 3184 02:30:12,046 --> 02:30:12,947 POPULATION THAT EXPERIENCE 3185 02:30:12,947 --> 02:30:13,581 HEALTH DISPARITIES WOULD BE VERY 3186 02:30:13,581 --> 02:30:13,848 IMPORTANT. 3187 02:30:13,848 --> 02:30:17,184 >> THANK YOU. 3188 02:30:17,184 --> 02:30:19,954 IT'S IMPORTANT TO HIGHLIGHT THAT 3189 02:30:19,954 --> 02:30:22,223 ACCESS DOESN'T NECESSARY MEAN 3190 02:30:22,223 --> 02:30:24,825 INDIVIDUALS WILL USE SERVICES SO 3191 02:30:24,825 --> 02:30:26,727 I THINK AS MENTIONED IN THE 3192 02:30:26,727 --> 02:30:28,963 CONCEPT IS UNDERSTANDING THE 3193 02:30:28,963 --> 02:30:30,164 MULTILEVEL FACTORS OR 3194 02:30:30,164 --> 02:30:32,233 DETERMINATES THAT MAY SERVE AS 3195 02:30:32,233 --> 02:30:32,500 BARRIERS. 3196 02:30:32,500 --> 02:30:34,435 SO IT WILL BE REALLY IMPORTANT 3197 02:30:34,435 --> 02:30:39,707 TO BE ABLE TO CHARACTERIZE THE 3198 02:30:39,707 --> 02:30:47,114 EXPERIENCES OF THE COMMUNITY A 3199 02:30:47,114 --> 02:30:49,317 QUALITY ENGAGEMENT AND LISTENING 3200 02:30:49,317 --> 02:30:54,388 SESSIONS AND BYE DIRECTIONAL 3201 02:30:54,388 --> 02:30:58,092 DISCUSSIONS WITH THE APPROPRIATE 3202 02:30:58,092 --> 02:31:00,027 STAKEHOLDERS WOULD BE ESSENTIAL 3203 02:31:00,027 --> 02:31:05,199 IN THE PRIORITY -- RIGHT 3204 02:31:05,199 --> 02:31:08,402 PROGRAMS AND THERE ARE BARRIERS 3205 02:31:08,402 --> 02:31:10,972 AND THERE'S CULTURAL COMPETENCY 3206 02:31:10,972 --> 02:31:14,141 OR INFLUENCES THAT MAY INTERACT 3207 02:31:14,141 --> 02:31:16,777 WITH THE ATTITUDES AND 3208 02:31:16,777 --> 02:31:19,180 OBLIGATIONS THAT MAY SUPERSEDE 3209 02:31:19,180 --> 02:31:22,717 ENGAGEMENT AND STIGMA AND 3210 02:31:22,717 --> 02:31:27,855 PERCEIVED DISCRIMINATION AND THE 3211 02:31:27,855 --> 02:31:31,025 LIST GOES ON SO I WANT TO 3212 02:31:31,025 --> 02:31:33,627 HIGHLIGHT IT'S CRITICAL AS THE 3213 02:31:33,627 --> 02:31:35,396 PROGRAMS ARE DEVELOPED. 3214 02:31:35,396 --> 02:31:36,964 THERE'S AN EMPHASIS ON PEDIATRIC 3215 02:31:36,964 --> 02:31:39,433 AND YOUNG ADULT POPULATIONS AND 3216 02:31:39,433 --> 02:31:41,469 I THINK I JUST WANT TO HIGHLIGHT 3217 02:31:41,469 --> 02:31:43,738 NOT TO OVERLOOK THE MENTAL 3218 02:31:43,738 --> 02:31:44,805 HEALTH CRISIS IN THAT COMMUNITY 3219 02:31:44,805 --> 02:31:46,974 ADDING SIGNIFICANT BURDEN. 3220 02:31:46,974 --> 02:31:49,944 IN ADDITION TO SYSTEMIC BURDEN 3221 02:31:49,944 --> 02:31:52,046 OF OTHER CONDITIONS FACED BY 3222 02:31:52,046 --> 02:31:53,147 YOUNG ADULTS. 3223 02:31:53,147 --> 02:31:55,516 ONE QUESTION I HAD WAS GIVEN 3224 02:31:55,516 --> 02:31:59,387 THERE IS EMPHASIS ON 3225 02:31:59,387 --> 02:32:00,755 SUSTAINABILITY OF THE PROGRAMS, 3226 02:32:00,755 --> 02:32:04,125 HAVE YOU CONSIDERED PROVIDING 3227 02:32:04,125 --> 02:32:04,959 GUIDANCE AND IMPLEMENTATION 3228 02:32:04,959 --> 02:32:07,528 MODELS OR OTHER FRAMEWORKS THAT 3229 02:32:07,528 --> 02:32:10,331 ARE AVAILABLE THAT WILL HELP 3230 02:32:10,331 --> 02:32:12,400 SHAPE THE RESEARCH DESIGNS AND 3231 02:32:12,400 --> 02:32:15,069 ADD SCIENTIFIC RIGOR AND METHODS 3232 02:32:15,069 --> 02:32:16,737 TO MAKE SURE MECHANISMS ARE IN 3233 02:32:16,737 --> 02:32:19,373 PLACE TO SUSTAIN WHATEVER 3234 02:32:19,373 --> 02:32:20,241 PROGRAMS ARE IMPLEMENTED WITHIN 3235 02:32:20,241 --> 02:32:23,110 THE PRIMARY CARE SETTINGS? 3236 02:32:23,110 --> 02:32:26,414 >> WE DID NOT DISCUSS 3237 02:32:26,414 --> 02:32:26,947 SPECIFICALLY CALLING FOR 3238 02:32:26,947 --> 02:32:29,016 SPECIFIC MODELS BUT IN GENERAL 3239 02:32:29,016 --> 02:32:31,652 HAVING A MODEL OR CONCEPTUAL 3240 02:32:31,652 --> 02:32:35,656 MODEL AT LEAST BEHIND ANY 3241 02:32:35,656 --> 02:32:39,693 RESEARCH PROPOSED IS HIGH 3242 02:32:39,693 --> 02:32:41,195 QUALITY AND WE WOULD BE LOOKING 3243 02:32:41,195 --> 02:32:43,464 FOR THOSE THINGS BUT WE HAVE NOT 3244 02:32:43,464 --> 02:32:46,000 DISCUSSED SPECIFIC MODELS. 3245 02:32:46,000 --> 02:32:46,667 THAT'S SOMETHING OUR TEAM COULD 3246 02:32:46,667 --> 02:32:46,934 CONSIDER. 3247 02:32:46,934 --> 02:32:50,104 >> WE HIGHLY ENCOURAGE THAT AND 3248 02:32:50,104 --> 02:32:52,540 I LIKE THE EMPHASIS ON 3249 02:32:52,540 --> 02:32:55,142 VALUE-BASED CARE AND WOULD ALSO 3250 02:32:55,142 --> 02:32:57,778 RECOMMEND MAKING SURE THE RIGHT 3251 02:32:57,778 --> 02:32:58,679 STAKEHOLDERS AND SPECIFICALLY 3252 02:32:58,679 --> 02:33:00,781 MANAGED DOSE AND RESOURCES AND 3253 02:33:00,781 --> 02:33:02,216 BUDGET AND CLINICAL WORK FLOWS 3254 02:33:02,216 --> 02:33:04,118 AND TRAINING ETCETERA, GET 3255 02:33:04,118 --> 02:33:04,985 ENGAGED THROUGH THE PROCESS 3256 02:33:04,985 --> 02:33:08,289 EARLY ON BECAUSE THOSE ARE 3257 02:33:08,289 --> 02:33:10,091 DECISION MAKERS. 3258 02:33:10,091 --> 02:33:13,027 WE RESEARCHERS CLINGS WILL GO IN 3259 02:33:13,027 --> 02:33:15,796 WITH THE BEST INTENTIONS AND 3260 02:33:15,796 --> 02:33:16,564 REALITIES OF THE PRESSURES MANY 3261 02:33:16,564 --> 02:33:20,835 SYSTEMS HAVE. 3262 02:33:20,835 --> 02:33:23,737 ENGAGING THOSE INDIVIDUALS AND 3263 02:33:23,737 --> 02:33:25,473 COST BENEFIT AND THE RIGHT 3264 02:33:25,473 --> 02:33:26,807 PROCESSES IN THE PRIMARY CARE 3265 02:33:26,807 --> 02:33:28,142 SETTINGS WHERE THEY UNDERSTAND 3266 02:33:28,142 --> 02:33:31,345 MAYBE NOT IMMEDIATELY BUT IN THE 3267 02:33:31,345 --> 02:33:34,548 LONG RUN THERE WILL BE COST 3268 02:33:34,548 --> 02:33:39,720 SAVINGS TO THE SYSTEM AND BETTER 3269 02:33:39,720 --> 02:33:41,222 WORK FLOWS AND LESS ON THE 3270 02:33:41,222 --> 02:33:41,522 CLINICIANS. 3271 02:33:41,522 --> 02:33:41,956 I THINK THAT'S IT. 3272 02:33:41,956 --> 02:33:45,126 THANK YOU. 3273 02:33:45,126 --> 02:33:46,494 >> THANK YOU VERY MUCH. 3274 02:33:46,494 --> 02:33:48,229 ANY OTHER COMMENTS OR CONCERNS 3275 02:33:48,229 --> 02:33:49,330 FROM COUNCIL MEMBERS? 3276 02:33:49,330 --> 02:33:52,900 >> THIS IS GREAT, THANK YOU. 3277 02:33:52,900 --> 02:33:55,769 IT'S CONSISTENT WITH THE NIH 3278 02:33:55,769 --> 02:33:56,937 DIRECTOR'S COMMON FUND PROGRAM 3279 02:33:56,937 --> 02:33:59,540 FOR PRIMARY CARE AND WONDER DO 3280 02:33:59,540 --> 02:34:00,774 YOU INCORPORATE THAT INTO WHAT 3281 02:34:00,774 --> 02:34:03,444 YOU'RE EXPECTING TO GET OR 3282 02:34:03,444 --> 02:34:05,980 HOPING TO SEE IN PROPOSALS? 3283 02:34:05,980 --> 02:34:09,917 >> WE DEFINITELY WILL TAKE A 3284 02:34:09,917 --> 02:34:10,851 LOOK AT THAT. 3285 02:34:10,851 --> 02:34:12,820 WE DIDN'T INCORPORATE THAT INTO 3286 02:34:12,820 --> 02:34:14,421 THIS PROPOSAL BUT THERE'S STILL 3287 02:34:14,421 --> 02:34:15,289 MORE WORK TO BE DONE. 3288 02:34:15,289 --> 02:34:21,228 THE WORK WE DO IS HOPEFULLY TO 3289 02:34:21,228 --> 02:34:22,163 COMPLEMENT OTHER EFFORTS AND 3290 02:34:22,163 --> 02:34:27,401 PART OF THAT IS LOOKING AT WHAT 3291 02:34:27,401 --> 02:34:28,068 THE COMMON FUND ALREADY HAS IN 3292 02:34:28,068 --> 02:34:29,537 PLACE AND NOT DUPLICATING BUT 3293 02:34:29,537 --> 02:34:38,612 ADVANCING. 3294 02:34:38,612 --> 02:34:40,814 >> ARE THERE OTHER COMMENTS FROM 3295 02:34:40,814 --> 02:34:41,515 OTHER COUNCIL MEMBERS. 3296 02:34:41,515 --> 02:34:45,853 SEEING NONE, MAY I HAVE A 3297 02:34:45,853 --> 02:34:46,086 MOTION. 3298 02:34:46,086 --> 02:34:53,360 >> I MOVE THAT THIS CONCEPT BE 3299 02:34:53,360 --> 02:35:03,837 APPROVED AND MOVED TO NOFO. 3300 02:35:04,038 --> 02:35:04,305 >> THANK YOU. 3301 02:35:04,305 --> 02:35:07,308 >> I SECOND THAT MOTION. 3302 02:35:07,308 --> 02:35:12,313 >> THANK YOU VERY MUCH. 3303 02:35:12,313 --> 02:35:22,723 BY SHOW OF HANDS. 3304 02:35:30,864 --> 02:35:32,900 THANK YOU THE CONCEPT IS PASSED 3305 02:35:32,900 --> 02:35:38,038 AND WILL BE MOVED FORWARD TO 3306 02:35:38,038 --> 02:35:48,148 NOFO. 3307 02:36:20,781 --> 02:36:21,582 >> GOOD MORNING. 3308 02:36:21,582 --> 02:36:25,085 THE CONCEPT IS UNDERSTANDING THE 3309 02:36:25,085 --> 02:36:28,188 INFLUENCE OF INTERPERSONAL 3310 02:36:28,188 --> 02:36:29,657 BIASES ON HEALTH OUTCOMES AND 3311 02:36:29,657 --> 02:36:29,957 DISPARITIES. 3312 02:36:29,957 --> 02:36:31,625 THE OBJECTIVE OF THE INITIATIVE 3313 02:36:31,625 --> 02:36:33,927 IS TO SUPPORT RESEARCH THAT 3314 02:36:33,927 --> 02:36:35,362 EXAMINES MECHANISMS AND PATHWAYS 3315 02:36:35,362 --> 02:36:36,797 LINKING EXPOSURE TO ADVERSE 3316 02:36:36,797 --> 02:36:37,598 HEALTH CONDITIONS AND 3317 02:36:37,598 --> 02:36:47,808 DISPARITIES. 3318 02:36:49,777 --> 02:36:51,645 IMPLICIT FORMS INDICATES 3319 02:36:51,645 --> 02:36:55,949 UNCONSCIOUS AND AUTOMATIC AND 3320 02:36:55,949 --> 02:36:57,951 EXPLICIT MEANS CONSCIOUS AND 3321 02:36:57,951 --> 02:37:00,688 OVERT AND LEADS TO DOWN STREAM 3322 02:37:00,688 --> 02:37:01,055 DISCRIMINATION. 3323 02:37:01,055 --> 02:37:04,758 THE INTERPERSONAL PORTION OF THE 3324 02:37:04,758 --> 02:37:06,527 PHRASE INTERPERSONAL BIASES 3325 02:37:06,527 --> 02:37:12,066 INFORM RELATED TO RELATIONSHIPS 3326 02:37:12,066 --> 02:37:12,700 TO COMMUNICATION BETWEEN PERSONS 3327 02:37:12,700 --> 02:37:16,136 HENCE THE WAY PERSONAL BIASES 3328 02:37:16,136 --> 02:37:17,037 ARE TRANSMITTED. 3329 02:37:17,037 --> 02:37:20,874 SO CONSISTENTLY AND RESEARCH 3330 02:37:20,874 --> 02:37:23,077 SHOWS INTERPERSONAL BIASES 3331 02:37:23,077 --> 02:37:25,045 PREDICT DOWN STREAM DISEASES, 3332 02:37:25,045 --> 02:37:26,246 CONDITIONS AND NEGATIVE 3333 02:37:26,246 --> 02:37:26,513 OUTCOMES. 3334 02:37:26,513 --> 02:37:28,582 FOR INSTANCE THE FIGURE ON THE 3335 02:37:28,582 --> 02:37:31,318 BOTTOM LEFT SHOWS A RELATIONSHIP 3336 02:37:31,318 --> 02:37:33,721 BETWEEN COMMUNITY LEVEL IMPLICIT 3337 02:37:33,721 --> 02:37:37,391 BIAS AND HEART FAILURE 3338 02:37:37,391 --> 02:37:38,459 PREVALENCE FOR BLACK AND WHITE 3339 02:37:38,459 --> 02:37:41,528 MEDICARE RECIPIENTS. 3340 02:37:41,528 --> 02:37:44,231 BOTH BLACK AND WHITE MEDICARE 3341 02:37:44,231 --> 02:37:44,965 RECIPIENTS SHOW HIGHER 3342 02:37:44,965 --> 02:37:46,567 PREVALENCE OF LIVING IN 3343 02:37:46,567 --> 02:37:49,837 COMMUNITIES HIGH IN IMPLICIT 3344 02:37:49,837 --> 02:37:53,340 PRO-WHITE, ANTI-BLACK BIAS BUT 3345 02:37:53,340 --> 02:37:54,575 THE RELATIONSHIP IS STRONGER FOR 3346 02:37:54,575 --> 02:37:57,211 BLACK MEDICARE RECIPIENTS. 3347 02:37:57,211 --> 02:38:00,047 THE FIGURE ON THE TOP RIGHT 3348 02:38:00,047 --> 02:38:06,120 SHOWS THE RELATIONSHIP BETWEEN 3349 02:38:06,120 --> 02:38:10,357 THE PHYSICAL WELL BEING OF THOSE 3350 02:38:10,357 --> 02:38:14,495 LIVING WITH THIS AND THE Y AXIS 3351 02:38:14,495 --> 02:38:15,763 INDICATES LOWER SCORES INDICATES 3352 02:38:15,763 --> 02:38:17,531 LOWER PHYSICAL WELL BEING. 3353 02:38:17,531 --> 02:38:20,968 AS YOU CAN SEE, HIGH IMPLICIT 3354 02:38:20,968 --> 02:38:23,337 AND EXPLICIT BIAS PREDICTS THE 3355 02:38:23,337 --> 02:38:27,007 LOWEST DEGREE OF PHYSICAL WELL 3356 02:38:27,007 --> 02:38:28,876 BEING OF PERSONS LIVING WITH HIV 3357 02:38:28,876 --> 02:38:32,279 AND BY VIRTUE OF BEING HUMAN 3358 02:38:32,279 --> 02:38:34,114 WE'RE MEMBERS OF VARIOUS SOCIAL 3359 02:38:34,114 --> 02:38:36,250 GROUPS BASED ON OUR STIGMATIZED 3360 02:38:36,250 --> 02:38:38,919 AND MARGINALIZED IDENTITIES AND 3361 02:38:38,919 --> 02:38:39,219 STATUSES. 3362 02:38:39,219 --> 02:38:43,857 SO THINK ABOUT A BLACK TRANS 3363 02:38:43,857 --> 02:38:48,128 WOMAN OF LOW SES LIVING WITH HIV 3364 02:38:48,128 --> 02:38:51,165 THAT PERSON WOULD BE ENCOUNTERED 3365 02:38:51,165 --> 02:38:55,502 JUST BASED ON THOSE CATEGORIES. 3366 02:38:55,502 --> 02:38:57,704 SO IT'S IMPORTANT THE RESEARCH 3367 02:38:57,704 --> 02:39:00,274 RIGHT NOW IS TOO PREMATURE TO BE 3368 02:39:00,274 --> 02:39:02,843 ABLE TO DEDUCE EXACTLY THE 3369 02:39:02,843 --> 02:39:07,147 INFLUENCES OF INTERSECTIONAL 3370 02:39:07,147 --> 02:39:08,182 APPROACHES AND HOW THEY 3371 02:39:08,182 --> 02:39:10,050 INFLUENCE DOWN STREAM HEALTH 3372 02:39:10,050 --> 02:39:11,819 OUTCOMES BUT CONSISTENTLY 3373 02:39:11,819 --> 02:39:16,156 RESEARCH DOES SHOW BIAS EXPOSURE 3374 02:39:16,156 --> 02:39:20,260 PREDICTS INFLAMMATION, OXIDATIVE 3375 02:39:20,260 --> 02:39:22,262 STRESS AND POOR CIRCULATION WITH 3376 02:39:22,262 --> 02:39:24,264 ASTHMA HYPERTENSION AND MATERNAL 3377 02:39:24,264 --> 02:39:25,532 HEALTH OUTCOMES AND MENTAL 3378 02:39:25,532 --> 02:39:31,772 HEALTH AND WELL BEING. 3379 02:39:31,772 --> 02:39:33,440 KNOWLEDGE GAPS REMAIN AND 3380 02:39:33,440 --> 02:39:35,409 RESEARCH MECHANISMS LINKING BIAS 3381 02:39:35,409 --> 02:39:36,677 EXPOSURE TO HEALTH OUTCOMES. 3382 02:39:36,677 --> 02:39:38,879 THE MODEL ON THE RIGHT IS BASED 3383 02:39:38,879 --> 02:39:44,585 ON A REVIEW PUBLISHED IN HEALTH 3384 02:39:44,585 --> 02:39:46,186 PSYCHOLOGY OUTLINING THE 3385 02:39:46,186 --> 02:39:48,822 ASSOCIATIONS AND PHYSIOLOGICAL 3386 02:39:48,822 --> 02:39:49,890 REPRESENTATIVES AND ADVERSE 3387 02:39:49,890 --> 02:39:51,291 HEALTH CONDITIONS AND HEALTH 3388 02:39:51,291 --> 02:39:52,693 DISPARITIES. 3389 02:39:52,693 --> 02:39:58,866 RESEARCH REMAINS SILOED IN THE 3390 02:39:58,866 --> 02:40:03,470 SCIENTIFIC DISCIPLINES AND 3391 02:40:03,470 --> 02:40:06,507 LOOKING AT HEALTH DISPARITIES 3392 02:40:06,507 --> 02:40:11,345 AND MOREOVER LIKE THE PLEAS OF 3393 02:40:11,345 --> 02:40:17,284 TRANS-DISCIPLINARY SCIENTISTS 3394 02:40:17,284 --> 02:40:20,888 THERE'S BEEN LITTLE APPROACHES 3395 02:40:20,888 --> 02:40:22,356 TO BIASES TO DOWN STREAM 3396 02:40:22,356 --> 02:40:22,656 DISPARITIES. 3397 02:40:22,656 --> 02:40:28,362 NIMHD HAS TAKEN INITIATIVES AND 3398 02:40:28,362 --> 02:40:31,431 EFFORT IN FUNDING PROJECTS THAT 3399 02:40:31,431 --> 02:40:33,767 LOOK AT BIASES IN HEALTH. 3400 02:40:33,767 --> 02:40:36,537 FOR INSTANCE THERE'S THE NOFO 3401 02:40:36,537 --> 02:40:40,741 ABOUT STRUCTURAL RACISM AND 3402 02:40:40,741 --> 02:40:43,477 DISCRIMINATION AND THE YOUTH 3403 02:40:43,477 --> 02:40:44,511 BIAS PREVENTION WITH A FOCUS ON 3404 02:40:44,511 --> 02:40:47,347 DISCRIMINATION AND INTERVENTIONS 3405 02:40:47,347 --> 02:40:49,449 TO LESSEN THE IMPACT OF 3406 02:40:49,449 --> 02:40:50,017 DISCRIMINATION. 3407 02:40:50,017 --> 02:40:53,186 MORE RELATED TO THIS IS A 3408 02:40:53,186 --> 02:40:55,022 WORKSHOP BEING LED BY NIMHD 3409 02:40:55,022 --> 02:40:58,358 ALONG SIDE OTHER PARTNER 3410 02:40:58,358 --> 02:41:00,460 INSTITUTES AND CENTERS THAT 3411 02:41:00,460 --> 02:41:01,695 ENTITLE THE ADDRESSING HEALTH 3412 02:41:01,695 --> 02:41:03,363 OUTCOMES AND DISPARITIES. 3413 02:41:03,363 --> 02:41:09,836 THAT WILL TAKE PLACE JUNE 17 AND 3414 02:41:09,836 --> 02:41:13,774 18, 2:30 AND 5:30 AND A CLINGS 3415 02:41:13,774 --> 02:41:14,741 PERSPECTIVE TO GAIN MORE 3416 02:41:14,741 --> 02:41:17,611 COMPREHENSIVE UNDERSTANDING OF 3417 02:41:17,611 --> 02:41:20,314 THE STATE OF THE SCIENCE. 3418 02:41:20,314 --> 02:41:24,585 WE RAN A PORTFOLIO ANALYSIS ON 3419 02:41:24,585 --> 02:41:29,423 NIH FUNDED PROJECTS TO 2023 FOR 3420 02:41:29,423 --> 02:41:31,325 RESEARCH PROJECT GRANTS USING 3421 02:41:31,325 --> 02:41:34,261 KEY WORDS ASSOCIATED WITH 3422 02:41:34,261 --> 02:41:36,163 INTERPERSONAL SCIENTISTS AND 3423 02:41:36,163 --> 02:41:38,231 PROJECTS WERE DEEMED AS 3424 02:41:38,231 --> 02:41:39,633 INCLUSIVE AND ASSOCIATED WITH 3425 02:41:39,633 --> 02:41:41,101 INTERPERSONAL BIASES. 3426 02:41:41,101 --> 02:41:43,437 NIMHD FUNDED 30 PROJECTS WHICH 3427 02:41:43,437 --> 02:41:46,907 IS THE HIGHEST -- THE SECOND 3428 02:41:46,907 --> 02:41:48,942 INSTITUTE THAT FUNDS THE HIGHEST 3429 02:41:48,942 --> 02:41:51,345 NUMBER OF PROJECTS ON THIS 3430 02:41:51,345 --> 02:41:52,212 SCIENCE. 3431 02:41:52,212 --> 02:41:57,184 OUT OF THOSE 30, 16 WERE R01s 3432 02:41:57,184 --> 02:42:00,754 AND TWO LOOKED AT THE DIFFERENCE 3433 02:42:00,754 --> 02:42:04,691 IN INTERPERSONAL BIASES AND ONE 3434 02:42:04,691 --> 02:42:07,694 LOOKED AT SUBSTANCE USE AMONG 3435 02:42:07,694 --> 02:42:10,497 SGM POPULATIONS BUT NONE LOOKED 3436 02:42:10,497 --> 02:42:14,201 AT INTERPERSONAL BIASES AND THE 3437 02:42:14,201 --> 02:42:14,801 RELATION TO HEALTH. 3438 02:42:14,801 --> 02:42:19,072 IT LEADS ME TO THE CONCEPT. 3439 02:42:19,072 --> 02:42:20,907 THE INITIATIVE HERE IS TO 3440 02:42:20,907 --> 02:42:25,112 SUPPORT MULTI-DISCIPLINARY 3441 02:42:25,112 --> 02:42:26,279 MULTI-LEVEL RESEARCH LEARNING 3442 02:42:26,279 --> 02:42:34,321 BIASES TO HEALTH OUTCOMES AND AL 3443 02:42:34,321 --> 02:42:36,356 AND LONGITUDINAL AND 3444 02:42:36,356 --> 02:42:37,424 INTERVENTIONAL AND OF PARTICULAR 3445 02:42:37,424 --> 02:42:39,092 IMPORTANCE OF STUDIES ARE HIGHLY 3446 02:42:39,092 --> 02:42:41,528 ENCOURAGED TO USE INTERSECTIONAL 3447 02:42:41,528 --> 02:42:42,996 APPROACHES TO EXAMINE THE 3448 02:42:42,996 --> 02:42:45,499 IMPLICATIONS OF MULTIPLE FORMS 3449 02:42:45,499 --> 02:42:47,234 OF BIASES. 3450 02:42:47,234 --> 02:42:50,504 STUDIES TO ALSO LOOK AT 3451 02:42:50,504 --> 02:42:53,006 ASSOCIATIONS BETWEEN AND AMONG 3452 02:42:53,006 --> 02:42:54,641 COGNITIVE PERCEPTUAL AND 3453 02:42:54,641 --> 02:42:59,379 PREJUDICE CONCERNS, VIGILANCE, 3454 02:42:59,379 --> 02:43:04,484 STIGMA, INTERNALIZED,ISMS AND 3455 02:43:04,484 --> 02:43:06,420 TRANSCRIPTIONAL REGULATION, 3456 02:43:06,420 --> 02:43:09,523 INFLAMMATION, TELOMERE LENGTH 3457 02:43:09,523 --> 02:43:12,092 AND CHRONIC PHYSICAL AND MENTAL 3458 02:43:12,092 --> 02:43:12,993 HEALTH CONDITIONS. 3459 02:43:12,993 --> 02:43:15,595 SO AMONG THE PRIORITIES ARE 3460 02:43:15,595 --> 02:43:18,098 STUDIES THAT ASSESS THE TEMPORAL 3461 02:43:18,098 --> 02:43:19,833 PROCESSES BETWEEN ACTUAL AND 3462 02:43:19,833 --> 02:43:21,034 PERCEIVED EXPOSURE AND ADVERSE 3463 02:43:21,034 --> 02:43:23,236 HEALTH OUTCOMES. 3464 02:43:23,236 --> 02:43:25,305 STUDIES THAT EXAMINE CUMULATIVE 3465 02:43:25,305 --> 02:43:30,744 EXPOSURE TO BIASES OVER TIME ON 3466 02:43:30,744 --> 02:43:32,779 OXIDATIVE STRESS AND THE 3467 02:43:32,779 --> 02:43:33,880 INFLUENCE OF BIAS EXPOSURE WITH 3468 02:43:33,880 --> 02:43:35,449 MULTIPLE SOCIAL DETERMINATES OF 3469 02:43:35,449 --> 02:43:37,050 HEALTH ACROSS DOMAINS INCLUDING 3470 02:43:37,050 --> 02:43:40,020 THE BUILT ENVIRONMENT AND LEVELS 3471 02:43:40,020 --> 02:43:41,988 OF INFLUENCE NAMELY THE 3472 02:43:41,988 --> 02:43:45,492 INTERPERSONAL AND COMMUNITY 3473 02:43:45,492 --> 02:43:45,726 LEVELS. 3474 02:43:45,726 --> 02:43:50,297 STUDIES THAT ASSESS BIASES AND 3475 02:43:50,297 --> 02:43:52,432 MITIGATE THE INFLUENCE OF BIAS 3476 02:43:52,432 --> 02:43:53,433 ON HEALTH. 3477 02:43:53,433 --> 02:43:54,334 STUDIES THAT EXAMINE THE 3478 02:43:54,334 --> 02:43:56,703 INFLUENCE OF BIAS EXPOSURE ON 3479 02:43:56,703 --> 02:43:58,672 HEALTH PROMOTED BEHAVIORS SUCH 3480 02:43:58,672 --> 02:44:00,874 AS ABSTAINING FROM SUBSTANCE USE 3481 02:44:00,874 --> 02:44:03,310 AND HEALTH CARE UTILIZATION AS 3482 02:44:03,310 --> 02:44:08,548 WITH THE CANCER GUIDELINES AND 3483 02:44:08,548 --> 02:44:14,488 LINKING BIASES TO MALADAPTIVE 3484 02:44:14,488 --> 02:44:17,524 PHYSIOLOGICAL RESPONSES AND 3485 02:44:17,524 --> 02:44:19,659 STEREOTYPING AND PREJUDICE IN 3486 02:44:19,659 --> 02:44:21,828 CONTRAST TO STRESS AND OTHER 3487 02:44:21,828 --> 02:44:23,697 PHYSIOLOGICAL RESPONSES AND 3488 02:44:23,697 --> 02:44:25,866 METHODS TO IMPROVE THE EXISTING 3489 02:44:25,866 --> 02:44:28,068 MEASUREMENT TOOLS AND NOW 3490 02:44:28,068 --> 02:44:32,305 TAILORED TOOL TO MEASURE THE 3491 02:44:32,305 --> 02:44:37,511 IMPACT TO BIASES IN MULTIPLE 3492 02:44:37,511 --> 02:44:37,811 POPULATIONS. 3493 02:44:37,811 --> 02:44:40,347 THANK YOU. 3494 02:44:40,347 --> 02:44:42,582 >> THANK YOU VERY MUCH. 3495 02:44:42,582 --> 02:44:45,252 >> THANK YOU FOR THIS REALLY 3496 02:44:45,252 --> 02:44:46,286 EXCITING CONCEPT. 3497 02:44:46,286 --> 02:44:47,888 I HAVE THREE MAJOR AREAS I WANT 3498 02:44:47,888 --> 02:44:51,825 TO HIGHLIGHT WITH THE HOPE OF 3499 02:44:51,825 --> 02:44:53,026 STRENGTHENING THIS FURTHER. 3500 02:44:53,026 --> 02:44:55,395 I AGREE WITH YOU THERE'S A HUGE 3501 02:44:55,395 --> 02:44:58,565 OPPORTUNITY HERE TO BE ABLE TO 3502 02:44:58,565 --> 02:45:05,505 MAKE STRIDES IN BOTH THEORETICAL 3503 02:45:05,505 --> 02:45:09,743 AND METHODOLOGICAL ISSUES ON 3504 02:45:09,743 --> 02:45:11,545 INTERPERSONAL BIAS AND WONDERING 3505 02:45:11,545 --> 02:45:13,513 IF YOU'RE WILLING TO SPEAK ABOUT 3506 02:45:13,513 --> 02:45:15,015 THE BUILT ENVIRONMENT AS PART OF 3507 02:45:15,015 --> 02:45:16,917 SITUATING IDENTITIES THAT MIGHT 3508 02:45:16,917 --> 02:45:18,985 RESOLVE THAT BIAS AS PART OF 3509 02:45:18,985 --> 02:45:19,786 THIS CONCEPT. 3510 02:45:19,786 --> 02:45:23,623 >> THAT'S AN EXCELLENT QUESTION. 3511 02:45:23,623 --> 02:45:25,392 IT'S ONE THAT INFLUENCED THIS 3512 02:45:25,392 --> 02:45:28,228 CONCEPT IN THAT SO WE HAVE THE 3513 02:45:28,228 --> 02:45:32,132 STRUCTURAL BASIS CONCEPT. 3514 02:45:32,132 --> 02:45:36,269 SO IT'S IN A TOP-DOWN MANNER 3515 02:45:36,269 --> 02:45:37,437 EXAMINING THE INFLUENCE OF 3516 02:45:37,437 --> 02:45:38,071 STRUCTURAL RACISM INCLUDING THE 3517 02:45:38,071 --> 02:45:48,381 BUILT ENVIRONMENT. 3518 02:45:51,585 --> 02:45:53,053 THE YIN TO THE YANG AND THE 3519 02:45:53,053 --> 02:45:56,923 OTHER SIDE OF THE COIN TO TARGET 3520 02:45:56,923 --> 02:46:00,727 THE PROBLEM OF THE EXPOSURE TO 3521 02:46:00,727 --> 02:46:08,101 BIASES AT THE STRUCTURAL OR 3522 02:46:08,101 --> 02:46:11,538 INTER PER 3523 02:46:11,538 --> 02:46:19,446 INTERPERSONAL DIFFERENCES. 3524 02:46:19,446 --> 02:46:26,219 >> AND LOOK FOR THOSE 3525 02:46:26,219 --> 02:46:26,553 OPPORTUNITIES. 3526 02:46:26,553 --> 02:46:29,189 MY OTHER TWO THOUGHTS ON THIS 3527 02:46:29,189 --> 02:46:34,928 ARE MORE CONCEPTUAL AS WE THINK 3528 02:46:34,928 --> 02:46:36,196 OF INTERPERSONAL BIAS AND ONE 3529 02:46:36,196 --> 02:46:37,330 THING I SEE WITHIN THE 3530 02:46:37,330 --> 02:46:39,266 LITERATURE IS WE END UP 3531 02:46:39,266 --> 02:46:41,434 MEASURING AT THE INDIVIDUAL 3532 02:46:41,434 --> 02:46:43,370 LEVEL UNIT OF ANALYSIS AND 3533 02:46:43,370 --> 02:46:44,738 PERSONAL PROCESS. 3534 02:46:44,738 --> 02:46:47,741 SO WOULD REALLY HOPE THAT WE'RE 3535 02:46:47,741 --> 02:46:50,043 THINKING AS WE THINK OF SEXUAL 3536 02:46:50,043 --> 02:46:52,646 IDENTITIES WE THINK OF NETWORK 3537 02:46:52,646 --> 02:46:55,015 LEVEL DYNAMICS SO IF WE ARE ABLE 3538 02:46:55,015 --> 02:46:58,251 TO UNDERSTAND HOW INTERPERSONAL 3539 02:46:58,251 --> 02:47:01,454 BIASES PROPAGATE OR CURTAIL OR 3540 02:47:01,454 --> 02:47:03,490 MITIGATE IT, IT MAY GIVE 3541 02:47:03,490 --> 02:47:04,858 INSIGHTS FOR INTERVENTION DOWN 3542 02:47:04,858 --> 02:47:05,725 THE LINE WHICH I THINK ARE 3543 02:47:05,725 --> 02:47:07,827 IMPORTANT FOR US. 3544 02:47:07,827 --> 02:47:08,828 AND EQUALLY THEN THINKING ABOUT 3545 02:47:08,828 --> 02:47:09,062 SYSTEMS. 3546 02:47:09,062 --> 02:47:14,467 SO WHAT ARE THE POLICIES AND 3547 02:47:14,467 --> 02:47:15,435 STRUCTURES AND COMMUNITY NORMS 3548 02:47:15,435 --> 02:47:18,939 THAT MAY BE ENABLING OR 3549 02:47:18,939 --> 02:47:20,740 DISSUADING THE BIASES FROM 3550 02:47:20,740 --> 02:47:21,007 OCCURRING. 3551 02:47:21,007 --> 02:47:23,743 EXCITED FOR THE CONCEPT AND 3552 02:47:23,743 --> 02:47:29,482 LOOKING FORWARD TO LEARNING 3553 02:47:29,482 --> 02:47:29,683 MORE. 3554 02:47:29,683 --> 02:47:29,849 >> 3555 02:47:29,849 --> 02:47:32,585 >> THANK YOU, FOR YOUR RESEARCH 3556 02:47:32,585 --> 02:47:34,587 AND FOR REALLY PUTTING THE 3557 02:47:34,587 --> 02:47:37,757 EFFORT INTO DEVELOPING THIS 3558 02:47:37,757 --> 02:47:38,091 INITIATIVE. 3559 02:47:38,091 --> 02:47:40,260 I'M PARTICULARLY STRUCK AND 3560 02:47:40,260 --> 02:47:42,796 IMPRESSED WITH THE PRIORITY FOR 3561 02:47:42,796 --> 02:47:43,964 MULTI-DISCIPLINARY AND 3562 02:47:43,964 --> 02:47:45,498 HIGH-LEVEL RESEARCH FOR 3563 02:47:45,498 --> 02:47:53,506 UNDERSTANDING MECHANISMS AND 3564 02:47:53,506 --> 02:47:55,608 PATHWAYS. 3565 02:47:55,608 --> 02:47:57,277 I HAVE TWO ADDITIONAL 3566 02:47:57,277 --> 02:47:58,745 CONSIDERATIONS AROUND WANT TO 3567 02:47:58,745 --> 02:48:04,150 ASK HOW YOU'RE THINKING 3568 02:48:04,150 --> 02:48:11,124 REGARDING PATHWAYS AND PATHWAYS 3569 02:48:11,124 --> 02:48:14,928 AND OUTCOMES AND HOW ARE YOU 3570 02:48:14,928 --> 02:48:15,261 DI 3571 02:48:15,261 --> 02:48:20,400 THINKING OF THE STRUCTURES AND 3572 02:48:20,400 --> 02:48:24,571 SYSTEMS AS AN OPPORTUNITY. 3573 02:48:24,571 --> 02:48:26,873 >> THE WAY THE CURRENT 3574 02:48:26,873 --> 02:48:27,907 LITERATURE ESTABLISH THE 3575 02:48:27,907 --> 02:48:32,712 PROCESSES INVOLVED IS FROM TO 3576 02:48:32,712 --> 02:48:34,381 INTERPERSONAL BIASES DOWN TO 3577 02:48:34,381 --> 02:48:36,383 HEALTH OUTCOMES AND SOCIETAL 3578 02:48:36,383 --> 02:48:36,683 DISPARITIES. 3579 02:48:36,683 --> 02:48:38,718 BY WAY OF DIFFERENT MECHANISMS 3580 02:48:38,718 --> 02:48:41,921 AND PATHWAYS AND THE MEDIATORS 3581 02:48:41,921 --> 02:48:44,791 AND THEY INVOLVE THE PRECLINICAL 3582 02:48:44,791 --> 02:48:47,927 AND ONE BEING PRECLINICAL END 3583 02:48:47,927 --> 02:48:49,596 POINTS AND CARDIOVASCULAR 3584 02:48:49,596 --> 02:48:52,932 REACTIVITY, PREMATURE AGING 3585 02:48:52,932 --> 02:48:54,434 MEASURES AND PROMOTE HEALTHFUL 3586 02:48:54,434 --> 02:48:55,168 BEHAVIORS AS WELL. 3587 02:48:55,168 --> 02:48:58,805 THERE'S A WHOLE CONSTELLATION OF 3588 02:48:58,805 --> 02:49:02,108 MEDIATORS BY WHICH INTERPERSONAL 3589 02:49:02,108 --> 02:49:03,209 BIASES INFLUENCE HEALTH 3590 02:49:03,209 --> 02:49:04,044 OUTCOMES. 3591 02:49:04,044 --> 02:49:05,345 BECAUSE THIS CONCEPT AND 3592 02:49:05,345 --> 02:49:10,717 INITIATIVE IS ROOTED IN THE 3593 02:49:10,717 --> 02:49:13,753 INTERPERSONAL LEVEL THEN THE 3594 02:49:13,753 --> 02:49:15,688 FOCUS IS LARGELY ON WHAT WE 3595 02:49:15,688 --> 02:49:18,491 DON'T KNOW YET WHICH IS A THREAD 3596 02:49:18,491 --> 02:49:21,127 BETWEEN EXPOSURE BIASES DOWN TO 3597 02:49:21,127 --> 02:49:22,395 HEALTH OUTCOMES. 3598 02:49:22,395 --> 02:49:28,234 WITH THAT SAID ALSO A SPECIAL 3599 02:49:28,234 --> 02:49:31,671 ATTENTION GIVEN TO INTERPERSONAL 3600 02:49:31,671 --> 02:49:33,740 BIASES AT THE THE INDIVIDUAL 3601 02:49:33,740 --> 02:49:36,376 LEVEL INFLUENCE BIASES AND 3602 02:49:36,376 --> 02:49:37,210 STRUCTURAL BASIS OF 3603 02:49:37,210 --> 02:49:37,811 DISCRIMINATION AT THE SYSTEMS 3604 02:49:37,811 --> 02:49:39,712 LEVEL. 3605 02:49:39,712 --> 02:49:44,651 LIKE I INDICATED BEFORE, WE'RE 3606 02:49:44,651 --> 02:49:45,718 NOT GOING TO -- WE'RE GOING TO 3607 02:49:45,718 --> 02:49:47,987 GET SOMEWHERE BUT NOT MAKE 3608 02:49:47,987 --> 02:49:51,024 HEADWAY UNLESS WE TACKLE THE 3609 02:49:51,024 --> 02:49:52,559 PROBLEM BI-DIRECTIONALLY. 3610 02:49:52,559 --> 02:49:55,161 >> THANK YOU. 3611 02:49:55,161 --> 02:49:57,397 I THINK THERE'S AN OPPORTUNITY 3612 02:49:57,397 --> 02:50:00,266 YOU'RE TAPPING INTO HERE TO 3613 02:50:00,266 --> 02:50:03,470 FURTHER OR EXPLICITLY NAME THE 3614 02:50:03,470 --> 02:50:09,075 EXPOSURES THROUGH INTERSECTING 3615 02:50:09,075 --> 02:50:09,709 SYSTEMS AND STRUCTURAL RACISM 3616 02:50:09,709 --> 02:50:11,644 AND THE OPPORTUNITY TO LOOK AT 3617 02:50:11,644 --> 02:50:13,513 DIVERSE IMPACTS FOR 3618 02:50:13,513 --> 02:50:17,517 MULTI-CULTURAL COMMUNITIES WHICH 3619 02:50:17,517 --> 02:50:19,652 IS TYPICALLY IN SILOS. 3620 02:50:19,652 --> 02:50:21,521 INTERPERSONAL BIASES OCCUR 3621 02:50:21,521 --> 02:50:23,890 WITHIN SOCIAL DOMAINS AND THOSE 3622 02:50:23,890 --> 02:50:29,195 SOCIAL DOMAINS AND STRUCTURES 3623 02:50:29,195 --> 02:50:33,066 ARE ROOTED IN HISTORY AND MAYBE 3624 02:50:33,066 --> 02:50:36,169 RECONSIDER AS A THOUGHT IN THE 3625 02:50:36,169 --> 02:50:39,439 CONCEPT THE EXPOSURES, SOME OF 3626 02:50:39,439 --> 02:50:43,476 THE WORK FOR SOME DOCTORS AND 3627 02:50:43,476 --> 02:50:46,913 CONSIDER IMMIGRATION POLICIES 3628 02:50:46,913 --> 02:50:48,448 AND OTHER POLICIES AND EDUCATION 3629 02:50:48,448 --> 02:50:49,516 AND HOUSING. 3630 02:50:49,516 --> 02:50:53,419 I THINK ALIGNING AND NAMING 3631 02:50:53,419 --> 02:50:56,523 ANOTHER PRIORITY EXPOSURES IN 3632 02:50:56,523 --> 02:50:59,993 TERMS OF INTERGENERATIONAL AND 3633 02:50:59,993 --> 02:51:03,596 HISTORICAL TRAUMA THAT COMES 3634 02:51:03,596 --> 02:51:07,867 FROM AMERICAN INDIAN SCHOLARS 3635 02:51:07,867 --> 02:51:11,037 AND SHEDDING LIGHT ON CURRENT 3636 02:51:11,037 --> 02:51:12,105 EXPOSURES. 3637 02:51:12,105 --> 02:51:17,076 THEY'RE TRIGGERS AND CAN 3638 02:51:17,076 --> 02:51:18,778 RE-TRIGGER PARTICULAR HEALTH 3639 02:51:18,778 --> 02:51:20,079 OUTCOME BUT NOT JUST AT AN 3640 02:51:20,079 --> 02:51:21,381 INDIVIDUAL LEVEL BUT IS THERE AN 3641 02:51:21,381 --> 02:51:27,887 OPPORTUNITY TO LOOK AT 3642 02:51:27,887 --> 02:51:37,030 INTERGENERATIONAL OUR FAMILIAL 3643 02:51:37,030 --> 02:51:40,033 OUTCOMES AND SCHOLARS ARE 3644 02:51:40,033 --> 02:51:46,339 LEADING GAP AREAS IN 3645 02:51:46,339 --> 02:51:52,145 POSITIONALITY BUT IN CANADA 3646 02:51:52,145 --> 02:51:56,249 LOOKING AT THE INTERSECTIONALITY 3647 02:51:56,249 --> 02:51:58,318 OF OPPRESSIVE SYSTEMS AND WHEN 3648 02:51:58,318 --> 02:52:01,354 YOU LOOK AT SYSTEMATIC REVIEWS 3649 02:52:01,354 --> 02:52:03,089 AND 40% LOOKS AT HEALTH OUTCOMES 3650 02:52:03,089 --> 02:52:06,426 SO THIS IS AN OPPORTUNITY FOR 3651 02:52:06,426 --> 02:52:09,495 NIMHD TO LEAD AND FOR YOU TO BE 3652 02:52:09,495 --> 02:52:15,902 PART OF THAT AND REINFORCING OR 3653 02:52:15,902 --> 02:52:18,571 PUTTING THE CALL FOR THE 3654 02:52:18,571 --> 02:52:19,005 QUANTITY OF METHODS. 3655 02:52:19,005 --> 02:52:22,375 QUALITATIVE RESEARCH HAS BEEN AT 3656 02:52:22,375 --> 02:52:23,409 THE CORE OF INTERSECTIONAL 3657 02:52:23,409 --> 02:52:25,511 RESEARCH AND OUTCOMES BUT THE 3658 02:52:25,511 --> 02:52:30,316 METHODS ARE SIMPLISTIC AND UNDER 3659 02:52:30,316 --> 02:52:35,288 REPRESENTED UP RESEARCH 3660 02:52:35,288 --> 02:52:35,855 SCHOLARSHIP. 3661 02:52:35,855 --> 02:52:38,358 CONSIDERING BEYOND MORE 3662 02:52:38,358 --> 02:52:39,125 SIMPLISTIC LOOKING AT 3663 02:52:39,125 --> 02:52:40,994 MULTI-LEVELS AND BRINGING IN THE 3664 02:52:40,994 --> 02:52:43,296 CALL FOR DIFFERENT DISCIPLINES 3665 02:52:43,296 --> 02:52:48,001 SUCH AS SOCIOLOGY AND 3666 02:52:48,001 --> 02:52:51,271 ANTHROPOLOGY AND ALSO POLITICAL 3667 02:52:51,271 --> 02:52:53,706 SCIENCE AND LEGAL SCHOLARS GIVEN 3668 02:52:53,706 --> 02:52:55,541 OPPORTUNITY TO LOOK DEEPER AND 3669 02:52:55,541 --> 02:53:00,079 TEST THE MEASUREMENTS OR DEVELOP 3670 02:53:00,079 --> 02:53:02,015 MEASUREMENTS AROUND 3671 02:53:02,015 --> 02:53:02,615 METHODOLOGIES. 3672 02:53:02,615 --> 02:53:03,283 >> THANK YOU. 3673 02:53:03,283 --> 02:53:05,852 THANK YOU SO MUCH. 3674 02:53:05,852 --> 02:53:09,289 THOSE ARE EXCELLENT POINTS. 3675 02:53:09,289 --> 02:53:11,090 IN PARTICULAR TO YOUR FIRST 3676 02:53:11,090 --> 02:53:12,692 POINT I THINK IT'S IMPORTANT TO 3677 02:53:12,692 --> 02:53:15,028 CONSIDER THE FACT THAT THERE'S 3678 02:53:15,028 --> 02:53:15,862 RESEARCH SHOWING THAT. 3679 02:53:15,862 --> 02:53:18,631 DOWN STREAM GENERATIONS CAN 3680 02:53:18,631 --> 02:53:20,600 PREDICT THE HEAVILY OF IMPLICIT 3681 02:53:20,600 --> 02:53:22,568 BIASES ENCOUNTERED BY OUR 3682 02:53:22,568 --> 02:53:32,879 ANCESTORS REALLY. 3683 02:53:33,646 --> 02:53:35,481 AND I THINK IT'S REALLY 3684 02:53:35,481 --> 02:53:36,549 IMPORTANT TO BE ABLE TO APPEAL 3685 02:53:36,549 --> 02:53:39,185 TO OTHER DISCIPLINES IN 3686 02:53:39,185 --> 02:53:45,391 PARTICULAR SOCIOLOGY AS WELL TO 3687 02:53:45,391 --> 02:53:50,296 ASSESS ASSOCIATIONS BETWEEN 3688 02:53:50,296 --> 02:53:57,203 EXPOSURES ON DOWN STREAM 3689 02:53:57,203 --> 02:53:58,371 TECHNOLOGIES AND A LOT CAN BE 3690 02:53:58,371 --> 02:54:01,040 GAINED BY USING QUANTITATIVE 3691 02:54:01,040 --> 02:54:02,642 METHODS TO ASSESS 3692 02:54:02,642 --> 02:54:11,884 INTERSECTIONALITY AND TWEAK THE 3693 02:54:11,884 --> 02:54:13,453 I.T. TO ASSESS THE INFLUENCES ON 3694 02:54:13,453 --> 02:54:14,954 DOWN STREAM HEALTH DISPARITIES 3695 02:54:14,954 --> 02:54:17,957 AND STATISTICALLY YOU CAN 3696 02:54:17,957 --> 02:54:18,858 CERTAINLY USE MODERATION IN 3697 02:54:18,858 --> 02:54:22,261 ORDER TO BE ABLE TO SEE HOW 3698 02:54:22,261 --> 02:54:29,502 THESE TYPES OF BIASES INTERACT 3699 02:54:29,502 --> 02:54:36,309 AND TO DIFFERENTIALLY PREDICT 3700 02:54:36,309 --> 02:54:36,809 HEALTH OUTCOMES. 3701 02:54:36,809 --> 02:54:37,243 THANK YOU. 3702 02:54:37,243 --> 02:54:38,644 >> THANK YOU. 3703 02:54:38,644 --> 02:54:40,146 >> THANK YOU FOR EXCELLENT WORK. 3704 02:54:40,146 --> 02:54:43,816 A COUPLE CONCERNS YOU MAY WANT 3705 02:54:43,816 --> 02:54:45,518 TO CONSIDER FROM THE POINT OF 3706 02:54:45,518 --> 02:54:49,088 VIEW OF BIO CHEMISTRY AND 3707 02:54:49,088 --> 02:54:49,322 BIOLOGY. 3708 02:54:49,322 --> 02:54:52,291 IN ADDITION TO BIAS, THERE ARE 3709 02:54:52,291 --> 02:54:54,961 MANY OTHER EXPOSURES THAT CAN 3710 02:54:54,961 --> 02:54:55,328 READ TO STRESS. 3711 02:54:55,328 --> 02:54:59,532 IT COULD BE A TYPE OF STRESS 3712 02:54:59,532 --> 02:55:04,604 LABELLED AS STRESS WHICH CAN 3713 02:55:04,604 --> 02:55:07,407 ALSO LEAD TO EPIGENETIC CHANGE 3714 02:55:07,407 --> 02:55:09,942 AND SLEEP DISORDERS MAY LEAD TO 3715 02:55:09,942 --> 02:55:11,711 CHANGES IN THE LEVELS OF 3716 02:55:11,711 --> 02:55:15,648 INFLAMMATORY MARKERS AND 3717 02:55:15,648 --> 02:55:20,520 INTERLEUKINS AND THE QUESTION 3718 02:55:20,520 --> 02:55:24,157 BECOMES HOW DO YOU DESIGN THIS 3719 02:55:24,157 --> 02:55:28,227 OR WE CAN ROOT OUT ALL THE OTHER 3720 02:55:28,227 --> 02:55:30,530 BACKGROUND WHICH ARE LIKELY TO 3721 02:55:30,530 --> 02:55:31,697 OCCUR. 3722 02:55:31,697 --> 02:55:34,867 I HOPE THAT YOU CONSIDER THE 3723 02:55:34,867 --> 02:55:37,637 NOTION OF INDIVIDUALS VERY 3724 02:55:37,637 --> 02:55:40,573 STRONG AND CLEAR INCREASING 3725 02:55:40,573 --> 02:55:43,009 CRITERIA FOR ROOM THE STUDIES 3726 02:55:43,009 --> 02:55:48,214 OTHERWISE THERE'LL BE OVERLAPS. 3727 02:55:48,214 --> 02:55:53,953 FOR EXAMPLE THERE'S GENETIC 3728 02:55:53,953 --> 02:55:55,555 DEFICIENCY AND THOUGHT IT WAS 3729 02:55:55,555 --> 02:55:56,322 BUILD UP OF STRESS. 3730 02:55:56,322 --> 02:56:04,297 THEY'RE PART OF THE STUDY HOW DO 3731 02:56:04,297 --> 02:56:04,864 YOU DISTINGUISH THIS? 3732 02:56:04,864 --> 02:56:07,200 >> THAT'S A GREAT POINT. 3733 02:56:07,200 --> 02:56:13,072 I THINK IT'S ALSO IMPORTANT TO 3734 02:56:13,072 --> 02:56:15,441 NOTE BIASES GIVE WAY SO SO IN 3735 02:56:15,441 --> 02:56:22,181 ADDITION TO THE PRECLINICAL END 3736 02:56:22,181 --> 02:56:24,484 POINTS AND PSYCHOLOGICAL 3737 02:56:24,484 --> 02:56:25,885 PROCESSES THAT INCLUDE INCLUDES 3738 02:56:25,885 --> 02:56:29,922 WORRY, RUMINATION, THREAT, 3739 02:56:29,922 --> 02:56:31,591 VIGILANCE FOR THREATENING CUES 3740 02:56:31,591 --> 02:56:35,094 IN THE ENVIRONMENT AND BY WAY OF 3741 02:56:35,094 --> 02:56:37,663 THOSE IS THAT A WAY TO 3742 02:56:37,663 --> 02:56:40,867 EMPIRICALLY OUTLINE THE 3743 02:56:40,867 --> 02:56:42,134 ASSOCIATIONS BETWEEN BIAS 3744 02:56:42,134 --> 02:56:44,070 EXPOSURE TO HEALTH OUTCOMES. 3745 02:56:44,070 --> 02:56:47,340 I THINK IT WILL BE REALLY 3746 02:56:47,340 --> 02:56:52,845 IMPORTANT TO EXPLICITLY OUTLINE 3747 02:56:52,845 --> 02:56:55,147 THE PROCESSES INVOLVED TO RULE 3748 02:56:55,147 --> 02:56:57,517 OUT OTHER FACTORS THAT ARE NOT 3749 02:56:57,517 --> 02:57:00,453 ASSOCIATED WITH THE EXPOSURE 3750 02:57:00,453 --> 02:57:00,753 BIASES. 3751 02:57:00,753 --> 02:57:05,091 >> AND SO THEN IN THAT CASE 3752 02:57:05,091 --> 02:57:08,060 THERE WILL BE AN EXPECTATION IF 3753 02:57:08,060 --> 02:57:11,264 THERE ISN'T INTERVENTION THE 3754 02:57:11,264 --> 02:57:12,498 MARKERS CAN GO DOWN. 3755 02:57:12,498 --> 02:57:17,069 >> EXACTLY. 3756 02:57:17,069 --> 02:57:18,237 GOOD POINT. 3757 02:57:18,237 --> 02:57:23,843 >> THREW DR. GARRIDO FOR AN 3758 02:57:23,843 --> 02:57:24,477 EXCELLENT PRESENTATION AND 3759 02:57:24,477 --> 02:57:25,011 DISCUSSION. 3760 02:57:25,011 --> 02:57:28,848 I'M WONDERING IF YOU HAVE OR 3761 02:57:28,848 --> 02:57:31,417 WOULD CONSIDER THE TECHNOLOGY TO 3762 02:57:31,417 --> 02:57:32,718 CAPTURE EXPOSURES IN REAL TIME 3763 02:57:32,718 --> 02:57:34,887 AT LEAST ON IMPACT BECAUSE WE 3764 02:57:34,887 --> 02:57:38,257 KNOW SHE'S EXPOSURES MAY NOT BE 3765 02:57:38,257 --> 02:57:39,592 THE SAME AS WHEN THEY'RE REAL 3766 02:57:39,592 --> 02:57:41,360 TIME OCCURRING IN THE 3767 02:57:41,360 --> 02:57:41,794 ENVIRONMENT. 3768 02:57:41,794 --> 02:57:43,262 SO IS THAT SOMETHING THAT IS 3769 02:57:43,262 --> 02:57:44,730 MAYBE BEING CONSIDERED? 3770 02:57:44,730 --> 02:57:47,199 >> EXCELLENT POINT. 3771 02:57:47,199 --> 02:57:47,600 ABSOLUTELY. 3772 02:57:47,600 --> 02:57:49,735 THAT'S THE OTHER NOTABLE 3773 02:57:49,735 --> 02:57:52,905 COMPONENT OF THIS INITIATIVE IS 3774 02:57:52,905 --> 02:57:56,509 USING UNCONVENTIONAL TECHNOLOGY 3775 02:57:56,509 --> 02:57:59,445 TO REALLY ASSESS ALL THESE 3776 02:57:59,445 --> 02:58:02,014 VARIOUS DIFFERENT ASSOCIATIONS. 3777 02:58:02,014 --> 02:58:12,358 SO, YES, THANK YOU. 3778 02:58:14,694 --> 02:58:15,928 >> THANK YOU FOR THAT EXCELLENT 3779 02:58:15,928 --> 02:58:20,600 SUMMARY. 3780 02:58:20,600 --> 02:58:24,003 I GUESS I HAVE TWO QUESTIONS. 3781 02:58:24,003 --> 02:58:29,075 ONE, DOES THIS POTENTIALLY HAVE 3782 02:58:29,075 --> 02:58:33,512 ANY OPPORTUNITY FOR FOLKS TO 3783 02:58:33,512 --> 02:58:40,853 START INTERVENING AND ARE THERE 3784 02:58:40,853 --> 02:58:42,054 POTENTIAL ETHICAL CONCERNS WE 3785 02:58:42,054 --> 02:58:48,327 SHOULD BE THINKING ABOUT? 3786 02:58:48,327 --> 02:58:53,399 >> SURE. 3787 02:58:53,399 --> 02:58:56,936 SO IN THE BEGINNING I CONSIDERED 3788 02:58:56,936 --> 02:58:58,404 MAKING THE INTERVENTION PORTION 3789 02:58:58,404 --> 02:59:00,206 A CORE COMPONENT OF THE 3790 02:59:00,206 --> 02:59:02,174 INITIATIVE BUT I THINK WE NEED 3791 02:59:02,174 --> 02:59:05,378 TO REALLY HAVE A CLEAR PICTURE 3792 02:59:05,378 --> 02:59:08,381 AND DEDUCE THE PATHWAYS AND 3793 02:59:08,381 --> 02:59:09,515 MECHANISMS FIRST BEFORE 3794 02:59:09,515 --> 02:59:11,283 CONSIDERING INTERVENTIONS. 3795 02:59:11,283 --> 02:59:15,955 IN SOCIAL PSYCHOLOGY THERE'S 3796 02:59:15,955 --> 02:59:17,356 INTERVENTIONS BEING DEVELOPED TO 3797 02:59:17,356 --> 02:59:20,693 ADDRESS NOT ONLY IMPLICIT BIAS 3798 02:59:20,693 --> 02:59:24,330 BUT THE BEHAVIORAL OUTCOMES AND 3799 02:59:24,330 --> 02:59:30,369 MAYBE MITIGATING INTERNAL BIASES 3800 02:59:30,369 --> 02:59:35,808 BECAUSE SCIENCE SHOWS A CORE 3801 02:59:35,808 --> 02:59:37,443 BATTLE TO NEUTRALIZE BIASES. 3802 02:59:37,443 --> 02:59:39,011 OF COURSE, IF PEOPLE WANT TO GO 3803 02:59:39,011 --> 02:59:40,946 AHEAD AND DEVELOP INTERVENTIONS 3804 02:59:40,946 --> 02:59:44,216 BASED ON THE MECHANISTIC 3805 02:59:44,216 --> 02:59:47,687 FINDINGS THEY'RE WORKING ON AND 3806 02:59:47,687 --> 02:59:49,855 IMPLEMENTING EVIDENCE-BASED 3807 02:59:49,855 --> 02:59:51,824 INTERVENTIONS FROM SOCIAL 3808 02:59:51,824 --> 02:59:54,527 PSYCHOLOGY THEN IT'S MORE THAN 3809 02:59:54,527 --> 02:59:56,595 WELCOME BUT THE FOCUS IS TO 3810 02:59:56,595 --> 03:00:00,366 OUTLINE WHAT EXACTLY ARE THE 3811 03:00:00,366 --> 03:00:02,368 CONSOLATION OF PROCESSES THAT 3812 03:00:02,368 --> 03:00:05,137 TRULY GIVE WAY TO THE CHRONIC WE 3813 03:00:05,137 --> 03:00:06,439 CONSISTENTLY SEE FROM EXPOSURE 3814 03:00:06,439 --> 03:00:08,974 TO BIASES? 3815 03:00:08,974 --> 03:00:09,575 AS FAR AS ETHICAL CONCERNS 3816 03:00:09,575 --> 03:00:11,844 THERE'S ALWAYS ETHICAL CONCERNS 3817 03:00:11,844 --> 03:00:14,613 WHEN WE TALK ABOUT AS SOCIALLY 3818 03:00:14,613 --> 03:00:19,218 SENSITIVE AS IMPLICIT BIAS. 3819 03:00:19,218 --> 03:00:23,622 AND SO ALL THE MORE REASON TO BE 3820 03:00:23,622 --> 03:00:25,524 ENSURE THAT ETHICAL PROCESSES 3821 03:00:25,524 --> 03:00:32,598 AND PROTOCOLS ARE USED BY 3822 03:00:32,598 --> 03:00:35,601 EXTERNAL GRANTEES. 3823 03:00:35,601 --> 03:00:42,708 >> ARE THERE OTHER COUNCIL 3824 03:00:42,708 --> 03:00:42,942 MEMBERS? 3825 03:00:42,942 --> 03:00:44,443 OKAY. 3826 03:00:44,443 --> 03:00:48,347 SEEING NONE PLAY MAY I HAVE I 3827 03:00:48,347 --> 03:00:51,450 AMOTION TO MOVE THIS CONCEPT 3828 03:00:51,450 --> 03:00:53,986 FORWARD FOR FUNDING DEVELOPMENT? 3829 03:00:53,986 --> 03:00:55,154 IS THERE A SECOND MOTION? 3830 03:00:55,154 --> 03:01:00,226 >> I SECOND THAT MOTION. 3831 03:01:00,226 --> 03:01:03,963 6: 3832 03:01:06,599 --> 03:01:08,167 >> THANK YOU. 3833 03:01:08,167 --> 03:01:10,402 IT'S BEEN PROPERLY MOVED AND 3834 03:01:10,402 --> 03:01:10,669 SECONDED. 3835 03:01:10,669 --> 03:01:15,775 ALL IN FAVOR BY SHOW OF HANDS.I 3836 03:01:15,775 --> 03:01:17,510 SECONDED. 3837 03:01:17,510 --> 03:01:18,110 ALL IN FAVOR BY SHOW OF HANDS. 3838 03:01:18,110 --> 03:01:20,479 THE MOTION PASSES. 3839 03:01:20,479 --> 03:01:25,518 >> THANK YOU. 3840 03:01:25,518 --> 03:01:31,524 >> WE'RE GOING TO MOVE INTO OUR 3841 03:01:31,524 --> 03:01:37,496 NEXT PRESENTATION. 3842 03:01:37,496 --> 03:01:47,973 >> GOOD AFTERNOON AND GOOD 3843 03:02:05,291 --> 03:02:05,457 MORNING. 3844 03:02:05,457 --> 03:02:08,727 THANK YOU FOR THE OPPORTUNITY TO 3845 03:02:08,727 --> 03:02:10,162 PRESENT TODAY. 3846 03:02:10,162 --> 03:02:13,432 I'M GOING TO TALK ABOUT 3847 03:02:13,432 --> 03:02:17,169 SUPPLEMENTAL INCOME PROGRAMS OR 3848 03:02:17,169 --> 03:02:18,838 SOCIAL INSURANCE PROGRAMS AND 3849 03:02:18,838 --> 03:02:20,306 HEALTH ACROSS THE LIFE COURSE 3850 03:02:20,306 --> 03:02:23,342 WITH A FOCUS ON HISPANIC 3851 03:02:23,342 --> 03:02:23,642 POPULATION. 3852 03:02:23,642 --> 03:02:27,580 IN MY PRESENTATION I WOULD LIKE 3853 03:02:27,580 --> 03:02:29,915 TO HIGHLIGHT THE IMPORTANCE OF 3854 03:02:29,915 --> 03:02:31,183 RESEARCHERS WORKING HAND IN HAND 3855 03:02:31,183 --> 03:02:34,753 WITH POLICY MAKERS TO DESIGN 3856 03:02:34,753 --> 03:02:35,955 MORE EFFECTIVE SOCIAL INSURANCE 3857 03:02:35,955 --> 03:02:40,626 PROGRAMS FOR VULNERABLE 3858 03:02:40,626 --> 03:02:43,896 POPULATIONS AND EXPERIMENTAL 3859 03:02:43,896 --> 03:02:46,465 DESIGNS ARE USED IN THE CLINICAL 3860 03:02:46,465 --> 03:02:47,466 SETTING AND ANALYZING SOCIAL 3861 03:02:47,466 --> 03:02:57,810 INSURANCE PROGRAMS. 3862 03:03:15,694 --> 03:03:17,162 I WOULD LIKE TO ACKNOWLEDGE A 3863 03:03:17,162 --> 03:03:18,731 LARGE TEAM OF COLLABORATORS FOR 3864 03:03:18,731 --> 03:03:23,435 THE DIFFERENT EXPERIMENTS I'M 3865 03:03:23,435 --> 03:03:24,169 GOING TO PRESENT AND 3866 03:03:24,169 --> 03:03:26,071 UNIVERSITIES AROUND THE COUNTRY, 3867 03:03:26,071 --> 03:03:31,310 MEXICO AND EUROPE. 3868 03:03:31,310 --> 03:03:33,579 SO PREVIOUS RESEARCH HAS FOUND 3869 03:03:33,579 --> 03:03:35,314 SOCIO ECONOMIC STAT IS A 3870 03:03:35,314 --> 03:03:38,050 FUNDAMENTAL CAUSE OF HEALTH 3871 03:03:38,050 --> 03:03:39,251 DISPARITIES. 3872 03:03:39,251 --> 03:03:40,819 SO SOCIO ECONOMIC STATUS COULD 3873 03:03:40,819 --> 03:03:42,821 BE EDUCATION AND INCOME. 3874 03:03:42,821 --> 03:03:46,058 SO LOWER SOCIO ECONOMIC STATUS 3875 03:03:46,058 --> 03:03:49,995 EXPERIENCE HEALTH PROBLEMS IN 3876 03:03:49,995 --> 03:03:54,066 INDIVIDUALS SHORTLY AFTER AND 3877 03:03:54,066 --> 03:03:57,503 HIGHER STATUS MAY NOT PRESENT 3878 03:03:57,503 --> 03:04:00,272 HEALTH PROBLEMS UNTIL 3879 03:04:00,272 --> 03:04:00,572 ENVIRONMENT. 3880 03:04:00,572 --> 03:04:02,975 THE LIFE COURSE PATTERNS BETWEEN 3881 03:04:02,975 --> 03:04:06,545 LOW SOCIO ECONOMIC STATUS 3882 03:04:06,545 --> 03:04:08,847 INDIVIDUALS MAY SUGGEST AN 3883 03:04:08,847 --> 03:04:09,782 INCREASING HEALTHY START IN 3884 03:04:09,782 --> 03:04:15,688 INDIVIDUALS. 3885 03:04:15,688 --> 03:04:16,255 IN THIS FIGURE I'M SHOWING 3886 03:04:16,255 --> 03:04:18,791 POVERTY RATES BY AGE GROUPS. 3887 03:04:18,791 --> 03:04:22,061 IN THE BLUE BAR 0 TO 17 AND 18 3888 03:04:22,061 --> 03:04:25,431 TO 65 IN THE ORANGE BAR AND 66 3889 03:04:25,431 --> 03:04:30,002 OR OLDER IN THE GRAY BAR AND WE 3890 03:04:30,002 --> 03:04:31,170 OBSERVE THE UNITED KINGDOM, 3891 03:04:31,170 --> 03:04:33,205 CANADA, THE UNITED STATES AND 3892 03:04:33,205 --> 03:04:34,073 MEXICO. 3893 03:04:34,073 --> 03:04:38,811 YOU CAN SEE HERE THAT THE 3894 03:04:38,811 --> 03:04:40,512 U.S. HAS HIGHER POVERTY RATES 3895 03:04:40,512 --> 03:04:42,147 THAN THE U.K. AND CANADA ACROSS 3896 03:04:42,147 --> 03:04:46,418 THE THREE AGE GROUPS WE HAVE 3897 03:04:46,418 --> 03:04:46,618 HERE. 3898 03:04:46,618 --> 03:04:49,421 THIS IS EXACTLY THE MOTIVATION 3899 03:04:49,421 --> 03:04:51,623 FOR THESE PRESENTATION AND FOR 3900 03:04:51,623 --> 03:04:52,224 THE RESEARCH PROJECTS. 3901 03:04:52,224 --> 03:04:57,463 AND IF WE ANALYZED FURTHER THE 3902 03:04:57,463 --> 03:04:58,297 POVERTY RATE IN THE U.S. IT'S 3903 03:04:58,297 --> 03:05:05,070 MUCH HIGHER IN BLACK AND 3904 03:05:05,070 --> 03:05:06,305 HISPANICS ALMOST DOUBLE IN THE 3905 03:05:06,305 --> 03:05:08,240 AGE GROUPS. 3906 03:05:08,240 --> 03:05:14,113 SO IN TERMS OF SOCIAL INSURANCE 3907 03:05:14,113 --> 03:05:23,389 PRMZ PROGRAMS COULD BE CASH OR 3908 03:05:23,389 --> 03:05:24,656 NON CASH AND PROGRAMS INCOME 3909 03:05:24,656 --> 03:05:28,293 PROGRAMS AND NON-CASH COULD BE 3910 03:05:28,293 --> 03:05:32,698 ACCESS TO HEALTH CARE, FOOD 3911 03:05:32,698 --> 03:05:36,068 STAMPS OR SUBSIDIES AND WE'LL 3912 03:05:36,068 --> 03:05:38,470 FOCUS ON CASH BENEFITS THAT 3913 03:05:38,470 --> 03:05:40,339 IMPACT OR IMPROVE SOCIO ECONOMIC 3914 03:05:40,339 --> 03:05:44,009 STATUS AND COULD BE TEMPORARY OR 3915 03:05:44,009 --> 03:05:44,510 PERMANENT. 3916 03:05:44,510 --> 03:05:50,015 SO TEMPORARY LIKE BASIC INCOME 3917 03:05:50,015 --> 03:05:53,485 PROGRAMS AND PERMANENT LIKE 3918 03:05:53,485 --> 03:05:56,288 OTHER INCOME PROGRAMS. 3919 03:05:56,288 --> 03:05:59,358 SO INTERVENTIONS ACCORDING TO 3920 03:05:59,358 --> 03:06:01,160 THEORY AND THE LIFE COURSE 3921 03:06:01,160 --> 03:06:02,594 APPROACH INTERVENTIONS THAT 3922 03:06:02,594 --> 03:06:06,031 IMPROVE SOCIO ECONOMIC STATUS 3923 03:06:06,031 --> 03:06:08,000 ACROSS THE LIFE COURSE COULD 3924 03:06:08,000 --> 03:06:12,204 AFFECT THE LIFE EXPOSURES AND 3925 03:06:12,204 --> 03:06:14,540 REDUCE HEALTH DISPARITIES. 3926 03:06:14,540 --> 03:06:16,742 WE'LL FOCUS ON THE DESIGN AND 3927 03:06:16,742 --> 03:06:18,477 EFFECT OF SUPPLEMENTAL PROGRAMS 3928 03:06:18,477 --> 03:06:21,547 FOR LOW-INCOME OLDER ADULTS AND 3929 03:06:21,547 --> 03:06:25,784 SINGLE MOTHERS WITH CHILDREN. 3930 03:06:25,784 --> 03:06:31,223 FIRST I'M GOING TO TALK ABOUT 3931 03:06:31,223 --> 03:06:31,857 THE EXPERIMENTAL SUPPLEMENTAL 3932 03:06:31,857 --> 03:06:33,659 PROGRAM FOR OLDER ADULTS. 3933 03:06:33,659 --> 03:06:38,730 THIS WAS CONDUCTED IN MEXICO IN 3934 03:06:38,730 --> 03:06:47,973 THE STATE OF YUCATAN PENINSULA 3935 03:06:47,973 --> 03:06:48,173 HERE. 3936 03:06:48,173 --> 03:06:50,142 IT HAS HIGH POVERTY RATES AND 3937 03:06:50,142 --> 03:06:53,178 INDIGENOUS POPULATION AND WE 3938 03:06:53,178 --> 03:06:54,379 FOCUSSED IN THE PROGRAM STARTED 3939 03:06:54,379 --> 03:06:57,950 70 YEARS OLD OR OLDER. 3940 03:06:57,950 --> 03:07:01,520 WE TESTED DIFFERENT 3941 03:07:01,520 --> 03:07:02,855 IMPLEMENTATION DESIGNS WHETHER 3942 03:07:02,855 --> 03:07:07,359 THE SUPPLEMENTAL INCOME WAS 3943 03:07:07,359 --> 03:07:11,897 DISPERSED EVERY MONTH OR TWO 3944 03:07:11,897 --> 03:07:13,132 MONTHS AND HOW WE IMPLEMENTED 3945 03:07:13,132 --> 03:07:15,467 WITH THE DEBIT CARD FOR 3946 03:07:15,467 --> 03:07:17,503 INDIVIDUALS WHO DOESN'T HAVE 3947 03:07:17,503 --> 03:07:20,772 PREVIOUS ACCESS TO THE FINANCIAL 3948 03:07:20,772 --> 03:07:23,809 SECTOR OR WERE ILLITERATE AND 3949 03:07:23,809 --> 03:07:25,811 WENT TO 28% OF THE MINIMUM WAGE 3950 03:07:25,811 --> 03:07:28,313 OR 55% OF THE MEDIAN HOUSEHOLD 3951 03:07:28,313 --> 03:07:28,547 INCOME. 3952 03:07:28,547 --> 03:07:31,884 I WOULD LIKE TO ACKNOWLEDGE THE 3953 03:07:31,884 --> 03:07:34,386 FUNDING FROM THE NATIONAL 3954 03:07:34,386 --> 03:07:35,754 INSTITUTE ON AGING, THE 3955 03:07:35,754 --> 03:07:38,157 GOVERNMENT OF THE STATE OF 3956 03:07:38,157 --> 03:07:39,591 YUCATAN MEXICO AND THE RAND 3957 03:07:39,591 --> 03:07:41,493 CORPORATION CENTER FOR THE STUDY 3958 03:07:41,493 --> 03:07:45,731 OF AGING. 3959 03:07:45,731 --> 03:07:48,233 I'M GOING TO BRIEFLY DESCRIBE 3960 03:07:48,233 --> 03:07:50,736 HOW WE ANALYZED THE EFFECTS OF 3961 03:07:50,736 --> 03:07:51,537 THE PROGRAM. 3962 03:07:51,537 --> 03:07:56,275 SO WE COLLECTED LONGITUDINAL 3963 03:07:56,275 --> 03:07:59,745 DATA AT BASELINE AND FOLLOW UP 3964 03:07:59,745 --> 03:08:01,680 SERVICE FOR TREATMENT AND 3965 03:08:01,680 --> 03:08:02,080 CONTROL GROUPS. 3966 03:08:02,080 --> 03:08:04,016 THE SURVEY WAS BASED ON THE 3967 03:08:04,016 --> 03:08:05,017 U.S. HEALTH AND RETIREMENT 3968 03:08:05,017 --> 03:08:08,887 SURVEY THE HRS AND THE MEXICAN 3969 03:08:08,887 --> 03:08:12,024 FAMILY SURVEY FROM THE HRS THAT 3970 03:08:12,024 --> 03:08:16,028 IS THE MEXICAN HEALTH AGING 3971 03:08:16,028 --> 03:08:16,228 STUDY. 3972 03:08:16,228 --> 03:08:19,998 WE COLLECTED DATA IN PERSON AND 3973 03:08:19,998 --> 03:08:23,135 ALSO COLLECTED BIOMARKERS AND 3974 03:08:23,135 --> 03:08:25,070 TROPO METRIC MEASUREMENTS AND 3975 03:08:25,070 --> 03:08:30,209 COLLECTED DATA AT THE COMMUNITY 3976 03:08:30,209 --> 03:08:38,884 LEVEL FOR INFRASTRUCTURE AND 3977 03:08:38,884 --> 03:08:40,452 THERE'S A LARGE INDIGENOUS 3978 03:08:40,452 --> 03:08:42,254 POPULATION AND MANY SPOKE MAYAN. 3979 03:08:42,254 --> 03:08:46,725 WE TRANSLATED TO SPANISH AND 3980 03:08:46,725 --> 03:08:49,228 MAYAN AND HIRED BILINGUAL 3981 03:08:49,228 --> 03:08:51,396 INTERVIEWERS TO CONDUCT THE 3982 03:08:51,396 --> 03:08:54,733 SURVEY IN SPANISH OR MAYAN AND 3983 03:08:54,733 --> 03:09:01,473 DID ABOUT 65,000 HOUSEHOLDS AND 3984 03:09:01,473 --> 03:09:03,408 INTRODUCED ABOUT 16,000 AND 3985 03:09:03,408 --> 03:09:07,879 VISITED GROCERY STORES AND LOOK 3986 03:09:07,879 --> 03:09:09,615 AT THE PRICES AND THE ECONOMY ON 3987 03:09:09,615 --> 03:09:12,217 THE PROGRAM. 3988 03:09:12,217 --> 03:09:14,386 SO I'M GOING TO GIVE AN OVERVIEW 3989 03:09:14,386 --> 03:09:20,459 OF THE FINDINGS OF THESE 3990 03:09:20,459 --> 03:09:21,226 SUPPLEMENTAL INCOME PROGRAM. 3991 03:09:21,226 --> 03:09:23,195 THIS IS THE RESULTS SIX MONTHS 3992 03:09:23,195 --> 03:09:27,366 AFTER THE INTRODUCTION OF THE 3993 03:09:27,366 --> 03:09:28,834 PROGRAM FOR THE PROGRAM 3994 03:09:28,834 --> 03:09:30,235 DISPERSED EVERY PUBLIC HEALTH. 3995 03:09:30,235 --> 03:09:33,272 SO WHAT WE FOUND WAS AN INCREASE 3996 03:09:33,272 --> 03:09:35,807 IN HEALTH CARE UTILIZATION. 3997 03:09:35,807 --> 03:09:36,975 AN INCREASE OF THOSE REPORTING 3998 03:09:36,975 --> 03:09:37,776 GOING TO THE DOCTOR AND NUMBER 3999 03:09:37,776 --> 03:09:40,946 OF VISITS TO THE DOCTOR AS WELL 4000 03:09:40,946 --> 03:09:41,847 IN MEDICATION ACCESS. 4001 03:09:41,847 --> 03:09:44,983 WE FOUND STRONG EFFECTS IN 4002 03:09:44,983 --> 03:09:46,251 COGNITIVE ABILITIES, REDUCTION 4003 03:09:46,251 --> 03:09:49,254 IN ANEMIA AND IMPROVEMENT IN 4004 03:09:49,254 --> 03:09:50,289 FOOD AVAILABILITY. 4005 03:09:50,289 --> 03:09:53,792 WE FOUND THERE WAS REDUCTION IN 4006 03:09:53,792 --> 03:09:55,327 WORK FOR PAY AND REDUCTION IN 4007 03:09:55,327 --> 03:09:57,129 FAMILY TRANSFER. 4008 03:09:57,129 --> 03:09:59,064 SO THIS MAY BE A POSITIVE OR 4009 03:09:59,064 --> 03:10:01,500 NEGATIVE OUTCOME OF THE PROGRAM 4010 03:10:01,500 --> 03:10:05,103 BECAUSE REDUCTION IN FAMILY 4011 03:10:05,103 --> 03:10:06,571 TRANSFERS WAS NOT COMPLETE NOT 4012 03:10:06,571 --> 03:10:09,274 100% OF THE AMOUNT OF THE SUB 4013 03:10:09,274 --> 03:10:12,044 SUBSIDY REPRESENTED BUT CLOSE TO 4014 03:10:12,044 --> 03:10:18,150 30% AND THAT MAY ALSO IMPLY AS 4015 03:10:18,150 --> 03:10:20,419 FREQUENTLY AND THE OLDER ADULT 4016 03:10:20,419 --> 03:10:23,822 AND MAY HELP IN OTHER CHORES OR 4017 03:10:23,822 --> 03:10:24,856 ACTIVITIES. 4018 03:10:24,856 --> 03:10:25,957 WE ANALYZED THE POTENTIAL 4019 03:10:25,957 --> 03:10:29,494 POSITIVE OR NEGATIVE EFFECTS OF 4020 03:10:29,494 --> 03:10:34,633 THE PROGRAM. 4021 03:10:34,633 --> 03:10:37,469 WE FOUND MECHANISMS FOR MEN AND 4022 03:10:37,469 --> 03:10:37,769 WOMEN. 4023 03:10:37,769 --> 03:10:40,539 WE FOUND A STRONG EFFECT ON 4024 03:10:40,539 --> 03:10:44,009 HEALTH FOR BOTH. 4025 03:10:44,009 --> 03:10:46,645 MAYBE EVEN MORE FOR WOMEN AND 4026 03:10:46,645 --> 03:10:49,314 WOMEN SPENT MORE ON HEALTH CARE 4027 03:10:49,314 --> 03:10:50,015 UTILIZATION AND MEN MORE ON FOOD 4028 03:10:50,015 --> 03:10:58,056 AVAILABILITY. 4029 03:10:58,056 --> 03:11:00,192 NOW, WHEN WE VARY THE FREQUENCY 4030 03:11:00,192 --> 03:11:00,792 OF THE PAYMENT WHAT HAPPENED? 4031 03:11:00,792 --> 03:11:03,929 SO WE CONFERRED A PROGRAM WHERE 4032 03:11:03,929 --> 03:11:05,497 THE INCOME SUPPLEMENT WAS 4033 03:11:05,497 --> 03:11:07,466 DISPERSED EVERY MONTH VERSUS 4034 03:11:07,466 --> 03:11:08,867 ANOTHER PROGRAM WHERE THE INCOME 4035 03:11:08,867 --> 03:11:11,169 SUPPLEMENT WAS DISPERSED EVERY 4036 03:11:11,169 --> 03:11:14,005 TWO MONTHS AND THESE ARE THE 4037 03:11:14,005 --> 03:11:15,941 EFFECTS OF THE PROGRAM 18 MONTHS 4038 03:11:15,941 --> 03:11:19,578 AFTER THE INTRODUCTION. 4039 03:11:19,578 --> 03:11:24,850 SO ACCORDING TO ECONOMIC THEORY, 4040 03:11:24,850 --> 03:11:26,618 IT SAYS THE INCREASE IN 4041 03:11:26,618 --> 03:11:29,221 PERMANENT INCOME WHAT HAPPENS TO 4042 03:11:29,221 --> 03:11:29,755 INDIVIDUALS? 4043 03:11:29,755 --> 03:11:32,124 THEY ADJUST THEIR BUDGET 4044 03:11:32,124 --> 03:11:34,826 CONSTRAINT AND CONSUMPTION 4045 03:11:34,826 --> 03:11:36,795 ACROSS PERIODS. 4046 03:11:36,795 --> 03:11:42,334 THIS WOULD IMPLY DIFFERENT 4047 03:11:42,334 --> 03:11:45,904 FREQUENCY PAYMENT AND MEAN 4048 03:11:45,904 --> 03:11:47,439 INDIVIDUALS CONTINUE CONSUMING 4049 03:11:47,439 --> 03:11:49,441 IN THE SAME RATE IN ALL THE 4050 03:11:49,441 --> 03:11:51,410 WEEKS DURING THE MONTHS. 4051 03:11:51,410 --> 03:11:53,812 NOW, PREVIOUS RESEARCH HAS FOUND 4052 03:11:53,812 --> 03:11:55,947 THAT FOR THE U.S. THAT 4053 03:11:55,947 --> 03:11:59,751 HOUSEHOLDS WITH LITTLE SAVINGS 4054 03:11:59,751 --> 03:12:07,659 DO NOT NUMBER HAVE CONSUMPTION 4055 03:12:07,659 --> 03:12:11,163 BETWEEN SOCIAL SECURITY PAYMENTS 4056 03:12:11,163 --> 03:12:12,898 AROUND IT'S LESS COSTLY FOR THE 4057 03:12:12,898 --> 03:12:15,167 GOVERNMENT TO DISPERSE INCOME 4058 03:12:15,167 --> 03:12:16,334 SUPPLEMENTS EVERY TWO MONTHS OR 4059 03:12:16,334 --> 03:12:18,937 WITH LESS FREQUENCY. 4060 03:12:18,937 --> 03:12:21,440 AROUND THE WORLD THERE ARE MORE 4061 03:12:21,440 --> 03:12:23,241 PROGRAMS DISPERSED EVERY TWO 4062 03:12:23,241 --> 03:12:27,946 MONTHS AND WANTED TO TEST WHAT 4063 03:12:27,946 --> 03:12:28,880 HAPPENS IF WE HAVE MORE FREQUENT 4064 03:12:28,880 --> 03:12:34,252 PAYMENTS IN CONSUMPTION AND 4065 03:12:34,252 --> 03:12:35,253 HEALTH. 4066 03:12:35,253 --> 03:12:37,589 HERE WE CAN OBSERVE FOOD 4067 03:12:37,589 --> 03:12:38,824 EXPENDITURE PER CAPITA AFTER THE 4068 03:12:38,824 --> 03:12:39,624 INTRODUCTION OF THE PROGRAM. 4069 03:12:39,624 --> 03:12:41,193 IF YOU CAN SEE THE FIRST ONE IS 4070 03:12:41,193 --> 03:12:43,762 FOR THE MONTHLY PROGRAM AND THE 4071 03:12:43,762 --> 03:12:46,264 SECOND ONE BELOW IS FOR THE 4072 03:12:46,264 --> 03:12:48,166 EVERY TWO MONTH PROGRAM. 4073 03:12:48,166 --> 03:12:53,505 THE EVERY TWO MONTH PROGRAM WE 4074 03:12:53,505 --> 03:13:03,915 SEE THE SAME AMOUNT EVERY TWO 4075 03:13:03,915 --> 03:13:04,516 MONTHS. 4076 03:13:04,516 --> 03:13:07,786 THIS IS THE DAY THEY RECEIVE THE 4077 03:13:07,786 --> 03:13:09,321 INCOME SUPPLEMENT AND IN THE 4078 03:13:09,321 --> 03:13:11,957 HORIZONTAL ACCESS YOU CAN SEE 4079 03:13:11,957 --> 03:13:15,627 THESE ARE THE NUMBER OF WAYS 4080 03:13:15,627 --> 03:13:22,133 AFTER THEY RECEIVE THE INCOME 4081 03:13:22,133 --> 03:13:23,068 SUPPLEMENT. 4082 03:13:23,068 --> 03:13:33,612 TWO WEEKS LATER WE SEE THE FLAT 4083 03:13:38,950 --> 03:13:42,420 PATTERN OF FOOD EXPOSURE SO LIKE 4084 03:13:42,420 --> 03:13:46,625 THE FIRST FIGURE. 4085 03:13:46,625 --> 03:13:48,393 AND ZERO WAS THE FIRST DAY OF 4086 03:13:48,393 --> 03:13:50,529 THE MONTH AND WE COULD OBSERVE A 4087 03:13:50,529 --> 03:13:53,098 FLAT OR FLATTER OR SMOOTHER 4088 03:13:53,098 --> 03:13:56,434 PATTERN OF FOOD EXPENDITURE FOR 4089 03:13:56,434 --> 03:13:58,436 BOTH POPULATIONS BEFORE THE 4090 03:13:58,436 --> 03:13:59,371 IMPLEMENTATION OF THE PROGRAM. 4091 03:13:59,371 --> 03:14:03,108 ONCE WE INTRODUCED IT EVERY 4092 03:14:03,108 --> 03:14:05,277 MONTH AND SEE A FLAT PATTERN AND 4093 03:14:05,277 --> 03:14:07,879 HIGHER LEVEL BECAUSE THEY HAVE 4094 03:14:07,879 --> 03:14:11,049 NOW THE SUBSIDIES AND SPENDING 4095 03:14:11,049 --> 03:14:13,518 MORE ON FOOD BUT IN THE EVERY 4096 03:14:13,518 --> 03:14:14,452 TWO MONTH PROGRAM WE OBSERVE 4097 03:14:14,452 --> 03:14:15,887 SOMETHING DIFFERENT. 4098 03:14:15,887 --> 03:14:20,058 YOU CAN SEE HERE WHERE WE HAVE 4099 03:14:20,058 --> 03:14:22,394 THE ZERO THE FIRST DAY THEY 4100 03:14:22,394 --> 03:14:23,495 START RECEIVING THE SUPPLEMENT 4101 03:14:23,495 --> 03:14:24,563 THEY INCREASE THEIR FOOD 4102 03:14:24,563 --> 03:14:27,632 EXPENDITURE AND MAYBE THE FIRST 4103 03:14:27,632 --> 03:14:30,101 2.5 WEEKS AND THEN THEY THERE 4104 03:14:30,101 --> 03:14:35,040 SAY SHARP DECLINE IN FOOD 4105 03:14:35,040 --> 03:14:35,874 EXPENDITURE. 4106 03:14:35,874 --> 03:14:39,010 SO THIS MAY IMPLY HOUSEHOLDS ARE 4107 03:14:39,010 --> 03:14:40,812 INCREASING THEIR FOOD 4108 03:14:40,812 --> 03:14:42,614 EXPENDITURE THE FIRST 2.5 WEEKS 4109 03:14:42,614 --> 03:14:45,951 AND THERE'S A SHARP DECLINE. 4110 03:14:45,951 --> 03:14:56,494 WE OBSERVE WHERE YOU SEE HERE AN 4111 03:14:58,730 --> 03:15:01,032 INCREASE IN FAMILY TRANSFERS AND 4112 03:15:01,032 --> 03:15:05,704 REDUCE THE FOOD EXPENDITURE THEY 4113 03:15:05,704 --> 03:15:07,505 START TRANSFERRING BEFORE THE 4114 03:15:07,505 --> 03:15:10,575 NEXT PAYCHECK OR JUST BEFORE 4115 03:15:10,575 --> 03:15:14,713 THEY RECEIVE THE NEXT 4116 03:15:14,713 --> 03:15:16,281 DISBURSEMENT OF THE INCOME 4117 03:15:16,281 --> 03:15:21,519 SUPPLEMENT AND MAY IMPLY BECAUSE 4118 03:15:21,519 --> 03:15:27,292 BECAUSE THEY DECLINE THE FOOD 4119 03:15:27,292 --> 03:15:30,595 EXPENDITURE AND THIS IS THE 4120 03:15:30,595 --> 03:15:32,530 POVERTY CYCLE FOR THE FIRST 4121 03:15:32,530 --> 03:15:37,569 WEEKS AND THEN FOOD EXPENDITURE 4122 03:15:37,569 --> 03:15:44,042 DROPS SIGNIFICANTLY. 4123 03:15:44,042 --> 03:15:45,744 SO WHY ARE INDIVIDUALS, WHY IS 4124 03:15:45,744 --> 03:15:46,878 THE CONSUMPTION MOVING. 4125 03:15:46,878 --> 03:15:49,514 IT MAY BE THE LACK OF SAVINGS. 4126 03:15:49,514 --> 03:15:56,788 PREVIOUS RESEARCH HAS FOUND 4127 03:15:56,788 --> 03:15:59,290 LOW-INCOME INDIVIDUALS DON'T 4128 03:15:59,290 --> 03:16:04,696 HAVE ACCESS TO THE FINANCIAL 4129 03:16:04,696 --> 03:16:07,666 SECTOR AND IF THEY SAVE UNDER 4130 03:16:07,666 --> 03:16:08,700 THEIR MATTRESS THEY MAY HAVE 4131 03:16:08,700 --> 03:16:10,468 FEAR OF IT BEING STOLEN AND 4132 03:16:10,468 --> 03:16:11,836 WAITING TO MAINTAIN A LARGE 4133 03:16:11,836 --> 03:16:12,804 AMOUNT OF MONEY PAUSE OF FAMILY 4134 03:16:12,804 --> 03:16:17,142 PRESSURES. 4135 03:16:17,142 --> 03:16:21,880 PREVIOUS RESEARCH FOUND WHEN 4136 03:16:21,880 --> 03:16:25,483 INDIVIDUALS RECEIVE LARGE 4137 03:16:25,483 --> 03:16:27,485 DISBURSEMENTS MAY FACILITATE 4138 03:16:27,485 --> 03:16:32,157 HOME IMPROVEMENTS OR DURABLE 4139 03:16:32,157 --> 03:16:34,693 GOODS WITH THAT AMOUNT AND SHOW 4140 03:16:34,693 --> 03:16:36,161 YOU WHAT WE FOUND IN THE AFFECTS 4141 03:16:36,161 --> 03:16:37,829 OF THE PROGRAM AND THE EVERY TWO 4142 03:16:37,829 --> 03:16:38,697 MONTH PROGRAM. 4143 03:16:38,697 --> 03:16:42,867 IN THE FIRST COLUMN WE SEE THE 4144 03:16:42,867 --> 03:16:45,837 EFFECTS OF THE PROGRAM. 4145 03:16:45,837 --> 03:16:48,039 STRONG INCREASING FOOD 4146 03:16:48,039 --> 03:16:49,507 AVAILABILITY AND HEALTH CARE 4147 03:16:49,507 --> 03:16:50,341 UTILIZATION. 4148 03:16:50,341 --> 03:16:54,412 NO CHANGES ON BUYING DURABLE 4149 03:16:54,412 --> 03:16:59,117 GOODS HOWEVER WE FOUND IMPROVED 4150 03:16:59,117 --> 03:17:01,352 AVAILABILITY IS NOT AS STRONG OR 4151 03:17:01,352 --> 03:17:03,121 HIGH AS IN THE PROGRAM. 4152 03:17:03,121 --> 03:17:05,623 AND WE FOUND NO EFFECTS ON 4153 03:17:05,623 --> 03:17:08,893 HEALTH CARE UTILIZATION BUT FIND 4154 03:17:08,893 --> 03:17:11,930 AN INCREASE IN DURABLE GOODS 4155 03:17:11,930 --> 03:17:12,597 PARTICULARLY CELL PHONES WITH 4156 03:17:12,597 --> 03:17:15,800 THE AMOUNT OF MONEY RECEIVED 4157 03:17:15,800 --> 03:17:18,069 EVERY MONTH THEY CAN AFFORD CELL 4158 03:17:18,069 --> 03:17:24,209 PHONES AND OTHER DURABLE GOODS 4159 03:17:24,209 --> 03:17:25,210 OF SIMILAR PRICE. 4160 03:17:25,210 --> 03:17:26,745 THIS IS AN OVERVIEW OF THE 4161 03:17:26,745 --> 03:17:27,879 DIFFERENT RESEARCH PRODUCED FROM 4162 03:17:27,879 --> 03:17:30,215 THE EXPERIMENTS BUT JUST TO GIVE 4163 03:17:30,215 --> 03:17:34,252 A SUMMARY. 4164 03:17:34,252 --> 03:17:35,620 SO THE SUPPLEMENTAL INCOME 4165 03:17:35,620 --> 03:17:36,588 PROGRAM IMPLEMENTED EVERY MONTH 4166 03:17:36,588 --> 03:17:42,627 OR TWO MONTHS AND FOUND 4167 03:17:42,627 --> 03:17:45,063 DIFFERENT MECHANISMS FOR WOMEN 4168 03:17:45,063 --> 03:17:47,665 AND MEN AND WOMEN INCREASING 4169 03:17:47,665 --> 03:17:48,500 THEIR HEALTH CARE UTILIZATION 4170 03:17:48,500 --> 03:17:51,636 AND MEN FOOD AVAILABILITY WE 4171 03:17:51,636 --> 03:17:55,774 FOUND STRONG EFFECTS IMPROVEMENT 4172 03:17:55,774 --> 03:17:57,275 IN LUNG FUNCTION AND IMMEDIATE 4173 03:17:57,275 --> 03:18:01,212 RECALL AND DECLINE OF DEPRESSIVE 4174 03:18:01,212 --> 03:18:03,014 SYMPTOMS AND IMPROVEMENT IN 4175 03:18:03,014 --> 03:18:06,151 OBJECTIVE LIFE EXPECTANCY AND 4176 03:18:06,151 --> 03:18:07,819 REDUCTION IN FRAILTY 4177 03:18:07,819 --> 03:18:09,053 PARTICULARLY FOR WOMEN. 4178 03:18:09,053 --> 03:18:11,289 IN CONTRAST THE EVERY TWO MONTH 4179 03:18:11,289 --> 03:18:13,491 PROGRAM WE FIND IMPROVEMENT IN 4180 03:18:13,491 --> 03:18:18,997 FOOD AVAILABILITY AND DURABLE 4181 03:18:18,997 --> 03:18:21,332 GOODS BUT NO EFFECTS IN THE 4182 03:18:21,332 --> 03:18:22,033 OUTCOMES I MENTIONED BEFORE IN 4183 03:18:22,033 --> 03:18:32,443 TERMS OF HEALTH. 4184 03:18:32,443 --> 03:18:34,412 EVEN WHEN THEY'RE OLDER ADULTS 4185 03:18:34,412 --> 03:18:42,053 OR OLDER IN A VERY DISADVANTAGED 4186 03:18:42,053 --> 03:18:43,054 SITUATION WITH CHRONIC 4187 03:18:43,054 --> 03:18:44,455 CONDITIONS THERE'S STRONG 4188 03:18:44,455 --> 03:18:51,296 EFFECTS OF A CASH TRANSFER 4189 03:18:51,296 --> 03:19:01,439 PROGRAM. 4190 03:19:07,645 --> 03:19:11,316 WE DECIDED TO ANALYZE THIS AND 4191 03:19:11,316 --> 03:19:14,819 NOW WORKING WITH THE CITY OF 4192 03:19:14,819 --> 03:19:17,388 PROMOTING CLINICAL RESEARCH TO 4193 03:19:17,388 --> 03:19:19,123 IMPLEMENT A CASH TRANSFER 4194 03:19:19,123 --> 03:19:24,229 PROGRAM FOR SINGLE MOTHERS FOR 4195 03:19:24,229 --> 03:19:24,562 CHILDREN. 4196 03:19:24,562 --> 03:19:30,368 I'M TALK BRIEFLY ABOUT THE 4197 03:19:30,368 --> 03:19:34,305 PROGRAM. 4198 03:19:34,305 --> 03:19:39,944 IT'S FOR 12 MONTHS AND THESE ARE 4199 03:19:39,944 --> 03:19:43,915 PARTICULARLY SINGLE MOTHER THAT 4200 03:19:43,915 --> 03:19:45,884 HAVE AN INCOME BELOW THE POVERTY 4201 03:19:45,884 --> 03:19:46,084 LINE. 4202 03:19:46,084 --> 03:19:46,985 THE PROJECT IS ONGOING. 4203 03:19:46,985 --> 03:19:49,220 I'M GOING TO SHOW THE PRIMARY 4204 03:19:49,220 --> 03:19:53,358 RESULTS OF THE BASELINE SURVEY 4205 03:19:53,358 --> 03:19:57,362 AND FOCUS GROUPS AND HAVE A 4206 03:19:57,362 --> 03:20:00,298 FOLLOW UP SURVEY AND HAVE A 4207 03:20:00,298 --> 03:20:01,833 CONTROL GROUP IN THIS EXPERIMENT 4208 03:20:01,833 --> 03:20:08,106 AS WELL. 4209 03:20:08,106 --> 03:20:10,208 THIS IS THE CONCEPTUAL WORK OF 4210 03:20:10,208 --> 03:20:11,075 THE SURVEY. 4211 03:20:11,075 --> 03:20:15,914 WHERE WE HAVE THE INTERVENTIONAL 4212 03:20:15,914 --> 03:20:17,882 INCOME PROGRAM AND HAVE. 4213 03:20:17,882 --> 03:20:18,883 EXPERTS IN THE DIFFERENT TOPICS 4214 03:20:18,883 --> 03:20:24,389 AND HAVE A MULTI-DISCIPLINARY 4215 03:20:24,389 --> 03:20:27,625 GROUP AND PRODUCED FINDINGS IN 4216 03:20:27,625 --> 03:20:29,594 MATERNAL AND CHILDHOOD AND 4217 03:20:29,594 --> 03:20:33,498 FAMILY OUTCOMES PARTICULARLY ON 4218 03:20:33,498 --> 03:20:35,199 HEALTH, AND CHANGES ON 4219 03:20:35,199 --> 03:20:37,035 EMPLOYMENT ALSO FAMILY OUTCOMES 4220 03:20:37,035 --> 03:20:40,271 RELATED TO FOOD AVAILABILITY, 4221 03:20:40,271 --> 03:20:41,506 ECONOMIC STRENGTH AND HEALTH 4222 03:20:41,506 --> 03:20:49,914 OUTCOMES FOR CHILDREN. 4223 03:20:49,914 --> 03:20:53,051 SO THESE ARE THE RESULTS OF THE 4224 03:20:53,051 --> 03:20:54,185 BASELINE STUDY OF THESE 4225 03:20:54,185 --> 03:20:54,686 PROGRAMS. 4226 03:20:54,686 --> 03:20:57,188 SO WE HAVE IN THE FIGURES 4227 03:20:57,188 --> 03:20:59,824 TREATMENT AND CONTROL GROUPS 4228 03:20:59,824 --> 03:21:02,760 INCLUDED IN THE FIGURES. 4229 03:21:02,760 --> 03:21:07,765 SO YOU CAN SEE HERE THAT MOST 4230 03:21:07,765 --> 03:21:09,167 THE WOMEN ARE BETWEEN 31 AND 40 4231 03:21:09,167 --> 03:21:09,934 YEARS OLD. 4232 03:21:09,934 --> 03:21:15,340 THEY HAVE BETWEEN ONE AND TWO 4233 03:21:15,340 --> 03:21:19,777 CHILDREN IN THE HOUSEHOLD 90% 4234 03:21:19,777 --> 03:21:24,782 ARE LATINX OR HISPANIC AND 4235 03:21:24,782 --> 03:21:26,651 INTERESTING TO HIGHLIGHT 4236 03:21:26,651 --> 03:21:30,922 EDUCATION AND CLOSE TO 80% OF 4237 03:21:30,922 --> 03:21:33,491 HIGH SCHOOL GRADUATES HAVE LESS 4238 03:21:33,491 --> 03:21:35,560 THAN HIGH SCHOOL AND BLUE 4239 03:21:35,560 --> 03:21:41,032 SECTIONS OF THE PIE AND I THINK 4240 03:21:41,032 --> 03:21:43,568 IT'S WORTH HIGHLIGHTING AND 4241 03:21:43,568 --> 03:21:44,168 THERE'S BEEN MORE RESEARCH 4242 03:21:44,168 --> 03:21:46,904 COMING OUT INDIVIDUALS THAT HAVE 4243 03:21:46,904 --> 03:21:49,974 LESS THAN COLLEGE EDUCATION ARE 4244 03:21:49,974 --> 03:21:54,846 MORE LIKELY TO EXPERIENCE 4245 03:21:54,846 --> 03:21:59,550 INVOLUNTARY JOB SEPARATION. 4246 03:21:59,550 --> 03:22:00,785 MANY ARE PUSHED OUT OF THE LABOR 4247 03:22:00,785 --> 03:22:03,454 FORCE AND MAY COME BACK TO WORK 4248 03:22:03,454 --> 03:22:08,259 AS SELF-EMPLOYED OR PART-TIME 4249 03:22:08,259 --> 03:22:13,031 WORKERS BUT IT'S NOW IN THE 4250 03:22:13,031 --> 03:22:14,799 MARKET THERE'S A LOT OF PEOPLE 4251 03:22:14,799 --> 03:22:15,666 PARTICULARLY TO SUCCEED 4252 03:22:15,666 --> 03:22:18,669 PARTICULARLY TO THOSE WITH LESS 4253 03:22:18,669 --> 03:22:20,438 THAN COLLEGE EDUCATION. 4254 03:22:20,438 --> 03:22:23,241 WE THINK OF POVERTY BEING IN 4255 03:22:23,241 --> 03:22:23,941 POVERTY DURING YOUR PRIME 4256 03:22:23,941 --> 03:22:26,110 WORKING YEARS WILL LIKELY 4257 03:22:26,110 --> 03:22:28,012 TRANSLATE TO POVERTY IN OLD AGE. 4258 03:22:28,012 --> 03:22:31,115 IT'S VERY IMPORTANT TO CONSIDER 4259 03:22:31,115 --> 03:22:32,717 THIS AS THE POPULATION IN THE 4260 03:22:32,717 --> 03:22:35,019 U.S. IS AGING RAPIDLY PROBABLY 4261 03:22:35,019 --> 03:22:38,990 MORE THAN EVER BEFORE AND WE 4262 03:22:38,990 --> 03:22:44,195 HAVE PARTICULARLY FOR BLACK AND 4263 03:22:44,195 --> 03:22:45,496 HISPANICS THEY'LL DOUBLE IN THE 4264 03:22:45,496 --> 03:22:48,633 NEXT DECADES AND SO WE HAVE TO 4265 03:22:48,633 --> 03:22:50,001 THINK ABOUT IF WE DON'T 4266 03:22:50,001 --> 03:22:55,239 INTERVENE SOON WE'RE GOING TO 4267 03:22:55,239 --> 03:22:57,575 HAVE A HIGHER POVERTY RATES AT 4268 03:22:57,575 --> 03:23:04,215 OLDER AGES. 4269 03:23:04,215 --> 03:23:06,517 THESE ARE OUTCOMES OF THE SURVEY 4270 03:23:06,517 --> 03:23:09,253 AND DEPRESSIVE SYMPTOMS WE FOUND 4271 03:23:09,253 --> 03:23:12,623 CLOSE TO 50% OF THE PARTICIPANTS 4272 03:23:12,623 --> 03:23:15,660 REPORT HAVING DEPRESSIVE 4273 03:23:15,660 --> 03:23:15,927 SYMPTOMS. 4274 03:23:15,927 --> 03:23:19,931 IN TERMS OF PERCEIVED STRESS WE 4275 03:23:19,931 --> 03:23:22,433 OBSERVED MOST THE TIME CLOSE TO 4276 03:23:22,433 --> 03:23:32,810 40% AND 44% SOMETIMES. 4277 03:23:33,177 --> 03:23:37,482 MORE THAN 50% SHOW THEY'RE NOT 4278 03:23:37,482 --> 03:23:38,683 CONFIDENT AT ALL AND THEY HAVE 4279 03:23:38,683 --> 03:23:40,618 THEIR DEBT UNDER CONTROL. 4280 03:23:40,618 --> 03:23:42,553 IN TERMS OF LIKE HOW MUCH DEBT 4281 03:23:42,553 --> 03:23:46,424 INFLUENCE THEIR LIFE MORE THAN 4282 03:23:46,424 --> 03:23:49,494 50% REPORT A LOT OF OR A GREAT 4283 03:23:49,494 --> 03:23:59,604 DEAL. 4284 03:24:01,439 --> 03:24:02,306 AND IN DECEMBER THAT WAS 4285 03:24:02,306 --> 03:24:03,875 INTRODUCTION OF THE PROGRAM AND 4286 03:24:03,875 --> 03:24:04,642 THE PARTICIPANTS REPORTED MAINLY 4287 03:24:04,642 --> 03:24:12,950 THEY WERE SPENDING THE MONEY ON 4288 03:24:12,950 --> 03:24:13,751 FOOD CLOTHING, SCHOOL SUPPLIES 4289 03:24:13,751 --> 03:24:24,061 AND RENT AND GAS. 4290 03:24:24,829 --> 03:24:26,364 AND THERE'S REDUCED ECONOMIC 4291 03:24:26,364 --> 03:24:28,199 STRENGTH AND IMPROVE MENTAL 4292 03:24:28,199 --> 03:24:29,700 HEALTH AND REDUCED DEPRESSION 4293 03:24:29,700 --> 03:24:32,803 AND ANXIETY. 4294 03:24:32,803 --> 03:24:35,406 THEY HIGHLIGHTED IMPROVED THE 4295 03:24:35,406 --> 03:24:36,073 FLEET AND CHILDREN'S IMPROVEMENT 4296 03:24:36,073 --> 03:24:38,709 UP MENTAL HEALTH AND REDUCED 4297 03:24:38,709 --> 03:24:41,279 ANXIETY AND IMPROVED HOME 4298 03:24:41,279 --> 03:24:41,913 ENVIRONMENT BECAUSE THEY FELT 4299 03:24:41,913 --> 03:24:44,148 LESS STRESS AND MORE ABLE TO 4300 03:24:44,148 --> 03:24:46,350 SPEND TIME WITH THEIR FAMILY AND 4301 03:24:46,350 --> 03:24:48,653 I THINK IT'S WORTH ALSO 4302 03:24:48,653 --> 03:24:53,524 HIGHLIGHTING THEY ALSO MANY OF 4303 03:24:53,524 --> 03:24:56,894 THEM REPORTED THEY WERE ALLOWED 4304 03:24:56,894 --> 03:24:59,330 TO GET OUT OF THE SURVIVAL MODE 4305 03:24:59,330 --> 03:25:00,231 AND PLAN AHEAD. 4306 03:25:00,231 --> 03:25:02,800 MOST THE FOCUS GROUP 4307 03:25:02,800 --> 03:25:04,135 PARTICIPANTS REPORTED FEELING 4308 03:25:04,135 --> 03:25:05,536 DESPERATE BECAUSE OF THE RISING 4309 03:25:05,536 --> 03:25:11,909 PRICES IN THE U.S. 4310 03:25:11,909 --> 03:25:15,213 MANY OTHERS REPORTED USING THE 4311 03:25:15,213 --> 03:25:15,413 CASH. 4312 03:25:15,413 --> 03:25:18,816 ONE SAID SHE USED THE MONEY TO 4313 03:25:18,816 --> 03:25:20,785 TAKE A COURSE TO BECOME A HAIR 4314 03:25:20,785 --> 03:25:23,054 DRESSER AND THAT WOULD HELP 4315 03:25:23,054 --> 03:25:25,456 IMPROVE THEIR CAREER PROSPECTS 4316 03:25:25,456 --> 03:25:26,190 MORE THAN THE CURRENT JOB SHE 4317 03:25:26,190 --> 03:25:36,400 HAD. 4318 03:25:36,400 --> 03:25:41,505 IN TERMS OF THE FINDINGS IN THE 4319 03:25:41,505 --> 03:25:42,807 RESEARCH AND ANXIETY RUNS 4320 03:25:42,807 --> 03:25:46,010 BETWEEN SOCIO CLERK AND HEALTH 4321 03:25:46,010 --> 03:25:46,744 AND ENVIRONMENTAL METHODS GIVES 4322 03:25:46,744 --> 03:25:51,949 US THE OPPORTUNITY TO ANALYZE 4323 03:25:51,949 --> 03:25:54,252 THE EFFECT OF AND SHOCK ON THE 4324 03:25:54,252 --> 03:25:58,656 HOUSEHOLD OF THE PARTICIPANTS ON 4325 03:25:58,656 --> 03:26:05,429 HEALTH AND WELL BEING OF THE 4326 03:26:05,429 --> 03:26:09,734 RECIPIENTS AND EXPERIMENTAL 4327 03:26:09,734 --> 03:26:15,606 DESIGN WILL HELP IDENTIFY THE 4328 03:26:15,606 --> 03:26:16,240 MECHANISMS BETWEEN INCOME AND 4329 03:26:16,240 --> 03:26:20,978 HEALTH AND IT TRANSLATED TO HELP 4330 03:26:20,978 --> 03:26:25,483 US IMPLEMENT A PROGRAM IN THE 4331 03:26:25,483 --> 03:26:28,452 U.S. AND OBTAIN POTENTIALLY 4332 03:26:28,452 --> 03:26:32,056 BETTER HEALTH OUTCOMES IN THE 4333 03:26:32,056 --> 03:26:37,495 CITY OF EL MONTE AND CALIFORNIA 4334 03:26:37,495 --> 03:26:41,465 AND ONE KEY TAKEAWAY IS 4335 03:26:41,465 --> 03:26:44,201 IMPLEMENTATION MATTERS. 4336 03:26:44,201 --> 03:26:45,202 IT'S IMPORTANT TO THINK OF 4337 03:26:45,202 --> 03:26:47,238 HEALTH FOOD DESIGN AND PROGRAMS 4338 03:26:47,238 --> 03:26:50,207 TO HAVE A MORE EFFECTED IMPACT. 4339 03:26:50,207 --> 03:26:54,312 AND IT SEEMS BOTH PERMANENT AND 4340 03:26:54,312 --> 03:26:55,379 TEMPORARY INCOME PROGRAMS MORE 4341 03:26:55,379 --> 03:26:56,547 FREQUENT PAYMENTS WILL IMPROVE 4342 03:26:56,547 --> 03:26:58,049 THE HEALTH AND WELL BEING OF 4343 03:26:58,049 --> 03:27:05,489 RECIPIENTS. 4344 03:27:05,489 --> 03:27:15,666 THANK YOU. 4345 03:27:30,448 --> 03:27:33,250 >> THIS WAS WONDERING AND 4346 03:27:33,250 --> 03:27:41,992 WONDERING IF YOU CAN SPEAK TO 4347 03:27:41,992 --> 03:27:43,361 IMPLEMENTATION AND ARE THERE 4348 03:27:43,361 --> 03:27:46,464 PROGRAMS BUNDLED WITH THE 4349 03:27:46,464 --> 03:27:50,634 SUPPLEMENT AND DO YOU SEE THAT 4350 03:27:50,634 --> 03:27:52,570 POTENTIAL PAIRING AS AN 4351 03:27:52,570 --> 03:27:54,004 OPPORTUNITY FOR RESEARCH OR HAS 4352 03:27:54,004 --> 03:27:57,608 THAT BEEN DONE? 4353 03:27:57,608 --> 03:27:59,810 THIS IS NOT MY AREA. 4354 03:27:59,810 --> 03:28:04,382 >> IT'S IMPORTANT TO ANALYZE HOW 4355 03:28:04,382 --> 03:28:05,049 PROGRAMS COMPLEMENT EACH OTHER. 4356 03:28:05,049 --> 03:28:09,320 THEY FOCUS ON THE EFFECT OF 4357 03:28:09,320 --> 03:28:11,555 SPECIFIC PROGRAM SO WE EXPECTED 4358 03:28:11,555 --> 03:28:14,658 LIKE A YEAR AGO ANALYZING HAVING 4359 03:28:14,658 --> 03:28:16,527 ACCESS TO HEALTH CARE AND INCOME 4360 03:28:16,527 --> 03:28:19,597 OR SUPPLEMENTAL INCOME PROGRAM, 4361 03:28:19,597 --> 03:28:21,966 HOW DO THEY COMPLEMENT AND HOW 4362 03:28:21,966 --> 03:28:24,835 CAN WE BEST DESIGN THE PROGRAMS 4363 03:28:24,835 --> 03:28:32,910 SO THEY CAN COMPLEMENT BETTER 4364 03:28:32,910 --> 03:28:33,844 BECAUSE HEALTH CARE PROVIDES AN 4365 03:28:33,844 --> 03:28:35,946 INDIVIDUAL PERHAPS ACCESS TO 4366 03:28:35,946 --> 03:28:40,785 HEALTH INSURANCE AND HAVING 4367 03:28:40,785 --> 03:28:41,819 ADDITIONAL INCOME. 4368 03:28:41,819 --> 03:28:45,823 THERE'S NOT A LOT OF RESEARCH 4369 03:28:45,823 --> 03:28:50,428 AND IT'S AN IMPORTANT QUESTION. 4370 03:28:50,428 --> 03:28:51,429 >> EXCELLENT PRESENTATION AND TO 4371 03:28:51,429 --> 03:28:52,630 HEAR ABOUT YOUR WORK. 4372 03:28:52,630 --> 03:28:54,999 THERE'S BEEN SOME STUDIES THAT 4373 03:28:54,999 --> 03:28:59,170 INDICATED THAT IF YOU REDUCE 4374 03:28:59,170 --> 03:29:02,940 MATERNAL DEPRESSION, MOTHERS 4375 03:29:02,940 --> 03:29:03,674 PSYCHOSOCIAL STRESS YOU ALSO 4376 03:29:03,674 --> 03:29:06,143 HAVE IMPACT ON THE CHILDREN. 4377 03:29:06,143 --> 03:29:08,212 SO I WONDER IF I DON'T KNOW IF 4378 03:29:08,212 --> 03:29:10,948 YOU'RE DOING THAT IN THE CURRENT 4379 03:29:10,948 --> 03:29:12,049 STUDY OR IF THAT'S IN 4380 03:29:12,049 --> 03:29:13,784 CONSIDERATION FOR OTHER STUDIES 4381 03:29:13,784 --> 03:29:15,119 BUT ARE YOU MEASURING THE IMPACT 4382 03:29:15,119 --> 03:29:25,329 ON CHILDREN? 4383 03:29:29,967 --> 03:29:31,735 >> IN THE FOCUS GROUPS BECAUSE 4384 03:29:31,735 --> 03:29:33,838 THE MOTHERS ARE LESS STRESSED IT 4385 03:29:33,838 --> 03:29:35,372 CORRELATES TO LESS ANXIETY IN 4386 03:29:35,372 --> 03:29:41,612 THE CHILDREN BECAUSE THEY FEEL 4387 03:29:41,612 --> 03:29:47,218 STRESS AND THEY'RE PERHAPS LESS 4388 03:29:47,218 --> 03:29:48,686 PATIENT AND IMPROVED THE HOME 4389 03:29:48,686 --> 03:29:49,220 ENVIRONMENT AND IT'S AN 4390 03:29:49,220 --> 03:29:49,587 IMPORTANT POINT. 4391 03:29:49,587 --> 03:29:59,263 THANK YOU. 4392 03:29:59,263 --> 03:30:03,434 >> THANK YOU SO MUCH FOR THE 4393 03:30:03,434 --> 03:30:03,767 PRESENTATION. 4394 03:30:03,767 --> 03:30:11,208 I JUST WANT TO REFLECT, IF YOU 4395 03:30:11,208 --> 03:30:17,748 COULD, ON THE CONTEXT OF LATIN 4396 03:30:17,748 --> 03:30:20,150 AMERICA AND THE U.S. AND THESE 4397 03:30:20,150 --> 03:30:22,520 PROGRAMS HAVE BEEN IMPLEMENTED 4398 03:30:22,520 --> 03:30:25,456 IN OTHER COUNTRIES AND I'M MORE 4399 03:30:25,456 --> 03:30:28,692 FAMILIAR OF THE MEXICAN ONES AND 4400 03:30:28,692 --> 03:30:28,959 ARGENTINA. 4401 03:30:28,959 --> 03:30:30,928 SOME OF THE CRITIQUES COMING 4402 03:30:30,928 --> 03:30:34,765 FROM SOME PARTS OF SOCIETY IS 4403 03:30:34,765 --> 03:30:41,338 THAT IT'S DIVERTED THE FUNDS FOR 4404 03:30:41,338 --> 03:30:46,210 OTHER THINGS AND NOT USED ASS 4405 03:30:46,210 --> 03:30:48,178 INTENDED AND KEEPS PEOPLE FROM 4406 03:30:48,178 --> 03:30:50,381 GAINFUL EMPLOYMENT BY OH, WE 4407 03:30:50,381 --> 03:30:53,484 HAVE A SUBSIDY, WE DON'T HAVE TO 4408 03:30:53,484 --> 03:30:56,754 WORRY ABOUT WORKING. 4409 03:30:56,754 --> 03:31:00,491 COMMENT ON THAT AND THEN 4410 03:31:00,491 --> 03:31:01,458 RECENTLY IT'S BECOME -- I'M 4411 03:31:01,458 --> 03:31:04,194 GOING TO A RELATED SPECTRUM 4412 03:31:04,194 --> 03:31:08,666 WHICH IS BEHAVIORAL ECONOMICS 4413 03:31:08,666 --> 03:31:11,769 THE WHOLE ISSUE OF PAYING 4414 03:31:11,769 --> 03:31:13,871 INDIVIDUALS TO CHANGE BEHAVIOR 4415 03:31:13,871 --> 03:31:15,973 AND SO THAT HAS GOTTEN SOME 4416 03:31:15,973 --> 03:31:19,877 TRACTION OFTEN FUNDED BY NIA BUT 4417 03:31:19,877 --> 03:31:23,080 NOT EXCLUSIVELY ON SMOKING 4418 03:31:23,080 --> 03:31:28,185 CESSATION OR LOSING WEIGHT AND 4419 03:31:28,185 --> 03:31:30,454 MORE RECENTLY I THINK I WAS 4420 03:31:30,454 --> 03:31:33,524 READING A PLAN ALREADY STARTED 4421 03:31:33,524 --> 03:31:38,395 PAYMENTS TO INDIVIDUALS WHO HAVE 4422 03:31:38,395 --> 03:31:41,298 ADDICTION TO PARTICULAR 4423 03:31:41,298 --> 03:31:44,668 SUBSTANCES, NOT OPIOIDS BUT 4424 03:31:44,668 --> 03:31:47,204 AMPHETAMINE LIKE SUBSTANCES, 4425 03:31:47,204 --> 03:31:54,111 COCAINE, IF THEY SHOWED THEY ARE 4426 03:31:54,111 --> 03:31:55,346 WITHOUT USING DRUGS THROUGH 4427 03:31:55,346 --> 03:31:56,480 URINE TESTING TO REMAIN THAT WAY 4428 03:31:56,480 --> 03:32:00,651 AND HAVING TO PROVE IT WITH THE 4429 03:32:00,651 --> 03:32:02,119 URINE TESTS PERIODICALLY. 4430 03:32:02,119 --> 03:32:05,689 WOULD YOU COMMENT ON THIS LINE 4431 03:32:05,689 --> 03:32:08,258 OF WORK OF HOW THIS CAN BE USED 4432 03:32:08,258 --> 03:32:10,461 IN IMPROVING HEALTH? 4433 03:32:10,461 --> 03:32:11,729 >> THANK YOU. 4434 03:32:11,729 --> 03:32:16,767 >> THANK YOU FOR THE GREAT 4435 03:32:16,767 --> 03:32:17,034 QUESTION. 4436 03:32:17,034 --> 03:32:23,407 SO YES, PARTICULARLY GOVERNMENTS 4437 03:32:23,407 --> 03:32:25,075 AROUND THE WORLD ASKING IF WE 4438 03:32:25,075 --> 03:32:26,844 GIVE CASH TO INDIVIDUALS HOW 4439 03:32:26,844 --> 03:32:32,383 WILL THEY USE THE MONEY USING ON 4440 03:32:32,383 --> 03:32:33,484 SMOKING OR AND AS THE BEEN SHOWN 4441 03:32:33,484 --> 03:32:40,324 THAT THIS IS NOT THE CASE. 4442 03:32:40,324 --> 03:32:43,761 VERY LOW INCOME POPULATION WE 4443 03:32:43,761 --> 03:32:45,396 SEE FREQUENT PAYMENTS MORE 4444 03:32:45,396 --> 03:32:47,665 FREQUENTLY ARE ABLE TO USE THE 4445 03:32:47,665 --> 03:32:53,504 CASH TRANSFER PROGRAMS FOR BASIC 4446 03:32:53,504 --> 03:32:53,704 NEEDS. 4447 03:32:53,704 --> 03:32:55,773 AND WE MAY THINK POLICY MAKERS 4448 03:32:55,773 --> 03:32:57,474 LIKE WE SHOULD DESIGN THIS TYPE 4449 03:32:57,474 --> 03:32:59,343 OF SPECIFIC PROGRAM BUT IT MAY 4450 03:32:59,343 --> 03:33:01,779 BE IT'S NOT ONE SIZE FITS ALL. 4451 03:33:01,779 --> 03:33:03,147 AND HAVING A CASH TRANSFER 4452 03:33:03,147 --> 03:33:05,582 PROGRAM I WOULD SAY IS MORE 4453 03:33:05,582 --> 03:33:07,418 FLEXIBLE AND INDIVIDUALS HAVE 4454 03:33:07,418 --> 03:33:09,486 THE AGENCY TO DECIDE HOW TO 4455 03:33:09,486 --> 03:33:10,721 SPEND THE MONEY. 4456 03:33:10,721 --> 03:33:13,590 AND I THINK WE SHOULD THINK THAT 4457 03:33:13,590 --> 03:33:15,492 ALL INDIVIDUALS HAVE THAT AGENCY 4458 03:33:15,492 --> 03:33:17,494 TO BE ABLE TO KNOW HOW TO SPEND 4459 03:33:17,494 --> 03:33:17,861 THE MONEY. 4460 03:33:17,861 --> 03:33:20,464 AND EVEN WHEN AS RESEARCHERS WE 4461 03:33:20,464 --> 03:33:22,833 MAY THINK THEY SHOULD HAVE SPENT 4462 03:33:22,833 --> 03:33:25,102 IT THIS WAY BECAUSE IT'S MAYBE 4463 03:33:25,102 --> 03:33:26,170 MORE EFFECTIVE I THINK EVERY 4464 03:33:26,170 --> 03:33:27,938 PERSON KNOWS HOW BEST AND HOW IT 4465 03:33:27,938 --> 03:33:32,209 WOULD BENEFIT THEM THE MOST 4466 03:33:32,209 --> 03:33:33,243 GIVEN THEIR CIRCUMSTANCES. 4467 03:33:33,243 --> 03:33:37,715 AND I THINK NOW THAT WE'RE USING 4468 03:33:37,715 --> 03:33:39,316 SOCIAL INSURANCE PROGRAMS 4469 03:33:39,316 --> 03:33:41,518 EXPERIMENTAL METHODS WE CAN 4470 03:33:41,518 --> 03:33:44,054 ANALYZE THE DIFFERENT EFFECTS IN 4471 03:33:44,054 --> 03:33:47,424 THE HEALTH AND WELL BEING OF 4472 03:33:47,424 --> 03:33:47,725 POPULATIONS. 4473 03:33:47,725 --> 03:33:50,527 SO I UNDERSTAND THE CONCERN BUT 4474 03:33:50,527 --> 03:33:52,496 I THINK NOW RESEARCH AROUND THE 4475 03:33:52,496 --> 03:33:53,497 WORLD HAS SHOWN THAT THIS IS NOT 4476 03:33:53,497 --> 03:33:59,203 THE CASE. 4477 03:33:59,203 --> 03:34:01,205 IN TERMS OF BEHAVIOR IT'S 4478 03:34:01,205 --> 03:34:02,406 DIFFICULT TO CHANGE BEHAVIOR. 4479 03:34:02,406 --> 03:34:03,974 THERE'S BEEN SO MANY EXPERIMENTS 4480 03:34:03,974 --> 03:34:08,779 ON HOW TO INCENTIVIZE OR SEE 4481 03:34:08,779 --> 03:34:13,717 CHANGES IN BEHAVIOR. 4482 03:34:13,717 --> 03:34:17,321 SO INCOME CAN BE RELATED 4483 03:34:17,321 --> 03:34:20,057 TRANSLATE TO LOWER DEPRESSIVE 4484 03:34:20,057 --> 03:34:21,592 SYMPTOMS OR LOWER ANXIETY AND 4485 03:34:21,592 --> 03:34:25,496 THIS COULD BE ASSOCIATED WITH 4486 03:34:25,496 --> 03:34:26,163 SPECIFIC BEHAVIORS. 4487 03:34:26,163 --> 03:34:28,599 SO I THINK THAT NEEDS TO BE 4488 03:34:28,599 --> 03:34:32,569 TESTED FURTHER BUT THERE COULD 4489 03:34:32,569 --> 03:34:35,572 BE A LINK BETWEEN THOSE ASPECTS 4490 03:34:35,572 --> 03:34:39,943 OF HEALTH RELATED BEHAVIORS. 4491 03:34:39,943 --> 03:34:46,183 I WILL SAY PARTICULARLY FROM THE 4492 03:34:46,183 --> 03:34:49,319 EXPERIMENT IN CALIFORNIA THEY'RE 4493 03:34:49,319 --> 03:34:50,821 ABLE TO USE TEMPORARY CASH 4494 03:34:50,821 --> 03:34:53,624 TRANSFER FOR 12 MONTHS AND HAVE 4495 03:34:53,624 --> 03:34:56,026 BEEN REPORTED BEING ABLE TO DO 4496 03:34:56,026 --> 03:34:57,227 COURSES OR DOING SOMETHING ELSE 4497 03:34:57,227 --> 03:35:00,998 THAT WOULD ALLOW THEM TO GET 4498 03:35:00,998 --> 03:35:03,534 MORE TRAINING AND BE ABLE TO 4499 03:35:03,534 --> 03:35:07,070 HAVE BETTER CAREER PROSPECTS. 4500 03:35:07,070 --> 03:35:10,340 SO, AGAIN, A SMALL AMOUNT OF 4501 03:35:10,340 --> 03:35:11,809 MONEY FREQUENTLY HIGHER 4502 03:35:11,809 --> 03:35:13,143 FREQUENCY COULD ALLOW 4503 03:35:13,143 --> 03:35:13,744 POPULATIONS TO CHANGE THEIR 4504 03:35:13,744 --> 03:35:19,950 BEHAVIORS. 4505 03:35:19,950 --> 03:35:21,451 >> DR. STONE. 4506 03:35:21,451 --> 03:35:25,489 THANK YOU FOR THE RESEARCH, 4507 03:35:25,489 --> 03:35:35,966 DR. AGUILA, AND HOW MANY 4508 03:35:36,767 --> 03:35:38,035 FAMILIES WERE YOU ABLE TO TEASE 4509 03:35:38,035 --> 03:35:38,669 OUT IMMIGRATION STATUS? 4510 03:35:38,669 --> 03:35:40,070 >> THAT WAS AN IMPORTANT 4511 03:35:40,070 --> 03:35:45,275 QUESTION FOR US. 4512 03:35:45,275 --> 03:35:48,779 WE WERE INTERESTED BUT WE DIDN'T 4513 03:35:48,779 --> 03:35:52,182 WANT TO ASK IMMIGRATION STATUS 4514 03:35:52,182 --> 03:35:53,350 BECAUSE THEY DIDN'T WANT TO 4515 03:35:53,350 --> 03:35:55,285 CAUSE FEAR ABOUT THIS SO WE 4516 03:35:55,285 --> 03:35:59,256 DON'T HAVE THAT INFORMATION. 4517 03:35:59,256 --> 03:36:00,490 >> THANK YOU. 4518 03:36:00,490 --> 03:36:01,091 THAT MAKES SENSE. 4519 03:36:01,091 --> 03:36:03,660 THE REASON I WAS ASKING AS WE 4520 03:36:03,660 --> 03:36:06,730 THINK OF FEDERAL, STATE AND 4521 03:36:06,730 --> 03:36:08,565 LOCALITIES IN TERMS OF OFFERING 4522 03:36:08,565 --> 03:36:11,735 CASH ASSISTANCE AND MITIGATING 4523 03:36:11,735 --> 03:36:14,571 THE CYCLES ACROSS FAMILIES 4524 03:36:14,571 --> 03:36:20,310 PARTICULARLY LOW-INCOME 4525 03:36:20,310 --> 03:36:22,679 IMMIGRANTS AND OTHERS, WITH 4526 03:36:22,679 --> 03:36:25,883 MINIMUM WAGE LOSS IT VARIES 4527 03:36:25,883 --> 03:36:29,620 BETWEEN $7 ALABAMA AND 4528 03:36:29,620 --> 03:36:31,555 MISSISSIPPI TO OTHER AREAS JUST 4529 03:36:31,555 --> 03:36:32,623 OVER $17. 4530 03:36:32,623 --> 03:36:35,058 MINIMUM WAGE PLAYS A BIG FACTOR 4531 03:36:35,058 --> 03:36:37,160 IN TERMS OF INCOME SECURITY BUT 4532 03:36:37,160 --> 03:36:43,600 THEN WITH SNAP AND FEDERAL 4533 03:36:43,600 --> 03:36:46,837 BENEFITS, IN AUTHORIZED OR 4534 03:36:46,837 --> 03:36:49,873 UNDOCUMENTED IMMIGRANTS ARE 4535 03:36:49,873 --> 03:36:51,208 INELIGIBLE BUT STATES ARE ABLE 4536 03:36:51,208 --> 03:36:52,276 TO DETERMINE AND POLICY WISE HOW 4537 03:36:52,276 --> 03:36:54,711 COULD WE TAKE SOME OF THE 4538 03:36:54,711 --> 03:36:57,047 FINDINGS SHOWING THE POSITIVE 4539 03:36:57,047 --> 03:36:58,148 IMPACTS AND MAKE THE CASE AT THE 4540 03:36:58,148 --> 03:37:01,485 STATE AND LOCAL LEVEL AND FOR 4541 03:37:01,485 --> 03:37:02,219 COUNTY GOVERNMENTS THERE'S ALSO 4542 03:37:02,219 --> 03:37:06,089 EXPRESSION AND AUTHORITY TO MAKE 4543 03:37:06,089 --> 03:37:11,828 CHOICES ON WHO CAN GET CASH 4544 03:37:11,828 --> 03:37:14,665 BENEFITS AND HOUSING ASSISTANCE. 4545 03:37:14,665 --> 03:37:20,304 I'M THINKING THILS IN TERMS 4546 03:37:20,304 --> 03:37:23,473 OF -- THIS IN TERMS OF POSITIVE 4547 03:37:23,473 --> 03:37:28,245 FINDING AND HOW TO SHARE THIS 4548 03:37:28,245 --> 03:37:31,581 WITH OTHER STATES AND RUNNING 4549 03:37:31,581 --> 03:37:32,249 THE DISSEMINATION. 4550 03:37:32,249 --> 03:37:36,853 >> THANK YOU FOR THE QUESTION. 4551 03:37:36,853 --> 03:37:38,789 YES, AS WE RANDOMIZE WE HAVE 4552 03:37:38,789 --> 03:37:41,325 MORE THAN 3,000 APPLICANTS FOR 4553 03:37:41,325 --> 03:37:44,895 ALL OVER THE COUNTRY. 4554 03:37:44,895 --> 03:37:47,698 SO THERE'S A HUGE NEED AND IT 4555 03:37:47,698 --> 03:37:50,701 WAS ONLY -- IT ONLY QUALIFIED 4556 03:37:50,701 --> 03:37:53,203 THOSE LIVING IN THE CITY OF EL 4557 03:37:53,203 --> 03:37:55,138 MONTE AND THOSE LIVING IN THAT 4558 03:37:55,138 --> 03:37:55,339 CITY. 4559 03:37:55,339 --> 03:37:57,240 THERE WERE NO OTHER REQUIREMENTS 4560 03:37:57,240 --> 03:38:01,345 BUT SHOWING YOU WERE BELOW THE 4561 03:38:01,345 --> 03:38:04,514 POVERTY LINE. 4562 03:38:04,514 --> 03:38:05,882 SO, WE DON'T HAVE THAT 4563 03:38:05,882 --> 03:38:08,018 RELATIONSHIP BECAUSE WE'RE NOT 4564 03:38:08,018 --> 03:38:13,323 ASKING BUT POTENTIALLY THERE ARE 4565 03:38:13,323 --> 03:38:14,958 IMMIGRANTS IN THE SAMPLE AND 4566 03:38:14,958 --> 03:38:16,326 IT'S AN IMPORTANT TOPIC. 4567 03:38:16,326 --> 03:38:19,663 THIS IS A GOOD OPTION TO HAVE 4568 03:38:19,663 --> 03:38:22,232 TEMPORARY CASH TRANSFER PROGRAMS 4569 03:38:22,232 --> 03:38:23,667 TO ALLOW PEOPLE TO MOST OF THEM 4570 03:38:23,667 --> 03:38:27,904 IN THE FOCUS GROUP BEING ABLE TO 4571 03:38:27,904 --> 03:38:30,941 BE LESS STRESSED AND THINK ABOUT 4572 03:38:30,941 --> 03:38:36,913 THE FUTURE AND HOW TO OVERCOME 4573 03:38:36,913 --> 03:38:39,149 COME THROUGH TRAINING OR HELPING 4574 03:38:39,149 --> 03:38:41,451 MORE THE CHILDREN THEY LAG 4575 03:38:41,451 --> 03:38:42,119 BEHIND DURING THE PANDEMIC. 4576 03:38:42,119 --> 03:38:44,554 MANY OF THEM WERE ONLINE AND 4577 03:38:44,554 --> 03:38:46,556 MANY REPORTED THEY HAD TO PAY 4578 03:38:46,556 --> 03:38:48,692 MONEY TO PAY PRIVATE CLASSES TO 4579 03:38:48,692 --> 03:38:50,560 HELP THEIR CHILDREN CATCH UP. 4580 03:38:50,560 --> 03:38:52,796 SO THERE'S MANY MANY NEEDS IN 4581 03:38:52,796 --> 03:38:54,931 THE COMMUNITY THAT THIS CASH 4582 03:38:54,931 --> 03:38:57,534 TRANSFER OR TEMPORARY CASH 4583 03:38:57,534 --> 03:38:59,269 TRANSFER COULD HELP. 4584 03:38:59,269 --> 03:39:03,273 IN TERMS OF DISSEMINATION OTHER 4585 03:39:03,273 --> 03:39:05,842 CITIES HAVE APPROACHES AND WE'VE 4586 03:39:05,842 --> 03:39:07,210 GIVEN INFORMATION ON THE SURVEY 4587 03:39:07,210 --> 03:39:07,844 AND MAY BE WORKING WITH SOME OF 4588 03:39:07,844 --> 03:39:14,551 THEM. 4589 03:39:14,551 --> 03:39:15,919 >> THANK YOU VERY MUCH. 4590 03:39:15,919 --> 03:39:17,487 IT'S BEEN A VERY GOOD 4591 03:39:17,487 --> 03:39:19,256 PRESENTATION AND RICH 4592 03:39:19,256 --> 03:39:19,890 DISCUSSION. 4593 03:39:19,890 --> 03:39:20,290 AND. 4594 03:39:20,290 --> 03:39:24,761 WE'RE GOING TO BREAK NOW FOR 4595 03:39:24,761 --> 03:39:24,995 LUNCH. 4596 03:39:24,995 --> 03:39:33,403 I REALLY NEED YOU BACK AT 1:14 4597 03:39:33,403 --> 03:39:35,372 UP YOUR SEATS BECAUSE THE 4598 03:39:35,372 --> 03:39:37,207 PRESENTATION WILL START AT 1:15 4599 03:39:37,207 --> 03:39:40,277 AND YOU WON'T WANT TO MISS A 4600 03:39:40,277 --> 03:39:41,111 MOMENT OF IT. 4601 03:39:41,111 --> 03:39:45,215 PLEASE GET BACK. 4602 03:39:45,215 --> 03:39:45,649 THANK YOU VERY MUCH. 4603 03:39:45,649 --> 03:39:45,715 4604 03:39:55,066 --> 03:39:57,902 >> WE'RE READY TO RESTART AND E 4605 03:39:57,902 --> 03:39:59,104 HAVE KARINA WALTERS. 4606 03:39:59,104 --> 03:40:00,672 IT'S BEEN A WONDERFUL 4607 03:40:00,672 --> 03:40:01,873 PARTNERSHIP ON MANY PROGRAMS. 4608 03:40:01,873 --> 03:40:02,941 I'M SURE SHE'S BEEN BUSY CROSS 4609 03:40:02,941 --> 03:40:07,812 THE AGENCY. 4610 03:40:07,812 --> 03:40:11,282 SHE'S A SOCIAL EPIDEMIOLOGIST 4611 03:40:11,282 --> 03:40:16,554 FOCUSED ON HEALTH PREVENTION AND 4612 03:40:16,554 --> 03:40:17,589 DISEASE. 4613 03:40:17,589 --> 03:40:21,026 SHE HAD A STELLAR CAREER IN THE 4614 03:40:21,026 --> 03:40:24,396 UNIVERSITY OF WASHINGTON WITH 4615 03:40:24,396 --> 03:40:27,599 RESEARCH IN SUBSTANCE ABUSE AND 4616 03:40:27,599 --> 03:40:30,568 PHYSICAL ACTIVITY PROMOTIONS AND 4617 03:40:30,568 --> 03:40:35,106 DIABETES PREVENTION AND 4618 03:40:35,106 --> 03:40:37,142 DEPRESSION IN HIV PREVENTION SHE 4619 03:40:37,142 --> 03:40:39,744 SERVED ON NUMEROUS NIH GRANTS AS 4620 03:40:39,744 --> 03:40:44,349 PRINCIPLE INVESTIGATOR OR 4621 03:40:44,349 --> 03:40:46,718 CLINICAL INVESTIGATOR INCLUDING 4622 03:40:46,718 --> 03:40:47,085 FROM NIMHD 4623 03:40:47,085 --> 03:40:49,954 >> I'LL GIVE A SHOUT OUT TO ONE 4624 03:40:49,954 --> 03:40:50,155 TODAY. 4625 03:40:50,155 --> 03:40:55,994 >> SHE WAS FULL PROFESSOR THERE 4626 03:40:55,994 --> 03:41:01,066 AS AT THE UNIVERSITY OF 4627 03:41:01,066 --> 03:41:03,401 WASHINGTON SCHOOL OF SOCIAL WORK 4628 03:41:03,401 --> 03:41:10,742 AND HER DEGREE IS FROM THE 4629 03:41:10,742 --> 03:41:12,043 UNIVERSITY OF CALIFORNIA LOS 4630 03:41:12,043 --> 03:41:12,944 ANGELES AND PLEASE WELCOME AND 4631 03:41:12,944 --> 03:41:15,180 WE LOOK FORWARD TO YOUR 4632 03:41:15,180 --> 03:41:23,488 PRESENTATION. 4633 03:41:23,488 --> 03:41:27,325 >> THANK YOU. 4634 03:41:27,325 --> 03:41:30,361 [SPEAKING NON-ENGLISH] 4635 03:41:30,361 --> 03:41:31,296 >> THE INDIGENOUS PEOPLES OF 4636 03:41:31,296 --> 03:41:31,896 THIS LAND. 4637 03:41:31,896 --> 03:41:32,897 GOOD AFTERNOON. 4638 03:41:32,897 --> 03:41:36,234 MY NAME IS KARINA WALTERS. 4639 03:41:36,234 --> 03:41:41,306 I JUST INTRODUCED MYSELF IN 4640 03:41:41,306 --> 03:41:42,307 INDIGENOUS LANGUAGE OF OKLAHOMA 4641 03:41:42,307 --> 03:41:43,942 AND PAY MY RESPECTS TO THE 4642 03:41:43,942 --> 03:41:45,343 INDIGENOUS PEOPLE OF THIS LAND 4643 03:41:45,343 --> 03:41:46,144 AND TERRITORY WE'RE IN. 4644 03:41:46,144 --> 03:41:48,046 IT'S AN HONOR AND PRIVILEGE TO 4645 03:41:48,046 --> 03:41:51,649 BE ABLE TO SHARE WITH YOU A 4646 03:41:51,649 --> 03:41:52,584 LITTLE BIT ABOUT THE TRIBAL 4647 03:41:52,584 --> 03:41:53,485 HEALTH RESEARCH OFFICE AND ABOUT 4648 03:41:53,485 --> 03:41:55,186 MY RESEARCH AND WHAT I BRING TO 4649 03:41:55,186 --> 03:41:57,589 THIS OFFICE AND A LITTLE BIT 4650 03:41:57,589 --> 03:41:58,623 ABOUT MY PHILOSOPHY IN THE WORK 4651 03:41:58,623 --> 03:42:05,864 I'VE BEEN DOING TO THIS POINT. 4652 03:42:05,864 --> 03:42:07,665 IT'S A BIG TRANSITION AN 4653 03:42:07,665 --> 03:42:08,733 EXCITING PLACE TO BE. 4654 03:42:08,733 --> 03:42:09,601 THE TRIBAL HEALTH RESEARCH 4655 03:42:09,601 --> 03:42:12,036 OFFICE SITS IN THE OFFICE OF THE 4656 03:42:12,036 --> 03:42:15,673 DIRECTOR WHERE ONE OF THE NOW 4657 03:42:15,673 --> 03:42:15,874 16. 4658 03:42:15,874 --> 03:42:19,677 IT WAS 14 OFFICES OF THE OFFICE 4659 03:42:19,677 --> 03:42:21,279 OF THE DIRECTOR. 4660 03:42:21,279 --> 03:42:30,221 WE'RE THE SYNERGISTIC HUB FOR 4661 03:42:30,221 --> 03:42:33,458 AMERICAN INDIAN AND INDIGENOUS 4662 03:42:33,458 --> 03:42:35,593 AND POPULATIONS AND TEND TO BE A 4663 03:42:35,593 --> 03:42:36,327 FORWARD FACING OFFICE A LITTLE 4664 03:42:36,327 --> 03:42:42,767 BIT MORE THAN OTHER OFFICES. 4665 03:42:42,767 --> 03:42:45,436 BECAUSE OF OUR ROLE AND WE 4666 03:42:45,436 --> 03:42:46,070 GENERATE DATA SCIENCE AND 4667 03:42:46,070 --> 03:42:48,606 WORKFORCE THAT BUILDS OFF THE 4668 03:42:48,606 --> 03:42:52,744 LIVES AND COMMUNITIES OUR 4669 03:42:52,744 --> 03:42:54,479 ULTIMATE GOAL IS TO BUILD HEALTH 4670 03:42:54,479 --> 03:43:00,118 EQUITY THROUGH CREDIBLE AND 4671 03:43:00,118 --> 03:43:01,386 MEANIN 4672 03:43:01,386 --> 03:43:09,460 MEANINGFUL INDIGENIST VIEWS AND 4673 03:43:09,460 --> 03:43:10,862 USING OUR VIEWS AND KNOWLEDGES 4674 03:43:10,862 --> 03:43:12,697 IN THE WORK WE DO. 4675 03:43:12,697 --> 03:43:15,200 AS THE THEME SUGGESTS IT'S ABOUT 4676 03:43:15,200 --> 03:43:16,301 INDIGENOUS KNOWLEDGES EMPOWERING 4677 03:43:16,301 --> 03:43:19,804 THE SCIENCE. 4678 03:43:19,804 --> 03:43:21,706 WE'RE FWIGUIDED BY VALUES DEVELD 4679 03:43:21,706 --> 03:43:22,974 SINCE I'VE BEEN HERE. 4680 03:43:22,974 --> 03:43:25,810 I KNEW I HAD TO MAKE AN ACRONYM 4681 03:43:25,810 --> 03:43:29,180 SO WE CHOSE THE ACRONYM CEDAR. 4682 03:43:29,180 --> 03:43:30,215 IT'S A BEAUTIFUL MEDICINE TO 4683 03:43:30,215 --> 03:43:32,584 INDIGENOUS PEOPLE ALL OVER THE 4684 03:43:32,584 --> 03:43:37,722 COUNTRY UP TO ALASKA AND OFTEN 4685 03:43:37,722 --> 03:43:39,257 IT'S A MEDICINE FOR CLEANSING 4686 03:43:39,257 --> 03:43:41,459 AND PURIFYING AND HEALING AND 4687 03:43:41,459 --> 03:43:42,060 MULTIPLE PURPOSES. 4688 03:43:42,060 --> 03:43:44,596 WE CHOSE THE WORD TO GUIDE US 4689 03:43:44,596 --> 03:43:47,332 THROUGH OUR ACTIONS AND C STAND 4690 03:43:47,332 --> 03:43:50,501 FOR CREATIVITY. 4691 03:43:50,501 --> 03:43:53,538 WE WANT TO MOVE BEYOND 4692 03:43:53,538 --> 03:43:55,940 CONVENTIONAL SCIENCES AND 4693 03:43:55,940 --> 03:43:58,243 EMPLOYEE INDIGENOUS METHODS TO 4694 03:43:58,243 --> 03:44:02,413 MAKE SURE SCIENCE DRIVES 4695 03:44:02,413 --> 03:44:03,448 SUSTAINABLE POPULATION HEALTH 4696 03:44:03,448 --> 03:44:04,682 CHANGE AND EMBRACE STRONGEST 4697 03:44:04,682 --> 03:44:06,084 ETHICS AS POSSIBLE. 4698 03:44:06,084 --> 03:44:09,087 WE WANT THE HIGHEST STANDARDS OF 4699 03:44:09,087 --> 03:44:11,322 ETHICAL AND PROFESSIONAL 4700 03:44:11,322 --> 03:44:12,824 BEHAVIOR AND WANT TO BE 4701 03:44:12,824 --> 03:44:15,093 CULTURALLY RESPONSIVE AND WE 4702 03:44:15,093 --> 03:44:16,427 WANT TRANSPARENCY AND HONESTY IN 4703 03:44:16,427 --> 03:44:17,695 OUR INTERACTIONS. 4704 03:44:17,695 --> 03:44:20,365 THIS HAS TO DO IN WITH 4705 03:44:20,365 --> 03:44:22,634 RECOGNIZING AND RESPECTING 4706 03:44:22,634 --> 03:44:26,371 TRIBAL SOVEREIGNTY AND RIGHTS TO 4707 03:44:26,371 --> 03:44:28,039 SELF-DETERMINATION AND WE HOLD 4708 03:44:28,039 --> 03:44:32,010 OURSELVES ACCOUNTABLE FOR THE 4709 03:44:32,010 --> 03:44:36,414 LASTING IMPACT OF OUR WORK AND 4710 03:44:36,414 --> 03:44:39,250 COMMITMENTS MADE TO PARTNERS AND 4711 03:44:39,250 --> 03:44:41,386 RESPONSIBLE SO WE RESPECT AND 4712 03:44:41,386 --> 03:44:44,489 VALUE THE UNIQUE DIVERSE TALENTS 4713 03:44:44,489 --> 03:44:45,723 THE COMMUNITIES BRING TO THE 4714 03:44:45,723 --> 03:44:47,992 ISSUES WE'RE TRYING TO ADDRESS 4715 03:44:47,992 --> 03:44:52,330 AND RESPECT THE CHALLENGE AT THE 4716 03:44:52,330 --> 03:44:56,801 NIH AND OTHER PARTNERS. 4717 03:44:56,801 --> 03:44:58,903 THE OTHER PIECE IS BEING MINDFUL 4718 03:44:58,903 --> 03:45:01,739 THAT WE'RE A GOOD ANCESTOR. 4719 03:45:01,739 --> 03:45:03,207 WE WANT TO MAKE SURE THE ACTIONS 4720 03:45:03,207 --> 03:45:04,842 WE TAKE AT THE OFFICE THAT IT 4721 03:45:04,842 --> 03:45:06,344 DOESN'T JUST IMPACT THE CURRENT 4722 03:45:06,344 --> 03:45:11,249 GENERATION BUT WE'RE THINKING 4723 03:45:11,249 --> 03:45:12,684 SEVEN GENERATIONS AHEAD AND A 4724 03:45:12,684 --> 03:45:13,918 GREAT OPPORTUNITY TO HEAL THE 4725 03:45:13,918 --> 03:45:15,653 THINGS OUR COMMUNITIES DIDN'T 4726 03:45:15,653 --> 03:45:17,989 GET A CHANCE TO HEAL SEVEN 4727 03:45:17,989 --> 03:45:20,024 GENERATIONS AGO AND CONSIDER 4728 03:45:20,024 --> 03:45:23,695 THAT RESPONSIBILITY TO BE AN 4729 03:45:23,695 --> 03:45:24,362 IMPORTANT POWERFUL PLACE TO BE 4730 03:45:24,362 --> 03:45:25,730 AND WANT TO HONOR THAT. 4731 03:45:25,730 --> 03:45:29,233 SO WHO DO WE SERVE? 4732 03:45:29,233 --> 03:45:31,936 WE SERVE 574 FEDERALLY 4733 03:45:31,936 --> 03:45:33,638 RECOGNIZED TRIBAL NATIONS. 4734 03:45:33,638 --> 03:45:37,208 IF YOU TAKE AMERICAN NATIVE AND 4735 03:45:37,208 --> 03:45:39,010 ALASKAN NATIVE ONLY WE'RE ABOUT 4736 03:45:39,010 --> 03:45:40,678 2.5% OF THE POPULATION RIGHT 4737 03:45:40,678 --> 03:45:41,045 NOW. 4738 03:45:41,045 --> 03:45:44,549 IF YOU INCLUDE PEOPLE WHO SAY 4739 03:45:44,549 --> 03:45:49,253 I'M AMERICAN INDIAN FIRST AND 4740 03:45:49,253 --> 03:45:50,088 FOREMOST AND HAVE OTHER ETHNIC 4741 03:45:50,088 --> 03:45:52,957 TIES AND AFFILIATIONS WE JUMP UP 4742 03:45:52,957 --> 03:45:57,028 TO 4% TO 97 MILLION PEOPLE WE 4743 03:45:57,028 --> 03:46:00,264 ENGAGE NATIVE HAWAIIAN AND OTHER 4744 03:46:00,264 --> 03:46:03,234 POPULATIONS OF THE 4745 03:46:03,234 --> 03:46:06,437 U.S. TERRITORY LIKE GUAM AND 4746 03:46:06,437 --> 03:46:11,876 OTHERS AND THAT'S A MANDATE AS 4747 03:46:11,876 --> 03:46:16,714 WELL THOUGH THEY'RE NOT -- 4748 03:46:16,714 --> 03:46:18,216 HAWAIIANS ARE NOT RECOGNIZED AS 4749 03:46:18,216 --> 03:46:20,284 TRIBAL GOVERNMENT BUT WE SEE 4750 03:46:20,284 --> 03:46:21,152 THEM AS INDIGENOUS PEOPLE AND 4751 03:46:21,152 --> 03:46:23,154 EXPECT TO CONFER AND CONSULT 4752 03:46:23,154 --> 03:46:25,289 WITH THEM IN THE WORK WE DO AS 4753 03:46:25,289 --> 03:46:26,524 WELL. 4754 03:46:26,524 --> 03:46:28,593 THAT BRINGS ME TO THE NEXT POINT 4755 03:46:28,593 --> 03:46:32,130 WHERE IT'S IMPORTANT TO HAVE A 4756 03:46:32,130 --> 03:46:32,597 TRIBAL. 4757 03:46:32,597 --> 03:46:36,534 HEALTH OFFICE AT THE NIH BECAUSE 4758 03:46:36,534 --> 03:46:37,435 AN IMPORTANT AND UNIQUE MEMBER 4759 03:46:37,435 --> 03:46:39,537 OF THE FAMILY. 4760 03:46:39,537 --> 03:46:41,439 YOU CAN'T PUT US IN A RACE OR 4761 03:46:41,439 --> 03:46:43,074 ETHNIC CLASS. 4762 03:46:43,074 --> 03:46:46,444 WE HAVE A POLITICAL STATUS IN 4763 03:46:46,444 --> 03:46:47,745 THE UNITED STATES. 4764 03:46:47,745 --> 03:46:52,383 OUR OBLIGATION IS TO THE 574 4765 03:46:52,383 --> 03:46:54,118 TRIBAL SOVEREIGN NATIONS AND 4766 03:46:54,118 --> 03:47:02,293 TREATIES AND LAWS IN THE AND 4767 03:47:02,293 --> 03:47:05,630 AFFIRMED THAT ABLE TO NATIONS 4768 03:47:05,630 --> 03:47:11,169 RETAIN THEIR POWERS OF 4769 03:47:11,169 --> 03:47:14,272 SELF-GOVERNMENT AND TRIBAL 4770 03:47:14,272 --> 03:47:16,841 INDIAN RESPONSIBILITY A LEGAL 4771 03:47:16,841 --> 03:47:18,709 ENFORCEABLE OBLIGATION ON THE 4772 03:47:18,709 --> 03:47:20,478 PART OF THE UNITED STATES 4773 03:47:20,478 --> 03:47:22,213 GOVERNMENT TO PROTECT TREATY 4774 03:47:22,213 --> 03:47:27,985 RIGHTS AND ASSETS AND RESOURCES 4775 03:47:27,985 --> 03:47:28,619 INCLUDING ECONOMIC, SOCIAL AND 4776 03:47:28,619 --> 03:47:33,658 HEALTH AND THE EXPECTATION IS 4777 03:47:33,658 --> 03:47:35,426 GOVERNMENT IN PERPETUITY HAS A 4778 03:47:35,426 --> 03:47:37,028 RESPONSIBILITY AND TRUST 4779 03:47:37,028 --> 03:47:38,362 RESPONSIBILITY TO ENSURE THEY'RE 4780 03:47:38,362 --> 03:47:40,465 WORKING TOWARDS RAISING THE 4781 03:47:40,465 --> 03:47:43,100 STANDARD OF LIVING AND SOCIAL 4782 03:47:43,100 --> 03:47:47,238 WELL BEING FOR AMERICAN INDIANS 4783 03:47:47,238 --> 03:47:52,009 AND ALASKAN NATIVES AS A 4784 03:47:52,009 --> 03:47:56,013 SOVEREIGN TREATY AND I TALKED 4785 03:47:56,013 --> 03:47:59,517 ABOUT HOW MANY NATIVE 4786 03:47:59,517 --> 03:48:03,588 POPULATIONS THERE ARE WE'RE 4787 03:48:03,588 --> 03:48:08,392 PROJECTED TO BE 10.1 MILLION BY 4788 03:48:08,392 --> 03:48:08,593 2060. 4789 03:48:08,593 --> 03:48:10,094 WE'RE A YOUNG POPULATION AND 4790 03:48:10,094 --> 03:48:11,329 HAVE MORE CHILDREN ON AVERAGE 4791 03:48:11,329 --> 03:48:15,266 THAN OTHER GROUPS AND THOUGH WE 4792 03:48:15,266 --> 03:48:18,736 HAVE 574 FEDERALLY RECOGNIZED 4793 03:48:18,736 --> 03:48:19,470 TRIBES WE HAVE STATE RECOGNIZED 4794 03:48:19,470 --> 03:48:22,240 TRIBES WE'RE ACCOUNTABLE TO. 4795 03:48:22,240 --> 03:48:26,177 WE HAVE 274 RESERVATION TRUST 4796 03:48:26,177 --> 03:48:28,379 LANDS WE HAVE TO BE MINDFUL OF 4797 03:48:28,379 --> 03:48:31,115 AND 200 UNIQUE LANGUAGES AND 4798 03:48:31,115 --> 03:48:32,383 MANY OF OUR TRIBES STILL SPEAK 4799 03:48:32,383 --> 03:48:35,319 AS A PRIMARY LANGUAGE THEIR 4800 03:48:35,319 --> 03:48:38,356 FIRST LANGUAGE THEIR TRIBAL 4801 03:48:38,356 --> 03:48:38,623 LANGUAGE. 4802 03:48:38,623 --> 03:48:40,291 I'M A MEMBER OF THE CHOCTAW 4803 03:48:40,291 --> 03:48:41,659 NATION OF OKLAHOMA AND THE 4804 03:48:41,659 --> 03:48:44,228 MISSISSIPPI BAND OVER 80% OF 4805 03:48:44,228 --> 03:48:46,397 THEIR CHILDREN THEIR FIRST 4806 03:48:46,397 --> 03:48:47,365 LANGUAGE IS CHOCTAW. 4807 03:48:47,365 --> 03:48:52,103 IT STILL EXISTS TODAY. 4808 03:48:52,103 --> 03:48:55,706 51% FOR THOSE WHO GO TO ALASKAN 4809 03:48:55,706 --> 03:49:00,011 NATIVE AND CALIFORNIA AND NEW 4810 03:49:00,011 --> 03:49:03,147 MEXICO AND STATES WITH THE 4811 03:49:03,147 --> 03:49:05,283 HIGHEST PERCENTAGE OF AMERICAN 4812 03:49:05,283 --> 03:49:10,488 NATIVES ARE PRIMARILY IN ALASKA, 4813 03:49:10,488 --> 03:49:12,189 MONTANA AND OKLAHOMA AND YOU'LL 4814 03:49:12,189 --> 03:49:14,258 SEE DIFFERENT THINGS. 4815 03:49:14,258 --> 03:49:23,434 THE LARGEST URBAN INDIAN PONGS 4816 03:49:23,434 --> 03:49:26,270 -- POPULATIONS ARE IN 4817 03:49:26,270 --> 03:49:29,173 CALIFORNIA AND NEW YORK AND 70% 4818 03:49:29,173 --> 03:49:33,644 OF COMMUNITY LIVES IN 4819 03:49:33,644 --> 03:49:35,846 OFF-RESERVATION AREAS BUT ONE OF 4820 03:49:35,846 --> 03:49:38,416 THREE PEOPLE LIVING IN TRIBAL 4821 03:49:38,416 --> 03:49:41,586 AREAS RETURN HOME ANNUALLY FOR 4822 03:49:41,586 --> 03:49:43,621 CEREMONIES OR TO BE CONNECTED 4823 03:49:43,621 --> 03:49:44,855 WITH FAMILY MEMBERS, SOMETIMES 4824 03:49:44,855 --> 03:49:47,391 DURING THE SUMMER MONTHS AND 4825 03:49:47,391 --> 03:49:48,025 OTHER TIMES FOR HEALTH CARE 4826 03:49:48,025 --> 03:49:49,493 BECAUSE THEY GET THEIR HEALTH 4827 03:49:49,493 --> 03:49:51,529 CARE THROUGH INDIAN HEALTH 4828 03:49:51,529 --> 03:49:52,129 SERVICE. 4829 03:49:52,129 --> 03:49:53,331 SOMETIMES THEY WAIT TO GET 4830 03:49:53,331 --> 03:49:55,833 SUPPORT BECAUSE THEY DON'T HAVE 4831 03:49:55,833 --> 03:49:56,601 INSURANCE IN THE URBAN 4832 03:49:56,601 --> 03:50:00,104 ENVIRONMENT AND WAIT AND MAKE 4833 03:50:00,104 --> 03:50:09,480 THAT LONG TREK HOME. 4834 03:50:09,480 --> 03:50:12,016 THAT'S NOT UNCOMMON. 4835 03:50:12,016 --> 03:50:13,684 WE'RE LIVING A HEALTH REALITY 4836 03:50:13,684 --> 03:50:15,119 OUR ANCESTORS DID NOT DREAM FOR 4837 03:50:15,119 --> 03:50:15,720 US. 4838 03:50:15,720 --> 03:50:18,556 WE SUFFER FROM CHRONICALLY UNDER 4839 03:50:18,556 --> 03:50:20,524 FUNDED INACCESSIBLE HEALTH CARE 4840 03:50:20,524 --> 03:50:21,959 SYSTEM. 4841 03:50:21,959 --> 03:50:23,527 TO GIVE AN EXAMPLE, INDIAN 4842 03:50:23,527 --> 03:50:26,530 HEALTH SERVICE FOR EXAMPLE WAS 4843 03:50:26,530 --> 03:50:27,598 FUNDED WELL BELOW WHAT FEDERAL 4844 03:50:27,598 --> 03:50:29,567 PRISONERS GET IN TERMS OF HEALTH 4845 03:50:29,567 --> 03:50:30,601 CARE. 4846 03:50:30,601 --> 03:50:35,239 SO WE ABSOLUTELY -- IT'S 4847 03:50:35,239 --> 03:50:38,476 IMPROVED BUT WE'RE NOWHERE NEAR 4848 03:50:38,476 --> 03:50:39,777 WHERE WE SHOULD BE. 4849 03:50:39,777 --> 03:50:41,012 OUR STRUCTURAL DETERMINATES OF 4850 03:50:41,012 --> 03:50:43,581 HEALTH ARE THE POOREST IN THE 4851 03:50:43,581 --> 03:50:45,950 NATION AND HAVE STANDARD OVER 4852 03:50:45,950 --> 03:50:50,454 CROWDED HOUSING AND FOOD DESERTS 4853 03:50:50,454 --> 03:50:55,092 AND HIGH INSECURITY THAT 4854 03:50:55,092 --> 03:50:56,694 SKYROCKETED DURING THE PANDEMIC 4855 03:50:56,694 --> 03:50:59,196 AND SOME DON'T HAVE ELECTRICITY 4856 03:50:59,196 --> 03:51:01,332 AND EXPOSURE TO POLLUTANTS AND 4857 03:51:01,332 --> 03:51:04,001 TOXIN. 4858 03:51:04,001 --> 03:51:05,636 THESE AROUND OTHER FACTORS LED 4859 03:51:05,636 --> 03:51:08,005 TO CHRONIC DISEASE. 4860 03:51:08,005 --> 03:51:10,141 WE DON'T HAVE JUST HEART DISEASE 4861 03:51:10,141 --> 03:51:15,012 OR DIABETES, WE HAVE MULTIPLE 4862 03:51:15,012 --> 03:51:15,946 SYNERGISTIC SIMULTANEOUSLY WHICH 4863 03:51:15,946 --> 03:51:17,214 MEANS DEVELOPING INTERVENTIONS 4864 03:51:17,214 --> 03:51:19,784 OR EVEN TRACKING SOME OF THE 4865 03:51:19,784 --> 03:51:22,019 CAUSAL FACTORS RELATED TO THAT. 4866 03:51:22,019 --> 03:51:24,021 YOU CAN'T JUST GO BY ONE 4867 03:51:24,021 --> 03:51:24,255 DISEASE. 4868 03:51:24,255 --> 03:51:28,025 WE HAVE TO LOOK ACROSS DIFFERENT 4869 03:51:28,025 --> 03:51:29,427 DISEASES FOR OUR COMMUNITIES. 4870 03:51:29,427 --> 03:51:30,895 THE MORTALITY RATES THIS GIVES A 4871 03:51:30,895 --> 03:51:31,729 COUPLE EXAMPLES. 4872 03:51:31,729 --> 03:51:34,598 WE HAVE THE HIGHEST 4873 03:51:34,598 --> 03:51:36,600 UNINTENTIONAL INJURY RATE AND 4874 03:51:36,600 --> 03:51:38,269 HIGHEST DIABETES RATES AND LIVER 4875 03:51:38,269 --> 03:51:42,006 DISEASE AND ALCOHOL-INDUCED 4876 03:51:42,006 --> 03:51:45,142 MORTALITY AND IN 2022 THE 4877 03:51:45,142 --> 03:51:51,849 HIGHEST RATES OF 56.6 DEATHS PER 4878 03:51:51,849 --> 03:51:54,819 100,000 AND 33% INCREASE IN 4879 03:51:54,819 --> 03:51:57,354 OVERDOSE DEATHS AND IN MONTANA 4880 03:51:57,354 --> 03:51:59,857 AN ELDER SAID FROM DECEMBER TO 4881 03:51:59,857 --> 03:52:03,394 FEBRUARY THEY LOST 24 YOUNG 4882 03:52:03,394 --> 03:52:05,463 PEOPLE TO FENTANYL IN A SMALL 4883 03:52:05,463 --> 03:52:08,332 COMMUNITY WE'RE NOT IN GOOD 4884 03:52:08,332 --> 03:52:16,006 HEALTH RIGHT NOW. 4885 03:52:16,006 --> 03:52:18,542 WE HAVE THE HIGHEST SUICIDE 4886 03:52:18,542 --> 03:52:20,411 RATES FOR MEN AND WOMEN AND IT 4887 03:52:20,411 --> 03:52:21,378 VARIES BY COMMUNITY. 4888 03:52:21,378 --> 03:52:22,947 SOME COMMUNITIES ARE GETTING HIT 4889 03:52:22,947 --> 03:52:24,281 HARDER WITH THE RATES THAN 4890 03:52:24,281 --> 03:52:34,425 OTHERS. 4891 03:52:34,692 --> 03:52:35,726 HOW MANY PEOPLE PARTICIPATE IN 4892 03:52:35,726 --> 03:52:37,161 CLINICAL TRIALS WE HAVE THE 4893 03:52:37,161 --> 03:52:45,102 HIGHEST RATE. 4894 03:52:45,102 --> 03:52:47,371 WHAT'S THE IMPACT? 4895 03:52:47,371 --> 03:52:50,841 WE NOW HAVE THE LOWEST LIFE 4896 03:52:50,841 --> 03:52:55,246 EXPECTANCY SINCE WORLD WAR II. 4897 03:52:55,246 --> 03:52:57,047 ONE OUT OF FOUR WILL LIVE TO 45. 4898 03:52:57,047 --> 03:52:58,382 MY MOTHER IS A GREAT CASE IN 4899 03:52:58,382 --> 03:52:58,582 POINT. 4900 03:52:58,582 --> 03:53:03,354 I THINK OF HER OFTEN BECAUSE 4901 03:53:03,354 --> 03:53:06,290 THIS WORK FOR ME IS PERSONAL AND 4902 03:53:06,290 --> 03:53:06,791 PROFESSIONAL. 4903 03:53:06,791 --> 03:53:11,595 MY MOM PAST AT 45 FROM HER THIRD 4904 03:53:11,595 --> 03:53:13,264 RARE FORM OF CANCER LIKELY 4905 03:53:13,264 --> 03:53:15,833 CAUSED FROM TOXIN EXPOSURE WHEN 4906 03:53:15,833 --> 03:53:22,339 HER MOM LABORED IN SALINAS SO 4907 03:53:22,339 --> 03:53:25,776 SHE FELL INTO THAT STATISTIC. 4908 03:53:25,776 --> 03:53:28,345 LIFE EXPECTANCY VARIES BY TIME. 4909 03:53:28,345 --> 03:53:30,681 IN THE SOUTH WEST SOME LIFE 4910 03:53:30,681 --> 03:53:31,949 EXPECTANCIES SOME TRIBES FOR MEN 4911 03:53:31,949 --> 03:53:36,020 IS ONLY 46. 4912 03:53:36,020 --> 03:53:37,888 FOR WOMEN IT'S 52. 4913 03:53:37,888 --> 03:53:41,559 WE'RE IN A HEALTH CRISIS AND 4914 03:53:41,559 --> 03:53:43,227 WE'RE INVISIBLE. 4915 03:53:43,227 --> 03:53:44,728 WE'RE NOT IN NATIONAL HEALTH 4916 03:53:44,728 --> 03:53:44,995 DATA. 4917 03:53:44,995 --> 03:53:49,166 IF YOU LOOK AT THE HEALTH DATA 4918 03:53:49,166 --> 03:53:51,235 AND GOES TO AFRICAN AMERICAN, 4919 03:53:51,235 --> 03:53:53,671 LATINO, ASIAN SOMETIMES, NOT 4920 03:53:53,671 --> 03:53:58,275 ALWAYS, AND WHITE. 4921 03:53:58,275 --> 03:54:03,547 WE'RE OTHER. 4922 03:54:03,547 --> 03:54:05,216 YET WE'RE DISPROPORTIONATELY 4923 03:54:05,216 --> 03:54:07,218 IMPACTED BY THE HEALTH OUTCOMES 4924 03:54:07,218 --> 03:54:09,954 AND IF YOU COULD HAVE TOLD ME IN 4925 03:54:09,954 --> 03:54:14,592 MY TRIBE ONE OF THREE CHILDREN 4926 03:54:14,592 --> 03:54:15,559 BY 25 WOULD BE LIVING WITH 4927 03:54:15,559 --> 03:54:22,199 DIABETES WHY IS THAT A HEALTH 4928 03:54:22,199 --> 03:54:23,400 CRISIS? 4929 03:54:23,400 --> 03:54:25,469 GRANDPARENTS WILL OUTLIVE THEIR 4930 03:54:25,469 --> 03:54:31,442 GRANDCHILDREN AND WE WERE THE 4931 03:54:31,442 --> 03:54:34,845 DESCENDANTS OF TRAIL OF TEARS. 4932 03:54:34,845 --> 03:54:36,847 THEY DID NOT WALK THAT TRAIL OF 4933 03:54:36,847 --> 03:54:38,015 TEARS FOR US TO DIE BUT A VISION 4934 03:54:38,015 --> 03:54:44,588 OF LIFE IN -- LOVE IN LIFE AND 4935 03:54:44,588 --> 03:54:50,461 IT'S MY PERSONAL OBLIGATION AND 4936 03:54:50,461 --> 03:54:52,029 OFFICE'S OBLIGATION TO HARNESS 4937 03:54:52,029 --> 03:54:55,099 OUR COLLECTIVE WISDOM AND 4938 03:54:55,099 --> 03:54:56,133 SCIENTIFIC KNOWLEDGE TO ACHIEVE 4939 03:54:56,133 --> 03:54:59,036 HEALTH AND HEALTH EQUITY. 4940 03:54:59,036 --> 03:55:04,441 I'M GIVE -- DRIVEN TO DO THIS. 4941 03:55:04,441 --> 03:55:07,244 IT'S ABOUT HARNESSING POWER TO 4942 03:55:07,244 --> 03:55:09,613 HEAL THROUGH SCIENCE. 4943 03:55:09,613 --> 03:55:11,782 WE'RE DOING THAT THROUGH FOUR 4944 03:55:11,782 --> 03:55:14,184 MAIN AREAS. 4945 03:55:14,184 --> 03:55:16,353 ONE IS THROUGH ADVANCING 4946 03:55:16,353 --> 03:55:19,823 INDIGENOUS RESEARCH THE CREATIVE 4947 03:55:19,823 --> 03:55:22,526 RESEARCH THAT WE'RE HOPING BY 4948 03:55:22,526 --> 03:55:24,595 AND FOUR COMMUNITIES INCLUDING 4949 03:55:24,595 --> 03:55:26,563 INNOVATION AND OTHER INDIGENOUS 4950 03:55:26,563 --> 03:55:28,866 METHODOLOGIES AND TO BEGIN TO 4951 03:55:28,866 --> 03:55:31,402 LOOK AT DEVELOPING NOT ONLY 4952 03:55:31,402 --> 03:55:33,604 CULTURALLY CREDIBLE AND VALID 4953 03:55:33,604 --> 03:55:38,275 SCIENCE BUT SUSTAINABLE HEALTH 4954 03:55:38,275 --> 03:55:40,210 IMPACT AND CULTIVATING CAPACITY. 4955 03:55:40,210 --> 03:55:42,746 IMPROVING NOT ONLY THE KNOWLEDGE 4956 03:55:42,746 --> 03:55:47,184 AT THE NIH WE DO WORK 4957 03:55:47,184 --> 03:55:49,320 INTRAMURALLY TO INCREASE 4958 03:55:49,320 --> 03:55:50,220 COMPETENCIES AND UNDERSTANDING 4959 03:55:50,220 --> 03:55:55,993 ABOUT ISSUES OUR COMMUNITIES ARE 4960 03:55:55,993 --> 03:55:59,530 FACING. 4961 03:55:59,530 --> 03:56:00,998 ALSO IF WE HAVE 1,000 Ph.D.s IN 4962 03:56:00,998 --> 03:56:03,634 THE ROOM HOW MANY DO YOU THINK 4963 03:56:03,634 --> 03:56:05,135 WOULD BE AMERICAN INDIAN OR 4964 03:56:05,135 --> 03:56:08,005 ALASKAN NATIVE? 4965 03:56:08,005 --> 03:56:18,315 TAKE A WILD GUESS. 4966 03:56:25,255 --> 03:56:28,792 IT'S ONE-THIRD OF ONE PERCENT 4967 03:56:28,792 --> 03:56:30,427 ARE Ph.D.s BUT HOW MANY ARE 4968 03:56:30,427 --> 03:56:30,728 RESEARCHERS? 4969 03:56:30,728 --> 03:56:34,832 VERY SMALL PROPORTION. 4970 03:56:34,832 --> 03:56:37,568 THE REASON IS OUR COMMUNITY GOES 4971 03:56:37,568 --> 03:56:44,108 INTO MORE SERVING PROFESSIONALS, 4972 03:56:44,108 --> 03:56:44,875 PSYCHOLOGY AND WE HAVE MORE WORK 4973 03:56:44,875 --> 03:56:47,911 TO DO TO CREATE A REPRESENTATIVE 4974 03:56:47,911 --> 03:56:49,913 WORKFORCE BECAUSE OF BRINGING 4975 03:56:49,913 --> 03:56:51,915 THAT EXPERIENCE TO THE TABLE TO 4976 03:56:51,915 --> 03:56:53,751 HELP FLUSH OUT AND BUILD SCIENCE 4977 03:56:53,751 --> 03:56:54,885 AND BUILD BETTER SCIENCE IN 4978 03:56:54,885 --> 03:56:56,553 PARTNERSHIP WITH COMMUNITIES. 4979 03:56:56,553 --> 03:56:58,589 THE THIRD ELEMENT WE DO WHICH IS 4980 03:56:58,589 --> 03:57:04,762 UNIQUE TO OUR OFFICE, WE ARE 4981 03:57:04,762 --> 03:57:07,998 RESPONSIBLE FOR TRIBAL 4982 03:57:07,998 --> 03:57:09,033 CONCENTRATION. 4983 03:57:09,033 --> 03:57:10,801 ARE AND FEDERAL AGENCIES CONSULT 4984 03:57:10,801 --> 03:57:13,637 WITH TRIBES BEFORE MAKING BIG 4985 03:57:13,637 --> 03:57:16,907 DECISIONS IMPACTING TRIBAL WELL 4986 03:57:16,907 --> 03:57:22,346 BEING AND WORKING WITH NIMHD 4987 03:57:22,346 --> 03:57:25,682 WITH THE CANCER MANDATES THAT 4988 03:57:25,682 --> 03:57:27,351 CAME THROUGH AND HELPING IN THE 4989 03:57:27,351 --> 03:57:30,354 CONSULT AND BLAZING NEW PATHS 4990 03:57:30,354 --> 03:57:33,390 FOR STRATEGIC INITIATIVES, 4991 03:57:33,390 --> 03:57:34,892 POLICIES AND COLLABORATIONS. 4992 03:57:34,892 --> 03:57:36,260 WE GET TO BRING OUR OWN 4993 03:57:36,260 --> 03:57:37,227 EXPERIENCE AND SCIENCE TO THE 4994 03:57:37,227 --> 03:57:39,997 FOREFRONT TO BEGIN TO PULL 4995 03:57:39,997 --> 03:57:42,366 TOGETHER ACROSS THE DIFFERENT 4996 03:57:42,366 --> 03:57:44,768 I.C.s OPPORTUNITIES TO DEVELOP 4997 03:57:44,768 --> 03:57:48,005 NEW INITIATIVES, PAUSE FOR NEW 4998 03:57:48,005 --> 03:57:49,740 SCIENCE THAT WOULD BE RESPONSIVE 4999 03:57:49,740 --> 03:58:00,250 TO COMMUNITY IDENTIFIED NEEDS. 5000 03:58:04,088 --> 03:58:06,023 WE'RE DEVELOPING GUIDANCE HERE 5001 03:58:06,023 --> 03:58:09,560 AND THE BIDEN ADMINISTRATION 5002 03:58:09,560 --> 03:58:12,496 MANDATED THAT FEDERAL AGENCIES 5003 03:58:12,496 --> 03:58:14,131 DEMONSTRATE HOW THEY'RE 5004 03:58:14,131 --> 03:58:14,698 INCORPORATING INDIGENOUS 5005 03:58:14,698 --> 03:58:16,300 KNOWLEDGES IN THE WORK THEY DO. 5006 03:58:16,300 --> 03:58:18,335 WE'LL HARMONIZE WITH THAT POLICY 5007 03:58:18,335 --> 03:58:20,003 AND WORKING WITH THE NIH ON THAT 5008 03:58:20,003 --> 03:58:26,677 AND NIMHD ON THAT. 5009 03:58:26,677 --> 03:58:29,279 WE'RE WORKING ON DEVELOPING AN 5010 03:58:29,279 --> 03:58:31,348 INDIGENOUS DATA SOVEREIGNTY 5011 03:58:31,348 --> 03:58:33,183 POLICY AT THE NIH. 5012 03:58:33,183 --> 03:58:35,552 WE'RE ALSO DEVELOPING 5013 03:58:35,552 --> 03:58:37,955 CROSS-CUTTING INITIATIVE AROUND 5014 03:58:37,955 --> 03:58:39,056 BOARDING SCHOOL HEALING 5015 03:58:39,056 --> 03:58:39,356 INITIATIVE. 5016 03:58:39,356 --> 03:58:41,592 I'LL GIVE A COUPLE HIGHLIGHTS ON 5017 03:58:41,592 --> 03:58:44,027 THAT RIGHT NOW. 5018 03:58:44,027 --> 03:58:47,865 IN TERMS OF THE DATA SOVEREIGNTY 5019 03:58:47,865 --> 03:58:49,766 AND AN INDIAN COUNTRY IT'S BEEN 5020 03:58:49,766 --> 03:58:51,702 STRONG A NUMBER OF YEARS AND THE 5021 03:58:51,702 --> 03:58:55,139 RECENT EXECUTIVE ORDER ALSO SAID 5022 03:58:55,139 --> 03:58:56,740 IN RECOGNIZING SELF-GOVERNANCE 5023 03:58:56,740 --> 03:58:57,474 WE'RE ALSO RECOGNIZING 5024 03:58:57,474 --> 03:59:03,413 INDIGENOUS DATA SOVEREIGNTY WORE 5025 03:59:03,413 --> 03:59:05,482 LOOKING TO HAVE A POLICY AND 5026 03:59:05,482 --> 03:59:06,850 ALREADY HAVE GUIDANCE BUT WE 5027 03:59:06,850 --> 03:59:11,989 NEED A POLICY TO WE DON'T HAVE 5028 03:59:11,989 --> 03:59:15,993 THE GIANT OCTOPUS WITH 27 5029 03:59:15,993 --> 03:59:18,462 INSTITUTES WITH ITS OWN BRAIN 5030 03:59:18,462 --> 03:59:20,130 SYSTEM DOING ITS OWN THING AND 5031 03:59:20,130 --> 03:59:27,070 THIS WILL HELP GET IN SYNC AND 5032 03:59:27,070 --> 03:59:28,872 HONORING DATA SOVEREIGNTY WITH 5033 03:59:28,872 --> 03:59:29,106 TRIBES. 5034 03:59:29,106 --> 03:59:31,208 IN TERMS OF BOARDING SCHOOL 5035 03:59:31,208 --> 03:59:33,477 HEALING INITIATIVE, TO GIVE A 5036 03:59:33,477 --> 03:59:34,444 COUPLE HIGHLIGHTS WHY THIS IS 5037 03:59:34,444 --> 03:59:36,013 IMPORTANT, I DON'T THINK I NEED 5038 03:59:36,013 --> 03:59:40,751 TO GO TOO MUCH INTO THIS. 5039 03:59:40,751 --> 03:59:42,586 DO YOU KNOW WHAT HAPPENED WITH 5040 03:59:42,586 --> 03:59:43,620 THE BOARDING SCHOOL? 5041 03:59:43,620 --> 03:59:47,357 1819 TO 1960s, FEDERAL 5042 03:59:47,357 --> 03:59:49,393 GOVERNMENT HAD A MASSIVE POLICY 5043 03:59:49,393 --> 03:59:50,894 TO REMOVE NATIVE KIDS AND PLACE 5044 03:59:50,894 --> 03:59:53,897 THEM IN RESIDENTIAL SCHOOLS 5045 03:59:53,897 --> 03:59:58,835 FORCING THEM TO ASSIMILATE TO 5046 03:59:58,835 --> 04:00:02,673 NOT SPEAK THEIR LANGUAGE AND 5047 04:00:02,673 --> 04:00:08,212 SPEAK ENGLISH AND ENFORCED 5048 04:00:08,212 --> 04:00:10,714 CHRISTIANITY AND THE IMPACT 5049 04:00:10,714 --> 04:00:11,949 IMPACTED GENERATIONS AND THEY 5050 04:00:11,949 --> 04:00:13,417 LAUNCHED THE BOARDING SCHOOL 5051 04:00:13,417 --> 04:00:18,288 HEALING INITIATIVE IN 2021. 5052 04:00:18,288 --> 04:00:19,356 FINISHED A REPORT WHERE SHE 5053 04:00:19,356 --> 04:00:21,525 LOOKED TO SEE HOW MANY BOARDING 5054 04:00:21,525 --> 04:00:23,493 SCHOOLS THEY WERE AND WHAT 5055 04:00:23,493 --> 04:00:24,561 IMPACT IT HAD. 5056 04:00:24,561 --> 04:00:27,598 WHERE ARE THE GRAVE SITES OF 5057 04:00:27,598 --> 04:00:28,732 CHILDREN WHERE EITHER MURDERED 5058 04:00:28,732 --> 04:00:39,176 OR DIED IN THESE SCHOOLS. 5059 04:00:41,278 --> 04:00:43,480 SHE SAID THE IMPACT OF THESE IS 5060 04:00:43,480 --> 04:00:44,214 HEARTBREAKING AND WANTS TO 5061 04:00:44,214 --> 04:00:47,217 CONTINUE TO SEE THE EVIDENCE AND 5062 04:00:47,217 --> 04:00:48,018 HAVE SEEN THE EVIDENCE 5063 04:00:48,018 --> 04:00:52,022 CONTINUING TO THIS DAY AND IT'S 5064 04:00:52,022 --> 04:00:53,590 WRITHING DISPARITY AND ARE NOT 5065 04:00:53,590 --> 04:01:00,330 ONLY GIVES VOICE TO SURVIVORS 5066 04:01:00,330 --> 04:01:03,533 AND LAUNCHED THE ROAD TO HEALING 5067 04:01:03,533 --> 04:01:05,302 RIGHT NOW. 5068 04:01:05,302 --> 04:01:07,070 THEY'RE IN THAT PHASE OF THE 5069 04:01:07,070 --> 04:01:07,738 INITIATIVE AND GOING TO AROUND 5070 04:01:07,738 --> 04:01:11,074 THE COUNTRY ASKING SURVIVORS TO 5071 04:01:11,074 --> 04:01:12,276 TOLL THEIR STORIES. 5072 04:01:12,276 --> 04:01:13,577 I WAS A FORMER THERAPIST. 5073 04:01:13,577 --> 04:01:16,013 WHEN I HEARD THAT I THOUGHT, OH, 5074 04:01:16,013 --> 04:01:18,215 WE NEED TO DO SOMETHING ELSE 5075 04:01:18,215 --> 04:01:18,415 HERE. 5076 04:01:18,415 --> 04:01:24,021 YOU CAN'T JUST OPEN UP THAT CAN 5077 04:01:24,021 --> 04:01:29,192 AND NOT HAVE SOMETHING FOR IT. 5078 04:01:29,192 --> 04:01:30,927 SHE'S HELPING █COMMUNITIES DO 5079 04:01:30,927 --> 04:01:32,829 MORE APPROACHES AND WE SHOULD BE 5080 04:01:32,829 --> 04:01:37,801 LEADING THE CONVERSATION ON 5081 04:01:37,801 --> 04:01:44,841 DEVELOPING RESEARCH ON THE 5082 04:01:44,841 --> 04:01:46,777 BIOLOGICAL TRAUMA SAYING WHAT IS 5083 04:01:46,777 --> 04:01:48,111 THE STATE OF SCIENCE WITH 5084 04:01:48,111 --> 04:01:51,581 RESPECT TO THAT AND WORKING WITH 5085 04:01:51,581 --> 04:01:52,516 BOARDING SCHOOL SURVIVORS AND 5086 04:01:52,516 --> 04:01:54,518 COMMUNITY MEMBERS DOING THE WORK 5087 04:01:54,518 --> 04:02:01,925 ON THE GROUND TO IDENTIFY WHAT 5088 04:02:01,925 --> 04:02:04,061 WOULD HELP BUILD INNOVATIVE 5089 04:02:04,061 --> 04:02:07,364 HEALING INTERVENTIONS AND HEALTH 5090 04:02:07,364 --> 04:02:07,964 PROMOTION INTERVENTIONS OF 5091 04:02:07,964 --> 04:02:09,466 COMMUNITY LEVEL. 5092 04:02:09,466 --> 04:02:12,502 WHAT WE'VE DONE IS WE'VE MOVE 5093 04:02:12,502 --> 04:02:15,572 FORWARD WITH BUILDING LOOKING TO 5094 04:02:15,572 --> 04:02:18,608 BUILD A SUMMIT PROBABLY THIS 5095 04:02:18,608 --> 04:02:21,144 FALL WHERE WE'RE GOING TO DO 5096 04:02:21,144 --> 04:02:23,413 JUST THAT AND BRINGING UP 5097 04:02:23,413 --> 04:02:26,450 SUBJECT MATTER EXPERTS IN 5098 04:02:26,450 --> 04:02:36,993 INTERACIAL PEOPLE AND INVITING 5099 04:02:38,028 --> 04:02:39,629 NIH AND HOPEFULLY EVERYONE COULD 5100 04:02:39,629 --> 04:02:43,100 BE THERE TO LISTEN IN AND HEAR 5101 04:02:43,100 --> 04:02:44,134 WHERE THE CURRENT STATE OF THE 5102 04:02:44,134 --> 04:02:53,577 SCIENCE AND PRACTICE IS. 5103 04:02:53,577 --> 04:02:58,682 WE CAN INNOVATE A PLAN TO 5104 04:02:58,682 --> 04:03:01,284 RESPOND AND INVITING TO 5105 04:03:01,284 --> 04:03:02,486 SYNCHRONIZE ACROSS HHS TO BUILD 5106 04:03:02,486 --> 04:03:02,819 INITIATIVES. 5107 04:03:02,819 --> 04:03:05,856 WE'RE PARTNERING WITH THE 5108 04:03:05,856 --> 04:03:06,790 NATIONAL BOARDING SCHOOL OF 5109 04:03:06,790 --> 04:03:09,826 HEALING COALITION IN CHARGE OF 5110 04:03:09,826 --> 04:03:11,762 THE REPORT AND ARE VERY EXCITED 5111 04:03:11,762 --> 04:03:12,295 ABOUT THIS. 5112 04:03:12,295 --> 04:03:13,363 STAY TUNED FOR THAT AND 5113 04:03:13,363 --> 04:03:16,266 SOMETHING WE CAN GET EXCITED 5114 04:03:16,266 --> 04:03:16,466 ABOUT. 5115 04:03:16,466 --> 04:03:19,369 FOR A MINUTE I WANT TO SHARE 5116 04:03:19,369 --> 04:03:20,537 BRIEFLY ABOUT MY OWN RESEARCH 5117 04:03:20,537 --> 04:03:21,605 AND THE REASON I GET EXCITED 5118 04:03:21,605 --> 04:03:23,373 ABOUT THIS IS BECAUSE I DID 5119 04:03:23,373 --> 04:03:25,575 RESEARCH IN HISTORICAL TRAUMA. 5120 04:03:25,575 --> 04:03:28,011 THAT'S MY BACKGROUND. 5121 04:03:28,011 --> 04:03:32,816 AND ONE OF THE THINGS WE 5122 04:03:32,816 --> 04:03:33,817 IDENTIFIED FOR A LONG TIME IS 5123 04:03:33,817 --> 04:03:40,857 IT'S NOT JUST ENOUGH TO IDENTIFY 5124 04:03:40,857 --> 04:03:44,361 EVENTS AND CREATE INTERVENTIONS 5125 04:03:44,361 --> 04:03:45,595 THAT ADDRESSED IT. 5126 04:03:45,595 --> 04:03:49,499 WE LOOKED AT INCORPORATING 5127 04:03:49,499 --> 04:03:51,334 ORIGINAL TEACHINGS, INSTRUCTION, 5128 04:03:51,334 --> 04:03:57,674 RESTORING RELATIONAL WAYS OF 5129 04:03:57,674 --> 04:04:00,944 BEING AND TO TRANSFORM HOW WE 5130 04:04:00,944 --> 04:04:04,347 TELL THE STORY OF OUR LIVES. 5131 04:04:04,347 --> 04:04:06,450 TO SHARE BRIEFLY WHY -- I SAY 5132 04:04:06,450 --> 04:04:07,584 ORIGINAL STRUCTURE AND SOMETIMES 5133 04:04:07,584 --> 04:04:09,786 PEOPLE AREN'T SURE WHAT THAT 5134 04:04:09,786 --> 04:04:13,323 MEANS SO I'LL DO A COMIC BOOK 5135 04:04:13,323 --> 04:04:14,024 VERSION FROM THE CHOCTAW POINT 5136 04:04:14,024 --> 04:04:14,458 OF VIEW. 5137 04:04:14,458 --> 04:04:18,428 WE HAVE A STORY WHERE SUN AND 5138 04:04:18,428 --> 04:04:20,530 MOON WERE LOVERS IN THE SKY. 5139 04:04:20,530 --> 04:04:22,899 AND THEY HAD ALL THEIR STAR 5140 04:04:22,899 --> 04:04:27,571 CHILDREN AND LIVED TOGETHER IN 5141 04:04:27,571 --> 04:04:31,508 THE BRIGHT SKY TOGETHER AND THE 5142 04:04:31,508 --> 04:04:33,944 MOON NOTICED THERE'S A SUN FLARE 5143 04:04:33,944 --> 04:04:35,846 SOMETIMES AND SAID IF ANY OF 5144 04:04:35,846 --> 04:04:37,080 YOUR FLARES HIT ME OR MY 5145 04:04:37,080 --> 04:04:39,182 CHILDREN WE'RE GOING TO THE 5146 04:04:39,182 --> 04:04:40,984 OTHER SIDE WORLD AND I'M TAKING 5147 04:04:40,984 --> 04:04:42,252 MY STAR CHILDREN AND GOING TO 5148 04:04:42,252 --> 04:04:43,887 THE OTHER SIDE AND SAID DON'T 5149 04:04:43,887 --> 04:04:46,089 WORRY, THAT WON'T HAPPEN. 5150 04:04:46,089 --> 04:04:49,392 SURE ENOUGH, SHE LOOKS UP AND HE 5151 04:04:49,392 --> 04:04:51,194 GOT HER STAR CHILDREN AND WENT 5152 04:04:51,194 --> 04:04:52,796 TO THE OTHER SIDE OF THE WORLD 5153 04:04:52,796 --> 04:04:55,332 AND HOW WE GOT DARKNESS AND 5154 04:04:55,332 --> 04:04:59,236 BEGGED HER AND SAID PLEASE COME 5155 04:04:59,236 --> 04:04:59,469 BACK. 5156 04:04:59,469 --> 04:05:02,506 IT WAS AN ACCIDENT AND SHE SAID, 5157 04:05:02,506 --> 04:05:05,909 NO, THIS IS THE PROTOCOL AND I 5158 04:05:05,909 --> 04:05:06,676 KNOW YOU LOVE ME AND I LOVE YOU 5159 04:05:06,676 --> 04:05:09,813 AND YOU NEED TO VISIT YOUR STAR 5160 04:05:09,813 --> 04:05:11,147 CHILDREN SO EVERY MONTH WE'LL 5161 04:05:11,147 --> 04:05:12,282 MEET IN THE MORNING AND SHARE 5162 04:05:12,282 --> 04:05:19,623 THE NIGHT SKY TOGETHER AND CAN 5163 04:05:19,623 --> 04:05:21,525 VISIT THE CHILDREN AND THAT'S 5164 04:05:21,525 --> 04:05:24,194 HOW IT WAS. 5165 04:05:24,194 --> 04:05:26,863 THAT'S A CHOCTAW STORY. 5166 04:05:26,863 --> 04:05:27,597 SO THAT'S WHAT WE TALK ABOUT 5167 04:05:27,597 --> 04:05:31,401 WHEN WE SAY MAKING THINGS 5168 04:05:31,401 --> 04:05:34,504 ORIGINAL IN STRUCTURED CENTERED 5169 04:05:34,504 --> 04:05:36,606 TO BRING OUT OUR STORIES AND 5170 04:05:36,606 --> 04:05:37,874 GUIDE OUR BEHAVIORS AND WORK 5171 04:05:37,874 --> 04:05:48,051 WITH THAT. 5172 04:05:52,155 --> 04:05:55,358 IF I CORRECT MY HEALTH NOW I'M 5173 04:05:55,358 --> 04:05:57,794 IMPACTING THE NEXT SEVEN 5174 04:05:57,794 --> 04:06:04,000 GENERATIONS AND I'M MY GREAT 5175 04:06:04,000 --> 04:06:06,870 GRAND MOTHER'S GRANDDAUGHTER AND 5176 04:06:06,870 --> 04:06:08,004 RESTORING OUR LIVES TO HEALTH 5177 04:06:08,004 --> 04:06:11,741 AND WELLNESS AND A PARADIGM 5178 04:06:11,741 --> 04:06:16,846 SHIFT THAT HELPED ME IN THE WORK 5179 04:06:16,846 --> 04:06:20,650 I'LL TAKE FIVE MINUTES ABOUT 5180 04:06:20,650 --> 04:06:23,653 HISTORICAL AND INTERGENERATIONAL 5181 04:06:23,653 --> 04:06:25,288 TRAUMA AND I WAS TOLD A STORY 5182 04:06:25,288 --> 04:06:26,990 ABOUT THE CRABS AND THE BUCKETS. 5183 04:06:26,990 --> 04:06:30,927 WE USE THAT FOR LATERAL 5184 04:06:30,927 --> 04:06:33,697 ALIGNMENTS OFTEN. 5185 04:06:33,697 --> 04:06:34,331 FIS 5186 04:06:34,331 --> 04:06:35,832 FISHERMEN PUT CRABS IN BUCKETS 5187 04:06:35,832 --> 04:06:37,534 BECAUSE THEY TRY TO CRAWL OUT 5188 04:06:37,534 --> 04:06:39,869 AND THEY PULL THE OTHER DONE AND 5189 04:06:39,869 --> 04:06:44,240 IF I WAS A SOCIAL WORKER CRAB 5190 04:06:44,240 --> 04:06:52,849 I'D SAY PUT OUR PINCERS TOGETHER 5191 04:06:52,849 --> 04:06:54,684 AND THE QUESTION MADE ME REALIZE 5192 04:06:54,684 --> 04:07:03,059 I'D BEEN BUCKETING MY OWN 5193 04:07:03,059 --> 04:07:07,964 SCIENCE BECAUSE HE SAID CRABS 5194 04:07:07,964 --> 04:07:09,399 DON'T LIVE IN A BUCKET. 5195 04:07:09,399 --> 04:07:15,772 WHY DO WE ACCEPT THAT AS THAT 5196 04:07:15,772 --> 04:07:17,507 NATURAL CRAB BEHAVIOR AND HE 5197 04:07:17,507 --> 04:07:23,279 SAID WHEN CRABS ARE IN A HEALTHY 5198 04:07:23,279 --> 04:07:24,047 ENVIRONMENT, WHEN THEY'RE IN 5199 04:07:24,047 --> 04:07:25,382 THEIR NATURAL HEALTHY 5200 04:07:25,382 --> 04:07:26,383 ENVIRONMENT THEY PULL EACH OTHER 5201 04:07:26,383 --> 04:07:27,717 UP ON ROCKS. 5202 04:07:27,717 --> 04:07:30,186 I'M SURE THERE'S ONE OR TWO 5203 04:07:30,186 --> 04:07:31,755 CRABS THERE BUT IT HAPPENS BUT 5204 04:07:31,755 --> 04:07:33,223 IT'S THE NATURAL CRAB BEHAVIOR 5205 04:07:33,223 --> 04:07:34,924 THAT LIFTED EACH OTHER UP IN 5206 04:07:34,924 --> 04:07:38,862 ROCKS AND SHIFTED MY THINKING 5207 04:07:38,862 --> 04:07:42,098 AND WE SEE THIS IN INDIAN 5208 04:07:42,098 --> 04:07:42,832 COUNTRY AND A BIG SHIFT. 5209 04:07:42,832 --> 04:07:44,768 IT'S NOT JUST ABOUT HISTORICAL 5210 04:07:44,768 --> 04:07:47,804 TRAUMA OR THINGS LIKE THAT BUT 5211 04:07:47,804 --> 04:07:49,105 HOW DO WE MAKE HEALTHIER 5212 04:07:49,105 --> 04:07:51,941 ENVIRONMENTS AND GET BACK TO THE 5213 04:07:51,941 --> 04:07:53,810 ENVIRONMENT AND DO SETTING SPACE 5214 04:07:53,810 --> 04:07:57,480 INTERVENTIONS OR WORK AND CREATE 5215 04:07:57,480 --> 04:08:01,985 HEALTHIER ENVIRONMENTS SO 5216 04:08:01,985 --> 04:08:04,788 HEALTHFUL HABITS EMERGE AND THE 5217 04:08:04,788 --> 04:08:05,989 BIG MOVE HAS BEEN LAND-BASED 5218 04:08:05,989 --> 04:08:11,494 HEALING WORK AND BUST OUT OF 5219 04:08:11,494 --> 04:08:12,762 TYPICAL SERVICES-ORIENTED 5220 04:08:12,762 --> 04:08:15,331 RESEARCH AND SERVICES ARE 5221 04:08:15,331 --> 04:08:15,999 CRITICAL BECAUSE THEY'RE 5222 04:08:15,999 --> 04:08:18,134 BAND-AIDS TO HELP US PUT THINGS 5223 04:08:18,134 --> 04:08:19,436 TOGETHER BUT DON'T PRODUCE 5224 04:08:19,436 --> 04:08:20,103 SUSTAINABLE CHANGE AT A 5225 04:08:20,103 --> 04:08:22,972 POPULATION LEVEL. 5226 04:08:22,972 --> 04:08:24,507 WE'RE AT THE POINT WHERE THE 5227 04:08:24,507 --> 04:08:26,910 TRAIN LEFT THE STATION. 5228 04:08:26,910 --> 04:08:32,849 ONE OF THREE KIDS WILL BE TYPE 5229 04:08:32,849 --> 04:08:34,951 II DIABETES AND DON'T HAVE TIME 5230 04:08:34,951 --> 04:08:36,419 FOR BEHAVIORS AND FAMILIES COME 5231 04:08:36,419 --> 04:08:38,088 TOGETHER BUT VA TO DO SOMETHING 5232 04:08:38,088 --> 04:08:39,956 TO IMPACT THE POPULATION. 5233 04:08:39,956 --> 04:08:46,029 IT WAS A PROJECT THAT MICHELLE 5234 04:08:46,029 --> 04:08:47,897 JOHNSON AND WE WORKED ON AND 5235 04:08:47,897 --> 04:08:50,834 I'LL SHARE SLIDES FROM OUR EARLY 5236 04:08:50,834 --> 04:08:53,203 WORK THE PILOT PHASE WORK FOR 5237 04:08:53,203 --> 04:08:58,441 THIS WAS FUNDED IN PART THROUGH 5238 04:08:58,441 --> 04:09:01,544 OUR NIMHD GRANT AS A 5239 04:09:01,544 --> 04:09:02,078 COMPREHENSIVE CENTER OF 5240 04:09:02,078 --> 04:09:03,546 EXCELLENCE BACK IN OUR DAY AND 5241 04:09:03,546 --> 04:09:04,848 WORKED WITH OUR TRIBE WHO ASKED 5242 04:09:04,848 --> 04:09:06,483 ME TO COME AND HELP ADDRESS THE 5243 04:09:06,483 --> 04:09:07,484 ISSUE. 5244 04:09:07,484 --> 04:09:09,452 THE THINGS WE FOCUSSED ON WAS ON 5245 04:09:09,452 --> 04:09:10,653 HEALTH PROMOTION AND WANTED TO 5246 04:09:10,653 --> 04:09:14,124 FLIP THE SCRIPT AND NOT HAVE IT 5247 04:09:14,124 --> 04:09:15,592 BE ABOUT SUBSTANCE ABUSE 5248 04:09:15,592 --> 04:09:17,761 PREVENTION BUT THE ORIGINAL 5249 04:09:17,761 --> 04:09:19,963 TEACHINGS AROUND MEDICINES AND 5250 04:09:19,963 --> 04:09:21,131 INCORRECT RELATIONSHIP WITH 5251 04:09:21,131 --> 04:09:23,199 MEDICINE WHAT ARE THE NATURAL 5252 04:09:23,199 --> 04:09:24,334 CONSEQUENCES AND HOW DO WE 5253 04:09:24,334 --> 04:09:25,602 CORRECT FOR THAT AND THOSE KIND 5254 04:09:25,602 --> 04:09:26,436 OF THINGS. 5255 04:09:26,436 --> 04:09:28,805 THEY ASKED US, MY TRIBE IS DOING 5256 04:09:28,805 --> 04:09:30,640 THE BEST THINGS FOR OBESITY 5257 04:09:30,640 --> 04:09:31,174 PREVENTION AND DIABETES 5258 04:09:31,174 --> 04:09:32,609 PREVENTION RIGHT NOW. 5259 04:09:32,609 --> 04:09:35,211 WE HAVE STATE OF THE ART GYMS. 5260 04:09:35,211 --> 04:09:36,479 BETTER THAN GOLD'S GYM. 5261 04:09:36,479 --> 04:09:39,949 WE HAVE STATE OF THE ART HEALTH 5262 04:09:39,949 --> 04:09:43,353 FACILITIES AND STATE OF THE ART 5263 04:09:43,353 --> 04:09:45,655 NUTRITION PROGRAMS AND THE BEST 5264 04:09:45,655 --> 04:09:46,890 BARIATRIC SURGERY YOU CAN GET 5265 04:09:46,890 --> 04:09:48,158 FOR FREE IN MY TRIBE. 5266 04:09:48,158 --> 04:09:52,195 WE HAVE STRUCTURAL INTERVENTIONS 5267 04:09:52,195 --> 04:09:55,131 WHERE THEY HAVE THE FOOD 5268 04:09:55,131 --> 04:09:56,399 PROGRAMMING FOR TRIBAL 5269 04:09:56,399 --> 04:09:58,468 CAFETERIAS AND PUT IN WALKWAYS 5270 04:09:58,468 --> 04:10:01,371 AND YET HAVE SEEN LESS THAN 3% 5271 04:10:01,371 --> 04:10:02,939 CHANGE IN TERMS OF HEALTH. 5272 04:10:02,939 --> 04:10:04,774 THE TRIBE SAID WHAT CAN WE DO 5273 04:10:04,774 --> 04:10:05,642 DIFFERENTLY. 5274 04:10:05,642 --> 04:10:10,947 AND IT CAME TO ME SIMPLY, OUR 5275 04:10:10,947 --> 04:10:11,614 ANCESTORS WEREN'T SUPPOSED TO BE 5276 04:10:11,614 --> 04:10:13,149 DYING THIS WAY. 5277 04:10:13,149 --> 04:10:14,918 WE HAVE TO RECONNECT TO THE LOVE 5278 04:10:14,918 --> 04:10:19,055 OF LIFE AND HAVE TO CREATE OUR 5279 04:10:19,055 --> 04:10:20,423 OWN CHOCTAW HEALTH PROMOTION 5280 04:10:20,423 --> 04:10:23,726 MODEL AND WE PARTNERED WITH A 5281 04:10:23,726 --> 04:10:26,696 CHIEF SISTER, SHARON FLEMING AND 5282 04:10:26,696 --> 04:10:28,198 DECIDED TO DO THAT TO COME UP 5283 04:10:28,198 --> 04:10:31,334 WITH OUR OWN HEALTH PROMOTION, 5284 04:10:31,334 --> 04:10:34,604 INTERVENTION BY FIRST REWALKING 5285 04:10:34,604 --> 04:10:36,639 THE TRAIL OF TEARS OURSELVES IN 5286 04:10:36,639 --> 04:10:38,708 PARTNERSHIP WITH OUR TRIBAL 5287 04:10:38,708 --> 04:10:38,975 COMMUNITY. 5288 04:10:38,975 --> 04:10:43,880 THAT SOUNDS A LITTLE BIT CRAZY 5289 04:10:43,880 --> 04:10:49,219 BUT WE FELT WALKING THE STEPS OF 5290 04:10:49,219 --> 04:10:50,920 OUR ANCESTORS WE SAID WE DON'T 5291 04:10:50,920 --> 04:10:52,889 WANT THIS TO BE A PROGRAM WE'RE 5292 04:10:52,889 --> 04:10:53,189 DEVELOPING. 5293 04:10:53,189 --> 04:10:58,294 WE WANT THIS TO BE A SHIFT IN 5294 04:10:58,294 --> 04:11:00,763 COMMUNITY ATTITUDES AND PUTTING 5295 04:11:00,763 --> 04:11:02,098 BACK IN CULTURAL ROLES AT A 5296 04:11:02,098 --> 04:11:05,134 COMMUNITY LEVEL THAT ARE FOR 5297 04:11:05,134 --> 04:11:05,335 FREE. 5298 04:11:05,335 --> 04:11:06,469 IT DOESN'T TAKE A LOT OF MONEY 5299 04:11:06,469 --> 04:11:15,445 TO DO. 5300 04:11:15,445 --> 04:11:18,181 THE TRIBE SAID OKAY AND SO WE 5301 04:11:18,181 --> 04:11:21,417 WALKED 8 TO 10 MILES A DAY IN 5302 04:11:21,417 --> 04:11:24,020 ARKANSAS IN THE MIDDLE OF JUNE 5303 04:11:24,020 --> 04:11:26,823 AND OVER 254 MILES DURING THAT 5304 04:11:26,823 --> 04:11:29,125 TRIP AND HAD A SIMPLE QUESTION, 5305 04:11:29,125 --> 04:11:33,062 WHAT'S THE ROAD TO CHOCTAW 5306 04:11:33,062 --> 04:11:34,664 HEALTH AND DID TRIBAL RESEARCH 5307 04:11:34,664 --> 04:11:37,800 AND WANTED TO GET BETA FROM THE 5308 04:11:37,800 --> 04:11:39,636 ARCHIVAL RESEARCH OF LETTERS AND 5309 04:11:39,636 --> 04:11:41,971 FEDERAL LETTERS FROM OTHERS THAT 5310 04:11:41,971 --> 04:11:44,340 GAVE US AN IDEA WHAT OUR AN 5311 04:11:44,340 --> 04:11:46,409 ANCESTORS IMAGINED FOR US AND 5312 04:11:46,409 --> 04:11:49,445 WORKED HARD TO FIND ORIGINAL 5313 04:11:49,445 --> 04:11:49,846 ROOTS. 5314 04:11:49,846 --> 04:11:53,716 WE HAD AN ARMY GUY WHO USED TO 5315 04:11:53,716 --> 04:11:58,888 DO THE G.I.S. MAPPING FOR THE 5316 04:11:58,888 --> 04:12:02,792 MILITARY AND TOOK OLD 1820, 1830 5317 04:12:02,792 --> 04:12:05,628 MILITARY MAPS AND WE WERE GOING 5318 04:12:05,628 --> 04:12:12,035 TO WALK THAT TRAIL THE INTACT 5319 04:12:12,035 --> 04:12:15,271 TRAILS AND DID IT THROUGH SWAMPS 5320 04:12:15,271 --> 04:12:21,811 AND WOUND UP IN WILDLIFE REFUGES 5321 04:12:21,811 --> 04:12:25,915 AND DID G.I.S. BLOGGING AND 5322 04:12:25,915 --> 04:12:28,084 PERFORM FOCUS GROUPS AND 5323 04:12:28,084 --> 04:12:31,521 INTERVIEWS AND 13 CHOCTAWS WHO 5324 04:12:31,521 --> 04:12:33,556 STEPPED FORWARD. 5325 04:12:33,556 --> 04:12:35,024 PRIMARILY WOMEN AND WE ASKED 5326 04:12:35,024 --> 04:12:35,758 ELDERS AND THEY SAID IT'S 5327 04:12:35,758 --> 04:12:38,127 SUPPOSED TO BE THE WOMEN WHO 5328 04:12:38,127 --> 04:12:40,496 STEP UP TRADITIONALLY IN ANCIENT 5329 04:12:40,496 --> 04:12:44,801 TIMES THE CHOCTAW WOMEN WERE 5330 04:12:44,801 --> 04:12:47,203 RESPONSIBLE FOR THE CEREMONIES 5331 04:12:47,203 --> 04:12:48,604 TO MAKE THINGS RIGHT AGAIN AND 5332 04:12:48,604 --> 04:12:50,373 WE WENT FORTHWITH THE WOMEN AND 5333 04:12:50,373 --> 04:12:51,741 HAD HEALTH SPECIALISTS WHO SAID 5334 04:12:51,741 --> 04:12:54,243 I'M GOING TO DO THIS BECAUSE IF 5335 04:12:54,243 --> 04:12:57,080 I'M GOING TO ASK MY COMMUNITY I 5336 04:12:57,080 --> 04:13:00,616 SHOULD ASK MYSELF FIRST. 5337 04:13:00,616 --> 04:13:03,119 THE ROOTED APPROACH IS HOW WE 5338 04:13:03,119 --> 04:13:04,020 LOOKED AT THIS. 5339 04:13:04,020 --> 04:13:13,262 WE HAVE TO FIX OURSELVES FIRST. 5340 04:13:13,262 --> 04:13:16,466 WE DID FASTING AND ABSTAINING 5341 04:13:16,466 --> 04:13:19,702 AND SHE CAN TELL YOU ABOUT PART 5342 04:13:19,702 --> 04:13:21,604 OF THIS AND THESE ARE PICTURES 5343 04:13:21,604 --> 04:13:32,015 FROM WALKING THE TRAIL. 5344 04:13:32,949 --> 04:13:35,985 THE IRB WAS A NIGHTMARE BECAUSE 5345 04:13:35,985 --> 04:13:40,523 YOU HAVE TO BE 12 YEARS OLD OR 5346 04:13:40,523 --> 04:13:43,893 OLDER TO SURVIVE IN THE 5347 04:13:43,893 --> 04:13:46,396 MOCCASINS AND SURVIVE AND WHERE 5348 04:13:46,396 --> 04:13:52,035 THE TEACHINGS ARE AROUND AND 5349 04:13:52,035 --> 04:13:54,437 LOOKING AT TEACHING AND IT WAS 5350 04:13:54,437 --> 04:13:56,005 NOT ABOUT MEMORIALIZING A WALK 5351 04:13:56,005 --> 04:13:57,106 OR TRAUMA. 5352 04:13:57,106 --> 04:13:59,942 IT WAS ABOUT RECONNECTING TO THE 5353 04:13:59,942 --> 04:14:01,177 LOVE AND CENTERING THE LOVE AND 5354 04:14:01,177 --> 04:14:11,554 IT WAS VERY POWERFUL. 5355 04:14:12,889 --> 04:14:13,956 MAIN OBSERVATIONS IS WE CONTINUE 5356 04:14:13,956 --> 04:14:17,827 TO CENTER THE TRAUMA AND 5357 04:14:17,827 --> 04:14:18,895 COLONIZING STRESS AND THE 5358 04:14:18,895 --> 04:14:20,763 YOUNGEST PERSON ON THE TRAIL 5359 04:14:20,763 --> 04:14:22,932 WHICH WAS POWERFUL ON DAY THREE 5360 04:14:22,932 --> 04:14:25,968 SHE SAID I GET IT NOW. 5361 04:14:25,968 --> 04:14:29,472 I HEAL OTHERS WHEN I MAKE MYSELF 5362 04:14:29,472 --> 04:14:30,173 HEALTHY. 5363 04:14:30,173 --> 04:14:33,376 IF I'M A HEALTHY TEENAGER I CAN 5364 04:14:33,376 --> 04:14:35,011 HEAL THE WORLD AND WE'RE LIKE 5365 04:14:35,011 --> 04:14:37,613 WE'RE DONE. 5366 04:14:37,613 --> 04:14:39,982 WHO NEEDS A KID'S INTERVENTION? 5367 04:14:39,982 --> 04:14:40,850 WE'RE DOWN. 5368 04:14:40,850 --> 04:14:43,086 AND THINGS ON THE LAND WERE 5369 04:14:43,086 --> 04:14:43,953 POWERFUL BECAUSE STORIES CAME 5370 04:14:43,953 --> 04:14:46,722 OUT THAT WOULD NOT HAVE 5371 04:14:46,722 --> 04:14:49,592 OTHERWISE COME OUT IF WE HAD A 5372 04:14:49,592 --> 04:14:51,294 50-MINUTE CONVERSATION. 5373 04:14:51,294 --> 04:14:56,132 STORIES EMERGED WHERE BEING ON 5374 04:14:56,132 --> 04:15:00,236 THE LAND SPARKED THE STORIES AND 5375 04:15:00,236 --> 04:15:04,107 GOT FUNDED AND TOOK OVER 150 5376 04:15:04,107 --> 04:15:09,879 CHOCTAW WOMEN AND DID A CLUSTER 5377 04:15:09,879 --> 04:15:11,114 RANDOMIZED STEP WEDGE DESIGN 5378 04:15:11,114 --> 04:15:12,281 ADDRESSING OBESITY AND SUBSTANCE 5379 04:15:12,281 --> 04:15:14,951 ABUSE AND WE SAID WE'RE BUILDING 5380 04:15:14,951 --> 04:15:17,753 CHOCTAW HEALTH LEADERS AND 5381 04:15:17,753 --> 04:15:19,355 ASKING CHOCTAW WOMEN TO STEP IN 5382 04:15:19,355 --> 04:15:20,623 THAT ROLE AND WHO WANTS TO BE A 5383 04:15:20,623 --> 04:15:23,493 LEADER AND START WITH YOU FIRST 5384 04:15:23,493 --> 04:15:24,727 TO START WITH YOURSELF ON BEHALF 5385 04:15:24,727 --> 04:15:27,897 OF YOU AND YOUR FAMILY AND LEARN 5386 04:15:27,897 --> 04:15:29,532 TO DO A PREVENTION EVENT YOU'LL 5387 04:15:29,532 --> 04:15:31,134 BE RESPONSIBLE FOR SUSTAINING 5388 04:15:31,134 --> 04:15:33,102 AND THEN ASK YOU TO BE YOUR 5389 04:15:33,102 --> 04:15:33,936 HEALTH LEADER FOR YOUR 5390 04:15:33,936 --> 04:15:34,270 COMMUNITY. 5391 04:15:34,270 --> 04:15:35,805 DO YOU WANT TO DO THAT? 5392 04:15:35,805 --> 04:15:37,106 WE HAD WOMEN WHO SIGNED UP WHO 5393 04:15:37,106 --> 04:15:39,909 WANTED TO DO THAT AND WHAT WAS 5394 04:15:39,909 --> 04:15:41,511 AMAZING ABOUT IT WAS BECAUSE WE 5395 04:15:41,511 --> 04:15:43,546 DIDN'T MAKE IT ABOUT A DISEASE 5396 04:15:43,546 --> 04:15:45,014 FOCUS BUT RATHER THE HEALTH 5397 04:15:45,014 --> 04:15:47,950 PROMOTION FOCUS AND STEPPING 5398 04:15:47,950 --> 04:15:49,185 INTO THE IMPORTANT ROLES, SO 5399 04:15:49,185 --> 04:15:52,955 THEY WENT THROUGH THE THREE-WEEK 5400 04:15:52,955 --> 04:15:54,824 CURRICULUM AT THE CULTURALLY 5401 04:15:54,824 --> 04:15:58,528 BASED CURRICULUM BASED ON OUR 5402 04:15:58,528 --> 04:15:59,662 PLANNED SYSTEMS FROM OUR TWO 5403 04:15:59,662 --> 04:16:02,532 WALKS AND THE BEHAVIORS 5404 04:16:02,532 --> 04:16:04,100 ASSOCIATED WITH EACH OF THE 5405 04:16:04,100 --> 04:16:07,503 CLANS AS MODELS FOR CHANGE AT 5406 04:16:07,503 --> 04:16:12,008 THE END OF THE 12 WEEKS THEY DID 5407 04:16:12,008 --> 04:16:14,377 A DID A CEREMONY RE-WALKING THE 5408 04:16:14,377 --> 04:16:16,979 TRAIL OF TEARS THEMSELVES AND AT 5409 04:16:16,979 --> 04:16:18,281 THE END THEY THEN WERE RECEIVED 5410 04:16:18,281 --> 04:16:23,085 BY THEIR COMMUNITY AND A FEAST 5411 04:16:23,085 --> 04:16:25,087 WAS HELD FOR THEM AND HONORED 5412 04:16:25,087 --> 04:16:27,456 THEM AS HEALTH LEADERS AND GOT 5413 04:16:27,456 --> 04:16:30,660 BOOSTER SESSIONS AND GOT $1,000 5414 04:16:30,660 --> 04:16:33,729 TO PUT ON A COMMUNITY EVENT THAT 5415 04:16:33,729 --> 04:16:35,598 HAD TO BE SUSTAINABLE BEYOND THE 5416 04:16:35,598 --> 04:16:37,233 PROJECT YEARS AND THEY DID THAT 5417 04:16:37,233 --> 04:16:40,803 AND STILL HAVE TO THIS DAY 5418 04:16:40,803 --> 04:16:42,572 PROJECTS WOMEN WHO ARE STILL 5419 04:16:42,572 --> 04:16:43,806 RUNNING PROJECTS ANNUALLY OR 5420 04:16:43,806 --> 04:16:45,341 STILL ONGOING TO. 5421 04:16:45,341 --> 04:16:53,649 THEY'RE CALLED -- IF YOU'VE SEEN 5422 04:16:53,649 --> 04:16:54,450 WALKING WARRIORS THEY'RE ONLINE. 5423 04:16:54,450 --> 04:16:56,319 THEY NOW HAVE THE NETWORK OF 5424 04:16:56,319 --> 04:17:00,022 WOMEN ACROSS THE WORLD ACTUALLY 5425 04:17:00,022 --> 04:17:01,457 WALKING WITH THEM. 5426 04:17:01,457 --> 04:17:02,858 IT WAS VERY TRANSFORMATIVE. 5427 04:17:02,858 --> 04:17:04,193 THAT'S SOMETHING I WANTED TO 5428 04:17:04,193 --> 04:17:06,495 SHARE THAT CAME FROM THE WORK WE 5429 04:17:06,495 --> 04:17:07,697 DID ORIGINALLY AT NIMHD AND 5430 04:17:07,697 --> 04:17:12,001 RETURNING IT BACK TO WHY IS THIS 5431 04:17:12,001 --> 04:17:14,036 IMPORTANT AND WE'RE LOOKING TO 5432 04:17:14,036 --> 04:17:15,671 LOOK AT INNOVATION AND LOOK AT 5433 04:17:15,671 --> 04:17:19,308 DIFFERENT WAYS OF APPROACHING, 5434 04:17:19,308 --> 04:17:22,712 ADDRESSING THE HEALTH INEQUITIES 5435 04:17:22,712 --> 04:17:23,579 IN INDIAN COUNTRY AND LOOKING 5436 04:17:23,579 --> 04:17:25,348 FOR CREATIVE WAYS TO ADDRESS 5437 04:17:25,348 --> 04:17:27,283 THESE ISSUES BECAUSE AS I SHOWED 5438 04:17:27,283 --> 04:17:29,418 YOU EARLIER, THIS IS PERSONAL. 5439 04:17:29,418 --> 04:17:30,253 THIS IS PROFESSIONAL. 5440 04:17:30,253 --> 04:17:32,855 AND WE'RE IN A CRISIS AND WE 5441 04:17:32,855 --> 04:17:33,422 NEED EVERYBODY'S HELP. 5442 04:17:33,422 --> 04:17:35,691 THANK YOU TO ALLOWING ME TO 5443 04:17:35,691 --> 04:17:36,325 SHARE THAT WITH YOU. 5444 04:17:36,325 --> 04:17:46,502 QUESTIONS? 5445 04:17:55,111 --> 04:17:57,847 >> THANK YOU. 5446 04:17:57,847 --> 04:18:02,952 WHAT'S THE POLICY NOW? 5447 04:18:02,952 --> 04:18:13,462 I DON'T KNOW ABOUT THE TISSUE 5448 04:18:14,330 --> 04:18:17,433 SAMPLES AND HOW DO YOU RECRUIT? 5449 04:18:17,433 --> 04:18:22,905 >> THE FIRST ON GENOMIC AND 5450 04:18:22,905 --> 04:18:25,074 GENETIC, THEY HAVE SOVEREIGNTY 5451 04:18:25,074 --> 04:18:28,177 POLICIES WE'RE LOOKING WITH THE 5452 04:18:28,177 --> 04:18:30,746 OFFICE OF SCIENCE POLICY AND 5453 04:18:30,746 --> 04:18:34,583 NHGRI AND OTHERS TO BASICALLY 5454 04:18:34,583 --> 04:18:39,021 ALIGN OUR GENOMICS POLICY WITH 5455 04:18:39,021 --> 04:18:43,492 TRIBAL ORDINANCES LAWS AND 5456 04:18:43,492 --> 04:18:43,859 STANDARDS. 5457 04:18:43,859 --> 04:18:48,597 THEY OWN THEIR DATA AND RIGHT TO 5458 04:18:48,597 --> 04:18:51,334 THEIR BIO SPECIMENS. 5459 04:18:51,334 --> 04:18:54,470 THE ISSUE IS DEVELOPING GOOD 5460 04:18:54,470 --> 04:18:59,175 MOUs AND HONOR THAT AND TRY TO 5461 04:18:59,175 --> 04:19:00,042 EQUALLY INVESTED IN HAVING 5462 04:19:00,042 --> 04:19:02,912 STRONG SCIENCE THAT'S GOING TO 5463 04:19:02,912 --> 04:19:04,480 BENEFIT THEIR COMMUNITY. 5464 04:19:04,480 --> 04:19:06,982 IT'S NOT CAUSING HARM, TRIBES 5465 04:19:06,982 --> 04:19:07,483 INTEREST AGREED TO IT. 5466 04:19:07,483 --> 04:19:13,055 WE HAVE A PROCESS OF ENGAGING 5467 04:19:13,055 --> 04:19:14,357 THE TRIBE AND WE'RE HAVING TO 5468 04:19:14,357 --> 04:19:17,860 WRITE THAT OUT NOW SO WE'RE IN 5469 04:19:17,860 --> 04:19:21,664 THE SAME PAGE WITH RESPECT TO 5470 04:19:21,664 --> 04:19:22,598 THAT. 5471 04:19:22,598 --> 04:19:24,700 BECAUSE OF TRIBAL SOVEREIGNTY 5472 04:19:24,700 --> 04:19:26,802 IT'S EXEMPT FROM THE COMMON 5473 04:19:26,802 --> 04:19:27,002 RULE. 5474 04:19:27,002 --> 04:19:29,105 THEIR ORDINANCES ARE MORE 5475 04:19:29,105 --> 04:19:31,474 STRINGENT THAN THE CURRENT 5476 04:19:31,474 --> 04:19:34,243 COMMON RULE IT TAKES PRECEDENCE 5477 04:19:34,243 --> 04:19:36,645 AND BIO SPECIMENS ARE PART OF 5478 04:19:36,645 --> 04:19:36,846 THAT. 5479 04:19:36,846 --> 04:19:38,948 IF OUR TRIBAL LANDS AND CHOCTAW 5480 04:19:38,948 --> 04:19:40,983 NATION IS BIGGER THAN THE STATE 5481 04:19:40,983 --> 04:19:41,450 OF MASSACHUSETTS. 5482 04:19:41,450 --> 04:19:42,918 PEOPLE DON'T REALIZE HOW BIG 5483 04:19:42,918 --> 04:19:46,288 THAT IS IN SOUTHEASTERN 5484 04:19:46,288 --> 04:19:46,555 OKLAHOMA. 5485 04:19:46,555 --> 04:19:48,257 ALASKAN TAKES UP THE MIDDLE HALF 5486 04:19:48,257 --> 04:19:56,031 OF THIS COUNTRY IF WE WERE TO 5487 04:19:56,031 --> 04:19:57,733 SUPERIMPOSE ALASKA AND WE HAVE 5488 04:19:57,733 --> 04:19:59,702 TO THINK OF WAYS AS SCIENTISTS 5489 04:19:59,702 --> 04:20:01,070 HOW TO DO TWO THINGS. 5490 04:20:01,070 --> 04:20:03,439 ONE WORK WITH SMALL SAMPLE SIZES 5491 04:20:03,439 --> 04:20:06,342 IN SOME CASES AND IN OTHER CASES 5492 04:20:06,342 --> 04:20:08,010 MAKING SURE WE HAVE ENOUGH 5493 04:20:08,010 --> 04:20:12,415 FUNDING SO TRIBES CAN DO A STUDY 5494 04:20:12,415 --> 04:20:15,951 IF YOU'RE LOOKING ACROSS LARGE 5495 04:20:15,951 --> 04:20:17,686 GEOGRAPHIC EXPANSES. 5496 04:20:17,686 --> 04:20:21,157 ALASKA USES PUDDLE JUMPER PLANES 5497 04:20:21,157 --> 04:20:23,726 TO GET TO REMOTE LOCATIONS. 5498 04:20:23,726 --> 04:20:25,694 IT CREATES A BIGGER BURDEN BUT 5499 04:20:25,694 --> 04:20:28,197 WE CAN BE CREATIVE. 5500 04:20:28,197 --> 04:20:31,567 WE APPRECIATED HAVING RANDOMIZED 5501 04:20:31,567 --> 04:20:33,769 STEP WEDGE SAMPLING BECAUSE WE. 5502 04:20:33,769 --> 04:20:36,005 GO BY COMMUNITY UP PLACE OF 5503 04:20:36,005 --> 04:20:36,539 INDIVIDUALS AND THAT WAS 5504 04:20:36,539 --> 04:20:47,016 IMPORTANT TO THE COMMUNITY. 5505 04:20:47,416 --> 04:20:48,784 >> THAT WAS WONDERFUL. 5506 04:20:48,784 --> 04:20:54,490 THE WORK SGRO HAS DONE IN THE 5507 04:20:54,490 --> 04:21:05,034 PAST IN THE PORTFOLIO ANALYSIS 5508 04:21:11,407 --> 04:21:14,076 WONDERING IF THE REVIEWERS DO 5509 04:21:14,076 --> 04:21:18,214 THE WORK TO BE DONE AND HOW MANY 5510 04:21:18,214 --> 04:21:22,852 PRs ARE NOFOs ARE AVAILABLE FOR 5511 04:21:22,852 --> 04:21:24,019 RESEARCH IN THE SPACE? 5512 04:21:24,019 --> 04:21:27,623 >> TO THE FIRST QUESTION, WE 5513 04:21:27,623 --> 04:21:29,959 ACTUALLY JUST LAUNCHED A DETAIL 5514 04:21:29,959 --> 04:21:34,263 THAT WENT LIVE END OF LAST WEEK 5515 04:21:34,263 --> 04:21:35,030 SPECIFICALLY ASKING FOR NIH TO 5516 04:21:35,030 --> 04:21:39,502 PLEASE COME OVER WITH DOING OUR 5517 04:21:39,502 --> 04:21:39,768 PORTFOLIO. 5518 04:21:39,768 --> 04:21:42,505 SO ANYBODY AT NIH COME SEE ME. 5519 04:21:42,505 --> 04:21:46,642 SO THAT'S ONE OF THE FIRST THING 5520 04:21:46,642 --> 04:21:49,879 WE'RE TRYING DO IS DO A 5521 04:21:49,879 --> 04:21:51,614 COMPREHENSIVE PORTFOLIO FOR A 5522 04:21:51,614 --> 04:21:54,183 STRATEGIC PLAN WE HOPE TO LAUNCH 5523 04:21:54,183 --> 04:21:57,620 NEXT YEAR. 5524 04:21:57,620 --> 04:21:58,754 SECOND QUESTION? 5525 04:21:58,754 --> 04:22:00,089 NOFOs. 5526 04:22:00,089 --> 04:22:01,290 THERE ARE SOME THAT ARE 5527 04:22:01,290 --> 04:22:02,825 FORTHCOMING RIGHT NOW. 5528 04:22:02,825 --> 04:22:07,363 THERE'S ONGOING ONES AVAILABLE 5529 04:22:07,363 --> 04:22:08,397 BUT. 5530 04:22:08,397 --> 04:22:09,832 INTERVENTION RESEARCH FOR NATIVE 5531 04:22:09,832 --> 04:22:13,202 AMERICAN HEALTH IS A GREAT ONE 5532 04:22:13,202 --> 04:22:17,339 FOR R01s AND R34s I BELIEVE NOW 5533 04:22:17,339 --> 04:22:19,608 AND I BELIEVE NIMHD IS ON THAT 5534 04:22:19,608 --> 04:22:24,914 AS WELL AND THE KNOWLEDGE GRANTS 5535 04:22:24,914 --> 04:22:28,784 ONGOING IN TWO MONTHS IN THE 5536 04:22:28,784 --> 04:22:30,986 NATIVE AMERICAN RESEARCH CENTERS 5537 04:22:30,986 --> 04:22:38,193 FOR HEALTH THROUGH NIGMS AND HAD 5538 04:22:38,193 --> 04:22:41,797 RECENT NOFOs IN PROCESS OR 5539 04:22:41,797 --> 04:22:43,933 FILLED I SHOULD SAY. 5540 04:22:43,933 --> 04:22:51,307 A PROGRAM TIED TO HEAL AND 5541 04:22:51,307 --> 04:22:54,810 OPIOID AND PAIN OVERDOSE AND 5542 04:22:54,810 --> 04:22:55,611 GENERAL NOFOs WHERE NATIVE 5543 04:22:55,611 --> 04:22:56,478 PEOPLE APPLY. 5544 04:22:56,478 --> 04:23:03,185 THE CENTERS OF EXCELLENCE FOR 5545 04:23:03,185 --> 04:23:13,662 NIMHD FOR EXAMPLE OR OTHER 5546 04:23:16,065 --> 04:23:18,367 NATIVE NOFOs. 5547 04:23:18,367 --> 04:23:24,039 ESPECIALLY AROUND THE 5548 04:23:24,039 --> 04:23:34,483 INTERGENERATIONAL TRAUMA. 5549 04:23:35,584 --> 04:23:37,319 >> THANK YOU SO MUCH. 5550 04:23:37,319 --> 04:23:39,088 THAT WAS AMAZING. 5551 04:23:39,088 --> 04:23:39,888 THAT WAS A WONDERFUL 5552 04:23:39,888 --> 04:23:43,559 PRESENTATION OF YOU AND THE 5553 04:23:43,559 --> 04:23:43,792 ISSUES. 5554 04:23:43,792 --> 04:23:47,930 A LOT TO DO AND LEARN TOGETHER. 5555 04:23:47,930 --> 04:23:55,104 WE DO HAVE ONE RCMI IN ARIZONA 5556 04:23:55,104 --> 04:23:59,508 THAT HAS A MAJOR FOCUS ON 5557 04:23:59,508 --> 04:24:02,311 AMERICAN INDIAN AND ALASKAN 5558 04:24:02,311 --> 04:24:02,544 NATIVE. 5559 04:24:02,544 --> 04:24:06,081 AS YOU KNOW HISTORICALLY SOME 5560 04:24:06,081 --> 04:24:08,150 GRANTS UNIVERSITY OF WASHINGTON 5561 04:24:08,150 --> 04:24:09,985 AND UNIVERSITY OF MEXICO HAD A 5562 04:24:09,985 --> 04:24:11,220 STRONG THEME AND WE ARE 5563 04:24:11,220 --> 04:24:14,823 CONTINUING TO WORK WITH THE 5564 04:24:14,823 --> 04:24:18,227 TRIBAL EPIDEMIOLOGY CENTERS. 5565 04:24:18,227 --> 04:24:20,596 HOPEFULLY WE'LL CONTINUE TO MOVE 5566 04:24:20,596 --> 04:24:23,799 ON THAT AND YOU ALSO REFERRED TO 5567 04:24:23,799 --> 04:24:28,937 THE NATIVE AMERICAN CANCER 5568 04:24:28,937 --> 04:24:37,980 OUTCOMES DIRECTIVE. 5569 04:24:37,980 --> 04:24:40,015 FOR LATER DISCUSSION, YOU 5570 04:24:40,015 --> 04:24:42,484 MENTIONED NOT JUST TRIBAL 5571 04:24:42,484 --> 04:24:46,855 MEMBERS BUT URBAN INDIAN AND 5572 04:24:46,855 --> 04:24:51,827 NATIVE HAWAIIANS AND WHAT ABOUT 5573 04:24:51,827 --> 04:24:52,828 INDIGENOUS PEOPLE OF LATIN 5574 04:24:52,828 --> 04:24:53,062 AMERICA? 5575 04:24:53,062 --> 04:24:57,032 >> THE BORDER CROSSES UP 5576 04:24:57,032 --> 04:24:59,902 PHENOMENA THAT'S TRUE FOR CANADA 5577 04:24:59,902 --> 04:25:01,637 AS WELL AND WE SAY NORTH AMERICA 5578 04:25:01,637 --> 04:25:07,309 INCLUDES INDIGENOUS PEOPLE OF 5579 04:25:07,309 --> 04:25:17,820 MEXICO AS WELL AND CERTAINLY 5580 04:25:19,855 --> 04:25:28,964 SOME COMMUNITIES AROUND AND 5581 04:25:28,964 --> 04:25:30,365 WHERE WE GET CALLED TO ADDRESS 5582 04:25:30,365 --> 04:25:34,503 THE ISSUES ARE AROUND LACK OF 5583 04:25:34,503 --> 04:25:36,038 PROPER INFORMED CONSENT FOR 5584 04:25:36,038 --> 04:25:37,339 SPECIMENS FOR INDIGENOUS 5585 04:25:37,339 --> 04:25:38,607 POPULATIONS SOUTH OF THE BORDER 5586 04:25:38,607 --> 04:25:39,942 BECAUSE PEOPLE CAN GET AWAY WITH 5587 04:25:39,942 --> 04:25:41,276 THAT. 5588 04:25:41,276 --> 04:25:44,913 WE END UP SPENDING A LOT OF TIME 5589 04:25:44,913 --> 04:25:45,681 SAYING THAT'S NOT OKAY AND 5590 04:25:45,681 --> 04:25:47,950 FIGURING OUT WAYS TO ADDRESS 5591 04:25:47,950 --> 04:25:48,183 THAT. 5592 04:25:48,183 --> 04:25:49,451 I'D LOVE TO SEE MORE WORK IN 5593 04:25:49,451 --> 04:25:49,752 THAT SPACE. 5594 04:25:49,752 --> 04:25:59,895 IT'S AN IMPORTANT AREA. 5595 04:25:59,895 --> 04:26:10,305 >> THANK YOU VERY MUCH. 5596 04:26:26,221 --> 04:26:27,089 >> WHILE THE SLIDE DECK IS 5597 04:26:27,089 --> 04:26:29,892 UPLOADING I WANT TO INTRODUCE MY 5598 04:26:29,892 --> 04:26:31,160 COLLEAGUE WHO WILL BE THE NEXT 5599 04:26:31,160 --> 04:26:32,761 AND FINAL PRESENTATION FOR TODAY 5600 04:26:32,761 --> 04:26:35,497 AND WE'LL WRAP UP. 5601 04:26:35,497 --> 04:26:37,533 JOSH DENNY IS THE CHIEF 5602 04:26:37,533 --> 04:26:39,535 EXECUTIVE OFFICER OF THE 5603 04:26:39,535 --> 04:26:40,769 NATIONAL INSTITUTE OF HEALTH ALL 5604 04:26:40,769 --> 04:26:44,673 OF US RESEARCH PROGRAM, WHICH 5605 04:26:44,673 --> 04:26:46,375 YOU HEARD ABOUT EARLIER TODAY 5606 04:26:46,375 --> 04:26:47,009 FROM ME. 5607 04:26:47,009 --> 04:26:49,344 JOSH IS ALSO A GENERAL 5608 04:26:49,344 --> 04:26:49,611 INTERNIST. 5609 04:26:49,611 --> 04:26:51,313 SO WE SHARE THAT IN COMMON. 5610 04:26:51,313 --> 04:26:54,316 HE CAME TO NIH FROM VANDERBILT 5611 04:26:54,316 --> 04:26:57,119 WHERE HE HAD BEEN FACULTY MEMBER 5612 04:26:57,119 --> 04:26:59,988 THERE FOR MANY YEARS. 5613 04:26:59,988 --> 04:27:01,156 THE ALL OF US RESEARCH PROGRAM 5614 04:27:01,156 --> 04:27:04,893 HAS A GOAL OF ENROLLING AT LEAST 5615 04:27:04,893 --> 04:27:06,929 1 MILLION PEOPLE AND THE 5616 04:27:06,929 --> 04:27:10,265 REASONING WAS CALLED THE 5617 04:27:10,265 --> 04:27:10,899 PRECISION MEDICINE INITIATIVE 5618 04:27:10,899 --> 04:27:13,502 FOCUSSED NOT JUST ON DEVELOPING 5619 04:27:13,502 --> 04:27:14,736 OR THINKING ABOUT PHYSICIAN 5620 04:27:14,736 --> 04:27:18,207 MEDICINE FOR ALL POPULATIONS BUT 5621 04:27:18,207 --> 04:27:23,645 CREATING A LARGE OBSERVATIONAL 5622 04:27:23,645 --> 04:27:27,983 COHORT STUDY IN THE UNITED 5623 04:27:27,983 --> 04:27:30,686 STATES IN PART WITH THE U.K. BIO 5624 04:27:30,686 --> 04:27:33,922 BANK STUDY AND WILL BE A 5625 04:27:33,922 --> 04:27:35,691 RESOURCE FOR RESEARCHERS AND FOR 5626 04:27:35,691 --> 04:27:38,393 UNDERSTANDING NOT ONLY 5627 04:27:38,393 --> 04:27:41,363 MECHANISMS AND GENERATING IDEAS 5628 04:27:41,363 --> 04:27:43,999 FOR INTERVENTIONS FOR REALLY 5629 04:27:43,999 --> 04:27:46,902 YEARS AND YEARS TO COME. 5630 04:27:46,902 --> 04:27:48,403 WE'RE AT AN INFLECTION POINT 5631 04:27:48,403 --> 04:27:52,040 WITH THE ALL OF US AND JOSH I'M 5632 04:27:52,040 --> 04:27:53,475 SURE WILL SHARE SOME THOUGHTS 5633 04:27:53,475 --> 04:27:53,775 WITH YOU. 5634 04:27:53,775 --> 04:27:55,577 HE AS I SAID CAME FROM 5635 04:27:55,577 --> 04:27:57,012 VANDERBILT AS PROFESSOR OF 5636 04:27:57,012 --> 04:28:01,950 INFORMATICS AND MEDICINE AND WAS 5637 04:28:01,950 --> 04:28:04,086 THE DIRECTOR FOR FAMILY 5638 04:28:04,086 --> 04:28:06,355 PRECISION MEDICINE AND VICE 5639 04:28:06,355 --> 04:28:08,891 PRESIDENT FOR PERSONALIZED 5640 04:28:08,891 --> 04:28:11,627 MEDICINE AT VANDERBILT 5641 04:28:11,627 --> 04:28:12,261 UNIVERSITY MEDICAL CENTER. 5642 04:28:12,261 --> 04:28:15,063 HE'S DONE A NUMBER OF THINGS IN 5643 04:28:15,063 --> 04:28:19,234 HIS OWN RESEARCH AND ACTIVE IN 5644 04:28:19,234 --> 04:28:20,769 RESEARCH AT NIH PARTICULARLY HAS 5645 04:28:20,769 --> 04:28:23,472 BEEN A PIONEER IN THE USE OF 5646 04:28:23,472 --> 04:28:28,543 ELECTRONIC HEALTH RECORDS FOR 5647 04:28:28,543 --> 04:28:31,546 GENOMIC STUDIES AS WELL AS 5648 04:28:31,546 --> 04:28:38,487 HAVING MANAGED COMPLEXITY OF 5649 04:28:38,487 --> 04:28:39,488 ELECTRONIC HEALTH RECORD DATA. 5650 04:28:39,488 --> 04:28:40,522 THE FLOOR IS YOURS. 5651 04:28:40,522 --> 04:28:42,524 >> THANK YOU VEX FOR THE WARM 5652 04:28:42,524 --> 04:28:43,725 INTRODUCTION AND THE OPPORTUNITY 5653 04:28:43,725 --> 04:28:45,694 TO SPEAK WITH YOU ALL TODAY. 5654 04:28:45,694 --> 04:28:49,164 IT IS A REAL PLEASURE TO COME 5655 04:28:49,164 --> 04:28:50,599 BEFORE YOU AND SHARE WHERE WE 5656 04:28:50,599 --> 04:28:54,970 ARE WITH THE ALL OF US RESEARCH 5657 04:28:54,970 --> 04:28:59,741 PROGRAM AND ENTHUSIASTIC TO WORK 5658 04:28:59,741 --> 04:29:10,285 WITH THE PROGRAM AND ACROSS NIH. 5659 04:29:16,792 --> 04:29:18,694 SO THE ALL OF US RESEARCH 5660 04:29:18,694 --> 04:29:20,462 PROGRAM WAS THOUGHT OF IN 2015 5661 04:29:20,462 --> 04:29:23,165 AND LAUNCHED IN 2018. 5662 04:29:23,165 --> 04:29:25,000 OUR MISSION FROM THE BEGINNING 5663 04:29:25,000 --> 04:29:28,003 HAS BEEN THE SAME TO ACCELERATE 5664 04:29:28,003 --> 04:29:29,404 HEALTH RESEARCH AND MEDICAL 5665 04:29:29,404 --> 04:29:30,038 BREAKS THROUGH AND PREVENTION 5666 04:29:30,038 --> 04:29:33,175 AND TREATMENT AND CARE FOR YOU 5667 04:29:33,175 --> 04:29:33,809 WILL OF US. 5668 04:29:33,809 --> 04:29:36,912 IT STARTS WITH THE IDEA OF 5669 04:29:36,912 --> 04:29:38,914 NURTURING RELATIONSHIPS WITH 5670 04:29:38,914 --> 04:29:40,849 INDIVIDUALS ACROSS THE COUNTRY 5671 04:29:40,849 --> 04:29:43,952 AND THE RICH DIVERSITY OF THE 5672 04:29:43,952 --> 04:29:46,321 UNITED STATES REFLECTING THE 5673 04:29:46,321 --> 04:29:48,557 PARTICIPANTS WE RECRUIT AND 5674 04:29:48,557 --> 04:29:51,593 LONGITUDINAL FOR DECADES AND 5675 04:29:51,593 --> 04:29:54,096 WANT TO GET THE SOURCE IN A 5676 04:29:54,096 --> 04:29:55,964 TRUSTWORTHY MANNER TO ACCELERATE 5677 04:29:55,964 --> 04:29:58,100 SCIENCE AND THINK ABOUT THIS AS 5678 04:29:58,100 --> 04:29:59,668 AN ECO SYSTEM OF RESEARCH 5679 04:29:59,668 --> 04:30:01,236 FUNDERS IN COMMUNITIES AS PART 5680 04:30:01,236 --> 04:30:05,974 OF THIS RESOURCE. 5681 04:30:05,974 --> 04:30:08,343 SINCE WE LAUNCHED NATIONALLY IN 5682 04:30:08,343 --> 04:30:13,448 2018 WE HAD OVER 800,000 CONSENT 5683 04:30:13,448 --> 04:30:15,417 TO BE PART OF THE STUDY ACROSS 5684 04:30:15,417 --> 04:30:17,786 ALL U.S. STATES AND MOST 5685 04:30:17,786 --> 04:30:28,096 U.S. TERRITORIES AND SEND IN BIO 5686 04:30:28,096 --> 04:30:30,198 SPECIMENS AND WE CAN SEND A KIT 5687 04:30:30,198 --> 04:30:31,033 FOR DNA COLLECTION. 5688 04:30:31,033 --> 04:30:34,269 THE VAST MAJORITY OF THE PEOPLE 5689 04:30:34,269 --> 04:30:35,504 AGREE TO SHARE ELECTRONIC HEALTH 5690 04:30:35,504 --> 04:30:36,938 RECORDS. 5691 04:30:36,938 --> 04:30:42,277 IN THIS COUNTRY IT'S HARD TO 5692 04:30:42,277 --> 04:30:44,246 GATHER THOSE SO THERE'S A GAP 5693 04:30:44,246 --> 04:30:49,518 FROM PEOPLE WHO SAY YES AND 5694 04:30:49,518 --> 04:30:51,887 COLLECTING THE RECORDS AND MANY 5695 04:30:51,887 --> 04:30:54,056 WANT TO CONTRIBUTE BIO SPECIMENS 5696 04:30:54,056 --> 04:30:55,824 AND NOT EVERYONE DOES AND THAT'S 5697 04:30:55,824 --> 04:30:59,494 OKAY BUT SEEK TO GET THE BIO 5698 04:30:59,494 --> 04:31:02,597 SPECIMEN NUMBER TO 1 MILLION. 5699 04:31:02,597 --> 04:31:05,400 IN 2023 WE LAUNCH PUERTO RICO AS 5700 04:31:05,400 --> 04:31:13,675 A LARGER SITE WITH BRICK AND 5701 04:31:13,675 --> 04:31:15,477 MORTAR RECRUITING EFFORT AND SEE 5702 04:31:15,477 --> 04:31:17,412 THOSE WHO JOINED IN PUERTO RICO. 5703 04:31:17,412 --> 04:31:20,549 THE RACE AND ETHNIC DIVERSITY IS 5704 04:31:20,549 --> 04:31:23,819 NOT THE ONLY MEASURE OF UNDER 5705 04:31:23,819 --> 04:31:24,553 REPRESENT REPRESENTATION WE 5706 04:31:24,553 --> 04:31:25,654 FOCUS ON. 5707 04:31:25,654 --> 04:31:26,955 WE WANT TO EMPHASIZE ALL MANNERS 5708 04:31:26,955 --> 04:31:29,157 OF DIVERSITY. 5709 04:31:29,157 --> 04:31:30,992 YOU CAN SEE WE'RE ABOUT HALF 5710 04:31:30,992 --> 04:31:35,430 IDENTIFYING AS A RACE AND/OR 5711 04:31:35,430 --> 04:31:36,498 ETHNICITY OTHER THAN 5712 04:31:36,498 --> 04:31:38,900 NON-HISPANIC WHITE AND THE OTHER 5713 04:31:38,900 --> 04:31:39,634 CATEGORIES. 5714 04:31:39,634 --> 04:31:42,037 AS YOU LOOK INTO THE RESOURCE 5715 04:31:42,037 --> 04:31:43,238 THERE'S INTERSECTIONALITY WE 5716 04:31:43,238 --> 04:31:45,006 THINK IS SO IMPORTANT. 5717 04:31:45,006 --> 04:31:46,541 THINKING ABOUT THAT YOU CAN LOOK 5718 04:31:46,541 --> 04:31:48,643 ACROSS THAT AS WE UPDATED SOME 5719 04:31:48,643 --> 04:31:49,611 OF THAT OVER TIME FOR INSTANCE 5720 04:31:49,611 --> 04:31:51,813 WHEN WE FIRST LAUNCHED WE DIDN'T 5721 04:31:51,813 --> 04:31:55,750 HAVE A DISABILITY QUESTIONNAIRE 5722 04:31:55,750 --> 04:31:57,085 TO ASSESS DISABILITIES AND ROOM 5723 04:31:57,085 --> 04:32:00,755 HAVE THE ABILITY TO ACCESS TO 5724 04:32:00,755 --> 04:32:01,356 HEALTH CARE. 5725 04:32:01,356 --> 04:32:03,592 AND SO THOSE ARE THINGS WE 5726 04:32:03,592 --> 04:32:05,060 UPDATED WITH OUR PARTICIPANTS 5727 04:32:05,060 --> 04:32:06,962 OVER TIME AND METRICS WE INCLUDE 5728 04:32:06,962 --> 04:32:07,262 HERE. 5729 04:32:07,262 --> 04:32:09,431 IN MOST WE OVER REPRESENT 5730 04:32:09,431 --> 04:32:11,666 COMPARED TO THE U.S. POPULATION. 5731 04:32:11,666 --> 04:32:15,303 IN SOME CASES WE DON'T. 5732 04:32:15,303 --> 04:32:17,305 RURAL AND ASIAN AMERICAN 5733 04:32:17,305 --> 04:32:19,808 INDIVIDUALS ARE A LITTLE BIT 5734 04:32:19,808 --> 04:32:20,375 LOWER THAN THE U.S. CENSUS 5735 04:32:20,375 --> 04:32:29,151 NUMBERS. 5736 04:32:29,151 --> 04:32:37,626 ABOUT 10% IDENTIFY AS SEX AND 5737 04:32:37,626 --> 04:32:39,528 GENDER MINORITIES AND WE GET THE 5738 04:32:39,528 --> 04:32:42,264 SAME INFORMATION NO MATTER HOW 5739 04:32:42,264 --> 04:32:47,702 AND WHERE THEY ENROLL INCLUDING 5740 04:32:47,702 --> 04:32:47,969 A SURVEY. 5741 04:32:47,969 --> 04:32:49,738 WE RELEASE ONE A YEAR AND 5742 04:32:49,738 --> 04:32:50,572 PHYSICAL MEASURES. 5743 04:32:50,572 --> 04:32:55,043 IF YOU COME IN PERSON AND DONATE 5744 04:32:55,043 --> 04:32:56,044 BIO SPECIMENS WE COLLECT 5745 04:32:56,044 --> 04:32:59,981 MEASURES FROM YOU OF BIO 5746 04:32:59,981 --> 04:33:05,020 SPECIMENS AND SERUM, PLASMA AND 5747 04:33:05,020 --> 04:33:06,188 CELL-FREE DNA AND COLLECT URINE 5748 04:33:06,188 --> 04:33:11,793 AND HAVE THE ABILITY IF YOU HAVE 5749 04:33:11,793 --> 04:33:15,363 WAYS TO LINK DEVICES IN AND HAVE 5750 04:33:15,363 --> 04:33:18,200 PILOT PROGRAMS THAT GIVE DEVICES 5751 04:33:18,200 --> 04:33:22,504 TO PEOPLE AS WELL. 5752 04:33:22,504 --> 04:33:24,472 AND WE'RE APPROACHING 60,000 5753 04:33:24,472 --> 04:33:24,706 DEVICES. 5754 04:33:24,706 --> 04:33:28,710 WE HAVE DONE IN ADDITION TO OUR 5755 04:33:28,710 --> 04:33:31,146 CORE SETS OF DNA DATA AND 5756 04:33:31,146 --> 04:33:33,248 GENERATING UP SOME CASES OTHER 5757 04:33:33,248 --> 04:33:36,218 OMICS DATA AS PILOT PROGRAMS AND 5758 04:33:36,218 --> 04:33:38,553 WE HAVE DONE STRUCTURAL VARIANCE 5759 04:33:38,553 --> 04:33:42,324 THERE AND DID TEST OF COVID 5760 04:33:42,324 --> 04:33:43,558 SEROLOGY EARLY IN THE PANDEMIC 5761 04:33:43,558 --> 04:33:44,392 FINDING EARLIER CASES THAN 5762 04:33:44,392 --> 04:33:48,863 EXPECTED IN SEVERAL STATES. 5763 04:33:48,863 --> 04:33:50,031 WE THOUGHT IT WAS REALLY 5764 04:33:50,031 --> 04:33:51,766 IMPORTANT TO RETURN VALUE TO 5765 04:33:51,766 --> 04:33:52,567 PARTICIPANTS. 5766 04:33:52,567 --> 04:33:54,102 WE ASKED THEM IN DIFFERENT 5767 04:33:54,102 --> 04:33:55,770 SCENARIOS ACROSS THE COUNTRY IN 5768 04:33:55,770 --> 04:33:57,906 FOCUS GROUPS AND SURVEYS WHAT 5769 04:33:57,906 --> 04:33:59,174 WOULD BE VALUABLE TO YOU. 5770 04:33:59,174 --> 04:34:02,911 THE NUMBER ONE REASON PEOPLE 5771 04:34:02,911 --> 04:34:06,848 JOIN IS TO PROVIDE HEALTHIER 5772 04:34:06,848 --> 04:34:07,882 FUTURE FOR THEMSELVES, THEIR 5773 04:34:07,882 --> 04:34:09,818 COMMUNITIES AN ALTRUISTIC 5774 04:34:09,818 --> 04:34:10,185 NATURE. 5775 04:34:10,185 --> 04:34:14,155 IN TERMS OF VALUE WE CAN ALSO 5776 04:34:14,155 --> 04:34:16,591 PROVIDE GENETICS CAME TO THE TOP 5777 04:34:16,591 --> 04:34:17,058 OF THE LIST. 5778 04:34:17,058 --> 04:34:18,760 WE RETURN TWO CLASS OF 5779 04:34:18,760 --> 04:34:19,060 INFORMATION. 5780 04:34:19,060 --> 04:34:22,831 ONE IS NON-HEALTH RELATED 5781 04:34:22,831 --> 04:34:24,499 ANCESTRY AND OTHER TRAITS LIKE 5782 04:34:24,499 --> 04:34:29,371 WHETHER YOU CAN TAKE CILANTRO 5783 04:34:29,371 --> 04:34:32,040 AND LAUNCHED THAT END OF 2020 5784 04:34:32,040 --> 04:34:34,309 AND MORE PEOPLE HAVE SEEN THAT 5785 04:34:34,309 --> 04:34:35,944 ABOUT 170,000 PEOPLE HAVE SEEN 5786 04:34:35,944 --> 04:34:38,046 THAT KIND OF INFORMATION AND GET 5787 04:34:38,046 --> 04:34:39,414 TO CHOOSE WHETHER THEY SEE THIS 5788 04:34:39,414 --> 04:34:42,250 OR NOT AND HAVE HEALTH-RELATED 5789 04:34:42,250 --> 04:34:44,753 RESULTS WHICH WE HAD FOR ABOUT A 5790 04:34:44,753 --> 04:34:46,921 YEAR AND A HALF HOW AND OFFER 5791 04:34:46,921 --> 04:34:48,890 THAT BETWEEN 1 TO 5,000 A WEEK. 5792 04:34:48,890 --> 04:34:51,726 THEY CAN CHOOSE TO RECEIVE THIS 5793 04:34:51,726 --> 04:34:52,160 INFORMATION. 5794 04:34:52,160 --> 04:34:54,129 IF THEY SAY YES WE GENERATE THAT 5795 04:34:54,129 --> 04:34:56,965 INFORMATION FOR THEM AND LOOK AT 5796 04:34:56,965 --> 04:34:59,067 THE VARIANCE AND RECALL WHETHER 5797 04:34:59,067 --> 04:35:01,569 THEY HAVE A LIKELY PATHOGENIC 5798 04:35:01,569 --> 04:35:04,005 AND GENES THAT HAVE ACTIONABLE 5799 04:35:04,005 --> 04:35:05,774 RESULTS AND INTERPRET PHARMACO 5800 04:35:05,774 --> 04:35:08,310 GENETICS FOR THEM AND PREPARE 5801 04:35:08,310 --> 04:35:10,078 THAT REPORT. 5802 04:35:10,078 --> 04:35:14,282 OF THE ACM59 GENES THROUGH 5803 04:35:14,282 --> 04:35:18,453 GENETIC COUNSELORS THEY'RE 5804 04:35:18,453 --> 04:35:20,355 AVAILABLE FOR ANY PURPOSE PEEK 5805 04:35:20,355 --> 04:35:24,025 ENGLISH OR SPANISH AROUND HAVE 5806 04:35:24,025 --> 04:35:26,361 TRANSLATION FOR 200 LANGUAGES 5807 04:35:26,361 --> 04:35:29,030 AND OVER 100,000 PEOPLE HAVE 5808 04:35:29,030 --> 04:35:30,665 RECEIVED HEALTH RELATED GENETIC 5809 04:35:30,665 --> 04:35:32,534 RESULTS AT THIS POINT. 5810 04:35:32,534 --> 04:35:35,036 THOSE INDIVIDUALS AMONG THE 59 5811 04:35:35,036 --> 04:35:37,172 GENES OF ACTIONABLE RESULTS 3% 5812 04:35:37,172 --> 04:35:41,409 WILL HAVE A POSITIVE RESULT 5813 04:35:41,409 --> 04:35:43,745 THAT'S PEOPLE WHO HAVE HAD 5814 04:35:43,745 --> 04:35:44,312 POTENTIALLY LIFE-CHANGING 5815 04:35:44,312 --> 04:35:48,683 RESULTS WHERE THEY LEARNED ABOUT 5816 04:35:48,683 --> 04:35:51,953 HEREDITARY CANCERS AND 5817 04:35:51,953 --> 04:35:54,255 HEREDITARY ARRHYTHMIAS IF THEY 5818 04:35:54,255 --> 04:35:55,990 HAVE VARIANTS AND ON THE 5819 04:35:55,990 --> 04:35:58,360 PHARMACO GENETIC GENES ABOUT 59% 5820 04:35:58,360 --> 04:35:59,961 HAVE AN ACTIONABLE RESULT. 5821 04:35:59,961 --> 04:36:03,631 ABOUT 20% OF PEOPLE WHO HAVE A 5822 04:36:03,631 --> 04:36:06,101 VARIANT WILL BE EXPOSED TO A 5823 04:36:06,101 --> 04:36:08,236 MEDICATION FOR WHICH THEY WOULD 5824 04:36:08,236 --> 04:36:10,071 HAVE AN ALTERNATE RECOMMENDATION 5825 04:36:10,071 --> 04:36:12,173 GIVEN THEIR PHARMACO GENETIC 5826 04:36:12,173 --> 04:36:16,945 RESULTS AND THERE'S ABOUT 50 5827 04:36:16,945 --> 04:36:20,048 MEDICATIONS WE PROVIDE SUPPORT 5828 04:36:20,048 --> 04:36:21,316 FOR. 5829 04:36:21,316 --> 04:36:22,384 THIS TO PERSONALIZE GIVES 5830 04:36:22,384 --> 04:36:26,688 DISTRIBUTION FOR TWO TOGETGENET 5831 04:36:26,688 --> 04:36:29,157 VARIANTS AND MY RESULTS ON THE 5832 04:36:29,157 --> 04:36:29,858 SIDE. 5833 04:36:29,858 --> 04:36:35,730 I'M FALLING IN THE INTERMEDIATE 5834 04:36:35,730 --> 04:36:39,067 METABOLIZER FOR WHAT WOULD GET 5835 04:36:39,067 --> 04:36:41,936 AN ALTERNATE MEDICATION AND IF I 5836 04:36:41,936 --> 04:36:43,772 NEED A STATIN I SHOULDN'T TAKE 5837 04:36:43,772 --> 04:36:46,441 THIS ONE BECAUSE I'D BE STRESS 5838 04:36:46,441 --> 04:36:51,913 FOR MUSCLE TOXICITY FOR THAT. 5839 04:36:51,913 --> 04:36:59,821 AND SO WE ARE RETURNING THE 5840 04:36:59,821 --> 04:37:03,825 GENETIC VARIANTS WE CALL INTO A 5841 04:37:03,825 --> 04:37:05,727 RESOURCE THAT AGGREGATES 5842 04:37:05,727 --> 04:37:07,061 CLINICAL INTERPRETATION ON 5843 04:37:07,061 --> 04:37:08,196 GENETIC VARIANTS. 5844 04:37:08,196 --> 04:37:09,097 WE MADE OUR FIRST SUBMISSION 5845 04:37:09,097 --> 04:37:12,534 ABOUT A MONTH OR SO AGO. 5846 04:37:12,534 --> 04:37:15,236 THIS WAS ABOUT 32,000 GENETIC 5847 04:37:15,236 --> 04:37:17,105 VARIANTS WE CALLED AND 5848 04:37:17,105 --> 04:37:20,008 INTERPRETED ACROSS THE 59 5849 04:37:20,008 --> 04:37:23,044 HEREDITARY DISEASE RISK GENES 5850 04:37:23,044 --> 04:37:24,279 AND THE VARIANTS INCLUDE 5851 04:37:24,279 --> 04:37:26,514 SUBMISSIONS THAT HAVE NOT BEEN 5852 04:37:26,514 --> 04:37:27,682 SUBMITTED BEFORE AND THE FIRST 5853 04:37:27,682 --> 04:37:29,851 SUBMISSION FROM OUR DATA SET 5854 04:37:29,851 --> 04:37:31,920 PUTS US IN THE TOP 20 OF ALL 5855 04:37:31,920 --> 04:37:37,559 SUBMITTERS TO CLENVAR SO FAR. 5856 04:37:37,559 --> 04:37:41,529 THAT'S WHAT WE BELIEVE ARE HIGH 5857 04:37:41,529 --> 04:37:42,897 QUALITY INTERPRETATIONS 5858 04:37:42,897 --> 04:37:44,299 AVAILABLE FOR THE WHOLE 5859 04:37:44,299 --> 04:37:46,868 COMMUNITY AS OTHER PHYSICIANS OR 5860 04:37:46,868 --> 04:37:48,203 PROVIDERS LOOK AT GENETIC 5861 04:37:48,203 --> 04:37:54,108 VARIANT ED -- VARIANTS AND THI 5862 04:37:54,108 --> 04:37:55,210 SHOWS THE RARE VARIATION 5863 04:37:55,210 --> 04:37:56,845 DISCOVERED OVER TIME AS WE'VE 5864 04:37:56,845 --> 04:37:58,546 HAD DIFFERENT DATA SETS 5865 04:37:58,546 --> 04:37:59,214 RELEASED. 5866 04:37:59,214 --> 04:38:02,283 OUR CURRENT GENOMIC DATA SET IS 5867 04:38:02,283 --> 04:38:05,386 245,000 WHOLE GENOME SEQUENCES. 5868 04:38:05,386 --> 04:38:09,224 IN THAT WE'VE SEEN OVER A 5869 04:38:09,224 --> 04:38:09,891 BILLION GENETIC VARIANTS ACROSS 5870 04:38:09,891 --> 04:38:13,061 THE GENOME AND WITHIN THAT, 5871 04:38:13,061 --> 04:38:15,730 TWO-THIRDS WAS NOT IN THE COMMON 5872 04:38:15,730 --> 04:38:18,266 IMMIGRATION SERVICE CALLED 5873 04:38:18,266 --> 04:38:18,766 NOMAD. 5874 04:38:18,766 --> 04:38:27,308 275 MILLION VARIANTS WERE NOT IN 5875 04:38:27,308 --> 04:38:29,511 DB SMITH AND IN PART DUE TO THE 5876 04:38:29,511 --> 04:38:32,180 RICH DIVERSITY OF OUR DATA SET. 5877 04:38:32,180 --> 04:38:34,215 THIS GETS AT HOW WE GIVE 5878 04:38:34,215 --> 04:38:35,316 RESEARCHERS ACCESS TO DATA. 5879 04:38:35,316 --> 04:38:37,685 WE HAVE A PUBLIC TIER ANYBODY 5880 04:38:37,685 --> 04:38:40,388 CAN GO IN AND QUERY THE DATA 5881 04:38:40,388 --> 04:38:41,689 SET. 5882 04:38:41,689 --> 04:38:43,491 WE ENCOURAGE PEOPLE TO EXPLORE, 5883 04:38:43,491 --> 04:38:46,060 SEE THE DIAGNOSIS, MEDICATION 5884 04:38:46,060 --> 04:38:48,196 EXPOSURES, LAB VALUE, 5885 04:38:48,196 --> 04:38:49,764 DISTRIBUTIONS HOW PEOPLE ANSWER 5886 04:38:49,764 --> 04:38:52,000 SERVICES AND WHETHER THERE'S 5887 04:38:52,000 --> 04:38:56,004 ENOUGH CASES OF A DISEASE THAT 5888 04:38:56,004 --> 04:39:01,109 STIMULATES HYPOTHESES. 5889 04:39:01,109 --> 04:39:06,414 ALL DATA THAT DOESN'T ALLOW FOR 5890 04:39:06,414 --> 04:39:08,650 REDEDICATION AND ALLOWS TO 5891 04:39:08,650 --> 04:39:11,019 EXPLORE THE GENETIC VARIANTS AND 5892 04:39:11,019 --> 04:39:11,719 DISTRIBUTED ACROSS THE 5893 04:39:11,719 --> 04:39:20,728 POPULATION CLINICALLY SIG 234I6 5894 04:39:20,728 --> 04:39:21,029 OF NIF CANT AND 5895 04:39:23,665 --> 04:39:24,799 SIGNIFICANCE AND YOU CAN GET 5896 04:39:24,799 --> 04:39:27,869 RESEARCHERS TO COME IN AND DO 5897 04:39:27,869 --> 04:39:31,239 RESEARCH ACROSS A MORE 5898 04:39:31,239 --> 04:39:33,308 DE-IDENTIFIED REGISTERED TIER OR 5899 04:39:33,308 --> 04:39:37,011 MORE DEEPER DETAILED CONTROL 5900 04:39:37,011 --> 04:39:38,046 TIER WHERE WE PUT OUR GENETIC 5901 04:39:38,046 --> 04:39:38,813 INFORMATION. 5902 04:39:38,813 --> 04:39:41,816 WE TRY TO ENCOURAGE PEOPLE TO 5903 04:39:41,816 --> 04:39:48,389 ACCESS THE DATA THEY NEED TO DO 5904 04:39:48,389 --> 04:39:49,524 THE RESEARCH THEY NEED. 5905 04:39:49,524 --> 04:39:50,792 THERE'S DIFFERENT PATHS. 5906 04:39:50,792 --> 04:39:52,794 HERE'S WHAT THE RESEARCHER WORK 5907 04:39:52,794 --> 04:39:53,661 BENCH LOOKS LIKE. 5908 04:39:53,661 --> 04:39:55,430 ONCE YOU GO THROUGH THE BASIC 5909 04:39:55,430 --> 04:39:57,732 TRAINING YOU CREATE WORK SPACES. 5910 04:39:57,732 --> 04:39:59,534 EVERYTHING I'M TALKING ABOUT IS 5911 04:39:59,534 --> 04:40:01,769 WHAT WE CONSIDER NON-HUMAN 5912 04:40:01,769 --> 04:40:03,271 SUBJECTS RESEARCH AND HAS BEEN 5913 04:40:03,271 --> 04:40:04,038 COVERED BY THEIR CONSENT WHICH 5914 04:40:04,038 --> 04:40:08,042 MEANS YOU DON'T HAVE TO DO A NEW 5915 04:40:08,042 --> 04:40:09,677 IRB APPROVAL FOR EACH PROJECT. 5916 04:40:09,677 --> 04:40:12,981 IT'S COVERED BY THE CONSENT AND 5917 04:40:12,981 --> 04:40:13,514 DE-IDENTIFICATION BASIC 5918 04:40:13,514 --> 04:40:15,083 PROFESSIONS ACROSS THE DATA. 5919 04:40:15,083 --> 04:40:18,886 THERE'S NO OBVIOUSLY IDENTIFYING 5920 04:40:18,886 --> 04:40:20,588 INFORMATION IN THE INFORMATION 5921 04:40:20,588 --> 04:40:30,832 AT THIS POINT. 5922 04:40:30,832 --> 04:40:36,237 THAT MEANS A NEW RESEARCHER CAN 5923 04:40:36,237 --> 04:40:40,008 DO RESEARCH AND YOU CAN DO 5924 04:40:40,008 --> 04:40:40,541 DESTIGMATIZING RESEARCH 5925 04:40:40,541 --> 04:40:43,111 TRIGGERING A REVIEW AND YOU GET 5926 04:40:43,111 --> 04:40:51,185 STARTED GET POSTED PUBLICALLY 5927 04:40:51,185 --> 04:40:52,720 AND OF IT IS AVAILABLE FOR US TO 5928 04:40:52,720 --> 04:40:53,755 LOOK AT. 5929 04:40:53,755 --> 04:40:56,257 THERE'S WEB-BASED TOOLS TO DO 5930 04:40:56,257 --> 04:40:58,493 BASIC COHORT DEVELOPMENTS AND 5931 04:40:58,493 --> 04:41:02,664 POINT AND CLICK AND CREATE A 5932 04:41:02,664 --> 04:41:04,098 BILLING CODE AND SURVEY ANSWERS 5933 04:41:04,098 --> 04:41:09,971 AND GO TO ONE OF THESE 5934 04:41:09,971 --> 04:41:13,841 STATISTICAL ENVIRONMENTS. 5935 04:41:13,841 --> 04:41:17,278 WE'VE HAD A JUPITER NOTEBOOK FOR 5936 04:41:17,278 --> 04:41:18,446 FROM THE BEGINNING. 5937 04:41:18,446 --> 04:41:21,282 THE FIRST IS WHETHER OR NOT YOUR 5938 04:41:21,282 --> 04:41:23,551 INSTITUTION DOESN'T HAVE TO BE 5939 04:41:23,551 --> 04:41:26,821 AN ACADEMIC INSTITUTION HAS AN 5940 04:41:26,821 --> 04:41:27,722 AGREEMENT WITH THE PROGRAM. 5941 04:41:27,722 --> 04:41:30,258 IF NOT, OBVIOUSLY YOUR 5942 04:41:30,258 --> 04:41:31,859 INSTITUTION HAS TO HAVE A 5943 04:41:31,859 --> 04:41:33,161 BLANKET STATEMENT. 5944 04:41:33,161 --> 04:41:38,499 WE HAVE ABOUT 800 INSTITUTIONS 5945 04:41:38,499 --> 04:41:41,235 RIGHT NOW THAT HAVE AGREEMENTS 5946 04:41:41,235 --> 04:41:44,772 WITH US AND IF STEP ONE IS DONE, 5947 04:41:44,772 --> 04:41:45,573 STEPS TWO THROUGH FOUR OF THE 5948 04:41:45,573 --> 04:41:47,642 INDIVIDUAL LEVEL COMING ON AND 5949 04:41:47,642 --> 04:41:49,343 CREATING AN ACCOUNT, GOING 5950 04:41:49,343 --> 04:41:50,611 THROUGH OUR TRAINING AND SIGNING 5951 04:41:50,611 --> 04:41:53,448 THE CODE OF CONDUCT CAN ALL BE 5952 04:41:53,448 --> 04:41:54,615 COMPLETED IN AN HOUR AND A HALF 5953 04:41:54,615 --> 04:41:56,184 OR TWO HOURS AND GET STARTED 5954 04:41:56,184 --> 04:41:56,784 WITH RESEARCH IMMEDIATELY AT 5955 04:41:56,784 --> 04:42:00,588 THAT POINT. 5956 04:42:00,588 --> 04:42:02,890 RIGHT NOW THE MEDIAN ACCESS TIME 5957 04:42:02,890 --> 04:42:05,460 FROM A RESEARCHER SIGNING ON TO 5958 04:42:05,460 --> 04:42:06,561 ACTUALLY GETTING THROUGH THAT 5959 04:42:06,561 --> 04:42:08,129 STEP AND BEING ABLE TO START 5960 04:42:08,129 --> 04:42:09,063 DOING WORK IS ABOUT 29 HOURS. 5961 04:42:09,063 --> 04:42:11,365 WE THINK WE'VE BEEN ABLE TO 5962 04:42:11,365 --> 04:42:12,300 FACILITATE THE ONBOARDING 5963 04:42:12,300 --> 04:42:14,435 PROCESS. 5964 04:42:14,435 --> 04:42:16,237 WE STARTED WITH THE BELIEF IN 5965 04:42:16,237 --> 04:42:18,573 THE IMPORTANCE OF ENGAGEMENT 5966 04:42:18,573 --> 04:42:19,440 BEFORE WE DID ANYTHING. 5967 04:42:19,440 --> 04:42:22,276 WE DID 77 ENGAGEMENT STUDIOS 5968 04:42:22,276 --> 04:42:24,378 LIKE FOCUS GROUPS IN 17 CITIES 5969 04:42:24,378 --> 04:42:25,346 ACROSS THE COUNTRY COVERING A 5970 04:42:25,346 --> 04:42:27,348 NUMBER OF TOPICS HOW TO BUILD 5971 04:42:27,348 --> 04:42:27,615 THE STUDY. 5972 04:42:27,615 --> 04:42:30,818 IT'S NOT JUST ABOUT ENGAGING 5973 04:42:30,818 --> 04:42:31,853 PARTICIPANTS, IT'S ALSO ABOUT 5974 04:42:31,853 --> 04:42:32,987 ENGAGING RESEARCHERS. 5975 04:42:32,987 --> 04:42:37,592 WE WANT TO BUILD A RESEARCHER 5976 04:42:37,592 --> 04:42:40,027 COMMUNITY THE BIOMEDICAL 5977 04:42:40,027 --> 04:42:41,462 WORKFORCE AND SUPPORT THEM AS 5978 04:42:41,462 --> 04:42:43,397 MUCH AS WE CAN. 5979 04:42:43,397 --> 04:42:45,399 THIS GIVES A SENSE OF 2023 OF 5980 04:42:45,399 --> 04:42:47,869 THE DEEP WORK OUR ENGAGEMENT 5981 04:42:47,869 --> 04:42:52,006 PARTNERS HAVE DONE ACROSS THE 5982 04:42:52,006 --> 04:42:54,876 COMMUNITY AND THINK ABOUT IT 5983 04:42:54,876 --> 04:42:57,378 FROM OUTREACH AND THE LEFT THE 5984 04:42:57,378 --> 04:42:59,313 MOBILIZATION OVER 600,000 PEOPLE 5985 04:42:59,313 --> 04:43:02,016 TOUCHED BY ENGAGEMENT EVENTS 5986 04:43:02,016 --> 04:43:05,052 OVER 1200 EVENTS. 5987 04:43:05,052 --> 04:43:07,054 WE REACHED 170,000 PROGRAM 5988 04:43:07,054 --> 04:43:10,625 PARTICIPANTS AND DO THEM IN 5989 04:43:10,625 --> 04:43:13,828 INTERNALLY AND WORK WITH 5990 04:43:13,828 --> 04:43:18,232 DIFFERENT HEALTH CARE CENTERS OF 5991 04:43:18,232 --> 04:43:24,038 RECRUITING ACROSS THE POINTS. 5992 04:43:24,038 --> 04:43:25,373 AND GET TO THE RESEARCH AS WELL 5993 04:43:25,373 --> 04:43:26,707 AS PARTICIPANT COMMUNITIES. 5994 04:43:26,707 --> 04:43:31,445 AND I JUST WANT TO HIGHLIGHT ONE 5995 04:43:31,445 --> 04:43:39,353 EVENT RECENTLY MAY OF THIS YEAR 5996 04:43:39,353 --> 04:43:44,025 AND WE'VE HAD A GROUP THAT LOOKS 5997 04:43:44,025 --> 04:43:46,093 AT THE LEGACY AND THE HEALTH 5998 04:43:46,093 --> 04:43:50,464 SERVICE STUDY OF UNTREATED 5999 04:43:50,464 --> 04:43:54,936 SYPHILIS IN TUSKEGEE AND THEY'VE 6000 04:43:54,936 --> 04:43:57,238 BEEN AN IMPORTANT PARTNER WITH 6001 04:43:57,238 --> 04:43:57,839 US AND PART OF OUR STEERING 6002 04:43:57,839 --> 04:43:59,173 COMMITTEE FOR A LONG TIME. 6003 04:43:59,173 --> 04:44:04,378 THE EVENT WAS DONE THERE AND 6004 04:44:04,378 --> 04:44:11,752 BRING THAT LEAD AND BROUGHT AN 6005 04:44:11,752 --> 04:44:13,754 ENGAGEMENT VAN AND YOU SEE 6006 04:44:13,754 --> 04:44:15,489 DR. WATSON ON THE FAR LEFT. 6007 04:44:15,489 --> 04:44:17,558 AND SO THIS IS JUST ONE OF THE 6008 04:44:17,558 --> 04:44:22,129 KINDS OF THINGS WE ENGAGED IN 6009 04:44:22,129 --> 04:44:24,765 AND ONE OF OUR ENROLLMENT 6010 04:44:24,765 --> 04:44:25,833 PARTNERS. 6011 04:44:25,833 --> 04:44:27,435 TUSKEGEE IS MOVING TO THE 6012 04:44:27,435 --> 04:44:30,204 ENGAGED ENROLLMENT AS WELL. 6013 04:44:30,204 --> 04:44:32,006 SO FAR WE HAVE OVER 11,000 6014 04:44:32,006 --> 04:44:32,940 RESEARCHERS THAT SIGNED UP TO 6015 04:44:32,940 --> 04:44:34,242 USE THE RESOURCE. 6016 04:44:34,242 --> 04:44:36,577 OUR GOAL WAS TO HIT 10,000 BY 6017 04:44:36,577 --> 04:44:39,447 THE END OF 2026. 6018 04:44:39,447 --> 04:44:43,985 SO WE HIT THE GOAL OF A LITTLE 6019 04:44:43,985 --> 04:44:44,652 OVER TWO AND A HALF YEARS EARLY 6020 04:44:44,652 --> 04:44:48,122 AND RECENTLY LAUNCHED AND 6021 04:44:48,122 --> 04:44:49,657 ALLOWED IN THE FALL 6022 04:44:49,657 --> 04:44:50,358 INTERNATIONAL RESEARCHERS TO 6023 04:44:50,358 --> 04:44:51,659 JOIN AS WELL. 6024 04:44:51,659 --> 04:44:55,863 WE HAVE FOCUSSED ON BEYOND OUR 6025 04:44:55,863 --> 04:44:58,399 TYPICAL R1 RESEARCH INSTITUTIONS 6026 04:44:58,399 --> 04:45:00,735 TO ENGAGE LESS RESOURCED 6027 04:45:00,735 --> 04:45:06,841 INSTITUTIONS, NON PROFITS, HBCUs 6028 04:45:06,841 --> 04:45:08,943 AND HISPANIC SERVING 6029 04:45:08,943 --> 04:45:10,778 INSTITUTIONS AND MENTORSHIP 6030 04:45:10,778 --> 04:45:12,246 PROGRAMS AND RESEARCH SCHOLARS 6031 04:45:12,246 --> 04:45:14,115 AND PARTNERING RESEARCHERS IN 6032 04:45:14,115 --> 04:45:24,325 THE PROCESS. 6033 04:45:25,192 --> 04:45:32,033 WE HAVE SIX CONTINENTS REPRESENT 6034 04:45:32,033 --> 04:45:38,306 ED A COLLEAGUE AND I ARE DOING 6035 04:45:38,306 --> 04:45:39,840 A SEMINAR VIRTUALLY IN AFRICA 6036 04:45:39,840 --> 04:45:41,342 NEXT WEEK AND TRYING TO THINK OF 6037 04:45:41,342 --> 04:45:43,210 THE RESOURCE HERE AND WHAT WE 6038 04:45:43,210 --> 04:45:45,179 CAN DO AND REACH PEOPLE. 6039 04:45:45,179 --> 04:45:47,715 THIS GIVES A RANGE OF CONDITIONS 6040 04:45:47,715 --> 04:45:48,249 AND RELEASE OFF THE DATA 6041 04:45:48,249 --> 04:45:56,424 RESOURCE. 6042 04:45:56,424 --> 04:46:00,861 THERE'S LARGE SAMPLE SIZES IN 6043 04:46:00,861 --> 04:46:04,065 THE DATA SET AND IT'S A QUARTER 6044 04:46:04,065 --> 04:46:05,099 MILLION GENOMES. 6045 04:46:05,099 --> 04:46:09,136 IT'S A HUGE DATA SET AND HAVE 6046 04:46:09,136 --> 04:46:13,774 OVER 560,000 NOW THAT DONATED 6047 04:46:13,774 --> 04:46:16,110 DNA. 6048 04:46:16,110 --> 04:46:18,846 THE NUMBERS WILL INCREASE AS WE 6049 04:46:18,846 --> 04:46:19,747 GET MORE ELECTRONIC HEALTH 6050 04:46:19,747 --> 04:46:21,549 RECORD DATA AND WE HAVE INCIDENT 6051 04:46:21,549 --> 04:46:22,483 DISEASE AS WELL. 6052 04:46:22,483 --> 04:46:24,051 THOUSANDS OF PEOPLE WITH 6053 04:46:24,051 --> 04:46:30,124 INCIDENT DIABETES FOR INSTANCE. 6054 04:46:30,124 --> 04:46:33,327 WE'RE APPROACHING 500 6055 04:46:33,327 --> 04:46:33,961 PUBLICATIONS AND GIVES A SENSE 6056 04:46:33,961 --> 04:46:35,730 OF SOME HERE. 6057 04:46:35,730 --> 04:46:36,364 I'LL GO DEEPER INTO SOME OF 6058 04:46:36,364 --> 04:46:39,867 THOSE AND THE THEMES WE SEE. 6059 04:46:39,867 --> 04:46:44,005 THE FIRST STUDY SURPRISINGLY 6060 04:46:44,005 --> 04:46:46,974 WERE MORE CASE CONTROL THINGS 6061 04:46:46,974 --> 04:46:50,511 AND WE'RE SEEING MORE GENETIC 6062 04:46:50,511 --> 04:46:51,946 STUDIES AND SEEING DIFFERENT 6063 04:46:51,946 --> 04:46:52,580 THINGS COME OUT WITH THAT AND 6064 04:46:52,580 --> 04:46:55,950 ONE THING I'M EXCITED ABOUT AND 6065 04:46:55,950 --> 04:47:00,021 I WORKED WITH THE E.P.A. BIO 6066 04:47:00,021 --> 04:47:03,124 BANK SET AND WHEN YOU SEE THE 6067 04:47:03,124 --> 04:47:05,426 COHORTS THEY'RE PREDOMINANTLY 6068 04:47:05,426 --> 04:47:09,263 ONE ANCESTRY AND THE ANALYSES 6069 04:47:09,263 --> 04:47:10,131 MAY START WITH EXCLUDING THE 6070 04:47:10,131 --> 04:47:11,365 PEOPLE THAT AREN'T AS COMMON IN 6071 04:47:11,365 --> 04:47:16,003 THE DATA SET AND FOCUSSING IN ON 6072 04:47:16,003 --> 04:47:21,876 THE PREDOMINANT ANCESTRY WHICH 6073 04:47:21,876 --> 04:47:24,745 IS EUROPEAN ANCESTRY AND AS 6074 04:47:24,745 --> 04:47:25,646 PEOPLE WATCH THE DATA SET 6075 04:47:25,646 --> 04:47:28,816 THEY'RE LOOKING AT DIVERSITY AND 6076 04:47:28,816 --> 04:47:30,484 INCLUDING THE BROAD -- WHATEVER 6077 04:47:30,484 --> 04:47:31,952 CONDITION THEY'RE LOOKING AT THE 6078 04:47:31,952 --> 04:47:33,654 BROAD REPRESENTATION WE HAVE IN 6079 04:47:33,654 --> 04:47:34,288 THE DATA SET. 6080 04:47:34,288 --> 04:47:38,259 I'M VERY GRATIFIED TO SEE THAT 6081 04:47:38,259 --> 04:47:38,592 BE OCCURRING. 6082 04:47:38,592 --> 04:47:45,132 IN FEBRUARY WE HAD A NUMBER OF 6083 04:47:45,132 --> 04:47:46,300 PUBLICATIONS THAT CAME OUT 6084 04:47:46,300 --> 04:47:51,672 TOGETHER AS A CLUSTER AND THIS 6085 04:47:51,672 --> 04:47:55,876 INCLUDED A PAPER THAT IS ON THE 6086 04:47:55,876 --> 04:47:58,846 TOP RIGHT HERE THAT WAS A PAPER 6087 04:47:58,846 --> 04:48:00,047 WRITTEN ACROSS THE DIFFERENT 6088 04:48:00,047 --> 04:48:02,750 DIRECTORS OF INSTITUTES AND 6089 04:48:02,750 --> 04:48:04,852 CENTERS OF THE NIH REALLY 6090 04:48:04,852 --> 04:48:07,922 HIGHLIGHTING THE VALUE OF THE 6091 04:48:07,922 --> 04:48:09,990 RESOURCE ACROSS ALL CONDITIONS, 6092 04:48:09,990 --> 04:48:15,963 HEALTH STATUSES FOR PROMOTION OF 6093 04:48:15,963 --> 04:48:19,700 HEALTH AND MACHINE LEARNING AND 6094 04:48:19,700 --> 04:48:22,236 HIGHLIGHTING IT'S AN OPPORTUNITY 6095 04:48:22,236 --> 04:48:23,637 TO DIVERSIFY THE RESEARCH AND 6096 04:48:23,637 --> 04:48:25,339 ONE RESOURCE TO PROMOTE THAT. 6097 04:48:25,339 --> 04:48:28,542 WE'RE TRYING TO SEE THE PLATFORM 6098 04:48:28,542 --> 04:48:29,944 FOR THE BROADER NIH COMMUNITY. 6099 04:48:29,944 --> 04:48:33,347 AND OTHER STUDIES I WON'T INTO 6100 04:48:33,347 --> 04:48:34,748 DEPTH WITH A LOT OF THESE. 6101 04:48:34,748 --> 04:48:36,050 I'LL MAYBE HIGHLIGHT ONE OTHER 6102 04:48:36,050 --> 04:48:37,818 AND GO DEEPER ON ONE. 6103 04:48:37,818 --> 04:48:41,122 ON THE BOTTOM LEFT IS ANOTHER 6104 04:48:41,122 --> 04:48:42,156 THING I'M INTERESTED IN BECAUSE 6105 04:48:42,156 --> 04:48:46,961 THIS LOOKED AT TAKING RISK 6106 04:48:46,961 --> 04:48:51,999 SCORES ESTABLISHED UP OTHER 6107 04:48:51,999 --> 04:48:55,136 COHORTS AND THEY'RE UNDERGOING 6108 04:48:55,136 --> 04:48:57,872 CLINICAL TRIALS THROUGH A 6109 04:48:57,872 --> 04:49:01,208 NETWORK FUNDED BY NHRGI AND 6110 04:49:01,208 --> 04:49:02,543 WITHOUT OUR RESOURCE WE WOULDN'T 6111 04:49:02,543 --> 04:49:05,279 HAVE FELT AS COMFORTABLE HAVING 6112 04:49:05,279 --> 04:49:08,249 A MORE BROADLY APPLICABLE RISK 6113 04:49:08,249 --> 04:49:11,852 SCORE TO APPLY IN A CLINICAL 6114 04:49:11,852 --> 04:49:13,354 POPULATION AND NOW TO TALK ABOUT 6115 04:49:13,354 --> 04:49:17,391 ONE OF THE STUDIES AND SOMETHING 6116 04:49:17,391 --> 04:49:21,295 WE DIDN'T DO AS WELL AND TO LOOK 6117 04:49:21,295 --> 04:49:28,035 HOW WE CAN EVOLVE AND IN THE 6118 04:49:28,035 --> 04:49:31,539 PAPER WE CONSIDER GENOMICS 6119 04:49:31,539 --> 04:49:32,473 MARKER PAPER, IF YOU WILL, ON 6120 04:49:32,473 --> 04:49:36,377 OUR RESOURCE, ONE OF THE FIGURES 6121 04:49:36,377 --> 04:49:44,018 DISPLAYED GENETIC ANCESTRY USING 6122 04:49:44,018 --> 04:49:49,723 A PROGRAM TO ARTIFICIALLY TAKE A 6123 04:49:49,723 --> 04:49:50,391 MATHEMATICAL REPRESENTATION 6124 04:49:50,391 --> 04:49:52,560 ACROSS THE DIMENSIONALITY OF 6125 04:49:52,560 --> 04:49:55,930 GENETIC ANCESTRY AND GROUP THEM 6126 04:49:55,930 --> 04:49:57,765 TOGETHER IN THE WAY THAT OVER 6127 04:49:57,765 --> 04:49:59,366 REPRESENTS AND HIGHLIGHTS IN 6128 04:49:59,366 --> 04:50:04,004 WAYS THAT ARE NOT REALLY 6129 04:50:04,004 --> 04:50:05,406 BIOLOGICAL CLUSTERING AND IN THE 6130 04:50:05,406 --> 04:50:08,842 PAPER AND FIGURE IN THE TOP LEFT 6131 04:50:08,842 --> 04:50:11,078 PANELS A AND B ARE FIGURES WE'RE 6132 04:50:11,078 --> 04:50:14,682 TALKING ABOUT WHERE THE INTENT 6133 04:50:14,682 --> 04:50:16,517 WAS TO LITTLE THE DIVERSITY OF 6134 04:50:16,517 --> 04:50:19,353 OUR DATA SET AND IT'S NOT AT ALL 6135 04:50:19,353 --> 04:50:20,020 ABOUT THE FIGURE. 6136 04:50:20,020 --> 04:50:24,225 IT WAS PART OF IT AND IT 6137 04:50:24,225 --> 04:50:25,893 ATTRACTED ATTENTION AND I THINK 6138 04:50:25,893 --> 04:50:27,528 FOR A PERFECT REASON. 6139 04:50:27,528 --> 04:50:29,697 IT SHOWS SOMETHING WE WEREN'T 6140 04:50:29,697 --> 04:50:33,367 INTENDING TO SHOW WITH THE DATA. 6141 04:50:33,367 --> 04:50:36,103 SO I WANT TO -- WE ISSUED A 6142 04:50:36,103 --> 04:50:37,304 COUPLE STATEMENTS AND TALKED 6143 04:50:37,304 --> 04:50:39,206 ABOUT IT IN DIFFERENT PLACES AND 6144 04:50:39,206 --> 04:50:41,842 WHAT I WANT TO SAY IS WE POSTED 6145 04:50:41,842 --> 04:50:46,013 THIS ON THE WEBSITE AND TALKED 6146 04:50:46,013 --> 04:50:48,015 WITH PARTNERS. 6147 04:50:48,015 --> 04:50:50,150 WE'RE CURRENTLY IN A PROCESS 6148 04:50:50,150 --> 04:50:51,218 WORKING TO REVISE THE FIGURE. 6149 04:50:51,218 --> 04:50:55,089 IT HAS TO GO THROUGH PEER REVIEW 6150 04:50:55,089 --> 04:50:57,258 AND IT WILL BE REPLACED BUT BE 6151 04:50:57,258 --> 04:50:58,259 THAT NORMAL PROCESS THAT THE 6152 04:50:58,259 --> 04:51:00,861 JOURNAL TAKES TO GO THROUGH PEER 6153 04:51:00,861 --> 04:51:03,163 REVIEW AND THAT PROCESS. 6154 04:51:03,163 --> 04:51:05,766 AND WE'RE DOING A MUCH BROADER 6155 04:51:05,766 --> 04:51:07,334 PANEL OF ADVISORS THAT HAVE 6156 04:51:07,334 --> 04:51:09,203 LOOKED AT THAT AND HELPED US 6157 04:51:09,203 --> 04:51:14,174 THINK ABOUT THIS. 6158 04:51:14,174 --> 04:51:16,744 I HOPE THE WAY WE ADDRESS THIS 6159 04:51:16,744 --> 04:51:18,345 AND WE'VE SEEN A NUMBER OF 6160 04:51:18,345 --> 04:51:20,014 STATEMENTS FROM JOURNALS TALKING 6161 04:51:20,014 --> 04:51:22,283 ABOUT HOW WE TALK ABOUT GENETIC 6162 04:51:22,283 --> 04:51:25,419 ANCESTRY AND TALK ABOUT RACE AND 6163 04:51:25,419 --> 04:51:25,686 ETHNICITY. 6164 04:51:25,686 --> 04:51:28,022 RECOGNIZING ONE AS A SOCIAL 6165 04:51:28,022 --> 04:51:30,858 CONSTRUCT THE MANY DIMENSIONAL 6166 04:51:30,858 --> 04:51:33,460 DEEP DIMENSIONS OF HUNDREDS OF 6167 04:51:33,460 --> 04:51:35,562 DIMENSIONS WE COULD THINK ABOUT 6168 04:51:35,562 --> 04:51:38,165 TOWARDS THE BIOLOGICAL 6169 04:51:38,165 --> 04:51:39,833 REPRESENTATION OF INHERITED 6170 04:51:39,833 --> 04:51:41,702 GENETIC VARIANCE AND HOW DO WE 6171 04:51:41,702 --> 04:51:42,970 DO THIS AND ELEVATE THE 6172 04:51:42,970 --> 04:51:45,606 DISCUSSION IN OUR JOURNALS. 6173 04:51:45,606 --> 04:51:47,341 SO PART OF THE THINGS WE HELPED 6174 04:51:47,341 --> 04:51:51,679 FUND WAS THE NASCENT REPORT AND 6175 04:51:51,679 --> 04:51:52,479 HAVE SEEN STATEMENTS FROM 6176 04:51:52,479 --> 04:51:53,547 JOURNALS COME OUT THAT PROVIDE 6177 04:51:53,547 --> 04:51:58,852 BEST GUIDANCE ON THIS AND SO I'M 6178 04:51:58,852 --> 04:52:00,621 HOPEFUL OUR PROCESS OF GOING 6179 04:52:00,621 --> 04:52:02,656 THROUGH THIS IS THAT HELPS 6180 04:52:02,656 --> 04:52:04,291 ELEVATE IT MORE BROADLY FOR THE 6181 04:52:04,291 --> 04:52:04,825 COMMUNITY. 6182 04:52:04,825 --> 04:52:06,860 WE HAVE ALSO INSTITUTED NEW 6183 04:52:06,860 --> 04:52:09,763 POLICIES IN PERSONALLY AROUND 6184 04:52:09,763 --> 04:52:11,298 CERTAINLY THE PAPERS WE CAN 6185 04:52:11,298 --> 04:52:14,501 REVIEW AND THAT SORT OF THING TO 6186 04:52:14,501 --> 04:52:16,170 HELP ISSUE OTHER GUIDANCES IN 6187 04:52:16,170 --> 04:52:19,573 THE PROCESS. 6188 04:52:19,573 --> 04:52:22,309 I WANT TO LOOK AT A COUPLE OTHER 6189 04:52:22,309 --> 04:52:24,745 DATA AROUND STUDIES THAT HAVE 6190 04:52:24,745 --> 04:52:27,147 COME OUT. 6191 04:52:27,147 --> 04:52:28,749 SO THIS IS TWO OTHER FIGURES 6192 04:52:28,749 --> 04:52:30,984 FROM THE PAPER AND A TABLE. 6193 04:52:30,984 --> 04:52:34,722 WHAT WE SEE HERE IS WE REPLICATE 6194 04:52:34,722 --> 04:52:36,924 AS YOU WOULD EXPECT LDL SIGNALS 6195 04:52:36,924 --> 04:52:39,460 IN A LARGE GENOMIC STUDY ON THE 6196 04:52:39,460 --> 04:52:44,031 MIDDLE PANEL WE'RE LOOKING AT 6197 04:52:44,031 --> 04:52:46,133 PHENOME WIDE ASSOCIATION STUDIES 6198 04:52:46,133 --> 04:52:48,569 AND DIFFERENT ASSOCIATIONS IN 6199 04:52:48,569 --> 04:52:49,837 DIFFERENT POPULATIONS. 6200 04:52:49,837 --> 04:52:53,207 AND THEN ON THE RIGHT THIS TABLE 6201 04:52:53,207 --> 04:52:56,043 HERE I THINK SHOWS THE BREADTH 6202 04:52:56,043 --> 04:52:56,777 AND REPLICATION OF OUR DATA 6203 04:52:56,777 --> 04:53:03,717 ACROSS A NUMBER OF GENETIC 6204 04:53:03,717 --> 04:53:04,618 VARIANTS ASSOCIATED WITH 6205 04:53:04,618 --> 04:53:05,986 DIFFERENT CONDITIONS AND HIGH 6206 04:53:05,986 --> 04:53:09,223 REPLICATION RATES AND WHAT IS 6207 04:53:09,223 --> 04:53:10,324 HIGHLIGHTED HERE IS BY 6208 04:53:10,324 --> 04:53:14,795 PREDOMINANT GENETIC ANCESTRY 6209 04:53:14,795 --> 04:53:15,729 THERE'S JUST NOT AS MUCH AS 6210 04:53:15,729 --> 04:53:20,033 KNOWN OUT THERE FOR DIVERSITY OF 6211 04:53:20,033 --> 04:53:21,502 GENETIC VARIANTS AND DISEASE 6212 04:53:21,502 --> 04:53:22,302 ASSOCIATIONS BECAUSE THE DATA 6213 04:53:22,302 --> 04:53:24,938 SETS AS YOU PROBABLY WELL KNOW 6214 04:53:24,938 --> 04:53:27,441 MORE THAN 90% OF GENETIC 6215 04:53:27,441 --> 04:53:29,309 ASSOCIATION STUDIES OUT THERE 6216 04:53:29,309 --> 04:53:30,844 USE PEOPLE OF EUROPEAN ANCESTRY. 6217 04:53:30,844 --> 04:53:35,616 THAT'S WHAT THE SECOND ROW IS. 6218 04:53:35,616 --> 04:53:38,919 THERE'S OVER 1,000 VARIANT 6219 04:53:38,919 --> 04:53:40,788 ASSOCIATION PAIRS AVAILABLE TO 6220 04:53:40,788 --> 04:53:42,389 TEST EUROPEAN ANCESTRIES BUT 6221 04:53:42,389 --> 04:53:43,857 LOOKING ACROSS OTHER POPULATIONS 6222 04:53:43,857 --> 04:53:46,827 WE DON'T HAVE AS DEEP A 6223 04:53:46,827 --> 04:53:47,961 KNOWLEDGE BASE. 6224 04:53:47,961 --> 04:53:52,032 THAT STOOD OUT IN THE STUDY. 6225 04:53:52,032 --> 04:53:57,438 ANOTHER STUDY THAT LOOKED AT 6226 04:53:57,438 --> 04:54:01,008 RISK VARIANCE A COMMON CAUSE OF 6227 04:54:01,008 --> 04:54:04,244 KIDNEY DISEASE IN WITH PEOPLE 6228 04:54:04,244 --> 04:54:09,550 WIN WEST AFRICAN ANCESTRY AND A 6229 04:54:09,550 --> 04:54:14,588 PERCENTAGE ON DIALYSIS HAVE THE 6230 04:54:14,588 --> 04:54:14,855 VARIANCE. 6231 04:54:14,855 --> 04:54:18,826 THERE'S AN A RARE VARIANT IN THE 6232 04:54:18,826 --> 04:54:25,098 CHANNEL OF APOL1 THE VARIANT 6233 04:54:25,098 --> 04:54:32,005 BEING LOOKED AT HERE THAT SEEMS 6234 04:54:32,005 --> 04:54:34,441 TO MITIGATE THE RISK AND IT 6235 04:54:34,441 --> 04:54:38,212 POINTS TO A POTENTIAL WAY TO 6236 04:54:38,212 --> 04:54:40,347 GENETICALLY HIGHLIGHT AND TARGET 6237 04:54:40,347 --> 04:54:45,419 AND MITIGATE THE RISK OF APOL1 6238 04:54:45,419 --> 04:54:46,687 MEDIATED KIDNEY DISEASE. 6239 04:54:46,687 --> 04:54:49,022 IT TOOK DIFFERENT DATA SETS AND 6240 04:54:49,022 --> 04:54:51,725 OUR DATA SET IS MUCH LARGER THAN 6241 04:54:51,725 --> 04:54:54,661 THE DATA USED IN THE STUDY AND 6242 04:54:54,661 --> 04:54:57,798 WILL CONTINUE TO GROW OVER TIME. 6243 04:54:57,798 --> 04:55:01,969 AND SO THERE ARE DRUGS IN -- I 6244 04:55:01,969 --> 04:55:05,372 DON'T KNOW IF THEY'RE PHASE III 6245 04:55:05,372 --> 04:55:08,041 TRIALS LOOKING AT THE MECHANISM. 6246 04:55:08,041 --> 04:55:10,077 I WANT TO TALK ABOUT OUR 6247 04:55:10,077 --> 04:55:11,078 SCIENTIFIC ROAD MAP AND WHAT 6248 04:55:11,078 --> 04:55:12,779 WE'RE THINKING ABOUT HERE. 6249 04:55:12,779 --> 04:55:17,384 WE START AT THE BOTTOM WITH A 6250 04:55:17,384 --> 04:55:19,720 SET OF CORE DATA AND METHODS AND 6251 04:55:19,720 --> 04:55:20,821 TOOLBOX TO PROVIDE TO 6252 04:55:20,821 --> 04:55:23,323 RESEARCHERS ON TOP OF THAT. 6253 04:55:23,323 --> 04:55:26,760 WITH THE ULTIMATE GOAL OF 6254 04:55:26,760 --> 04:55:29,229 ADVANCING PRECISION HEALTH 6255 04:55:29,229 --> 04:55:31,398 MEDICINE EQUITABLY ACROSS 6256 04:55:31,398 --> 04:55:32,466 ASSESSMENT AND COMMUNITIES. 6257 04:55:32,466 --> 04:55:35,969 AND WE THINK WE CAN DEAL WITH 6258 04:55:35,969 --> 04:55:37,671 AND ADVANCE HEALTH TOWARDS BOTH 6259 04:55:37,671 --> 04:55:39,907 COMMON AND RARE CONDITIONS. 6260 04:55:39,907 --> 04:55:41,408 WE FIND PEOPLE WITH RARE DISEASE 6261 04:55:41,408 --> 04:55:43,944 ARE OVER REPRESENTED IN THE DATA 6262 04:55:43,944 --> 04:55:44,545 SET. 6263 04:55:44,545 --> 04:55:46,046 WE THINK ABOUT MATERNAL CHILD 6264 04:55:46,046 --> 04:55:47,214 HEALTH AND ONE REASON WE'RE LOOK 6265 04:55:47,214 --> 04:55:51,051 BEING FORWARD TO LAUNCHING THE 6266 04:55:51,051 --> 04:55:52,386 PEDIATRIC COHORT WE CAN TALK 6267 04:55:52,386 --> 04:55:53,153 ABOUT LATER. 6268 04:55:53,153 --> 04:55:56,456 WE WANT TO GET TO ENVIRONMENTAL 6269 04:55:56,456 --> 04:55:59,393 MEASURES AND WORKING WITH NIEHS 6270 04:55:59,393 --> 04:56:02,095 TO ADD TO THE DATA SET AND HAVE 6271 04:56:02,095 --> 04:56:03,297 QUESTIONS ABOUT LIFESTYLE AND 6272 04:56:03,297 --> 04:56:04,998 SUBSTANCE ABUSE AND BEHAVIORAL 6273 04:56:04,998 --> 04:56:06,466 HEALTH AND LOOKING ACROSS THESE 6274 04:56:06,466 --> 04:56:08,135 KINDS OF THINGS WE HAD DONE 6275 04:56:08,135 --> 04:56:09,603 INITIAL MAPS THAT LOOK AT THE 6276 04:56:09,603 --> 04:56:13,874 WORK SPACES PEOPLE ARE DOING 6277 04:56:13,874 --> 04:56:14,808 USING TERMINOLOGY QUERIES AND 6278 04:56:14,808 --> 04:56:16,143 THINGS LIKE THAT AND SEE THE 6279 04:56:16,143 --> 04:56:17,978 NUMBER ONE THEME WE SEE IN THE 6280 04:56:17,978 --> 04:56:19,513 RESEARCHERS USING THE RESOURCE 6281 04:56:19,513 --> 04:56:20,914 ARE INCLUDING THEMES OF HEALTH 6282 04:56:20,914 --> 04:56:21,281 EQUITY. 6283 04:56:21,281 --> 04:56:23,584 IT'S ALSO THE MOST COMMON THING 6284 04:56:23,584 --> 04:56:26,486 WE SEE AS THEMES IN PUBLICATIONS 6285 04:56:26,486 --> 04:56:28,021 PEOPLE ARE WRITING WHICH I'M 6286 04:56:28,021 --> 04:56:34,494 EXCITED TO SEE. 6287 04:56:34,494 --> 04:56:37,230 WE ARE BUILDING A FOUNDATION OF 6288 04:56:37,230 --> 04:56:38,298 DATA WHERE WE'LL NEED PEOPLE TO 6289 04:56:38,298 --> 04:56:40,767 NOT ONLY DO RESEARCH BUT USE THE 6290 04:56:40,767 --> 04:56:44,471 BIO SPECIMEN OR BUILD OUT AND 6291 04:56:44,471 --> 04:56:45,772 ENROLL PEOPLE TO FURTHER 6292 04:56:45,772 --> 04:56:46,039 STUDIES. 6293 04:56:46,039 --> 04:56:48,842 WE CALL THESE ANCILLARY STUDIES. 6294 04:56:48,842 --> 04:56:53,213 WRITING A STUDY AND DOING AND 6295 04:56:53,213 --> 04:56:55,148 BUILD OUT FROM ANOTHER NIH AND 6296 04:56:55,148 --> 04:56:57,117 WE THINK THIS CAN GO FROM 6297 04:56:57,117 --> 04:56:59,386 RANDOMIZED CONTROL TRIALS TO USE 6298 04:56:59,386 --> 04:57:02,122 OF A BIO SPECIMEN TO A 6299 04:57:02,122 --> 04:57:02,556 CUSTOMIZED SURVEY. 6300 04:57:02,556 --> 04:57:05,225 HERE'S THREE WE LAUNCHED SO FAR. 6301 04:57:05,225 --> 04:57:09,296 AND I MENTION THE SEROLOGY STUDY 6302 04:57:09,296 --> 04:57:13,367 EARLIER EXPLORING THE MIND AND 6303 04:57:13,367 --> 04:57:16,303 NUTRITION FOR PRECISION HEALTH 6304 04:57:16,303 --> 04:57:25,145 WILL ENROLL 10,000 PEOPLE AND VA 6305 04:57:25,145 --> 04:57:28,015 MEASUREMENTS LIKE THE MICROBIOME 6306 04:57:28,015 --> 04:57:30,617 AND METABOLOMICS AND HAVE OTHER 6307 04:57:30,617 --> 04:57:35,756 STUDIES AND SURVEYS THAT GO OUT. 6308 04:57:35,756 --> 04:57:38,825 GOOD MORNING AMERICA DID A PIECE 6309 04:57:38,825 --> 04:57:42,529 ON THIS AND THERE'S A PIECE AND 6310 04:57:42,529 --> 04:57:43,930 THIS GOOD MORNING AMERICA VIDEO 6311 04:57:43,930 --> 04:57:45,298 RESULTED IN THE HIGHEST SINGLE 6312 04:57:45,298 --> 04:57:47,134 DAY ENROLLMENT WE EVER HAD. 6313 04:57:47,134 --> 04:57:49,569 I THINK IT CAME OUT A FEW WEEKS 6314 04:57:49,569 --> 04:57:49,736 AGO. 6315 04:57:49,736 --> 04:57:51,872 SHE'S PART OF THE STUDY AND GOT 6316 04:57:51,872 --> 04:57:53,573 HER GENETIC HEALTH RESULTS BACK 6317 04:57:53,573 --> 04:57:56,009 AND IS ALSO PART OF THE STUDY 6318 04:57:56,009 --> 04:58:03,617 HERE. 6319 04:58:03,617 --> 04:58:04,751 THIS GIVES QUANTITATIVE MEASURES 6320 04:58:04,751 --> 04:58:08,288 OF THINGS THAT HAVE TO DO WITH 6321 04:58:08,288 --> 04:58:10,190 COGNITION AND BEHAVIORS. 6322 04:58:10,190 --> 04:58:15,662 THINGS LIKE RISK TAKING, 6323 04:58:15,662 --> 04:58:16,596 RECOGNIZING EMOTION, WE'RE 6324 04:58:16,596 --> 04:58:19,032 LOOKING AT CITY OR MOUNTAIN AND 6325 04:58:19,032 --> 04:58:21,234 HOW FAST WE DO IT AND METRIC 6326 04:58:21,234 --> 04:58:21,535 BEHIND IT. 6327 04:58:21,535 --> 04:58:23,970 ONE THING THAT'S EXCITING ABOUT 6328 04:58:23,970 --> 04:58:25,672 THIS IS IT'S BEEN THROUGH -- 6329 04:58:25,672 --> 04:58:26,940 THERE'S ANOTHER PROJECT AT NIMHD 6330 04:58:26,940 --> 04:58:29,342 HAS BEEN WORKING ON FOR A NUMBER 6331 04:58:29,342 --> 04:58:32,079 OF YEARS THAT HAVE HAD THE 6332 04:58:32,079 --> 04:58:35,182 AVAILABLE STUDIES AND IN A FEW 6333 04:58:35,182 --> 04:58:38,151 MONTHS WE GOT THE NUMBER OF 6334 04:58:38,151 --> 04:58:40,020 RESPONSES OVER A NUMBER OF YEARS 6335 04:58:40,020 --> 04:58:42,289 BY LAUNCHING OUR PROGRAM AND 6336 04:58:42,289 --> 04:58:44,324 IT'S OPEN TO THE PUBLIC AS WELL. 6337 04:58:44,324 --> 04:58:47,694 AND OF COURSE THE POWER IS THE 6338 04:58:47,694 --> 04:58:55,302 DATA ARE LOCATED AND 6339 04:58:55,302 --> 04:58:56,436 CROSS-ANALYZED AND WITH OTHER 6340 04:58:56,436 --> 04:58:57,804 INSTITUTES AND CENTERS EXPANDED 6341 04:58:57,804 --> 04:58:58,472 TO OTHER METRICS AND TESTS AS 6342 04:58:58,472 --> 04:59:08,582 WELL. 6343 04:59:08,882 --> 04:59:11,985 ELISEO MENTIONED THE INFLECTION 6344 04:59:11,985 --> 04:59:13,320 POINTS AND WE'RE FUNDED THROUGH 6345 04:59:13,320 --> 04:59:15,622 TWO SOURCES AND THIS IS ONE OF 6346 04:59:15,622 --> 04:59:17,591 THE CHALLENGING POINTS SO FAR 6347 04:59:17,591 --> 04:59:20,327 THIS YEAR. 6348 04:59:20,327 --> 04:59:22,195 OUR FUNDING COMES FROM BASE 6349 04:59:22,195 --> 04:59:24,030 APPROPRIATIONS WHICH IS THE 6350 04:59:24,030 --> 04:59:26,767 TYPICAL WAY THE NIH FUNDED AND 6351 04:59:26,767 --> 04:59:31,905 THEN IN 2016 THE 21st CENTURIES 6352 04:59:31,905 --> 04:59:33,240 CURES ACT WAS PASSED WITH 6353 04:59:33,240 --> 04:59:36,009 DIFFERENT LEVELS OF FUNDING 6354 04:59:36,009 --> 04:59:38,478 DECIDED UPON IN 2016 AND AS A 6355 04:59:38,478 --> 04:59:43,617 RESULT OF THE BOLUS OF 2023 THE 6356 04:59:43,617 --> 04:59:46,453 BASIC APPROPRIATION WAS REDUCED 6357 04:59:46,453 --> 04:59:46,787 SIGNIFICANTLY. 6358 04:59:46,787 --> 04:59:49,089 THE CURES FUNDING REDUCED IN 6359 04:59:49,089 --> 04:59:51,391 2024 BUT WE DIDN'T HAVE CHANGE 6360 04:59:51,391 --> 04:59:53,393 IN THE BASE FUNDING. 6361 04:59:53,393 --> 04:59:56,897 THAT RESULTED IN 34% BUDGET LOSS 6362 04:59:56,897 --> 04:59:58,365 FOR US THIS YEAR AND THE 6363 04:59:58,365 --> 05:00:00,567 POTENTIAL FOR ANOTHER DECREASE 6364 05:00:00,567 --> 05:00:02,969 EVEN MORE SIGNIFICANT NEXT YEAR. 6365 05:00:02,969 --> 05:00:08,742 THIS HAS HAD DRAMATIC INFLUENCES 6366 05:00:08,742 --> 05:00:13,280 ACROSS OUR CONSORTIUM AND THE 6367 05:00:13,280 --> 05:00:14,781 HARDEST HIT AREAS ARE ENROLLMENT 6368 05:00:14,781 --> 05:00:15,816 AND ENGAGEMENT. 6369 05:00:15,816 --> 05:00:18,385 IF YOU IMAGINE YOU CAN'T LET 6370 05:00:18,385 --> 05:00:20,420 YOUR SAMPLES GET WARM YOU HAVE 6371 05:00:20,420 --> 05:00:25,058 TO PROTECT YOUR DATA AND HAVE TO 6372 05:00:25,058 --> 05:00:26,960 FOCUS ON YOUR EXISTING AND IN 6373 05:00:26,960 --> 05:00:29,429 TERMS OF RETURN RESULTS AND THE 6374 05:00:29,429 --> 05:00:31,164 GENETIC SEQUENCES AND HEALTH 6375 05:00:31,164 --> 05:00:32,032 RELATED RESULTS AND THOSE KINDS 6376 05:00:32,032 --> 05:00:33,567 OF THINGS. 6377 05:00:33,567 --> 05:00:36,369 SO IT'S HIT HARD A NUMBER OF OUR 6378 05:00:36,369 --> 05:00:38,138 ENGAGEMENT ENROLLMENT ARMS. 6379 05:00:38,138 --> 05:00:42,342 LAST YEAR WE EXPECTED TO ENROLL 6380 05:00:42,342 --> 05:00:44,611 OVER 330,000 PEOPLE AND THINK 6381 05:00:44,611 --> 05:00:49,416 WE'LL ENROLL 40,000, 50,000 AND 6382 05:00:49,416 --> 05:00:53,787 PAUSED OUR LAUNCH OF PEDIATRICS 6383 05:00:53,787 --> 05:00:55,722 WHICH WE DID A FULL SCALE TEST 6384 05:00:55,722 --> 05:00:56,957 OF AND DEVELOPED EVERYTHING IN 6385 05:00:56,957 --> 05:01:01,261 2023 AND TESTED WITH A SMALL 6386 05:01:01,261 --> 05:01:03,063 NUMBER OF PEOPLE AND WERE ABLE 6387 05:01:03,063 --> 05:01:07,133 TO BETA LAUNCH THAT AND WE CAN 6388 05:01:07,133 --> 05:01:08,635 CONTINUE IN THE PROMISE AND 6389 05:01:08,635 --> 05:01:11,037 DEVELOP THE COHORT AND DELIVER 6390 05:01:11,037 --> 05:01:13,974 ON THE PROMISE WHEN WE ENROLL. 6391 05:01:13,974 --> 05:01:15,942 THE DOCUMENT WALKS US THROUGH 6392 05:01:15,942 --> 05:01:16,543 SOME OF THAT. 6393 05:01:16,543 --> 05:01:19,679 WHAT ARE OUR PRIORITIES? 6394 05:01:19,679 --> 05:01:23,116 IN 2024 WE'RE IMPLEMENTING NEW 6395 05:01:23,116 --> 05:01:24,084 TECHNOLOGIES TO HELP US CLOSE 6396 05:01:24,084 --> 05:01:28,788 SOME OF THE ELECTRONIC HEALTH 6397 05:01:28,788 --> 05:01:30,891 REPORT GAP AND OTHER IS CHANGING 6398 05:01:30,891 --> 05:01:32,092 OUR PARTICIPANT FACING 6399 05:01:32,092 --> 05:01:33,193 TECHNOLOGIES BOTH HAVE THE 6400 05:01:33,193 --> 05:01:35,495 ABILITY TO HELP US REDUCE OUR 6401 05:01:35,495 --> 05:01:38,064 COST WHICH IS IMPORTANT RIGHT 6402 05:01:38,064 --> 05:01:39,165 NOW. 6403 05:01:39,165 --> 05:01:40,533 ALSO WITH PARTICIPANT PREVALENCE 6404 05:01:40,533 --> 05:01:43,603 SHOULD HELP GET TO OUR 6405 05:01:43,603 --> 05:01:51,411 PARTICIPANTS IN MORE WAYS AND 6406 05:01:51,411 --> 05:01:55,515 MORE MODALITIES AND WOULD LIKE 6407 05:01:55,515 --> 05:01:56,082 TO ADD ADDITIONAL LANGUAGES. 6408 05:01:56,082 --> 05:01:57,317 WE'RE LOOK BEING TO CLOSE THE 6409 05:01:57,317 --> 05:01:59,786 GAP IN TERMS OF GENOMIC RESULTS 6410 05:01:59,786 --> 05:02:00,754 AND WANT TO FOCUS AND EXPAND ON 6411 05:02:00,754 --> 05:02:02,455 THE STUDIES AND DEVELOP OUR 6412 05:02:02,455 --> 05:02:04,190 CAPABILITY MORE SO AS A PLATFORM 6413 05:02:04,190 --> 05:02:07,260 FOR OTHER PEOPLE TO BUILD ON AND 6414 05:02:07,260 --> 05:02:13,500 INTEND TO DIVERSIIFY RESEARCHER 6415 05:02:13,500 --> 05:02:16,102 ACCESS IN THE SAME TRUSTED 6416 05:02:16,102 --> 05:02:17,771 VETTED WAY WE ALLOW OTHERS TO 6417 05:02:17,771 --> 05:02:18,872 ACCESS THE RESOURCE. 6418 05:02:18,872 --> 05:02:23,076 AND WE STAND READY TO LAUNCH 6419 05:02:23,076 --> 05:02:24,611 PEDIATRICS AS A CORE CAPABILITY 6420 05:02:24,611 --> 05:02:26,279 AND COHORT WHEN WE HAVE FUNDING 6421 05:02:26,279 --> 05:02:28,315 TO SUPPORT IT. 6422 05:02:28,315 --> 05:02:29,716 WE'RE PLANNING FOR THE NEXT 6423 05:02:29,716 --> 05:02:30,784 RELEASE IN 2024. 6424 05:02:30,784 --> 05:02:33,286 THIS GIVES A SENSE OF THAT. 6425 05:02:33,286 --> 05:02:35,855 RIGHT NOW YOU HAVE 24,000 WHOLE 6426 05:02:35,855 --> 05:02:37,691 GENOMES THAT WILL BRING THE 6427 05:02:37,691 --> 05:02:48,134 NUMBER UP TO 400,000 AND 6428 05:02:49,602 --> 05:02:51,204 INCREASE OUR DATA SETS AND WE'RE 6429 05:02:51,204 --> 05:02:53,907 LOOKING FORWARD TO THE RACIAL 6430 05:02:53,907 --> 05:02:56,876 AND ETHNIC SUB CATEGORIZATION 6431 05:02:56,876 --> 05:02:58,144 AND ASK WHAT POPULATION YOU 6432 05:02:58,144 --> 05:03:04,050 IDENTIFY WITH AND THE HIGH-LEVEL 6433 05:03:04,050 --> 05:03:06,586 ANSWE 6434 05:03:06,586 --> 05:03:08,288 ANSWERS AND THOUGHTS HOW TO FEEL 6435 05:03:08,288 --> 05:03:13,259 COMFORTABLE WITH 6436 05:03:13,259 --> 05:03:13,994 RE-IDENTIFICATION RISK AND FEEL 6437 05:03:13,994 --> 05:03:15,695 GOOD ABOUT THE NEXT LEVEL OF 6438 05:03:15,695 --> 05:03:17,697 QUESTIONS AND SOME PEOPLE HAVE 6439 05:03:17,697 --> 05:03:18,064 SPECIFICATIONS. 6440 05:03:18,064 --> 05:03:19,933 FOR PEOPLE ANSWER ASIAN, MORE 6441 05:03:19,933 --> 05:03:23,169 THAN 90% IDENTIFY ANOTHER LEVEL 6442 05:03:23,169 --> 05:03:25,772 OF CLASSIFICATION OF WHAT 6443 05:03:25,772 --> 05:03:26,673 COUNTRY THEY'RE FROM TYPICALLY 6444 05:03:26,673 --> 05:03:28,274 OR ETHNICITY. 6445 05:03:28,274 --> 05:03:29,943 THAT WILL BE COMING OUT WITH THE 6446 05:03:29,943 --> 05:03:37,550 NEXT DATA SET AND IMPORTANTLY 6447 05:03:37,550 --> 05:03:40,820 WE'VE BEEN WORKING CLOSELY WITH 6448 05:03:40,820 --> 05:03:41,788 ANOTHER TRIBAL CONSULTATION OVER 6449 05:03:41,788 --> 05:03:42,155 THE LAST YEAR. 6450 05:03:42,155 --> 05:03:44,357 THAT REPORT WAS RELEASED IN 2024 6451 05:03:44,357 --> 05:03:46,893 AND WITH THAT WORK WE'VE DONE WE 6452 05:03:46,893 --> 05:03:49,896 WILL RELEASE OUR FIRST DATA SET 6453 05:03:49,896 --> 05:03:53,299 OF PARTICIPANTS TO INCLUDE AS 6454 05:03:53,299 --> 05:03:57,137 PART OF THE SELF-IDENTIFICATION 6455 05:03:57,137 --> 05:03:59,973 ALASKAN INDIAN AND AMERICAN 6456 05:03:59,973 --> 05:04:01,674 INDIAN OR ALASKAN NATIVE AND 6457 05:04:01,674 --> 05:04:03,676 WILL COME AS PART OF THE DATA 6458 05:04:03,676 --> 05:04:06,613 SET IN CONCERT WITH THE WORK 6459 05:04:06,613 --> 05:04:10,650 DOING WITH TRIBAL COMMUNITIES. 6460 05:04:10,650 --> 05:04:15,855 WE HAD A LEADERSHIP TRANSITION 6461 05:04:15,855 --> 05:04:18,825 TO ANNOUNCE AND MARTIN MENDOZA 6462 05:04:18,825 --> 05:04:20,093 OUR FIRST DIRECTOR OF HEALTH 6463 05:04:20,093 --> 05:04:23,530 EQUITY LEFT TO ASSUME THE FIRST 6464 05:04:23,530 --> 05:04:25,799 CHIEF HEALTH EQUITY OFFICER FOR 6465 05:04:25,799 --> 05:04:26,800 CMS. 6466 05:04:26,800 --> 05:04:28,068 WE'RE EXCITED FOR HIM BUT WILL 6467 05:04:28,068 --> 05:04:32,005 MISS HIM. 6468 05:04:32,005 --> 05:04:34,340 IN THE MEANTIME DR. JANET 6469 05:04:34,340 --> 05:04:36,910 SANCHEZ WILL TAKE OVER BUT WE 6470 05:04:36,910 --> 05:04:38,511 INTEND TO INITIATE A NATIONAL 6471 05:04:38,511 --> 05:04:39,746 SEARCH FOR THIS. 6472 05:04:39,746 --> 05:04:41,948 FOR THOSE WATCHING THIS KNOW 6473 05:04:41,948 --> 05:04:44,050 THAT SUCH AN ANNOUNCEMENT WILL 6474 05:04:44,050 --> 05:04:45,685 BE COMING AND I HOPE WE'LL GET A 6475 05:04:45,685 --> 05:04:48,021 NUMBER OF GOOD CANDIDATES FOR 6476 05:04:48,021 --> 05:04:50,356 THAT POSITION. 6477 05:04:50,356 --> 05:04:51,024 WITH THAT I'LL SAY THANK YOU FOR 6478 05:04:51,024 --> 05:04:52,926 THIS AND HAPPY TO TAKE 6479 05:04:52,926 --> 05:04:53,326 QUESTIONS. 6480 05:04:53,326 --> 05:04:55,662 I APPRECIATE YOUR TIME, 6481 05:04:55,662 --> 05:04:55,929 INTEREST. 6482 05:04:55,929 --> 05:05:00,333 THOSE USING THE RESOURCE AND 6483 05:05:00,333 --> 05:05:03,403 LISTENING OR HERE THANK YOU FOR 6484 05:05:03,403 --> 05:05:04,604 THAT AS WELL TO MAKE THE STUDIES 6485 05:05:04,604 --> 05:05:05,572 THAT MAKE A DIFFERENCE IN IMPACT 6486 05:05:05,572 --> 05:05:07,140 OVER TIME. 6487 05:05:07,140 --> 05:05:17,317 THANK YOU. 6488 05:05:24,090 --> 05:05:27,227 >> HOW ARE YOU DOING? 6489 05:05:27,227 --> 05:05:34,901 WITH 34% BUDGET CUT AND 6490 05:05:34,901 --> 05:05:36,069 POTENTIALLY CUT WHAT'S THE 6491 05:05:36,069 --> 05:05:38,705 OUTLOOK FOUR OR FIVE YEARS FROM 6492 05:05:38,705 --> 05:05:39,439 NOW? 6493 05:05:39,439 --> 05:05:47,847 >> I'M HOPEFUL THAT THIS LOOKS 6494 05:05:47,847 --> 05:05:49,516 LIKE WHAT WAS CREATED WITH THE 6495 05:05:49,516 --> 05:05:50,650 CURES ACT. 6496 05:05:50,650 --> 05:05:52,152 HOPING FOR ACTION THAT WOULD 6497 05:05:52,152 --> 05:05:53,520 INCREASE OUR BASE SUPPORT. 6498 05:05:53,520 --> 05:05:56,856 THE PRESIDENT'S BUDGET REQUEST 6499 05:05:56,856 --> 05:05:58,992 IS FOR RESTORATION TO THE 2023 6500 05:05:58,992 --> 05:06:01,227 LEVELS AND SO I'M HOPEFUL THAT 6501 05:06:01,227 --> 05:06:04,998 WILL BE THE OUTLOOK. 6502 05:06:04,998 --> 05:06:07,200 THAT'S INCREASED IN WHAT WILL BE 6503 05:06:07,200 --> 05:06:09,435 REQUIRED TO SUPPORT ENROLLMENT 6504 05:06:09,435 --> 05:06:11,971 AND LAUNCH THE PEDIATRIC COHORT. 6505 05:06:11,971 --> 05:06:13,740 WE'RE A LARGE COHORT AND ONE OF 6506 05:06:13,740 --> 05:06:15,708 THE LARGEST IN THE WORLD. 6507 05:06:15,708 --> 05:06:18,578 WE HAVE DIVERSITY UNMATCHED IN 6508 05:06:18,578 --> 05:06:19,179 TERMS OF NATIONAL OR 6509 05:06:19,179 --> 05:06:21,314 INTERNATIONAL COHORTS IN TERMS 6510 05:06:21,314 --> 05:06:24,017 OF PERCENTAGES BUT IT'S REALLY 6511 05:06:24,017 --> 05:06:25,785 IMPORTANT WE GET BIGGER BECAUSE 6512 05:06:25,785 --> 05:06:28,021 THERE'S CERTAIN QUESTIONS YOU 6513 05:06:28,021 --> 05:06:29,989 CAN'T ANSWER UNLESS YOU HAVE 6514 05:06:29,989 --> 05:06:31,991 HUGE COHORTS AND THERE ARE 6515 05:06:31,991 --> 05:06:33,426 POPULATIONS AND COMMUNITIES WE 6516 05:06:33,426 --> 05:06:34,827 STILL NEED TO GET TO AND WE HAVE 6517 05:06:34,827 --> 05:06:36,362 AN INFRASTRUCTURE TO DO THAT. 6518 05:06:36,362 --> 05:06:38,031 SO WE'RE CERTAINLY LOOKING AT 6519 05:06:38,031 --> 05:06:41,201 WAYS WE CAN REDUCE OUR COST AND 6520 05:06:41,201 --> 05:06:44,103 BECOME MORE EFFICIENT IN TERM OF 6521 05:06:44,103 --> 05:06:46,139 TECHNOLOGIES AND WAYS TO REACH 6522 05:06:46,139 --> 05:06:47,473 PEOPLE BUT IN THE END MONEY 6523 05:06:47,473 --> 05:06:49,709 WOULD BE NEEDED TO SUPPORT THE 6524 05:06:49,709 --> 05:06:51,344 ENROLLMENT EFFORT AT THE SCALE 6525 05:06:51,344 --> 05:06:58,418 WE WANT TO DO. 6526 05:06:58,418 --> 05:07:00,520 ANYONE WHO WANTS TO HELP CARRY 6527 05:07:00,520 --> 05:07:04,324 THE MESSAGE FORWARD I'M ALWAYS 6528 05:07:04,324 --> 05:07:05,959 HAPPY -- WE WOULD LOVE TO BE 6529 05:07:05,959 --> 05:07:10,263 PART OF ANY COMMUNITY MEETINGS 6530 05:07:10,263 --> 05:07:11,397 YOU MIGHT HAVE WITH OFFICIALS 6531 05:07:11,397 --> 05:07:12,899 AND THINGS LIKE THAT. 6532 05:07:12,899 --> 05:07:15,835 WE ARE TRYING TO CARRY THAT 6533 05:07:15,835 --> 05:07:17,470 MESSAGE AND WHERE THERE'S 6534 05:07:17,470 --> 05:07:19,172 PARTNERSHIPS TO ENGAGE IN THE 6535 05:07:19,172 --> 05:07:20,106 DISCUSSION TO TELL THE REAL 6536 05:07:20,106 --> 05:07:23,443 VALUE OF OUR COHORT. 6537 05:07:23,443 --> 05:07:28,014 >> THANK YOU FOR THE EXCELLENT 6538 05:07:28,014 --> 05:07:28,581 PRESENTATION AND IMPRESSIVE 6539 05:07:28,581 --> 05:07:33,987 WORK. 6540 05:07:33,987 --> 05:07:36,823 WHAT DO YOU THINK OF A SAMPLE 6541 05:07:36,823 --> 05:07:38,124 SELECTION OF SPECIFIC MINORITY 6542 05:07:38,124 --> 05:07:38,358 GROUPS. 6543 05:07:38,358 --> 05:07:45,665 YOU MENTIONED ALREADY YOU HAVE 6544 05:07:45,665 --> 05:07:49,302 THE COHORTS YOU ALREADY HAVE BUT 6545 05:07:49,302 --> 05:07:51,671 FOR SOME WONDERING WHETHER YOU 6546 05:07:51,671 --> 05:07:56,009 HAVE SAMPLES AND HOW TO OVERCOME 6547 05:07:56,009 --> 05:07:59,879 THAT. 6548 05:07:59,879 --> 05:08:02,882 >> IS YOUR QUESTION DO WE FOCUS 6549 05:08:02,882 --> 05:08:05,551 ON CERTAIN TYPES OF RECRUITMENT 6550 05:08:05,551 --> 05:08:08,021 OR IF THERE IS A POPULATION 6551 05:08:08,021 --> 05:08:09,222 INTERESTED IN JOINING? 6552 05:08:09,222 --> 05:08:11,691 >> I WAS WONDERING WHETHER YOU 6553 05:08:11,691 --> 05:08:16,095 COMPARED THE CHARACTERISTICS AND 6554 05:08:16,095 --> 05:08:17,497 TRYING TO UNDERSTAND EVEN IF YOU 6555 05:08:17,497 --> 05:08:19,198 HAVE DIFFERENT MINORITY GROUPS 6556 05:08:19,198 --> 05:08:23,269 WHETHER YOU HAVE SOME SAMPLE 6557 05:08:23,269 --> 05:08:24,737 SELECTION IN TERMS OF EDUCATION 6558 05:08:24,737 --> 05:08:26,973 PERHAPS HIGHER INDIVIDUALS AND 6559 05:08:26,973 --> 05:08:29,175 MINORITY GROUPS FROM HIGHER 6560 05:08:29,175 --> 05:08:34,480 EDUCATION AND BACKGROUND AND 6561 05:08:34,480 --> 05:08:36,215 ENROLLED AND THOSE WITH 6562 05:08:36,215 --> 05:08:40,119 EDUCATION AND HOW TO OVERCOME 6563 05:08:40,119 --> 05:08:42,555 THAT WILL BE VERY AVAILABLE. 6564 05:08:42,555 --> 05:08:43,323 >> GREAT QUESTION. 6565 05:08:43,323 --> 05:08:47,060 IT MAY OR MAY NOT BE OBVIOUS TO 6566 05:08:47,060 --> 05:08:48,795 EVERYONE BUT WE'RE NOT NOR 6567 05:08:48,795 --> 05:08:50,163 INTENDING TO BE A REPRESENTATIVE 6568 05:08:50,163 --> 05:08:50,396 COHORT. 6569 05:08:50,396 --> 05:08:54,200 WE INTEND TO REFLECT AND OVER 6570 05:08:54,200 --> 05:08:55,234 REPRESENT AS MUCH AS POSSIBLE 6571 05:08:55,234 --> 05:08:55,802 DIVERSITY ACROSS THE UNITED 6572 05:08:55,802 --> 05:08:59,439 STATES AND ANYONE CAN SIGN UP. 6573 05:08:59,439 --> 05:09:01,107 ANYONE CAN GO TO THE WEBSITE AND 6574 05:09:01,107 --> 05:09:01,341 JOIN. 6575 05:09:01,341 --> 05:09:05,578 WE HAVE SPECIFIC ENGAGEMENT AND 6576 05:09:05,578 --> 05:09:06,245 ENROLLMENT EFFORTS WE PICKED AND 6577 05:09:06,245 --> 05:09:08,948 CHANGED TO SOME DEGREE OVER TIME 6578 05:09:08,948 --> 05:09:10,550 TO TRY TO OVER REPRESENT CERTAIN 6579 05:09:10,550 --> 05:09:11,484 POPULATIONS AND THERE HAVE BEEN 6580 05:09:11,484 --> 05:09:15,855 A COUPLE STUDIES OUT THERE AND 6581 05:09:15,855 --> 05:09:18,358 WE HAVE COMPARED U.S. CENSUS 6582 05:09:18,358 --> 05:09:19,359 NUMBERS AND THINGS LIKE THAT. 6583 05:09:19,359 --> 05:09:23,363 IF YOU LOOK AT A STATE BY STATE 6584 05:09:23,363 --> 05:09:23,563 LEVEL. 6585 05:09:23,563 --> 05:09:24,731 WE HAVE MORE REPRESENTATION THAN 6586 05:09:24,731 --> 05:09:26,265 YOU'D EXPECT IN CERTAIN STATES 6587 05:09:26,265 --> 05:09:28,568 THAN OTHERS AND THAT'S A FACTOR 6588 05:09:28,568 --> 05:09:32,038 WHERE WE HAVE LARGE RECRUITMENT 6589 05:09:32,038 --> 05:09:34,674 SITES AND THE NORMAL COMPETITIVE 6590 05:09:34,674 --> 05:09:35,908 PROCESS WHO MADE IT THROUGH AND 6591 05:09:35,908 --> 05:09:37,176 WAS SELECTED TO BE AN ENROLLMENT 6592 05:09:37,176 --> 05:09:38,378 SITE. 6593 05:09:38,378 --> 05:09:41,381 AND THAT WAS BASED ON FACTORS OF 6594 05:09:41,381 --> 05:09:44,650 HOW THEY CAN REACH A DIVERSE 6595 05:09:44,650 --> 05:09:45,318 COMMUNITY. 6596 05:09:45,318 --> 05:09:46,986 THERE'S CERTAIN AREAS I WOULD 6597 05:09:46,986 --> 05:09:48,354 LIKE TO CONTINUE TO INCREASE. 6598 05:09:48,354 --> 05:09:53,025 IF YOU LOOK AT THE NUMBER OF 6599 05:09:53,025 --> 05:09:55,261 ASIAN-AMERICANS, NATIVE 6600 05:09:55,261 --> 05:09:57,730 HAWAIIANS, PACIFIC ISLANDERS 6601 05:09:57,730 --> 05:09:59,399 THEY'RE LOWER THAN THE CENSUS 6602 05:09:59,399 --> 05:10:00,433 NUMBERS AND THERE'S A COALITION 6603 05:10:00,433 --> 05:10:03,503 THAT'S A PARTNER OF OURS AND WE 6604 05:10:03,503 --> 05:10:05,872 HAVE DONE WORK WITH HAWAI'I AND 6605 05:10:05,872 --> 05:10:09,642 WOULD LOVE TO EXTEND THAT 6606 05:10:09,642 --> 05:10:11,344 RESEARCH FOR INSTANCE AND GO ON 6607 05:10:11,344 --> 05:10:14,347 THROUGH IN OTHER COMMUNITIES AND 6608 05:10:14,347 --> 05:10:17,483 WE'RE ALWAYS LOOKING TO FILL IN 6609 05:10:17,483 --> 05:10:24,590 THOSE GAPS AND ONE THING WE SEE 6610 05:10:24,590 --> 05:10:26,759 IT MIGHT BE A COMMUNITY OR 6611 05:10:26,759 --> 05:10:29,429 ORGANIZATION AND HAVE DONE 6612 05:10:29,429 --> 05:10:31,798 PARTNERSHIPS THAT REPRESENT 6613 05:10:31,798 --> 05:10:33,599 COMMUNITY AND MAYBE THERE ARE 6614 05:10:33,599 --> 05:10:35,802 EASY WAYS BECAUSE WE HAVE THE 6615 05:10:35,802 --> 05:10:36,335 NATURAL INFRASTRUCTURE TO 6616 05:10:36,335 --> 05:10:39,906 PARTNER WITH THEM AND SEND OUT A 6617 05:10:39,906 --> 05:10:43,810 MAILER COULD BE THE EASIEST 6618 05:10:43,810 --> 05:10:45,711 IMPLEMENTATION POINT AND COULD 6619 05:10:45,711 --> 05:10:50,817 BE DEEPER AND WE DO THIS NOW AND 6620 05:10:50,817 --> 05:10:51,417 HAVE MOBILE ENGAGEMENT UNITS 6621 05:10:51,417 --> 05:10:56,622 WHERE PEOPLE CAN ENROLL. 6622 05:10:56,622 --> 05:11:03,362 PARTNER WITH A COMMUNITY CENTER 6623 05:11:03,362 --> 05:11:07,066 AND LOTS OF WAYS WE LOOK TO 6624 05:11:07,066 --> 05:11:07,433 CLOSE THE GAPS. 6625 05:11:07,433 --> 05:11:12,138 WE'RE ALWAYS INTERESTED IN IDEAS 6626 05:11:12,138 --> 05:11:12,738 BY THE WAY. 6627 05:11:12,738 --> 05:11:14,607 IF YOU HAVE OTHER IDEAS, WE'D 6628 05:11:14,607 --> 05:11:18,110 LOVE TO CONTINUE TO FORM THE 6629 05:11:18,110 --> 05:11:18,444 PARTNERSHIPS. 6630 05:11:18,444 --> 05:11:23,983 >> I APPRECIATE THE RACIAL AND 6631 05:11:23,983 --> 05:11:25,751 ETHNIC DIVERSITY. 6632 05:11:25,751 --> 05:11:27,386 ARE YOU ABLE TO COMMENT ON THE 6633 05:11:27,386 --> 05:11:28,187 DIVERSITY. 6634 05:11:28,187 --> 05:11:31,524 >> THOSE ARE QUESTIONS IT WAS ON 6635 05:11:31,524 --> 05:11:32,091 THE RIGHT SIDE OF THE EARLY 6636 05:11:32,091 --> 05:11:32,325 FIGURES. 6637 05:11:32,325 --> 05:11:38,464 I DIDN'T CALL IT OUT AS MUCH. 6638 05:11:38,464 --> 05:11:43,870 WE CAPTURED THAT I'M NOT SURE 6639 05:11:43,870 --> 05:11:47,273 HOW THEY COMPARE TO THE CENSUS 6640 05:11:47,273 --> 05:11:47,540 AVERAGES. 6641 05:11:47,540 --> 05:11:50,543 MY RECOLLECTION IS WE'RE SIMILAR 6642 05:11:50,543 --> 05:11:52,712 OR EXCEED AND HAVE QUESTIONS ON 6643 05:11:52,712 --> 05:11:55,114 INCOME, FAMILY SIZE, HEALTH 6644 05:11:55,114 --> 05:12:00,987 INSURANCE STATUS, ACCESS TO 6645 05:12:00,987 --> 05:12:03,589 HEALTH CARE, EDUCATION. 6646 05:12:03,589 --> 05:12:05,091 WE MAY BE A LITTLE MORE EDUCATED 6647 05:12:05,091 --> 05:12:07,727 THAN THE U.S. POPULATION BUT NOT 6648 05:12:07,727 --> 05:12:08,528 A WHOLE LOT. 6649 05:12:08,528 --> 05:12:11,264 >> AND REGARDING SOCIO 6650 05:12:11,264 --> 05:12:11,531 ECONOMICS. 6651 05:12:11,531 --> 05:12:12,698 >> SOCIAL DETERMINATES OF HEALTH 6652 05:12:12,698 --> 05:12:15,601 MODULE IT'S ONE OF THE MODULES I 6653 05:12:15,601 --> 05:12:16,302 FOUND INTERESTING FROM THE FACT 6654 05:12:16,302 --> 05:12:19,472 WHEN WE DO OUR TESTING WITH 6655 05:12:19,472 --> 05:12:21,240 PARTICIPANTS AND HAVE THEM GIVE 6656 05:12:21,240 --> 05:12:23,042 OUR FEEDBACK IT'S THE ONLY TIME 6657 05:12:23,042 --> 05:12:29,348 WE HAD OUR PARTICIPANTS TELL US 6658 05:12:29,348 --> 05:12:35,488 THEY WANTED MORE QUESTIONS. 6659 05:12:35,488 --> 05:12:38,157 PEOPLE DON'T WANT TO ANSWER MORE 6660 05:12:38,157 --> 05:12:41,794 AND THE MODULE BUILDS FROM 6661 05:12:41,794 --> 05:12:42,828 STANDARD QUESTIONS SHARED 6662 05:12:42,828 --> 05:12:48,467 THROUGH OTHER TOOL SETS AND THE 6663 05:12:48,467 --> 05:12:49,969 DATA SET IS AVAILABLE AS WELL. 6664 05:12:49,969 --> 05:12:51,137 YOU CAN LOOK THROUGH THE 6665 05:12:51,137 --> 05:12:52,138 QUESTIONS ONLINE. 6666 05:12:52,138 --> 05:12:53,439 OUR QUESTIONNAIRES ARE PUBLIC 6667 05:12:53,439 --> 05:12:55,908 AND QUESTIONS CAN BE REUSED. 6668 05:12:55,908 --> 05:12:59,779 WE ENCOURAGE THAT NATIONALLY AND 6669 05:12:59,779 --> 05:13:00,413 INTERNATIONALLY BECAUSE IT 6670 05:13:00,413 --> 05:13:01,781 INCREASES COMPARABILITY OF OUR 6671 05:13:01,781 --> 05:13:03,349 STUDIES FOR META-ANALYSES AND 6672 05:13:03,349 --> 05:13:06,686 THINGS LIKE THAT AND FOR 6673 05:13:06,686 --> 05:13:07,753 RESEARCH PURPOSES AND AS WELL AS 6674 05:13:07,753 --> 05:13:08,354 LOOK AT HOW PEOPLE ANSWERED 6675 05:13:08,354 --> 05:13:14,427 THEM. 6676 05:13:14,427 --> 05:13:15,661 >> THANK YOU FOR YOUR 6677 05:13:15,661 --> 05:13:15,995 PRESENTATION. 6678 05:13:15,995 --> 05:13:26,339 WONDERFUL TO SEE IT. 6679 05:13:28,941 --> 05:13:31,043 WE LOOKED AT THE SOCIAL 6680 05:13:31,043 --> 05:13:32,011 DETERMINATES OF HEALTH 6681 05:13:32,011 --> 05:13:35,081 QUESTIONNAIRE SO THANK YOU FOR 6682 05:13:35,081 --> 05:13:37,350 INCLUDING THE INDEX AND THEY'RE 6683 05:13:37,350 --> 05:13:38,818 RICH AND POWERFUL. 6684 05:13:38,818 --> 05:13:43,055 I'M GOING TO GO BACK FROM A WISH 6685 05:13:43,055 --> 05:13:47,693 LIST PERSPECTIVE TO WHAT 6686 05:13:47,693 --> 05:13:52,098 DR. AGUILAR STARTED US WITH AND 6687 05:13:52,098 --> 05:13:54,900 THE ABILITY TO HAVE STATISTICAL 6688 05:13:54,900 --> 05:13:59,572 SAMPLING WEIGHTS AS A VARIABLE 6689 05:13:59,572 --> 05:14:00,673 TO ADJUST HOW MUCH A PARTICIPANT 6690 05:14:00,673 --> 05:14:03,309 OF DATA CONTRIBUTES TO THE 6691 05:14:03,309 --> 05:14:04,977 POPULATION AND HEALTH ANALYSES 6692 05:14:04,977 --> 05:14:07,046 SOME OF US ARE INTERESTED IN AND 6693 05:14:07,046 --> 05:14:09,148 ADVANCE THE CURRENT LIMITATIONS 6694 05:14:09,148 --> 05:14:12,418 WE HAVE POPULATIONS WHERE THE 6695 05:14:12,418 --> 05:14:14,220 CRITIQUES COME BACK AND SAY 6696 05:14:14,220 --> 05:14:15,821 CAN'T YOU MAKE THIS LOOK A 6697 05:14:15,821 --> 05:14:16,922 LITTLE BIT MORE REPRESENTATIVE 6698 05:14:16,922 --> 05:14:20,259 AND LOOK AT THE SGM COMMUNITIES, 6699 05:14:20,259 --> 05:14:21,894 FOR INSTANCE. 6700 05:14:21,894 --> 05:14:25,998 WILL THERE BE A PLACE OR 6701 05:14:25,998 --> 05:14:27,166 INTEREST IN THINKING AND PULLING 6702 05:14:27,166 --> 05:14:28,567 IN DEMOGRAPHERS -- 6703 05:14:28,567 --> 05:14:34,040 >> WE HAVE A PARTNERSHIP WITH 6704 05:14:34,040 --> 05:14:35,975 THE CDC AND IS DEVELOPING 6705 05:14:35,975 --> 05:14:38,044 POPULATION WEIGHTS YOU COULD USE 6706 05:14:38,044 --> 05:14:40,980 TO JUST SOME METRICS AND THERE'S 6707 05:14:40,980 --> 05:14:43,616 A COUPLE ANALYSES -- OTHERS HAVE 6708 05:14:43,616 --> 05:14:46,218 DONE THAT BUT WE LOOK FORWARD TO 6709 05:14:46,218 --> 05:14:46,919 INCLUDING SOME OF THOSE METRICS 6710 05:14:46,919 --> 05:14:52,491 IN THE DATA SET AS WELL. 6711 05:14:52,491 --> 05:15:00,733 >> 6712 05:15:00,733 --> 05:15:02,535 >> THERE'S OVERLAP -- 6713 05:15:02,535 --> 05:15:05,304 >> WHICH COHORT? 6714 05:15:05,304 --> 05:15:10,042 >> THE WORK IN MAG 3 AND 4. 6715 05:15:10,042 --> 05:15:13,312 DO THEY OVERLAP THE WORK WITH 6716 05:15:13,312 --> 05:15:14,146 THIS NOW? 6717 05:15:14,146 --> 05:15:15,981 >> I'M NOT SURE ACTUALLY. 6718 05:15:15,981 --> 05:15:18,284 WHICH COHORT. 6719 05:15:18,284 --> 05:15:19,819 >> EMERGE 6720 05:15:19,819 --> 05:15:23,522 >> OH, EMERGE, I KNOW THAT 6721 05:15:23,522 --> 05:15:24,090 REALLY WELL. 6722 05:15:24,090 --> 05:15:27,359 THERE'S PROBABLY SOME OVERLAP 6723 05:15:27,359 --> 05:15:29,795 WITH EMERGE AND SOME SITES. 6724 05:15:29,795 --> 05:15:31,630 LESS THAN YOU'D EXPECT. 6725 05:15:31,630 --> 05:15:33,232 THAT KIND OF ANALYSIS HIGHLIGHTS 6726 05:15:33,232 --> 05:15:36,836 AN INTERESTING TAKE BECAUSE YOU 6727 05:15:36,836 --> 05:15:42,842 WOULD HAVE TO THINK ABOUT 6728 05:15:42,842 --> 05:15:44,877 DE-DUPLICATING THE DATA SET AND 6729 05:15:44,877 --> 05:15:46,879 DON'T HAVE A CLEAR WAY YET. 6730 05:15:46,879 --> 05:15:52,885 THAT FROM A GENETIC DATA SET IS 6731 05:15:52,885 --> 05:15:55,755 ONE CASE THAT WOULD COME. 6732 05:15:55,755 --> 05:15:58,524 SOME SITES ARE IN VOGUE AND THE 6733 05:15:58,524 --> 05:16:01,093 BEST WAY TO DO EMERGE ANALYSIS 6734 05:16:01,093 --> 05:16:04,630 NOW IS TO REMOVE THE SITES THAT 6735 05:16:04,630 --> 05:16:07,066 OVERLAP IN THE EMERGE DATA SET 6736 05:16:07,066 --> 05:16:09,034 AND JUST USE THE ONES THAT DON'T 6737 05:16:09,034 --> 05:16:12,538 OVERLAP. 6738 05:16:12,538 --> 05:16:17,977 >> AND I DO RECALL WHERE YOU 6739 05:16:17,977 --> 05:16:20,012 GUYS LOOK AT THE RESULTS. 6740 05:16:20,012 --> 05:16:21,814 HOW COMPLICATED IS THIS ONE HERE 6741 05:16:21,814 --> 05:16:24,116 WITH ALL OF US AND THE RETURN OF 6742 05:16:24,116 --> 05:16:25,885 THE RESULTS? 6743 05:16:25,885 --> 05:16:28,587 >> SO WITH EMERGE WE SPENT FOUR 6744 05:16:28,587 --> 05:16:32,825 YEARS WE DID ACMG58 AND 59 AND 6745 05:16:32,825 --> 05:16:37,296 IN EARLIER EMERGE AWARD AND WITH 6746 05:16:37,296 --> 05:16:39,598 THAT WE BASICALLY IT WAS EACH 6747 05:16:39,598 --> 05:16:40,966 SITE DOING ABOUT 4,000 PEOPLE 6748 05:16:40,966 --> 05:16:43,335 AND WE'RE DOING ABOUT THAT PER 6749 05:16:43,335 --> 05:16:45,471 WEEK INSTEAD OF OVER FOUR YEARS. 6750 05:16:45,471 --> 05:16:47,373 AND SO IT'S A MUCH BIGGER SCALE 6751 05:16:47,373 --> 05:16:48,507 OF WHAT WE'RE DOING. 6752 05:16:48,507 --> 05:16:51,343 BUT IN SOME WAYS IT'S EASIER TOO 6753 05:16:51,343 --> 05:16:53,712 BECAUSE WE HAVE THREE CLINICAL 6754 05:16:53,712 --> 05:16:56,315 VALIDATION HATS THAT WORK IN 6755 05:16:56,315 --> 05:16:56,649 CONCERT. 6756 05:16:56,649 --> 05:16:58,551 WE BUILT ONE RE-HARMONIZATION 6757 05:16:58,551 --> 05:16:59,819 PIPELINE FOR DOING THE 6758 05:16:59,819 --> 05:17:01,587 PROTOCOLING AND EVERYTHING TO DO 6759 05:17:01,587 --> 05:17:04,590 THE SCALE WE'RE DOING AND HAD TO 6760 05:17:04,590 --> 05:17:05,224 BE LIKE SO PIPELINE. 6761 05:17:05,224 --> 05:17:07,993 SO IN SOME WAYS I THINK THE 6762 05:17:07,993 --> 05:17:10,830 EFFORT IS PROBABLY EASIER AFTER 6763 05:17:10,830 --> 05:17:11,997 WE GOT IT INSTRUMENTED FOR 6764 05:17:11,997 --> 05:17:14,400 SCALE. 6765 05:17:14,400 --> 05:17:16,902 THAT PART TOOK LONGER. 6766 05:17:16,902 --> 05:17:21,006 I THINK WHAT WE DON'T HAVE THAT 6767 05:17:21,006 --> 05:17:23,442 EMERGE HAD YET IS FOLLOW UP WITH 6768 05:17:23,442 --> 05:17:24,710 THE OUTCOMES. 6769 05:17:24,710 --> 05:17:27,346 AND THAT WILL BE DONE IN TWO 6770 05:17:27,346 --> 05:17:27,580 WAYS. 6771 05:17:27,580 --> 05:17:31,750 ONE IS PROBABLY THE MOST 6772 05:17:31,750 --> 05:17:37,523 DEFINITIVE FOLLOW-UP IS HOW WE 6773 05:17:37,523 --> 05:17:38,123 PUT THAT INTO THE RESEARCH 6774 05:17:38,123 --> 05:17:40,593 PLATFORM SUCH THAT RESEARCHERS 6775 05:17:40,593 --> 05:17:42,661 CAN ASK ALL KIND OF QUESTIONS 6776 05:17:42,661 --> 05:17:47,566 THE OUTCOMES AFTER THEY GET 6777 05:17:47,566 --> 05:17:49,468 SUBSEQUENT PROCEDURES AND THINGS 6778 05:17:49,468 --> 05:17:51,036 LIKE THAT. 6779 05:17:51,036 --> 05:17:58,844 >> AND A FOLLOW-UP QUESTION IS 6780 05:17:58,844 --> 05:18:00,646 LOOKING AT THE STATE OF 6781 05:18:00,646 --> 05:18:03,682 TENNESSEE AND LOOKING AS THE 6782 05:18:03,682 --> 05:18:06,852 REPRESENTATION BASED ON THE 6783 05:18:06,852 --> 05:18:09,455 STATE OF TENNESSEE AND 200 OR 6784 05:18:09,455 --> 05:18:09,622 SO. 6785 05:18:09,622 --> 05:18:14,660 >> SO TENNESSEE WE HAVE 6786 05:18:14,660 --> 05:18:21,267 RECRUITMENT FROM A COUPLE HBCs 6787 05:18:21,267 --> 05:18:24,403 AND MY HUNCH IS THE 6788 05:18:24,403 --> 05:18:25,170 REPRESENTATIVE OF AFRICAN 6789 05:18:25,170 --> 05:18:28,107 AMERICANS IN TENNESSEE IS 6790 05:18:28,107 --> 05:18:29,575 PROBABLY GREATER THAN YOU'D 6791 05:18:29,575 --> 05:18:30,242 EXPECT BUT THE 6792 05:18:30,242 --> 05:18:31,043 OVERREPRESENTATION IN TENNESSEE 6793 05:18:31,043 --> 05:18:34,580 BECAUSE WE DON'T HAVE A LARGE 6794 05:18:34,580 --> 05:18:36,448 RECRUITING PLATFORM IN TENNESSEE 6795 05:18:36,448 --> 05:18:40,452 LIKE A BIG MAJOR HOSPITAL IS 6796 05:18:40,452 --> 05:18:42,454 PROBABLY LESS THAN POPULATION 6797 05:18:42,454 --> 05:18:43,989 SPECIFIC REPRESENTATIONS IN 6798 05:18:43,989 --> 05:18:48,027 OTHER LOCATIONS AVANDERBILT AND 6799 05:18:48,994 --> 05:18:50,963 MEHARRY YOU CAN INCLUDE AND 6800 05:18:50,963 --> 05:18:59,405 KNOXVILLE AND JACKSON. 6801 05:18:59,405 --> 05:19:00,706 >> THANK YOU, JOSH. 6802 05:19:00,706 --> 05:19:02,141 WE HAVE OTHER OPPORTUNITIES TO 6803 05:19:02,141 --> 05:19:04,243 TALK SO I'LL DEFER ON SPECIFIC 6804 05:19:04,243 --> 05:19:05,744 QUESTIONS BUT YOU MENTIONED 6805 05:19:05,744 --> 05:19:08,881 SOMETHING I THOUGHT I WANTED TO 6806 05:19:08,881 --> 05:19:11,116 CLARIFY FROM OUR COMMUNITY. 6807 05:19:11,116 --> 05:19:14,753 SO IN THE RECENT ETHNIC DATA 6808 05:19:14,753 --> 05:19:15,921 AVAILABLE YOU ONLY MAKE 6809 05:19:15,921 --> 05:19:17,923 AVAILABLE RIGHT NOW THE BIG 6810 05:19:17,923 --> 05:19:21,060 CATEGORIES IS THAT RIGHT WITH 6811 05:19:21,060 --> 05:19:22,127 AMERICAN INDIAN AND ALASKAN 6812 05:19:22,127 --> 05:19:23,729 NATIVE NOT BEING IDENTIFIED 6813 05:19:23,729 --> 05:19:27,166 UNTIL YOU SORT THROUGH THE FINAL 6814 05:19:27,166 --> 05:19:27,399 PHASES. 6815 05:19:27,399 --> 05:19:28,834 IS THAT CORRECT? 6816 05:19:28,834 --> 05:19:29,268 >> CORRECT. 6817 05:19:29,268 --> 05:19:31,003 RIGHT FLOU IT'S HIGH-LEVEL 6818 05:19:31,003 --> 05:19:34,273 CLASSIFICATION AND THE NEXT 6819 05:19:34,273 --> 05:19:38,811 RELEASE FALL-WINTER '24 WILL 6820 05:19:38,811 --> 05:19:41,880 INCLUDE SUB CATEGORIZATIONS AND 6821 05:19:41,880 --> 05:19:44,516 THOSE WHO SELF-IDENTIFIED IB 6822 05:19:44,516 --> 05:19:47,653 AMERICAN INDIAN AND ALASKAN 6823 05:19:47,653 --> 05:19:48,087 NATIVE. 6824 05:19:48,087 --> 05:19:49,188 >> IN THE HISPANIC COMMUNITY 6825 05:19:49,188 --> 05:19:53,859 HEALTH CENTER WE LEARNED TO SAY 6826 05:19:53,859 --> 05:19:54,994 SUB POPULATIONS. 6827 05:19:54,994 --> 05:19:58,130 YOU REFERRED TO THE NATIONAL 6828 05:19:58,130 --> 05:20:02,801 HERITAGE AND AS YOU SAW EARLIER 6829 05:20:02,801 --> 05:20:06,238 TODAY WE TALKED ABOUT THE NEW 6830 05:20:06,238 --> 05:20:10,309 OMB CATEGORIZATION AND THE FIRST 6831 05:20:10,309 --> 05:20:13,879 LEVEL, SECOND LEVEL ARE REQUIRED 6832 05:20:13,879 --> 05:20:15,514 AND SECOND LEVEL IS THE NATIONAL 6833 05:20:15,514 --> 05:20:20,185 HERITAGE IS MOST COMMON WITH 6834 05:20:20,185 --> 05:20:22,721 OPTION TO ADD AND THIS IS TRUE 6835 05:20:22,721 --> 05:20:24,456 FOR ALL GROUPS. 6836 05:20:24,456 --> 05:20:26,225 WAS ALL OF US SET UP THAT WAY OR 6837 05:20:26,225 --> 05:20:28,093 NOT AND THAT WOULD BE A QUESTION 6838 05:20:28,093 --> 05:20:33,699 IF IT WASN'T WOULD THERE BE A 6839 05:20:33,699 --> 05:20:38,971 POSSIBILITY FOR A PROPOSAL TO 6840 05:20:38,971 --> 05:20:41,640 ADDRESS THAT IN A SUBSEQUENT 6841 05:20:41,640 --> 05:20:42,741 WAY? 6842 05:20:42,741 --> 05:20:44,610 >> WE WERE DESIGN LARGELY AROUND 6843 05:20:44,610 --> 05:20:47,813 THE ORIGINAL PLAN OF THE 2020 6844 05:20:47,813 --> 05:20:49,448 CENSUS FOR A SINGLE QUESTION. 6845 05:20:49,448 --> 05:20:53,886 >> I'M AWARE. 6846 05:20:53,886 --> 05:20:55,421 >> OKAY. 6847 05:20:55,421 --> 05:21:01,660 >> I DON'T KNOW HOW MUCH WE'RE 6848 05:21:01,660 --> 05:21:03,028 ALIGNED TO THE NEW QUESTIONS AND 6849 05:21:03,028 --> 05:21:05,397 WOULD BE GREAT TO TALK ABOUT 6850 05:21:05,397 --> 05:21:06,265 THAT FURTHER. 6851 05:21:06,265 --> 05:21:09,401 >> YOU HAVE A MIDDLE EASTERN AND 6852 05:21:09,401 --> 05:21:10,803 NORTH AMERICAN CATEGORY AND A 6853 05:21:10,803 --> 05:21:11,870 SINGLE QUESTION OPPOSED TO THE 6854 05:21:11,870 --> 05:21:12,905 TWO-PART QUESTION. 6855 05:21:12,905 --> 05:21:15,908 BUT I THINK IN MY THINKING AND 6856 05:21:15,908 --> 05:21:19,912 THIS IS NOT SET INTO THE NEW 6857 05:21:19,912 --> 05:21:21,313 CATEGORIES BUT THERE ARE 6858 05:21:21,313 --> 05:21:23,048 PROBABLY FOR RESEARCHERS IN 6859 05:21:23,048 --> 05:21:24,883 PARTICULAR NOT SUPPOSED TO 6860 05:21:24,883 --> 05:21:26,919 REQUIRE FOR THE FEDERAL 6861 05:21:26,919 --> 05:21:30,456 WORKFORCE OR AGENCIES 6862 05:21:30,456 --> 05:21:31,490 SUBCATEGORIES, SUBPOPULATIONS 6863 05:21:31,490 --> 05:21:34,426 THAT WOULD BE GOOD TO BE ABLE TO 6864 05:21:34,426 --> 05:21:44,937 IDENTIFY PARTICULARLY IN THE 6865 05:21:47,773 --> 05:21:52,211 HET 6866 05:21:52,211 --> 05:21:55,914 HETTER -- HETEROGENEOUS 6867 05:21:55,914 --> 05:21:56,215 CATEGORIES. 6868 05:21:56,215 --> 05:21:57,883 >> THERE'S INDIVIDUAL COUNTRIES 6869 05:21:57,883 --> 05:22:00,586 IN THERE AND SAME FOR THE ASIAN 6870 05:22:00,586 --> 05:22:01,653 SUBPOPULATIONS AND IN TERMS OF 6871 05:22:01,653 --> 05:22:03,355 THE EXACT ALIGNMENT I DON'T KNOW 6872 05:22:03,355 --> 05:22:06,058 THAT. 6873 05:22:06,058 --> 05:22:10,295 IT WOULD BE GREAT TO EXPLORE 6874 05:22:10,295 --> 05:22:11,330 THAT AND WE ARE LOOKING FOR 6875 05:22:11,330 --> 05:22:13,132 FILING IF NEEDED. 6876 05:22:13,132 --> 05:22:14,199 >> THANK YOU FOR THE 6877 05:22:14,199 --> 05:22:15,400 PRESENTATION AND UPDATE AND 6878 05:22:15,400 --> 05:22:16,969 TAKING THE TIME ON A FRIDAY 6879 05:22:16,969 --> 05:22:20,339 AFTERNOON TO SPEND AN HOUR WITH 6880 05:22:20,339 --> 05:22:25,010 US. 6881 05:22:25,010 --> 05:22:30,549 I'LL NOW TURN TO EMMA TO SAY A 6882 05:22:30,549 --> 05:22:31,617 FEW WORDS. 6883 05:22:31,617 --> 05:22:33,051 SHE'S BEEN A MEMBER OF OUR 6884 05:22:33,051 --> 05:22:36,021 COUNCIL FOUR YEARS. 6885 05:22:36,021 --> 05:22:39,591 YOU STARTED WITH THE PANDEMIC 6886 05:22:39,591 --> 05:22:40,592 AND HAVE NOW CLOSING IN PERSON 6887 05:22:40,592 --> 05:22:42,561 AND WE EXTENDED YOU FOR ONE YEAR 6888 05:22:42,561 --> 05:22:46,398 SO WE COULD SEE YOU AGAIN AND 6889 05:22:46,398 --> 05:22:49,067 JOIN US. 6890 05:22:49,067 --> 05:22:51,036 SO EMMA. 6891 05:22:51,036 --> 05:22:51,803 >> THANK YOU. 6892 05:22:51,803 --> 05:22:53,071 I WROTE SOMETHING VERY BRIEF. 6893 05:22:53,071 --> 05:22:59,044 I'LL BE QUICK SO I KNOW 6894 05:22:59,044 --> 05:23:00,112 EVERYBODY'S IN A HURRY. 6895 05:23:00,112 --> 05:23:02,981 I WOULD LIKE TO ESPECIALLY THANK 6896 05:23:02,981 --> 05:23:05,250 ELISEO AND MONICA TO BE PART OF 6897 05:23:05,250 --> 05:23:06,685 THE NATIONAL ADVISORY COUNCIL. 6898 05:23:06,685 --> 05:23:09,054 IT'S BEEN TRULY INSPIRING TO 6899 05:23:09,054 --> 05:23:11,290 WITNESS YOUR LEADERSHIP AND 6900 05:23:11,290 --> 05:23:11,924 COMMITMENT TO IMPROVING MINORITY 6901 05:23:11,924 --> 05:23:16,828 HEALTH RESEARCH. 6902 05:23:16,828 --> 05:23:19,364 ALSO SUPPORTING MINORITY 6903 05:23:19,364 --> 05:23:21,500 RESEARCHERS AND STRENGTHENING 6904 05:23:21,500 --> 05:23:22,100 THE INFRASTRUCTURE RESEARCH 6905 05:23:22,100 --> 05:23:23,802 ACROSS THE COUNTRY. 6906 05:23:23,802 --> 05:23:25,771 REFLECTING ON THE PAST YEARS' 6907 05:23:25,771 --> 05:23:27,339 EXPERIENCE ON THE COUNCIL HAS 6908 05:23:27,339 --> 05:23:30,876 BEEN A MILE STONE IN MY CAREER 6909 05:23:30,876 --> 05:23:31,877 AS A HEALTH ECONOMIST OUR 6910 05:23:31,877 --> 05:23:33,512 RESEARCH IS GUIDED BY METHODS 6911 05:23:33,512 --> 05:23:37,316 AND THERE'S NOT A STRONG FOCUS 6912 05:23:37,316 --> 05:23:37,849 NOR TRAINING ON SPECIFIC 6913 05:23:37,849 --> 05:23:38,150 POPULATIONS. 6914 05:23:38,150 --> 05:23:42,955 AT THE COUNCIL I HAVE LEARNED 6915 05:23:42,955 --> 05:23:45,324 RESEARCH IN A WIDE RANGE OF 6916 05:23:45,324 --> 05:23:47,893 TOPICS CRUCIAL FOR MINORITY 6917 05:23:47,893 --> 05:23:50,329 POPULATIONS AND HAS HAD A 6918 05:23:50,329 --> 05:23:51,997 PROFOUND EFFECT ON MY RESEARCH 6919 05:23:51,997 --> 05:23:55,067 AND WIDENED MY VIEW OF THE 6920 05:23:55,067 --> 05:23:57,102 IMPORTANCE OF MULTI-DISCIPLINARY 6921 05:23:57,102 --> 05:24:00,505 RESEARCH AND WOULD LIKE TO THANK 6922 05:24:00,505 --> 05:24:03,575 THE OTHER COUNCIL MEMBERS AND 6923 05:24:03,575 --> 05:24:09,948 DR. COTTON FOR ALL THE SUPPORT 6924 05:24:09,948 --> 05:24:12,584 AND DR. STINSON AND ALL THE 6925 05:24:12,584 --> 05:24:14,586 STAFF FOR THE EXCEPTIONAL WORK. 6926 05:24:14,586 --> 05:24:15,687 IT HAS BEEN A PRIVILEGE TO WORK 6927 05:24:15,687 --> 05:24:19,992 WITH ALL OF YOU. 6928 05:24:19,992 --> 05:24:26,531 THANK YOU. 6929 05:24:26,531 --> 05:24:27,099 >> OKAY. 6930 05:24:27,099 --> 05:24:29,401 I DON'T BELIEVE WE HAVE PUBLIC 6931 05:24:29,401 --> 05:24:31,270 COMMENT SUBMITTED, RIGHT? 6932 05:24:31,270 --> 05:24:31,970 OKAY. 6933 05:24:31,970 --> 05:24:37,609 SO WITH THAT I WILL THANK 6934 05:24:37,609 --> 05:24:40,178 EVERYONE FOR ATTENDING AND THOSE 6935 05:24:40,178 --> 05:24:41,780 ONLINE FOR LISTENING AND THIS 6936 05:24:41,780 --> 05:24:45,317 WILL BE ARCHIVED ONCE WE GET IT 6937 05:24:45,317 --> 05:24:47,552 ALL SET UP AND FOR THE COUNCIL 6938 05:24:47,552 --> 05:24:51,857 MEMBERS TO HAVE A SAFE TRIP HOME 6939 05:24:51,857 --> 05:24:54,493 ACROSS THE CITY FOR ONE AND 6940 05:24:54,493 --> 05:24:57,796 WHEREVER ELSE YOU'RE ALL HEADED. 6941 05:24:57,796 --> 05:25:01,199 TO SEE YOU IN SEPTEMBER. 6942 05:25:01,199 --> 05:25:04,002 SO THIS MEETING IS ADJOURNED. 6943 05:25:04,002 --> 05:25:04,069