1 00:00:06,641 --> 00:00:11,813 >> OUR EX-OFFICIO MEMBERS, 2 00:00:11,813 --> 00:00:15,283 HENDERSON WHO IS ONLINE. 3 00:00:15,283 --> 00:00:17,819 WE'LL CIRCLE BACK. 4 00:00:17,819 --> 00:00:22,490 MICHELLE AND SIMMONE. 5 00:00:22,490 --> 00:00:24,325 >> DEPARTMENT OF DEFENSE, 6 00:00:24,325 --> 00:00:24,959 EX-OFFICIO MEMBER. 7 00:00:24,959 --> 00:00:26,528 >> OKAY. 8 00:00:26,528 --> 00:00:29,564 LET'S GO BACK. 9 00:00:29,564 --> 00:00:34,836 >> PROFESSOR UNIVERSITY OF 10 00:00:34,836 --> 00:00:35,170 PENNSYLVANIA. 11 00:00:35,170 --> 00:00:39,107 6: 12 00:00:42,043 --> 00:00:43,411 >> GOOD MORNING, PROFESSOR AT 13 00:00:43,411 --> 00:00:44,779 MIAMI. 14 00:00:44,779 --> 00:00:55,089 >> AND HENDERSON. 15 00:00:55,457 --> 00:00:55,924 OKAY. 16 00:00:55,924 --> 00:00:58,359 WE'LL COME BACK TO HENDERSON IF 17 00:00:58,359 --> 00:01:00,261 SHE POPS UP. 18 00:01:00,261 --> 00:01:05,200 WE'RE GOING TO GO TO THE TABLE. 19 00:01:05,200 --> 00:01:10,371 WE'LL START WITH DR. DOSS. 20 00:01:10,371 --> 00:01:13,608 >> I'M THE DIVISION DIRECTOR FOR 21 00:01:13,608 --> 00:01:15,276 ONE OF THE THREE EXTRAMURAL 22 00:01:15,276 --> 00:01:17,178 DIVISIONS OF ENDOCRINE AND 23 00:01:17,178 --> 00:01:18,580 BIOLOGICAL AND BEHAVIORAL 24 00:01:18,580 --> 00:01:22,250 SCIENCES. 25 00:01:22,250 --> 00:01:23,985 >> I'M THE DIRECTOR OF THE 26 00:01:23,985 --> 00:01:26,821 DIVISION OF COMMUNITY HEALTH AND 27 00:01:26,821 --> 00:01:31,993 POPULATION SCIENCE AT NIMHD. 28 00:01:31,993 --> 00:01:33,261 >> GOOD MORNING. 29 00:01:33,261 --> 00:01:34,395 I AM THE DIRECTOR OF THE 30 00:01:34,395 --> 00:01:36,531 DIVISION OF CLINICAL AND HEALTH 31 00:01:36,531 --> 00:01:40,935 SERVICES RESEARCH AT THE NIMHD. 32 00:01:40,935 --> 00:01:46,508 >> IS THERE ANY STAFF THAT -- 33 00:01:46,508 --> 00:01:52,714 KIMBERLY, JIMMY, KELLY? 34 00:01:52,714 --> 00:01:57,018 OKAY. 35 00:01:57,018 --> 00:01:58,953 >> KIMBERLY ALLEN, EXECUTIVE 36 00:01:58,953 --> 00:02:09,230 OFFICER, NIMHD. 37 00:02:13,501 --> 00:02:16,738 >> ABOUT MORNING, KELLY 38 00:02:16,738 --> 00:02:17,372 CARRINGTON, NIMHD COMMUNICATIONS 39 00:02:17,372 --> 00:02:18,373 DIRECTOR. 40 00:02:18,373 --> 00:02:20,642 >> OKAY. 41 00:02:20,642 --> 00:02:23,711 WE'RE GOING TO CIRCLE BACK LATER 42 00:02:23,711 --> 00:02:24,979 OR THE OTHER INTRODUCTION AND 43 00:02:24,979 --> 00:02:25,713 ADDITIONAL INFORMATION. 44 00:02:25,713 --> 00:02:29,317 OKAY, WE'RE NOW GOING TO REVIEW 45 00:02:29,317 --> 00:02:31,953 THE MINUTES FOR THE MAY 20, 2024 46 00:02:31,953 --> 00:02:35,957 COUNCIL MINUTES. 47 00:02:35,957 --> 00:02:37,158 VOTING INSTRUCTIONS, THOSE IN 48 00:02:37,158 --> 00:02:39,260 THE ROOM BY SHOW OF HAND WHEN WE 49 00:02:39,260 --> 00:02:42,096 GET TO THAT POINT. 50 00:02:42,096 --> 00:02:46,968 THOSE ONLINE WILL PUT A YES OR A 51 00:02:46,968 --> 00:02:50,171 NO IN THE CHAT BOX. 52 00:02:50,171 --> 00:02:53,775 THE MINUTES FROM THE MAY 2024 53 00:02:53,775 --> 00:02:57,245 COUNCIL MEETING WERE POSTED IN 54 00:02:57,245 --> 00:02:58,713 THE ELECTRONIC COUNCIL BOOK. 55 00:02:58,713 --> 00:03:00,815 HAVING REVIEWED THE MINUTES, ARE 56 00:03:00,815 --> 00:03:02,584 THERE QUESTIONS, CONCERNS OR 57 00:03:02,584 --> 00:03:07,922 CORRECTIONS TO THESE MINUTES. 58 00:03:07,922 --> 00:03:09,157 HEARING NONE, MAY I HAVE A 59 00:03:09,157 --> 00:03:11,960 MOTION TO APPROVE THE MINUTES 60 00:03:11,960 --> 00:03:14,362 FOR THE MAY COUNCIL? 61 00:03:14,362 --> 00:03:15,930 >> SO MOVED. 62 00:03:15,930 --> 00:03:18,766 >> MAY I HAVE A SECOND. 63 00:03:18,766 --> 00:03:22,036 >> SECONDED. 64 00:03:22,036 --> 00:03:25,039 >> ALL IN FAVOR SHOW MY RAISING 65 00:03:25,039 --> 00:03:28,343 OF HANDS. 66 00:03:28,343 --> 00:03:28,943 LET ME CHECK -- YES FROM 67 00:03:28,943 --> 00:03:39,120 EVERYONE. 68 00:03:40,622 --> 00:03:50,999 THE MINUTES ARE APPROVED. 69 00:03:57,238 --> 00:03:58,506 WE HAVE FUTURE COUNCIL MEETING 70 00:03:58,506 --> 00:04:00,908 DATES FEBRUARY 4, 2025. 71 00:04:00,908 --> 00:04:06,914 THAT THERE BE A VIRTUAL MEETING. 72 00:04:06,914 --> 00:04:10,785 MAY 16, 2025 WILL BE FACE TO 73 00:04:10,785 --> 00:04:14,155 FACE ONCE AGAIN. 74 00:04:14,155 --> 00:04:19,661 SEPTEMBER 5, 2025 -- FACE TO 75 00:04:19,661 --> 00:04:21,562 FACE. 76 00:04:21,562 --> 00:04:27,368 FEBRUARY 6, 2026 WILL BE VIRTUAL 77 00:04:27,368 --> 00:04:28,236 MEETING. 78 00:04:28,236 --> 00:04:31,305 MAY 19, 2026 WILL BE A VIRTUAL 79 00:04:31,305 --> 00:04:33,341 MEETING AND WE'RE GOING TO HOLD 80 00:04:33,341 --> 00:04:35,977 OFF FROM THE AUGUST 11 MEETING 81 00:04:35,977 --> 00:04:37,845 WE'RE GOING TO DO SOME THINGS 82 00:04:37,845 --> 00:04:40,982 AND SEE IF WE CAN ADD AN 83 00:04:40,982 --> 00:04:45,153 ALTERNATIVE DATE BUT PLEASE 84 00:04:45,153 --> 00:04:47,655 REMEMBER IF THERE IS ISSUES LET 85 00:04:47,655 --> 00:04:48,790 ME KNOW IMMEDIATELY BECAUSE A 86 00:04:48,790 --> 00:04:51,959 COUNCIL MEMBER MAY HAVE ONE 87 00:04:51,959 --> 00:04:53,795 ABSENCE PER CALENDAR YEAR. 88 00:04:53,795 --> 00:04:56,698 ALSO REMEMBER THAT AN INDIVIDUAL 89 00:04:56,698 --> 00:05:01,235 CANNOT SERVE ON ANY NIH 90 00:05:01,235 --> 00:05:02,070 PEER-REVIEWED PANELS WHILE 91 00:05:02,070 --> 00:05:03,705 SERVING ON THE COUNCIL. 92 00:05:03,705 --> 00:05:05,973 I'LL NOW TURN THE MEETING OVER 93 00:05:05,973 --> 00:05:07,842 TO DR. PEREZ-STABLE FOR THE 94 00:05:07,842 --> 00:05:18,152 DIRECTOR'S REPORT. 95 00:05:27,929 --> 00:05:28,896 >> OKAY. 96 00:05:28,896 --> 00:05:29,764 GOOD MORNING AGAIN. 97 00:05:29,764 --> 00:05:31,232 WE'LL HOPEFULLY CATCH UP SO 98 00:05:31,232 --> 00:05:33,668 WE'LL HAVE TIME FOR OUR 99 00:05:33,668 --> 00:05:35,703 SCHEDULED BREAK. 100 00:05:35,703 --> 00:05:37,205 I'M ELISEO PEREZ-STABLE THE 101 00:05:37,205 --> 00:05:39,707 DIRECTOR OF MINORITY HEALTH AND 102 00:05:39,707 --> 00:05:42,810 HEALTH DISPARITIES AND PROVIDING 103 00:05:42,810 --> 00:05:43,344 YOUR ANNUAL REPORT. 104 00:05:43,344 --> 00:05:46,380 LET ME SEE IF I CAN WORK THIS 105 00:05:46,380 --> 00:05:56,524 SYSTEM. 106 00:06:05,566 --> 00:06:07,835 >> WANT ME TO SHARE YOUR SLIDE? 107 00:06:07,835 --> 00:06:10,304 >> CAN I ADVANCE THE SLIDE? 108 00:06:10,304 --> 00:06:11,506 I'D LIKE TO BUT I CAN'T GET IT 109 00:06:11,506 --> 00:06:16,944 TO DO IT. 110 00:06:16,944 --> 00:06:20,748 I'LL START WITH UPDATES FROM NIH 111 00:06:20,748 --> 00:06:22,784 IN GENERAL. 112 00:06:22,784 --> 00:06:32,727 OUR COLLEAGUE JOESH -- JOSH 113 00:06:32,727 --> 00:06:34,829 GORDON LEFT NIH EARLIER THIS 114 00:06:34,829 --> 00:06:36,798 YEAR. 115 00:06:36,798 --> 00:06:38,800 HE IS RETURNING TO COLUMBIA AS 116 00:06:38,800 --> 00:06:41,435 CHAIR OF THE DEPARTMENT OF 117 00:06:41,435 --> 00:06:45,006 PSYCHIATRY AND NEW YORK STATE 118 00:06:45,006 --> 00:06:49,677 PSYCHIATRIC INSTITUTE, RETURNING 119 00:06:49,677 --> 00:06:53,481 TO HE HAS BEEN A VERY CREATIVE 120 00:06:53,481 --> 00:06:55,616 AND INNOVATIVE LEADER OF THAT 121 00:06:55,616 --> 00:06:55,883 INSTITUTE. 122 00:06:55,883 --> 00:07:02,623 MOST RECENTLY HE SERVED AS A 123 00:07:02,623 --> 00:07:11,465 CO-CHAIR OF THE COMPASS 124 00:07:11,465 --> 00:07:19,207 INITIATIVE ACROSS NIH THE 125 00:07:19,207 --> 00:07:20,942 COMMUNITY-BASED RESEARCH COMPASS 126 00:07:20,942 --> 00:07:23,978 REPRESENTS COMING FROM A LARGER 127 00:07:23,978 --> 00:07:28,182 INSTITUTE HELPED MYSELF AND 128 00:07:28,182 --> 00:07:28,983 JANINE CLAYTON IN THAT 129 00:07:28,983 --> 00:07:39,193 DEVELOPMENT. 130 00:10:09,844 --> 00:10:10,378 SORRY. 131 00:10:10,378 --> 00:10:11,846 I'LL START OVER. 132 00:10:11,846 --> 00:10:14,749 I'M ELISEO PEREZ-STABLE THE 133 00:10:14,749 --> 00:10:15,883 DIRECTOR OF MINORITY HEALTH AND 134 00:10:15,883 --> 00:10:17,818 HEALTH DISPARITY AND PRESENTING 135 00:10:17,818 --> 00:10:20,654 MY REPORT FOR THE 67th MEETING 136 00:10:20,654 --> 00:10:22,390 OF THE NATIONAL ADVISORY COUNCIL 137 00:10:22,390 --> 00:10:30,197 OF OUR INSTITUTE. 138 00:10:30,197 --> 00:10:33,167 SO, FIRST FOR NIH OVER ALL USE, 139 00:10:33,167 --> 00:10:34,368 DR. JOSH GORDON DEPARTED FROM 140 00:10:34,368 --> 00:10:36,303 THE NATIONAL INSTITUTE OF MENTAL 141 00:10:36,303 --> 00:10:39,273 HEALTH IN JUNE OF THIS YEAR. 142 00:10:39,273 --> 00:10:40,741 HE'D BEEN DIRECTOR SINCE THE 143 00:10:40,741 --> 00:10:43,511 FALL OF 2016. 144 00:10:43,511 --> 00:10:48,449 HE'S RETURNING TO COLUMBIA TO BE 145 00:10:48,449 --> 00:10:50,151 CHAIR OF THE DEPARTMENT OF 146 00:10:50,151 --> 00:10:56,690 PSYCHIATRY AND THE NEW DIRECTOR 147 00:10:56,690 --> 00:10:59,593 OF NEW YORK STATE PSYCHIATRIC 148 00:10:59,593 --> 00:11:00,061 INSTITUTE. 149 00:11:00,061 --> 00:11:03,297 HE MADE CONTRIBUTIONS WHILE 150 00:11:03,297 --> 00:11:10,171 DIRECTOR AT NIMHD AND WAS MY 151 00:11:10,171 --> 00:11:11,372 COLLEAGUE IN CO-CHAIRING THE 152 00:11:11,372 --> 00:11:14,375 COMPASS INITIATIVE AND DID A 153 00:11:14,375 --> 00:11:19,380 NUMBER OF OTHER INITIATIVES AT 154 00:11:19,380 --> 00:11:24,185 NIMHD AND ACCELERATING THE MODE 155 00:11:24,185 --> 00:11:27,555 SINS PARTNERSHIP FOR 156 00:11:27,555 --> 00:11:32,927 SCHIZOPHRENIA AND TELEMEDICINE 157 00:11:32,927 --> 00:11:43,270 DURING THE PANDEMIC. 158 00:12:20,374 --> 00:12:30,851 -- BACK WITH YOU IN ONE MOMENT. 159 00:13:42,423 --> 00:13:44,925 >> WELL, AGAIN, APOLOGIES FOR 160 00:13:44,925 --> 00:13:45,259 THE DELAY. 161 00:13:45,259 --> 00:13:48,529 LET'S GO AHEAD AND GO TO JOSH 162 00:13:48,529 --> 00:13:48,762 GORDON. 163 00:13:48,762 --> 00:13:54,702 THIRD TIME'S A CHARM AS THEY SAY 164 00:13:54,702 --> 00:13:55,936 IN ENGLISH. 165 00:13:55,936 --> 00:13:58,472 HE DEPARTED IN JUNE AND WAS A 166 00:13:58,472 --> 00:14:08,816 DIRECTOR SINCE 2016. 167 00:14:16,590 --> 00:14:21,562 HE WENT BACK TO BEING CHAIR OF 168 00:14:21,562 --> 00:14:22,696 COLOMBIA UNIVERSITY AND NEW YORK 169 00:14:22,696 --> 00:14:24,832 STATE INSTITUTE AND WAS PART OF 170 00:14:24,832 --> 00:14:25,699 THE COMMON FUND INITIATIVE THAT 171 00:14:25,699 --> 00:14:28,369 IS FOCUSSED ON COMMUNITY ENGAGED 172 00:14:28,369 --> 00:14:32,172 RESEARCH AND WE WILL MISS HIM IN 173 00:14:32,172 --> 00:14:32,673 THAT ROLE. 174 00:14:32,673 --> 00:14:36,076 HE ALSO LED A NUMBER OF 175 00:14:36,076 --> 00:14:41,181 INITIATIVES AT NIMHD THAT REALLY 176 00:14:41,181 --> 00:14:48,656 MOVED THE INSTITUTE INTO A 177 00:14:48,656 --> 00:14:58,365 BROADER SPECTRUM OF RESEARCH. 178 00:14:58,365 --> 00:15:07,007 DR. BERTAGNOLLI JOINED IN 2001 179 00:15:07,007 --> 00:15:09,143 IN THE NIMHD INTRAMURAL PROGRAM 180 00:15:09,143 --> 00:15:11,078 AND WAS PART OF THE DISORDERS 181 00:15:11,078 --> 00:15:16,950 BRANCH AND WE'LL WORK WITH 182 00:15:16,950 --> 00:15:22,289 DR. ABIGNOLI IN THE COMPASS 183 00:15:22,289 --> 00:15:30,431 INITIATIVE AND THE ANOTHER 184 00:15:30,431 --> 00:15:38,505 INSTITUTE IS THE OFFICE 185 00:15:38,505 --> 00:15:41,208 STRATEGIC COORDINATION WILL BE 186 00:15:41,208 --> 00:15:44,011 CARO 187 00:15:44,011 --> 00:15:44,878 CAROLYN HUTTER WITH OVER 20 188 00:15:44,878 --> 00:15:53,120 YEARS OF MANAGING LARGE 189 00:15:53,120 --> 00:15:53,487 COLLABORATIONS. 190 00:15:53,487 --> 00:16:01,161 THE COMMON FUND IS IT'S TO 191 00:16:01,161 --> 00:16:05,065 CREATE SPECIAL RESEARCH 192 00:16:05,065 --> 00:16:08,235 INITIATIVES OR PROGRAMS THAT ARE 193 00:16:08,235 --> 00:16:10,137 CROSS-CUTTING ACROSS NIH. 194 00:16:10,137 --> 00:16:14,375 I MENTIONED PREVIOUSLY THE 195 00:16:14,375 --> 00:16:16,744 COMPASS INITIATIVE AS BEING PART 196 00:16:16,744 --> 00:16:19,680 OF THIS A $700 MILLION IN 197 00:16:19,680 --> 00:16:20,614 FUNDING AVAILABLE TO THE COMMON 198 00:16:20,614 --> 00:16:24,752 FUND AND SO THIS IS A CRITICAL 199 00:16:24,752 --> 00:16:26,019 ROLE. 200 00:16:26,019 --> 00:16:28,422 LARGER THAN MANY INSTITUTES AS 201 00:16:28,422 --> 00:16:29,990 POINTED OUT WHEN SHE WAS NAMED. 202 00:16:29,990 --> 00:16:32,092 IT RUNS ABOUT 10 YEARS AND THE 203 00:16:32,092 --> 00:16:34,194 EXPECTATION IS OF THE 204 00:16:34,194 --> 00:16:38,132 INITIATIVES ARE SUCCESSFUL, THEY 205 00:16:38,132 --> 00:16:41,535 WILL BE PICKED UP BY DIFFERENT 206 00:16:41,535 --> 00:16:43,637 INSTITUTES IN ITS FUNCTION. 207 00:16:43,637 --> 00:16:46,340 THE COMMON FUND HAS HAD SOME 208 00:16:46,340 --> 00:16:49,643 EVOLUTION IN THE LAST COUPLE OF 209 00:16:49,643 --> 00:16:51,779 YEARS INCLUDING THE DEVELOPMENT 210 00:16:51,779 --> 00:16:56,984 OF VENTURE CAPITAL INITIATIVE 211 00:16:56,984 --> 00:16:58,385 UNDER THE COMMON FUND THAT FOR 212 00:16:58,385 --> 00:16:59,386 SHORT TERM INITIATIVES THAT MAY 213 00:16:59,386 --> 00:17:01,288 OR MAY NOT BE READY FOR THE FULL 214 00:17:01,288 --> 00:17:06,827 10 YEARS. 215 00:17:06,827 --> 00:17:12,332 DR. HUTTER WAS PREVIOUSLY PART 216 00:17:12,332 --> 00:17:13,600 OF ANOTHER CONSORTIUM. 217 00:17:13,600 --> 00:17:15,669 ANOTHER ANNOUNCEMENT TO BE TUNED 218 00:17:15,669 --> 00:17:16,036 INTO. 219 00:17:16,036 --> 00:17:17,337 THIS WILL BE COMING FROM THE 220 00:17:17,337 --> 00:17:19,873 CENTER FOR SCIENTIFIC REVIEW IN 221 00:17:19,873 --> 00:17:22,676 MORE DETAIL TO LET YOU KNOW THE 222 00:17:22,676 --> 00:17:27,981 SIMPLIFIED REVIEW FRAMEWORK WILL 223 00:17:27,981 --> 00:17:33,220 BE NOW GOING FORWARD FOR ANY 224 00:17:33,220 --> 00:17:36,356 APPLICATION THAT IS DUE ON OR 225 00:17:36,356 --> 00:17:38,692 AFTER JANUARY 25 OF 2025. 226 00:17:38,692 --> 00:17:41,061 THESE ARE REVISIONS THAT WILL BE 227 00:17:41,061 --> 00:17:44,198 FOR MOST RESEARCH PROJECT GRANTS 228 00:17:44,198 --> 00:17:50,537 OR RO1s, R21, ETCETERA. 229 00:17:50,537 --> 00:17:54,608 REVISIONS OF THE NIH FELLOWSHIP 230 00:17:54,608 --> 00:17:56,944 AND T32s AND OTHERS. 231 00:17:56,944 --> 00:17:59,880 UPDATES ON REFERENCE LETTERS AND 232 00:17:59,880 --> 00:18:01,381 APPLICATION FORMS. 233 00:18:01,381 --> 00:18:04,852 AFTER MAY 25, 2025, UPDATES ON 234 00:18:04,852 --> 00:18:06,720 THE BIO GRAPHICAL SKETCH AND 235 00:18:06,720 --> 00:18:07,955 CURRENT OTHER SUPPORT. 236 00:18:07,955 --> 00:18:12,392 DETAILS WILL BE AVAILABLE BUT 237 00:18:12,392 --> 00:18:15,729 JUST TO GIVE YOU AN OVER ALL 238 00:18:15,729 --> 00:18:16,663 TASTE ON THE RESEARCH PROJECT 239 00:18:16,663 --> 00:18:18,398 GRANT APPLICATIONS AND THE IDEA 240 00:18:18,398 --> 00:18:22,202 IS TO TRY AND MITIGATE WHAT MANY 241 00:18:22,202 --> 00:18:26,273 HAVE THOUGHT ARE BIASES RELATED 242 00:18:26,273 --> 00:18:28,275 TO REPUTATION AND INSTITUTION. 243 00:18:28,275 --> 00:18:30,277 SO SORT OF ALWAYS COMING FROM 244 00:18:30,277 --> 00:18:31,545 INSTITUTION X, THEY'RE GREAT. 245 00:18:31,545 --> 00:18:32,846 THEY'LL BE FINE NO MATTER WHAT 246 00:18:32,846 --> 00:18:35,015 THE CRITIQUES ARE OR THIS 247 00:18:35,015 --> 00:18:36,583 INVESTIGATOR HAS BEEN VERY 248 00:18:36,583 --> 00:18:37,417 SUCCESSFUL. 249 00:18:37,417 --> 00:18:41,522 SO THE IDEA THAT GETS SCORED IN 250 00:18:41,522 --> 00:18:43,891 A WAY THAT INFLUENCES BIAS 251 00:18:43,891 --> 00:18:45,626 TOWARDS THOSE APPLICATIONS 252 00:18:45,626 --> 00:18:49,429 COMING FROM THOSE INDIVIDUALS OR 253 00:18:49,429 --> 00:18:49,830 INSTITUTIONS. 254 00:18:49,830 --> 00:18:53,300 SO TO REALLY HELP THE REVIEWERS 255 00:18:53,300 --> 00:18:55,369 FOCUS ON SCIENTIFIC AND 256 00:18:55,369 --> 00:18:56,003 TECHNICAL MERIT THERE'LL BE 257 00:18:56,003 --> 00:18:57,571 THREE FACTORS NOW. 258 00:18:57,571 --> 00:19:00,040 THE FACTOR ONE IS IMPORTANCE OF 259 00:19:00,040 --> 00:19:00,307 RESEARCH. 260 00:19:00,307 --> 00:19:04,278 SO REALLY THINKING ABOUT IMPACT 261 00:19:04,278 --> 00:19:07,180 AND I THINK THIS GOT A LITTLE 262 00:19:07,180 --> 00:19:10,384 BIT -- I DON'T WANT TO SAY LOST 263 00:19:10,384 --> 00:19:13,020 BUT DILUTED IN THE PRIOR FORMAT 264 00:19:13,020 --> 00:19:14,354 WHERE PEOPLE WERE MORE FOCUSSED 265 00:19:14,354 --> 00:19:16,223 ON WHAT'S THE INNOVATION OR 266 00:19:16,223 --> 00:19:19,159 WHAT'S THIS AND I THINK THE 267 00:19:19,159 --> 00:19:20,561 IMPACT SOMETIMES MEANS IDEAS 268 00:19:20,561 --> 00:19:22,296 THAT ARE A LITTLE BIT OUT OF THE 269 00:19:22,296 --> 00:19:25,999 BOX THAT MAY NOT HAVE THE MOST 270 00:19:25,999 --> 00:19:28,035 SOLID METHODS YET THAT COULD BE 271 00:19:28,035 --> 00:19:31,171 IMPACTFUL IF SUCCESSFUL. 272 00:19:31,171 --> 00:19:33,707 FACTOR TWO IS RIGOR AND 273 00:19:33,707 --> 00:19:35,008 FEASIBILITY. 274 00:19:35,008 --> 00:19:36,677 ARE THE METHODS SOLID? 275 00:19:36,677 --> 00:19:39,646 YOU STILL NEED SOLID METHODS NO 276 00:19:39,646 --> 00:19:40,781 MATTER WHAT YOU'RE DOING IN 277 00:19:40,781 --> 00:19:42,516 WHATEVER AREA OF SCIENCE YOU'RE 278 00:19:42,516 --> 00:19:44,718 WORKING ON AND IS THIS FEASIBLE. 279 00:19:44,718 --> 00:19:45,852 CAN YOU PULL THIS OFF? 280 00:19:45,852 --> 00:19:48,221 DO YOU HAVE THE RIGHT TEAM AND 281 00:19:48,221 --> 00:19:54,361 APPROACH TO RECRUITMENT OR 282 00:19:54,361 --> 00:19:56,330 ANALYSIS AND EXPERTISE AND OVER 283 00:19:56,330 --> 00:20:01,802 ALL IMPACT BUT DO NOT GET AN 284 00:20:01,802 --> 00:20:03,704 INDIVIDUAL SCORE. 285 00:20:03,704 --> 00:20:05,839 SO KEEP THIS IN MIND FROM CSR. 286 00:20:05,839 --> 00:20:07,608 WE'LL HAVE MORE DETAIL AVAILABLE 287 00:20:07,608 --> 00:20:08,842 AS CSR MAKES THAT AVAILABLE ON 288 00:20:08,842 --> 00:20:13,447 OUR WEBSITE. 289 00:20:13,447 --> 00:20:15,682 SHARING AN ANALYSIS WE'VE HAD OF 290 00:20:15,682 --> 00:20:19,653 WHAT DO OUR PROGRAM 291 00:20:19,653 --> 00:20:21,622 ANNOUNCEMENTS DO AND THESE ARE 292 00:20:21,622 --> 00:20:23,390 SOME OF THE MORE HIGHLY APPLIED 293 00:20:23,390 --> 00:20:25,292 TO PROGRAM ANNOUNCEMENTS OVER 294 00:20:25,292 --> 00:20:29,630 THE LAST FIVE YEARS OR SO. 295 00:20:29,630 --> 00:20:32,499 YOU CAN SEE THE SUCCESS RATE FOR 296 00:20:32,499 --> 00:20:33,767 APPLICATIONS FOR THESE DIFFERENT 297 00:20:33,767 --> 00:20:40,841 ONES PARTICULARLY IMMIGRANT 298 00:20:40,841 --> 00:20:42,442 POPULATIONS COMBINING THE 299 00:20:42,442 --> 00:20:44,311 ETIOLOGIES AND INTERVENTIONS AND 300 00:20:44,311 --> 00:20:47,547 SOCIAL EPIGENOMICS ANNOUNCEMENT 301 00:20:47,547 --> 00:20:49,950 AND SLEEP DISPARITIES AND LIVER 302 00:20:49,950 --> 00:20:52,119 DISEASE ARE LISTED HERE. 303 00:20:52,119 --> 00:20:54,855 THEY'RE ABOVE 10% SUCCESS 304 00:20:54,855 --> 00:20:55,722 APPROACHING 17%. 305 00:20:55,722 --> 00:20:57,958 WE'VE HAD MANY APPLICATIONS IN 306 00:20:57,958 --> 00:21:02,295 HEALTH SERVICES AND ON THE 307 00:21:02,295 --> 00:21:03,096 IMMIGRANT INITIATIVE AS WELL AS 308 00:21:03,096 --> 00:21:06,133 THE SOCIAL EPIGENOMICS AND 309 00:21:06,133 --> 00:21:08,068 SURGICAL DISPARITIES. 310 00:21:08,068 --> 00:21:09,770 THE POINT IS ALSO THAT OUR 311 00:21:09,770 --> 00:21:11,605 COMMUNITY, YOU, THE SCIENTIFIC 312 00:21:11,605 --> 00:21:12,873 COMMUNITY FOR NIMHD HAS BEEN 313 00:21:12,873 --> 00:21:15,208 MOSTLY RESPONDING TO OUR PROGRAM 314 00:21:15,208 --> 00:21:15,609 ANNOUNCEMENTS. 315 00:21:15,609 --> 00:21:17,844 THERE MAY BE MULTIPLE REASONS 316 00:21:17,844 --> 00:21:20,714 FOR THIS. 317 00:21:20,714 --> 00:21:23,350 THIS HAPPENED AROUND THE TIME 318 00:21:23,350 --> 00:21:24,885 THE SWITCH FOLLOWING THE COVID 319 00:21:24,885 --> 00:21:26,219 PANDEMIC SO IT WASN'T ANY 320 00:21:26,219 --> 00:21:29,589 SPECIFIC TIME SO YOU SEE FROM 321 00:21:29,589 --> 00:21:34,594 FISCAL '21 WE'RE IN A MORE 50/50 322 00:21:34,594 --> 00:21:37,197 BALANCE THAN THE LAST TWO FISCAL 323 00:21:37,197 --> 00:21:40,033 YEAR WHERE WE HAVE COMPLETE 324 00:21:40,033 --> 00:21:40,233 DATA. 325 00:21:40,233 --> 00:21:41,635 THE APPLICATIONS HAVE BEEN IN 326 00:21:41,635 --> 00:21:42,669 RESPONSE TO PROGRAM 327 00:21:42,669 --> 00:21:43,003 ANNOUNCEMENT. 328 00:21:43,003 --> 00:21:45,906 I WANT TO REITERATE THAT NIMHD 329 00:21:45,906 --> 00:21:48,008 IS INTERESTED IN YOUR BEST 330 00:21:48,008 --> 00:21:48,208 IDEAS. 331 00:21:48,208 --> 00:21:52,612 WE WANT YOUR CREATIVITY AND 332 00:21:52,612 --> 00:21:52,946 APPLICATIONS. 333 00:21:52,946 --> 00:21:56,049 WE'RE NOT RESTRICTED TO PROGRAM 334 00:21:56,049 --> 00:21:56,683 ANNOUNCEMENTS AS LONG AS IT'S 335 00:21:56,683 --> 00:21:57,551 ADDRESSING THE PRIORITIES OF 336 00:21:57,551 --> 00:22:00,253 NIMHD WE WELCOME YOUR 337 00:22:00,253 --> 00:22:02,289 APPLICATION FOCUSSED ON ANY OF 338 00:22:02,289 --> 00:22:05,525 OUR THREE MAJOR AREAS OF 339 00:22:05,525 --> 00:22:06,493 RESEARCH AS DEFINED BY OUR 340 00:22:06,493 --> 00:22:09,696 DIVISIONS. 341 00:22:09,696 --> 00:22:12,499 NIMHD HAS GROWN SIGNIFICANTLY. 342 00:22:12,499 --> 00:22:16,269 WE'VE SHARED THE INCREASE IN 343 00:22:16,269 --> 00:22:17,904 BUDGET OVER THE FEBRUARY COUNCIL 344 00:22:17,904 --> 00:22:22,709 OR ONCE WE HAVE OUR BUDGET FOR 345 00:22:22,709 --> 00:22:24,544 THE FISCAL YEARS. 346 00:22:24,544 --> 00:22:25,579 LOOKING BACK OVER THE LAST FIVE 347 00:22:25,579 --> 00:22:27,380 YEARS YOU SEE THE GROWTH IN 348 00:22:27,380 --> 00:22:27,581 STAFF. 349 00:22:27,581 --> 00:22:29,182 WE'RE STILL UNDER STAFFED. 350 00:22:29,182 --> 00:22:32,853 WE'RE STILL RECRUITING 351 00:22:32,853 --> 00:22:34,421 PARTICULARLY IN SCIENTIFIC 352 00:22:34,421 --> 00:22:38,391 PROGRAMS BUT WE ARE NOW 353 00:22:38,391 --> 00:22:41,728 OFFICIALLY RUNNING 117 FTEs. 354 00:22:41,728 --> 00:22:42,696 WE'VE HAD A COUPLE MORE PEOPLE 355 00:22:42,696 --> 00:22:43,864 AND THERE'S MORE IN THE PIPELINE 356 00:22:43,864 --> 00:22:49,469 JOINING US THIS FALL. 357 00:22:49,469 --> 00:22:51,805 THE DIVISION OF INTRAMURAL 358 00:22:51,805 --> 00:22:56,042 RESEARCH THIS ONLY REFLECTED THE 359 00:22:56,042 --> 00:22:57,544 STAFF AND TENURE TRACK 360 00:22:57,544 --> 00:22:57,878 INVESTIGATORS. 361 00:22:57,878 --> 00:23:03,884 THERE'S USUALLY AROUND 30 TO 40 362 00:23:03,884 --> 00:23:08,388 TRAINEES IN OUR INTRAMURAL 363 00:23:08,388 --> 00:23:09,589 RESEARCH DIVISION. 364 00:23:09,589 --> 00:23:11,158 SWITCHING TO EX TERMING 365 00:23:11,158 --> 00:23:14,494 ACTIVITIES I HAD A GOOD MEETING 366 00:23:14,494 --> 00:23:17,631 WITH THE ASSOCIATION OF MINORITY 367 00:23:17,631 --> 00:23:22,102 HEALTH PROFESSIONS SCHOOL 368 00:23:22,102 --> 00:23:23,537 PICTURED IN THE PHOTO. 369 00:23:23,537 --> 00:23:26,540 THIS GATHERS NOT EXCLUSIVELY 370 00:23:26,540 --> 00:23:29,543 RESEARCH CENTERS FROM MINORITY 371 00:23:29,543 --> 00:23:37,250 INSTITUTIONS AS WELL AS HBCUs WE 372 00:23:37,250 --> 00:23:47,027 MET IN PERSON AND HAD A MEETING 373 00:23:47,027 --> 00:23:49,095 WITH THE MOREHOUSE SCHOOL OF 374 00:23:49,095 --> 00:23:52,699 MEDICINE HERE ON CAMPUS AND HAD 375 00:23:52,699 --> 00:23:53,700 MEETINGS WITH THE NATIONAL 376 00:23:53,700 --> 00:23:55,836 HISPANIC MEDICAL ASSOCIATION 377 00:23:55,836 --> 00:24:00,340 FOUNDATION GIVING A SEMINAR, 378 00:24:00,340 --> 00:24:01,074 CONVERSATION WITH FELLOWS 379 00:24:01,074 --> 00:24:02,242 INTERESTED IN RESEARCH AND 380 00:24:02,242 --> 00:24:03,743 FOLLOW UP MEETINGS WITH A COUPLE 381 00:24:03,743 --> 00:24:14,221 AFTER THAT SESSION IN JUNE. 382 00:24:22,195 --> 00:24:25,565 AND DISCUSSED THE ISSUE OF THE 383 00:24:25,565 --> 00:24:26,366 INCLUSION OF RACE IN CLINICAL 384 00:24:26,366 --> 00:24:34,975 ALGORITHMS. 385 00:24:34,975 --> 00:24:37,277 I GAVE A VIRTUAL WEBINAR TO THE 386 00:24:37,277 --> 00:24:41,248 UNIVERSITY OF HOUSTON COLLEGE OF 387 00:24:41,248 --> 00:24:41,648 MEDICINE. 388 00:24:41,648 --> 00:24:44,017 MOST RELEVANT PRESENTATION I 389 00:24:44,017 --> 00:24:47,954 MADE SINCE LAST COUNCIL WAS THIS 390 00:24:47,954 --> 00:24:49,556 COMMENCEMENT ADDRESS AT THE CITY 391 00:24:49,556 --> 00:24:55,028 UNIVERSITY OF NEW YORK. 392 00:24:55,028 --> 00:24:57,364 I ADDRESSED THEIR 2024 393 00:24:57,364 --> 00:25:02,269 GRADUATING CLASS AND FEATURED IS 394 00:25:02,269 --> 00:25:05,238 CARMEN GREEN THE DEAN OF 395 00:25:05,238 --> 00:25:06,973 MEDICINE AND CARMEN AN 396 00:25:06,973 --> 00:25:09,442 ANESTHESIOLOGIST BY TRAINING WAS 397 00:25:09,442 --> 00:25:12,045 A SCHOLAR IN THE RESEARCH 398 00:25:12,045 --> 00:25:14,381 CENTERS FOR MINORITY RESEARCH AT 399 00:25:14,381 --> 00:25:17,484 THE UNIVERSITY OF MICHIGAN UNDER 400 00:25:17,484 --> 00:25:19,119 JAMES JACKSON BACK 20 YEARS AGO. 401 00:25:19,119 --> 00:25:25,325 SHE REACHED OUT TO ME AND IT WAS 402 00:25:25,325 --> 00:25:28,862 AN IMPORTANT EVENT TO ATTEND. 403 00:25:28,862 --> 00:25:32,098 ALSO A JOY REALLY TO DO THIS 404 00:25:32,098 --> 00:25:34,534 WITH A VERY DIVERSE MEDICAL 405 00:25:34,534 --> 00:25:35,101 SCHOOL CLASS. 406 00:25:35,101 --> 00:25:42,375 THEY GAVE ME AN AWARD IN HONOR 407 00:25:42,375 --> 00:25:48,615 OF JACK GEIGER AN ICON IN SOCIAL 408 00:25:48,615 --> 00:25:48,882 MEDICINE. 409 00:25:48,882 --> 00:25:51,685 HE WAS A WRITER AND THINKING 410 00:25:51,685 --> 00:25:54,554 ABOUT ISSUES RELATED TO BOTH 411 00:25:54,554 --> 00:25:57,590 CLINICAL MEDICINE AND POPULATION 412 00:25:57,590 --> 00:25:59,359 HEALTH AND SOCIAL EPIDEMIOLOGY 413 00:25:59,359 --> 00:26:05,165 AS AN ADVOCATE AND SCIENTIST. 414 00:26:05,165 --> 00:26:14,507 I HAD THE PRIVILEGE TO MEET HIM 415 00:26:14,507 --> 00:26:18,278 AND SPEAK. 416 00:26:18,278 --> 00:26:22,349 AND DR. MONICA WEBB HOOPER WAS 417 00:26:22,349 --> 00:26:26,820 PART OF AN INTERAGENCY COMMITTEE 418 00:26:26,820 --> 00:26:30,523 ON DISABILITY RESEARCH. 419 00:26:30,523 --> 00:26:31,624 A GOVERNMENT WIDE INTERAGENCY 420 00:26:31,624 --> 00:26:32,492 COMMITTEE THAT FOCUSES ON 421 00:26:32,492 --> 00:26:33,860 DISABILITY AND THE UNIVERSITY OF 422 00:26:33,860 --> 00:26:37,697 BUFFALO HEALTH SCIENCES. 423 00:26:37,697 --> 00:26:40,066 SHE ALSO PRESENTED TO THE 424 00:26:40,066 --> 00:26:42,369 AMERICAN ASSOCIATION OF 425 00:26:42,369 --> 00:26:47,007 PHYSICIAN ASSISTANTS AND I'M 426 00:26:47,007 --> 00:26:51,578 HAPPY TO ANNOUNCE THE SELECTION 427 00:26:51,578 --> 00:26:59,285 OF THE FINANCIAL MANAGEMENT 428 00:26:59,285 --> 00:27:00,253 BRANCH CHIEF OUR BUDGET OFFICER 429 00:27:00,253 --> 00:27:01,221 HERE IN THE ROOM. 430 00:27:01,221 --> 00:27:02,956 HE CAME FROM THE NATIONAL 431 00:27:02,956 --> 00:27:06,226 INSTITUTE OF DENTAL CRANIOFACIAL 432 00:27:06,226 --> 00:27:10,130 RESEARCH WHERE HE WAS PREVIOUSLY 433 00:27:10,130 --> 00:27:11,765 ACTING BUDGET OFFICER FOR A 434 00:27:11,765 --> 00:27:13,299 NUMBER OF YEARS. 435 00:27:13,299 --> 00:27:19,806 JIMMY CAME JUST IN TIME TO HELP 436 00:27:19,806 --> 00:27:21,708 SET US UP FOR CLOSING UP THE 437 00:27:21,708 --> 00:27:24,110 FISCAL YEAR WE'RE WORKING ON NOW 438 00:27:24,110 --> 00:27:27,647 AND PART OF THE FEDERATED ASIAN 439 00:27:27,647 --> 00:27:32,819 NETWORK AND WAS PART OF OTHER 440 00:27:32,819 --> 00:27:33,153 ORGANIZATIONS. 441 00:27:33,153 --> 00:27:39,859 WE WILL ALSO NOTE THE DEPARTURE 442 00:27:39,859 --> 00:27:45,398 OF TILDA FARMHAT AND SHE CAME 443 00:27:45,398 --> 00:27:47,700 BEFORE I ARRIVED. 444 00:27:47,700 --> 00:27:49,736 SINCE EARLY 2020 WAS THE 445 00:27:49,736 --> 00:27:53,006 DIRECTOR OF OFFICE SCIENCE, 446 00:27:53,006 --> 00:27:56,109 PLANNING, EVALUATION AND 447 00:27:56,109 --> 00:27:56,376 REPORTING. 448 00:27:56,376 --> 00:27:59,779 WE CALL THAT OSPER AT NIMHD 449 00:27:59,779 --> 00:28:00,680 SINCE 2020. 450 00:28:00,680 --> 00:28:06,619 A NUMBER OF CRITICAL PROJECTS 451 00:28:06,619 --> 00:28:08,488 LED FROM THAT OFFICE, ECONOMIC 452 00:28:08,488 --> 00:28:10,723 BURDEN OF HEALTH DISPARITIES 453 00:28:10,723 --> 00:28:12,959 PROJECT IN COLLABORATION WITH 454 00:28:12,959 --> 00:28:17,597 EXTRAMURAL SCIENTISTS OR 455 00:28:17,597 --> 00:28:17,997 CONTACT. 456 00:28:17,997 --> 00:28:19,632 SHE FACILITATED OPERATIONALIZING 457 00:28:19,632 --> 00:28:22,368 THAT AND IS COMING TO A CLOSE IN 458 00:28:22,368 --> 00:28:25,705 THE NEXT FEW WEEKS. 459 00:28:25,705 --> 00:28:27,740 THE EXPANSION OF HD PULSE WITH 460 00:28:27,740 --> 00:28:29,642 AN INTERVENTION PORTAL WHICH 461 00:28:29,642 --> 00:28:32,045 I'LL MENTION AGAIN IN A MINUTE 462 00:28:32,045 --> 00:28:33,646 AND SHE CONTRIBUTED TO THE 463 00:28:33,646 --> 00:28:35,014 DEVELOPMENT OF THE MINORITY 464 00:28:35,014 --> 00:28:37,484 HEALTH AND HEALTH DISPARITIES 465 00:28:37,484 --> 00:28:41,921 CATEGORIES UNDER THE RCDC SYSTEM 466 00:28:41,921 --> 00:28:44,324 AT NIH. 467 00:28:44,324 --> 00:28:47,827 SHE'S ALSO BEEN INVOLVED IN THE 468 00:28:47,827 --> 00:28:49,963 PHOENIX SOCIAL DETERMINATES OF 469 00:28:49,963 --> 00:28:51,965 HEALTH COLLECTION. 470 00:28:51,965 --> 00:28:55,068 TILDA FOLLOWED DURAN AS THE 471 00:28:55,068 --> 00:28:56,336 DIRECTOR OF THE OFFICE AND WE 472 00:28:56,336 --> 00:28:57,904 ARE NOW ACTIVELY SEARCHING FOR A 473 00:28:57,904 --> 00:29:00,373 NEW DIRECTOR OF THIS OFFICE. 474 00:29:00,373 --> 00:29:02,942 SHE WILL BE GOING TO THE WHITE 475 00:29:02,942 --> 00:29:05,011 HOUSE AS IT TURNED OUT AS A 476 00:29:05,011 --> 00:29:08,615 SENIOR EXECUTIVE AND PRINCIPLE 477 00:29:08,615 --> 00:29:11,451 ADVISER FOR THE OFFICE OF 478 00:29:11,451 --> 00:29:12,285 TRANSLATIONAL RESEARCH AND 479 00:29:12,285 --> 00:29:14,053 OFFICE OF DRUG POLICY AND 480 00:29:14,053 --> 00:29:14,787 EXECUTIVE OFFICE OF THE 481 00:29:14,787 --> 00:29:16,356 PRESIDENT OF THE WHITE HOUSE. 482 00:29:16,356 --> 00:29:18,858 THIS IS THE POSITION BACK IN THE 483 00:29:18,858 --> 00:29:23,329 DAY WAS LABELLED A DRUG CZAR 484 00:29:23,329 --> 00:29:25,498 THOUGH HAS NOT HAS AS HIGH A 485 00:29:25,498 --> 00:29:26,499 PROFILE THEY CONTINUE TO 486 00:29:26,499 --> 00:29:28,768 FUNCTIONALITY A HIGH LEVEL 487 00:29:28,768 --> 00:29:30,303 WITHIN THE EXECUTIVE BRANCH. 488 00:29:30,303 --> 00:29:33,006 THEY'RE BRINGING HER ON TO 489 00:29:33,006 --> 00:29:36,142 REALLY FOCUS ON THE ANALYTICAL 490 00:29:36,142 --> 00:29:38,578 DATA RELATED TO HEALTH AS 491 00:29:38,578 --> 00:29:44,784 OPPOSED TO THE ASPECTS OF 492 00:29:44,784 --> 00:29:45,585 ENFORCEMENT THAT INITIALLY WAS 493 00:29:45,585 --> 00:29:46,119 THE MAIN FUNCTION OF THAT 494 00:29:46,119 --> 00:29:48,354 OFFICE. 495 00:29:48,354 --> 00:29:50,823 WE WILL MISS TILDA AND WE'LL 496 00:29:50,823 --> 00:29:53,092 LOOK FORWARD TO SEEING HER 497 00:29:53,092 --> 00:29:58,298 ACCOMPLISHMENTS IN HER NEW ROLE. 498 00:29:58,298 --> 00:30:01,467 SOME LEGISLATIVE UPDATES. 499 00:30:01,467 --> 00:30:02,402 RIGHT NOW CONGRESS CONTINUES TO 500 00:30:02,402 --> 00:30:05,939 BE IN RECESS UNTIL NEXT WEEK BUT 501 00:30:05,939 --> 00:30:15,014 WE HAD A BRIEFING WITH STAFF OF 502 00:30:15,014 --> 00:30:20,420 SENATOR HEINRICH WHERE WE 503 00:30:20,420 --> 00:30:21,688 DISCUSSED A PLATFORM AND THEY 504 00:30:21,688 --> 00:30:25,692 WERE INTERESTED IN WHAT WE WERE 505 00:30:25,692 --> 00:30:27,860 DOING PARTICULARLY AROUND THE 506 00:30:27,860 --> 00:30:30,630 INTEREST OF BIAS AND ARTIFICIAL 507 00:30:30,630 --> 00:30:31,030 INTELLIGENCE. 508 00:30:31,030 --> 00:30:35,034 AND IN JULY, MONICA AND MYSELF 509 00:30:35,034 --> 00:30:37,937 AND FROM THE HEALTH LABOR AND 510 00:30:37,937 --> 00:30:40,240 SUBCOMMITTEE ON THE RESEARCH 511 00:30:40,240 --> 00:30:42,375 CENTERS IN MINORITY INSTITUTIONS 512 00:30:42,375 --> 00:30:43,643 PROGRAM WHERE THEY WERE 513 00:30:43,643 --> 00:30:49,882 QUESTIONS ASKED ABOUT HOW WE HAD 514 00:30:49,882 --> 00:30:51,017 ALLOCATED THE FUNDS CONGRESS 515 00:30:51,017 --> 00:30:51,284 PROVIDED. 516 00:30:51,284 --> 00:30:52,418 THIS WAS THE MAJORITY OF STAFF 517 00:30:52,418 --> 00:30:58,358 INTERESTED IN THEM. 518 00:30:58,358 --> 00:31:01,327 WE HAD A COUPLE HIGHLY 519 00:31:01,327 --> 00:31:03,196 SUCCESSFUL WORKSHOPS WE EITHER 520 00:31:03,196 --> 00:31:04,631 LED OR CO-SPONSORED. 521 00:31:04,631 --> 00:31:07,667 UNFORTUNATELY I MISSED TWO OF 522 00:31:07,667 --> 00:31:08,401 THEM. 523 00:31:08,401 --> 00:31:14,374 THIS WAS THE INFLUENCE OF 524 00:31:14,374 --> 00:31:15,808 INTERPERSONAL BIASES THAT LED TO 525 00:31:15,808 --> 00:31:19,112 THE ENHANCES MECHANISMS LINKED 526 00:31:19,112 --> 00:31:21,147 TO BIAS EXPOSURE TO HELP 527 00:31:21,147 --> 00:31:22,815 DISPARITIES AND OUTCOMES AND 528 00:31:22,815 --> 00:31:24,317 STRATEGIES. 529 00:31:24,317 --> 00:31:31,624 THE NEED FOR MEASURES AND AND 530 00:31:31,624 --> 00:31:34,460 CONSIDER INTERSECTIONALITY IN 531 00:31:34,460 --> 00:31:38,431 PRIORITIZING ACROSS DISCIPLINARY 532 00:31:38,431 --> 00:31:42,635 COLLABORATIONS ON THIS AND 533 00:31:42,635 --> 00:31:46,072 INCORPORATING PATIENT BIAS IN 534 00:31:46,072 --> 00:31:47,273 EXPOSURES IN HEALTH CARE. 535 00:31:47,273 --> 00:31:49,008 THE WORKSHOP IS AVAILABLE ON 536 00:31:49,008 --> 00:31:51,711 VIDEOCAST AND YOU CAN LOOK FOR 537 00:31:51,711 --> 00:31:53,680 IT THERE ON THE NIH VIDEOCAST 538 00:31:53,680 --> 00:31:55,982 AND IT'S QUITE OUTSTANDING SET 539 00:31:55,982 --> 00:31:58,384 OF PRESENTATIONS. 540 00:31:58,384 --> 00:32:01,821 WE WERE ALSO VERY INVOLVED IN 541 00:32:01,821 --> 00:32:04,657 THE UNITE SPONSOR WORKSHOP ON 542 00:32:04,657 --> 00:32:06,893 STRUCTURAL RACISM. 543 00:32:06,893 --> 00:32:11,364 THIS IS ALSO VIRTUAL HELD IN 544 00:32:11,364 --> 00:32:13,566 JULY 18 AND 19. 545 00:32:13,566 --> 00:32:18,671 THERE WERE NEARLY 3,000 546 00:32:18,671 --> 00:32:23,710 PARTICIPANTS VIRTUAL LY THE IDE 547 00:32:23,710 --> 00:32:25,611 WAS TO BRING IN SCIENTISTS, 548 00:32:25,611 --> 00:32:30,383 THOUGHT LEADERS IN DISCIPLINES 549 00:32:30,383 --> 00:32:33,686 THAT ARE NOT USUALLY AT THE 550 00:32:33,686 --> 00:32:34,320 TABLE DISCUSSING POPULATION 551 00:32:34,320 --> 00:32:35,388 HEALTH ISSUES OTHERWISE. 552 00:32:35,388 --> 00:32:41,194 THE MOST SIGNIFICANT I HEARD WAS 553 00:32:41,194 --> 00:32:44,263 THE PERSPECTIVE OF LAW AND 554 00:32:44,263 --> 00:32:46,299 CRIMINAL JUSTICE. 555 00:32:46,299 --> 00:32:48,267 MOST THE OTHER INDIVIDUALS 556 00:32:48,267 --> 00:32:49,502 PEOPLE COMING FROM SOCIAL 557 00:32:49,502 --> 00:32:53,206 SCIENCES OR PUBLIC POLICY, 558 00:32:53,206 --> 00:32:56,509 EDUCATION AND OTHER AREAS THAT 559 00:32:56,509 --> 00:32:58,378 WE DO WORK WITH WERE PRESENT. 560 00:32:58,378 --> 00:33:00,747 I THINK IT DOES MANDATE THE 561 00:33:00,747 --> 00:33:02,415 IMPORTANCE OF INCORPORATING ALL 562 00:33:02,415 --> 00:33:04,984 THESE DIFFERENT PERSPECTIVES IN 563 00:33:04,984 --> 00:33:07,320 OUR THINKING ABOUT ADVANCING 564 00:33:07,320 --> 00:33:08,855 KNOWLEDGE AND DECREASING 565 00:33:08,855 --> 00:33:09,756 DISPARITIES IN THIS ISSUE. 566 00:33:09,756 --> 00:33:11,991 THIS IS NOT GOING TO BE AN 567 00:33:11,991 --> 00:33:14,460 EASY -- IT'S GOING TO BE A HARD 568 00:33:14,460 --> 00:33:15,895 LIFT LET'S PUT IT THIS WAY. 569 00:33:15,895 --> 00:33:21,667 OUR EFFORT ON FUNDING GRANTS FOR 570 00:33:21,667 --> 00:33:23,002 ADDRESSING STRUCTURAL RACISM 571 00:33:23,002 --> 00:33:23,302 CONTINUE. 572 00:33:23,302 --> 00:33:30,376 WE HAD A SUCCESSFUL RFA IN 2021 573 00:33:30,376 --> 00:33:31,644 THAT WAS NIH WIDE. 574 00:33:31,644 --> 00:33:33,312 WE'RE CONTINUING TO LEAD THAT 575 00:33:33,312 --> 00:33:36,149 NOT AS A SET ASIDE BUT CALL WITH 576 00:33:36,149 --> 00:33:38,451 AN EMPHASIS ON INTERVENTIONS 577 00:33:38,451 --> 00:33:40,086 SINCE WE THINK WE HAVE TO GET 578 00:33:40,086 --> 00:33:43,623 OUT OF THE MOLD OF THINKING 579 00:33:43,623 --> 00:33:46,993 ABOUT DESCRIBING AND REALLY PUSH 580 00:33:46,993 --> 00:33:50,363 THE ENVELOPE ON INTERVENTIONS 581 00:33:50,363 --> 00:33:51,898 THAT WILL BE SOME WILL FAIL BUT 582 00:33:51,898 --> 00:33:54,400 IF WE DON'T TRY WE WON'T BE ABLE 583 00:33:54,400 --> 00:33:55,501 TO FIND OUT. 584 00:33:55,501 --> 00:33:57,336 SO THIS WORKSHOP HELPED 585 00:33:57,336 --> 00:33:58,004 CONTRIBUTE TO THE UNDERSTANDING 586 00:33:58,004 --> 00:34:00,473 OF THAT. 587 00:34:00,473 --> 00:34:03,309 WE DO THINK WE HAVE A WAYS TO GO 588 00:34:03,309 --> 00:34:04,277 BUT IT'S A GOOD START TO GET 589 00:34:04,277 --> 00:34:08,080 GOING ON THIS. 590 00:34:08,080 --> 00:34:11,617 WE HAD ALSO A HIGHLY SUCCESSFUL 591 00:34:11,617 --> 00:34:13,286 HEALTH DISPARITIES RESEARCH 592 00:34:13,286 --> 00:34:17,590 INSTITUTE GATHERING IN AUGUST OF 593 00:34:17,590 --> 00:34:18,925 2024 JUST LAST MONTH. 594 00:34:18,925 --> 00:34:21,894 IN THIS VERY ROOM WE'RE SITTING 595 00:34:21,894 --> 00:34:24,297 IN NOW WE SELECTED 51 EARLY 596 00:34:24,297 --> 00:34:28,835 STAGE CAREER SCIENTISTS THAT 597 00:34:28,835 --> 00:34:31,070 REPRESENTED 22 STATES IN THE 598 00:34:31,070 --> 00:34:32,004 DISTRICT OF COLUMBIA. 599 00:34:32,004 --> 00:34:36,476 I THINK IN A PALPABLE WAY WE HAD 600 00:34:36,476 --> 00:34:39,078 DIVERSE INSTITUTIONS PRESENT. 601 00:34:39,078 --> 00:34:40,980 WE ALWAYS HAD DIVERSE 602 00:34:40,980 --> 00:34:42,148 INDIVIDUALS, MULTIPLE 603 00:34:42,148 --> 00:34:42,715 DISCIPLINES. 604 00:34:42,715 --> 00:34:46,285 USUALLY SOMEWHERE IN THE 20% OR 605 00:34:46,285 --> 00:34:48,855 CLINICIANS, MOSTLY PHYSICIANS 606 00:34:48,855 --> 00:34:53,025 BUT NOT INCLUSIVELY AND A NUMBER 607 00:34:53,025 --> 00:34:57,930 OF RNs AND PHARMACIST AND 608 00:34:57,930 --> 00:34:59,799 PSYCHOLOGY AND EPIDEMIOLOGY 609 00:34:59,799 --> 00:35:00,433 Ph.D.s. 610 00:35:00,433 --> 00:35:05,004 THIS IS I THINK A SPECIAL 611 00:35:05,004 --> 00:35:05,471 PROGRAM. 612 00:35:05,471 --> 00:35:07,373 I'M VERY PROUD OF. 613 00:35:07,373 --> 00:35:09,108 OUR STAFF WORKED HARD TO MAKE 614 00:35:09,108 --> 00:35:09,709 THIS HAPPEN. 615 00:35:09,709 --> 00:35:12,778 THIS IS ON DAY ONE WHERE I GAVE 616 00:35:12,778 --> 00:35:16,616 AN OPENING LECTURE TO THE GROUP 617 00:35:16,616 --> 00:35:23,723 AND THIS YEAR'S WINNER IS 618 00:35:23,723 --> 00:35:30,296 PICTURED THERE ON THE SLIDE, AN 619 00:35:30,296 --> 00:35:37,403 AWARDEE TO ADDRESS THIS IN THE 620 00:35:37,403 --> 00:35:41,207 SYSTEM PROFESSOR AT I THINK ONE 621 00:35:41,207 --> 00:35:47,013 OF THE BOSTON HOSPITALS AND 622 00:35:47,013 --> 00:35:48,948 CONTINUED CLAB RAGE WITH 623 00:35:48,948 --> 00:35:51,384 NATIONAL NIB, NATIONAL INSTITUTE 624 00:35:51,384 --> 00:35:55,955 OF BIO MEDICAL IMAGING AND 625 00:35:55,955 --> 00:35:58,991 BIOENGINEERING TO PROVIDE AWARDS 626 00:35:58,991 --> 00:36:01,227 FOR INNOVATIVE PROPOSALS COMING 627 00:36:01,227 --> 00:36:04,897 FROM COLLEGE UNDERGRADUATES. 628 00:36:04,897 --> 00:36:08,501 THE AWARDS ARE $15,000 FOR THE 629 00:36:08,501 --> 00:36:10,603 FIRST PLACE. 630 00:36:10,603 --> 00:36:13,005 WE PARTICIPATE WITH NIB AND A 631 00:36:13,005 --> 00:36:16,509 COUPLE OTHER INSTITUTES ON THIS. 632 00:36:16,509 --> 00:36:18,644 STAFF REVIEWED THEY'RE ALL 633 00:36:18,644 --> 00:36:20,212 SUBMITTED AT VIDEOS. 634 00:36:20,212 --> 00:36:22,982 THEY'RE FUN TO LOOK AT AND 635 00:36:22,982 --> 00:36:23,783 ENCOURAGE ANYONE WHO TAKES THE 636 00:36:23,783 --> 00:36:25,818 TIME TO LOOK AT THESE. 637 00:36:25,818 --> 00:36:27,553 THEY'RE ONLY THREE MINUTES LONG 638 00:36:27,553 --> 00:36:29,655 SO YOU'RE NOT SPENDING A LOT OF 639 00:36:29,655 --> 00:36:33,759 TIME AND THEY'RE CREATIVE IN HOW 640 00:36:33,759 --> 00:36:35,494 THEY PRESENT. 641 00:36:35,494 --> 00:36:36,662 I ALWAYS ENJOY SEEING HOW 642 00:36:36,662 --> 00:36:38,998 THEY'RE VIEWING WHAT IS OFTEN A 643 00:36:38,998 --> 00:36:42,935 CLINICAL ISSUE IN COMING FROM 644 00:36:42,935 --> 00:36:46,639 PEOPLE WHO HAVE NO REAL CLINICAL 645 00:36:46,639 --> 00:36:47,006 BACKGROUND. 646 00:36:47,006 --> 00:36:48,207 THESE ARE PRIMARILY ENGINEERING 647 00:36:48,207 --> 00:36:51,777 STUDENTS JUST TO GIVE YOU THE 648 00:36:51,777 --> 00:36:52,812 SENSE. 649 00:36:52,812 --> 00:36:56,215 THE WINNER FROM OUR PERSPECTIVE 650 00:36:56,215 --> 00:36:59,485 WAS THE RAPID LED SALIVA TEST TO 651 00:36:59,485 --> 00:37:00,753 ADDRESS THE CHALLENGES THAT 652 00:37:00,753 --> 00:37:03,589 PERSIST IN SOME PARTS OF THE 653 00:37:03,589 --> 00:37:03,823 COUNTRY. 654 00:37:03,823 --> 00:37:06,025 IT USED TO BE LED COMING FROM 655 00:37:06,025 --> 00:37:09,528 PAIN AND WHEN PAIN AND WEN LEAD 656 00:37:09,528 --> 00:37:12,164 REWAS REMOVED FROM PAINT THE 657 00:37:12,164 --> 00:37:13,699 PROBLEM SEEMED READY TO GO AWAY 658 00:37:13,699 --> 00:37:15,201 AND CAN SUNSET THE PROBLEM OF 659 00:37:15,201 --> 00:37:18,537 LEAD EXPOSURE AND WE KNOW ANY 660 00:37:18,537 --> 00:37:19,972 DETECTABLE LEAD IN ANYONE BUT 661 00:37:19,972 --> 00:37:26,212 PARTICULARLY IN A CHILD IS 662 00:37:26,212 --> 00:37:28,681 POTENTIALLY HARMFUL TO COGNITIVE 663 00:37:28,681 --> 00:37:30,950 DEVELOPMENT AND CAN BE IN WATER 664 00:37:30,950 --> 00:37:34,920 DUE TO AGING PLUMBING. 665 00:37:34,920 --> 00:37:38,391 SO THIS IS A WORTHWHILE TEST TO 666 00:37:38,391 --> 00:37:40,126 INTEREST FOR FUTURE DEVELOPMENT. 667 00:37:40,126 --> 00:37:43,996 I MENTIONED EARLIER THE HD PULSE 668 00:37:43,996 --> 00:37:46,599 INTERVENTIONS PORTAL LAUNCH. 669 00:37:46,599 --> 00:37:48,501 THIS WAS IN CONJUNCTION OR 670 00:37:48,501 --> 00:37:51,737 COLLABORATION WITH THE OFFICE OF 671 00:37:51,737 --> 00:37:53,172 MINORITY HEALTH IN THE HEALTH 672 00:37:53,172 --> 00:37:56,976 AND UMAN SERVICES DEPARTMENT AND 673 00:37:56,976 --> 00:37:58,377 WILL PROVIDE ACCESS TO 674 00:37:58,377 --> 00:38:01,514 INTERVENTIONS THAT WE HAVE 675 00:38:01,514 --> 00:38:04,250 VETTED AS SUCCESSFULLY IMPROVING 676 00:38:04,250 --> 00:38:04,850 MINORITY HEALTH OR REDUCING 677 00:38:04,850 --> 00:38:06,052 HEALTH DISPARITIES. 678 00:38:06,052 --> 00:38:11,157 THEY GO THROUGH RIGOROUS REVIEW 679 00:38:11,157 --> 00:38:16,495 BY STAFF AND EVIDENCE-BASED 680 00:38:16,495 --> 00:38:17,229 INTERVENTIONS TO ADDRESS 681 00:38:17,229 --> 00:38:27,773 PROBLEMS WE'RE STILL WORKING OUT 682 00:38:29,075 --> 00:38:30,376 AND HAPPY WITH TO THE RESULT AND 683 00:38:30,376 --> 00:38:31,777 THE OFFICE OF MINORITY HEALTH 684 00:38:31,777 --> 00:38:35,715 WILL CONTINUE TO PARTNER WITH US 685 00:38:35,715 --> 00:38:39,552 TO POST THUR PROGRAMS THAT HAVE 686 00:38:39,552 --> 00:38:40,086 EVIDENCE-BASED SUPPORT. 687 00:38:40,086 --> 00:38:45,458 I'LL SWITCH TO GIVE AN UPDATE ON 688 00:38:45,458 --> 00:38:48,260 A FEW SCIENCE ADVANCES ONLY 689 00:38:48,260 --> 00:38:51,197 GRANTS PRODUCED OR FUNDED BY 690 00:38:51,197 --> 00:38:52,531 NIMHD. 691 00:38:52,531 --> 00:38:58,003 IN THIS CASE START WITH A PAPER 692 00:38:58,003 --> 00:39:03,943 TWO PROGRAM STAFF A REVIEW OF 693 00:39:03,943 --> 00:39:06,412 MATERNAL AN INFANT MORTALITY 694 00:39:06,412 --> 00:39:09,949 LITERATURE TO DETERMINE THE 695 00:39:09,949 --> 00:39:10,683 MULTI-LEVEL SOCIAL DETERMINATES 696 00:39:10,683 --> 00:39:14,353 OF HEALTH THAT LEAD TO 697 00:39:14,353 --> 00:39:15,287 MORTALITY. 698 00:39:15,287 --> 00:39:16,655 BLACK MOTHERS AND INFANTS HAD 699 00:39:16,655 --> 00:39:22,762 THE HIGHEST MORTALITY RATES DUE 700 00:39:22,762 --> 00:39:24,563 AND STRUCTURAL EXPERIENCE ACROSS 701 00:39:24,563 --> 00:39:26,999 THE LIFE COURSE AND UP STREAM 702 00:39:26,999 --> 00:39:28,801 CONTRIBUTORS WERE IMPORTANT AND 703 00:39:28,801 --> 00:39:36,642 UNLESS THEY'RE ADDRESSED THEY'RE 704 00:39:36,942 --> 00:39:38,377 -- THEIR SITUATION IS UNLIKELY 705 00:39:38,377 --> 00:39:39,078 TO IMPROVE. 706 00:39:39,078 --> 00:39:44,483 THIS IS THE BEST PAPER AWARD 707 00:39:44,483 --> 00:39:45,551 FROM THE JOURNAL ON CHILDREN IN 708 00:39:45,551 --> 00:39:46,352 THE STUDY. 709 00:39:46,352 --> 00:39:51,824 THERE'S A PUBLICATION COMING 710 00:39:51,824 --> 00:39:55,694 FROM OUR OS PER OFFICE STAFF OF 711 00:39:55,694 --> 00:39:58,230 THAT OFFICE CO-AUTHORED. 712 00:39:58,230 --> 00:40:01,033 IT EXAMINED THE NIMHD PORTFOLIO 713 00:40:01,033 --> 00:40:06,105 OF 675 FUNDED UNIQUE GRANTS 714 00:40:06,105 --> 00:40:10,342 MOSTLY RO1s OR UR 1s IN SOCIAL 715 00:40:10,342 --> 00:40:14,680 DETERMINATES OF HEALTH FROM 2019 716 00:40:14,680 --> 00:40:17,550 TO 2023 USING THE NIH 717 00:40:17,550 --> 00:40:19,852 CLASSIFICATION SYSTEM TO 718 00:40:19,852 --> 00:40:21,954 IDENTIFY NIMHD FUNDED PROJECTS. 719 00:40:21,954 --> 00:40:23,389 PARTICIPANTS AND SOCIAL 720 00:40:23,389 --> 00:40:26,425 DEMOGRAPHICS AND SOCIAL MINORITY 721 00:40:26,425 --> 00:40:28,894 GROUPS AND EXPECT STATUS AND SEX 722 00:40:28,894 --> 00:40:30,229 AND GENDER MINORITY GROUPS WERE 723 00:40:30,229 --> 00:40:31,363 THE FOUR CATEGORIES EVALUATED IN 724 00:40:31,363 --> 00:40:34,600 THE PUBLICATION. 725 00:40:34,600 --> 00:40:40,739 THIS IS BEFORE THE DESIGNATION 726 00:40:40,739 --> 00:40:49,281 OF PEOPLE WIAND THE HEALTHY PEOE 727 00:40:49,281 --> 00:40:49,915 2030 DOMAINS. 728 00:40:49,915 --> 00:40:52,184 THE MOST FREQUENTLY STUDIED 729 00:40:52,184 --> 00:40:54,386 TOPICS ON MENTAL HEALTH AND IN 730 00:40:54,386 --> 00:40:56,589 FENG HOUSE DISEASE AND NUTRITION 731 00:40:56,589 --> 00:41:01,861 AND YOUTH VIOLENCE, CANCER AND 732 00:41:01,861 --> 00:41:02,628 OBESITY AND NOTABLE 733 00:41:02,628 --> 00:41:04,897 CARDIOVASCULAR DISEASE IS NOT 734 00:41:04,897 --> 00:41:06,799 THERE AND OBESITY IS RELATED AS 735 00:41:06,799 --> 00:41:11,604 WELL AS MENTAL HEALTH. 736 00:41:11,604 --> 00:41:13,005 WE'RE ALSO PROUD OF THE SPECIAL 737 00:41:13,005 --> 00:41:16,375 ISSUE THAT CAME OUT IN JAMA AND 738 00:41:16,375 --> 00:41:17,977 NETWORK OPEN. 739 00:41:17,977 --> 00:41:23,148 THIS WAS A CONSEQUENCE OF A 740 00:41:23,148 --> 00:41:27,953 VARIETY OF DISCUSSIONS WITH 741 00:41:27,953 --> 00:41:33,592 STAFF AND NEUROLOGICAL AND 742 00:41:33,592 --> 00:41:36,562 BEHAVIORAL SCIENCES DIVISION AND 743 00:41:36,562 --> 00:41:40,032 TURNED OUT TO BE THE RIGHT PLACE 744 00:41:40,032 --> 00:41:42,801 TO PROMOTE THE INITIATIVE A 745 00:41:42,801 --> 00:41:44,870 BROADLY READ JOURNAL AND THE 746 00:41:44,870 --> 00:41:47,706 JAMA FAMILY DISSEMINATES 747 00:41:47,706 --> 00:41:52,845 EFFECTIVELY AND THIS WHOLE 748 00:41:52,845 --> 00:41:56,248 COMPONENT OF BRANDING AS AN 749 00:41:56,248 --> 00:41:58,851 NIMHD EPIGENOMICS RESEARCH AND 750 00:41:58,851 --> 00:42:01,086 THEY CARRIED IT OUT IN THE 751 00:42:01,086 --> 00:42:01,287 TITLE. 752 00:42:01,287 --> 00:42:04,990 I SPOKE TO AT LEAST ONE 753 00:42:04,990 --> 00:42:09,662 PREVENTION WHO LED ONE OF THESE 754 00:42:09,662 --> 00:42:10,362 GRANTS WHO THOUGHT IT WAS A 755 00:42:10,362 --> 00:42:12,131 GREAT WAY TO PROMOTE THE 756 00:42:12,131 --> 00:42:12,431 INITIATIVE. 757 00:42:12,431 --> 00:42:17,770 IT'S BEEN GOING ON A NUMBER OF 758 00:42:17,770 --> 00:42:21,974 YEARS THEY DRAFTED THE EDITORIAL 759 00:42:21,974 --> 00:42:26,245 I ALSO CO-AUTHORED ON THIS 760 00:42:26,245 --> 00:42:26,445 ISSUE. 761 00:42:26,445 --> 00:42:27,379 I'D RECOMMEND INDIVIDUALS TO 762 00:42:27,379 --> 00:42:34,219 REFER TO IT. 763 00:42:34,219 --> 00:42:38,223 ONE OF THE PAPERS PUBLISHED WAS 764 00:42:38,223 --> 00:42:41,961 ON SLEEP AND HEALTH ON URBAN 765 00:42:41,961 --> 00:42:44,396 ALASKAN AMERICANS AND WE SLEEP 766 00:42:44,396 --> 00:42:47,433 IS PROTECTIVE AGAINST CHRONIC 767 00:42:47,433 --> 00:42:47,866 DISEASE. 768 00:42:47,866 --> 00:42:49,702 IT'S AN ASPECT OF LIFE WE SPEND 769 00:42:49,702 --> 00:42:51,570 UP TO A THIRD OF OUR TIME OR 770 00:42:51,570 --> 00:42:57,743 SHOULD SPEND A THIRTY OF OUR 771 00:42:57,743 --> 00:42:59,645 TIME DOING AND YET WE DON'T KNOW 772 00:42:59,645 --> 00:43:01,080 NOT ENOUGH WHAT IT DOES FOR 773 00:43:01,080 --> 00:43:02,614 LONG-TERM HEALTH. 774 00:43:02,614 --> 00:43:06,885 IT'S A STUDY OF ADOLESCENTS FROM 775 00:43:06,885 --> 00:43:07,720 URBAN AREAS IN CALIFORNIA 776 00:43:07,720 --> 00:43:09,588 COMPLETING A NUMBER OF SURVEYS 777 00:43:09,588 --> 00:43:13,692 ON SLEEP, MENTAL AND BEHAVIORAL 778 00:43:13,692 --> 00:43:17,329 HEALTH AND CARDIO METABOLIC 779 00:43:17,329 --> 00:43:19,898 OUTCOMES AT BASELINE AND 780 00:43:19,898 --> 00:43:22,167 FOLLOW-UP AND SHORTER SLEEP 781 00:43:22,167 --> 00:43:22,868 DURATION PREDICTED MORE 782 00:43:22,868 --> 00:43:26,038 DEPRESSION AND ANXIETY AND 783 00:43:26,038 --> 00:43:28,774 INCREASED LIKELIHOOD OF CANNABIS 784 00:43:28,774 --> 00:43:32,711 AND ALCOHOL USE AT FOLLOW. 785 00:43:32,711 --> 00:43:36,615 THIS IS A USEFUL PROSPECTIVE 786 00:43:36,615 --> 00:43:39,251 DESIGN AS IT CONTRIBUTES AS A 787 00:43:39,251 --> 00:43:39,952 CAUSAL INFERENCE. 788 00:43:39,952 --> 00:43:44,523 THERE'S A NUMBER OF STUDIES WITH 789 00:43:44,523 --> 00:43:46,191 ADOLESCENTS THAT HAVE FOUND 790 00:43:46,191 --> 00:43:48,527 DIFFERENT FORMS OF STRESS. 791 00:43:48,527 --> 00:43:55,367 SHORT SLEEP IS A FORMED OF 792 00:43:55,367 --> 00:43:59,038 STRESS AND THERE WERE SYMPTOMS 793 00:43:59,038 --> 00:44:04,243 THAT ARE SIGNIFICANT ISSUES TO 794 00:44:04,243 --> 00:44:06,612 ADDRESS AMONG YOUTH AND YOUNG 795 00:44:06,612 --> 00:44:08,013 ADULTS AND THE ISSUE OF 796 00:44:08,013 --> 00:44:10,582 CARDIOVASCULAR HEALTH IS ONE AT 797 00:44:10,582 --> 00:44:12,818 LOOKING AT BODY MASS INDEX AND 798 00:44:12,818 --> 00:44:14,353 OTHER MEASURES OF OBESITY. 799 00:44:14,353 --> 00:44:17,623 AND LOOKING AT THE DIFFERENCES 800 00:44:17,623 --> 00:44:21,060 THAT PEOPLE HAVE AND PATTERNS OF 801 00:44:21,060 --> 00:44:21,693 SLEEPING LESS DURING THE WEEK 802 00:44:21,693 --> 00:44:23,062 AND MORE ON THE WEEKENDS AND HOW 803 00:44:23,062 --> 00:44:30,903 IT CAN HAVE EFFECT. 804 00:44:30,903 --> 00:44:32,304 LOOKING AT HOW IT INFLUENCES 805 00:44:32,304 --> 00:44:38,377 YOUTH IS WHAT WE LOOK AT IN THIS 806 00:44:38,377 --> 00:44:41,013 POPULATION. 807 00:44:41,013 --> 00:44:47,019 AGRICULTURAL FIELD WORKERS HAVE 808 00:44:47,019 --> 00:44:47,920 COME UNDER SOME ATTENTION. 809 00:44:47,920 --> 00:44:49,922 THEY PLAY A CRITICAL ROLE IN OUR 810 00:44:49,922 --> 00:44:54,026 SOCIETY IN TERMS OF ABUNDANCE 811 00:44:54,026 --> 00:44:55,127 AND VARIETY OF FRESH FOOD 812 00:44:55,127 --> 00:44:58,497 AVAILABLE TO MUCH OF THE UNITED 813 00:44:58,497 --> 00:45:08,774 STATES, NOT ALL. 814 00:45:11,510 --> 00:45:19,785 THE EXPOSURE IS DOESN'T THAT GET 815 00:45:19,785 --> 00:45:20,652 AS MUCH ATTENTION AS IT SHOULD 816 00:45:20,652 --> 00:45:22,387 AND MOTHERS WORKING IN THE FIELD 817 00:45:22,387 --> 00:45:26,158 AND CHILDREN WORKING IN THE 818 00:45:26,158 --> 00:45:27,960 FIELD ARE EXPOSED. 819 00:45:27,960 --> 00:45:31,230 IT'S A STUDY FOR THOSE WHO ARE 820 00:45:31,230 --> 00:45:36,535 CONNECTED TO THAT HISTORY IN OUR 821 00:45:36,535 --> 00:45:41,840 COUNTRY THIS IS THE HOME OF JOHN 822 00:45:41,840 --> 00:45:44,143 STEINBACK ONE OF THE MOST 823 00:45:44,143 --> 00:45:45,043 FERTILE VALLEYS IN THE COUNTRY 824 00:45:45,043 --> 00:45:47,312 IF YOU WISH IN TERMS OF GROWING 825 00:45:47,312 --> 00:45:49,748 FRUITS AND VEGETABLES. 826 00:45:49,748 --> 00:45:52,918 THEY LOOKED AT THE SAMPLES OF 827 00:45:52,918 --> 00:45:58,357 290 PREDOMINANTLY MEXICAN 828 00:45:58,357 --> 00:46:02,494 MOTHER-CHILD PAIRS IN A 829 00:46:02,494 --> 00:46:04,596 LONGITUDINAL COHORT AND 830 00:46:04,596 --> 00:46:06,532 AGRICULTURAL FIELD WORK WAS 831 00:46:06,532 --> 00:46:11,904 ASSOCIATED WITH HIGHER RISK, 832 00:46:11,904 --> 00:46:15,941 GREATER EPIGENETIC AGE 833 00:46:15,941 --> 00:46:16,975 ACCELERATION. 834 00:46:16,975 --> 00:46:20,145 THE NOTION OF WHAT THE 835 00:46:20,145 --> 00:46:22,047 ACTIVITIES DO LONG-TERM MEASURED 836 00:46:22,047 --> 00:46:27,452 IN THIS CASE THROUGH THE 837 00:46:27,452 --> 00:46:32,724 BIOLOGICAL METRIC OF THE 838 00:46:32,724 --> 00:46:34,126 EPIGENETIC CLOCK I THINK IS ONE 839 00:46:34,126 --> 00:46:35,694 OF THE KINDS OF RESEARCH THAT 840 00:46:35,694 --> 00:46:41,099 NIMHD HAS BEEN FUNDING WHICH I 841 00:46:41,099 --> 00:46:42,868 THINK IS IMPORTANT TO IMPORTANT 842 00:46:42,868 --> 00:46:45,103 IN CONTRIBUTING TO THE KNOWLEDGE 843 00:46:45,103 --> 00:46:49,007 AND MEDIATORS IN ETHNIC IDENTITY 844 00:46:49,007 --> 00:46:52,044 IN RACIAL HEALTH AND SAMPLE OF 845 00:46:52,044 --> 00:46:53,011 279 INDIVIDUALS. 846 00:46:53,011 --> 00:46:58,383 SEE THE BREAK DOWN BY RACE AND 847 00:46:58,383 --> 00:47:00,185 ETHNICITY, MAJORITY FEMALE 848 00:47:00,185 --> 00:47:02,754 SURVEYED ABOUT ETHNIC AND RACIAL 849 00:47:02,754 --> 00:47:03,555 IDENTITY EXPLORATION. 850 00:47:03,555 --> 00:47:06,525 IT GETS TO THE ISSUE OF WHAT IN 851 00:47:06,525 --> 00:47:10,362 THE END DOES THIS ALL MEAN AND 852 00:47:10,362 --> 00:47:13,165 WHAT DOES RACE AND ETHNICITY. 853 00:47:13,165 --> 00:47:14,933 THERE ARE PROPONENTS OF SAYING 854 00:47:14,933 --> 00:47:16,635 WELL, WE'RE ALL HUMANS. 855 00:47:16,635 --> 00:47:22,007 WHAT IS THIS THING ABOUT RACE. 856 00:47:22,007 --> 00:47:25,811 PARTICULARLY HEAR THAT FROM SOME 857 00:47:25,811 --> 00:47:27,246 IMMIGRANTS TO THE 858 00:47:27,246 --> 00:47:31,183 U.S. IDENTIFIED AS ETHNIC AND 859 00:47:31,183 --> 00:47:31,717 MINORITY PERSON. 860 00:47:31,717 --> 00:47:33,285 IS THIS SOMETHING THAT WILL GO 861 00:47:33,285 --> 00:47:36,622 AWAY WITH TIME? 862 00:47:36,622 --> 00:47:41,760 AS WE INTERMINGLE MORE AND IT'S 863 00:47:41,760 --> 00:47:42,160 PLAUSIBLE. 864 00:47:42,160 --> 00:47:46,365 THE REALITY IN 2024 IS IT'S 865 00:47:46,365 --> 00:47:49,601 LIKELY NOT GOING TO GO AWAY IN 866 00:47:49,601 --> 00:47:52,738 MY LIFE TIME. 867 00:47:52,738 --> 00:47:57,042 THIS IS STRESS RESPONSE MEASURED 868 00:47:57,042 --> 00:48:00,779 IN YOUTH AND LOOKING AT SLEEP 869 00:48:00,779 --> 00:48:05,350 QUALITY SYMPTOMS, SOMATIC 870 00:48:05,350 --> 00:48:07,786 SYMPTOMS WHETHER THEY RELATE TO 871 00:48:07,786 --> 00:48:10,088 HEADACHE AND NAUSEA THAT ARE 872 00:48:10,088 --> 00:48:11,256 MANIFESTATIONS OF STRESS AND NOT 873 00:48:11,256 --> 00:48:13,492 CALLED BY A PARTICULAR ILLNESS 874 00:48:13,492 --> 00:48:15,661 AND DISCRIMINATION AND STRESS 875 00:48:15,661 --> 00:48:20,032 RESPONSES DO EXACERBATE THE 876 00:48:20,032 --> 00:48:22,200 NEGATIVE ASSOCIATIONS IN THESE 877 00:48:22,200 --> 00:48:24,403 ETHNIC AND RACIAL IDENTITY 878 00:48:24,403 --> 00:48:26,471 EXPLORATION OF ADOLESCENTS IN 879 00:48:26,471 --> 00:48:28,407 THEIR SLEEP AND SYMPTOMS. 880 00:48:28,407 --> 00:48:32,878 THEIR IDENTITY HELPED MEDIATE BY 881 00:48:32,878 --> 00:48:34,880 BUFFERING THE POSITIVE 882 00:48:34,880 --> 00:48:35,347 ASSOCIATION BETWEEN 883 00:48:35,347 --> 00:48:36,815 DISCRIMINATION AND PROBLEM 884 00:48:36,815 --> 00:48:39,251 SOLVING WHILE THE STRESS 885 00:48:39,251 --> 00:48:40,752 EXACERBATED THE ASSOCIATIONS. 886 00:48:40,752 --> 00:48:45,891 LESSON HERE IS DISCRIMINATION 887 00:48:45,891 --> 00:48:48,794 AND STRESS ARE PERCEIVED BY 888 00:48:48,794 --> 00:48:54,866 YOUTH HAVING THIS ETHNIC RACIAL 889 00:48:54,866 --> 00:48:59,037 IDENTITY REALLY DOES HELP IN 890 00:48:59,037 --> 00:49:03,809 DISCRIMINATION MAKE EXACERBATE 891 00:49:03,809 --> 00:49:14,286 THESE SYMPTOMS THIS IS ON A 892 00:49:16,121 --> 00:49:17,723 COVID VACCINATION AND EVERYBODY 893 00:49:17,723 --> 00:49:19,758 SHOULD CONSIDER GENT VACCINATED 894 00:49:19,758 --> 00:49:20,559 THIS FALL. 895 00:49:20,559 --> 00:49:23,729 A SURVEY OF ALMOST 300 LATINO 896 00:49:23,729 --> 00:49:26,765 AND BLACK AUMENT DIFFICULTS 897 00:49:26,765 --> 00:49:29,401 ENROLLED IN AN HIV AIDS PROGRAM 898 00:49:29,401 --> 00:49:32,170 UNDER THE RON WHITE PROGRAM IN 899 00:49:32,170 --> 00:49:37,309 THE YEAR 2022. 900 00:49:37,309 --> 00:49:39,644 STILL TOWARDS THE PERIOD PERIOD 901 00:49:39,644 --> 00:49:43,115 OF COVID EMERGENCY. 902 00:49:43,115 --> 00:49:43,749 FULLY VACCINATED PARTICIPANTS 903 00:49:43,749 --> 00:49:50,489 WERE LIKELY TO BE OLDER, 904 00:49:50,489 --> 00:49:52,491 CISGENDER MALES AND SOME COLLEGE 905 00:49:52,491 --> 00:49:55,460 EDUCATION AND COMING FROM 906 00:49:55,460 --> 00:50:00,031 HOUSEHOLDS UNDER 100% POVERTY. 907 00:50:00,031 --> 00:50:01,400 FULLY VACCINATED PARTICIPANTS 908 00:50:01,400 --> 00:50:05,637 WERE LESS LIKELY TO BE PLAQUE OR 909 00:50:05,637 --> 00:50:08,907 ENDORSE VACCINE MISCONCEPTIONS 910 00:50:08,907 --> 00:50:13,645 AND REPORTED MORE VACCINATION 911 00:50:13,645 --> 00:50:16,948 ENCOURAGEMENT AND IT'S ONE OF 912 00:50:16,948 --> 00:50:21,086 THE STUDIES THAT WE FUNDED ON 913 00:50:21,086 --> 00:50:28,293 THE ISSUE OF VACCINE UPTAKE AND 914 00:50:28,293 --> 00:50:30,195 WE'LL CONTINUE TO WORK ON THAT. 915 00:50:30,195 --> 00:50:35,834 IN THIS PARTICULAR ANALYSIS OF 916 00:50:35,834 --> 00:50:40,539 STROKE PREVALENCE THEY 917 00:50:40,539 --> 00:50:42,340 SURVEILLED THE SYSTEM OVER 918 00:50:42,340 --> 00:50:44,309 MULTIPLE CROSS SECTIONAL SAMPLES 919 00:50:44,309 --> 00:50:47,312 TO ASK ABOUT SELF-REPORTED 920 00:50:47,312 --> 00:50:49,614 STROKE AMONG AMERICAN INDIAN AND 921 00:50:49,614 --> 00:50:50,782 ALASKAN NATIVE. 922 00:50:50,782 --> 00:50:54,886 STROKE INCIDENTS IS SOMETHING 923 00:50:54,886 --> 00:50:58,156 THAT IS A SUCCESS OF U.S. HEALTH 924 00:50:58,156 --> 00:51:01,593 BECAUSE CONTROL OF HYPERTENSION 925 00:51:01,593 --> 00:51:03,962 DETECTION TREATMENT AND CONTROL 926 00:51:03,962 --> 00:51:06,832 OF HYPERTENSION HAVE LED TO A 927 00:51:06,832 --> 00:51:11,369 DRAMATIC INCREASE OF STROKE 928 00:51:11,369 --> 00:51:13,405 INCIDENCE OVER 40 YEARS. 929 00:51:13,405 --> 00:51:17,375 THE LAST 10 TO 15 YEARS WE'VE 930 00:51:17,375 --> 00:51:19,177 SEEN A FLATTENING TO SOME OF 931 00:51:19,177 --> 00:51:22,147 EXTENT INCREASES AND MORTALITY 932 00:51:22,147 --> 00:51:25,584 IS ALSO NOT JUST THE RATES HAVE 933 00:51:25,584 --> 00:51:26,918 FLATTENED IN INCREASE BUT ALSO 934 00:51:26,918 --> 00:51:29,454 MORTALITY DONE THE SAME THING. 935 00:51:29,454 --> 00:51:32,524 THIS IS OF GREAT CONCERN TO THE 936 00:51:32,524 --> 00:51:34,960 SCIENTIFIC COMMUNITY AND BOTH 937 00:51:34,960 --> 00:51:39,231 THE GENERAL HEALTH ISSUES AND 938 00:51:39,231 --> 00:51:41,066 NEUROLOGY RESEARCHERS. 939 00:51:41,066 --> 00:51:43,134 SIMILAR TO WHAT WE'VE SEEN WITH 940 00:51:43,134 --> 00:51:44,703 CARDIOVASCULAR OUTCOMES IN 941 00:51:44,703 --> 00:51:44,936 GENERAL. 942 00:51:44,936 --> 00:51:48,573 IN THIS PARTICULAR POPULATION WE 943 00:51:48,573 --> 00:51:50,242 SAW PREVALENCE INCREASE BY 944 00:51:50,242 --> 00:51:54,913 SELF-REPORT FROM 2.9 TO 3.3%. 945 00:51:54,913 --> 00:51:56,381 AT BEST IT IS NOT GOING TO 946 00:51:56,381 --> 00:52:00,585 CONTINUE TO GO DOWN AND IT WAS 947 00:52:00,585 --> 00:52:01,786 HIGHEST IN AMERICAN INDIAN AND 948 00:52:01,786 --> 00:52:05,924 ALASKAN NATIVE ADULTS IN 2011 949 00:52:05,924 --> 00:52:11,096 AND 2021 COMPARED TO WHITES. 950 00:52:11,096 --> 00:52:13,365 WE'RE MORE LIKELY TO HAVE A 951 00:52:13,365 --> 00:52:15,734 HIGHER NUMBER OF RISK FACTORS. 952 00:52:15,734 --> 00:52:21,273 WE KNOW WHAT TO DO FOR THESE 953 00:52:21,273 --> 00:52:24,643 RISK FACTORS. 954 00:52:24,643 --> 00:52:27,279 AND FOR STROKE AND HYPERTENSION 955 00:52:27,279 --> 00:52:31,750 AND HYPERLIPIDEMIA OR VASCULAR 956 00:52:31,750 --> 00:52:34,619 DISEASE, OBESITY AND LESS PAID 957 00:52:34,619 --> 00:52:37,122 ATTENTION TO IS ALCOHOL USE 958 00:52:37,122 --> 00:52:39,491 AMONG OTHERS THAT NEED TO BE 959 00:52:39,491 --> 00:52:40,058 ADDRESSED. 960 00:52:40,058 --> 00:52:41,192 THIS PERSISTENT DISPARITY IS 961 00:52:41,192 --> 00:52:44,796 SOMETHING TO CONSIDER. 962 00:52:44,796 --> 00:52:48,633 INDICATORS OF STRUCTURAL RACISM 963 00:52:48,633 --> 00:52:49,401 AND SEVERE MATERNAL MORBIDITY 964 00:52:49,401 --> 00:52:54,339 WERE EVALUATED IN THE STUDY FROM 965 00:52:54,339 --> 00:52:57,576 THE U.S. THAT ABSTRACTED TO 966 00:52:57,576 --> 00:52:59,578 ASSESS ASSOCIATION AT A STATE 967 00:52:59,578 --> 00:53:00,879 LEVEL. 968 00:53:00,879 --> 00:53:05,917 THIS IS ONE OF THE EARLY 401 969 00:53:05,917 --> 00:53:10,221 GRANTS WE FUNDED LOOKING AT 970 00:53:10,221 --> 00:53:12,924 BLACK TO WHITE INEQUITY ISSUES 971 00:53:12,924 --> 00:53:15,293 IN SEVERE MATERNAL MORBIDITY AND 972 00:53:15,293 --> 00:53:18,697 THOUGH THERE'S 1,000 DEATHS A 973 00:53:18,697 --> 00:53:20,565 YEAR AND GEORGIA IS CERTAINLY AN 974 00:53:20,565 --> 00:53:22,434 AREA THIS IS COMING FROM THE 975 00:53:22,434 --> 00:53:24,936 STATE OF GEORGIA I THINK WHERE 976 00:53:24,936 --> 00:53:27,539 WE HAVE CONCERNS ABOUT POCKETS 977 00:53:27,539 --> 00:53:32,043 OF HIGH MORTALITY. 978 00:53:32,043 --> 00:53:34,813 MORBIDITY IS ABOUT 50 TO 100,000 979 00:53:34,813 --> 00:53:40,218 EVENTS A YEAR AND LOOKING AT THE 980 00:53:40,218 --> 00:53:42,387 LARGE SAMPLE SIZE 22% WERE BLACK 981 00:53:42,387 --> 00:53:44,789 WOMEN AND SEVERE MATERNAL 982 00:53:44,789 --> 00:53:47,559 MORBIDITY WAS SEVERE IN BLACK 983 00:53:47,559 --> 00:53:50,028 COMPARED TO WHITE WOMEN THE ONLY 984 00:53:50,028 --> 00:53:51,229 COMPARISON IN THE ANALYSIS. 985 00:53:51,229 --> 00:53:54,599 THE ODDS OF SEVERE MATERNAL 986 00:53:54,599 --> 00:53:57,068 MORBIDITY INCREASE FOR 1% 987 00:53:57,068 --> 00:53:58,169 INCREASE IN UNEMPLOYMENT AND 988 00:53:58,169 --> 00:53:59,938 MORE THAN IT DID FOR WHITE WOMEN 989 00:53:59,938 --> 00:54:04,442 AND THE ODDS OF SEVERE MATERNAL 990 00:54:04,442 --> 00:54:06,878 MORBIDITY INCREASED PER ONE UNIT 991 00:54:06,878 --> 00:54:09,014 INCREASE FOR BLACK WOMEN 992 00:54:09,014 --> 00:54:11,950 INCARCERATION COMPARED TO BLACK 993 00:54:11,950 --> 00:54:14,386 WOMEN. 994 00:54:14,386 --> 00:54:16,921 THESE STRUCTURAL RACISM 995 00:54:16,921 --> 00:54:18,323 INDICATORS OR SOCIO ECONOMIC 996 00:54:18,323 --> 00:54:19,958 INDICATORS IN THE CASE OF 997 00:54:19,958 --> 00:54:21,059 UNEMPLOYMENT AND INCARCERATION 998 00:54:21,059 --> 00:54:27,065 REALLY ARE REFLECTED IN THE 999 00:54:27,065 --> 00:54:28,600 MEDIATOR IN MATERNAL MORTALITY. 1000 00:54:28,600 --> 00:54:33,638 THIS IS A PUBLICATION FROM OUR 1001 00:54:33,638 --> 00:54:36,307 INTRAMURAL PROGRAM LED BY 1002 00:54:36,307 --> 00:54:38,376 DR. WILLIAMS IN ANALYZING 1003 00:54:38,376 --> 00:54:41,846 MULTIPLE YEARS OF THE NATIONAL 1004 00:54:41,846 --> 00:54:44,049 HEALTH INTERVIEW SURVEY TO 1005 00:54:44,049 --> 00:54:48,953 EXAMINE MODERATE TO SEVERE 1006 00:54:48,953 --> 00:54:50,555 PSYCHOLOGICAL DISTRESS IN 1007 00:54:50,555 --> 00:54:51,990 NEIGHBORHOOD COHESION STRATIFIED 1008 00:54:51,990 --> 00:54:55,126 BY YEARS LIVING IN THE U.S. 1009 00:54:55,126 --> 00:54:56,761 WE ALL LIKE ROUND NUMBERS SO 10 1010 00:54:56,761 --> 00:54:59,597 IS USUALLY USED THOUGH I DON'T 1011 00:54:59,597 --> 00:55:01,199 THINK THERE'S SIGNS IN SAYING 10 1012 00:55:01,199 --> 00:55:02,734 YEARS IS THE MAGICAL TIME YOU'RE 1013 00:55:02,734 --> 00:55:05,704 A RESIDENT IN THE COUNTRY. 1014 00:55:05,704 --> 00:55:08,473 LOW TO MEDIUM NEIGHBORHOOD 1015 00:55:08,473 --> 00:55:10,175 COHESION REGARDLESS OF RESIDENCE 1016 00:55:10,175 --> 00:55:11,876 WAS RELATED TO HIGHER ODDS OF 1017 00:55:11,876 --> 00:55:17,048 MODERATE SEVERE PSYCHOLOGICAL 1018 00:55:17,048 --> 00:55:17,315 DISTRESS. 1019 00:55:17,315 --> 00:55:18,950 THIS IS AN IMPORTANT RESEARCH 1020 00:55:18,950 --> 00:55:22,353 QUESTION IS WHAT IS THE ROLE OF 1021 00:55:22,353 --> 00:55:26,057 A GOOD NEIGHBORHOOD, QUOTE, 1022 00:55:26,057 --> 00:55:27,692 UNQUOTE GOOD NEIGHBORHOOD AND 1023 00:55:27,692 --> 00:55:29,427 HOW DO YOU MEASURE THAT? 1024 00:55:29,427 --> 00:55:31,996 MOST RESEARCHERS HAD TRY TO GET 1025 00:55:31,996 --> 00:55:34,632 AT THIS USING MACRO DATA OF 1026 00:55:34,632 --> 00:55:35,700 NEIGHBORHOOD COHESION AND IN 1027 00:55:35,700 --> 00:55:42,507 THIS CASE WAS LOOKING AT 1028 00:55:42,507 --> 00:55:44,542 PERCEPTION AND DISTRESS IN THE 1029 00:55:44,542 --> 00:55:46,377 OTHER FACTORS THAT ARE 1030 00:55:46,377 --> 00:55:47,278 STRATIFIED BY YEARS OF LIVING IN 1031 00:55:47,278 --> 00:55:50,381 THE U.S. 1032 00:55:50,381 --> 00:55:53,051 THIS IS I THINK AN IMPORTANT 1033 00:55:53,051 --> 00:55:54,352 RESEARCH AND SCIENCE QUESTION 1034 00:55:54,352 --> 00:55:59,858 FOR OUR COMMUNITY ENGAGEMENT 1035 00:55:59,858 --> 00:56:01,693 APPROACH TO RESEARCH IN THAT WE 1036 00:56:01,693 --> 00:56:03,161 THINK THAT BETTER MORE COHESION 1037 00:56:03,161 --> 00:56:08,767 IS ACTUALLY REALLY GOOD FOR 1038 00:56:08,767 --> 00:56:10,368 INDIVIDUAL'S HEALTH. 1039 00:56:10,368 --> 00:56:14,706 I THINK THE DATA NEEDS TO BE 1040 00:56:14,706 --> 00:56:15,039 CONSOLIDATED. 1041 00:56:15,039 --> 00:56:18,109 I DON'T THINK THE EVIDENCE IS 1042 00:56:18,109 --> 00:56:18,409 COMPELLING. 1043 00:56:18,409 --> 00:56:20,879 THERE'S MORE EVIDENCE THAT 1044 00:56:20,879 --> 00:56:22,547 PROBLEMS ARE A PROBLEM. 1045 00:56:22,547 --> 00:56:27,152 IF YOU HAVE A NEIGHBORHOOD WITH 1046 00:56:27,152 --> 00:56:28,520 PROBLEMS THAT PEOPLE HAVE 1047 00:56:28,520 --> 00:56:30,622 INDIVIDUALS HAVE WORSE HEALTH. 1048 00:56:30,622 --> 00:56:32,323 HAVING THOUGHT ABOUT THIS AND 1049 00:56:32,323 --> 00:56:34,392 WORKING ON THIS THROUGH 1050 00:56:34,392 --> 00:56:38,696 SECONDARY DATA THIS IS AN AREA 1051 00:56:38,696 --> 00:56:41,299 THAT NEEDS CONTINUED ATTENTION. 1052 00:56:41,299 --> 00:56:45,637 IN THIS PARTICULAR ANALYSIS FORN 1053 00:56:45,637 --> 00:56:46,805 FOREIGN-BORN INDIVIDUALS HAVE 1054 00:56:46,805 --> 00:56:47,572 LOWER STRESS AFTER 10 YEARS OF 1055 00:56:47,572 --> 00:56:53,878 RESIDENCY. 1056 00:56:53,878 --> 00:56:55,480 IN ONE OF THE PAPERS WE 1057 00:56:55,480 --> 00:56:59,184 PUBLISHED ON OUR COLLABORATION 1058 00:56:59,184 --> 00:57:02,020 WITH THE INSTITUTE FOR HEALTH 1059 00:57:02,020 --> 00:57:02,854 METRIC EVALUATION INSTITUTE OF 1060 00:57:02,854 --> 00:57:04,155 WASHINGTON WHAT WE CALL THE 1061 00:57:04,155 --> 00:57:06,124 GLOBAL BURDEN OF DISEASE, 1062 00:57:06,124 --> 00:57:07,959 U.S. HEALTH DISPARITIES GROUP, 1063 00:57:07,959 --> 00:57:12,230 THIS PAPER IS PUBLISHED ON THE 1064 00:57:12,230 --> 00:57:23,007 SORCIRRHOSIS MORTALITY WE LOOKET 1065 00:57:29,681 --> 00:57:33,785 CIRRHOSIS MORTALITY AND FOUND 1066 00:57:33,785 --> 00:57:37,622 HIGHEST AMONG THE AMERICAN 1067 00:57:37,622 --> 00:57:38,389 INDIAN ALASKAN NATIVE 1068 00:57:38,389 --> 00:57:40,491 POPULATIONS AND THE PROBLEM IS 1069 00:57:40,491 --> 00:57:43,061 WIDESPREAD AND THE MORTALITY HAS 1070 00:57:43,061 --> 00:57:45,797 INCREASED IN ALL COUNTY FOR 1071 00:57:45,797 --> 00:57:47,065 WHITE AND AMERICAN INDIAN AND 1072 00:57:47,065 --> 00:57:50,368 ALASKAN NATIVE AND FEWER FOR 1073 00:57:50,368 --> 00:57:51,469 ASIAN, BLACK AND LATINO 1074 00:57:51,469 --> 00:57:51,769 POPULATION. 1075 00:57:51,769 --> 00:57:53,071 THE IMPORTANCE. 1076 00:57:53,071 --> 00:57:56,808 OF TRYING TO PREVENT CIRRHOSIS 1077 00:57:56,808 --> 00:58:00,111 IS NOT JUST CAUSED BY EXCESSIVE 1078 00:58:00,111 --> 00:58:00,845 ALCOHOL CONSUMPTION WHICH IS 1079 00:58:00,845 --> 00:58:06,317 WHAT A LOT OF LAY INDIVIDUALS 1080 00:58:06,317 --> 00:58:10,154 MAY THINK, AS AN INTERN IN 1081 00:58:10,154 --> 00:58:12,390 MEDICINE HEPATITIS B AND C ALSO 1082 00:58:12,390 --> 00:58:17,295 LEAD TO CIRRHOSIS AND THESE ARE 1083 00:58:17,295 --> 00:58:19,631 MOSTLY PREVENTIBLE THROUGH 1084 00:58:19,631 --> 00:58:21,799 VACCINES OR CURABLE WITH 1085 00:58:21,799 --> 00:58:23,668 MEDICATIONS AT 12 WEEK COURSE 1086 00:58:23,668 --> 00:58:27,138 FOR HEPATITIS B AND THE 1087 00:58:27,138 --> 00:58:29,807 DEVELOPMENT OF INFLAMMATION FROM 1088 00:58:29,807 --> 00:58:31,743 FATTY INFILTRATION IN THE LIVER 1089 00:58:31,743 --> 00:58:34,379 WHICH IS THE LEADING CAUSE OF 1090 00:58:34,379 --> 00:58:35,980 CIRRHOSIS IN SOME POPULATIONS. 1091 00:58:35,980 --> 00:58:38,116 THIS IS THE KIND OF ANALYSIS 1092 00:58:38,116 --> 00:58:39,183 ANYONE CAN DOWNLOAD FROM THEIR 1093 00:58:39,183 --> 00:58:41,853 WEBSITE AND LOOK AT THE MAPS AND 1094 00:58:41,853 --> 00:58:44,455 HIGHLIGHT THIS IS WHAT WE WERE 1095 00:58:44,455 --> 00:58:46,357 FOCUSSED ON AMERICAN INDIAN. 1096 00:58:46,357 --> 00:58:49,060 SO RED IS INCREASING RATES OF 1097 00:58:49,060 --> 00:58:52,230 CIRRHOSIS MORTALITY AND THE 1098 00:58:52,230 --> 00:58:54,832 BLUE, GREEN, WHATEVER, TEAL 1099 00:58:54,832 --> 00:58:59,570 COLOR THIS IS IS IMPROVEMENT. 1100 00:58:59,570 --> 00:59:01,406 AMONG ASIAN POPULATIONS WE'VE 1101 00:59:01,406 --> 00:59:02,774 SEEN PREDOMINANT IMPROVEMENT 1102 00:59:02,774 --> 00:59:08,413 SINCE AS THE PRIMARY CAUSE OF 1103 00:59:08,413 --> 00:59:12,417 CIRRHOSIS RELATED TO HEPATITIS B 1104 00:59:12,417 --> 00:59:16,054 AND THE UPTAKE IN THIS COMMUNITY 1105 00:59:16,054 --> 00:59:18,356 HAS BEEN HIGH IN THE COUNTRIES 1106 00:59:18,356 --> 00:59:25,063 WHERE IMMIGRANTS ARE COMING FROM 1107 00:59:25,063 --> 00:59:33,871 AND ASIA AND SUCCESSFUL 1108 00:59:33,871 --> 00:59:36,741 VACCINATION AND WHEN CHRONICALLY 1109 00:59:36,741 --> 00:59:40,678 INFECTED MOMS VERTICALLY 1110 00:59:40,678 --> 00:59:44,182 TRANSMIT TO THEIR CHILD IN UTERO 1111 00:59:44,182 --> 00:59:46,384 OR EARLY CHILDHOOD THEY HAVE THE 1112 00:59:46,384 --> 00:59:47,852 HIGHEST RISK OF DEVELOPING 1113 00:59:47,852 --> 00:59:50,955 CIRRHOSIS OVER TIME. 1114 00:59:50,955 --> 00:59:52,457 WE SEE FOR BLACK AMERICAN 1115 00:59:52,457 --> 00:59:53,658 PINKISH RED AREAS SO WE'RE NOT 1116 00:59:53,658 --> 00:59:54,859 ALL MAKING PROGRESS. 1117 00:59:54,859 --> 00:59:57,395 SOME AREAS ARE GOOD. 1118 00:59:57,395 --> 00:59:59,597 AMONG LATINO HISPANICS WE SEE 1119 00:59:59,597 --> 01:00:01,265 THE SAME THING. 1120 01:00:01,265 --> 01:00:04,135 BIG PROBLEMS IN THE SOUTHWEST 1121 01:00:04,135 --> 01:00:04,969 AND SOUTHEAST. 1122 01:00:04,969 --> 01:00:09,440 IT VARIES ACROSS THE COUNTRY BUT 1123 01:00:09,440 --> 01:00:11,009 WHITE POPULATION BE THE LARGEST 1124 01:00:11,009 --> 01:00:13,411 WE SEE THE TOTAL POPULATION AND 1125 01:00:13,411 --> 01:00:15,747 PICTURE FOR SIR ROVES WORSENING 1126 01:00:15,747 --> 01:00:17,148 ACROSS THE COUNTRY. 1127 01:00:17,148 --> 01:00:19,617 I WANT TO CLOSE AGAIN AS WE DO 1128 01:00:19,617 --> 01:00:22,754 USUALLY WITH A SNAPSHOT OF OUR 1129 01:00:22,754 --> 01:00:27,392 SUMMER INTERNS THAT PRESENTED AT 1130 01:00:27,392 --> 01:00:27,925 THE SESSION. 1131 01:00:27,925 --> 01:00:33,464 THESE ARE SUMMER INTERNS WHO 1132 01:00:33,464 --> 01:00:35,266 COME TO NIMHD FOR SUPPORTED 1133 01:00:35,266 --> 01:00:37,502 EIGHT WEEK PERIOD AND THEN THERE 1134 01:00:37,502 --> 01:00:41,172 IS A POSTER SESSION THAT IS 1135 01:00:41,172 --> 01:00:41,372 HELD. 1136 01:00:41,372 --> 01:00:48,012 IT INCLUDES THE SUMMER INTERNS I 1137 01:00:48,012 --> 01:00:51,449 HAD IN MY LAB PICTURED HERE AS 1138 01:00:51,449 --> 01:00:52,817 WELL AS WELL AS THOSE FROM 1139 01:00:52,817 --> 01:00:53,551 NIMHD. 1140 01:00:53,551 --> 01:00:54,786 THANK YOU FOR YOUR ATTENTION. 1141 01:00:54,786 --> 01:00:57,221 ENCOURAGE ANYONE OUT THERE WHO 1142 01:00:57,221 --> 01:01:00,558 WANTS A CAREER IN NIMHD TO APPLY 1143 01:01:00,558 --> 01:01:03,428 AND WE NEED SCIENTISTS IN OUR 1144 01:01:03,428 --> 01:01:06,364 SCIENTIFIC PROGRAMS AND WE 1145 01:01:06,364 --> 01:01:08,366 WELCOME APPLICATIONS FROM ANYONE 1146 01:01:08,366 --> 01:01:11,469 AND THANK YOU AGAIN FOR YOUR 1147 01:01:11,469 --> 01:01:11,736 ATTENTION. 1148 01:01:11,736 --> 01:01:14,272 I'LL STOP SHARING AND TAKE A FEW 1149 01:01:14,272 --> 01:01:15,206 MINUTES FOR COMMENTS OR 1150 01:01:15,206 --> 01:01:15,773 QUESTIONS FROM THE COUNCIL 1151 01:01:15,773 --> 01:01:23,448 MEMBERS. 1152 01:01:23,448 --> 01:01:26,384 WE'RE RUNNING BEHIND BUT WE CAN 1153 01:01:26,384 --> 01:01:35,526 ENTERTAIN QUESTIONS. 1154 01:01:35,526 --> 01:01:36,661 >> LET ME LOOK ONLINE. 1155 01:01:36,661 --> 01:01:46,404 I SEE NONE IN THE ROOM. 1156 01:01:46,404 --> 01:01:52,743 I SEE NONE ONLINE. 1157 01:01:52,743 --> 01:01:56,981 >> OKAY. 1158 01:01:56,981 --> 01:01:58,382 WELL, WE CAN TAKE A WONDERFUL 1159 01:01:58,382 --> 01:02:01,152 EIGHT MINUTE BREAK AND GET BACK 1160 01:02:01,152 --> 01:02:03,020 ON TRACK. 1161 01:02:03,020 --> 01:02:04,956 THANK YOU VERY MUCH. 1162 01:02:04,956 --> 01:02:06,224 I'M NOT SWEATING AS MUCH AS I 1163 01:02:06,224 --> 01:02:06,691 WAS NOW ON THE TIME. 1164 01:02:06,691 --> 01:02:10,860 THANK YOU. 1165 01:02:14,974 --> 01:02:16,042 >> GOOD MORNING, AGAIN. 1166 01:02:16,042 --> 01:02:20,513 WE'RE GOING TO NOW GO TO OUR 1167 01:02:20,513 --> 01:02:24,617 FIRST PRESENTATION FOR THE 1168 01:02:24,617 --> 01:02:26,119 SESSION OF COUNCIL. 1169 01:02:26,119 --> 01:02:29,088 IT'S A PLEASURE TO INTRODUCE A 1170 01:02:29,088 --> 01:02:31,390 COLLEAGUE AND FRIEND, 1171 01:02:31,390 --> 01:02:33,926 DR. DARRELL GASKIN A HEALTH 1172 01:02:33,926 --> 01:02:36,095 ECONOMIST WHO HAS BEEN MOST OF 1173 01:02:36,095 --> 01:02:42,435 HIS CAREER AT JOHNS HOPKINS 1174 01:02:42,435 --> 01:02:42,768 UNIVERSITY. 1175 01:02:42,768 --> 01:02:45,037 HE'S AN ACCOMPLISHED 1176 01:02:45,037 --> 01:02:47,140 INVESTIGATOR IN HEALTH 1177 01:02:47,140 --> 01:02:49,976 DISPARITIES SCIENCE. 1178 01:02:49,976 --> 01:02:53,579 I MET HIM FIRST IN I THINK 2017 1179 01:02:53,579 --> 01:02:54,747 INVESTING THE INVESTIGATION OF 1180 01:02:54,747 --> 01:02:58,985 MICHIGAN AND WAS A SPEAKER AT A 1181 01:02:58,985 --> 01:03:01,988 SYMPOSIUM ON THE CENTERS OF 1182 01:03:01,988 --> 01:03:03,589 EXCELLENCE WITH A NUMBER OF 1183 01:03:03,589 --> 01:03:04,290 OTHER INVESTIGATORS. 1184 01:03:04,290 --> 01:03:07,460 HE WAS A MEMBER OF THE NATIONAL 1185 01:03:07,460 --> 01:03:10,296 ACADEMIES COMMITTEE THAT 1186 01:03:10,296 --> 01:03:14,734 PRODUCED THE ENDING ON UNEQUAL 1187 01:03:14,734 --> 01:03:25,144 REPORT WITH LISA SUMMER. 1188 01:03:33,586 --> 01:03:35,555 NIMHD HELPED FUND THE REPORT AND 1189 01:03:35,555 --> 01:03:38,658 GUIDED BY STAFF AND I THINK IT'S 1190 01:03:38,658 --> 01:03:39,625 GOING TO BE AN IMPORTANT 1191 01:03:39,625 --> 01:03:39,892 DOCUMENT. 1192 01:03:39,892 --> 01:03:47,333 WE DON'T WORRY SO MUCH ABOUT THE 1193 01:03:47,333 --> 01:03:50,503 BUZZ AND THE TREATMENT IT GETS 1194 01:03:50,503 --> 01:03:53,172 IN UNEQUAL TREATMENT PART 1 IS 1195 01:03:53,172 --> 01:03:57,043 WHAT THE COMMUNITY DOES WITH IT 1196 01:03:57,043 --> 01:03:58,010 AND WHAT OUR SCIENTIFIC 1197 01:03:58,010 --> 01:03:58,844 COMMUNITY REFERS TO WHAT IS IN 1198 01:03:58,844 --> 01:04:04,317 THE REPORT AS TIME PASSES. 1199 01:04:04,317 --> 01:04:10,756 IT'S BEEN ALMOST 20 YEARS SINCE 1200 01:04:10,756 --> 01:04:12,291 UNEQUAL TREATMENT 1 AND 1201 01:04:12,291 --> 01:04:15,328 REFLECTED BY THE EFFORTS MADE BY 1202 01:04:15,328 --> 01:04:20,700 ALL OF YOU IN REFERRING TO IT. 1203 01:04:20,700 --> 01:04:23,603 I ENCOURAGE YOU TO READ THIS AND 1204 01:04:23,603 --> 01:04:25,104 REFLECT ON IT. 1205 01:04:25,104 --> 01:04:26,072 DARRELL WILL GIVE US A 1206 01:04:26,072 --> 01:04:28,274 PRESENTATION AND WE'LL HAVE TIME 1207 01:04:28,274 --> 01:04:31,577 FOR SOME CONVERSATION. 1208 01:04:31,577 --> 01:04:38,217 DR. GASKIN. 1209 01:04:38,217 --> 01:04:48,761 >> THANK YOU, DR. PEREZ-STABLE. 1210 01:04:49,295 --> 01:04:58,771 I ALSO APPRECIATE THE 1211 01:04:58,771 --> 01:05:00,573 OPPORTUNITY TO PRESENT THE 1212 01:05:00,573 --> 01:05:01,207 COMMITTEE'S REPORT. 1213 01:05:01,207 --> 01:05:06,279 I'M LOOKING ACROSS THE ROOM AND 1214 01:05:06,279 --> 01:05:08,014 SEE OTHERS ON THE COMMITTEE. 1215 01:05:08,014 --> 01:05:10,950 I SAY IF YOU'RE ON THE COMMITTEE 1216 01:05:10,950 --> 01:05:12,351 WHY AREN'T YOU DOING THIS 1217 01:05:12,351 --> 01:05:15,588 INSTEAD OF ME BECAUSE YOU'RE 1218 01:05:15,588 --> 01:05:16,889 CERTAINLY AS CAPABLE OF 1219 01:05:16,889 --> 01:05:17,890 PRESENTING THE COMMITTEE'S 1220 01:05:17,890 --> 01:05:18,124 REPORT. 1221 01:05:18,124 --> 01:05:21,827 I WILL SAY THIS, IF YOU HAVE 1222 01:05:21,827 --> 01:05:23,062 DIFFICULT OR HARD QUESTIONS 1223 01:05:23,062 --> 01:05:25,831 PLEASE DIRECT THEM TO THE OTHER 1224 01:05:25,831 --> 01:05:31,203 SIDE OF THE ROOM. 1225 01:05:31,203 --> 01:05:41,747 ANYWAY, SO WE PRODUCED A REPORT 1226 01:05:45,885 --> 01:05:47,420 TO ADDRESS HEALTH UNEQUAL AND 1227 01:05:47,420 --> 01:05:48,788 BRING CHANGE TO NOT ONLY IMPROVE 1228 01:05:48,788 --> 01:05:50,990 THE HEALTH OF INDIVIDUALS AND 1229 01:05:50,990 --> 01:05:52,291 FAMILIES BUT THE OVER ALL 1230 01:05:52,291 --> 01:06:02,768 PRODUCTIVITY OF THE NATION. 1231 01:06:05,171 --> 01:06:07,573 WE'RE APPRECIATE OF THE SPONSORS 1232 01:06:07,573 --> 01:06:10,543 AND THANK THE NATIONAL INSTITUTE 1233 01:06:10,543 --> 01:06:12,411 OF MINORITY HEATH AND HEALTH 1234 01:06:12,411 --> 01:06:18,317 DISPARITIES FOR THE MEETING AND 1235 01:06:18,317 --> 01:06:23,589 ENCOURAGE THE NATIONAL ACADEMIES 1236 01:06:23,589 --> 01:06:27,593 OF MEDICINE TO LOOK TO THE 1237 01:06:27,593 --> 01:06:28,060 FUTURE. 1238 01:06:28,060 --> 01:06:31,097 THESE ARE THE COMMITTEE MEMBERS 1239 01:06:31,097 --> 01:06:33,599 APPOINTED TO CONDUCT THE CITY 1240 01:06:33,599 --> 01:06:37,303 WITH LEADERS AND EXPERTS ON 1241 01:06:37,303 --> 01:06:42,074 SOCIAL POLICY AND DISPARITIES 1242 01:06:42,074 --> 01:06:47,513 AND PUBLIC HEALTH, PRIMARY CARE, 1243 01:06:47,513 --> 01:06:48,547 NURSING, HEALTH TECHNOLOGY, 1244 01:06:48,547 --> 01:06:52,284 HEALTH CARE FINANCING, 1245 01:06:52,284 --> 01:06:55,588 COMMUNITY-ENGAGED RESEARCHER AND 1246 01:06:55,588 --> 01:06:57,056 HEALTH PROFESSIONS AS WELL AS 1247 01:06:57,056 --> 01:06:58,424 HEALTH ECONOMICS AND HEALTH 1248 01:06:58,424 --> 01:07:08,734 SERVICES RESEARCH. 1249 01:07:11,237 --> 01:07:17,143 THE COMMUNITY WAS LED BY GEORGE 1250 01:07:17,143 --> 01:07:22,148 BENJAMIN AND JENNIFER DA VOE. 1251 01:07:22,148 --> 01:07:23,482 EFFORTS CAN BE TRACED BACK TO 1252 01:07:23,482 --> 01:07:25,918 THE LATE 20th CENTURY WITH THE 1253 01:07:25,918 --> 01:07:29,889 PUBLICATION OF THE 1985 REPORT 1254 01:07:29,889 --> 01:07:34,293 OF THE SECRETARY'S TASK FORCE ON 1255 01:07:34,293 --> 01:07:35,795 BLACK AND MINORITY HEALTH 1256 01:07:35,795 --> 01:07:37,029 RESULTING IN SEVERAL ACTIONS 1257 01:07:37,029 --> 01:07:40,733 TAKEN TO ADDRESS THIS ISSUE. 1258 01:07:40,733 --> 01:07:44,804 THEN IN 2003 THE INSTITUTE OF 1259 01:07:44,804 --> 01:07:47,773 MEDICINE'S UNEQUAL TREATMENT 1260 01:07:47,773 --> 01:07:53,446 CONFRONTING BIAS AND ETHNIC 1261 01:07:53,446 --> 01:07:54,814 DISPARITIES DOCUMENTED 1262 01:07:54,814 --> 01:07:57,883 INEQUITIES AND QUALITY OF HEALTH 1263 01:07:57,883 --> 01:08:08,394 CARE RECEIVED BY MINORITIZED 1264 01:08:11,997 --> 01:08:13,432 POPULATIONS AND MAKING 1265 01:08:13,432 --> 01:08:16,302 PHYSICIANS AWARE OF POTENTIAL 1266 01:08:16,302 --> 01:08:21,707 UNCONSCIOUS BIAS IN CLINICAL , 1267 01:08:21,707 --> 01:08:23,609 IMPROVING EDUCATION TO IMPROVE 1268 01:08:23,609 --> 01:08:27,913 CULTURAL COMPETENCY IN MEDICAL 1269 01:08:27,913 --> 01:08:33,252 AND STANDARDIZING COLLECTION OF 1270 01:08:33,252 --> 01:08:37,656 DATA AND THE THERE'S BEEN THE 1271 01:08:37,656 --> 01:08:40,292 QUALITY AND DISPARITIES REPORT 1272 01:08:40,292 --> 01:08:41,560 TO PRESENT TRENDS FOR MEASURES 1273 01:08:41,560 --> 01:08:44,497 RELATED TO ACCESS TO CARE, 1274 01:08:44,497 --> 01:08:46,298 AFFORDABLE CARE, COORDINATION OF 1275 01:08:46,298 --> 01:08:49,001 CARE AND EFFECTIVE TREATMENT, 1276 01:08:49,001 --> 01:08:51,170 HEALTHY LIVING, PATIENT SAFETY 1277 01:08:51,170 --> 01:08:54,139 AND PERSON-CENTERED CARE. 1278 01:08:54,139 --> 01:08:57,009 FOR THE PAST TWO DECADES WE'VE 1279 01:08:57,009 --> 01:09:00,779 SEEN THE PROLIFERATION OF 1280 01:09:00,779 --> 01:09:04,250 EXECUTIVE ORDERS, STRATEGIC 1281 01:09:04,250 --> 01:09:08,754 PLANS, POLICY STATEMENTS. 1282 01:09:08,754 --> 01:09:10,289 CHIEF AMONG THEM WAS THE PATIENT 1283 01:09:10,289 --> 01:09:12,291 AND AFFORDABILITY CARE ACT KNOWN 1284 01:09:12,291 --> 01:09:15,294 AS THE AFFORDABLE CARE ACT IN 1285 01:09:15,294 --> 01:09:17,463 2010. 1286 01:09:17,463 --> 01:09:20,666 THIS IS A MAJOR POLICY STRIFE 1287 01:09:20,666 --> 01:09:25,170 AND THE MOST COMPREHENSIVE 1288 01:09:25,170 --> 01:09:28,274 LEGISLATIVE MEASURE FOR REFORM 1289 01:09:28,274 --> 01:09:30,342 AND THERE'S INEQUITIES ACROSS 1290 01:09:30,342 --> 01:09:32,978 ALL STATES EVEN IN THE STATES 1291 01:09:32,978 --> 01:09:35,581 THAT HAVE BEEN FOUND TO HAVE 1292 01:09:35,581 --> 01:09:37,750 BETTER HEALTH SYSTEM PERFORMS 1293 01:09:37,750 --> 01:09:38,651 AND WHERE HEALTH OUTCOMES HAVE 1294 01:09:38,651 --> 01:09:40,286 IMPROVED OVER TIME. 1295 01:09:40,286 --> 01:09:41,921 RESEARCH CITED IN OUR REPORT 1296 01:09:41,921 --> 01:09:46,292 SHOWS INEQUITIES DUE TO MILLIONS 1297 01:09:46,292 --> 01:09:48,294 OF PREMATURE DEATH INVOLVING THE 1298 01:09:48,294 --> 01:09:50,629 LOSS OF PRODUCTIVE LIFE AND 1299 01:09:50,629 --> 01:09:53,065 ECONOMIC ACTIVITY AND COSTING 1300 01:09:53,065 --> 01:09:56,235 THE UNITED STATES HUNDREDS OF 1301 01:09:56,235 --> 01:09:56,769 BILLIONS ANNUALLY. 1302 01:09:56,769 --> 01:09:58,170 MORE LIKE CLOSE TO A TRILLION 1303 01:09:58,170 --> 01:10:05,277 DOLLARS ANNUALLY. 1304 01:10:05,277 --> 01:10:07,580 SO THE NATIONAL ACADEMIES OF 1305 01:10:07,580 --> 01:10:09,682 SCIENCES, ENGINEERING AND 1306 01:10:09,682 --> 01:10:11,250 MEDICINE CONVENED THIS EXPERT 1307 01:10:11,250 --> 01:10:17,056 COMMITTEE TO REVISIT THE 2003 1308 01:10:17,056 --> 01:10:21,694 REPORT AND THE COMMITTEE WAS 1309 01:10:21,694 --> 01:10:28,300 TASKED TO LOOK AT SUCCESSFUL AND 1310 01:10:28,300 --> 01:10:29,635 UNSUCCESSFUL INTERVENTIONS AND 1311 01:10:29,635 --> 01:10:31,604 IDENTIFY GAPS AND LOOK AT 1312 01:10:31,604 --> 01:10:35,574 STRATEGIES TOE CLOSE THESE GAPS. 1313 01:10:35,574 --> 01:10:37,977 CONSIDER WAYS TO SCALE AND 1314 01:10:37,977 --> 01:10:40,112 SPREAD EFFECTIVE INTERVENTIONS 1315 01:10:40,112 --> 01:10:42,514 TO REDUCE RACE AND ETHNIC 1316 01:10:42,514 --> 01:10:44,750 INEQUITIES IN HEALTH CARE AND 1317 01:10:44,750 --> 01:10:48,687 MAKE RECOMMENDATIONS TO ADVANCE 1318 01:10:48,687 --> 01:10:49,555 HEALTH EQUITY. 1319 01:10:49,555 --> 01:10:51,957 A LITTLE BIT ABOUT OUR STUDY 1320 01:10:51,957 --> 01:10:52,257 METHODOLOGY. 1321 01:10:52,257 --> 01:10:53,993 WE CONDUCTED REVIEW OF THE 1322 01:10:53,993 --> 01:10:58,297 LITERATURE RELEVANT TO THE 1323 01:10:58,297 --> 01:11:03,602 STATEMENT OF TASK. 1324 01:11:03,602 --> 01:11:05,771 TO SUPPLEMENT THAT REVIEW THE 1325 01:11:05,771 --> 01:11:07,873 COMMITTEE HAD THREE PAPERS 1326 01:11:07,873 --> 01:11:10,209 DOCUMENTING THE EVIDENCE ON 1327 01:11:10,209 --> 01:11:11,877 RACIAL AND ETHNIC INEQUITIES 1328 01:11:11,877 --> 01:11:13,779 MEASURED BY ACCESS, USE AND 1329 01:11:13,779 --> 01:11:15,280 QUALITY OF CARE. 1330 01:11:15,280 --> 01:11:16,515 THE EVOLUTION OF THE U.S. HEALTH 1331 01:11:16,515 --> 01:11:21,420 CARE AND CIVIL RIGHTS LAWS SINCE 1332 01:11:21,420 --> 01:11:26,125 2003 AND POLICY INITIATIVES THAT 1333 01:11:26,125 --> 01:11:29,428 HAVE BEEN EFFECTIVE IN PRODUCING 1334 01:11:29,428 --> 01:11:31,263 RACIAL INEQUITIES IN HEALTH 1335 01:11:31,263 --> 01:11:31,597 CARE. 1336 01:11:31,597 --> 01:11:36,301 THEY CONDUCTED PUBLIC WORKSHOPS 1337 01:11:36,301 --> 01:11:39,571 TO OBTAIN INSIGHT AND CURRENT 1338 01:11:39,571 --> 01:11:41,840 NEW APPROACHES TO ALLEVIATE 1339 01:11:41,840 --> 01:11:42,941 THEM. 1340 01:11:42,941 --> 01:11:47,980 THE PROCEEDINGS ARE SUMMARIZED 1341 01:11:47,980 --> 01:11:52,885 IN THE DISCUSSION PUBLISHED BY 1342 01:11:52,885 --> 01:12:03,328 THE PRESS IN JANUARY 2024. 1343 01:12:05,597 --> 01:12:09,101 SOME TERMS TO DIVE IN THE 1344 01:12:09,101 --> 01:12:09,368 FINDINGS. 1345 01:12:09,368 --> 01:12:11,603 TERMS CONSIDERED IN THIS REPORT 1346 01:12:11,603 --> 01:12:17,209 ARE HEALTH, HEALTH CARE, HEALTH 1347 01:12:17,209 --> 01:12:22,314 CARE SYSTEM INEQUITABLE 1348 01:12:22,314 --> 01:12:32,524 DISPARITIES. 1349 01:12:34,359 --> 01:12:37,463 THEY'RE LINKED BUT THERE'S A 1350 01:12:37,463 --> 01:12:43,302 STATE OF FIPHYSICAL AND MENTAL 1351 01:12:43,302 --> 01:12:44,703 WELL BEING AND HEALTH CARE 1352 01:12:44,703 --> 01:12:46,138 REFERS TO SERVICES TO 1353 01:12:46,138 --> 01:12:46,705 INDIVIDUALS, FAMILIES AND 1354 01:12:46,705 --> 01:12:49,575 COMMUNITIES FOR THE PURPOSES OF 1355 01:12:49,575 --> 01:12:51,410 PROMOTING, MAINTAINING AND 1356 01:12:51,410 --> 01:12:52,311 RESTORING HEALTH ACROSS SETTINGS 1357 01:12:52,311 --> 01:12:54,113 OF QUAR. 1358 01:12:54,113 --> 01:12:58,283 THE REPORT USES HEALTH WHEN 1359 01:12:58,283 --> 01:12:59,017 DISCUSSING OUTCOMES. 1360 01:12:59,017 --> 01:13:00,419 AND HEALTH CARE WHEN DISCUSSING 1361 01:13:00,419 --> 01:13:01,754 SERVICES PROVIDED TO 1362 01:13:01,754 --> 01:13:03,622 INDIVIDUALS, FAMILIES OR 1363 01:13:03,622 --> 01:13:04,823 COMMUNITIES. 1364 01:13:04,823 --> 01:13:08,660 THE REPORT USES THE TERM HEALTH 1365 01:13:08,660 --> 01:13:10,896 CARE SYSTEM, ACTIVITIES RELATED 1366 01:13:10,896 --> 01:13:12,664 TO THE DELIVERY OF CARE ACROSS 1367 01:13:12,664 --> 01:13:14,733 THE CONTINUUM OF CARE TO 1368 01:13:14,733 --> 01:13:17,102 DESCRIBE U.S. HEALTH CARE SYSTEM 1369 01:13:17,102 --> 01:13:19,805 AS A WHOLE AS WELL AS TO 1370 01:13:19,805 --> 01:13:20,372 DESCRIBE INDIVIDUAL HEALTH 1371 01:13:20,372 --> 01:13:25,844 CARES. 1372 01:13:25,844 --> 01:13:30,716 PE 1373 01:13:30,716 --> 01:13:31,583 PE 1374 01:13:31,583 --> 01:13:33,619 THE REDUCTION REQUIRES 1375 01:13:33,619 --> 01:13:35,587 IMPROVEMENT TO HEALTH CARE AND 1376 01:13:35,587 --> 01:13:38,957 OTHER FACTORS THAT INFLUENCE 1377 01:13:38,957 --> 01:13:40,292 HEALTH. 1378 01:13:40,292 --> 01:13:46,298 AND TO THAT WE PRESENT THE 1379 01:13:46,298 --> 01:13:46,899 CONCEPTUAL FRAMEWORK. 1380 01:13:46,899 --> 01:13:49,101 AND SYSTEM IN CLINICAL CARE 1381 01:13:49,101 --> 01:13:52,171 ALONE ARE INEFFICIENT TO ADVANCE 1382 01:13:52,171 --> 01:13:56,975 RACIAL AND ETHNIC HEALTH EQUITY. 1383 01:13:56,975 --> 01:13:57,810 DISPARITIES VERSUS INEQUITY. 1384 01:13:57,810 --> 01:14:06,084 HEALTH DISPARITIES AS DEFINED IN 1385 01:14:06,084 --> 01:14:07,786 THE 2003 UNEQUAL TREATMENT 1386 01:14:07,786 --> 01:14:10,289 REPORT IN THE QUALITY OF HEALTH 1387 01:14:10,289 --> 01:14:14,326 CARE NOT DUE TO ACCESS RELATED 1388 01:14:14,326 --> 01:14:16,762 FACTORS OR CLINICAL NEEDS OR 1389 01:14:16,762 --> 01:14:17,196 PREFERENCES OR THE 1390 01:14:17,196 --> 01:14:21,066 APPROPRIATENESS OF INTERVENTIONS 1391 01:14:21,066 --> 01:14:26,205 MOREOVER, THE COMMITTEE FOCUSES 1392 01:14:26,205 --> 01:14:28,473 ON TWO AREAS AS DRIVERS OF 1393 01:14:28,473 --> 01:14:34,346 HEALTH CARE SYSTEMS AND THE 1394 01:14:34,346 --> 01:14:36,882 REGULATORY CLIMATE AND 1395 01:14:36,882 --> 01:14:38,250 DISCRIMINATION AT THE PROVIDER 1396 01:14:38,250 --> 01:14:38,617 LEVEL. 1397 01:14:38,617 --> 01:14:41,253 IN THE YEARS SINCE THE REPORT 1398 01:14:41,253 --> 01:14:43,088 RESEARCH HAS PROVIDED BETTER 1399 01:14:43,088 --> 01:14:44,623 UNDERSTANDING HOW THE DRIVERS 1400 01:14:44,623 --> 01:14:48,560 AND IDENTIFIED OTHER FACTORS 1401 01:14:48,560 --> 01:14:54,032 THAT CONTRIBUTE TO INEQUITABLE 1402 01:14:54,032 --> 01:14:54,399 OUTCOMES. 1403 01:14:54,399 --> 01:14:55,968 HEALTH CARE INEQUITIES REFER TO 1404 01:14:55,968 --> 01:14:57,903 THE STATE OF BEING WHERE SOMEONE 1405 01:14:57,903 --> 01:15:00,138 IS DENIED THE POSSIBILITY OF 1406 01:15:00,138 --> 01:15:06,712 BEING HEALTHY BELONGING TO A 1407 01:15:06,712 --> 01:15:10,082 GROUP THAT'S BEEN HISTORICALLY 1408 01:15:10,082 --> 01:15:10,716 DISADVANTAGED. 1409 01:15:10,716 --> 01:15:13,919 IT'S AN AVOIDABLE AND 1410 01:15:13,919 --> 01:15:14,553 UNNECESSARY AND UNJUST HEALTH 1411 01:15:14,553 --> 01:15:16,321 DIFFERENCE. 1412 01:15:16,321 --> 01:15:17,789 HEALTH DISPARITIES INTEREST THE 1413 01:15:17,789 --> 01:15:19,524 METRICS FOR MEASURING PROGRESS 1414 01:15:19,524 --> 01:15:21,727 TOWARDS HEALTH EQUITY AND 1415 01:15:21,727 --> 01:15:24,496 REDUCING THEM IS A STEP TOWARDS 1416 01:15:24,496 --> 01:15:26,965 GREATER HEALTH EQUITY BUT 1417 01:15:26,965 --> 01:15:28,667 ACHIEVING HEALTH EQUITY REQUIRES 1418 01:15:28,667 --> 01:15:33,906 VALUING EVERYONE EQUALLY WITH 1419 01:15:33,906 --> 01:15:35,574 FOCUS AND ONGOING SOCIAL EFFORTS 1420 01:15:35,574 --> 01:15:40,045 TO ADDRESS AVOIDABLE ANYONE 1421 01:15:40,045 --> 01:15:41,613 EQUALITIES AND HISTORICAL ANDIN 1422 01:15:41,613 --> 01:15:43,882 JUSTICES AND TO ELIMINATE HEALTH 1423 01:15:43,882 --> 01:15:46,251 AND HEALTH DISPARITIES DUE TO 1424 01:15:46,251 --> 01:15:51,657 PAST AND PRESENT QUALITIES. 1425 01:15:51,657 --> 01:15:59,998 THIS REPORT USES INEQUITY AND 1426 01:15:59,998 --> 01:16:07,572 PUBLICATIONS THAT USE IT FOR 1427 01:16:07,572 --> 01:16:09,942 DISPARITIES. 1428 01:16:09,942 --> 01:16:17,649 NOW, ONE LAST BIT ABOUT 1429 01:16:17,649 --> 01:16:20,786 DISPARITY INEQUITABLE AND 1430 01:16:20,786 --> 01:16:25,557 UNEQUAL SOUND INTERCHANGEABLE 1431 01:16:25,557 --> 01:16:28,160 BUT INEQUITY CAPTURES DIFFERENT 1432 01:16:28,160 --> 01:16:28,894 INDIVIDUALS NEED DIFFERENT 1433 01:16:28,894 --> 01:16:30,462 SUPPORTS OR TREATMENTS TO 1434 01:16:30,462 --> 01:16:32,531 ACHIEVE SIMILAR OUTCOMES. 1435 01:16:32,531 --> 01:16:34,700 I'LL SAY IT AGAIN. 1436 01:16:34,700 --> 01:16:39,571 EQUITY CAPTURES THE FACT THAT 1437 01:16:39,571 --> 01:16:41,807 DIFFERENT INDIVIDUALS NEED 1438 01:16:41,807 --> 01:16:42,541 DIFFERENT SUPPORTS AND 1439 01:16:42,541 --> 01:16:43,942 TREATMENTS TO ACHIEVE SIMILAR 1440 01:16:43,942 --> 01:16:48,647 OUTCOMES. 1441 01:16:48,647 --> 01:16:51,483 WHEREAS EQUALITY CENTRAL TO 1442 01:16:51,483 --> 01:16:53,118 FOUNDATIONAL PURPOSE OF CIVIL 1443 01:16:53,118 --> 01:16:58,190 RIGHTS LAW AND POLICY COULD LEAD 1444 01:16:58,190 --> 01:17:00,158 PEOPLE TO MISTAKENLY BELIEVE 1445 01:17:00,158 --> 01:17:02,694 EQUAL OPPORTUNITY OR OPTIMAL 1446 01:17:02,694 --> 01:17:05,530 HEALTH IS ACHIEVED ONLY WHEN 1447 01:17:05,530 --> 01:17:06,365 EVERYONE RECEIVES IDENTICAL 1448 01:17:06,365 --> 01:17:11,837 SUPPORT AND TREATMENT. 1449 01:17:11,837 --> 01:17:15,907 THE USE OF UNEQUAL TREATMENT IN 1450 01:17:15,907 --> 01:17:18,477 THE 2003 REPORT IMPLIES HEALTH 1451 01:17:18,477 --> 01:17:20,579 CARE INEQUITIES COULD BE 1452 01:17:20,579 --> 01:17:23,048 ELIMINATED BY PROVIDING THE SAME 1453 01:17:23,048 --> 01:17:24,783 TREATMENT TO ALL REGARDLESS OF 1454 01:17:24,783 --> 01:17:26,018 RACE AND ETHNICITY. 1455 01:17:26,018 --> 01:17:28,120 HOWEVER, WITH THE AVAILABILITY 1456 01:17:28,120 --> 01:17:30,822 OF E.H.R. SYSTEMS AND THE 1457 01:17:30,822 --> 01:17:32,557 ABILITY TO OBSERVE POPULATION 1458 01:17:32,557 --> 01:17:35,694 DATA IT IS CLEAR THAT EQUAL 1459 01:17:35,694 --> 01:17:39,097 TREATMENT IS NOT NECESSARILY 1460 01:17:39,097 --> 01:17:39,364 EQUITABLE. 1461 01:17:39,364 --> 01:17:40,332 FOR EXAMPLE, DIFFERENT 1462 01:17:40,332 --> 01:17:41,933 INDIVIDUALS CAN HAVE THE SAME 1463 01:17:41,933 --> 01:17:45,704 CONDITIONS SUCH AS HYPERTENSION 1464 01:17:45,704 --> 01:17:49,508 AND DIABETES AND HAVE DIFFERENT 1465 01:17:49,508 --> 01:17:51,510 PROGNOSIS, RESPOND TO TREATMENT, 1466 01:17:51,510 --> 01:17:53,979 DIFFERENT RESPONSES TO TREATMENT 1467 01:17:53,979 --> 01:17:56,214 AND LARGER RESULTING FROM 1468 01:17:56,214 --> 01:17:57,582 GENOTYPIC OR PHENOTYPIC 1469 01:17:57,582 --> 01:17:59,518 VARIATIONS OR SOCIAL AND 1470 01:17:59,518 --> 01:18:01,153 ENVIRONMENTAL DIFFERENCES. 1471 01:18:01,153 --> 01:18:03,188 SO APPLYING THE SAME TREATMENT 1472 01:18:03,188 --> 01:18:07,626 TO ALL PATIENTS WITH THE SAME 1473 01:18:07,626 --> 01:18:09,261 CONDITION OVERLOOKS THOSE 1474 01:18:09,261 --> 01:18:09,728 CRUCIAL FACTORS. 1475 01:18:09,728 --> 01:18:12,864 AND UNDER SCORING THE NEED FOR 1476 01:18:12,864 --> 01:18:14,866 PERSONALIZED TREATMENT THAT MAY 1477 01:18:14,866 --> 01:18:15,467 NOT BE THE SAME TREATMENT FOR 1478 01:18:15,467 --> 01:18:17,836 EVERYONE. 1479 01:18:17,836 --> 01:18:20,305 SO TO ADDRESS THIS OUR COMMITTEE 1480 01:18:20,305 --> 01:18:24,009 FOCUSSED ON EQUITABLE PROCESSES 1481 01:18:24,009 --> 01:18:25,477 TO MAKE TREATMENT DECISIONS. 1482 01:18:25,477 --> 01:18:28,146 THIS ENTAILS A FULL 1483 01:18:28,146 --> 01:18:29,648 UNDERSTANDING OF THE 1484 01:18:29,648 --> 01:18:31,416 DETERMINATES OF HEALTH. 1485 01:18:31,416 --> 01:18:33,385 MANY OF WHICH ARE SOCIAL 1486 01:18:33,385 --> 01:18:37,789 DETERMINATES MAKING TREATMENT 1487 01:18:37,789 --> 01:18:39,558 RECOMMENDATIONS THAT DO NOTING 1488 01:18:39,558 --> 01:18:40,325 DISADVANTAGE AN INDIVIDUAL BASED 1489 01:18:40,325 --> 01:18:42,861 ON THEIR RACE OR ETHNICITY OR 1490 01:18:42,861 --> 01:18:45,897 SOCIAL ISSUE. 1491 01:18:45,897 --> 01:18:47,632 I SAID JUST ONE BUT I HAVE ONE 1492 01:18:47,632 --> 01:18:50,535 MORE. 1493 01:18:50,535 --> 01:18:53,071 RACIALLY AND ETHNICALLY 1494 01:18:53,071 --> 01:18:58,276 MINORITIZED POPULATIONS. 1495 01:18:58,276 --> 01:19:01,813 SO, IN MARCH OF 2024, THE OFFICE 1496 01:19:01,813 --> 01:19:04,082 OF MANAGEMENT AND BUDGET 1497 01:19:04,082 --> 01:19:06,218 RELEASED REVISED STANDARDS FOR 1498 01:19:06,218 --> 01:19:08,220 COLLECTING RACE, ETHNICITY AND 1499 01:19:08,220 --> 01:19:11,289 UPDATED THOSE IN USE BY THE 1500 01:19:11,289 --> 01:19:14,025 FEDERAL GOVERNMENT SINCE 1997. 1501 01:19:14,025 --> 01:19:16,962 CHANGES IN THE REVISED STANDARDS 1502 01:19:16,962 --> 01:19:18,530 INCLUDE COMBINING RACE AND 1503 01:19:18,530 --> 01:19:21,199 ETHNICITY IN ONE QUESTION ADDING 1504 01:19:21,199 --> 01:19:24,336 THE CATEGORY OF MIDDLE EASTERN 1505 01:19:24,336 --> 01:19:26,138 AND NORTH AFRICAN WHICH WAS 1506 01:19:26,138 --> 01:19:26,638 PREVIOUSLY IN THE WHITE 1507 01:19:26,638 --> 01:19:31,309 CATEGORY. 1508 01:19:31,309 --> 01:19:33,678 RACIALLY AND ETHNICALLY 1509 01:19:33,678 --> 01:19:35,313 MINORITIZED USES THE REPORT IN 1510 01:19:35,313 --> 01:19:39,184 RACIAL AND ETHNIC MINORITIES ARE 1511 01:19:39,184 --> 01:19:40,452 MEMBERS OF MINORITY GROUPS OR 1512 01:19:40,452 --> 01:19:42,888 UNDER REPRESENTED MINORITIES TO 1513 01:19:42,888 --> 01:19:46,992 USE THE TERM MINORITIZED TO 1514 01:19:46,992 --> 01:19:51,263 REFER TO PEOPLE FROM GROUPS 1515 01:19:51,263 --> 01:19:54,599 HISTORICALLY AND SYSTEMICALLY 1516 01:19:54,599 --> 01:19:55,734 MARGINALIZED OR UNDER SERVED 1517 01:19:55,734 --> 01:19:58,870 BASED ON THEIR RACE OR ETHNICITY 1518 01:19:58,870 --> 01:19:59,604 AS A RESULT OF RACISM. 1519 01:19:59,604 --> 01:20:01,406 MINORITIZED IS NOT ABOUT THE 1520 01:20:01,406 --> 01:20:03,608 NUMBER OF PEOPLE IN THE 1521 01:20:03,608 --> 01:20:03,909 POPULATION. 1522 01:20:03,909 --> 01:20:04,543 IT'S ABOUT POWER AND IT'S ABOUT 1523 01:20:04,543 --> 01:20:09,314 EQUITY. 1524 01:20:09,314 --> 01:20:12,918 SO, WE HAVE A CONCEPTUAL 1525 01:20:12,918 --> 01:20:14,719 FRAMEWORK. 1526 01:20:14,719 --> 01:20:17,022 THE CONCEPTUAL FRAMEWORK IS A 1527 01:20:17,022 --> 01:20:18,223 HOLISTIC APPROACH TO CONSIDER 1528 01:20:18,223 --> 01:20:20,058 THE HEALTH SYSTEM IN THE CONTEXT 1529 01:20:20,058 --> 01:20:22,727 OF COMMUNITY IN WHICH IT EXISTS. 1530 01:20:22,727 --> 01:20:24,196 THIS MEANS WE BELIEVE YOU HAVE 1531 01:20:24,196 --> 01:20:27,199 TO ADDRESS THE SOCIAL, POLITICAL 1532 01:20:27,199 --> 01:20:28,733 AND FINANCIAL DETERMINATES THAT 1533 01:20:28,733 --> 01:20:30,435 INFLUENCE HEALTH AND 1534 01:20:30,435 --> 01:20:33,205 UNDERSTANDING THIS REALITY THE 1535 01:20:33,205 --> 01:20:35,407 COMMITTEE DEVELOPED A CONCEPTUAL 1536 01:20:35,407 --> 01:20:37,142 FRAMEWORK THAT FORMS THE REPORT 1537 01:20:37,142 --> 01:20:42,747 ORGANIZATION AND RECOMMENDED 1538 01:20:42,747 --> 01:20:43,582 ACTION. 1539 01:20:43,582 --> 01:20:45,050 THE CONCEPTUAL FRAMEWORK 1540 01:20:45,050 --> 01:20:47,519 INCLUDES FACTORS OR FORCES THAT 1541 01:20:47,519 --> 01:20:48,486 IMPACT HEALTH AND THE HEALTH 1542 01:20:48,486 --> 01:20:51,590 CARE SYSTEM AND FOUR 1543 01:20:51,590 --> 01:20:52,857 INTERSECTING MECHANISMS WITHIN 1544 01:20:52,857 --> 01:20:58,830 THE HEALTH CARE SYSTEM THAT CAN 1545 01:20:58,830 --> 01:21:01,032 REINFORCE OR MITIGATE 1546 01:21:01,032 --> 01:21:06,538 INEQUITIES. 1547 01:21:06,538 --> 01:21:17,048 SO OPPRESSION AND STRUCTURAL 1548 01:21:21,152 --> 01:21:22,354 RACISM WHICH IS HISTORICALLY 1549 01:21:22,354 --> 01:21:26,224 CONTINUED POLICIES SUCH AS 1550 01:21:26,224 --> 01:21:27,058 RESIDENTIAL SEGREGATION, 1551 01:21:27,058 --> 01:21:30,629 SYSTEMIC OPPRESSION, BIAS OF ANY 1552 01:21:30,629 --> 01:21:30,829 FORM. 1553 01:21:30,829 --> 01:21:33,832 THESE THINGS WHICH ADVERSELY 1554 01:21:33,832 --> 01:21:37,969 AFFECT PHYSICAL, SOCIAL, 1555 01:21:37,969 --> 01:21:39,571 BEHAVIORAL AND ECONOMIC NEEDS OF 1556 01:21:39,571 --> 01:21:49,781 COMMUNITIES. 1557 01:21:50,115 --> 01:21:51,082 SOCIAL DETERMINATES OF HEALTH. 1558 01:21:51,082 --> 01:21:52,350 THE CONDITIONS IN WHICH PEOPLE 1559 01:21:52,350 --> 01:21:55,587 LIVE, WORK, PLAY, WORSHIP AND 1560 01:21:55,587 --> 01:22:05,196 AGE. 1561 01:22:05,196 --> 01:22:06,965 THERE'S SOCIAL SERVICE AGENCIES 1562 01:22:06,965 --> 01:22:09,834 WHICH HAVE PRIORITY AND PROGRAMS 1563 01:22:09,834 --> 01:22:11,236 THAT IMPACT HEALTH CARE SYSTEMS 1564 01:22:11,236 --> 01:22:19,577 EVEN NEGATIVELY OR EXACERBATE 1565 01:22:19,577 --> 01:22:23,581 AND WIDEN INEQUITABLE GAPS. 1566 01:22:23,581 --> 01:22:25,684 THE FIFTH FACTOR WHICH ARE 1567 01:22:25,684 --> 01:22:26,885 IMPORTANT IS SOCIETY'S 1568 01:22:26,885 --> 01:22:37,329 COMMITMENT TO THIS EFFORT. 1569 01:22:39,197 --> 01:22:40,965 SOMETIMES SOCIETY IS 1570 01:22:40,965 --> 01:22:42,834 ENTHUSIASTIC AND SOMETIMES IT 1571 01:22:42,834 --> 01:22:43,668 PULLS BACK FROM TRYING TO 1572 01:22:43,668 --> 01:22:51,409 ADDRESS THIS EFFORT. 1573 01:22:51,409 --> 01:22:54,479 RACIAL AND ETHNIC INEQUITIES ARE 1574 01:22:54,479 --> 01:22:57,082 DRIVEN BY A COMPLEX AND 1575 01:22:57,082 --> 01:22:59,451 INTERACTION BETWEEN HEALTH CARE 1576 01:22:59,451 --> 01:23:01,286 AND KEY SOCIETAL SOCIAL FORCES 1577 01:23:01,286 --> 01:23:03,588 THAT SERVE AS ENABLERS OR 1578 01:23:03,588 --> 01:23:05,623 BARRIERS TO ACHIEVING EQUITABLE 1579 01:23:05,623 --> 01:23:09,327 HEALTH CARE AND OPTIMAL HEALTH. 1580 01:23:09,327 --> 01:23:12,330 SO, I WANT TO SPEND TIME TALKING 1581 01:23:12,330 --> 01:23:16,000 ABOUT THE HEALTH CARE SYSTEM 1582 01:23:16,000 --> 01:23:18,036 ITSELF AND WHAT MAKES AN 1583 01:23:18,036 --> 01:23:19,537 EQUITABLE HEALTH CARE SYSTEM. 1584 01:23:19,537 --> 01:23:22,374 THE COMMITTEE IDENTIFIED FOUR 1585 01:23:22,374 --> 01:23:24,642 KEY INTERSECTING DOMAINS. 1586 01:23:24,642 --> 01:23:26,811 THESE ARE CRITICAL MECHANISMS BY 1587 01:23:26,811 --> 01:23:29,247 WHICH THE SYSTEM CAN REINFORCE 1588 01:23:29,247 --> 01:23:30,615 OR MITIGATE INEQUITIES. 1589 01:23:30,615 --> 01:23:32,417 THE FIRST ARE THESE HEALTH CARE 1590 01:23:32,417 --> 01:23:39,190 LAWS AND PAYMENT POLICIES. 1591 01:23:39,190 --> 01:23:40,358 THESE POLICIES SUPPORT EQUITABLE 1592 01:23:40,358 --> 01:23:42,627 HEALTH CARE ACCESS, QUALITY AND 1593 01:23:42,627 --> 01:23:44,295 AFFORDABILITY SERVE AS A 1594 01:23:44,295 --> 01:23:46,297 FOUNDATION FOR REMOVING 1595 01:23:46,297 --> 01:23:49,300 PERSISTENT BARRIERS AND ENSURE 1596 01:23:49,300 --> 01:23:50,602 INDIVIDUALS RECEIVING EQUITABLE 1597 01:23:50,602 --> 01:23:52,370 HEALTH CARE SERVICES. 1598 01:23:52,370 --> 01:23:55,607 THE HEALTH CARE DELIVERY SYSTEM. 1599 01:23:55,607 --> 01:23:57,275 THIS DOMAIN IS DELIVERING HIGH 1600 01:23:57,275 --> 01:24:00,578 QUALITY CULTURALLY SENSITIVE 1601 01:24:00,578 --> 01:24:03,381 CARE TO ALL AND MAXIMIZING A 1602 01:24:03,381 --> 01:24:05,016 HEALTH CARE'S POTENTIAL TO 1603 01:24:05,016 --> 01:24:07,619 ELIMINATE RACIAL AND ETHNIC 1604 01:24:07,619 --> 01:24:09,254 INEQUITIES IN HEALTH CARE. 1605 01:24:09,254 --> 01:24:11,589 THIS DOMAIN INCLUDES HEALTH CARE 1606 01:24:11,589 --> 01:24:13,725 DELIVERY MODELS, HEALTH CARE 1607 01:24:13,725 --> 01:24:15,593 WORKFORCE, CLINICAL DECISION 1608 01:24:15,593 --> 01:24:17,395 MAKING, IMPLICIT BIAS, 1609 01:24:17,395 --> 01:24:19,864 INTEGRATING HEALTH AND SOCIAL 1610 01:24:19,864 --> 01:24:21,900 CARE, INDIVIDUAL CARE SEEKING 1611 01:24:21,900 --> 01:24:24,836 BEHAVIOR, MEDICAL MISTRUST, 1612 01:24:24,836 --> 01:24:26,037 HEALTH LITERACY AND HEALTH 1613 01:24:26,037 --> 01:24:27,572 INFORMATION TECHNOLOGY. 1614 01:24:27,572 --> 01:24:32,210 THE THIRD DOMAIN IS DISCOVERING 1615 01:24:32,210 --> 01:24:34,712 EVIDENCE GENERATION WHICH NIH IS 1616 01:24:34,712 --> 01:24:37,549 A MAJOR PARTICIPANT IN. 1617 01:24:37,549 --> 01:24:39,584 DATA AND RESEARCH THAT'S 1618 01:24:39,584 --> 01:24:41,586 CRITICAL RESOURCE NEEDED TO 1619 01:24:41,586 --> 01:24:43,054 IMPLEMENT AND EVALUATE FOUR 1620 01:24:43,054 --> 01:24:45,356 STRATEGIES THAT ELIMINATE RACIAL 1621 01:24:45,356 --> 01:24:48,159 AND ETHNIC HEALTH CARE AND 1622 01:24:48,159 --> 01:24:50,128 INEQUITIES AND ADVANCE HEALTH 1623 01:24:50,128 --> 01:24:50,361 EQUITY. 1624 01:24:50,361 --> 01:24:54,199 FACTORS IN THIS DOMAIN INCLUDES 1625 01:24:54,199 --> 01:24:55,700 ADVANCING HEALTH EQUITY 1626 01:24:55,700 --> 01:24:58,870 RESEARCH, HISTORICAL AND CURRENT 1627 01:24:58,870 --> 01:25:01,973 HEALTH EQUITY RESEARCH FUNDING, 1628 01:25:01,973 --> 01:25:06,644 RESEARCH WORKFORCE, HEALTH CARE 1629 01:25:06,644 --> 01:25:08,613 EQUITY RESEARCH DATA AND 1630 01:25:08,613 --> 01:25:09,481 RESEARCH INFRASTRUCTURE AND 1631 01:25:09,481 --> 01:25:11,749 MOVING HEALTH EQUITY RESEARCH 1632 01:25:11,749 --> 01:25:12,917 FROM OBSERVATIONAL TO 1633 01:25:12,917 --> 01:25:16,154 INTERVENTION RESEARCH. 1634 01:25:16,154 --> 01:25:20,024 AND THEN THE LAST DOMAIN IS 1635 01:25:20,024 --> 01:25:20,391 ACCOUNTABILITY. 1636 01:25:20,391 --> 01:25:23,595 THESE ARE THE GOALS TO ACHIEVE 1637 01:25:23,595 --> 01:25:25,163 INEQUITABLE HEALTH CARE SYSTEM 1638 01:25:25,163 --> 01:25:26,564 NEED TO BE ACHIEVED IN THE 1639 01:25:26,564 --> 01:25:27,966 SYSTEM TO REMAIN RESPONSIVE TO 1640 01:25:27,966 --> 01:25:30,468 THE THESE OF COMMUNITY. 1641 01:25:30,468 --> 01:25:33,004 THIS MEANS LEGISLATIVE OVERSIGHT 1642 01:25:33,004 --> 01:25:35,573 TO ENSURE LAWS HAVE THEIR 1643 01:25:35,573 --> 01:25:36,875 INTENDED IMPACT AND IDENTIFY 1644 01:25:36,875 --> 01:25:37,942 ACTIONS NECESSARY TO IMPROVE 1645 01:25:37,942 --> 01:25:42,447 PERFORMANCE. 1646 01:25:42,447 --> 01:25:44,816 IT ALSO MEANS DEVELOPING 1647 01:25:44,816 --> 01:25:47,085 SYSTEMATIC STANDARDS THAT SHOULD 1648 01:25:47,085 --> 01:25:49,287 EXIST TO ENABLE PERIODIC 1649 01:25:49,287 --> 01:25:51,389 COMPREHENSIVE REVIEWS AND 1650 01:25:51,389 --> 01:25:52,190 INTERVENTIONS AND THEIR 1651 01:25:52,190 --> 01:25:52,557 IMPLEMENTATION. 1652 01:25:52,557 --> 01:25:56,928 ALL FOUR OF THESE DOMAINS 1653 01:25:56,928 --> 01:25:59,998 INTERSECT AND WITHIN LOCAL 1654 01:25:59,998 --> 01:26:01,399 COMMUNITIES WHERE HEALTH CARE 1655 01:26:01,399 --> 01:26:02,600 SYSTEMS OPERATE AND I THINK ONE 1656 01:26:02,600 --> 01:26:06,304 OF THE THINGS THAT WE HAVE TO 1657 01:26:06,304 --> 01:26:10,375 AND WILL KEEP AT THE FOREFRONT 1658 01:26:10,375 --> 01:26:12,510 IS THAT ULTIMATELY THE SYSTEMS 1659 01:26:12,510 --> 01:26:14,979 ARE THERE TO SUPPORT AND BENEFIT 1660 01:26:14,979 --> 01:26:16,347 COMMUNITIES AND INDIVIDUALS. 1661 01:26:16,347 --> 01:26:19,584 AND SO THEY'RE NOT JUST SYSTEMS 1662 01:26:19,584 --> 01:26:29,861 UNTO THEMSELVES. 1663 01:26:47,645 --> 01:26:52,750 AND OPTIMAL HEALTH OUTCOME 1664 01:26:52,750 --> 01:26:54,619 REGARDLESS OF NECESSITY OR OTHER 1665 01:26:54,619 --> 01:26:56,921 FACTORS INFLUENCING THEIR 1666 01:26:56,921 --> 01:26:58,523 ABILITY TO RECEIVE EQUITABLE 1667 01:26:58,523 --> 01:26:59,591 HEALTH CARE AND ACHIEVE OPTIMAL 1668 01:26:59,591 --> 01:27:09,734 HEALTH. 1669 01:27:16,207 --> 01:27:18,209 OPTIMAL HEALTH FOR ALL. 1670 01:27:18,209 --> 01:27:22,780 THE FIRST REPORT WAS UNEQUAL AND 1671 01:27:22,780 --> 01:27:25,750 THIS IS STRATEGIES TO ACHIEVE 1672 01:27:25,750 --> 01:27:27,585 EQUITABLE HEALTH CARE AND 1673 01:27:27,585 --> 01:27:33,124 OPTIMAL HEALTH FOR ALL. 1674 01:27:33,124 --> 01:27:35,259 RACIAL AND ETHNIC INEQUITIES 1675 01:27:35,259 --> 01:27:39,564 REMAIN A FUNDAMENTAL FLAW OF OUR 1676 01:27:39,564 --> 01:27:44,168 HEALTH CARE SYSTEM WHICH BY ITS 1677 01:27:44,168 --> 01:27:45,036 DESIGN DELIVERS DIFFER OUTCOMES 1678 01:27:45,036 --> 01:27:46,371 FOR DIFFERENT POPULATIONS AND 1679 01:27:46,371 --> 01:27:49,173 THE MOVEMENT HAS BEEN SLOW, 1680 01:27:49,173 --> 01:27:51,242 UNEVEN AND INCONSISTENT. 1681 01:27:51,242 --> 01:27:52,377 THE POOR PERFORMANCE OF THE 1682 01:27:52,377 --> 01:27:58,383 SYSTEM AFFECTS EVERYBODY BUT 1683 01:27:58,383 --> 01:27:59,384 DISPROPORTIONATELY AFFECTS 1684 01:27:59,384 --> 01:28:01,886 ETHNIC POPULATIONS. 1685 01:28:01,886 --> 01:28:02,587 ELIMINATE BEING HEALTH CARE 1686 01:28:02,587 --> 01:28:06,991 INEQUITIES IS ACHIEVABLE GOAL 1687 01:28:06,991 --> 01:28:10,662 AND IMPROVING THE HEALTH OF 1688 01:28:10,662 --> 01:28:12,530 COMMUNITIES IMPROVES THE QUALITY 1689 01:28:12,530 --> 01:28:14,232 OF CARE FOR EVERYONE. 1690 01:28:14,232 --> 01:28:17,702 THIS ISN'T A ZERO SUM GAME. 1691 01:28:17,702 --> 01:28:19,303 TOO OFTEN PEOPLE WHO OPPOSE 1692 01:28:19,303 --> 01:28:21,472 HEALTH CARE EQUITY THINK OF IT 1693 01:28:21,472 --> 01:28:23,074 AS A ZERO SUM GAME. 1694 01:28:23,074 --> 01:28:30,882 SOMEHOW -- TAKING SOMETHING AWAY 1695 01:28:30,882 --> 01:28:36,821 FROM SOMEONE ELSE. 1696 01:28:36,821 --> 01:28:47,365 REINFORCING THE NOTION THIS IS 1697 01:29:04,449 --> 01:29:14,926 TO ACHIEVE THE OPTIMAL CARE FOR 1698 01:29:15,660 --> 01:29:25,670 ALL. 1699 01:29:26,637 --> 01:29:31,609 THIS HIGHLIGHTS THE FIVE GOALS 1700 01:29:31,609 --> 01:29:41,619 THE REPORT RECOMMENDS. 1701 01:29:41,619 --> 01:29:43,187 BEFORE I LAUNCH INTO THEM. 1702 01:29:43,187 --> 01:29:45,423 OVER THE FIVE YEARS WE HAVE DONE 1703 01:29:45,423 --> 01:29:47,592 A LOT OF RESEARCH AND DEVELOPED 1704 01:29:47,592 --> 01:29:50,328 A LOT OF SOLUTIONS. 1705 01:29:50,328 --> 01:29:51,929 WE UNDERSTAND HOW THIS PROBLEM 1706 01:29:51,929 --> 01:29:55,366 IN MANY WAYS WORKS AND WHAT CAN 1707 01:29:55,366 --> 01:29:59,604 HAPPEN, HOW WE CAN IMPROVE THE 1708 01:29:59,604 --> 01:30:03,608 HEALTH OF MINORITIZED 1709 01:30:03,608 --> 01:30:05,610 POPULATIONS. 1710 01:30:05,610 --> 01:30:08,780 THE CHALLENGE ISN'T THAT WE 1711 01:30:08,780 --> 01:30:11,349 DON'T KNOW IT ALL. 1712 01:30:11,349 --> 01:30:15,720 WE CAN'T IMPLEMENT WHAT WE KNOW 1713 01:30:15,720 --> 01:30:18,790 BECAUSE OUR SYSTEM DOES NOT 1714 01:30:18,790 --> 01:30:22,493 SUPPORT THE IMPLEMENTATION OF 1715 01:30:22,493 --> 01:30:32,904 THE THINGS WE KNOW WORK. 1716 01:30:34,872 --> 01:30:38,109 THE THINGS WE THINK WE KNOW ARE 1717 01:30:38,109 --> 01:30:43,247 THINGS THAT SCIENTISTS DEVELOP 1718 01:30:43,247 --> 01:30:52,456 AND KNOWLEDGE THAT THEY GENERATE 1719 01:30:52,456 --> 01:30:54,759 AND HELP MAKE A MORE EQUITABLE 1720 01:30:54,759 --> 01:30:57,562 HEALTH CARE SYSTEM. 1721 01:30:57,562 --> 01:30:59,564 IT'S NOT THAT WE DON'T KNOW 1722 01:30:59,564 --> 01:31:02,633 ANYTHING OR THE LAST 20 YEARS 1723 01:31:02,633 --> 01:31:05,903 HASN'T HELPED BUT WE HAVE A BIG 1724 01:31:05,903 --> 01:31:07,605 ROAD BLOCK AND THAT'S THE HEALTH 1725 01:31:07,605 --> 01:31:09,740 CARE SYSTEM AND THE WAY IT'S 1726 01:31:09,740 --> 01:31:10,408 ORGANIZED. 1727 01:31:10,408 --> 01:31:14,045 SO WE HAVE THESE FIVE 1728 01:31:14,045 --> 01:31:19,116 RECOMMENDATIONS, GENERATE BEING 1729 01:31:19,116 --> 01:31:29,660 DATA ON INEQUITIES, EVIDENCE TO 1730 01:31:31,662 --> 01:31:34,398 GENERATE INTERVENTIONS, ENSURE 1731 01:31:34,398 --> 01:31:39,604 ADEQUATE RESOURCES TO ENFORCE 1732 01:31:39,604 --> 01:31:42,740 LAWS AND BUILD SYSTEMS OF 1733 01:31:42,740 --> 01:31:46,377 RESPONSIBILITY AND ACCESS AND 1734 01:31:46,377 --> 01:31:46,811 QUALITY. 1735 01:31:46,811 --> 01:31:57,355 SO LET ME GO TO THE FIRST GOAL 1736 01:31:58,122 --> 01:32:06,631 THE FIRST IS ACCURATE AND TIMELY 1737 01:32:06,631 --> 01:32:07,598 DATA. 1738 01:32:07,598 --> 01:32:11,602 YOU CAN'T MEASURE IT, YOU CAN'T 1739 01:32:11,602 --> 01:32:19,577 SOLVE IT. 1740 01:32:19,577 --> 01:32:22,480 THERE'S RACE AND ETHNICITY IN 1741 01:32:22,480 --> 01:32:24,982 UNIFORM AND COMPREHENSIVE TIMELY 1742 01:32:24,982 --> 01:32:26,851 MANNER. 1743 01:32:26,851 --> 01:32:28,386 I'LL PAUSE TO SAY EVEN THOUGH 1744 01:32:28,386 --> 01:32:34,625 RACE AND ETHNICITY ARE NOT 1745 01:32:34,625 --> 01:32:37,261 BIOLOGY, IT DOESN'T MEAN THEY'RE 1746 01:32:37,261 --> 01:32:42,533 NOT REAL AND THAT THEY DON'T 1747 01:32:42,533 --> 01:32:44,035 IMP 1748 01:32:44,035 --> 01:32:45,670 IMPACT EXPOSURE TO HARM AND 1749 01:32:45,670 --> 01:32:56,013 ACCESS TO RESOURCES. 1750 01:32:58,349 --> 01:33:01,352 FOR SOMEONE TO SUGGEST BECAUSE 1751 01:33:01,352 --> 01:33:02,753 IT'S NOT BIOLOGY IT'S NOT 1752 01:33:02,753 --> 01:33:04,021 INFORMATION IS LIKE TRYING TO 1753 01:33:04,021 --> 01:33:05,656 CLOSE YOUR EYES AND TRYING TO 1754 01:33:05,656 --> 01:33:07,358 WALK. 1755 01:33:07,358 --> 01:33:10,394 IT DOESN'T NEED TO BE BIOLOGY TO 1756 01:33:10,394 --> 01:33:16,133 BE REASONABLE TO COLLECT. 1757 01:33:16,133 --> 01:33:17,835 THE DATA SHOULD BE A PRIORITY. 1758 01:33:17,835 --> 01:33:19,670 THE REPORT RECOMMENDS THE 1759 01:33:19,670 --> 01:33:23,541 U.S. DEPARTMENT OF HEALTH AND 1760 01:33:23,541 --> 01:33:25,343 HUMAN SERVICES SHOULD IMPLEMENT 1761 01:33:25,343 --> 01:33:30,915 EXECUTIVE ORDER 13 985 AND 1762 01:33:30,915 --> 01:33:33,918 ACCOUNTABLE DATA REPORT BEING TO 1763 01:33:33,918 --> 01:33:39,590 AGENCIES AND AGENCIES UNDER HHS 1764 01:33:39,590 --> 01:33:39,857 OVERSIGHT. 1765 01:33:39,857 --> 01:33:44,195 THE THUD INCLUDE HOSPITAL 1766 01:33:44,195 --> 01:33:51,569 BILLING FORMS FOR THE OFFICE OF 1767 01:33:51,569 --> 01:33:54,572 BUDGET STATUS AND INSTITUTE A 1768 01:33:54,572 --> 01:33:57,742 PROCESS OF RACE AND ETHNICITY 1769 01:33:57,742 --> 01:33:59,543 DATA ON HEALTH CARE WORKFORCE. 1770 01:33:59,543 --> 01:34:02,113 MOREOVER THE OFFICE OF MANAGING 1771 01:34:02,113 --> 01:34:03,948 BUDGETS SHOULD SET AN 1772 01:34:03,948 --> 01:34:06,751 ADMINISTRATIVE WIDE REQUIREMENT 1773 01:34:06,751 --> 01:34:10,388 OF ROUTINE COLLECTION OF DATA BY 1774 01:34:10,388 --> 01:34:15,459 ALL AGENCIES OVERSEEING HEALTH 1775 01:34:15,459 --> 01:34:17,028 CARE AND RESEARCH PROGRAMS AND 1776 01:34:17,028 --> 01:34:18,929 SHOULD REGULAR MONITOR AND 1777 01:34:18,929 --> 01:34:25,069 REPORT ON AGENCY COMPLIANCE. 1778 01:34:25,069 --> 01:34:27,838 I'LL ALSO SAY I'VE BEEN THINKING 1779 01:34:27,838 --> 01:34:31,509 WHAT IS A FLUID ANALOGY FOR THIS 1780 01:34:31,509 --> 01:34:36,047 AND IT WOULD BE TELLING FOR 1781 01:34:36,047 --> 01:34:37,548 HEALTH CARE PROVIDERS NOT TO 1782 01:34:37,548 --> 01:34:39,917 COLLECT ETHNICITY DATA IS LIKE 1783 01:34:39,917 --> 01:34:41,986 TELLING A SHOE COMPANY NOT TO 1784 01:34:41,986 --> 01:34:46,390 COLLECT THE SIZES OF THE SHOES 1785 01:34:46,390 --> 01:34:56,801 THEY'RE CUSTOMERS WEAR. 1786 01:34:58,636 --> 01:35:01,539 YOU NEED THAT TO DEVELOP 1787 01:35:01,539 --> 01:35:03,941 CULTURALLY COMPETENT CARE. 1788 01:35:03,941 --> 01:35:05,576 IT'S LIKE TELLING THE SHOE 1789 01:35:05,576 --> 01:35:07,745 COMPANY YOU JUST PRODUCE ONE 1790 01:35:07,745 --> 01:35:08,312 SHOE AND IT JUST WORKS FOR 1791 01:35:08,312 --> 01:35:18,489 EVERYBODY. 1792 01:35:26,764 --> 01:35:27,598 THEY NEED JUST AS MUCH ANYONE 1793 01:35:27,598 --> 01:35:29,467 BECAUSE THEY NEED IT TO MAKE 1794 01:35:29,467 --> 01:35:37,942 GOOD CLINICAL DECISIONS. 1795 01:35:37,942 --> 01:35:42,913 GOAL TWO IS TO EQUIP THE HEALTH 1796 01:35:42,913 --> 01:35:44,782 CARE SYSTEM AND EXPAND A 1797 01:35:44,782 --> 01:35:46,383 SUSTAINABLE AND EFFECTIVE 1798 01:35:46,383 --> 01:35:53,991 INTERVENTION. 1799 01:35:53,991 --> 01:35:56,527 THERE'S MANY KNOWN SOLUTIONS AND 1800 01:35:56,527 --> 01:35:57,695 SUSTAINED EFFORTS TO IMPROVE 1801 01:35:57,695 --> 01:35:58,362 HEALTH CARE ACROSS THE CONTINUUM 1802 01:35:58,362 --> 01:36:04,168 OF CARE. 1803 01:36:04,168 --> 01:36:05,469 FOR EXAMPLE LARGE AND WELL 1804 01:36:05,469 --> 01:36:10,141 TRAINED CADRES OF WORKFORCE SUCH 1805 01:36:10,141 --> 01:36:14,345 AS COMMUNITY HEALTH WORKERS, 1806 01:36:14,345 --> 01:36:15,379 NURSES, MENTAL AND BEHAVIORAL 1807 01:36:15,379 --> 01:36:17,081 HEALTH PROFESSIONALS AND CASE 1808 01:36:17,081 --> 01:36:21,819 MANAGERS AND SOCIAL WORKERS 1809 01:36:21,819 --> 01:36:22,353 IMPORTANT FOR RESTORING 1810 01:36:22,353 --> 01:36:26,790 INDIVIDUAL AND COMMUNITY HEALTH. 1811 01:36:26,790 --> 01:36:28,893 WE DISCUSSED THE NEED FOR 1812 01:36:28,893 --> 01:36:30,828 DIVERSE HEALTH AND SCIENCE 1813 01:36:30,828 --> 01:36:32,429 WORKFORCE REPRESENTING 1814 01:36:32,429 --> 01:36:34,198 COMMUNITIES AS BEING ESSENTIAL 1815 01:36:34,198 --> 01:36:36,200 FOR HEALTH CARE EQUITY AND ALSO 1816 01:36:36,200 --> 01:36:40,070 EMERGING APPROACHES TO ACHIEVING 1817 01:36:40,070 --> 01:36:41,772 HEALTH CARE EQUITY SHOW PROMISE 1818 01:36:41,772 --> 01:36:44,708 AND POISED FOR INCREASED 1819 01:36:44,708 --> 01:36:45,576 INVESTMENT, IMPLEMENTATION AND 1820 01:36:45,576 --> 01:36:47,778 EXPANSION SO THE PROGRESS IS 1821 01:36:47,778 --> 01:36:48,345 TRANSLATED INTO LONG-TERM 1822 01:36:48,345 --> 01:36:55,286 IMPROVEMENTS IN HEALTH. 1823 01:36:55,286 --> 01:36:56,687 I WANT TO BE MINDFUL OF TIME. 1824 01:36:56,687 --> 01:36:58,622 I DON'T WANT TO GO OVER. 1825 01:36:58,622 --> 01:37:05,496 WHERE AM I ON TIME? 1826 01:37:05,496 --> 01:37:06,130 I'M CLOSE? 1827 01:37:06,130 --> 01:37:14,905 OKAY. 1828 01:37:14,905 --> 01:37:16,874 I'LL HIGHLIGHT THE ONES I THINK 1829 01:37:16,874 --> 01:37:19,343 ARE MOST IMPORTANT TO AT LEAST 1830 01:37:19,343 --> 01:37:27,585 HAVE SOME TIME FOR YOU TO ASK 1831 01:37:27,585 --> 01:37:35,292 DR. JERNIGEN SOME QUESTIONS. 1832 01:37:35,292 --> 01:37:40,631 THE THIRD GOAL IS TO INVEST IN 1833 01:37:40,631 --> 01:37:43,567 RESEARCH AND EVIDENCE GENERATION 1834 01:37:43,567 --> 01:37:48,072 TO IDENTIFY AND WIDELY IMPLEMENT 1835 01:37:48,072 --> 01:37:53,377 INTERVENTIONS THAT ELIMINATE 1836 01:37:53,377 --> 01:37:53,978 HEALTH CARE INEQUITY. 1837 01:37:53,978 --> 01:37:56,247 PROGRESS BEEN SLOW DUE TO 1838 01:37:56,247 --> 01:37:59,316 FUNDING AND EXCLUSION OF 1839 01:37:59,316 --> 01:38:00,217 ETHNICALLY MINORITIZED 1840 01:38:00,217 --> 01:38:01,485 POPULATIONS FROM WORKFORCE AND 1841 01:38:01,485 --> 01:38:07,524 PERSISTENT LIMITATIONS ON DATA 1842 01:38:07,524 --> 01:38:09,793 ON RACIAL ETHNICITY AND CONDUCT 1843 01:38:09,793 --> 01:38:11,161 TYPES AND SCALES OF HEALTH 1844 01:38:11,161 --> 01:38:16,667 EQUITY RESEARCH AND TO TRANSLATE 1845 01:38:16,667 --> 01:38:18,302 POLICY INTO. 1846 01:38:18,302 --> 01:38:21,238 GIVEN THE MAGNITUDE OF PROBLEMS 1847 01:38:21,238 --> 01:38:25,175 AND YEARS OF LIFE LOST DUE TO 1848 01:38:25,175 --> 01:38:26,610 INEQUITY THE PLAUSIBILITY OF 1849 01:38:26,610 --> 01:38:28,178 RESEARCH RESOURCES DEVOTED TO 1850 01:38:28,178 --> 01:38:33,584 THE STUDY OF SUCCESSFUL 1851 01:38:33,584 --> 01:38:34,985 TREATMENT FOR SCALING UP 1852 01:38:34,985 --> 01:38:38,522 INTERVENTIONS IS PROFOUND. 1853 01:38:38,522 --> 01:38:40,724 TO HIGHLIGHT WE DO THESE 1854 01:38:40,724 --> 01:38:43,127 ESTIMATES OF ECONOMIC BURDEN OF 1855 01:38:43,127 --> 01:38:45,663 HEALTH INEQUITY AND SHOW IT'S 1856 01:38:45,663 --> 01:38:47,197 MORE THAN A TRILLION DOLLARS 1857 01:38:47,197 --> 01:38:49,867 DEPENDING ON IF YOU LOOK AT RACE 1858 01:38:49,867 --> 01:38:52,403 AND ETHNICITY OR LOOK AT 1859 01:38:52,403 --> 01:38:53,804 EDUCATIONAL RELATED THE AMOUNT 1860 01:38:53,804 --> 01:38:56,173 OF MONEY WE'RE SPENDING ON 1861 01:38:56,173 --> 01:38:57,808 RESEARCH AND DEVELOPMENT IN THIS 1862 01:38:57,808 --> 01:39:02,146 AREA, PAYOUTS AND COMPARISON AND 1863 01:39:02,146 --> 01:39:12,523 WE DO NEED TO DO MORE. 1864 01:39:23,467 --> 01:39:26,670 AND LOOK AT LAWS CURRENTLY IN 1865 01:39:26,670 --> 01:39:29,673 THE AFFORDABLE CARE ACT, THE 1866 01:39:29,673 --> 01:39:32,676 ENVISION FOR ADVANCING RACIAL 1867 01:39:32,676 --> 01:39:34,745 AND ETHNIC INEQUITY ARE 1868 01:39:34,745 --> 01:39:35,012 ENFORCED. 1869 01:39:35,012 --> 01:39:39,183 THE PROBLEMS ARE MANY PROVISIONS 1870 01:39:39,183 --> 01:39:41,318 ARE NOT BEING ENFORCED. 1871 01:39:41,318 --> 01:39:47,591 IN SECTION 1557 OF THE AACA 1872 01:39:47,591 --> 01:39:51,595 REENFORCES THE LONG STANDING 1873 01:39:51,595 --> 01:39:53,297 PROTECTION FOR PROHIBITION OF 1874 01:39:53,297 --> 01:39:54,631 RACE, NATIONAL ORIGIN, AGE, 1875 01:39:54,631 --> 01:40:04,441 DISABILITY OR SEX. 1876 01:40:04,441 --> 01:40:06,009 THE ACCOUNTABILITY AT ALL LEVELS 1877 01:40:06,009 --> 01:40:07,578 IS IMPORTANT. 1878 01:40:07,578 --> 01:40:12,583 AND I HAVE TO SAY MY OWN 1879 01:40:12,583 --> 01:40:15,519 PERSONAL FAVORITE GOAL IS GOAL 1880 01:40:15,519 --> 01:40:15,853 NUMBER FIVE. 1881 01:40:15,853 --> 01:40:19,123 I'M AN ECONOMIST AND RESEARCHER. 1882 01:40:19,123 --> 01:40:21,291 THIS IS ELIMINATING INEQUITIES 1883 01:40:21,291 --> 01:40:22,426 IN HEALTH CARE AND ACCESS AND 1884 01:40:22,426 --> 01:40:32,569 QUALITY. 1885 01:40:33,170 --> 01:40:35,572 THERE'S DIFFERENT STRUCTURES OF 1886 01:40:35,572 --> 01:40:36,673 PAYMENT FOR SAME SERVICES 1887 01:40:36,673 --> 01:40:43,046 AMONGST INSURANCE PAYERS. 1888 01:40:43,046 --> 01:40:47,484 THIS IS ONE OF THE BARRIERS THAT 1889 01:40:47,484 --> 01:40:50,954 PRE FRIENDS US FROM 1890 01:40:50,954 --> 01:40:51,855 DISSEMINATING, IMPLEMENTING THE 1891 01:40:51,855 --> 01:40:52,856 GOOD WORK THAT'S BEEN DONE OVER 1892 01:40:52,856 --> 01:41:01,932 THE LAST 20 YEARS. 1893 01:41:01,932 --> 01:41:03,467 RIGHT NOW OUR HEALTH CARE SYSTEM 1894 01:41:03,467 --> 01:41:07,571 WHEN YOU ENTER INTO IT, IT 1895 01:41:07,571 --> 01:41:15,579 ALLOCATES RESOURCES BASED ON 1896 01:41:15,579 --> 01:41:21,785 AFFLUENCE. 1897 01:41:21,785 --> 01:41:22,920 AND WHEN SOMEONE ENTERS THE 1898 01:41:22,920 --> 01:41:24,555 HEALTH CARE SYSTEM THE ACTORS IN 1899 01:41:24,555 --> 01:41:25,722 THAT SYSTEM RESPOND TO THEIR 1900 01:41:25,722 --> 01:41:26,256 AFFLUENCE. 1901 01:41:26,256 --> 01:41:35,532 THEY TRY TO SOLVE THE PROBLEM 1902 01:41:35,532 --> 01:41:36,733 AND HAVING THE BEST AND 1903 01:41:36,733 --> 01:41:38,769 BRIGHTEST MINDS WORKING ON 1904 01:41:38,769 --> 01:41:40,204 PROBLEMS OF HEALTH NEED AND THE 1905 01:41:40,204 --> 01:41:44,641 ROUTE CAUSE OF THAT IS BECAUSE 1906 01:41:44,641 --> 01:41:50,647 IN OUR SYSTEM, WE DON'T ONLY 1907 01:41:50,647 --> 01:41:52,449 HAVE DISCRIMINATION IN THE SENSE 1908 01:41:52,449 --> 01:41:54,985 THAT TWO PEOPLE CAN HAVE THE 1909 01:41:54,985 --> 01:41:58,388 SAME HEALTH NEEDS BUT BECAUSE OF 1910 01:41:58,388 --> 01:42:03,594 WHAT THEIR INSURANCE COVERAGE IS 1911 01:42:03,594 --> 01:42:10,300 THEY'LL PAY DIFFERENT PRICES. 1912 01:42:10,300 --> 01:42:13,270 MARKETS DO WHAT THEY DO. 1913 01:42:13,270 --> 01:42:19,576 THEY SERVE THE ONES THAT ARE 1914 01:42:19,576 --> 01:42:29,152 AFFLUENT. 1915 01:42:29,152 --> 01:42:31,121 WE DON'T HAVE THE BEST AND 1916 01:42:31,121 --> 01:42:31,955 BRIGHTEST WORKING ON THE HEALTH 1917 01:42:31,955 --> 01:42:35,025 NEEDS BUT THE BEST AND BRIGHTEST 1918 01:42:35,025 --> 01:42:36,793 OF THOSE MOST AFFLUENT OR THE 1919 01:42:36,793 --> 01:42:37,127 BEST PAYERS. 1920 01:42:37,127 --> 01:42:42,399 NOW, SOMETIMES IT WORKS OUT FOR 1921 01:42:42,399 --> 01:42:50,541 OUT BUT MOST TIMES IT DOESN'T. 1922 01:42:50,541 --> 01:42:52,242 YOU HAVE INSTITUTIONS NOT TAKING 1923 01:42:52,242 --> 01:42:53,410 CARE OF THE SICKEST. 1924 01:42:53,410 --> 01:42:58,448 THE REASON IS BECAUSE MEDICARE 1925 01:42:58,448 --> 01:43:00,317 PAYS LESS THAN COMMERCIAL AND 1926 01:43:00,317 --> 01:43:03,020 COMMERCIAL AND MEDICAID PAYS 1927 01:43:03,020 --> 01:43:11,295 LESS THAN THEM BOTH. 1928 01:43:11,295 --> 01:43:14,298 AS A RESULT YOU HAVE SAFETY NET 1929 01:43:14,298 --> 01:43:16,366 PROGRAMS WE DON'T FUND VERY 1930 01:43:16,366 --> 01:43:16,567 WELL. 1931 01:43:16,567 --> 01:43:18,769 THE INDIAN HEALTH SERVICES YOU 1932 01:43:18,769 --> 01:43:21,004 NEVER FUND AT THE APPROPRIATE 1933 01:43:21,004 --> 01:43:21,204 LEVEL. 1934 01:43:21,204 --> 01:43:25,676 THESE THINGS -- EVEN IF YOU 1935 01:43:25,676 --> 01:43:27,844 BUILD A BETTER MOUSE TRAP, YOU 1936 01:43:27,844 --> 01:43:30,914 HAVE THE SOLUTION, WE DON'T HAVE 1937 01:43:30,914 --> 01:43:33,584 A SYSTEM IN PLACE THAT WOULD GET 1938 01:43:33,584 --> 01:43:35,986 THE SOLUTION TO THE PEOPLE THAT 1939 01:43:35,986 --> 01:43:39,590 NEED THE SOLUTION BECAUSE OUR 1940 01:43:39,590 --> 01:43:42,492 SYSTEM IS DESIGN TO SERVE 1941 01:43:42,492 --> 01:43:47,531 AFFLUENCE AND THE HEALTH NEEDS 1942 01:43:47,531 --> 01:43:50,867 OF THE AFFLUENCE FIRST OPPOSED 1943 01:43:50,867 --> 01:43:52,202 TO THE REST OF THE WORLD ARE 1944 01:43:52,202 --> 01:43:55,572 EVERYONE HAS TO PAY THE SAME 1945 01:43:55,572 --> 01:43:57,507 THING. 1946 01:43:57,507 --> 01:43:58,642 INSTEAD OF TRYING TO MAKE 1947 01:43:58,642 --> 01:44:07,985 CHASING DOLLARS I'M TRYING TO 1948 01:44:07,985 --> 01:44:10,454 SOLVE THE PROBLEM AND BRING MY 1949 01:44:10,454 --> 01:44:11,555 EXPERTISE. 1950 01:44:11,555 --> 01:44:12,689 I ENCOURAGE YOU TO VISIT AND 1951 01:44:12,689 --> 01:44:14,057 READ THE REPORT. 1952 01:44:14,057 --> 01:44:15,592 IT'S A NICE READ. 1953 01:44:15,592 --> 01:44:21,999 IT'S LOTS OF GOOD INFORMING AND 1954 01:44:21,999 --> 01:44:23,967 SORRY FOR TAKING TOO LONG BUT 1955 01:44:23,967 --> 01:44:25,002 IT'S AN IMPORTANT ISSUE. 1956 01:44:25,002 --> 01:44:27,471 IN 20 YEARS SOMEBODY ELSE WILL 1957 01:44:27,471 --> 01:44:32,075 BE HERE TO TELL YOU WE ENDED 1958 01:44:32,075 --> 01:44:34,478 UNEQUAL TREATMENT. 1959 01:44:34,478 --> 01:44:35,278 >> OKAY. 1960 01:44:35,278 --> 01:44:38,348 ARE THERE ANY COUNCIL MEMBERS 1961 01:44:38,348 --> 01:44:40,817 THAT HAVE COMMENTS? 1962 01:44:40,817 --> 01:44:42,486 >> I HAVE A QUESTION. 1963 01:44:42,486 --> 01:44:45,288 I ENJOYED YOUR PRESENTATION. 1964 01:44:45,288 --> 01:44:46,423 VERY THOROUGH EXPLANATION OF 1965 01:44:46,423 --> 01:44:48,358 WHERE WE'VE COME OVER THE LAST 1966 01:44:48,358 --> 01:44:49,860 20 YEARS. 1967 01:44:49,860 --> 01:44:54,498 I'LL DIRECT THIS TO -- SO WHAT 1968 01:44:54,498 --> 01:45:03,073 IS THE FIX? 1969 01:45:03,073 --> 01:45:07,044 HOW DO WE REBUILD THE SYSTEM IN 1970 01:45:07,044 --> 01:45:08,378 A STEP WISE FASHION? 1971 01:45:08,378 --> 01:45:12,616 DO YOU HAVE A HUGE DREAM MODEL 1972 01:45:12,616 --> 01:45:16,486 OF REBUILDING FROM A STRUCTURAL, 1973 01:45:16,486 --> 01:45:19,256 PERSONAL AND HSH BASE? 1974 01:45:19,256 --> 01:45:21,692 >> NOT SO MUCH WE NEED TO 1975 01:45:21,692 --> 01:45:25,929 REBUILD IT. 1976 01:45:25,929 --> 01:45:28,131 ON THE COVERAGE SIDE WE NEED TO 1977 01:45:28,131 --> 01:45:34,471 FINISH THE EXPANSION OF 1978 01:45:34,471 --> 01:45:35,572 MEDICAID. 1979 01:45:35,572 --> 01:45:38,275 WE NEED TO DO THE EQUALIZATION 1980 01:45:38,275 --> 01:45:41,678 OF MEDICAID AND MEDICARE AND 1981 01:45:41,678 --> 01:45:44,381 WHEN THE PATIENT ENTERS INTO THE 1982 01:45:44,381 --> 01:45:46,483 MARKETPLACE THEY'RE NOT RAT A 1983 01:45:46,483 --> 01:45:52,589 DISADVANTAGE AND THEN NEED TO DO 1984 01:45:52,589 --> 01:45:57,127 THE ENFORCEMENT AND HOLD 1985 01:45:57,127 --> 01:45:58,328 THEMSELVES ACCOUNTABLE AND 1986 01:45:58,328 --> 01:45:59,429 GOVERNMENT NEEDS TO HOLD THEM 1987 01:45:59,429 --> 01:46:04,501 ACCOUNTABLE FOR THE ACTIONS AS 1988 01:46:04,501 --> 01:46:10,340 WELL AS HEALTH PLANS AND I'M 1989 01:46:10,340 --> 01:46:11,308 ABLE TO MEASURE THE THINGS IN 1990 01:46:11,308 --> 01:46:15,078 WHICH I DO AND DO IT THE RIGHT 1991 01:46:15,078 --> 01:46:15,579 WAY. 1992 01:46:15,579 --> 01:46:19,116 IF I DON'T HOLD MYSELF 1993 01:46:19,116 --> 01:46:22,486 ACCOUNTABLE I CAN'T. 1994 01:46:22,486 --> 01:46:26,623 THE DATA COLLECTION IS CRUCIAL. 1995 01:46:26,623 --> 01:46:30,727 THE RECOMMENDATIONS AROUND DATA 1996 01:46:30,727 --> 01:46:31,528 GENERATION ARE CRITICAL. 1997 01:46:31,528 --> 01:46:33,797 WE CAN'T ACHIEVE IT OTHER THAN 1998 01:46:33,797 --> 01:46:39,569 WE SEE ITS OTHER THAN SEEING THE 1999 01:46:39,569 --> 01:46:42,939 TRAIN WRECKS THAT OCCUR. 2000 01:46:42,939 --> 01:46:44,541 THIS IS A NOTION OF TRYING TO 2001 01:46:44,541 --> 01:46:46,276 TAKE WHAT WE HAVE AND SAY THESE 2002 01:46:46,276 --> 01:46:47,677 ARE THE PROBLEMS THAT NEED TO BE 2003 01:46:47,677 --> 01:46:50,413 PLUGGED UP. 2004 01:46:50,413 --> 01:46:51,481 WE NEED DATA. 2005 01:46:51,481 --> 01:46:52,482 WE NEED TO CONTINUE TO DO 2006 01:46:52,482 --> 01:46:57,454 RESEARCH IN THE AREA BECAUSE WE 2007 01:46:57,454 --> 01:46:59,823 DON'T KNOW EVERYTHING WE NEED TO 2008 01:46:59,823 --> 01:47:03,026 CHANGE THE WAY IN WHICH WE'RE 2009 01:47:03,026 --> 01:47:08,064 PAYING FOR HEALTH CARE AND 2010 01:47:08,064 --> 01:47:12,536 ENFORCE THE LAWS AND MY KWLEEGZ 2011 01:47:12,536 --> 01:47:13,403 THAT DO RESEARCH FOR THIS 2012 01:47:13,403 --> 01:47:15,605 INSTITUTE DEVELOPED LOTS OF 2013 01:47:15,605 --> 01:47:16,473 GREAT INTERVENTIONS. 2014 01:47:16,473 --> 01:47:18,375 THE PROBLEMS IS WE OFTEN HAVE A 2015 01:47:18,375 --> 01:47:19,810 WRONG POCKET PROBLEM. 2016 01:47:19,810 --> 01:47:21,545 THE PERSON WHO IS SAVING MONEY 2017 01:47:21,545 --> 01:47:27,751 ISN'T THE PERSON MAKING MONEY. 2018 01:47:27,751 --> 01:47:32,055 THE PERSON MAKING MON STANDS IN 2019 01:47:32,055 --> 01:47:33,657 THE WAY OF THE PERSON SAVING 2020 01:47:33,657 --> 01:47:34,424 MONEY. 2021 01:47:34,424 --> 01:47:34,991 WE KNOW DIABETES PREVENTION 2022 01:47:34,991 --> 01:47:38,161 PROGRAMS WORK. 2023 01:47:38,161 --> 01:47:43,600 WE KNOW THEY WORK. 2024 01:47:43,600 --> 01:47:46,102 WE CAN'T GET THEM OUT AND 2025 01:47:46,102 --> 01:47:49,005 PROMULGATE IT SO PEOPLE WHO ARE 2026 01:47:49,005 --> 01:47:52,309 AT RISK OF DEVELOPING DIABETES 2027 01:47:52,309 --> 01:47:54,211 ARE REFERRED TO THEM, ENROLLED 2028 01:47:54,211 --> 01:47:55,111 IN THEM AND THE INSURANCE 2029 01:47:55,111 --> 01:47:58,248 COMPANY PAYS FOR THEM BUT WE CAN 2030 01:47:58,248 --> 01:48:01,518 FIGURE OUT HOW TO PAY FOR THE 2031 01:48:01,518 --> 01:48:01,718 BILL. 2032 01:48:01,718 --> 01:48:03,386 THEN WE SAY IT'S THE PATIENT'S 2033 01:48:03,386 --> 01:48:04,020 FAULT BECAUSE THEY DON'T WANT 2034 01:48:04,020 --> 01:48:05,789 IT. 2035 01:48:05,789 --> 01:48:09,426 BUT THEY DON'T EVEN HAVE THE 2036 01:48:09,426 --> 01:48:10,460 OPPORTUNITY TO DO LIFESTYLE 2037 01:48:10,460 --> 01:48:16,299 CHANGES. 2038 01:48:16,299 --> 01:48:22,472 >> THANK YOU VERY MUCH FOR THE 2039 01:48:22,472 --> 01:48:25,008 REPORT. 2040 01:48:25,008 --> 01:48:26,810 SOME OF THESE ISSUES I DON'T 2041 01:48:26,810 --> 01:48:32,682 KNOW HOW EEL BE ABLE TO RESOLVE 2042 01:48:32,682 --> 01:48:34,084 IT. 2043 01:48:34,084 --> 01:48:36,653 AND AS SOON AS THEY HEAR THIS 2044 01:48:36,653 --> 01:48:39,856 THEY SAY HERE THEY GO AGAIN WITH 2045 01:48:39,856 --> 01:48:44,494 EQUITY, EQUITY AND INCLUSION. 2046 01:48:44,494 --> 01:48:47,597 WE SHOULD DO THIS AND THAT NOW 2047 01:48:47,597 --> 01:48:49,432 IF YOU LOOK AT THE POPULATION 2048 01:48:49,432 --> 01:48:52,369 THERE'S INCENTIVES FUNDED BY 2049 01:48:52,369 --> 01:48:56,473 NIMHD. 2050 01:48:56,473 --> 01:48:57,574 IF YOU DON'T HAVE INSURANCE YOU 2051 01:48:57,574 --> 01:49:03,613 WILL NOT BE ADMITTED. 2052 01:49:03,613 --> 01:49:10,487 YOU MAY SPEND YOUR LIFE TIME 2053 01:49:10,487 --> 01:49:17,260 WORKING ON INCENTIVES YOU DON'T 2054 01:49:17,260 --> 01:49:19,429 SET FOOT IN THOSE AREAS. 2055 01:49:19,429 --> 01:49:24,334 HOW DO WE ADDRESS AND LOOK AT 2056 01:49:24,334 --> 01:49:30,707 THINGS THAT NIH HAS CONTROL. 2057 01:49:30,707 --> 01:49:36,646 >> I TEND TO BE A GLASS HALF 2058 01:49:36,646 --> 01:49:38,982 FULL GUY OPPOSED TO GLASS HALF 2059 01:49:38,982 --> 01:49:39,582 EMPTY. 2060 01:49:39,582 --> 01:49:42,018 I LOOK FROM A HISTORICAL 2061 01:49:42,018 --> 01:49:42,585 STANDPOINT. 2062 01:49:42,585 --> 01:49:44,054 WE'RE NOT WHERE WE NEED TO BE 2063 01:49:44,054 --> 01:49:48,825 BUT NOT WHERE WE WERE 20 YEARS 2064 01:49:48,825 --> 01:49:50,260 AGO. 2065 01:49:50,260 --> 01:49:54,130 THIS IS A GENERATIONAL FIGHT. 2066 01:49:54,130 --> 01:50:00,637 THOUGH RIGHT NOW VIA CONGRESS 2067 01:50:00,637 --> 01:50:02,138 AND CERTAIN LEGISLATURE SEEM TO 2068 01:50:02,138 --> 01:50:03,306 HAVE THE UPPER HAND. 2069 01:50:03,306 --> 01:50:05,208 THEY WON'T HAVE IT ALWAYS. 2070 01:50:05,208 --> 01:50:10,480 IF YOU LOOK OVER THE ARC OF 2071 01:50:10,480 --> 01:50:12,949 TIME, WE'RE IMPROVING. 2072 01:50:12,949 --> 01:50:15,919 HAVING SAID THAT, THERE ARE SOME 2073 01:50:15,919 --> 01:50:17,354 THINGS IN WHICH WE CAN CONTINUE 2074 01:50:17,354 --> 01:50:22,025 TO DO. 2075 01:50:22,025 --> 01:50:28,832 I ENCOURAGE FOLKS -- WILLIAM 2076 01:50:28,832 --> 01:50:31,001 SHAKESPEARE SAID THROUGH JULIET, 2077 01:50:31,001 --> 01:50:33,103 A ROSE BY ANY OTHER NAME STILL 2078 01:50:33,103 --> 01:50:33,636 AS SWEET. 2079 01:50:33,636 --> 01:50:39,242 SO EQUITY, WE KNOW WHAT WE MEAN 2080 01:50:39,242 --> 01:50:43,680 BY EQUITY SOMETIMES WE TELL 2081 01:50:43,680 --> 01:50:47,584 OTHER FOLKS WHAT THEY ARE MEAN 2082 01:50:47,584 --> 01:50:50,286 BY IT AND THEY DECIDE THEY WANT 2083 01:50:50,286 --> 01:50:55,592 US TO CHANGE OUR TERMS. 2084 01:50:55,592 --> 01:50:57,227 CALL THE QUESTION WHAT 2085 01:50:57,227 --> 01:50:59,596 INEQUITIES ARE YOU FOR? 2086 01:50:59,596 --> 01:51:02,132 WHO SHOULD HAVE LESS HEALTH 2087 01:51:02,132 --> 01:51:02,866 CARE? 2088 01:51:02,866 --> 01:51:04,567 WHO SHOULD HAVE POORER QUALITY 2089 01:51:04,567 --> 01:51:05,735 CARE? 2090 01:51:05,735 --> 01:51:07,337 IS IT POOR PEOPLE? 2091 01:51:07,337 --> 01:51:09,939 LESS EDUCATED PEOPLE? 2092 01:51:09,939 --> 01:51:11,574 RACIAL AND ETHNIC MINORITY 2093 01:51:11,574 --> 01:51:12,242 PEOPLE? 2094 01:51:12,242 --> 01:51:14,044 WHO SHOULD HAVE LESS? 2095 01:51:14,044 --> 01:51:18,481 THE OPPOSITE OF EQUITY WHERE WE 2096 01:51:18,481 --> 01:51:19,582 SAY OPTIMAL HEALTH CARE FOR ALL 2097 01:51:19,582 --> 01:51:22,385 REGARDLESS OF WHERE YOU WORK, 2098 01:51:22,385 --> 01:51:23,653 LIVE AND PLAY AND IF YOU'RE 2099 01:51:23,653 --> 01:51:25,622 AGAINST THAT YOU MUST BE FOR 2100 01:51:25,622 --> 01:51:32,195 THIS, WHO SHOULD BE LEFT OUT OF? 2101 01:51:32,195 --> 01:51:37,767 CALL IT INTO QUESTION OPPOSED TO 2102 01:51:37,767 --> 01:51:39,235 RUNNING TO ANOTHER TERM BECAUSE 2103 01:51:39,235 --> 01:51:49,679 EQUITY SMELLS SWEET TO ME. 2104 01:51:50,013 --> 01:51:52,482 >> I APPRECIATE THE SUMMARY. 2105 01:51:52,482 --> 01:51:55,585 I ENCOURAGE EVERYONE TO READ THE 2106 01:51:55,585 --> 01:52:02,992 REPORT. 2107 01:52:02,992 --> 01:52:06,663 AND BECAUSE OUR COLLEAGUES ARE 2108 01:52:06,663 --> 01:52:09,065 NINDS ARE HERE WE'LL MOVE ON. 2109 01:52:09,065 --> 01:52:09,966 THERE'S REGIONAL DIFFERENCES IN 2110 01:52:09,966 --> 01:52:11,801 THE COUNTRY AND HOW HEALTH CARE 2111 01:52:11,801 --> 01:52:12,735 IS DONE. 2112 01:52:12,735 --> 01:52:15,238 LET'S PUT IT THAT WAY. 2113 01:52:15,238 --> 01:52:17,707 I WAS ACTUALLY SHOCKED IN A WAY 2114 01:52:17,707 --> 01:52:20,477 WHEN I MOVED TO THIS AREA AND 2115 01:52:20,477 --> 01:52:23,313 SAW THE ENORMOUS DIFFERENCES 2116 01:52:23,313 --> 01:52:27,283 WITH THE PLACE I'D SPENT MY 2117 01:52:27,283 --> 01:52:28,318 ENTIRE PROFESSIONAL CAREER AS A 2118 01:52:28,318 --> 01:52:29,018 HEALTH CARE CLINICIAN. 2119 01:52:29,018 --> 01:52:31,521 I THINK THE MODELS ARE OUT THERE 2120 01:52:31,521 --> 01:52:33,022 AND ARE BEING DONE IN OTHER 2121 01:52:33,022 --> 01:52:35,325 PARTS OF THE COUNTRY THAT ARE 2122 01:52:35,325 --> 01:52:37,360 MUCH BETTER THAN WHAT IS 2123 01:52:37,360 --> 01:52:41,831 EXPERIENCED HERE. 2124 01:52:41,831 --> 01:52:47,070 I WONDER IF AND IF THE FIXES ARE 2125 01:52:47,070 --> 01:52:51,407 BUILT IN AND A MATTER OF 2126 01:52:51,407 --> 01:52:52,342 POLITICAL WISH AND COMMITMENT TO 2127 01:52:52,342 --> 01:52:58,882 THESE ISSUES. 2128 01:52:58,882 --> 01:53:02,785 THERE'S A THE EMERGENCE OF 2129 01:53:02,785 --> 01:53:03,419 CONCIERGE AREA. 2130 01:53:03,419 --> 01:53:06,422 EMERGED MORE THEN A DECADE AGO 2131 01:53:06,422 --> 01:53:07,924 AND BECOME MORE WIDESPREAD AND 2132 01:53:07,924 --> 01:53:13,329 HOW IT'S CATERING TO THE 2133 01:53:13,329 --> 01:53:13,963 AFFLUENT. 2134 01:53:13,963 --> 01:53:14,164 OKAY. 2135 01:53:14,164 --> 01:53:15,231 THANK YOU SO MUCH. 2136 01:53:15,231 --> 01:53:19,369 LET ME OVER ON TO THE NEXT 2137 01:53:19,369 --> 01:53:19,636 PRESENTER. 2138 01:53:19,636 --> 01:53:20,670 IS IT GOING TO BE, YOU WALTER 2139 01:53:20,670 --> 01:53:24,307 AND RICHARD OR BOTH? 2140 01:53:24,307 --> 01:53:25,408 YOU'RE GOING TO START? 2141 01:53:25,408 --> 01:53:25,875 OKAY. 2142 01:53:25,875 --> 01:53:27,577 LET ME SAY A COUPLE THINGS ABOUT 2143 01:53:27,577 --> 01:53:29,646 MY COLLEAGUE, DR. WALTER 2144 01:53:29,646 --> 01:53:32,282 KOROSHETZ -- NO? 2145 01:53:32,282 --> 01:53:33,650 DIRECTOR OF THE NATIONAL 2146 01:53:33,650 --> 01:53:36,619 INSTITUTE OF NEUROLOGICAL 2147 01:53:36,619 --> 01:53:38,021 DISORDERS AND STROKE. 2148 01:53:38,021 --> 01:53:46,462 WE START THE SAME YEAR AS 2149 01:53:46,462 --> 01:53:50,066 DIRECTORS. 2150 01:53:50,066 --> 01:53:51,367 YOU'D BEEN AT NIH HAVING BEEN 2151 01:53:51,367 --> 01:53:53,970 KEEP OUT DIRECTOR. 2152 01:53:53,970 --> 01:53:55,738 WALTER IS A COLLEGIATE THE 2153 01:53:55,738 --> 01:53:58,641 DIRECTOR'S TABLE BUT HE DOES 2154 01:53:58,641 --> 01:54:02,045 BRING A PERSPECTIVE THAT I 2155 01:54:02,045 --> 01:54:04,981 SHARED AS A PRACTICING CLINICIAN 2156 01:54:04,981 --> 01:54:08,151 WHO CAME TO NIH, RAN NOT SKWHUFT 2157 01:54:08,151 --> 01:54:09,819 THE DEPARTMENT BUT HB IN THE 2158 01:54:09,819 --> 01:54:12,789 HOSPITAL AND HAD THE PROSPECTIVE 2159 01:54:12,789 --> 01:54:14,691 OF THE PATIENT ALWAYS ON HIS 2160 01:54:14,691 --> 01:54:16,292 MIND AS WELL AS HOW CLINICIANS 2161 01:54:16,292 --> 01:54:16,826 ARE FUNCTIONING AND TO 2162 01:54:16,826 --> 01:54:20,396 ADDRESSING NOT JUST THE SCIENCE 2163 01:54:20,396 --> 01:54:25,001 AND DISCOVERY SIDE OF WHICH 2164 01:54:25,001 --> 01:54:27,604 THERE'S MANY TO LEARN AND 2165 01:54:27,604 --> 01:54:29,205 ACHIEVEMENTS BUT IN THE HEALTH 2166 01:54:29,205 --> 01:54:32,742 CARE DELIVERY OF THESE ISSUES. 2167 01:54:32,742 --> 01:54:33,843 WALTER AND THEN YOU'LL INTRODUCE 2168 01:54:33,843 --> 01:54:43,987 RICHARD. 2169 01:54:55,298 --> 01:54:56,966 >> WE'RE HERE TO TELL YOU WHAT 2170 01:54:56,966 --> 01:54:59,035 WE'RE DOING AND LOOKING FOR HELP 2171 01:54:59,035 --> 01:55:01,537 AND OBVIOUS WHAT WE NEED IN A 2172 01:55:01,537 --> 01:55:01,771 SECOND. 2173 01:55:01,771 --> 01:55:04,307 I'M THE DIRECTOR AND DR. BENSON 2174 01:55:04,307 --> 01:55:07,577 IS THE DIRECTOR OF OFFICE OF 2175 01:55:07,577 --> 01:55:11,581 HEALTH EQUITY AND GLOBAL HEALTH 2176 01:55:11,581 --> 01:55:22,125 AND WHEN I CAME OUT OF TRAINING 2177 01:55:22,125 --> 01:55:26,529 IN THE '80s, IT WAS 2178 01:55:26,529 --> 01:55:27,997 OBSERVATIONAL AND NOT 2179 01:55:27,997 --> 01:55:28,364 INTERVENTIONAL. 2180 01:55:28,364 --> 01:55:33,536 MY CAREER HAS BEEN ALWAYS TO 2181 01:55:33,536 --> 01:55:36,739 REVERSE THE TREND AND SEEING IF 2182 01:55:36,739 --> 01:55:40,043 WE CAN TAKE IT INTO THE HEALTH 2183 01:55:40,043 --> 01:55:44,147 DISPARITIES PROBLEM IN THE 2184 01:55:44,147 --> 01:55:45,281 NEURAL SPHERE. 2185 01:55:45,281 --> 01:55:46,816 ABOUT OUR INSTITUTE WE'RE 2186 01:55:46,816 --> 01:55:50,186 RESPONSIBLE FOR ABOUT 200 TO 400 2187 01:55:50,186 --> 01:55:51,587 DIFFERENT NEUROLOGICAL 2188 01:55:51,587 --> 01:55:51,854 DISORDERS. 2189 01:55:51,854 --> 01:55:54,324 MOST OF THAT NUMBER ARE THESE 2190 01:55:54,324 --> 01:56:03,466 RARE NEUROGENETIC DISORDERS. 2191 01:56:03,466 --> 01:56:04,133 THERE'S A TREMENDOUS POTENTIAL 2192 01:56:04,133 --> 01:56:06,669 FOR THE FUTURE TO GET GENOMIC 2193 01:56:06,669 --> 01:56:07,870 THERAPIES TO HAVE BIG EFFECT 2194 01:56:07,870 --> 01:56:09,572 SIZES IN THOSE DISORDERS WHICH 2195 01:56:09,572 --> 01:56:18,114 ARE CURRENTLY NOW UNTREATABLE TO 2196 01:56:18,114 --> 01:56:21,851 SEVERE NEUROLOGICAL PROBLEMS AND 2197 01:56:21,851 --> 01:56:22,385 EPILE 2198 01:56:22,385 --> 01:56:22,652 EPILEPSY. 2199 01:56:22,652 --> 01:56:28,091 THAT'S COMING AND WILL PRESENT 2200 01:56:28,091 --> 01:56:38,468 ISSUES WITH REGARD TO 2201 01:56:40,436 --> 01:56:46,008 AFFORDABILITY. 2202 01:56:46,008 --> 01:56:47,510 STROKE IS THE FIFTH LEADING 2203 01:56:47,510 --> 01:56:50,413 CAUSE OF DEATH IN THE UNITED 2204 01:56:50,413 --> 01:56:50,646 STATES. 2205 01:56:50,646 --> 01:56:52,348 TRAUMATIC BRAIN INJURY IS 2206 01:56:52,348 --> 01:56:55,585 SOMETHING THAT CAN CHANGE 2207 01:56:55,585 --> 01:57:06,062 SOMEONE'S LIFE IN A SECOND. 2208 01:57:07,263 --> 01:57:09,866 AND THERE'S DIFFERENT DEMENTIAS. 2209 01:57:09,866 --> 01:57:11,567 WE TRIED TO DO RESEARCH THAT 2210 01:57:11,567 --> 01:57:12,902 WILL FLOAT ALL BOATS AS WE CAN'T 2211 01:57:12,902 --> 01:57:14,203 PUT ALL THE RESOURCES INTO THE 2212 01:57:14,203 --> 01:57:24,580 DISEASES THEY REQUIRE. 2213 01:57:37,193 --> 01:57:42,465 AND HAVE SOME PROJECTS FROM 2214 01:57:42,465 --> 01:57:52,642 CONGRESS. 2215 01:57:57,547 --> 01:57:59,615 AND TRYING TO ADVANCE HEALTH 2216 01:57:59,615 --> 01:58:00,016 EQUITY. 2217 01:58:00,016 --> 01:58:01,584 THERE'S THE HEAL INITIATIVE. 2218 01:58:01,584 --> 01:58:03,619 HELPING END ADDICTION LONG-TERM. 2219 01:58:03,619 --> 01:58:06,155 THERE'S TWO COMPONENTS TO THAT. 2220 01:58:06,155 --> 01:58:06,823 A MAJOR COMPONENT GOES TO THE 2221 01:58:06,823 --> 01:58:10,393 NATIONAL INSTITUTE OF DRUG 2222 01:58:10,393 --> 01:58:10,593 ABUSE. 2223 01:58:10,593 --> 01:58:12,695 AND SIGNIFICANT PROPORTION OF 2224 01:58:12,695 --> 01:58:15,097 THE FUNDS COMES TO NINDS ARE WE 2225 01:58:15,097 --> 01:58:16,699 HAVE ALL THE INSTITUTES 2226 01:58:16,699 --> 01:58:19,969 INTERESTED IN PAIN INCLUDING 2227 01:58:19,969 --> 01:58:21,471 ELISO AT THE TABLE AND MAKE 2228 01:58:21,471 --> 01:58:23,105 DECISIONS ON FUNDING PROJECTS 2229 01:58:23,105 --> 01:58:29,512 THAT ARE GOING TO TRY TO I AM -- 2230 01:58:29,512 --> 01:58:31,080 IMPROVE THE MANAGEMENT, 2231 01:58:31,080 --> 01:58:32,415 TREATMENT AND PAIN AND RISK OF 2232 01:58:32,415 --> 01:58:40,823 ADDICTION. 2233 01:58:40,823 --> 01:58:43,593 AND MODELS OF PAIN MANAGEMENT 2234 01:58:43,593 --> 01:58:46,162 AND UNDER SERVED POPULATIONS IN 2235 01:58:46,162 --> 01:58:48,931 RURAL HEALTH AREAS AND NEXT WEEK 2236 01:58:48,931 --> 01:58:53,169 WE'RE GOING TO LAUNCH A PROGRAM 2237 01:58:53,169 --> 01:58:56,138 IN NATIVE PERSON POPULATIONS. 2238 01:58:56,138 --> 01:58:57,874 -- NATIVE AMERICAN POPULATIONS. 2239 01:58:57,874 --> 01:59:01,511 WE ALSO HAVE FUNDING ABOUT $3.5 2240 01:59:01,511 --> 01:59:04,447 BILLION A YEAR CAME TO THE NIH 2241 01:59:04,447 --> 01:59:08,150 MOSTLY TO THE AGING INSTITUTE 2242 01:59:08,150 --> 01:59:09,185 FOR DEMENTIA INSTITUTE AND 2243 01:59:09,185 --> 01:59:11,754 MANAGE 10% NOW OVER $300 MILLION 2244 01:59:11,754 --> 01:59:14,824 A YEAR AND HAVE PROGRAMS THAT 2245 01:59:14,824 --> 01:59:18,261 HAVE BEEN DESIGN TO TRY AND 2246 01:59:18,261 --> 01:59:20,696 ATTACK THE PROBLEMS PARTICULARLY 2247 01:59:20,696 --> 01:59:22,465 THE PROBLEMS OF THE VASCULAR 2248 01:59:22,465 --> 01:59:27,570 CONTRIBUTIONS OF DEMENTIA WHICH 2249 01:59:27,570 --> 01:59:34,310 WE THINK IS REALLY 2250 01:59:34,310 --> 01:59:38,648 DISPROPORTIONATELY AFFECTING THE 2251 01:59:38,648 --> 01:59:41,050 AFRICAN POPULATION IN THE UNITED 2252 01:59:41,050 --> 01:59:43,586 STATES THE MAJOR DRIVERS ARE 2253 01:59:43,586 --> 01:59:43,920 HYPERTENSION. 2254 01:59:43,920 --> 01:59:45,688 WE NOW HOW TO TREAT 2255 01:59:45,688 --> 01:59:46,222 HYPERTENSION. 2256 01:59:46,222 --> 01:59:49,725 THERE'S NO REASON WHY EVERYONE 2257 01:59:49,725 --> 01:59:51,594 IN THE WHOLE UNITED STATES CAN'T 2258 01:59:51,594 --> 01:59:54,263 HAVE THEIR BLOOD PRESSURE 2259 01:59:54,263 --> 01:59:54,564 CONTROLLED. 2260 01:59:54,564 --> 01:59:55,698 SOME MAY HAVE IT DIFFICULT TO 2261 01:59:55,698 --> 01:59:58,701 CONTROL BUT EVERYBODY SHOULD GET 2262 01:59:58,701 --> 02:00:00,336 THE SAME OPPORTUNITIES AND FROM 2263 02:00:00,336 --> 02:00:01,203 THE MAJORITY OF PEOPLE IT'S 2264 02:00:01,203 --> 02:00:02,371 GOING TO WORK. 2265 02:00:02,371 --> 02:00:04,473 WE FUNDED A PROJECT AT KAISER TO 2266 02:00:04,473 --> 02:00:09,312 TRY AND REDUCE DISPARITIES IN 2267 02:00:09,312 --> 02:00:10,513 BLOOD PRESSURE CONTROL AND I'M 2268 02:00:10,513 --> 02:00:12,415 SURE WE WEREN'T THE ONLY FORCE 2269 02:00:12,415 --> 02:00:16,252 IN THAT BUT KAISER COMPLETELY 2270 02:00:16,252 --> 02:00:21,757 GOT RID OF THEIR HEALTH 2271 02:00:21,757 --> 02:00:24,927 DISPARITIES IN THEIR POPULATION. 2272 02:00:24,927 --> 02:00:26,562 THAT BROUGHT THE POINT TO ME IF 2273 02:00:26,562 --> 02:00:31,167 WE CAN WORK WITH THE HEALTH CARE 2274 02:00:31,167 --> 02:00:31,934 SYSTEMS AND SHOW SOMETHING WORKS 2275 02:00:31,934 --> 02:00:33,469 AND WORK WITH THE SYSTEM THAT 2276 02:00:33,469 --> 02:00:36,539 SAYS, YEAH, IF IT WORKS, AND 2277 02:00:36,539 --> 02:00:38,441 IT'S REASONABLE COST WELL ADOPT 2278 02:00:38,441 --> 02:00:40,176 IT, THAT IS THE GOAL. 2279 02:00:40,176 --> 02:00:40,776 THAT'S THE HOLEY GRAIL WE'RE 2280 02:00:40,776 --> 02:00:46,482 AFTER. 2281 02:00:46,482 --> 02:00:50,186 I'D SAY THAT WE HAVE AS I SAID, 2282 02:00:50,186 --> 02:00:53,089 400 DIFFERENT DISEASES. 2283 02:00:53,089 --> 02:00:54,590 EVERY DISEASE WOULD LIKE TO DO A 2284 02:00:54,590 --> 02:00:55,524 STUDY TO COLLECT DATA. 2285 02:00:55,524 --> 02:00:57,593 WE DON'T HAVE THE DATA TO DO 2286 02:00:57,593 --> 02:00:57,893 THAT. 2287 02:00:57,893 --> 02:01:00,029 INSTEAD AND I THINK FOR HEALTH 2288 02:01:00,029 --> 02:01:01,163 DISPARITIES WE'RE MOVING THIS 2289 02:01:01,163 --> 02:01:03,599 DIRECTION AS WELL. 2290 02:01:03,599 --> 02:01:04,600 WE RUN PROGRAMS THE REGARDS 2291 02:01:04,600 --> 02:01:06,235 PROGRAM IS A GOOD EXAMPLE. 2292 02:01:06,235 --> 02:01:10,506 IT'S BEEN LOOKING AT THE STROKE 2293 02:01:10,506 --> 02:01:12,808 BELT FOR 30 YEARS AND THE DATA 2294 02:01:12,808 --> 02:01:15,578 IS COMING BACK AND IT'S BAD. 2295 02:01:15,578 --> 02:01:19,582 IT'S REALLY BAD. 2296 02:01:19,582 --> 02:01:23,319 AND NO ONE'S DOING ANYTHING IT'S 2297 02:01:23,319 --> 02:01:27,590 FRUSTRATING TO DO THAT. 2298 02:01:27,590 --> 02:01:28,791 OUR VANDERBILTERS WOULD LIKE TO 2299 02:01:28,791 --> 02:01:30,059 JUST KEEP COLLECTING DATA AND 2300 02:01:30,059 --> 02:01:33,462 PUSH THEM TO DO AN INTERVENTION 2301 02:01:33,462 --> 02:01:36,699 IS LIKE PULLING TEETH. 2302 02:01:36,699 --> 02:01:39,001 BUT WE HAVE TO PULL TEETH. 2303 02:01:39,001 --> 02:01:41,504 WE'D LIKE TO DO HEALTH 2304 02:01:41,504 --> 02:01:42,338 DISPARITIES RESEARCH AND RICH 2305 02:01:42,338 --> 02:01:46,509 WILL TALK ABOUT IT TO IMPROVE 2306 02:01:46,509 --> 02:01:48,044 HEALTH EQUITY BUT IT'S GOT TO 2307 02:01:48,044 --> 02:01:48,511 HAVE AN INTERVENTION. 2308 02:01:48,511 --> 02:01:51,313 YOU HAVE TO THINK ABOUT THE END 2309 02:01:51,313 --> 02:01:51,580 GOAL. 2310 02:01:51,580 --> 02:01:53,315 IF THE END GOAL ESPECIALLY FOR 2311 02:01:53,315 --> 02:01:55,584 AN INSTITUTE LIKE US, YOU GUYS 2312 02:01:55,584 --> 02:01:57,486 HAVE THE BIG PROBLEMS. 2313 02:01:57,486 --> 02:02:00,589 OUR PROBLEM IS HOW WE CONTROL 2314 02:02:00,589 --> 02:02:02,224 BLOOD PRESSURE AND TREAT 2315 02:02:02,224 --> 02:02:02,725 EPILEPSY. 2316 02:02:02,725 --> 02:02:04,727 YOU HAVE THE BIG SYSTEMIC 2317 02:02:04,727 --> 02:02:06,362 PROBLEMS WHICH I WE APPRECIATE 2318 02:02:06,362 --> 02:02:09,065 YOU WORKING ON AND CERTAINLY 2319 02:02:09,065 --> 02:02:10,299 CULTIVATING THE FIELD TO BE MORE 2320 02:02:10,299 --> 02:02:11,434 SUCCESSFUL WHEN WE COME IN. 2321 02:02:11,434 --> 02:02:14,336 WE WOULD LIKE TO DO THINGS THAT 2322 02:02:14,336 --> 02:02:16,405 ARE WHEN YOU COLLECT THE DATA 2323 02:02:16,405 --> 02:02:17,873 IT'S CLINICAL TRIAL READINESS. 2324 02:02:17,873 --> 02:02:20,576 YOU COLLECT DATA FOR THE PURPOSE 2325 02:02:20,576 --> 02:02:21,444 OF DOING A TRIAL IN THE SYSTEM 2326 02:02:21,444 --> 02:02:23,546 THAT WE HAVE NOW. 2327 02:02:23,546 --> 02:02:26,816 WE DON'T LIKE THE SYSTEM BUT WE 2328 02:02:26,816 --> 02:02:31,120 HAVE PEOPLE -- I HAVE BEEN A PRO 2329 02:02:31,120 --> 02:02:31,821 AT GETTING AROUND SYSTEMS IN THE 2330 02:02:31,821 --> 02:02:34,056 PAST AND MAKING THEM WORK FOR ME 2331 02:02:34,056 --> 02:02:35,791 AND I THINK THERE'S OTHER PEOPLE 2332 02:02:35,791 --> 02:02:37,693 WHO CAN LOOK AT THE SYSTEM AND 2333 02:02:37,693 --> 02:02:40,029 FIGURE OUT HOW TO GAIN THE 2334 02:02:40,029 --> 02:02:43,666 SYSTEM TO GET WHAT YOU WANT TO 2335 02:02:43,666 --> 02:02:44,834 HAVE HAPPEN. 2336 02:02:44,834 --> 02:02:50,039 THAT'S WHAT TO LOOK FOR. 2337 02:02:50,039 --> 02:02:52,274 IT'S NOT EASY. 2338 02:02:52,274 --> 02:02:56,679 AND WE HAVE THE KEY THING TO 2339 02:02:56,679 --> 02:02:58,781 PUSH AND WITH THAT I WOULD LIKE 2340 02:02:58,781 --> 02:03:03,619 TO TURN IT OVER TO RICHARD TO 2341 02:03:03,619 --> 02:03:04,887 DESCRIBE WHERE WE ARE RIGHT NOW 2342 02:03:04,887 --> 02:03:07,590 AND HIS VISION FOR WHERE WE 2343 02:03:07,590 --> 02:03:09,925 MIGHT GO. 2344 02:03:09,925 --> 02:03:11,227 SO DR. BENSON. 2345 02:03:11,227 --> 02:03:12,461 >> THANK YOU, DR. KOROSHETZ FOR 2346 02:03:12,461 --> 02:03:14,497 THE INTRODUCTION AND GIVING THE 2347 02:03:14,497 --> 02:03:14,864 CONTEXT. 2348 02:03:14,864 --> 02:03:17,933 I THINK I'LL BE ABLE TO MAKE UP 2349 02:03:17,933 --> 02:03:19,001 SOME TIME GOING THROUGH THE 2350 02:03:19,001 --> 02:03:22,438 SLIDES BECAUSE OF THE EXCELLENT 2351 02:03:22,438 --> 02:03:25,941 PRESENTATION FROM DR. GASKINS 2352 02:03:25,941 --> 02:03:28,410 AND THE INTRODUCTION 2353 02:03:28,410 --> 02:03:31,046 DR. KOROSHETZ JUST MADE. 2354 02:03:31,046 --> 02:03:32,648 DR. KOROSHETZ TALKED ABOUT THE 2355 02:03:32,648 --> 02:03:39,588 MISSION OF THE NINDS AND THE WAY 2356 02:03:39,588 --> 02:03:40,489 WE'RE DIVIDED. 2357 02:03:40,489 --> 02:03:42,358 AND OUR OFFICE IS WITHIN THE 2358 02:03:42,358 --> 02:03:46,128 DIVISION OF CLINICAL RESEARCH. 2359 02:03:46,128 --> 02:03:48,931 THIS LIST HERE THE PEOPLE THAT 2360 02:03:48,931 --> 02:03:54,503 ARE IN THE OFFICE THAT DO ALL OF 2361 02:03:54,503 --> 02:03:56,038 THE WORK. 2362 02:03:56,038 --> 02:04:06,582 MY OFFICE AND WE HAVE NEGATIVE 2363 02:04:30,973 --> 02:04:32,708 OUTCOMES ASSOCIATED WITH 2364 02:04:32,708 --> 02:04:34,510 NEUROLOGICAL DISORDERS HAVE BEEN 2365 02:04:34,510 --> 02:04:35,811 DESIGNATED AS THE POPULATIONS 2366 02:04:35,811 --> 02:04:37,880 THAT EXPERIENCE HEALTH 2367 02:04:37,880 --> 02:04:42,818 DISPARITIES AND I'LL HAVE THEM 2368 02:04:42,818 --> 02:04:53,162 LISTED ON THE SLIDE. 2369 02:05:21,857 --> 02:05:23,592 AND WE HAD A STRATEGIC PLAN AN 2370 02:05:23,592 --> 02:05:25,227 PUT TOGETHER A WORKING GROUP OF 2371 02:05:25,227 --> 02:05:26,729 OUR NATIONAL ADVISORY COUNCIL. 2372 02:05:26,729 --> 02:05:30,266 WE HAD OVER 30 EXPERTS. 2373 02:05:30,266 --> 02:05:33,135 DR. GASKINS WAS AN EXPERT ON THE 2374 02:05:33,135 --> 02:05:36,105 WORK WE DID AS WELL AS 2375 02:05:36,105 --> 02:05:37,539 DR. MANSON WHO WAS PREVIOUSLY ON 2376 02:05:37,539 --> 02:05:46,515 THE COUNCIL. 2377 02:05:46,515 --> 02:05:48,717 WE LEARNED HOW OTHER INSTITUTES 2378 02:05:48,717 --> 02:05:51,587 DID THEIR STRATEGIC PLANNING FOR 2379 02:05:51,587 --> 02:05:52,354 GLOBAL HEALTH AND HAD 2380 02:05:52,354 --> 02:05:54,924 DR. STINSON AND OTHERS 2381 02:05:54,924 --> 02:05:55,824 PARTICIPATING IN THE TRANS NIH 2382 02:05:55,824 --> 02:05:56,091 GROUP. 2383 02:05:56,091 --> 02:06:01,830 WE STARTED A HEALTH EQUITY WORK 2384 02:06:01,830 --> 02:06:03,766 GROUP FOR THE EXTRAMURAL STAFF 2385 02:06:03,766 --> 02:06:07,202 THAT WORKED ON A PORTFOLIO 2386 02:06:07,202 --> 02:06:10,472 ANALYSIS OF WHAT THE NINDS 2387 02:06:10,472 --> 02:06:12,474 FUNDED IN THE GLOBAL HEALTH 2388 02:06:12,474 --> 02:06:15,577 EQUITY SPACE FROM 2016 TO 2022. 2389 02:06:15,577 --> 02:06:26,121 WE HAD A REQUEST FOR INFORMATION 2390 02:06:26,121 --> 02:06:27,923 AND IN THE HEART OF THE PANDEMIC 2391 02:06:27,923 --> 02:06:29,825 WE DID THIS VIRTUALLY. 2392 02:06:29,825 --> 02:06:31,794 THE CAP STONE WAS A VIRTUAL 2393 02:06:31,794 --> 02:06:37,232 THREE AND A HALF DAY, TWO AND A 2394 02:06:37,232 --> 02:06:40,536 HALF DAY WORKSHOP WHERE WE GOT 2395 02:06:40,536 --> 02:06:43,706 MORE UNPUT FROM THE PUBLIC AND 2396 02:06:43,706 --> 02:06:46,809 HAD RESULTS PRESENTED TO OUR 2397 02:06:46,809 --> 02:06:49,778 WORKING GROUP OF OUR NATIONAL 2398 02:06:49,778 --> 02:06:50,312 ADVISORY COUNCIL AND PUT 2399 02:06:50,312 --> 02:06:51,413 TOGETHER RECOMMENDATIONS. 2400 02:06:51,413 --> 02:06:53,816 WE HAD RECOMMENDATIONS PUBLISHED 2401 02:06:53,816 --> 02:06:56,752 IN THE SERIES, DEDICATED SERIES 2402 02:06:56,752 --> 02:06:58,854 IN THE NEUROLOGY JOURNAL THAT 2403 02:06:58,854 --> 02:07:01,423 LISTED ALL THE OUTPUTS OF OUR 2404 02:07:01,423 --> 02:07:03,592 STRATEGIC PLANNING PROCESS. 2405 02:07:03,592 --> 02:07:07,363 WE USED THE HEALTHY PEOPLE 2030 2406 02:07:07,363 --> 02:07:09,331 DEFINITION OF HEALTH 2407 02:07:09,331 --> 02:07:09,932 DISPARITIES. 2408 02:07:09,932 --> 02:07:12,668 I WON'T GO THROUGH THAT. 2409 02:07:12,668 --> 02:07:15,170 I THINK DR. GASKINS TALKED ABOUT 2410 02:07:15,170 --> 02:07:18,273 AND THE DEFINITION OF HEALTH 2411 02:07:18,273 --> 02:07:24,580 EQUITY AND DID AN EXCELLENT JOB 2412 02:07:24,580 --> 02:07:26,448 TALKING ABOUT HEALTH EQUITY AND 2413 02:07:26,448 --> 02:07:26,715 EQUALITY. 2414 02:07:26,715 --> 02:07:28,684 THIS IS OPEN ACCESS AND WANTED 2415 02:07:28,684 --> 02:07:32,054 TO BE TRANS PARENT TO THE 2416 02:07:32,054 --> 02:07:34,523 PUBLIC. 2417 02:07:34,523 --> 02:07:37,359 -- TRANSPARENT TO THE PUBLIC AND 2418 02:07:37,359 --> 02:07:39,728 YOU DON'T NEED TO HAVE ACCESS TO 2419 02:07:39,728 --> 02:07:40,696 THIS BUT LOOK AT THE MANUSCRIPTS 2420 02:07:40,696 --> 02:07:48,137 HERE. 2421 02:07:48,137 --> 02:07:51,240 HE WANTED TO START THE 2422 02:07:51,240 --> 02:07:51,840 SUPPLEMENT WITH SOMETHING 2423 02:07:51,840 --> 02:07:53,742 SHOWING THE BANG OF DISPARITIES 2424 02:07:53,742 --> 02:08:03,585 AT NEUROLOGICAL DISORDERS. 2425 02:08:03,585 --> 02:08:08,357 THEY ASKED A QUESTION, WHAT 2426 02:08:08,357 --> 02:08:10,159 WOULD BE THE -- WHAT IS THE 2427 02:08:10,159 --> 02:08:11,527 ACCESS THAT OCCURS IN OTHER 2428 02:08:11,527 --> 02:08:16,498 RACIAL AND ETHNIC GROUPS USING 2429 02:08:16,498 --> 02:08:18,067 WHITES AS THE COMPARATOR IF THE 2430 02:08:18,067 --> 02:08:20,335 OTHER GROUPS HAD THE SAME 2431 02:08:20,335 --> 02:08:21,837 MORTALITY RATE AS WHITES. 2432 02:08:21,837 --> 02:08:24,740 WE CHOSE TO USE WHITES 2433 02:08:24,740 --> 02:08:26,075 INITIALLY, A PRIORITY THAT'S 2434 02:08:26,075 --> 02:08:28,744 USUALLY WHAT IS USED AS A 2435 02:08:28,744 --> 02:08:31,580 COMPARATOR AND WE LOOKED AT 2436 02:08:31,580 --> 02:08:33,949 OTHER GROUPS. 2437 02:08:33,949 --> 02:08:38,287 WE LOOKED AT THE C.D.C. DEATH 2438 02:08:38,287 --> 02:08:43,926 COUNTS AND ICD10 COUNTS AND 2439 02:08:43,926 --> 02:08:45,127 LOOKED THROUGH THOSE AND PULLED 2440 02:08:45,127 --> 02:08:47,262 OUT DISEASES THAT ARE 2441 02:08:47,262 --> 02:08:51,633 NEUROLOGICAL DISEASES AND THOSE 2442 02:08:51,633 --> 02:08:54,436 RELATED TO LIKE HYPERTENSION AND 2443 02:08:54,436 --> 02:08:57,573 USED NON-HISPANIC WHITE AS THE 2444 02:08:57,573 --> 02:08:57,840 REFERENCE. 2445 02:08:57,840 --> 02:09:00,576 WE LOOKED AT THE DEATH RATES 2446 02:09:00,576 --> 02:09:03,145 FROM 2010 TO 2019 AND THE 2447 02:09:03,145 --> 02:09:04,413 AGE-ADJUSTED MORTALITY RATE DUE 2448 02:09:04,413 --> 02:09:10,519 TO NEUROLOGICAL DISEASES BY RACE 2449 02:09:10,519 --> 02:09:16,458 AND ETHNICITY. 2450 02:09:16,458 --> 02:09:20,295 FOR NON-HISPANIC WHITES THERE'S 2451 02:09:20,295 --> 02:09:23,432 A SLIGHT DECLINE IN MORTALITY 2452 02:09:23,432 --> 02:09:29,771 DUE TO NEUROLOGICAL DISEASES AND 2453 02:09:29,771 --> 02:09:33,142 WE NOTICED A DECREASE IN THE 2454 02:09:33,142 --> 02:09:34,610 STROKE RATE IN THE UNITED STATES 2455 02:09:34,610 --> 02:09:39,581 HAUFR WE'RE STARTING TO SEE 2456 02:09:39,581 --> 02:09:41,650 YOUNGER STROKES IN AFRICAN 2457 02:09:41,650 --> 02:09:42,217 AMERICAN POPULATIONS. 2458 02:09:42,217 --> 02:09:44,186 THOUGH THERE'S BEEN A DECREASE, 2459 02:09:44,186 --> 02:09:46,788 THE MORTALITY RATIO COMPARING 2460 02:09:46,788 --> 02:09:48,257 NON-HISPANIC WHITES WITH 2461 02:09:48,257 --> 02:09:49,424 NON-HISPANIC BLACKS HAS BEEN THE 2462 02:09:49,424 --> 02:09:49,925 SAME. 2463 02:09:49,925 --> 02:09:51,560 THE DISPARITY HAS CONTINUED 2464 02:09:51,560 --> 02:09:54,796 DESPITE THE DECREASE. 2465 02:09:54,796 --> 02:09:56,031 THAT'S ALSO INCREASING FOR 2466 02:09:56,031 --> 02:09:57,065 AFRICAN AMERICANS. 2467 02:09:57,065 --> 02:10:00,269 INTERESTINGLY WHAT WE FOUND IS 2468 02:10:00,269 --> 02:10:03,038 THERE'S OTHER RACE ETHNIC GROUPS 2469 02:10:03,038 --> 02:10:04,740 IN THE UNITED STATES THAT HAVE 2470 02:10:04,740 --> 02:10:06,475 LOWER RATES THAN FOR WHITE 2471 02:10:06,475 --> 02:10:06,742 AMERICANS. 2472 02:10:06,742 --> 02:10:08,911 THIS IS WHY THE CONCEPT OF 2473 02:10:08,911 --> 02:10:09,878 HEALTH EQUITY IS IMPORTANT. 2474 02:10:09,878 --> 02:10:12,114 WE CAN LEARN FROM OTHER GROUPS 2475 02:10:12,114 --> 02:10:13,949 WHAT IS DIFFERENT IN THESE 2476 02:10:13,949 --> 02:10:16,718 POPULATIONS THAT THEY HAVE LESS 2477 02:10:16,718 --> 02:10:19,288 MORTALITY FROM NEUROLOGICAL 2478 02:10:19,288 --> 02:10:20,556 DISORDERS THAN WHITE PERSONS. 2479 02:10:20,556 --> 02:10:22,524 TO SUM THIS UP THERE WERE A 2480 02:10:22,524 --> 02:10:24,426 TOTAL OF EXCESS OF NEARLY 30,000 2481 02:10:24,426 --> 02:10:29,731 DEATHS THAT OCCURRED DURING THIS 2482 02:10:29,731 --> 02:10:33,035 PERIOD OF TIME IF THEY'D HAD THE 2483 02:10:33,035 --> 02:10:34,503 SAME MORTALITY RATES AS WHITES 2484 02:10:34,503 --> 02:10:38,140 THEY WOULD HAVE BEEN PRESERVED. 2485 02:10:38,140 --> 02:10:39,575 IF WE USED THE LOWER MORTALITY 2486 02:10:39,575 --> 02:10:41,443 RATES THE NUMBERS WOULD BE 2487 02:10:41,443 --> 02:10:42,711 HIGHER AND IN THE MANUSCRIPT WE 2488 02:10:42,711 --> 02:10:51,086 TALK ABOUT THAT AS WELL. 2489 02:10:51,086 --> 02:10:55,958 WE HAD A FRAMEWORK AND THERE'S 2490 02:10:55,958 --> 02:10:57,593 UPSTREAK BARRIERS TO HEALTH 2491 02:10:57,593 --> 02:10:59,561 EQUITY WE SEE IN NEUROLOGICAL 2492 02:10:59,561 --> 02:10:59,828 DISEASES. 2493 02:10:59,828 --> 02:11:01,530 WE HAD A COMMITTEE THAT FOCUSSED 2494 02:11:01,530 --> 02:11:07,369 ON THIS AND THIS WAS 2495 02:11:07,369 --> 02:11:10,138 SPECIFICALLY RELATED TO 2496 02:11:10,138 --> 02:11:10,839 NEUROLOGICAL DISEASES. 2497 02:11:10,839 --> 02:11:14,276 WE WANTED THE FRAMEWORK TO BE 2498 02:11:14,276 --> 02:11:14,977 COMPATIBLE WOMEN OTHER FRAME 2499 02:11:14,977 --> 02:11:17,412 WORKS AND IT'S COMBATABLE WITH 2500 02:11:17,412 --> 02:11:27,756 THE NIMHD FRAMEWORK. 2501 02:11:30,392 --> 02:11:36,164 AND SHOWED THE FACTORS. 2502 02:11:36,164 --> 02:11:37,532 THIS NINDS SOCIAL DETERMINATES 2503 02:11:37,532 --> 02:11:39,067 FRAMEWORK IS COMPATIBLE WITH 2504 02:11:39,067 --> 02:11:41,837 OTHERS AND WANT THE FUTURE 2505 02:11:41,837 --> 02:11:43,905 FUNDING ANNOUNCEMENTS FOR 2506 02:11:43,905 --> 02:11:47,042 ADVOCATORS TO CONSIDER THE 2507 02:11:47,042 --> 02:11:48,844 UPSTREAM BARRIERS IN IN HOW THEY 2508 02:11:48,844 --> 02:11:51,580 IMPACT HEALTH EQUITY MOVING 2509 02:11:51,580 --> 02:11:56,918 FORWARD. 2510 02:11:56,918 --> 02:11:59,154 THERE WERE RECOMMENDATIONS IN 2511 02:11:59,154 --> 02:12:01,356 PROBABLY SIX OF THE 10 2512 02:12:01,356 --> 02:12:02,424 MANUSCRIPTS PUBLISHED HERE. 2513 02:12:02,424 --> 02:12:10,332 OUR CHAIR OF OUR WORKING GROUP, 2514 02:12:10,332 --> 02:12:12,434 DR. KAREN JOHNSON AND OTHERS 2515 02:12:12,434 --> 02:12:14,870 CONDENSED THEM TO 18 HIGH-LEVEL 2516 02:12:14,870 --> 02:12:16,505 RECOMMENDATIONS PRESENTED TO OUR 2517 02:12:16,505 --> 02:12:17,572 NATIONAL ADVISORY COUNCIL AND 2518 02:12:17,572 --> 02:12:21,910 VOTED ON THIS AS BEING THE 2519 02:12:21,910 --> 02:12:23,178 RECOMMENDATIONS FROM THE 2520 02:12:23,178 --> 02:12:24,112 COMMITTEE WE SHOULD CONSIDER IN 2521 02:12:24,112 --> 02:12:26,148 TERMS OF ADDRESSING HEALTH 2522 02:12:26,148 --> 02:12:26,381 EQUITY. 2523 02:12:26,381 --> 02:12:31,586 WE TOOK THOSE 18 RECOMMENDATIONS 2524 02:12:31,586 --> 02:12:35,290 AND ACTUALLY TRANSFERRED THOSE 2525 02:12:35,290 --> 02:12:37,793 INTO AN IMPLEMENTATION MAN A 2526 02:12:37,793 --> 02:12:41,930 AND -- PLAN AND CREATED FOUR 2527 02:12:41,930 --> 02:12:43,098 BUCKETS INCLUDING EXPANDING 2528 02:12:43,098 --> 02:12:44,533 SUPPORT FOR HEALTH EQUITY 2529 02:12:44,533 --> 02:12:48,203 RESEARCH, PROMOTE COMMUNITY 2530 02:12:48,203 --> 02:12:54,743 ENGAGEMENT WITH THE NIMHD BY 2531 02:12:54,743 --> 02:12:56,778 POPULATION AND THE WORKFORCE 2532 02:12:56,778 --> 02:13:03,418 WHICH IS AN UNDERLYING THEME AND 2533 02:13:03,418 --> 02:13:04,853 EXPAND COMMUNICATION AND 2534 02:13:04,853 --> 02:13:07,422 OUTREACH AND WE LOOKED AT THE 2535 02:13:07,422 --> 02:13:10,425 POLICY LEVERS AND RELATED THINGS 2536 02:13:10,425 --> 02:13:11,526 TO ENACT OUR HEALTH EQUITY 2537 02:13:11,526 --> 02:13:11,993 STRATEGIC PLANS. 2538 02:13:11,993 --> 02:13:14,196 I'M GOING TO HIGHLIGHT A FEW OF 2539 02:13:14,196 --> 02:13:15,597 THE THINGS WE'RE DOING IN THIS 2540 02:13:15,597 --> 02:13:22,304 PARTICULAR SPACE. 2541 02:13:22,304 --> 02:13:23,505 ONE IS A PUBLIC HEALTH CAMPAIGN 2542 02:13:23,505 --> 02:13:25,640 THAT WAS A REFRESH OF A PREVIOUS 2543 02:13:25,640 --> 02:13:29,211 CAMPAIGN INITIATED THROUGH THE 2544 02:13:29,211 --> 02:13:31,146 NINDS CALLED THE MIND YOUR RISK 2545 02:13:31,146 --> 02:13:31,413 CAMPAIGN. 2546 02:13:31,413 --> 02:13:34,049 THIS WAS GEARED SPECIFICALLY TO 2547 02:13:34,049 --> 02:13:36,518 AFRICAN AMERICAN MEN BETWEEN 28 2548 02:13:36,518 --> 02:13:37,786 TO 45. 2549 02:13:37,786 --> 02:13:39,321 THAT POPULATION IS THE PONG THAT 2550 02:13:39,321 --> 02:13:44,393 IS AT HIGHEST RISK FOR 2551 02:13:44,393 --> 02:13:45,961 DEVELOPING IMPAIRMENT AND 2552 02:13:45,961 --> 02:13:49,464 DEMENTIA LATER ON LIFE BASED ON 2553 02:13:49,464 --> 02:13:55,137 THE SPRINT TRIAL AND A SUB STUDY 2554 02:13:55,137 --> 02:13:56,104 CALLED THE SPRINT MIND STUDY 2555 02:13:56,104 --> 02:13:59,141 THEY LOOKED AT THE STUDY LOOKING 2556 02:13:59,141 --> 02:14:02,544 AT MODERATE CONTROL VERSUS 2557 02:14:02,544 --> 02:14:06,047 HAWAHIGH 2558 02:14:06,047 --> 02:14:10,819 CONTROL AND OUTCOMES AND IT WAS 2559 02:14:10,819 --> 02:14:11,820 INCREASED IN PEOPLE WITH HIGH 2560 02:14:11,820 --> 02:14:13,588 BLOOD PRESSURE AND THEY HAD 2561 02:14:13,588 --> 02:14:14,756 LOWER RATES OF COGNITIVE 2562 02:14:14,756 --> 02:14:16,758 IMPAIRMENT WHICH IS THE FIRST 2563 02:14:16,758 --> 02:14:18,260 STEP TOWARDS DEVELOPING DEMENTIA 2564 02:14:18,260 --> 02:14:20,295 LATER IN LIFE. 2565 02:14:20,295 --> 02:14:21,763 SO WE PUT TOGETHER FOCUS GROUPS 2566 02:14:21,763 --> 02:14:23,165 AND WE CAME UP WITH TAG LINES 2567 02:14:23,165 --> 02:14:24,466 RELATED TO THIS THAT WOULD BE 2568 02:14:24,466 --> 02:14:25,700 MOTIVATE BEING TO OUR TARGET 2569 02:14:25,700 --> 02:14:32,741 POPULATION TO ADDRESS THIS. 2570 02:14:32,741 --> 02:14:35,210 THAT GROUP IS AT HIGHEST RISK 2571 02:14:35,210 --> 02:14:40,515 FOR UNCONTROLLED HYPERTENSION. 2572 02:14:40,515 --> 02:14:46,521 WE ESTABLISHED COMMUNITY 2573 02:14:46,521 --> 02:14:46,788 PARTNERS. 2574 02:14:46,788 --> 02:14:50,292 WHERE HE HAD THE AMERICAN STROKE 2575 02:14:50,292 --> 02:14:52,761 ASSOCIATION CENTER FOR BLACK 2576 02:14:52,761 --> 02:14:54,129 HEALTH INEQUITY AND OTHERS AND 2577 02:14:54,129 --> 02:14:58,400 WORKED WITH HBCUs AND ALUMNI 2578 02:14:58,400 --> 02:15:04,506 NETWORKS AND DID A LOT OF 2579 02:15:04,506 --> 02:15:10,512 WEBINARS WITH MOREHOUSE COLLEGE 2580 02:15:10,512 --> 02:15:12,981 AND THE WORK WITH HEALTH CENTER 2581 02:15:12,981 --> 02:15:16,218 AND HBCU ALLIANCE AND 2582 02:15:16,218 --> 02:15:18,954 PHILADELPHIA HBCU ALLIANCE AND 2583 02:15:18,954 --> 02:15:23,225 ATLANTA HBCU ALLIANCE AND DID 2584 02:15:23,225 --> 02:15:24,359 SEVERAL RADIO STATIONS AND DID 2585 02:15:24,359 --> 02:15:27,596 SEVERAL WEBINARS WITH THEM AS 2586 02:15:27,596 --> 02:15:33,568 WELL. 2587 02:15:33,568 --> 02:15:35,370 AND THERE WAS THE NATIONAL 2588 02:15:35,370 --> 02:15:37,739 ASSOCIATION OF BLACK JOURNALISTS 2589 02:15:37,739 --> 02:15:40,509 WELL ATTENDED. 2590 02:15:40,509 --> 02:15:42,110 SEVERAL PEOPLE PARTICIPATED. 2591 02:15:42,110 --> 02:15:45,780 I TALKED ABOUT THIS PUBLIC 2592 02:15:45,780 --> 02:15:47,582 COMMENT CAMPAIGN AND WE LOOKED 2593 02:15:47,582 --> 02:15:49,784 AT MEASURES OF SUCCESS AND WE 2594 02:15:49,784 --> 02:15:51,052 IMPROVED PEOPLE'S BLOOD PRESSURE 2595 02:15:51,052 --> 02:15:53,154 AND DECREASED THE RATES OF 2596 02:15:53,154 --> 02:15:55,090 DEVELOPING STROKE. 2597 02:15:55,090 --> 02:15:56,892 WHAT WE DID AS IS LOOK AT THE 2598 02:15:56,892 --> 02:16:01,596 NUMBER OF VIEWS AND CLIKDZ TO 2599 02:16:01,596 --> 02:16:06,067 THE WEBSITE AND PEOPLE THAT -- 2600 02:16:06,067 --> 02:16:07,469 CLICKS TO THE WEBSITE AND PEOPLE 2601 02:16:07,469 --> 02:16:09,471 THAT LOOKED AT THE INFORMING AND 2602 02:16:09,471 --> 02:16:10,505 I APOLOGIZE FOR THE SLIDES. 2603 02:16:10,505 --> 02:16:13,975 FOR SOME REASON THEY'RE NOT 2604 02:16:13,975 --> 02:16:14,809 TRANSFERRING WELL. 2605 02:16:14,809 --> 02:16:16,177 WE DID SOMETHING CALLED THE 2606 02:16:16,177 --> 02:16:19,581 COMMUNITY ENGAGED HEALTH EQUITY 2607 02:16:19,581 --> 02:16:20,515 RESEARCH INITIATIVE. 2608 02:16:20,515 --> 02:16:24,853 IT WAS AN INITIATIVE TO INCREASE 2609 02:16:24,853 --> 02:16:27,055 OUR POTENTIAL FUNDING PORTFOLIO 2610 02:16:27,055 --> 02:16:28,523 RELATED TO HEALTH EQUITY 2611 02:16:28,523 --> 02:16:28,790 RESEARCH. 2612 02:16:28,790 --> 02:16:31,526 WITH THIS INITIATIVE WE HAD 2613 02:16:31,526 --> 02:16:32,127 THREE COMPONENTS. 2614 02:16:32,127 --> 02:16:36,698 ONE WAS COMMUNITY ENGAGEMENT. 2615 02:16:36,698 --> 02:16:40,502 THE OTHER HEALTH EQUITY RESEARCH 2616 02:16:40,502 --> 02:16:43,371 HAD TO BE A HEALTH EQUITY 2617 02:16:43,371 --> 02:16:45,373 RESEARCH AND MULTI-DISCIPLINARY 2618 02:16:45,373 --> 02:16:45,574 TEAM. 2619 02:16:45,574 --> 02:16:46,675 THE COMMUNITY ENGAGEMENT I'LL 2620 02:16:46,675 --> 02:16:49,844 TALK ABOUT IN TERMS OF MAKING 2621 02:16:49,844 --> 02:16:51,580 SURE THIS WAS AN EFFECTIVE 2622 02:16:51,580 --> 02:16:54,950 COMMUNITY ENGAGEMENT WITH THE 2623 02:16:54,950 --> 02:16:57,552 POPULATIONS IDENTIFIED TO 2624 02:16:57,552 --> 02:16:59,521 EXPERIENCE HEALTH DISPARITIES. 2625 02:16:59,521 --> 02:17:02,090 DR. KOROSHETZ WAS CLEAR HE 2626 02:17:02,090 --> 02:17:03,825 WANTED US TO MOVE FROM 2627 02:17:03,825 --> 02:17:06,127 CONTINUING TO ADMIRING THE 2628 02:17:06,127 --> 02:17:08,229 PROBLEMS OF DISPARITIES AND MOVE 2629 02:17:08,229 --> 02:17:10,532 TOWARDS INTERVENTION. 2630 02:17:10,532 --> 02:17:12,300 ONE WAS CLINICAL TRIAL. 2631 02:17:12,300 --> 02:17:15,403 WITH THE INTENTION OF CLINICAL 2632 02:17:15,403 --> 02:17:16,671 TRIAL READINESS FOR FUTURE 2633 02:17:16,671 --> 02:17:19,574 CLINICAL TRIALS IN THIS 2634 02:17:19,574 --> 02:17:20,275 PARTICULAR AREA. 2635 02:17:20,275 --> 02:17:22,177 I TALKED ABOUT THE COMMUNITY 2636 02:17:22,177 --> 02:17:22,510 ENGAGEMENT. 2637 02:17:22,510 --> 02:17:23,979 WE WANTED TO HAVE EFFECTIVE 2638 02:17:23,979 --> 02:17:25,046 COMMUNITY ENGAGEMENT. 2639 02:17:25,046 --> 02:17:26,881 WE ASKED IN THEIR APPLICATION 2640 02:17:26,881 --> 02:17:32,087 THEY PUT IN WHAT WE CALL A 2641 02:17:32,087 --> 02:17:34,089 COMMUNITY ENGAGEMENT AND 2642 02:17:34,089 --> 02:17:36,157 INCLUSION PLAN AND PLAN TO 2643 02:17:36,157 --> 02:17:38,526 ENHANCE DIVERSE PERSPECTIVES. 2644 02:17:38,526 --> 02:17:39,861 THOSE WERE SEPARATE ATTACHMENTS 2645 02:17:39,861 --> 02:17:42,530 THEY INCLUDED IN THEIR 2646 02:17:42,530 --> 02:17:42,931 APPLICATION. 2647 02:17:42,931 --> 02:17:45,600 THEY HAD TO INCLUDE PEOPLE WITH 2648 02:17:45,600 --> 02:17:46,968 LIVED EXPERIENCE OR PEOPLE THAT 2649 02:17:46,968 --> 02:17:48,637 ARE FAMILY MEMBERS RELATED TO 2650 02:17:48,637 --> 02:17:51,072 THE DISEASE THEY'RE STUDYING 2651 02:17:51,072 --> 02:17:52,540 FROM ONE OF THE POMPS THAT 2652 02:17:52,540 --> 02:17:54,709 EXPERIENCE HEALTH DISPARITIES. 2653 02:17:54,709 --> 02:17:58,913 HAD TO HAVE A COMMUNITY PARTNER 2654 02:17:58,913 --> 02:18:00,515 AS WELL THEY WORKED WITH. 2655 02:18:00,515 --> 02:18:03,051 HOPEFULLY YOU CAN SEE THAT ON 2656 02:18:03,051 --> 02:18:03,618 THE SLIDE. 2657 02:18:03,618 --> 02:18:04,853 ESTABLISH AND ASKED SPECIFICALLY 2658 02:18:04,853 --> 02:18:07,222 FOR THEM TO ESTABLISH A 2659 02:18:07,222 --> 02:18:09,924 PARTNERSHIP AGREEMENT WITH THE 2660 02:18:09,924 --> 02:18:10,458 COMMUNITY PARTNER AS WELL. 2661 02:18:10,458 --> 02:18:12,160 AND TO WRITE THIS DOWN IN TERMS 2662 02:18:12,160 --> 02:18:18,533 OF HOW THEY'LL INCORPORATE THIS 2663 02:18:18,533 --> 02:18:19,167 BI-DIRECTIONAL INPUT BACK TO THE 2664 02:18:19,167 --> 02:18:21,403 RESEARCH. 2665 02:18:21,403 --> 02:18:24,272 AND WE WANTED THIS TO BE 2666 02:18:24,272 --> 02:18:25,740 COMMUNITY-ENGAGED RESEARCH AND 2667 02:18:25,740 --> 02:18:28,343 INCLUDE SUCCESS METRICS SHOWING 2668 02:18:28,343 --> 02:18:32,080 THE COMMUNITY ENGAGEMENT AND 2669 02:18:32,080 --> 02:18:34,983 OUTCOMES ARE A SUCCESS AND 2670 02:18:34,983 --> 02:18:35,216 WORKING. 2671 02:18:35,216 --> 02:18:38,953 THE OTHER THING WE'VE DONE IS 2672 02:18:38,953 --> 02:18:40,422 WE'RE TRULY TRANS NINDS. 2673 02:18:40,422 --> 02:18:44,659 WE WORKED WITH OTHER PROGRAM 2674 02:18:44,659 --> 02:18:44,926 DIRECTORS. 2675 02:18:44,926 --> 02:18:47,162 MY IS STROKE BUT WE HAVE OTHER 2676 02:18:47,162 --> 02:18:51,299 EXPERTS WITH OTHER NEUROLOGICAL 2677 02:18:51,299 --> 02:18:52,967 DISEASES ACROSS THE NINDS. 2678 02:18:52,967 --> 02:18:58,540 WE WORK WITH THEM THROUGH THE 2679 02:18:58,540 --> 02:19:00,742 STROKE NETWORK AND HAD SOMEONE 2680 02:19:00,742 --> 02:19:01,409 WORK WITH THE HEAL INITIATIVE 2681 02:19:01,409 --> 02:19:03,778 DOING EQUITY WITH THAT AND THE 2682 02:19:03,778 --> 02:19:06,181 UNDIAGNOSED NETWORK PREVIOUSLY A 2683 02:19:06,181 --> 02:19:09,350 COMMON FUND NETWORK THAT WAS 2684 02:19:09,350 --> 02:19:11,352 RECENTLY TRANSFERRED TO THE 2685 02:19:11,352 --> 02:19:11,953 NINDS AS WELL. 2686 02:19:11,953 --> 02:19:16,424 THAT'S ANOTHER NETWORK I WORKED 2687 02:19:16,424 --> 02:19:16,624 WITH. 2688 02:19:16,624 --> 02:19:18,426 NOW I'LL BRIEFLY TALK ABOUT THE 2689 02:19:18,426 --> 02:19:20,595 CONCEPT OF GLOBAL HEALTH EQUITY. 2690 02:19:20,595 --> 02:19:24,232 AGAIN THE MISSION IS TO DECREASE 2691 02:19:24,232 --> 02:19:27,135 THE BURDEN OF NEUROLOGICAL 2692 02:19:27,135 --> 02:19:29,370 DISEASE FOR ALL NATIONALLY AND 2693 02:19:29,370 --> 02:19:29,738 INTERNATIONALLY. 2694 02:19:29,738 --> 02:19:31,573 ONE OF THE THINGS WE'RE 2695 02:19:31,573 --> 02:19:33,374 CURRENTLY GOING THROUGH THE 2696 02:19:33,374 --> 02:19:34,008 STRATEGIC PLANNING PROCESS FOR 2697 02:19:34,008 --> 02:19:35,443 GLOBAL HEALTH. 2698 02:19:35,443 --> 02:19:39,647 WE MET WITH VARIOUS INSTITUTES 2699 02:19:39,647 --> 02:19:41,616 ACROSS THE NIH THAT DO GLOBAL 2700 02:19:41,616 --> 02:19:44,252 HEALTH RESEARCH AND WANTED TO 2701 02:19:44,252 --> 02:19:45,653 DEFINE GLOBAL HEALTH RESEARCH. 2702 02:19:45,653 --> 02:19:47,922 THE DEFINITION WE'RE USING IS 2703 02:19:47,922 --> 02:19:49,290 RESEARCH SPECIFICALLY GEARED 2704 02:19:49,290 --> 02:19:50,358 TOWARDS LOW AND MIDDLE INCOME 2705 02:19:50,358 --> 02:19:52,727 COUNTRIES AND SEPARATED THAT 2706 02:19:52,727 --> 02:19:54,395 FROM INTERNATIONAL RESEARCH WITH 2707 02:19:54,395 --> 02:19:56,664 HIGH INCOME COUNTRIES AS WELL. 2708 02:19:56,664 --> 02:19:59,567 WHEN WE FOCUS WE'LL LOOK AMOUNT 2709 02:19:59,567 --> 02:20:01,069 OUR WHOLE PORTFOLIO OF 2710 02:20:01,069 --> 02:20:01,836 INTERNATIONAL RESEARCH AND 2711 02:20:01,836 --> 02:20:05,140 GEARING OUR RESEARCH TO LOW AND 2712 02:20:05,140 --> 02:20:06,674 MIDDLE INCOME COUNTRIES. 2713 02:20:06,674 --> 02:20:08,710 I WANTED TO SHOW DATA IN TERMS 2714 02:20:08,710 --> 02:20:12,614 OF THE BURDEN OF NEUROLOGICAL 2715 02:20:12,614 --> 02:20:13,848 DISEASES. 2716 02:20:13,848 --> 02:20:15,583 THIS WAS PUBLISHED IN MARCH OF 2717 02:20:15,583 --> 02:20:18,653 THIS YEAR AND NEUROLOGICAL 2718 02:20:18,653 --> 02:20:20,121 CONDITIONS ARE THE LEADING CAUSE 2719 02:20:20,121 --> 02:20:23,057 OF DISEASE BURDEN WORLDWIDE. 2720 02:20:23,057 --> 02:20:25,393 IN 2023 THERE WERE 3.4 2721 02:20:25,393 --> 02:20:27,595 INDIVIDUALS IN THE WORLD WITH 2722 02:20:27,595 --> 02:20:29,531 CONDITIONS AFFECTING THEIR 2723 02:20:29,531 --> 02:20:32,433 NERVOUS SYSTEM KEY EQUIVALENT OF 2724 02:20:32,433 --> 02:20:34,135 THE WORLD'S POPULATION AND LOOK 2725 02:20:34,135 --> 02:20:38,206 AT ADJUSTED LIFE YEARS THAT'S 2726 02:20:38,206 --> 02:20:40,475 443 MILLION OF DAILIES THERE. 2727 02:20:40,475 --> 02:20:44,779 I HAVE SOME DISEASES ON THE 2728 02:20:44,779 --> 02:20:46,080 RIGHT SIDE. 2729 02:20:46,080 --> 02:20:47,582 STROKE IS THE FIFTH MOST COMMON 2730 02:20:47,582 --> 02:20:49,951 CAUSE OF DEATH IN THE UNITED 2731 02:20:49,951 --> 02:20:50,185 STATES. 2732 02:20:50,185 --> 02:20:51,686 IT'S THE SECOND MOST COMMON 2733 02:20:51,686 --> 02:20:53,121 CAUSE OF DEATH WORLDWIDE. 2734 02:20:53,121 --> 02:20:54,956 IT'S MAJOR AND THEN WE HAVE 2735 02:20:54,956 --> 02:20:58,493 OTHER NEUROLOGICAL CONDITIONS. 2736 02:20:58,493 --> 02:21:03,598 SO NEUROLOGICAL CONDITIONS ARE 2737 02:21:03,598 --> 02:21:09,671 BIG GLOBALLY AS WELL. 2738 02:21:09,671 --> 02:21:13,308 WE SEE LOW AND MIDDLE INCOME 2739 02:21:13,308 --> 02:21:15,276 COUNTRIES AND OTHER AREAS WELL. 2740 02:21:15,276 --> 02:21:18,012 I APOLOGIZE WE PUT A LOT OF TIME 2741 02:21:18,012 --> 02:21:19,447 IN THE SLIDES AND THEY'RE NOT 2742 02:21:19,447 --> 02:21:20,582 SHOWING WELL. 2743 02:21:20,582 --> 02:21:26,588 A LOT OF OUR FUNDING IS IN 2744 02:21:26,588 --> 02:21:29,457 SUB-SAHARAN AFRICA. 2745 02:21:29,457 --> 02:21:30,391 WE ALSO FUND WORK IN SOUTH 2746 02:21:30,391 --> 02:21:33,628 AMERICA AND ASIA AS WELL. 2747 02:21:33,628 --> 02:21:35,563 THERE'S LOW AND MIDDLE INCOME 2748 02:21:35,563 --> 02:21:36,331 COUNTRIES AS WELL. 2749 02:21:36,331 --> 02:21:38,399 JUST LISTING VARIOUS COUNTRIES 2750 02:21:38,399 --> 02:21:39,567 WHERE WE FUND GLOBAL HEALTH 2751 02:21:39,567 --> 02:21:39,901 RESEARCH. 2752 02:21:39,901 --> 02:21:45,707 A LOT OF OUR FUNDING IS THROUGH 2753 02:21:45,707 --> 02:21:47,508 THE FOGARTY GLOBAL BRAIN AND 2754 02:21:47,508 --> 02:21:53,147 HAVE AN R21 AND RO1 I WON'T GO 2755 02:21:53,147 --> 02:21:56,684 INTO FOR TIME AND WE TRAIN 2756 02:21:56,684 --> 02:22:07,262 PEOPLE AND RESEARCH WE FUND TO 2757 02:22:07,262 --> 02:22:09,030 CONSORTIA THAT FOCUS ON 2758 02:22:09,030 --> 02:22:12,133 NEUROLOGICAL DISORDERS AND FUND 2759 02:22:12,133 --> 02:22:15,036 INDIVIDUALS UNDER THESE TWO 2760 02:22:15,036 --> 02:22:15,303 PROGRAMS. 2761 02:22:15,303 --> 02:22:19,073 WITH THIS PROGRAM WE HAVE A NICE 2762 02:22:19,073 --> 02:22:20,108 MIXTURE OF TRAINING WHERE WE CAN 2763 02:22:20,108 --> 02:22:21,376 SEND PEOPLE FROM THE U.S. OR 2764 02:22:21,376 --> 02:22:23,711 FROM THESE COUNTRIES CAN COME TO 2765 02:22:23,711 --> 02:22:28,316 THE U.S. TO TRAIN TO DO 2766 02:22:28,316 --> 02:22:29,517 BIOMEDICAL RESEARCH IN 2767 02:22:29,517 --> 02:22:30,518 NEUROLOGICAL DISORDERS. 2768 02:22:30,518 --> 02:22:32,453 LASTLY I'LL TALK ABOUT THE WORK 2769 02:22:32,453 --> 02:22:34,822 WE'RE DOING IN ZAMBIA WITH TWO 2770 02:22:34,822 --> 02:22:39,594 OF OUR FUNDED ADVOCATORS, 2771 02:22:39,594 --> 02:22:45,333 DR. SAILOR AND DR. GRETCHEN 2772 02:22:45,333 --> 02:22:46,501 BURK. 2773 02:22:46,501 --> 02:22:48,069 THEY'VE BEEN WORK BEING IN 2774 02:22:48,069 --> 02:22:50,338 ZAMBIA FOR A LONG PERIOD OF 2775 02:22:50,338 --> 02:22:51,572 TIME. 2776 02:22:51,572 --> 02:22:59,147 UP TO 2018 THERE WERE NO ZAMBIAN 2777 02:22:59,147 --> 02:23:00,782 TRAINED BIOLOGISTS IN THE 2778 02:23:00,782 --> 02:23:01,516 COUNTRY. 2779 02:23:01,516 --> 02:23:05,386 I EXPLAINED THE BURDEN OF 2780 02:23:05,386 --> 02:23:07,221 NEUROLOGICAL DISEASE THERE AND 2781 02:23:07,221 --> 02:23:09,590 THEY STARTED A NEUROLOGY 2782 02:23:09,590 --> 02:23:10,491 RESIDENCY TRAINING PROGRAM IN 2783 02:23:10,491 --> 02:23:12,160 THE COUNTRY WHERE THEY WORKED 2784 02:23:12,160 --> 02:23:14,028 WITH THEM THROUGH THEIR RESEARCH 2785 02:23:14,028 --> 02:23:16,064 PROGRAMS BUT ALSO TAUGHT THEM 2786 02:23:16,064 --> 02:23:20,535 HOW TO BE A NEUROLOGIST AND TOOK 2787 02:23:20,535 --> 02:23:21,569 INTERNISTS AND OTHER SPECIALTIES 2788 02:23:21,569 --> 02:23:23,571 AND TRAINED THEM TO BE 2789 02:23:23,571 --> 02:23:25,473 NEUROLOGISTS. 2790 02:23:25,473 --> 02:23:27,809 WE TRAVELED THERE WITH THE 2791 02:23:27,809 --> 02:23:28,843 DIVISION DIRECTOR FOR OUR 2792 02:23:28,843 --> 02:23:29,944 DIVISION OF CLINICAL RESEARCH 2793 02:23:29,944 --> 02:23:33,881 AND MYSELF AND ONE OTHER PERSON 2794 02:23:33,881 --> 02:23:41,389 AND STACY CHAMBER AND WENT TO I 2795 02:23:41,389 --> 02:23:45,827 AGRADUA GAR 2796 02:23:45,827 --> 02:23:47,595 TO A GRADUATION AND YOU SHOULD 2797 02:23:47,595 --> 02:23:53,101 HAVE A CLEAR PICTURE OF THE 2798 02:23:53,101 --> 02:23:54,469 SYMPTOMOLOGY AND YOU SHOULD GET 2799 02:23:54,469 --> 02:23:58,339 A GOOD MENTAL PICTURE. 2800 02:23:58,339 --> 02:24:02,310 INTERESTINGLY THERE WERE SEVERAL 2801 02:24:02,310 --> 02:24:04,545 WHO TRAINED ZAMBIAN NEUROLOGISTS 2802 02:24:04,545 --> 02:24:15,089 AND SAID THEY DID AN EXCELLENT 2803 02:24:16,858 --> 02:24:20,595 JOB AND WE HAVE IT IN THE RECORD 2804 02:24:20,595 --> 02:24:20,828 LISTED. 2805 02:24:20,828 --> 02:24:22,196 WE'RE CURRENTLY GOING THROUGH 2806 02:24:22,196 --> 02:24:24,899 THE SAME PROCESS WE WENT THROUGH 2807 02:24:24,899 --> 02:24:26,434 FOR HEALTH EQUITY. 2808 02:24:26,434 --> 02:24:27,869 WE'RE GOING THROUGH THE SAME 2809 02:24:27,869 --> 02:24:30,004 PROFESSION FOR GLOBAL HEALTH AS 2810 02:24:30,004 --> 02:24:30,371 WELL. 2811 02:24:30,371 --> 02:24:33,841 I WON'T GO EACH OF THOSE IN 2812 02:24:33,841 --> 02:24:34,075 DETAIL. 2813 02:24:34,075 --> 02:24:36,544 THIS COULD NOT BE DONE ALONE. 2814 02:24:36,544 --> 02:24:42,116 WE HAVE A SMALL OFFICE BUT 2815 02:24:42,116 --> 02:24:43,284 PROFESSIONAL STAFF FOCUSSED ON 2816 02:24:43,284 --> 02:24:44,152 THIS RESEARCH. 2817 02:24:44,152 --> 02:24:46,054 WE ALSO WORK ACROSS OUR 2818 02:24:46,054 --> 02:24:47,288 INSTITUTE WITH OTHER PEOPLE. 2819 02:24:47,288 --> 02:24:49,223 I'D LIKE TO HIGHLIGHT THEIR 2820 02:24:49,223 --> 02:24:50,324 NAMES HERE IN THEIR PARTICULAR 2821 02:24:50,324 --> 02:24:51,559 SLIDE AS WELL. 2822 02:24:51,559 --> 02:24:55,596 WE HAVE A NEWSLETTER MY OFFICE 2823 02:24:55,596 --> 02:24:56,497 PUTS OUT AND SEND OUT 2824 02:24:56,497 --> 02:24:59,200 INFORMATION RELATED TO HEALTH 2825 02:24:59,200 --> 02:24:59,901 EQUITY AS WELL AS GLOBAL HEALTH 2826 02:24:59,901 --> 02:25:03,604 AND HAVE FUNDING ANNOUNCEMENT ON 2827 02:25:03,604 --> 02:25:05,673 THE WEBSITE AS WELL. 2828 02:25:05,673 --> 02:25:06,574 SO THAT'S MY LAST SLIDE. 2829 02:25:06,574 --> 02:25:09,310 I'M GOING TO STOP HERE AND SEE 2830 02:25:09,310 --> 02:25:12,480 IF YOU HAVE QUESTIONS FOR 2831 02:25:12,480 --> 02:25:19,821 DR. KOROSHETZ AND I. 2832 02:25:19,821 --> 02:25:21,889 >> THANK YOU, RICHARD THAT WAS 2833 02:25:21,889 --> 02:25:24,258 TERRIFIC AND WALTER AS WELL. 2834 02:25:24,258 --> 02:25:27,195 I APPRECIATE THE AND IMPORTANCE 2835 02:25:27,195 --> 02:25:30,231 OF THE DIMENSION OF THE PROBLEM. 2836 02:25:30,231 --> 02:25:33,434 I'M GLAD YOU MENTIONED THE STUDY 2837 02:25:33,434 --> 02:25:35,603 IN KAISER WHICH IS WHAT I WAS 2838 02:25:35,603 --> 02:25:38,106 IMPLYING ABOUT MODELS WE KNOW 2839 02:25:38,106 --> 02:25:40,341 WORK THAT HAVE NOT BEEN 2840 02:25:40,341 --> 02:25:41,375 DISSEMINATED AS WIDELY IN OTHER 2841 02:25:41,375 --> 02:25:42,743 PARTS OF THE COUNTRY. 2842 02:25:42,743 --> 02:25:46,547 COMMENTS AND QUESTIONS FROM OUR 2843 02:25:46,547 --> 02:25:49,283 COUNCIL MEMBERS? 2844 02:25:49,283 --> 02:25:49,617 YES, VALERIE. 2845 02:25:49,617 --> 02:25:52,553 >> THANK YOU FOR THE SCLEPT 2846 02:25:52,553 --> 02:25:54,589 PRESENTATION. 2847 02:25:54,589 --> 02:26:00,061 I'M CURIOUS ABOUT EFFORTS TO 2848 02:26:00,061 --> 02:26:01,362 TRAIN AND SUPPORT MEDICAL 2849 02:26:01,362 --> 02:26:03,564 STUDENTS WHO WOULD LIKE TO GO 2850 02:26:03,564 --> 02:26:09,570 INTO THIS AREA IN OUR TRIBAL 2851 02:26:09,570 --> 02:26:09,871 POPULATIONS. 2852 02:26:09,871 --> 02:26:15,877 THERE'S LIMITED ACCESS TO 2853 02:26:15,877 --> 02:26:17,845 NEUROLOGISTS. 2854 02:26:17,845 --> 02:26:17,945 6: 2855 02:26:19,647 --> 02:26:21,315 AS THE POPULATION AGES WE'RE 2856 02:26:21,315 --> 02:26:24,752 SEEING YEAR-PLUS WAITS TO SEE 2857 02:26:24,752 --> 02:26:25,086 NEUROLOGISTS. 2858 02:26:25,086 --> 02:26:30,324 I'M WONDERING IF THERE'S BEEN AN 2859 02:26:30,324 --> 02:26:32,760 EMPHASIS ON TRAINING PHYSICIANS 2860 02:26:32,760 --> 02:26:36,731 WOULD WOULD LIKE TO WORK IN 2861 02:26:36,731 --> 02:26:46,974 TRIBAL HEALTH. 2862 02:26:51,112 --> 02:26:53,247 >> I DON'T KNOW ANYTHING IN THAT 2863 02:26:53,247 --> 02:26:53,481 SPACE. 2864 02:26:53,481 --> 02:26:57,785 WE HAVE AT NINDS A PROGRAM THAT 2865 02:26:57,785 --> 02:27:00,388 BRINGS IN STUDENTS INTO 2866 02:27:00,388 --> 02:27:02,623 NEUROSCIENCE IN THE SUMMER AND 2867 02:27:02,623 --> 02:27:04,458 THEY'RE MINTED OVER THE YEAR. 2868 02:27:04,458 --> 02:27:06,561 THE PROBLEM HAS BEEN DOING ON 2869 02:27:06,561 --> 02:27:08,162 PROBABLY 15, 20 YEARS. 2870 02:27:08,162 --> 02:27:15,136 MANY OF THOSE FOLKS GO ON TO 2871 02:27:15,136 --> 02:27:19,974 CAREERS IN MEDICINE. 2872 02:27:19,974 --> 02:27:22,543 DO YOU HAVE THOUGHTS IN HOW TO 2873 02:27:22,543 --> 02:27:30,284 DO THAT IF IT HAPPENED? 2874 02:27:30,284 --> 02:27:38,693 >> WITH OUR MEDICAL SCHOOL 2875 02:27:38,693 --> 02:27:42,029 PLACED ONE IN RESERVATION AND 2876 02:27:42,029 --> 02:27:44,098 GEKT THEM TO GO TO GENERAL HAS 2877 02:27:44,098 --> 02:27:49,003 BEEN SUCCESSFUL SO FAR IN 2878 02:27:49,003 --> 02:27:49,637 GETTING PHYSICIANS TO STAY IN 2879 02:27:49,637 --> 02:27:56,510 THESE RURAL LOCATIONS. 2880 02:27:56,510 --> 02:27:57,511 WHEN THEY'RE TRAINED THERE THEY 2881 02:27:57,511 --> 02:28:00,214 TEND TO MARRY AND STAY LOCAL BUT 2882 02:28:00,214 --> 02:28:04,919 I HAVEN'T SEEN ANYTHING THAT 2883 02:28:04,919 --> 02:28:06,988 ENCOURAGES CONTINUED TRAINING IN 2884 02:28:06,988 --> 02:28:09,590 THE AREAS OF NEUROLOGY AND 2885 02:28:09,590 --> 02:28:13,027 CANCER ARE THE BIG AREAS WHERE 2886 02:28:13,027 --> 02:28:14,028 YOU SEE A LOT OF WEIGHT AND 2887 02:28:14,028 --> 02:28:15,363 PEOPLE FALLING THROUGH THE 2888 02:28:15,363 --> 02:28:16,564 CRACKS AND NOT GETTING THE CARE 2889 02:28:16,564 --> 02:28:23,137 THEY NEED. 2890 02:28:23,137 --> 02:28:25,706 >> I WAS GOING TO ADD TO WHAT 2891 02:28:25,706 --> 02:28:28,109 DR. KOROSHETZ MENTIONED THERE'S 2892 02:28:28,109 --> 02:28:30,911 LEVERS IN PLACE IN TERMS OF OUR 2893 02:28:30,911 --> 02:28:31,545 DIVERSITY SUPPLEMENT PROGRAM 2894 02:28:31,545 --> 02:28:33,147 WHICH IS A WAY IT TRAIN PEOPLE 2895 02:28:33,147 --> 02:28:35,516 BUT IN ORDER TO DO THAT WE HAVE 2896 02:28:35,516 --> 02:28:42,790 TO HAVE ONE OF THE NIH GRANTS TO 2897 02:28:42,790 --> 02:28:44,659 DO THAT. 2898 02:28:44,659 --> 02:28:46,227 WE HAVE DISCUSSED OTHER 2899 02:28:46,227 --> 02:28:46,927 POTENTIAL TRAINING PROGRAMS AND 2900 02:28:46,927 --> 02:28:51,098 THAT'S ONE WAY TO THINK OF HOW 2901 02:28:51,098 --> 02:28:52,566 TO DO THAT AND LIKE 2902 02:28:52,566 --> 02:28:58,539 DR. KOROSHETZ MENTIONED THROUGH 2903 02:28:58,539 --> 02:29:02,643 THE HELE PROGRAM AND MAY IN A 2904 02:29:02,643 --> 02:29:04,545 MECHANISM TO DEAL WITH THE 2905 02:29:04,545 --> 02:29:05,212 NATIVE AMERICAN PONG. 2906 02:29:05,212 --> 02:29:10,051 THAT'S A MAJOR GAP IN OUR 2907 02:29:10,051 --> 02:29:10,451 PORTFOLIO. 2908 02:29:10,451 --> 02:29:13,054 GIVEN WITH THAT THE IMPROVE 2909 02:29:13,054 --> 02:29:14,188 PROGRAM AND HEAL HOPEFULLY PE 2910 02:29:14,188 --> 02:29:16,357 CAN ADDRESS THAT BUT IT'S A 2911 02:29:16,357 --> 02:29:18,793 GREAT POINT. 2912 02:29:18,793 --> 02:29:20,628 DR. KOROSHETZ MENTIONED WE'RE 2913 02:29:20,628 --> 02:29:25,266 OPEN TO SUGGESTIONS. 2914 02:29:25,266 --> 02:29:28,569 >> I'M TRYING TO THINK OF A 2915 02:29:28,569 --> 02:29:32,306 QUICK FIX. 2916 02:29:32,306 --> 02:29:34,542 CERTAINLY CAN McI THINK THERE 2917 02:29:34,542 --> 02:29:35,476 ARE PROBABLY PEOPLE REALLY 2918 02:29:35,476 --> 02:29:41,115 INTERESTED IN TRYING TO MAKE A 2919 02:29:41,115 --> 02:29:43,584 DIFFERENCE IN THE NATIVE 2920 02:29:43,584 --> 02:29:44,418 AMERICAN POPULATIONS. 2921 02:29:44,418 --> 02:29:45,786 THE QUESTION IS IF THEY DON'T 2922 02:29:45,786 --> 02:29:48,489 LIVE THERE IS THERE WAY A TO USE 2923 02:29:48,489 --> 02:29:50,758 TECHNOLOGY TO HOOK THEM UP SO IF 2924 02:29:50,758 --> 02:29:55,463 SOMETHING HAPPENED TOMORROW 2925 02:29:55,463 --> 02:29:56,530 OPPOSED TO TRYING TO TRAIN 2926 02:29:56,530 --> 02:29:58,332 PEOPLE WHO THEN GO IN THE 2927 02:29:58,332 --> 02:30:02,069 COMMUNITY WHICH MAY TAKE 20 2928 02:30:02,069 --> 02:30:02,803 YEARS. 2929 02:30:02,803 --> 02:30:05,973 THAT'S A PROJECT THAT WOULD 2930 02:30:05,973 --> 02:30:07,942 DEFINITELY BE SOMETHING WE WOULD 2931 02:30:07,942 --> 02:30:17,418 FUND TO IMPROVE HEALTH EQUITY. 2932 02:30:17,418 --> 02:30:19,086 THAT COULD MAKE A DIFFERENCE IN 2933 02:30:19,086 --> 02:30:19,987 THE SHORT TERM IF YOU CAN PULL 2934 02:30:19,987 --> 02:30:22,323 IT OFF BUT IF YOU GO TO THE 2935 02:30:22,323 --> 02:30:23,557 YOUNG NEUROLOGISTS THERE'S 2936 02:30:23,557 --> 02:30:25,359 PEOPLE WHO WANT TO DO THE RIGHT 2937 02:30:25,359 --> 02:30:25,559 THING. 2938 02:30:25,559 --> 02:30:27,962 SO WE KEEP TALKING ABOUT MONEY 2939 02:30:27,962 --> 02:30:30,197 BUT THERE'S ALSO SOME PEOPLE 2940 02:30:30,197 --> 02:30:34,802 JUST REALLY WANT TO DO THE RIGHT 2941 02:30:34,802 --> 02:30:35,536 THING. 2942 02:30:35,536 --> 02:30:36,904 SO FINDING THOSE PEOPLES AND 2943 02:30:36,904 --> 02:30:39,240 GIVING THEM OPPORTUNITIES AND WE 2944 02:30:39,240 --> 02:30:43,010 SEE THAT IN THE GLOBAL HEALTH. 2945 02:30:43,010 --> 02:30:45,212 NO ONE GETS RICH. 2946 02:30:45,212 --> 02:30:48,482 BUT PEOPLE VOLUNTEER TO DO IT 2947 02:30:48,482 --> 02:30:52,086 AND THEY MAKE A HUGE DIFFERENCE. 2948 02:30:52,086 --> 02:30:54,388 I THINK THAT'S A REALLY GOOD 2949 02:30:54,388 --> 02:30:57,691 POINT AND NEED TO FOLLOW UP. 2950 02:30:57,691 --> 02:31:05,266 THERE'S A BASE WE CAN WORK WITH. 2951 02:31:08,602 --> 02:31:17,178 >> I JUST WANT TO SUPPORT SOME 2952 02:31:17,178 --> 02:31:19,480 AT THE UNIVERSITY OF NEW MEXICO 2953 02:31:19,480 --> 02:31:22,583 WITH THE ECHO MODEL NOT JUST 2954 02:31:22,583 --> 02:31:26,220 INCLUDING HUBS AND ECHO HUBS AND 2955 02:31:26,220 --> 02:31:27,888 REGISTERED HUB BUT EXPANDED TO 2956 02:31:27,888 --> 02:31:28,656 EDUCATION AND TRAINING IN THE 2957 02:31:28,656 --> 02:31:31,592 WORKFORCE SO THAT COULD BE A 2958 02:31:31,592 --> 02:31:33,494 POSSIBLE COLLABORATION WITH THE 2959 02:31:33,494 --> 02:31:34,562 ECHO HUB AND MODEL. 2960 02:31:34,562 --> 02:31:39,767 I JUST WANT TO OFFER THAT AND 2961 02:31:39,767 --> 02:31:46,540 WITH OUR COLLEAGUES HERE. 2962 02:31:46,540 --> 02:31:55,583 >> ANY OTHER COMMENTS? 2963 02:31:55,583 --> 02:31:58,085 >> I WOULD THINK VALERIE'S 2964 02:31:58,085 --> 02:31:59,286 COMMENT COULD BE ADDRESSED WITH 2965 02:31:59,286 --> 02:32:01,355 GOOD WILL AND SOME ARRANGEMENTS 2966 02:32:01,355 --> 02:32:03,591 IN TELEMEDICINE. 2967 02:32:03,591 --> 02:32:10,564 I REALIZE THERE'S NOTHING LIKE 2968 02:32:10,564 --> 02:32:12,266 THE EXAM IN NEUROLOGY BUT YOU 2969 02:32:12,266 --> 02:32:15,603 CAN DO A LOT WITH A GOOD 2970 02:32:15,603 --> 02:32:19,039 GENERALIST WITH A QUESTION AND 2971 02:32:19,039 --> 02:32:27,381 THE BIGGEST ISSUES IS 2972 02:32:27,381 --> 02:32:28,983 GENERALISTS AND MANAGING 2973 02:32:28,983 --> 02:32:30,017 PARKINSON'S DISEASE AND THE 2974 02:32:30,017 --> 02:32:39,593 THINGS I SAW AS AN INTERNIST IN 2975 02:32:39,593 --> 02:32:46,066 NEUROLOGY CONSULTS WERE ALMOST 2976 02:32:46,066 --> 02:32:47,067 EXTREMELY HELPFUL RATHER THAN 2977 02:32:47,067 --> 02:32:49,069 WAIT BEING 20 YEARS TO GET 2978 02:32:49,069 --> 02:32:50,170 NEUROLOGISTS TO GET THERE. 2979 02:32:50,170 --> 02:32:56,210 >> I WAS TRAINED ON THE STRONG 2980 02:32:56,210 --> 02:32:57,478 HEART STUDY WHICH TRAINED A 2981 02:32:57,478 --> 02:33:00,247 WHOLE GENERATION OF US IN 2982 02:33:00,247 --> 02:33:04,318 CARDIOVASCULAR DISEASE AND RISK 2983 02:33:04,318 --> 02:33:04,585 REDUCTION. 2984 02:33:04,585 --> 02:33:09,623 THERE'S AN ESTABLISHED NETWORK 2985 02:33:09,623 --> 02:33:11,392 THERE THAT HAS BEEN A STRONG 2986 02:33:11,392 --> 02:33:13,394 NETWORK OF DATA COLLECTION AND 2987 02:33:13,394 --> 02:33:15,629 NOW THAT THEY'VE MOVED INTO 2988 02:33:15,629 --> 02:33:20,834 INTERVENTIONS I WONDER IF SOME 2989 02:33:20,834 --> 02:33:23,971 OF THESE LONG-TERM COHORT TRIALS 2990 02:33:23,971 --> 02:33:25,773 NIH FUNDS, THOSE RELATIONSHIPS 2991 02:33:25,773 --> 02:33:31,245 CAN THEN BE TURNED INTO 2992 02:33:31,245 --> 02:33:34,915 INTERVENTIONS WITH THE SAME 2993 02:33:34,915 --> 02:33:35,182 PARTNERS. 2994 02:33:35,182 --> 02:33:37,585 THE PARTNERSHIP NETWORKS THEY'VE 2995 02:33:37,585 --> 02:33:38,652 ESTABLISHED AND THE TRIBES TRUST 2996 02:33:38,652 --> 02:33:40,421 THOSE RESEARCHERS AND THEY HAVE 2997 02:33:40,421 --> 02:33:41,822 A STRONG VERY LONG RELATIONSHIP. 2998 02:33:41,822 --> 02:33:44,258 I MEAN, HOW LONG IS THAT STUDY 2999 02:33:44,258 --> 02:33:48,028 GOING ON SINCE THE '80s, I 3000 02:33:48,028 --> 02:33:51,265 THINK. 3001 02:33:51,265 --> 02:33:57,771 >> WE CAN TELL A STORY AND 3002 02:33:57,771 --> 02:34:03,611 ELISEO MENTIONED TELEMEDICINE. 3003 02:34:03,611 --> 02:34:04,745 THE HOSPITALS OFTEN START 3004 02:34:04,745 --> 02:34:08,983 AFFLUENT PEOPLE. 3005 02:34:08,983 --> 02:34:11,151 WHEN HEAT STROKE CAME ON AND THE 3006 02:34:11,151 --> 02:34:14,955 PEOPLE IN MARTHA'S VINEYARD WERE 3007 02:34:14,955 --> 02:34:16,957 HEALTHY AND WANTED STROKE CARE 3008 02:34:16,957 --> 02:34:22,563 AND SET UP A TELEMEDICINE SYSTEM 3009 02:34:22,563 --> 02:34:24,531 WITH MARTHA'S VINEYARD AND IT 3010 02:34:24,531 --> 02:34:27,568 WAS SO SUCCESSFUL IT SPREAD 3011 02:34:27,568 --> 02:34:31,038 AROUND NEW ENGLAND. 3012 02:34:31,038 --> 02:34:37,511 AND HAD LICENSES IN 10 STATES 3013 02:34:37,511 --> 02:34:44,585 BUT IT WORKED. 3014 02:34:44,585 --> 02:34:48,355 AND WE EXAMINED THE PATIENT IN 3015 02:34:48,355 --> 02:34:48,989 TELEMEDICINE AND ADVISED WHAT TO 3016 02:34:48,989 --> 02:34:59,066 DO. 3017 02:35:00,968 --> 02:35:02,970 THE TECHNOLOGIES CAN CHANGE THE 3018 02:35:02,970 --> 02:35:04,938 GAME AND SOME TRAINEES DID IT 3019 02:35:04,938 --> 02:35:07,975 AROUND THE COUNTRY AND SAT AT 3020 02:35:07,975 --> 02:35:08,942 THE COMPUTER ALL DAY AND TOOK 3021 02:35:08,942 --> 02:35:10,544 CARE OF STROKES ALL OVER THE 3022 02:35:10,544 --> 02:35:11,578 COUNTRY SO THESE THINGS CAN 3023 02:35:11,578 --> 02:35:16,350 HAPPEN. 3024 02:35:16,350 --> 02:35:18,118 >> WELL, THANK YOU SO MUCH FOR 3025 02:35:18,118 --> 02:35:22,589 TAKING THE TIME ON A FRIDAY TO 3026 02:35:22,589 --> 02:35:27,027 CO MANY HERE AND WE'VE TALKED 3027 02:35:27,027 --> 02:35:32,332 BEFORE WITH THIS PROGRAMS YOU 3028 02:35:32,332 --> 02:35:38,238 BEGIN TO LAUNCH AND SELE AND WE 3029 02:35:38,238 --> 02:35:39,206 LOOK FORWARD TO SEEING THAT 3030 02:35:39,206 --> 02:35:40,874 DEVELOP FURTHER AND I SEE A LOT 3031 02:35:40,874 --> 02:35:44,278 OF OPPORTUNITY FOR SYNERGY. 3032 02:35:44,278 --> 02:35:46,680 >> WE NEED ALL THE HELP WE CAN 3033 02:35:46,680 --> 02:35:46,847 GET. 3034 02:35:46,847 --> 02:35:49,216 PLEASE HELP. 3035 02:35:49,216 --> 02:35:51,919 >> OKAY. 3036 02:35:51,919 --> 02:35:55,089 OUR FINAL PRESENTATION TODAY FOR 3037 02:35:55,089 --> 02:35:57,524 COUNCIL IS FROM COUNCIL MEMBER 3038 02:35:57,524 --> 02:35:59,393 DR. JANE SIMONI THE ASSOCIATE 3039 02:35:59,393 --> 02:36:00,494 DIRECTOR FOR BEHAVIORAL AND 3040 02:36:00,494 --> 02:36:02,763 SOCIAL SCIENCE RESEARCH AT THE 3041 02:36:02,763 --> 02:36:06,300 NATIONAL INSTITUTES OF HEALTH 3042 02:36:06,300 --> 02:36:08,802 AND THE DIRECTOR OF THE OFFICE 3043 02:36:08,802 --> 02:36:10,437 OF BEHAVIORAL AND SCIENCE 3044 02:36:10,437 --> 02:36:12,573 RESEARCH OR OPS AND SAR. 3045 02:36:12,573 --> 02:36:15,576 SHE HAS MORE THAN 30 YEARS OF 3046 02:36:15,576 --> 02:36:20,314 EXPERIENCE FOCUSSED ON DISPARITY 3047 02:36:20,314 --> 02:36:21,749 AND RESILIENCE AMONG GROUPS 3048 02:36:21,749 --> 02:36:26,320 SOCIALLY MARGINALIZED INCLUDING 3049 02:36:26,320 --> 02:36:33,961 THOSE WITH HIV AND LATINO LGBTQ 3050 02:36:33,961 --> 02:36:38,031 AND IS A PSYCHOLOGIST BY 3051 02:36:38,031 --> 02:36:39,433 TRAINING AND SHE CAN NO LONGER 3052 02:36:39,433 --> 02:36:40,701 CLAIM BEING A NEWBIE FROM THE 3053 02:36:40,701 --> 02:36:42,703 UNIVERSITY OF WASHINGTON. 3054 02:36:42,703 --> 02:36:44,204 SHE WAS PROFESSOR AND DIRECTOR 3055 02:36:44,204 --> 02:36:45,172 OF CLINICAL TRAINING IN THE 3056 02:36:45,172 --> 02:36:47,508 DEPARTMENT OF PSYCHOLOGY AND 3057 02:36:47,508 --> 02:36:50,177 FOUNDING DIRECTOR OF THE 3058 02:36:50,177 --> 02:36:51,044 UNIVERSITY OF WASHINGTON 3059 02:36:51,044 --> 02:36:55,849 BEHAVIORAL RESEARCH CENTER FOR 3060 02:36:55,849 --> 02:37:02,689 HIV OR BIRCH AND CO-DIRECTED THE 3061 02:37:02,689 --> 02:37:09,329 FRED HUTCHINSON CENTER FOR HIV. 3062 02:37:09,329 --> 02:37:12,432 >> THEY TOLD ME IT TAKE THREE 3063 02:37:12,432 --> 02:37:15,068 YEARS SO I KNOW I'M THE LAST 3064 02:37:15,068 --> 02:37:18,639 PRESENTATION BEFORE LUNCH SO 3065 02:37:18,639 --> 02:37:20,841 I'LL STICK TO TIME. 3066 02:37:20,841 --> 02:37:22,609 START RUBBING YOUR STOMACHS IF I 3067 02:37:22,609 --> 02:37:24,511 GET CLOSE TO TIME I'M HAPPY IT 3068 02:37:24,511 --> 02:37:27,247 GIVE YOU THE TIME AND WAS HAPPY 3069 02:37:27,247 --> 02:37:28,515 TO SEE THE PRESENTATIONS BEFORE 3070 02:37:28,515 --> 02:37:28,682 ME. 3071 02:37:28,682 --> 02:37:30,551 I'LL TALK ABOUT THE ROLE OF 3072 02:37:30,551 --> 02:37:31,585 SOCIAL SCIENCE IN TERMS OF 3073 02:37:31,585 --> 02:37:33,220 HEALTH AND DISPARITIES. 3074 02:37:33,220 --> 02:37:35,789 LET ME TELL YOU ABOUT MY OFFICE 3075 02:37:35,789 --> 02:37:38,625 AND WHAT WE ARE DOING. 3076 02:37:38,625 --> 02:37:41,061 THIS IS A QR CODE TO OUR 3077 02:37:41,061 --> 02:37:41,628 WEBSITE. 3078 02:37:41,628 --> 02:37:42,963 HAPPY IT CLICK ON THAT NOW. 3079 02:37:42,963 --> 02:37:44,798 WE CAN GET MORE CLICKS FOR OUR 3080 02:37:44,798 --> 02:37:45,032 WEBSITE. 3081 02:37:45,032 --> 02:37:47,034 YOU CAN LOOK IN MORE DETAIL 3082 02:37:47,034 --> 02:37:47,701 ABOUT SOME OF THE THINGS THAT 3083 02:37:47,701 --> 02:37:49,670 I'M GOING TO BE TALKING ABOUT 3084 02:37:49,670 --> 02:37:50,871 TODAY FOR THE OFFICE OF 3085 02:37:50,871 --> 02:37:54,942 BEHAVIORAL AND SOCIAL SCIENCES 3086 02:37:54,942 --> 02:37:59,580 AT THE NIH. 3087 02:37:59,580 --> 02:38:10,090 IN A WORD AND WE CAN LOOK AT 3088 02:38:17,998 --> 02:38:19,900 SOME OF THE DETAILS OF THIS IN 3089 02:38:19,900 --> 02:38:25,038 TERMS OF INFANT AND MORTALITY 3090 02:38:25,038 --> 02:38:28,375 AND THE AVERAGE AND MATERNAL 3091 02:38:28,375 --> 02:38:30,644 MORTALITY IS PARTICULARLY 3092 02:38:30,644 --> 02:38:32,713 SHAMEFUL, 23.8 WHEN THE AVERAGE 3093 02:38:32,713 --> 02:38:35,582 IS ONLY 9.8 IN HIGH INCOME 3094 02:38:35,582 --> 02:38:35,849 COUNTRIES. 3095 02:38:35,849 --> 02:38:37,651 IN TERMS OF OBESITY AND MULTIPLE 3096 02:38:37,651 --> 02:38:39,586 CHRONIC ILLNESS A THIRD OF US 3097 02:38:39,586 --> 02:38:45,092 ARE OBESE IN THE UNITED STATES. 3098 02:38:45,092 --> 02:38:48,195 SORRY, 42% AND DOUBLE THE 3099 02:38:48,195 --> 02:38:49,429 AVERAGE AND MULTIPLE CHRONIC 3100 02:38:49,429 --> 02:38:54,101 CONDITIONS' AFFECT A THIRD. 3101 02:38:54,101 --> 02:38:57,971 DEATH FROM ASSAULT A LOT FROM 3102 02:38:57,971 --> 02:39:01,241 FIREARMS RECENTLY IN GEORGIA, 3103 02:39:01,241 --> 02:39:03,210 7.4 PER 100,000 WELL ABOVE WHAT 3104 02:39:03,210 --> 02:39:06,446 IT SHOULD BE FOR A HIGH INCOME 3105 02:39:06,446 --> 02:39:06,680 COUNTRY. 3106 02:39:06,680 --> 02:39:09,116 MOST TELLINGLY, LIFE EXPECTANCY. 3107 02:39:09,116 --> 02:39:10,250 WE DON'T LIVE AS LONG AS FOLKS 3108 02:39:10,250 --> 02:39:12,486 IN OTHER COUNTRY. 3109 02:39:12,486 --> 02:39:15,622 THE LOWEST ACROSS THE LARGE AND 3110 02:39:15,622 --> 02:39:16,256 WEALTHY COUNTRIES. 3111 02:39:16,256 --> 02:39:17,858 IT'S NOT JUST THAT OUR HEALTH IS 3112 02:39:17,858 --> 02:39:19,593 NOT GOOD, IT'S THAT THERE ARE 3113 02:39:19,593 --> 02:39:22,596 MAJOR DISPARITIES IN HEALTH 3114 02:39:22,596 --> 02:39:22,896 OUTCOMES. 3115 02:39:22,896 --> 02:39:26,133 THESE ARE PREVENTIBLE 3116 02:39:26,133 --> 02:39:28,201 DIFFERENCES IN HEALTH BASED ON 3117 02:39:28,201 --> 02:39:29,670 NON-BIOLOGICAL FACTORS. 3118 02:39:29,670 --> 02:39:33,307 BY RACE, ETHNICITY AND SES AND I 3119 02:39:33,307 --> 02:39:36,643 CAN'T TALK ABOUT THIS WITHOUT 3120 02:39:36,643 --> 02:39:39,579 TALKING ABOUT INTERSECTIONALITY. 3121 02:39:39,579 --> 02:39:44,351 THEY INTERSECT WITH GENDER AND 3122 02:39:44,351 --> 02:39:47,587 STATUS AND OTHER DISABILITY 3123 02:39:47,587 --> 02:39:49,022 STATUS. 3124 02:39:49,022 --> 02:39:50,657 INTERSECTIONALITY IS A KEY POINT 3125 02:39:50,657 --> 02:39:51,591 OF DISPARITIES. 3126 02:39:51,591 --> 02:39:54,161 I'M PREACHING TO THE CHOIR HERE 3127 02:39:54,161 --> 02:39:55,796 BUT YOU CAN NEVER SEE THE SLIDES 3128 02:39:55,796 --> 02:39:57,965 TOO OFTEN. 3129 02:39:57,965 --> 02:40:01,401 LIFE EXPECTANCY BY RACE, LONG 3130 02:40:01,401 --> 02:40:02,836 STANDING INEQUALITIES 3131 02:40:02,836 --> 02:40:04,371 CONTRIBUTED TO DISEASE OUTCOME 3132 02:40:04,371 --> 02:40:07,140 FOR RACIAL AND ETHNIC MINORITY 3133 02:40:07,140 --> 02:40:08,775 GROUPS WITH AMERICAN ALASKAN 3134 02:40:08,775 --> 02:40:10,610 INDIAN AND ALASKAN NATIVES DOING 3135 02:40:10,610 --> 02:40:12,846 THE WORSE IN TERMS OF LIFE 3136 02:40:12,846 --> 02:40:14,314 EXPECTANCY. 3137 02:40:14,314 --> 02:40:15,582 ASIAN, WHITE AND EVEN HISPANIC 3138 02:40:15,582 --> 02:40:23,156 DOING BETTER. 3139 02:40:23,156 --> 02:40:25,592 YOU ARE SEE DIFFERENCES AND IT 3140 02:40:25,592 --> 02:40:27,561 REALLY HASN'T IMPROVED MUCH. 3141 02:40:27,561 --> 02:40:29,129 IN 20 YEARS WE'D LIKE TO COME 3142 02:40:29,129 --> 02:40:33,200 BACK AND SEE AT LEAST MORE EQUAL 3143 02:40:33,200 --> 02:40:34,334 CARE, I HOPE. 3144 02:40:34,334 --> 02:40:39,106 IT HASN'T GONE WELL THE PAST 70. 3145 02:40:39,106 --> 02:40:41,508 WE HAVEN'T MADE STRIDES WITH 3146 02:40:41,508 --> 02:40:48,782 LIFE EXPECTANCY AND MISSING 3147 02:40:48,782 --> 02:40:49,983 AFRICAN AMERICANS AND THEY 3148 02:40:49,983 --> 02:40:51,551 SHOULD BE HERE WITH THEIR 3149 02:40:51,551 --> 02:40:52,619 FAMILIES, WORKING, LIVING IN 3150 02:40:52,619 --> 02:40:53,286 COMMUNITY BUT THEY'RE IN THE 3151 02:40:53,286 --> 02:40:55,455 HERE BECAUSE OF DISPARITIES. 3152 02:40:55,455 --> 02:40:57,657 NOT BECAUSE OF THINGS WE 3153 02:40:57,657 --> 02:40:58,592 COULDN'T PREVENT OR COULDN'T 3154 02:40:58,592 --> 02:41:06,199 ADDRESS. 3155 02:41:06,199 --> 02:41:09,403 AND SES WAS A FUNDAMENTAL HEALTH 3156 02:41:09,403 --> 02:41:11,004 OF HEALTH INEQUITY AND SOCIAL 3157 02:41:11,004 --> 02:41:13,273 DISTRIBUTION OF RISK FACTORS 3158 02:41:13,273 --> 02:41:15,575 MARK BY MONETARY INCOME. 3159 02:41:15,575 --> 02:41:18,945 THIS HAS BEEN WELL DESCRIBED. 3160 02:41:18,945 --> 02:41:21,048 WHEN YOU LOOK AT THE RELATIVE 3161 02:41:21,048 --> 02:41:23,750 RISK OF ALL-CAUSE MORTALITY BY 3162 02:41:23,750 --> 02:41:25,585 INCOME IT'S CLEAR MANY IF YOU 3163 02:41:25,585 --> 02:41:27,921 MAKE LESS THAN $25,000 YOU'RE 3164 02:41:27,921 --> 02:41:31,591 THREE TIMES THE RISK OF 3165 02:41:31,591 --> 02:41:37,998 ALL-CAUSE MORTALITY. 3166 02:41:37,998 --> 02:41:38,632 MEDIAN HOUSEHOLD INCOME SHOWS 3167 02:41:38,632 --> 02:41:41,334 SOME GROUPS ARE MORE LIKELY TO 3168 02:41:41,334 --> 02:41:45,138 BE SUBJECT TO THESE INCOMES AS 3169 02:41:45,138 --> 02:41:46,506 BLACK, NATIVE AMERICAN, HISPANIC 3170 02:41:46,506 --> 02:41:51,078 AND HAVE WORSE OUTCOMES IN THOSE 3171 02:41:51,078 --> 02:41:51,378 CATEGORIES. 3172 02:41:51,378 --> 02:41:52,012 AGAIN, NOT MUCH IMPROVEMENT OVER 3173 02:41:52,012 --> 02:41:56,483 TIME. 3174 02:41:56,483 --> 02:41:57,317 THERE NEEDS TO BE SOME 3175 02:41:57,317 --> 02:41:58,251 DISRUPTION TO MAKE CHANGES 3176 02:41:58,251 --> 02:41:59,619 BECAUSE IT'S NOT GOING IN THE 3177 02:41:59,619 --> 02:42:01,188 DIRECTION WE WANT. 3178 02:42:01,188 --> 02:42:02,989 IS IT WE'RE NOT SPENDING ENOUGH 3179 02:42:02,989 --> 02:42:03,190 MONEY? 3180 02:42:03,190 --> 02:42:04,558 WE NEED TO THROW MORE MONEY AT 3181 02:42:04,558 --> 02:42:05,158 IT? 3182 02:42:05,158 --> 02:42:05,859 THAT'S NOT IT. 3183 02:42:05,859 --> 02:42:07,527 WE'RE SPENDING ALMOST DOUBLE 3184 02:42:07,527 --> 02:42:09,763 WHAT OTHER COMPARABLE NATIONS 3185 02:42:09,763 --> 02:42:14,835 ARE DOING IN 2022, OVER 4,000 3186 02:42:14,835 --> 02:42:15,502 PER CAPITA ON HEALTH COMPARED TO 3187 02:42:15,502 --> 02:42:17,604 THE NEXT HIGHEST COUNTRY YET YOU 3188 02:42:17,604 --> 02:42:21,508 SEE THIS GAP. 3189 02:42:21,508 --> 02:42:22,809 I'M NOT SURE HOW THIS THING 3190 02:42:22,809 --> 02:42:23,410 WORKS. 3191 02:42:23,410 --> 02:42:24,811 YOU SEE THE GAP. 3192 02:42:24,811 --> 02:42:26,246 WE SPEND MORE BUT WITH NOTHING 3193 02:42:26,246 --> 02:42:28,515 TO SHOW FOR IT. 3194 02:42:28,515 --> 02:42:32,452 IT ISN'T WE'RE NOT JUST SPENDING 3195 02:42:32,452 --> 02:42:34,521 ENOUGH ON HEALTH CARE. 3196 02:42:34,521 --> 02:42:36,823 WHAT LITERALLY IS KILLING US? 3197 02:42:36,823 --> 02:42:37,991 WHAT ARE THE TOP TEN LEADING 3198 02:42:37,991 --> 02:42:38,959 CAUSES OF MORTALITY IN THE 3199 02:42:38,959 --> 02:42:39,559 UNITED STATES? 3200 02:42:39,559 --> 02:42:41,895 NOT SURPRISINGLY, HEART 3201 02:42:41,895 --> 02:42:45,866 DISEASE -- I'M MISSING A COUPLE 3202 02:42:45,866 --> 02:42:46,399 HERE. 3203 02:42:46,399 --> 02:42:50,103 CANCER, UNINTENTIONAL INJURIES, 3204 02:42:50,103 --> 02:42:52,606 OTHER FACTORS THAT ARE 3205 02:42:52,606 --> 02:42:54,407 CONTRIBUTING IN HOMICIDE, 3206 02:42:54,407 --> 02:42:56,977 SUICIDE, FIREARMS IS NOT FAR 3207 02:42:56,977 --> 02:42:58,478 BEHIND ON THE LIST ACTUALLY. 3208 02:42:58,478 --> 02:43:02,115 WHEN I LOOK AT THE LIST, TO ME 3209 02:43:02,115 --> 02:43:05,051 IT SCREAMS BEHAVIORAL, SOCIAL 3210 02:43:05,051 --> 02:43:08,221 FACTORS AND STRUCTURAL 3211 02:43:08,221 --> 02:43:08,555 DETERMINATES. 3212 02:43:08,555 --> 02:43:15,595 POOR DIET, INADEQUATE NUTRITION, 3213 02:43:15,595 --> 02:43:21,568 PHYSICAL INACTIVITY, ALCOHOL 3214 02:43:21,568 --> 02:43:22,569 CONSUMPTION, SUN EXPOSURE AND 3215 02:43:22,569 --> 02:43:25,338 EXCESSIVE RISKY BEHAVIOR, UNSAFE 3216 02:43:25,338 --> 02:43:29,075 SEX PARTICULARLY FOR HIV, STIs, 3217 02:43:29,075 --> 02:43:31,278 NOT WEAR SEAT BELTS, DRIVING 3218 02:43:31,278 --> 02:43:32,846 UNDER THE INFLUENCE, LACK OF 3219 02:43:32,846 --> 02:43:36,082 VACCINE UPDATE YOU SAW DURING 3220 02:43:36,082 --> 02:43:39,419 THE COVID EPIDEMIC AND SOCIAL 3221 02:43:39,419 --> 02:43:39,686 ISOLATION. 3222 02:43:39,686 --> 02:43:41,555 WE'RE SEEING ISOLATION KILLS. 3223 02:43:41,555 --> 02:43:44,124 IT CORRELATES WITH MORTALITY. 3224 02:43:44,124 --> 02:43:45,959 AND THE STRUCTURAL FACTORS AND 3225 02:43:45,959 --> 02:43:47,527 LIMITED ACCESS. 3226 02:43:47,527 --> 02:43:48,795 IT'S NOT THAT PEOPLE DON'T JUST 3227 02:43:48,795 --> 02:43:50,463 CHOOSE IT DO THESE THINGS. 3228 02:43:50,463 --> 02:43:52,599 THEY DON'T HAVE ACCESS TO FOOD 3229 02:43:52,599 --> 02:43:54,601 DESERTS AND OTHER RURAL AREAS. 3230 02:43:54,601 --> 02:43:57,070 SAFE PLACES FOR PHYSICAL 3231 02:43:57,070 --> 02:43:58,205 ACTIVITY. 3232 02:43:58,205 --> 02:44:00,440 I HAVE NOWHERE TO MOVE AROUND. 3233 02:44:00,440 --> 02:44:03,076 SHOULD I MOVE UP AND DOWN AND 3234 02:44:03,076 --> 02:44:05,812 PREVENTIVE SERVICES AND 3235 02:44:05,812 --> 02:44:07,647 ENVIRONMENTAL OCCUPATIONAL 3236 02:44:07,647 --> 02:44:08,315 EXPOSURES. 3237 02:44:08,315 --> 02:44:11,585 THERE'S ENVIRONMENTAL RACISM AND 3238 02:44:11,585 --> 02:44:15,188 TOXICANTS AND POLLUTANTS AND 3239 02:44:15,188 --> 02:44:16,590 SES, INCOME AND EDUCATION LEVELS 3240 02:44:16,590 --> 02:44:19,125 WHICH AFFECT ALL OF THE FACTORS. 3241 02:44:19,125 --> 02:44:20,427 IT'S NOT LIKE WE CAN'T MEASURE 3242 02:44:20,427 --> 02:44:20,927 THESE THINGS. 3243 02:44:20,927 --> 02:44:23,697 THESE ARE PREVENTIBLE THINGS WE 3244 02:44:23,697 --> 02:44:24,631 CAN DO. 3245 02:44:24,631 --> 02:44:25,966 PEOPLE AREN'T BORN BEING 3246 02:44:25,966 --> 02:44:27,133 DESTINED TO HAVE 20 YEARS LEFT 3247 02:44:27,133 --> 02:44:28,602 TO LIVE THEIR LIFE. 3248 02:44:28,602 --> 02:44:30,570 YOU CAN LOOK AT THE NEIGHBORHOOD 3249 02:44:30,570 --> 02:44:31,805 AND OPPORTUNITY INDEX LOOK AT 3250 02:44:31,805 --> 02:44:34,307 INSTITUTIONS AND QUALITY OF 3251 02:44:34,307 --> 02:44:37,210 SCHOOLS, EARLIER CHILDHOOD 3252 02:44:37,210 --> 02:44:39,212 INFLUENCES AND WHAT SHAPES NORMS 3253 02:44:39,212 --> 02:44:40,580 AND EXPECTATIONS AND GRADUATION 3254 02:44:40,580 --> 02:44:44,017 RATES AND PLOID EMPLOYED ADULTS 3255 02:44:44,017 --> 02:44:46,586 AND HOME OWNERSHIP, EMPLOYMENT, 3256 02:44:46,586 --> 02:44:48,488 PUBLIC ASSISTANCE, THE QUALITY 3257 02:44:48,488 --> 02:44:50,490 OF THE ENVIRONMENT IN TERMS OF 3258 02:44:50,490 --> 02:44:55,061 AIR, WATER, SOIL, HAZARDOUS 3259 02:44:55,061 --> 02:44:58,431 WASTE SITES AND GREEN SPACE AND 3260 02:44:58,431 --> 02:44:58,732 WALKABILITY. 3261 02:44:58,732 --> 02:45:00,600 THESE ARE MEASURABLE THINGS TO 3262 02:45:00,600 --> 02:45:02,402 INTERVENE AND THESE DIFFER BY 3263 02:45:02,402 --> 02:45:03,570 RACE. 3264 02:45:03,570 --> 02:45:06,506 YOU CAN SEE IN THE HIGH LEVELS 3265 02:45:06,506 --> 02:45:07,574 OF NEIGHBORHOOD OPPORTUNITY YOU 3266 02:45:07,574 --> 02:45:09,809 CAN SEE MOSTLY 65% OF WHITE 3267 02:45:09,809 --> 02:45:11,578 PEOPLE FALL IN THAT CATEGORY BUT 3268 02:45:11,578 --> 02:45:14,014 WHEN YOU LOOK AT LOW LEVELS FOR 3269 02:45:14,014 --> 02:45:16,583 OPPORTUNITY IT'S THE SAME 3270 02:45:16,583 --> 02:45:18,118 DISPARITY, BLACK, AMERICAN, 3271 02:45:18,118 --> 02:45:19,586 NATIVE HISPANIC THAT FALL IN 3272 02:45:19,586 --> 02:45:20,687 THAT CATEGORY. 3273 02:45:20,687 --> 02:45:22,255 WE CAN MEASURE THESE THINGS AND 3274 02:45:22,255 --> 02:45:23,690 KNOW WHAT'S CAUSING THE PROBLEMS 3275 02:45:23,690 --> 02:45:27,594 AND DIFFERENCES BY RACE AND 3276 02:45:27,594 --> 02:45:33,266 ETHNICITY AND WE KNOW IT'S 3277 02:45:33,266 --> 02:45:34,000 EVERYDAY DISCRIMINATION 3278 02:45:34,000 --> 02:45:36,303 ASSOCIATED WITH INFLAMMATION, 3279 02:45:36,303 --> 02:45:40,507 HEART DISEASE, BLOOD PRESSURE, 3280 02:45:40,507 --> 02:45:41,608 BIRTH WEIGHT AND COGNITIVE 3281 02:45:41,608 --> 02:45:43,576 FACTORS LIKE SLEEP AND DIET AND 3282 02:45:43,576 --> 02:45:46,613 HAS AN EFFECT ON ALL-CAUSE 3283 02:45:46,613 --> 02:45:51,484 MORTALITY AS WELL. 3284 02:45:51,484 --> 02:45:53,720 IN TERMS OF BEHAVIORAL AND 3285 02:45:53,720 --> 02:45:55,588 SOCIAL SCIENCE. 3286 02:45:55,588 --> 02:45:57,724 WE'VE BEEN INTERESTED IN BEDSIDE 3287 02:45:57,724 --> 02:46:01,161 LAB AT THE FOREFRONT OF 3288 02:46:01,161 --> 02:46:01,795 BEHAVIORAL RESEARCH AND LET'S 3289 02:46:01,795 --> 02:46:05,799 START WITH THE DEFINITION WE USE 3290 02:46:05,799 --> 02:46:07,000 AT NIH. 3291 02:46:07,000 --> 02:46:09,969 THE SYSTEMATIC STUDY OF THE 3292 02:46:09,969 --> 02:46:15,141 BEHAVIORAL AND SOCIAL 3293 02:46:15,141 --> 02:46:15,575 PHENOMENON. 3294 02:46:15,575 --> 02:46:16,743 OBSERVABLE ACTIONS AND THE 3295 02:46:16,743 --> 02:46:18,111 MENTAL PHENOMENON. 3296 02:46:18,111 --> 02:46:19,579 YOU CAN'T SEE BUT IT'S IMPORTANT 3297 02:46:19,579 --> 02:46:23,149 FOR BEHAVIOR AND KNOWLEDGE, 3298 02:46:23,149 --> 02:46:26,753 ATTITUDES, BELIEFS, MOTIVATIONS, 3299 02:46:26,753 --> 02:46:28,521 PERCEPTIONS, COGNITION, VALUES, 3300 02:46:28,521 --> 02:46:30,890 CULTURAL BELIEFS AND PRACTICES. 3301 02:46:30,890 --> 02:46:33,326 AND SOCIAL PHENOMENON. 3302 02:46:33,326 --> 02:46:35,462 INTERACTIONS BETWEEN AND AMONG 3303 02:46:35,462 --> 02:46:35,762 INDIVIDUALS. 3304 02:46:35,762 --> 02:46:37,297 THE LARGER CHARACTERISTICS AND 3305 02:46:37,297 --> 02:46:38,698 FUNCTIONS OF SOCIAL GROUPS AND 3306 02:46:38,698 --> 02:46:39,432 INSTITUTIONS. 3307 02:46:39,432 --> 02:46:43,570 SUCH AS FAMILIES, COMMUNITIES, 3308 02:46:43,570 --> 02:46:47,874 SCHOOLS, WORKPLACES AND THAT 3309 02:46:47,874 --> 02:46:49,676 INVOLVES PHYSICAL AND POLICY 3310 02:46:49,676 --> 02:46:52,178 ENVIRONMENT AND A BROAD ARRAY OF 3311 02:46:52,178 --> 02:46:54,013 STUDIES AND HEALTH NOT JUST 3312 02:46:54,013 --> 02:46:56,015 PHYSICAL OR KEEPING YOU ALIVE 3313 02:46:56,015 --> 02:46:58,318 BUT PHYSICAL, MENTAL AND SOCIAL 3314 02:46:58,318 --> 02:47:03,022 WELL BEING. 3315 02:47:03,022 --> 02:47:05,592 THAT'S A W.H.O. METRIC AND 3316 02:47:05,592 --> 02:47:07,694 RESEARCH CAN ADDRESS HEALTH 3317 02:47:07,694 --> 02:47:10,130 OUTCOMES AND HEALTH DISPARITIES. 3318 02:47:10,130 --> 02:47:12,265 THEY CAN ANSWER SUCH QUESTIONS. 3319 02:47:12,265 --> 02:47:13,500 THERE'S WORK IN ALL THESE AREAS 3320 02:47:13,500 --> 02:47:15,135 BUT MORE NEEDS TO BE DONE. 3321 02:47:15,135 --> 02:47:17,670 WHAT ARE THE PSYCHOLOGICAL AND 3322 02:47:17,670 --> 02:47:19,372 CULTURAL DETERMINATES OF HEALTH 3323 02:47:19,372 --> 02:47:20,840 BEHAVIORS AND OUTCOMES. 3324 02:47:20,840 --> 02:47:23,977 WE'RE INTERESTED IN GENETICS. 3325 02:47:23,977 --> 02:47:26,913 EVERY PERSON WHO COMES IN THE 3326 02:47:26,913 --> 02:47:30,650 CLINICAL CENTER AND IF YOU ASK 3327 02:47:30,650 --> 02:47:32,352 ANY ARE YOU FEELING SAFE? 3328 02:47:32,352 --> 02:47:33,887 HAVE YOU BEEN DOWN, SAD OR 3329 02:47:33,887 --> 02:47:34,154 DEPRESSED? 3330 02:47:34,154 --> 02:47:36,756 THESE FACTORS WE CAN ASSESS AND 3331 02:47:36,756 --> 02:47:38,858 HAVE AN IMPORTANT OUTCOMES. 3332 02:47:38,858 --> 02:47:41,161 THESE INCLUDE STRESS, 3333 02:47:41,161 --> 02:47:42,729 DISCRIMINATION AND STIGMA. 3334 02:47:42,729 --> 02:47:45,565 WHAT ARE THE MOST EFFECTIVE 3335 02:47:45,565 --> 02:47:48,401 STRATEGIES FOR CHANGING 3336 02:47:48,401 --> 02:47:54,140 UNHEALTHY BEHAVIORS AND 3337 02:47:54,140 --> 02:47:56,209 INITIATING HEALTHY BEHAVIORS AND 3338 02:47:56,209 --> 02:47:58,545 IT'S NOT JUST INDIVIDUAL BUT 3339 02:47:58,545 --> 02:47:59,579 CHANGING THE ENVIRONMENT. 3340 02:47:59,579 --> 02:48:01,748 HOW DO SOCIAL DETERMINATES SUCH 3341 02:48:01,748 --> 02:48:03,483 AS INCOME, DISCRIMINATION IMPACT 3342 02:48:03,483 --> 02:48:05,585 OUTCOMES AND HOW CAN WE ADDRESS 3343 02:48:05,585 --> 02:48:05,785 THEM? 3344 02:48:05,785 --> 02:48:07,086 THERE'S A REASON WE HAVEN'T 3345 02:48:07,086 --> 02:48:08,922 FOCUSSED ON SOCIAL DETERMINATES. 3346 02:48:08,922 --> 02:48:10,590 IT'S HARD RESEARCH. 3347 02:48:10,590 --> 02:48:13,660 IT'S HARD TO DO AT MULTIPLE 3348 02:48:13,660 --> 02:48:13,993 LEVELS. 3349 02:48:13,993 --> 02:48:15,662 AND ONCE WE IDENTIFY THE 3350 02:48:15,662 --> 02:48:18,731 FACTORS, HOW DO WE DO HEALTH 3351 02:48:18,731 --> 02:48:19,032 DISPARITIES? 3352 02:48:19,032 --> 02:48:25,438 DO WE NEED TAILORED OR 3353 02:48:25,438 --> 02:48:31,578 CULTURALLY RELEVANT MATERIAL AND 3354 02:48:31,578 --> 02:48:33,746 MAKE SURE INTERVENTIONS ARE 3355 02:48:33,746 --> 02:48:37,750 RELEVANT AND SUSTAINABLE. 3356 02:48:37,750 --> 02:48:40,787 HOW CAN WE MOST EFFECTIVELY 3357 02:48:40,787 --> 02:48:42,388 IMPLEMENT AND DISSEMINATE THE 3358 02:48:42,388 --> 02:48:44,591 INTERVENTIONS TO HAVE 3359 02:48:44,591 --> 02:48:45,291 SUSTAINMENT? 3360 02:48:45,291 --> 02:48:48,127 THOSE WILL BEND THE CURVE ON THE 3361 02:48:48,127 --> 02:48:48,528 ISSUES. 3362 02:48:48,528 --> 02:48:50,730 AND THESE ARE SOME EXAMPLES NOT 3363 02:48:50,730 --> 02:48:54,634 JUST HEALTH DISPARITIES BUT 3364 02:48:54,634 --> 02:48:56,402 SMOKING CESSATION, HIV 3365 02:48:56,402 --> 02:48:58,605 PREVENTION, PHYSICAL ACTIVITY, 3366 02:48:58,605 --> 02:49:00,840 PROMOTION, DIET, VACCINE 3367 02:49:00,840 --> 02:49:01,608 CAMPAIGNS, MENTAL HEALTH 3368 02:49:01,608 --> 02:49:03,743 INTERVENTION AND ADHERENCE TO 3369 02:49:03,743 --> 02:49:04,844 MEDICATION TREATMENT. 3370 02:49:04,844 --> 02:49:06,880 GET DOWN DEEPER AND HAVE IT IN 3371 02:49:06,880 --> 02:49:09,516 COPIES OF THE SLIDE AND WHEN YOU 3372 02:49:09,516 --> 02:49:12,252 LOOK AT VACCINE CAMPAIGNS WHAT 3373 02:49:12,252 --> 02:49:13,987 DOES BEHAVIORAL SOCIAL SCIENCE 3374 02:49:13,987 --> 02:49:15,788 DO AND WAS NOT ASKED TO DO 3375 02:49:15,788 --> 02:49:16,789 DURING THE PANDEMIC WHICH YOU 3376 02:49:16,789 --> 02:49:18,558 SHOULD HAVE DONE. 3377 02:49:18,558 --> 02:49:19,993 UNDERSTANDING THE FACTORS 3378 02:49:19,993 --> 02:49:24,864 INFLUENCING VACCINE ACCEPTANCE. 3379 02:49:24,864 --> 02:49:27,667 ADDRESSING VACCINE HESITANCY. 3380 02:49:27,667 --> 02:49:29,469 AND VACCINATION RATES TO PREVENT 3381 02:49:29,469 --> 02:49:31,037 THE SPREAD OF INFECTIOUS 3382 02:49:31,037 --> 02:49:31,271 DISEASE. 3383 02:49:31,271 --> 02:49:32,772 WE HAVE GOOD VACCINES BUT IN THE 3384 02:49:32,772 --> 02:49:34,007 END IT WAS PEOPLE NOT TAKING 3385 02:49:34,007 --> 02:49:44,584 THEM THAT WAS THE BIGGEST ISSUE. 3386 02:49:44,584 --> 02:49:47,520 THERE'S 24 INSTITUTES AND WE 3387 02:49:47,520 --> 02:49:56,696 NEED TO DO TEAM SCIENCE AND LOOK 3388 02:49:56,696 --> 02:49:58,331 AT ENVIRONMENTAL CONTEXTUAL 3389 02:49:58,331 --> 02:50:01,601 RESEARCH TO UNDERSTAND HOW 3390 02:50:01,601 --> 02:50:02,602 PHYSICAL AND SOCIAL ENVIRONMENTS 3391 02:50:02,602 --> 02:50:06,205 INFLUENCE HEALTH AND LOOK AMOUNT 3392 02:50:06,205 --> 02:50:10,610 STUDIES IN THE ENVIRONMENT AND 3393 02:50:10,610 --> 02:50:15,214 FOOD DESSERTS AND QUANTIFY 3394 02:50:15,214 --> 02:50:16,616 ASSOCIATIONS WITH COHORT 3395 02:50:16,616 --> 02:50:18,585 ANDCATION CONTROL STUDIES TO 3396 02:50:18,585 --> 02:50:20,286 UNDERSTAND PREVALENCE AND RISK 3397 02:50:20,286 --> 02:50:21,955 AND DO THIS BY RACE ETHNICITY 3398 02:50:21,955 --> 02:50:24,657 AND OTHER DISPARITY FACTORS AND 3399 02:50:24,657 --> 02:50:27,093 HEALTH SERVICES AND NOT A HUGE 3400 02:50:27,093 --> 02:50:35,201 PRIORITY AT THE HIP -- NIH AND 3401 02:50:35,201 --> 02:50:38,071 LOOKING AT HEALTH CARE ACCESS 3402 02:50:38,071 --> 02:50:38,805 AND POLICY AND CHANGES IN HEALTH 3403 02:50:38,805 --> 02:50:45,378 OUTCOMES. 3404 02:50:45,378 --> 02:50:47,580 WE NEED TO DEVELOP AND ASSESS 3405 02:50:47,580 --> 02:50:50,116 EDUCATIONAL PROGRAMS TO LOOK AT 3406 02:50:50,116 --> 02:50:55,455 HEALTH LITERACY AND BEHAVIOR 3407 02:50:55,455 --> 02:50:56,189 CHANGE. 3408 02:50:56,189 --> 02:50:58,291 AND GRADUATE WORK WAS IN THAT 3409 02:50:58,291 --> 02:51:00,360 AREA IN STUDIES IN HEALTH CARE 3410 02:51:00,360 --> 02:51:03,429 PROVIDERS AND WHAT DO WITH NEED 3411 02:51:03,429 --> 02:51:06,566 TO TEACH AND CHANGE THE 3412 02:51:06,566 --> 02:51:07,834 WORKFORCE AND BEHAVIORAL SCIENCE 3413 02:51:07,834 --> 02:51:10,303 NEEDS TO GET IN IN TERMS OF 3414 02:51:10,303 --> 02:51:11,838 M.V.P. LEARNING AND WHAT CAN 3415 02:51:11,838 --> 02:51:14,173 SOCIAL SCIENCE TEACH US? 3416 02:51:14,173 --> 02:51:15,575 HOW CAN IT INFORM THE PROGRAMS 3417 02:51:15,575 --> 02:51:20,246 AND HOW CAN A.I. BENEFIT WHAT WE 3418 02:51:20,246 --> 02:51:20,446 DO? 3419 02:51:20,446 --> 02:51:21,381 AND THEN ECONOMIC RESEARCH 3420 02:51:21,381 --> 02:51:23,316 ASSESSING THE IMPACT AND 3421 02:51:23,316 --> 02:51:25,051 BEHAVIORAL INCENTIVES AND THE 3422 02:51:25,051 --> 02:51:26,786 COST EFFECTIVENESS OF 3423 02:51:26,786 --> 02:51:27,820 INTERVENTION AND POLICY 3424 02:51:27,820 --> 02:51:28,321 RESEARCH. 3425 02:51:28,321 --> 02:51:29,856 WE DON'T DO ADVOCACY AT THE HIP 3426 02:51:29,856 --> 02:51:31,090 BUT IT DOESN'T MEAN WE CAN'T 3427 02:51:31,090 --> 02:51:34,794 LOOK AT THE IMPACT OF POLICIES 3428 02:51:34,794 --> 02:51:36,396 AND CHANGE POLICIES TO INFORM 3429 02:51:36,396 --> 02:51:38,431 THEM FOR THE BETTER AND WE'VE 3430 02:51:38,431 --> 02:51:42,135 DONE THIS WITH TOBACCO AND 3431 02:51:42,135 --> 02:51:42,935 ALCOHOL RATES. 3432 02:51:42,935 --> 02:51:45,672 WE CAN CONTRIBUTE TO IDENTIFYING 3433 02:51:45,672 --> 02:51:48,474 AND ADDRESSING DISPARITY AND 3434 02:51:48,474 --> 02:51:49,809 ULTIMATELY LEADING TO MORE 3435 02:51:49,809 --> 02:51:51,811 EQUITABLE HEALTH OUTCOMES IN A 3436 02:51:51,811 --> 02:51:55,581 FRAMEWORK AND APPROACH AND IN AN 3437 02:51:55,581 --> 02:51:56,783 INTERDISCIPLINARY AND 3438 02:51:56,783 --> 02:51:58,351 MULTI-LEVEL APPROACH AND 3439 02:51:58,351 --> 02:52:01,120 INTEGRATE INSIGHTS IN SCIENCE 3440 02:52:01,120 --> 02:52:01,788 AND PUBLIC COMMENT EFFORTS AND 3441 02:52:01,788 --> 02:52:05,324 HOW WE'LL HAVE A BIG IMPACT. 3442 02:52:05,324 --> 02:52:05,825 LOOKING TO THE FUTURE. 3443 02:52:05,825 --> 02:52:07,360 WHAT CAN WE DO IN TERMS OF 3444 02:52:07,360 --> 02:52:09,228 BEHAVIORAL AND SOCIAL SCIENCE. 3445 02:52:09,228 --> 02:52:12,965 I FEEL AT THIS MOMENT A SENSE OF 3446 02:52:12,965 --> 02:52:16,402 URGENCY AND WINDOW OF 3447 02:52:16,402 --> 02:52:16,703 OPPORTUNITY. 3448 02:52:16,703 --> 02:52:19,572 THE COVID PANDEMIC CLAIMED OVER 3449 02:52:19,572 --> 02:52:22,075 A MILLION LIVES AND I LEFT 3450 02:52:22,075 --> 02:52:23,543 ACADEMIA AND I LEFT TO HAVE A 3451 02:52:23,543 --> 02:52:25,712 BROADER IMPACT BECAUSE I SEE A 3452 02:52:25,712 --> 02:52:27,580 WINDOW OF OPPORTUNITY AND PART 3453 02:52:27,580 --> 02:52:30,883 OF THIS IS EVEN AT THE NIH 3454 02:52:30,883 --> 02:52:39,592 THERE'S AN INCREASED FOCUS ON 3455 02:52:39,592 --> 02:52:42,095 BEHAVIOR. 3456 02:52:42,095 --> 02:52:44,697 I LOOK FOR AN NIH STRATEGIC PLAN 3457 02:52:44,697 --> 02:52:44,931 UPDATE. 3458 02:52:44,931 --> 02:52:45,998 WE HAVEN'T OFFICIALLY CHANGED 3459 02:52:45,998 --> 02:52:47,100 THE MISSION YET BUT IN THE 3460 02:52:47,100 --> 02:52:49,001 STRATEGIC PLAN WE CHANGED 3461 02:52:49,001 --> 02:52:50,837 EXPANDED BIO MEDICAL RESEARCH TO 3462 02:52:50,837 --> 02:52:53,306 INCLUDE BIO MEDICAL AND 3463 02:52:53,306 --> 02:52:53,906 BEHAVIORAL RESEARCH. 3464 02:52:53,906 --> 02:52:56,375 CAN'T TELL YOU HOW BIG THIS WAS. 3465 02:52:56,375 --> 02:52:59,178 IT WAS A REAL SHIFT. 3466 02:52:59,178 --> 02:53:00,613 SOME PEOPLE POSTED SAID I'M 3467 02:53:00,613 --> 02:53:02,248 INCLUDING IT ANYWAY. 3468 02:53:02,248 --> 02:53:04,484 WHEN WE SAW AND ADDED THE WORDS, 3469 02:53:04,484 --> 02:53:06,486 WE GOT MORE GRANT APPLICATIONS 3470 02:53:06,486 --> 02:53:08,988 AND BEHAVIORAL AND SOCIAL 3471 02:53:08,988 --> 02:53:09,455 SCIENCES INVOLVED. 3472 02:53:09,455 --> 02:53:13,526 WE HAD TO MAKE A CATEGORY FOR 3473 02:53:13,526 --> 02:53:16,496 THE WORKFORCE AT NIH AND SAW AN 3474 02:53:16,496 --> 02:53:18,197 UPTAKE IN THE BEHAVIORAL 3475 02:53:18,197 --> 02:53:18,731 SCIENCE. 3476 02:53:18,731 --> 02:53:20,933 THERE'S A REPORT ON BEHAVIORAL 3477 02:53:20,933 --> 02:53:22,602 AND SOCIAL SCIENCE DURING COVID 3478 02:53:22,602 --> 02:53:24,937 AND CONGRESS SAID WHAT THE HECK. 3479 02:53:24,937 --> 02:53:27,540 WHERE IS BEHAVIORAL SOCIAL 3480 02:53:27,540 --> 02:53:27,774 SCIENCE? 3481 02:53:27,774 --> 02:53:31,577 IT'S DECENTRALIZED. 3482 02:53:31,577 --> 02:53:33,579 WHY ISN'T IT INTEGRATE AND THEY 3483 02:53:33,579 --> 02:53:36,449 SAID YOU HAVE TO INTEGRATE IT AT 3484 02:53:36,449 --> 02:53:37,416 EVERY LEVEL. 3485 02:53:37,416 --> 02:53:38,584 YOU HAVE THE OFFICE HERE BUT HAS 3486 02:53:38,584 --> 02:53:41,354 TO BE INTEGRATED. 3487 02:53:41,354 --> 02:53:45,424 THE IT HAS TO BE INCORPORATED. 3488 02:53:45,424 --> 02:53:49,195 AND WORKING WITH THE OFFICE OF 3489 02:53:49,195 --> 02:53:50,396 SCIENCE AND TECHNOLOGY BLUE 3490 02:53:50,396 --> 02:53:50,596 PRINT. 3491 02:53:50,596 --> 02:53:55,401 PRESIDENT BIDEN HAD A PUSH FOR 3492 02:53:55,401 --> 02:53:56,035 DOING EVIDENCE-BASED POLICY 3493 02:53:56,035 --> 02:53:58,604 ABOUT USING SCIENCE AS A BASE OF 3494 02:53:58,604 --> 02:53:59,806 EVIDENCE TO IMPACT POLICY. 3495 02:53:59,806 --> 02:54:01,440 THREE THINGS THAT ARE HUGE AND 3496 02:54:01,440 --> 02:54:03,209 PROVIDE A WINDOW OF OPPORTUNITY. 3497 02:54:03,209 --> 02:54:04,744 LET ME TELL YOU ABOUT OUR OFFICE 3498 02:54:04,744 --> 02:54:10,349 AND I'LL GET YOU OUT ON TIME, I 3499 02:54:10,349 --> 02:54:10,583 PROMISE. 3500 02:54:10,583 --> 02:54:14,453 WE OPENED UP BY CONGRESSIONAL 3501 02:54:14,453 --> 02:54:19,492 MANDATE TO COORDINATE ALL THE 3502 02:54:19,492 --> 02:54:24,797 HEALTH RELEVANT AND IDENTIFY 3503 02:54:24,797 --> 02:54:34,707 GAPS AND CHALLENGES AND WE HAVE 3504 02:54:34,707 --> 02:54:38,477 A STRATEGIC PLAN AND VISION 3505 02:54:38,477 --> 02:54:41,480 THERE'S SYNERGISTIC INTEGRATION 3506 02:54:41,480 --> 02:54:43,516 OF SCIENCE INTO HEALTH RESEARCH 3507 02:54:43,516 --> 02:54:46,586 AND IT WORKS BOTH WAYS. 3508 02:54:46,586 --> 02:54:48,254 IT'S BI-DIRECTIONAL RELATIONSHIP 3509 02:54:48,254 --> 02:54:51,490 AND THINK IT WILL GIVE 3510 02:54:51,490 --> 02:54:52,225 ACCELERATED DISCOVERY FOR 3511 02:54:52,225 --> 02:54:55,595 TREATMENTS FOR HEALTH PROMOTION 3512 02:54:55,595 --> 02:54:57,463 AND INTERVENTIONS AND STRATEGY 3513 02:54:57,463 --> 02:54:58,798 TO IMPROVE HEALTH. 3514 02:54:58,798 --> 02:55:02,768 THAT'S OUR VISION VERY BROAD AND 3515 02:55:02,768 --> 02:55:03,202 WIDE. 3516 02:55:03,202 --> 02:55:06,672 WE ENHANCE AND ELEVATE THE 3517 02:55:06,672 --> 02:55:10,943 IMPACT OF THE S SR AND IDENTIFY 3518 02:55:10,943 --> 02:55:13,446 GAPS AND DEVELOP A COORDINATED 3519 02:55:13,446 --> 02:55:13,746 INITIATIVES. 3520 02:55:13,746 --> 02:55:16,616 I'LL TELL YOU ABOUT A FEW WE'RE 3521 02:55:16,616 --> 02:55:20,152 DOING AND COMMUNICATE THESE WITH 3522 02:55:20,152 --> 02:55:21,787 NIN AND BEYOND. 3523 02:55:21,787 --> 02:55:23,556 AND MY DIRECTORSHIP IS TO TALK 3524 02:55:23,556 --> 02:55:25,358 MORE WHAT WE'RE DOING AND 3525 02:55:25,358 --> 02:55:26,525 COMMUNICATE THAT AND BEYOND. 3526 02:55:26,525 --> 02:55:30,029 WITH OUR NEW STRATEGIC PLAN WE 3527 02:55:30,029 --> 02:55:31,130 HAVE RESEARCH PRIORITIES AND 3528 02:55:31,130 --> 02:55:32,298 CAPACITY DEVELOPMENT AREAS AND 3529 02:55:32,298 --> 02:55:33,366 OPERATION FOR RESEARCH AND 3530 02:55:33,366 --> 02:55:34,600 COLLABORATIVE SCIENCE. 3531 02:55:34,600 --> 02:55:40,373 WE WANT TO DO MORE COLLABORATE 3532 02:55:40,373 --> 02:55:42,742 RATION AND TEAM SCIENCE. 3533 02:55:42,742 --> 02:55:44,810 TWO, BASIC AND APPLIED. 3534 02:55:44,810 --> 02:55:46,612 THERE'S BASIC RESEARCH AND 3535 02:55:46,612 --> 02:55:49,849 BEHAVIORAL AND SOCIAL SCIENCES. 3536 02:55:49,849 --> 02:55:50,249 NON INTERVENTION. 3537 02:55:50,249 --> 02:55:52,585 IT'S A MECHANISTIC WAY AND THIS 3538 02:55:52,585 --> 02:55:54,620 CAME UP THE MECHANISMS OF 3539 02:55:54,620 --> 02:55:56,255 LOOKING AT WHAT ARE SOME OF THE 3540 02:55:56,255 --> 02:55:59,492 EFFECTS OF INTERVENTIONS. 3541 02:55:59,492 --> 02:56:00,526 THEN FINALLY OUR ONTOLOGIES AND 3542 02:56:00,526 --> 02:56:03,596 THE WAY WE THINK OF KNOWLEDGE 3543 02:56:03,596 --> 02:56:05,398 AND INVESTING IN BEHAVIORAL AND 3544 02:56:05,398 --> 02:56:07,166 SOCIAL SCIENCE AND HAVE A 3545 02:56:07,166 --> 02:56:10,569 CONTEXT FOR VOCABULARY AND FOCUS 3546 02:56:10,569 --> 02:56:11,704 ON SCIENTIFIC INVESTIGATION AND 3547 02:56:11,704 --> 02:56:15,308 I CARE ABOUT MEASURES AND THE 3548 02:56:15,308 --> 02:56:17,777 DESIGNS WE USE AND ABOUT HOW WE 3549 02:56:17,777 --> 02:56:19,845 ANALYZE THE DATA. 3550 02:56:19,845 --> 02:56:22,048 ALL THREE CAN BE IMPACTED BY 3551 02:56:22,048 --> 02:56:26,319 A.I. AND HOW TO CHANGE THE 3552 02:56:26,319 --> 02:56:26,886 SCIENCE. 3553 02:56:26,886 --> 02:56:27,486 AND IMPLEMENTATION AND 3554 02:56:27,486 --> 02:56:29,322 DISSEMINATION AND EQUITABLE 3555 02:56:29,322 --> 02:56:29,555 IMPACT. 3556 02:56:29,555 --> 02:56:31,424 IF WE HAVE THE INTERVENTIONS 3557 02:56:31,424 --> 02:56:33,726 WE'RE NOT DONE UNTIL PEOPLE 3558 02:56:33,726 --> 02:56:44,770 EXPERIENCE THEM AND CAPACITY, DK 3559 02:56:50,776 --> 02:56:53,245 COLLABORATIVE PARTNERSHIPS IN 3560 02:56:53,245 --> 02:56:56,749 NIH AND OUTSIDE, WE COMMUNICATE 3561 02:56:56,749 --> 02:56:57,083 OUTREACH. 3562 02:56:57,083 --> 02:56:58,818 I WANT TO SAY QUICKLY OUR OFFICE 3563 02:56:58,818 --> 02:57:02,555 WAS PUT IN THE OFFICE OF THE 3564 02:57:02,555 --> 02:57:06,058 DIRECTOR BY CONGRESS, 3565 02:57:06,058 --> 02:57:08,461 SPECIFICALLY. 3566 02:57:08,461 --> 02:57:09,228 WITHIN PROGRAM COORDINATION, 3567 02:57:09,228 --> 02:57:10,730 DPCPSI IN THE O.D. WHERE OUR 3568 02:57:10,730 --> 02:57:11,230 OFFICE IS. 3569 02:57:11,230 --> 02:57:14,400 I DON'T WANT TO BE IN ANY ONE OF 3570 02:57:14,400 --> 02:57:14,767 THE INSTITUTES. 3571 02:57:14,767 --> 02:57:18,871 I WANT TO BE IN THE O.D. TO WORK 3572 02:57:18,871 --> 02:57:20,072 ACROSS THE OTHER INSTITUTES. 3573 02:57:20,072 --> 02:57:23,876 WE HAVE A SMALL STAFF OF 25, 3574 02:57:23,876 --> 02:57:27,513 WE'RE THE MIGHTY ENGINE THAT 3575 02:57:27,513 --> 02:57:28,814 COULD, WHO WORK ON INITIATIVES 3576 02:57:28,814 --> 02:57:32,418 WITH THE I.C.s. 3577 02:57:32,418 --> 02:57:35,855 WE'RE TRYING TO HELP THE ICOS 3578 02:57:35,855 --> 02:57:36,856 FACILITATE AND ACHIEVE THEIR 3579 02:57:36,856 --> 02:57:39,825 AIMS, AND YOU CAN'T DO THAT 3580 02:57:39,825 --> 02:57:41,160 OFTEN WITHOUT INCLUDING 3581 02:57:41,160 --> 02:57:42,028 BEHAVIORAL AND SOCIAL SCIENCE, 3582 02:57:42,028 --> 02:57:44,096 THAT'S WHAT WE SAW IN THE PAST 3583 02:57:44,096 --> 02:57:47,500 AGAIN, KEEP BRINGING UP THE 3584 02:57:47,500 --> 02:57:50,770 COVID EPIDEMIC IN THAT REGARD. 3585 02:57:50,770 --> 02:57:52,938 $50 BILLION IS THE OVERALL 3586 02:57:52,938 --> 02:57:53,706 BUDGET. 3587 02:57:53,706 --> 02:57:55,708 WE'RE THE BUDGET WITH THE M, 3588 02:57:55,708 --> 02:57:59,211 SMALLER BY SEVERAL ORDERS OF 3589 02:57:59,211 --> 02:58:00,079 MAGNITUDE BUT DOESN'T MEAN WE 3590 02:58:00,079 --> 02:58:01,614 CAN'T USE MONEY TO SEED AND 3591 02:58:01,614 --> 02:58:01,847 INVEST. 3592 02:58:01,847 --> 02:58:06,185 A FRIEND SAID YOU'RE LIKE A 3593 02:58:06,185 --> 02:58:07,620 VENTURE CAPITAL FIRM, YES, A 3594 02:58:07,620 --> 02:58:08,487 SMALL ONE. 3595 02:58:08,487 --> 02:58:09,789 WE'RE INVESTING IN BROADER 3596 02:58:09,789 --> 02:58:11,557 PROJECTS TO HOPEFULLY HAVE AN 3597 02:58:11,557 --> 02:58:11,991 IMPACT. 3598 02:58:11,991 --> 02:58:16,395 WE GIVE ABOUT 80%, WE INVEST 80% 3599 02:58:16,395 --> 02:58:20,633 OF THIS BUDGET DIRECTLY INTO 3600 02:58:20,633 --> 02:58:21,667 P.I.-FUNDED RESEARCH. 3601 02:58:21,667 --> 02:58:24,703 FISCAL YEAR, WE GOT A BUMP IN 3602 02:58:24,703 --> 02:58:27,106 COVID THANKS TO ADVOCACY OUTSIDE 3603 02:58:27,106 --> 02:58:30,976 OUR AGENCY, WE FUND ACROSS ALL 3604 02:58:30,976 --> 02:58:32,011 ICOS. 3605 02:58:32,011 --> 02:58:36,082 IT'S HIGHER FOR NIMH, NIA HAS 3606 02:58:36,082 --> 02:58:40,886 HUGE BEHAVIORAL AND SOCIAL 3607 02:58:40,886 --> 02:58:42,421 SCIENCE COMPONENT, NIMHD AS 3608 02:58:42,421 --> 02:58:52,932 WELL, MY GOAL TO MAKE SURE THE 3609 02:58:52,932 --> 02:58:54,200 INSTITUTES, WE INTEGRATE HERE IS 3610 02:58:54,200 --> 02:58:54,700 THE ISSUE. 3611 02:58:54,700 --> 02:58:57,736 IT IS SOMETHING ABOUT THIS ROOM. 3612 02:58:57,736 --> 02:59:00,406 I TRY THE PDF. 3613 02:59:00,406 --> 02:59:02,374 THIS IS UNFORTUNATE. 3614 02:59:02,374 --> 02:59:06,312 IT STARTED FINE, BUT THESE ARE 3615 02:59:06,312 --> 02:59:07,847 INITIATIVES, WANTED TO SHOW 3616 02:59:07,847 --> 02:59:09,148 YOU -- I'LL SKIP AND SEE IF WE 3617 02:59:09,148 --> 02:59:11,884 CAN GET BACK ON TIME, WORKING IN 3618 02:59:11,884 --> 02:59:12,785 BASIC BEHAVIORAL SCIENCE. 3619 02:59:12,785 --> 02:59:16,622 WE WANT TO WORK IN A.I., ANOTHER 3620 02:59:16,622 --> 02:59:17,823 AREA, SOCIAL CONNECTEDNESS AND 3621 02:59:17,823 --> 02:59:21,861 HEALTH, A BIG PART IS SOCIAL 3622 02:59:21,861 --> 02:59:22,194 DETERMINANTS. 3623 02:59:22,194 --> 02:59:23,129 SOCIAL AND STRUCTURAL 3624 02:59:23,129 --> 02:59:24,497 DETERMINANTS, LOOKING AT 3625 02:59:24,497 --> 02:59:25,598 MULTI-LEVEL WE SEARCH AND 3626 02:59:25,598 --> 02:59:27,266 BEHAVIOR CHANGE AND MAINTAINING 3627 02:59:27,266 --> 02:59:28,134 THIS BEHAVIOR CHANGE. 3628 02:59:28,134 --> 02:59:30,970 KEY CORE AREAS OF BEHAVIORAL AND 3629 02:59:30,970 --> 02:59:31,670 SOCIAL SCIENCE. 3630 02:59:31,670 --> 02:59:33,806 AND THEN SOME OF THE INITIATIVES 3631 02:59:33,806 --> 02:59:35,975 I CAN TELL YOU BRIEFLY SOME WORK 3632 02:59:35,975 --> 02:59:37,843 WE'RE DOING, THE BRAIN 3633 02:59:37,843 --> 02:59:42,548 INITIATIVE IS A HUGE 3634 02:59:42,548 --> 02:59:45,284 MULTI-BILLION DOLLAR INITIATIVE. 3635 02:59:45,284 --> 02:59:46,619 WE SEED MONEY, A BRAIN WITHOUT 3636 02:59:46,619 --> 02:59:49,555 BEHAVIOR WON'T HAVE AN IMPACT ON 3637 02:59:49,555 --> 02:59:52,391 WHAT WE DO OR HEALTH OUTCOMES. 3638 02:59:52,391 --> 02:59:55,361 WE HAVE TO MEASURE THE IMPACT. 3639 02:59:55,361 --> 03:00:01,066 WE HAVE A HUGE VIOLENCE RESEARCH 3640 03:00:01,066 --> 03:00:02,701 INITIATIVE, VICKIE AMENDMENT, 3641 03:00:02,701 --> 03:00:03,569 YOU CAN'T STUDY SPECIFICALLY GUN 3642 03:00:03,569 --> 03:00:05,871 CONTROL BUT THERE'S A LOOSENING, 3643 03:00:05,871 --> 03:00:08,841 YOU CAN LIKE AT FIREARM VIOLENCE 3644 03:00:08,841 --> 03:00:09,341 PREVENTION. 3645 03:00:09,341 --> 03:00:13,646 THAT'S WHAT WE'RE DOING WITH 3646 03:00:13,646 --> 03:00:14,413 $12.5 MILLION IN CONGRESSIONAL 3647 03:00:14,413 --> 03:00:15,648 APPROPRIATION EVERY YEAR, THE 3648 03:00:15,648 --> 03:00:17,716 OFFICE WAS INSTRUCT AND TITLED 3649 03:00:17,716 --> 03:00:20,986 WITH THE PRIVILEGE ACTUALLY OF 3650 03:00:20,986 --> 03:00:22,288 DISTRIBUTING THIS AND SEEING 3651 03:00:22,288 --> 03:00:25,257 THIS HAVE AN IMPACT ON GUN 3652 03:00:25,257 --> 03:00:25,824 VIOLENCE. 3653 03:00:25,824 --> 03:00:28,227 WE HAVE -- IT'S FUNNY, I CAN SEE 3654 03:00:28,227 --> 03:00:32,398 THE SLIDES ON MY END, BUT NOT 3655 03:00:32,398 --> 03:00:36,435 WHERE THEY COME UP. 3656 03:00:36,435 --> 03:00:38,637 INITIATIVES LED OR CO-LED 3657 03:00:38,637 --> 03:00:40,606 INCLUDE RESEARCH, APPLICATION, 3658 03:00:40,606 --> 03:00:41,707 TEAM SCIENCE. 3659 03:00:41,707 --> 03:00:43,442 AGAIN, WE HAVE THE ENTIRE 3660 03:00:43,442 --> 03:00:44,543 NETWORK OF BASIC RESEARCH THAT 3661 03:00:44,543 --> 03:00:45,344 WE'RE DOING. 3662 03:00:45,344 --> 03:00:51,984 ONE THING TO LOOK AT NEXT, GOP-1 3663 03:00:51,984 --> 03:00:53,118 AGONIST WITH BEHAVIORAL 3664 03:00:53,118 --> 03:00:54,954 COMPONENTS, STIGMA, USING OR NOT 3665 03:00:54,954 --> 03:00:57,022 USING, BEHAVIOR CHANGE THAT 3666 03:00:57,022 --> 03:00:57,690 NEEDS TO HAPPEN. 3667 03:00:57,690 --> 03:00:59,024 WE'RE INTERESTED IN THE 3668 03:00:59,024 --> 03:01:03,262 BEHAVIORAL ASPECT OF THAT. 3669 03:01:03,262 --> 03:01:03,929 AND THEN COVID COORDINATING 3670 03:01:03,929 --> 03:01:12,071 COMMITTEE MORE MORE INTO A PANC 3671 03:01:12,071 --> 03:01:13,872 PREPAREDNESS, WHAT WAS THE 3672 03:01:13,872 --> 03:01:15,708 IMPACT OF CLOSING SCHOOLS, LIKE 3673 03:01:15,708 --> 03:01:17,276 MY HIGH SCHOOLER KNEW THE IMPACT 3674 03:01:17,276 --> 03:01:20,112 WAS LARGE, THIS REPORT DOCUMENTS 3675 03:01:20,112 --> 03:01:21,013 EFFECTS THAT HAPPENED. 3676 03:01:21,013 --> 03:01:23,182 ALSO WORKING IN TEAM SCIENCE, AS 3677 03:01:23,182 --> 03:01:25,584 I MENTIONED, IN THE ONTOLOGIES. 3678 03:01:25,584 --> 03:01:27,686 COMING UP WITH A UNIFORM 3679 03:01:27,686 --> 03:01:28,988 STRUCTURE IN VOCABULARY, SO 3680 03:01:28,988 --> 03:01:30,823 THINKING HOW WE STUDY BEHAVIORAL 3681 03:01:30,823 --> 03:01:32,224 AND SOCIAL SCIENCE MECHANISMS 3682 03:01:32,224 --> 03:01:34,660 AND OUTCOMES. 3683 03:01:34,660 --> 03:01:38,497 I MENTIONED THE FIREARMS 3684 03:01:38,497 --> 03:01:38,931 VIOLENCE PREVENTION, 3685 03:01:38,931 --> 03:01:39,698 $12.5 MILLION IN CONGRESSIONAL 3686 03:01:39,698 --> 03:01:41,467 APPROPRIATION, WE HAVE A NETWORK 3687 03:01:41,467 --> 03:01:42,368 VIOLENCE PREVENTION AWARDS 3688 03:01:42,368 --> 03:01:44,103 TRYING TO DEVELOP A WORKFORCE IN 3689 03:01:44,103 --> 03:01:44,637 THIS AREA. 3690 03:01:44,637 --> 03:01:46,372 NOT MANY PEOPLE TOLD THEIR 3691 03:01:46,372 --> 03:01:48,007 STUDENTS TO GO INTO THIS 3692 03:01:48,007 --> 03:01:49,341 RESEARCH WHEN CONGRESS SAID WITH 3693 03:01:49,341 --> 03:01:55,914 THE DICKEY COMMANDMENT IT -- 3694 03:01:55,914 --> 03:01:57,650 AMENDMENT IT WASN'T GOING TO BE 3695 03:01:57,650 --> 03:01:59,852 FUNDED BUT WE'RE DEVELOPING A 3696 03:01:59,852 --> 03:02:00,119 WORKFORCE. 3697 03:02:00,119 --> 03:02:07,626 WE HAVE A MATILDA WHITE RILEY 3698 03:02:07,626 --> 03:02:09,061 LECTURE, AND EARLY-STAGE 3699 03:02:09,061 --> 03:02:10,596 INVESTIGATOR COMPETITION OPEN TO 3700 03:02:10,596 --> 03:02:12,665 JUNIOR INVESTIGATORS TO COME TO 3701 03:02:12,665 --> 03:02:13,966 THE NIH, PRESENT THEIR WORK, 3702 03:02:13,966 --> 03:02:16,869 TALK ABOUT HOW THEY CAN BECOME 3703 03:02:16,869 --> 03:02:18,270 NIH-FUNDED RESEARCHERS. 3704 03:02:18,270 --> 03:02:20,339 WE HAVE A FESTIVAL IN TERMS OF 3705 03:02:20,339 --> 03:02:21,106 BEHAVIORAL AND SOCIAL SCIENCE 3706 03:02:21,106 --> 03:02:23,075 RESEARCH, WORK WITH THE OTHER 3707 03:02:23,075 --> 03:02:24,076 INSTITUTES, LET'S SHOWCASE THE 3708 03:02:24,076 --> 03:02:25,811 BEST BEHAVIORAL AND SOCIAL 3709 03:02:25,811 --> 03:02:28,881 SCIENCE WE'VE DONE, EVERY YEAR, 3710 03:02:28,881 --> 03:02:30,416 IN NOVEMBER, A BIG FOCUS ON A.I. 3711 03:02:30,416 --> 03:02:32,518 THIS YEAR AS WELL FOR THIS 3712 03:02:32,518 --> 03:02:32,785 FESTIVAL. 3713 03:02:32,785 --> 03:02:33,919 WE OFFER TRAININGS. 3714 03:02:33,919 --> 03:02:38,424 WE HAVE A RESEARCH AND DOCTORAL 3715 03:02:38,424 --> 03:02:40,392 TRAINING PROGRAM FOR BEHAVIORAL 3716 03:02:40,392 --> 03:02:42,027 ANALYTICS, R25 SHORT COURSES 3717 03:02:42,027 --> 03:02:42,928 PROGRAM ON METHODOLOGY. 3718 03:02:42,928 --> 03:02:44,129 SOME OF YOU PARTICIPATED IN SOME 3719 03:02:44,129 --> 03:02:44,663 OF THESE. 3720 03:02:44,663 --> 03:02:47,399 AND WE HAVE FOR OUR FIREARMS 3721 03:02:47,399 --> 03:02:50,703 FUNDING A K18 SO MID-CAREER 3722 03:02:50,703 --> 03:02:52,671 INVESTIGATORS GOING INTO THIS 3723 03:02:52,671 --> 03:02:53,272 RESEARCH. 3724 03:02:53,272 --> 03:02:55,507 WE HAVE TRAINING RESOURCES, GOOD 3725 03:02:55,507 --> 03:03:00,112 PRACTICE, THOSE OF YOU WHO HAVE 3726 03:03:00,112 --> 03:03:04,383 DONE CLINICAL TRIALS PROBABLY 3727 03:03:04,383 --> 03:03:06,251 TOOK THIS COURSE. 3728 03:03:06,251 --> 03:03:06,985 REVAMPING COMMUNICATION, 3729 03:03:06,985 --> 03:03:09,555 SOMETHING I WANT TO DO MORE OF. 3730 03:03:09,555 --> 03:03:11,724 WE A DIRECTOR SPOTLIGHT, 3731 03:03:11,724 --> 03:03:14,360 TECHNICAL ASSISTANCE WEBINARS, 3732 03:03:14,360 --> 03:03:15,594 HIGHLIGHT FUNDING OPPORTUNITIES, 3733 03:03:15,594 --> 03:03:16,995 NEWSLETTER, WE HIGHLIGHT 3734 03:03:16,995 --> 03:03:17,329 RESEARCH. 3735 03:03:17,329 --> 03:03:19,198 NEXT COUPLE MONTHS WE HAVE A 3736 03:03:19,198 --> 03:03:21,934 TALK BY DR. WANG IN SEPTEMBER, 3737 03:03:21,934 --> 03:03:24,370 RESEARCH FESTIVAL IN NOVEMBER, 3738 03:03:24,370 --> 03:03:25,471 STAY TUNED, 30th BIRTHDAY NEXT 3739 03:03:25,471 --> 03:03:27,206 YEAR, WE HAVE FUN PLANS TO DO. 3740 03:03:27,206 --> 03:03:28,974 I WILL END WITH A CALL TO 3741 03:03:28,974 --> 03:03:31,810 ACTION, WHAT CAN YOU DO FOR THE 3742 03:03:31,810 --> 03:03:32,244 FUTURE. 3743 03:03:32,244 --> 03:03:33,445 I SAID I'M OPTIMISTIC ABOUT THE 3744 03:03:33,445 --> 03:03:34,179 FUTURE. 3745 03:03:34,179 --> 03:03:35,547 I SEE A WINDOW OF OPPORTUNITIES 3746 03:03:35,547 --> 03:03:37,182 FOR BEHAVIORAL AND SOCIAL 3747 03:03:37,182 --> 03:03:39,551 SCIENCE RESEARCH, I'VE BEEN 3748 03:03:39,551 --> 03:03:41,220 DOING THIS 30, 35 YEARS, LIVED 3749 03:03:41,220 --> 03:03:44,957 THROUGH THE DECADE OF THE 3750 03:03:44,957 --> 03:03:46,358 BRAIN, fMRI RESEARCH, 3751 03:03:46,358 --> 03:03:47,359 NEUROSCIENCE, GENETICS, 3752 03:03:47,359 --> 03:03:48,560 PSYCHOLOGY PROGRAMS, CHANGING 3753 03:03:48,560 --> 03:03:49,194 THE PSYCHOLOGY AND NEUROSCIENCE 3754 03:03:49,194 --> 03:03:51,163 BUT I SEE AN OPPORTUNITY NOW TO 3755 03:03:51,163 --> 03:03:52,698 BALANCE OUT THAT FOCUS AND 3756 03:03:52,698 --> 03:03:54,666 REALLY LOOK AT THE GAPS FOR 3757 03:03:54,666 --> 03:03:56,668 BEHAVIORAL AND SOCIAL SCIENCE TO 3758 03:03:56,668 --> 03:03:59,405 PUSH FORWARD ALL THESE SCIENCES. 3759 03:03:59,405 --> 03:04:00,506 FOR RESEARCH, THESE ARE THEMES I 3760 03:04:00,506 --> 03:04:02,608 BROUGHT UP. 3761 03:04:02,608 --> 03:04:03,609 TEAM SCIENCE, MULTI-DISCIPLINARY 3762 03:04:03,609 --> 03:04:06,645 SCIENCE, THIS NEEDS TO BE PART 3763 03:04:06,645 --> 03:04:09,615 OF IT. 3764 03:04:09,615 --> 03:04:12,551 WE NEED BASIC AND APPLIED 3765 03:04:12,551 --> 03:04:13,886 BEHAVIORAL AND SOCIAL SCIENCE, 3766 03:04:13,886 --> 03:04:15,754 THE MYTH NIH DOES INTERVENTION, 3767 03:04:15,754 --> 03:04:19,024 NOT TRUE, WE DO BASIC BEHAVIORAL 3768 03:04:19,024 --> 03:04:22,428 RESEARCH ESPECIALLY IN THE 3769 03:04:22,428 --> 03:04:23,429 INSTITUTES BIOMEDICALLY GEARED. 3770 03:04:23,429 --> 03:04:25,063 WE NEED TO ADDRESS STRUCTURAL 3771 03:04:25,063 --> 03:04:26,031 AND SOCIAL DETERMINANTS OF 3772 03:04:26,031 --> 03:04:27,933 HEALTH IN A MULTI-LEVEL WAY, NOT 3773 03:04:27,933 --> 03:04:30,869 EASY BUT IT'S IMPORTANT TO DO. 3774 03:04:30,869 --> 03:04:31,937 WE NEED METHODOLOGICALLY 3775 03:04:31,937 --> 03:04:32,771 INNOVATIVE AND RIGOROUS 3776 03:04:32,771 --> 03:04:33,071 RESEARCH. 3777 03:04:33,071 --> 03:04:34,907 I SAY EVEN MORE SO FOR 3778 03:04:34,907 --> 03:04:37,576 BEHAVIORAL AND SOCIAL SCIENCE, 3779 03:04:37,576 --> 03:04:38,777 SO-CALLED SOFT SCIENCE. 3780 03:04:38,777 --> 03:04:40,179 WE'RE NOT SOFT. 3781 03:04:40,179 --> 03:04:41,046 WE'RE HARD. 3782 03:04:41,046 --> 03:04:41,980 WE'RE DIFFICULT. 3783 03:04:41,980 --> 03:04:45,751 TO DO THAT WELL IS ALSO THIS, 3784 03:04:45,751 --> 03:04:50,122 IT'S HARD TO MEASURE CONSTRUCTS 3785 03:04:50,122 --> 03:04:52,224 BUT IMPORTANT, AND WE CAN HOLD 3786 03:04:52,224 --> 03:04:55,694 OUR OWN WITH LONGER STANDING 3787 03:04:55,694 --> 03:04:57,796 BIOMEDICAL SCIENCES. 3788 03:04:57,796 --> 03:04:58,464 ADDRESSING HEALTH DISPARITIES, 3789 03:04:58,464 --> 03:05:00,632 IMPLANTS FOR FEASIBILITY AND 3790 03:05:00,632 --> 03:05:04,236 IMPACT, WHAT GOOD IS SCIENCE IF 3791 03:05:04,236 --> 03:05:05,771 NO ONE READS IT? 3792 03:05:05,771 --> 03:05:07,739 IT HAS TO BE CONNECTED TO 3793 03:05:07,739 --> 03:05:08,373 COMMUNITY. 3794 03:05:08,373 --> 03:05:10,609 NOT JUST DO RESEARCH BUT 3795 03:05:10,609 --> 03:05:11,210 COMMUNICATE, OUTREACH, PUBLISH 3796 03:05:11,210 --> 03:05:17,616 WIDELY NOT JUST IN TYPICAL 3797 03:05:17,616 --> 03:05:21,320 JOURNAL, PUBLISH OP-ED PIECES, 3798 03:05:21,320 --> 03:05:22,988 UNIVERSITY NEWSLETTERS. 3799 03:05:22,988 --> 03:05:25,290 SHOW BEHAVIORAL SOCIAL SCIENCE 3800 03:05:25,290 --> 03:05:26,358 WORKS, EDUCATE PEERS, LEADERS, 3801 03:05:26,358 --> 03:05:27,059 BIOMEDICAL COLLEAGUES. 3802 03:05:27,059 --> 03:05:29,428 HALF DON'T KNOW WHAT BEHAVIORAL 3803 03:05:29,428 --> 03:05:35,000 SOCIAL SCIENCE IS. 3804 03:05:35,000 --> 03:05:37,970 A DIRECTOR REMAINING NAMELESS 3805 03:05:37,970 --> 03:05:39,838 CALLED IT THAT QUALITATIVE 3806 03:05:39,838 --> 03:05:40,038 STUFF. 3807 03:05:40,038 --> 03:05:41,106 WE NEED TO EDUCATE COLLEAGUES 3808 03:05:41,106 --> 03:05:44,977 ABOUT WHAT IT IS AND WHAT IT CAN 3809 03:05:44,977 --> 03:05:45,143 DO. 3810 03:05:45,143 --> 03:05:47,179 AND ENGAGE WITH DECISION MAKERS, 3811 03:05:47,179 --> 03:05:50,015 I CAN'T TELL YOU WHAT TO SAY TO 3812 03:05:50,015 --> 03:05:51,116 YOUR ELECTED REPRESENTATIVES BUT 3813 03:05:51,116 --> 03:05:52,518 I CAN TELL YOU TO TALK TO THEM, 3814 03:05:52,518 --> 03:05:54,152 TO USE YOUR VOICE AND MAKE YOUR 3815 03:05:54,152 --> 03:05:55,821 OPINION KNOWN. 3816 03:05:55,821 --> 03:05:57,122 IT HAS A BIG IMPACT ON WHAT 3817 03:05:57,122 --> 03:06:02,361 WE'RE ABLE TO DO AT NIH. 3818 03:06:02,361 --> 03:06:04,029 FINALLY MENTORING AND TRAINING, 3819 03:06:04,029 --> 03:06:05,097 QUANTITATIVE SKILLS, A.I., MIXED 3820 03:06:05,097 --> 03:06:06,398 METHODS ARE VERY IMPORTANT IF 3821 03:06:06,398 --> 03:06:08,934 WE'LL HAVE AN IMPACT FOR 3822 03:06:08,934 --> 03:06:12,104 BEHAVIORAL AND SOCIAL SCIENCE 3823 03:06:12,104 --> 03:06:12,838 RESEARCH. 3824 03:06:12,838 --> 03:06:16,041 COLLABORATIONS WITH PARTNERSHIPS 3825 03:06:16,041 --> 03:06:17,342 IN RESEARCH OUTSIDE PUBLIC, 3826 03:06:17,342 --> 03:06:20,445 PRIVATE, IN A TEAM-ORIENTED 3827 03:06:20,445 --> 03:06:21,113 SCIENCE APPROACH. 3828 03:06:21,113 --> 03:06:24,583 I'LL END LOOKING AT THIS CURVE 3829 03:06:24,583 --> 03:06:24,783 AGAIN. 3830 03:06:24,783 --> 03:06:27,119 DR. MARTIN LUTHER KING KING SAID 3831 03:06:27,119 --> 03:06:30,188 THE ARC OF THE MORAL UNIVERSE 3832 03:06:30,188 --> 03:06:31,623 BENDS TOWARDS JUSTICE, LET'S 3833 03:06:31,623 --> 03:06:32,925 HOPE IT CAN BEND TOWARD HEALTH. 3834 03:06:32,925 --> 03:06:35,561 WE HAVE TO DO SOMETHING 3835 03:06:35,561 --> 03:06:35,827 DIFFERENT. 3836 03:06:35,827 --> 03:06:37,062 IT'S NOT GOING IN THAT 3837 03:06:37,062 --> 03:06:37,663 DIRECTION. 3838 03:06:37,663 --> 03:06:46,905 THANK YOU VERY MUCH. 3839 03:06:46,905 --> 03:06:48,540 >> THANK YOU SO MUCH, JANE. 3840 03:06:48,540 --> 03:06:50,976 WE HAVE TIME FOR COMMENTS OR 3841 03:06:50,976 --> 03:06:52,511 QUESTIONS FROM THE COUNCIL 3842 03:06:52,511 --> 03:06:58,083 MEMBERS. 3843 03:06:58,083 --> 03:07:01,954 >> THANK YOU VERY MUCH FOR THE 3844 03:07:01,954 --> 03:07:02,387 PRESENTATION. 3845 03:07:02,387 --> 03:07:03,889 SO, THE LAST SLIDE WHICH SHOWED 3846 03:07:03,889 --> 03:07:07,626 THE LIFE EXPECTANCY I THINK YOU 3847 03:07:07,626 --> 03:07:08,794 SHOWED EARLIER ON. 3848 03:07:08,794 --> 03:07:11,363 I WAS WONDERING, DO YOU THINK 3849 03:07:11,363 --> 03:07:14,099 THE FACT UNITED STATES HAS ALL 3850 03:07:14,099 --> 03:07:14,967 THESE DIVERSE ETHNIC GROUPS, WE 3851 03:07:14,967 --> 03:07:15,968 LEARNED TODAY AND KNEW 3852 03:07:15,968 --> 03:07:20,038 PREVIOUSLY WE'RE NOT TAKING CARE 3853 03:07:20,038 --> 03:07:24,776 WITH THE HEALTH CARE SYSTEM, 3854 03:07:24,776 --> 03:07:25,877 WOULD THAT CONTRIBUTE? 3855 03:07:25,877 --> 03:07:27,079 >> YES, I THINK IT DOES. 3856 03:07:27,079 --> 03:07:29,147 I LIKE TO THINK OF DIVERSITY AS 3857 03:07:29,147 --> 03:07:30,449 A STRENGTH, IN SOME WAYS WE HAVE 3858 03:07:30,449 --> 03:07:33,085 TO WORK HARDER THOUGH TO REACH 3859 03:07:33,085 --> 03:07:33,485 DIFFERENT GROUPS. 3860 03:07:33,485 --> 03:07:34,786 THE DISPARITIES ARE IMPORTANT 3861 03:07:34,786 --> 03:07:37,923 PART OF WHY THIS IS LOWER, I 3862 03:07:37,923 --> 03:07:39,625 THINK. 3863 03:07:39,625 --> 03:07:40,659 HISTORY, HISTORIC AND CURRENT, 3864 03:07:40,659 --> 03:07:42,160 SYSTEMIC PROBLEMS IN OUR 3865 03:07:42,160 --> 03:07:43,795 HEALTHCARE STRUCTURE AND SOCIAL 3866 03:07:43,795 --> 03:07:44,463 STRUCTURE, ECONOMIC STRUCTURE 3867 03:07:44,463 --> 03:07:46,665 THAT ALL CONTRIBUTE TO THIS. 3868 03:07:46,665 --> 03:07:48,300 SO CERTAINLY, I THINK IT DOES. 3869 03:07:48,300 --> 03:07:50,369 DID YOU HAVE IDEAS WHY? 3870 03:07:50,369 --> 03:07:53,805 WERE YOU THINKING OF SOMETHING? 3871 03:07:53,805 --> 03:08:02,314 NO? 3872 03:08:02,314 --> 03:08:11,490 >> OTHER COMMENTS OR QUESTIONS? 3873 03:08:11,490 --> 03:08:15,661 SO THANK YOU FOR BRINGING THE 3874 03:08:15,661 --> 03:08:20,599 CONTEXT OF THE OFFICE INTO VIEW 3875 03:08:20,599 --> 03:08:23,869 WITH OUR PROGRAMS. 3876 03:08:23,869 --> 03:08:27,606 I THINK THAT NIMHD WAS HIGH ON 3877 03:08:27,606 --> 03:08:31,143 THE LIST OF BENEFICIARY OF YOUR 3878 03:08:31,143 --> 03:08:32,978 CO-FUNDING EFFORTS. 3879 03:08:32,978 --> 03:08:35,714 AND YOUR PREDECESSOR BILL RILEY 3880 03:08:35,714 --> 03:08:37,582 WAS SOMEONE I KNEW FOR MANY 3881 03:08:37,582 --> 03:08:43,588 YEARS BEFORE EVEN COMING TO NIH. 3882 03:08:43,588 --> 03:08:47,659 I THINK OBSSR CO-FUNDED ONE OF 3883 03:08:47,659 --> 03:08:48,860 OUR RESEARCH CENTERS FOR 3884 03:08:48,860 --> 03:08:54,099 MINORITY AGING RESEARCH THAT WE 3885 03:08:54,099 --> 03:08:56,168 HAD BACK IN TWO THOUSAND 3886 03:08:56,168 --> 03:08:57,335 SOMETHING, THE SECOND ROUND, ONE 3887 03:08:57,335 --> 03:08:57,602 OF THOSE. 3888 03:08:57,602 --> 03:09:01,540 AT THE TIME I DON'T THINK I KNEW 3889 03:09:01,540 --> 03:09:04,042 WHAT OBSSR WAS. 3890 03:09:04,042 --> 03:09:08,647 I ALSO WILL NOTE THAT NORMAN 3891 03:09:08,647 --> 03:09:12,484 WAS -- ANDERSON WAS PART OF 3892 03:09:12,484 --> 03:09:14,753 OUR -- I WAS ON NIA COUNCIL WHEN 3893 03:09:14,753 --> 03:09:16,955 HE WAS ALREADY OUT OF NIH, SO HE 3894 03:09:16,955 --> 03:09:20,058 HAD BEEN THE FOUNDING DIRECTOR 3895 03:09:20,058 --> 03:09:25,964 OF THE OFFICE, SO 25 YEARS AGO, 3896 03:09:25,964 --> 03:09:26,298 I GUESS. 3897 03:09:26,298 --> 03:09:27,399 OR 30? 3898 03:09:27,399 --> 03:09:27,833 THIRTY YEARS. 3899 03:09:27,833 --> 03:09:28,934 SO THANK YOU, JANE. 3900 03:09:28,934 --> 03:09:32,637 I THINK WE NOW HAVE THE LUNCH 3901 03:09:32,637 --> 03:09:34,072 BREAK? 3902 03:09:34,072 --> 03:09:41,980 >> YES. 3903 03:09:41,980 --> 03:09:44,783 YES, WE HAVE LUNCH. 3904 03:09:44,783 --> 03:09:47,219 WE ACTUALLY HAVE AN EXTRA 30 OR 3905 03:09:47,219 --> 03:09:48,186 40 SECONDS FOR LUNCH. 3906 03:09:48,186 --> 03:09:50,122 PLEASE BE BACK IN YOUR SEATS AT 3907 03:09:50,122 --> 03:09:51,256 1:00 P.M. 3908 03:09:51,256 --> 03:09:53,892 THOSE THAT HAVE ORDERED LUNCHES, 3909 03:09:53,892 --> 03:10:00,332 THE LUNCHES ARE OVER IN THE 3910 03:10:00,332 --> 03:10:01,333 BREAKOUT ROOM F. 3911 03:10:01,333 --> 03:10:05,027 AND WE'LL BE BACK AT 1:00 P.M. 3912 03:10:09,671 --> 03:10:12,407 >> WELCOME BACK. 3913 03:10:12,407 --> 03:10:15,143 I HOPE EVERYONE HAD A FULFILLING 3914 03:10:15,143 --> 03:10:16,878 LUNCH. 3915 03:10:16,878 --> 03:10:17,179 UNDERSTOOD. 3916 03:10:17,179 --> 03:10:19,715 WE'RE GOING TO GO AHEAD AND GET 3917 03:10:19,715 --> 03:10:21,717 STARTED WITH OUR ANNUAL 3918 03:10:21,717 --> 03:10:27,089 STATEMENT OF UNDERSTANDING. 3919 03:10:27,089 --> 03:10:29,725 BY OUR CHIEF GRANTS MANAGEMENT 3920 03:10:29,725 --> 03:10:29,958 OFFICER. 3921 03:10:29,958 --> 03:10:31,259 PRISCILLA, TAKE IT AWAY. 3922 03:10:31,259 --> 03:10:36,264 >> I'M GOING TO BRIEFLY OUTLINE 3923 03:10:36,264 --> 03:10:36,832 STATEMENT OF UNDERSTANDING 3924 03:10:36,832 --> 03:10:38,567 BETWEEN NIMHD AND COUNCIL AND 3925 03:10:38,567 --> 03:10:41,670 HIGHLIGHT PARTS OF IT. 3926 03:10:41,670 --> 03:10:44,172 THE STATEMENT IS IN YOUR 3927 03:10:44,172 --> 03:10:46,041 e-FOLDER, SUMMARIZES OUR 3928 03:10:46,041 --> 03:10:48,110 UNDERSTANDING WITH YOU ABOUT HOW 3929 03:10:48,110 --> 03:10:50,212 OUR INTERACTIONS WILL PROCEED 3930 03:10:50,212 --> 03:10:51,179 OVER THE NEXT YEAR. 3931 03:10:51,179 --> 03:10:52,781 I'LL GO THROUGH IT IN THE ORDER 3932 03:10:52,781 --> 03:10:58,053 THE SECTIONS APPEAR IN THE 3933 03:10:58,053 --> 03:10:59,387 DOCUMENT,WHY I WILL MENTION SOME 3934 03:10:59,387 --> 03:11:00,822 SECTIONS THAT DIDN'T MENTION TO 3935 03:11:00,822 --> 03:11:01,923 THE GRANTS REVIEWED THIS ROUND. 3936 03:11:01,923 --> 03:11:07,262 AFTER THE MEETING IF YOU HAVE 3937 03:11:07,262 --> 03:11:08,563 QUESTIONS FEEL FREE TO CONTACT 3938 03:11:08,563 --> 03:11:08,797 ME. 3939 03:11:08,797 --> 03:11:10,298 MY CONTACT INFORMATION IS ON THE 3940 03:11:10,298 --> 03:11:11,333 LAST SLIDE. 3941 03:11:11,333 --> 03:11:13,735 TO HELP ACHIEVE THE GOALS, THIS 3942 03:11:13,735 --> 03:11:15,570 COUNCIL IS RESPONSIBLE FOR 3943 03:11:15,570 --> 03:11:17,539 ADVISING, CONSULTING WITH, AND 3944 03:11:17,539 --> 03:11:19,741 MAKING RECOMMENDATIONS TO THE 3945 03:11:19,741 --> 03:11:21,710 DIRECTOR OF NIMHD ON MATTERS 3946 03:11:21,710 --> 03:11:23,445 RELATING TO RESEARCH ACTIVITIES 3947 03:11:23,445 --> 03:11:26,715 AND FUNCTIONS OF THE NIMHD. 3948 03:11:26,715 --> 03:11:29,785 COUNCIL MEMBERS SERVE AS 3949 03:11:29,785 --> 03:11:32,654 NATIONAL RESOURCE IN DEVELOPING, 3950 03:11:32,654 --> 03:11:33,822 RECOMMENDING, SETTING THE 3951 03:11:33,822 --> 03:11:35,490 INSTITUTES'S POLICY AND RESEARCH 3952 03:11:35,490 --> 03:11:36,291 PRIORITIES. 3953 03:11:36,291 --> 03:11:37,125 ON OCCASION SPECIAL WORKING 3954 03:11:37,125 --> 03:11:40,128 GROUPS MAY BE FORMED BY OUR AT 3955 03:11:40,128 --> 03:11:43,131 THE REQUEST OF COUNCIL TO 3956 03:11:43,131 --> 03:11:43,999 EXAMINE AND ADDRESS CRITICAL 3957 03:11:43,999 --> 03:11:45,567 SCIENTIFIC OR POLICY ISSUES OF 3958 03:11:45,567 --> 03:11:48,069 IMPORTANCE TO THE INSTITUTE AND 3959 03:11:48,069 --> 03:11:49,404 ITS CONSTITUENCIES. 3960 03:11:49,404 --> 03:11:53,441 THE NIMHD WILL INFORM COUNCIL OF 3961 03:11:53,441 --> 03:11:54,442 CURRENT SCIENTIFIC BUDGETARY, 3962 03:11:54,442 --> 03:11:55,310 LEGISLATIVE, OR OTHER ISSUES 3963 03:11:55,310 --> 03:12:00,816 THAT MAY HAVE AN IMPACT ON THE 3964 03:12:00,816 --> 03:12:05,053 NIMHD AND ITS CONSTITUENCIES. 3965 03:12:05,053 --> 03:12:06,221 THERE ARE TWO COUNCIL SESSIONS. 3966 03:12:06,221 --> 03:12:08,356 ONE IS OPEN TO THE PUBLIC, THE 3967 03:12:08,356 --> 03:12:10,792 OTHER IS CLOSED TO THE PUBLIC. 3968 03:12:10,792 --> 03:12:12,861 IN THE OPEN SESSION, THERE'S 3969 03:12:12,861 --> 03:12:14,830 DISCUSSION OF SCIENTIFIC AND 3970 03:12:14,830 --> 03:12:16,698 POLICY ISSUES, AND CONCEPT 3971 03:12:16,698 --> 03:12:19,968 CLEARANCE OF SPECIAL 3972 03:12:19,968 --> 03:12:20,669 INITIATIVES. 3973 03:12:20,669 --> 03:12:21,269 CONCEPT CLEARANCE IS DESCRIBED 3974 03:12:21,269 --> 03:12:22,170 IN THE STATEMENT OF 3975 03:12:22,170 --> 03:12:24,005 UNDERSTANDING IN MORE DETAIL. 3976 03:12:24,005 --> 03:12:26,441 IN THE CLOSED SESSIONE THERE'S 3977 03:12:26,441 --> 03:12:28,643 SECONDARY REVIEW OF GRANT 3978 03:12:28,643 --> 03:12:29,945 APPLICATIONS, STATEMENT PROVIDES 3979 03:12:29,945 --> 03:12:32,547 MORE DETAILS ON THIS. 3980 03:12:32,547 --> 03:12:33,982 CERTAIN ACTIONS MUST BE 3981 03:12:33,982 --> 03:12:34,649 CONSIDERED INDIVIDUALLY BY 3982 03:12:34,649 --> 03:12:36,818 COUNCIL, AND WE BRING TO YOUR 3983 03:12:36,818 --> 03:12:39,221 ATTENTION ANY THAT APPLY TO 3984 03:12:39,221 --> 03:12:40,655 GRANTS BEING REVIEWED. 3985 03:12:40,655 --> 03:12:42,390 SO, TWO MOST IMPORTANT FUNCTIONS 3986 03:12:42,390 --> 03:12:44,593 ARE CLEARANCE OF NEW INITIATIVES 3987 03:12:44,593 --> 03:12:46,995 IN THE OPEN SESSION AND 3988 03:12:46,995 --> 03:12:47,662 SECONDARY REVIEW OF GRANT 3989 03:12:47,662 --> 03:12:52,400 APPLICATIONS IN THE CLOSED 3990 03:12:52,400 --> 03:12:52,634 SESSION. 3991 03:12:52,634 --> 03:12:53,668 ACTIONS CONSIDERED INDIVIDUALLY 3992 03:12:53,668 --> 03:12:56,638 INCLUDE PLANS FOR FUNDING UNDER 3993 03:12:56,638 --> 03:13:00,041 RFAs, APPLICATIONS OF HIGH OR 3994 03:13:00,041 --> 03:13:01,243 LOW PROGRAM PRIORITY, 3995 03:13:01,243 --> 03:13:02,344 APPLICATIONS FROM FOREIGN 3996 03:13:02,344 --> 03:13:05,280 INSTITUTIONS WITHIN A FUNDABLE 3997 03:13:05,280 --> 03:13:06,381 RANGE, SUMMARY STATEMENTS OF 3998 03:13:06,381 --> 03:13:08,416 SPECIAL INTERESTS OR NEEDING 3999 03:13:08,416 --> 03:13:09,684 DISCUSSION OR ACTION, FOR 4000 03:13:09,684 --> 03:13:12,854 EXAMPLE IF SOME ASPECT OF THE 4001 03:13:12,854 --> 03:13:14,623 SRG'S RECOMMENDATION HAS BEEN 4002 03:13:14,623 --> 03:13:14,923 QUESTIONED. 4003 03:13:14,923 --> 03:13:15,891 CO-FUNDING APPLICATIONS FOR 4004 03:13:15,891 --> 03:13:18,793 WHICH OTHER I.C.s HAVE PRIMARY 4005 03:13:18,793 --> 03:13:20,962 RESPONSIBILITY, IF THE NIMHD DID 4006 03:13:20,962 --> 03:13:22,264 NOT HAVE PRIMARY OR DUAL 4007 03:13:22,264 --> 03:13:26,534 ASSIGNMENT ON THE COMPETING 4008 03:13:26,534 --> 03:13:26,868 APPLICATIONS. 4009 03:13:26,868 --> 03:13:27,636 AND SOME INVESTIGATORS INITIATED 4010 03:13:27,636 --> 03:13:31,406 APPLICATIONS OF P.I.s 4011 03:13:31,406 --> 03:13:34,542 RECEIVING OVER $2 MILLION TOTAL 4012 03:13:34,542 --> 03:13:40,649 COST PER YEAR FROM ACTIVE OR 4013 03:13:40,649 --> 03:13:41,883 RESEARCH PROJECT GRANTS AWARDS. 4014 03:13:41,883 --> 03:13:49,090 THERE'S A SECTION ON REVIEW AND 4015 03:13:49,090 --> 03:13:50,525 RESOLUTION APPEALS. 4016 03:13:50,525 --> 03:13:51,159 NIH-PUBLISHED RFAs DON'T ALLOW 4017 03:13:51,159 --> 03:13:52,160 PEER REVIEW. 4018 03:13:52,160 --> 03:13:54,896 IF WE HAVE APPEALS OF REVIEW OF 4019 03:13:54,896 --> 03:14:00,568 UNSOLICITED APPLICATIONS WE'LL 4020 03:14:00,568 --> 03:14:01,102 INFORM YOU. 4021 03:14:01,102 --> 03:14:03,471 THE STATEMENT HAS A SECTION THAT 4022 03:14:03,471 --> 03:14:05,540 LISTS ADMINISTRATIVE DECISIONS 4023 03:14:05,540 --> 03:14:07,709 AND ACTIONS THAT DON'T REQUIRE 4024 03:14:07,709 --> 03:14:08,810 COUNCIL RECOMMENDATION. 4025 03:14:08,810 --> 03:14:11,112 THE ITEMS LISTED IN THIS SLIDE 4026 03:14:11,112 --> 03:14:12,447 ARE EXAMPLES OF ACTIONS THAT 4027 03:14:12,447 --> 03:14:16,384 ONCE BE BROUGHT BEFORE COUNCIL, 4028 03:14:16,384 --> 03:14:19,421 SUCH AS CHANGING PI, CHANGE OF 4029 03:14:19,421 --> 03:14:26,428 DOMESTIC ADMINISTRATION, 4030 03:14:26,428 --> 03:14:29,597 ADMINISTRATIVE COSTS WITHIN THE 4031 03:14:29,597 --> 03:14:30,932 SCOPE OF A GRANT. 4032 03:14:30,932 --> 03:14:32,133 A SECTION DESCRIBED OPTIONS 4033 03:14:32,133 --> 03:14:33,902 AVAILABLE TO THE COUNCIL WHEN 4034 03:14:33,902 --> 03:14:35,337 REVIEWING GRANT APPLICATIONS 4035 03:14:35,337 --> 03:14:37,072 DURING THE CLOSED SESSION, THE 4036 03:14:37,072 --> 03:14:39,808 COUNCIL MAY NOT CHANGE THE 4037 03:14:39,808 --> 03:14:41,977 SCORES ASSIGNED BY THE 4038 03:14:41,977 --> 03:14:43,878 SCIENTIFIC REVIEW GROUP, SRG, 4039 03:14:43,878 --> 03:14:49,084 HERE ARE THE OPTIONS AVAILABLE. 4040 03:14:49,084 --> 03:14:52,387 CONCURRENCE WITH SRG'S 4041 03:14:52,387 --> 03:14:53,154 RECOMMENDATION, NON-CONCURRENCE 4042 03:14:53,154 --> 03:14:55,457 BASED ON SCIENTIFIC OR TECHNICAL 4043 03:14:55,457 --> 03:14:56,758 MERIT OR POLICY CONSIDERATIONS, 4044 03:14:56,758 --> 03:14:59,627 RECOMMENDATION OF HIGH OR LOW 4045 03:14:59,627 --> 03:15:01,896 PROGRAM PRIORITY, OR DEFERRAL TO 4046 03:15:01,896 --> 03:15:02,764 OBTAIN ADDITIONAL INFORMATION 4047 03:15:02,764 --> 03:15:05,834 FOR CONSIDERATION AT ANOTHER 4048 03:15:05,834 --> 03:15:06,368 MEETING. 4049 03:15:06,368 --> 03:15:08,236 A REPORT OF THE EN BLOC 4050 03:15:08,236 --> 03:15:10,438 RECOMMENDATIONS IS PRESENTED. 4051 03:15:10,438 --> 03:15:12,407 SUMMARY STATEMENTS NOT REQUIRING 4052 03:15:12,407 --> 03:15:13,174 INDIVIDUAL DISCUSSION ARE 4053 03:15:13,174 --> 03:15:15,377 TREATED EN BLOC. 4054 03:15:15,377 --> 03:15:17,779 ANY COUNCIL MEMBER MAY REQUEST 4055 03:15:17,779 --> 03:15:19,647 THAT AN INDIVIDUAL SUMMARY 4056 03:15:19,647 --> 03:15:21,716 STATEMENT BE DISCUSSED 4057 03:15:21,716 --> 03:15:24,052 INDIVIDUALLY BY THE COUNCIL. 4058 03:15:24,052 --> 03:15:25,553 THE EXPEDITED REVIEW PROCESS IS 4059 03:15:25,553 --> 03:15:26,988 NOT MENTIONED IN THESE SLIDES 4060 03:15:26,988 --> 03:15:28,957 BECAUSE IT DESCRIBES AN OPTIONAL 4061 03:15:28,957 --> 03:15:30,892 PROCESS THAT DIDN'T APPLY TO 4062 03:15:30,892 --> 03:15:31,559 THIS ROUND'S APPLICATIONS. 4063 03:15:31,559 --> 03:15:33,328 IF WE WERE TO FOLLOW THIS 4064 03:15:33,328 --> 03:15:35,497 PROCESS IN THE FUTURE, FOR 4065 03:15:35,497 --> 03:15:36,498 CERTAIN APPLICATIONS, YOU WOULD 4066 03:15:36,498 --> 03:15:39,434 BE PROVIDED WITH DETAILS IN 4067 03:15:39,434 --> 03:15:40,101 ADVANCE. 4068 03:15:40,101 --> 03:15:41,069 A SECTION DESCRIBED OPTIONS 4069 03:15:41,069 --> 03:15:43,371 AVAILABLE TO THE COUNCIL WHEN 4070 03:15:43,371 --> 03:15:44,906 REVIEWING NEW CONCEPTS FOR 4071 03:15:44,906 --> 03:15:48,943 CLEARANCE DURING THE OPEN 4072 03:15:48,943 --> 03:15:50,145 SESSION, APPROVAL, DISAPPROVAL, 4073 03:15:50,145 --> 03:15:53,214 DEFERRAL, OR APPROVAL WITH 4074 03:15:53,214 --> 03:15:54,649 RECOMMENDATIONS FOR SPECIFIC 4075 03:15:54,649 --> 03:15:54,983 MODIFICATIONS. 4076 03:15:54,983 --> 03:15:57,052 TO SUMMARIZE, THE STATEMENT OF 4077 03:15:57,052 --> 03:15:58,386 UNDERSTANDING WAS WRITTEN TO BE 4078 03:15:58,386 --> 03:16:00,121 COMPREHENSIVE, NOT ALL THE 4079 03:16:00,121 --> 03:16:01,356 SECTIONS IN IT WERE APPLICABLE 4080 03:16:01,356 --> 03:16:03,725 TO THE PARTICULAR GRANTS AND 4081 03:16:03,725 --> 03:16:05,193 ITEMS DISCUSSED AT THIS COUNCIL 4082 03:16:05,193 --> 03:16:05,927 ROUND. 4083 03:16:05,927 --> 03:16:07,462 HOWEVER, WE BRING TO YOUR 4084 03:16:07,462 --> 03:16:09,864 ATTENTION ANY GRANTS OR OTHER 4085 03:16:09,864 --> 03:16:10,565 MATTERS REQUIRING YOUR 4086 03:16:10,565 --> 03:16:12,500 CONSIDERATION OR THAT MAY HAVE 4087 03:16:12,500 --> 03:16:19,541 AN IMPACT ON THE NIMHD AND ITS 4088 03:16:19,541 --> 03:16:19,941 CONSTITUENCIES. 4089 03:16:19,941 --> 03:16:20,675 AND MY CONTACT INFORMATION IS 4090 03:16:20,675 --> 03:16:22,110 THERE IN CASE THERE ARE 4091 03:16:22,110 --> 03:16:25,346 QUESTIONS. 4092 03:16:25,346 --> 03:16:27,148 >> WE ARE OPEN FOR QUESTIONS 4093 03:16:27,148 --> 03:16:28,950 NOW, ARE THERE ANY QUESTIONS OR 4094 03:16:28,950 --> 03:16:33,488 COMMENTS REGARDING THE STATEMENT 4095 03:16:33,488 --> 03:16:40,762 OF UNDERSTANDING? 4096 03:16:40,762 --> 03:16:51,139 THANK YOU, PRISCILLA. 4097 03:17:40,755 --> 03:17:42,590 WE WILL NOW MOVE TO THE 4098 03:17:42,590 --> 03:17:43,658 CONCEPTS. 4099 03:17:43,658 --> 03:17:47,128 THERE ARE TWO CONCEPTS FOR 4100 03:17:47,128 --> 03:17:52,400 APPROVAL THAT WE WERE PREVENTED 4101 03:17:52,400 --> 03:17:55,470 AND REVIEWED IN ABBREVIATED 4102 03:17:55,470 --> 03:17:55,837 FORM. 4103 03:17:55,837 --> 03:17:58,806 OTHER MEMBERS WERE ASKED TO 4104 03:17:58,806 --> 03:18:01,342 SHARE COMMENTS WITH AN ASSIGNED 4105 03:18:01,342 --> 03:18:03,011 REVIEWER, AND REVIEWERS ASKED TO 4106 03:18:03,011 --> 03:18:05,647 INCLUDE THESE THOUGHTS AND THEIR 4107 03:18:05,647 --> 03:18:06,447 OWN BRIEF COMMENTS. 4108 03:18:06,447 --> 03:18:09,984 THERE WILL BE AN OPEN DISCUSSION 4109 03:18:09,984 --> 03:18:11,452 PERIOD FOR ADDITIONAL COMMENTS 4110 03:18:11,452 --> 03:18:12,987 FROM COUNCIL MEMBERS WITH ANY 4111 03:18:12,987 --> 03:18:15,924 MEMBER AND A MOTION TO APPROVE 4112 03:18:15,924 --> 03:18:20,295 OR DISAPPROVE AND A VOTE BY ALL 4113 03:18:20,295 --> 03:18:21,896 VOTING MEMBERS. 4114 03:18:21,896 --> 03:18:27,635 REVIEWERS WILL MOVE AND SECOND 4115 03:18:27,635 --> 03:18:29,270 THE CONCEPTS. 4116 03:18:29,270 --> 03:18:35,543 FIRST CONCEPT WILL BE BY DR. 4117 03:18:35,543 --> 03:18:36,711 LUKA CARZONE. 4118 03:18:36,711 --> 03:18:40,215 >> THANK YOU. 4119 03:18:40,215 --> 03:18:42,417 GOOD AFTERNOON. 4120 03:18:42,417 --> 03:18:45,620 I'M A DIVISION DATA SCIENTIST 4121 03:18:45,620 --> 03:18:47,789 AND PROGRAM OFFICER AT NIMHD. 4122 03:18:47,789 --> 03:18:52,594 I'M BEEN WORKING WITH DR. MONICA 4123 03:18:52,594 --> 03:18:54,128 WEBB HOOPER ON DEVELOPING 4124 03:18:54,128 --> 03:18:59,500 CONCEPTS TO ADVANCE DATA SCIENCE 4125 03:18:59,500 --> 03:19:01,669 APPROACHES HEALTH DISPARITIES, 4126 03:19:01,669 --> 03:19:03,404 A.I., MACHINE LEARNING, 4127 03:19:03,404 --> 03:19:04,839 COMMUNITY ENGAGED RESEARCH. 4128 03:19:04,839 --> 03:19:05,607 HEALTH DISPARITIES PERSIST 4129 03:19:05,607 --> 03:19:10,111 GLOBALLY AND IN THE U.S. 4130 03:19:10,111 --> 03:19:10,411 ESPECIALLY. 4131 03:19:10,411 --> 03:19:11,946 AND THE SOCIAL DETERMINANTS OF 4132 03:19:11,946 --> 03:19:14,148 HEALTH CONTRIBUTE SIGNIFICANTLY 4133 03:19:14,148 --> 03:19:16,351 TO THESE DISPARITIES. 4134 03:19:16,351 --> 03:19:18,219 A.I. AND MACHINE LEARNING 4135 03:19:18,219 --> 03:19:20,288 APPLICATIONS IN HEALTH CARE 4136 03:19:20,288 --> 03:19:23,358 OFFER NEW AVENUES TO EXPLORE AND 4137 03:19:23,358 --> 03:19:24,125 ADDRESS THESE HEALTH 4138 03:19:24,125 --> 03:19:28,162 DISPARITIES, AND THEY ARE 4139 03:19:28,162 --> 03:19:28,429 PROMISING. 4140 03:19:28,429 --> 03:19:33,067 THEY SHOW PROMISE IN PREDICTION, 4141 03:19:33,067 --> 03:19:33,735 PERSONALIZED MEDICINE, 4142 03:19:33,735 --> 03:19:34,836 OPTIMIZING HEALTH CARE, BUT 4143 03:19:34,836 --> 03:19:37,372 THESE SAME TOOLS THAT CAN HELP 4144 03:19:37,372 --> 03:19:39,874 ADDRESS DISPARITIES CAN ALSO 4145 03:19:39,874 --> 03:19:41,409 EXACERBATE THEM BECAUSE OF 4146 03:19:41,409 --> 03:19:44,479 INHERENT BIASES THAT THEY OFTEN 4147 03:19:44,479 --> 03:19:45,346 CONTAIN. 4148 03:19:45,346 --> 03:19:48,983 THESE BIASES CAN STEM FROM 4149 03:19:48,983 --> 03:19:49,517 PRESENTATION OF DIVERSE 4150 03:19:49,517 --> 03:19:52,120 POPULATIONS IN TRAINING DATA OR 4151 03:19:52,120 --> 03:19:55,223 FROM DESIGN FLAWS, IN THE 4152 03:19:55,223 --> 03:19:57,759 ALGORITHMS, OR FROM ISSUES IN 4153 03:19:57,759 --> 03:19:58,359 IMPLEMENTATION. 4154 03:19:58,359 --> 03:20:03,331 AND THEY CAN RESULT IN 4155 03:20:03,331 --> 03:20:04,966 DIAGNOSTIC ERRORS, AND UNEQUAL 4156 03:20:04,966 --> 03:20:06,601 ACCESS TO HEALTH CARE, 4157 03:20:06,601 --> 03:20:09,570 EXACERBATING HEALTH DISPARITIES 4158 03:20:09,570 --> 03:20:10,238 THIS WAY. 4159 03:20:10,238 --> 03:20:13,941 SO WE NEED TO ADDRESS THESE 4160 03:20:13,941 --> 03:20:14,842 BIASES TO ENSURE EQUITABLE 4161 03:20:14,842 --> 03:20:15,176 OUTCOMES. 4162 03:20:15,176 --> 03:20:19,681 ONE WAY TO DO THAT IS THROUGH 4163 03:20:19,681 --> 03:20:22,517 COMMUNITY-ENGAGED RESEARCH WHICH 4164 03:20:22,517 --> 03:20:23,851 IS A COLLABORATIVE METHODOLOGY 4165 03:20:23,851 --> 03:20:25,153 TO INVOLVE COMMUNITY MEMBERS IN 4166 03:20:25,153 --> 03:20:27,989 ALL ASPECTS OF THE RESEARCH 4167 03:20:27,989 --> 03:20:28,323 PROCESS. 4168 03:20:28,323 --> 03:20:32,894 SO THE EMPHASIS IS ON 4169 03:20:32,894 --> 03:20:34,128 COLLABORATION, CULTURE 4170 03:20:34,128 --> 03:20:34,996 SENSITIVITY, BIDIRECTIONAL 4171 03:20:34,996 --> 03:20:36,197 LEARNING WHERE RESEARCHERS LEARN 4172 03:20:36,197 --> 03:20:39,701 FROM COMMUNITY MEMBERS AND 4173 03:20:39,701 --> 03:20:41,769 COMMUNITY MEMBERS LEARN FROM 4174 03:20:41,769 --> 03:20:42,770 RESEARCHERS, AND CAPACITY 4175 03:20:42,770 --> 03:20:43,638 BUILDING WITHIN THOSE 4176 03:20:43,638 --> 03:20:44,272 COMMUNITIES. 4177 03:20:44,272 --> 03:20:47,775 THE OBJECTIVES OF THE INITIATIVE 4178 03:20:47,775 --> 03:20:52,714 ARE TO ADDRESS BIAS BY 4179 03:20:52,714 --> 03:20:54,549 INTEGRATING WITH COMMUNITY 4180 03:20:54,549 --> 03:20:55,783 ENGAGED RESEARCH, FOSTER 4181 03:20:55,783 --> 03:20:56,651 INCLUSIVITY, CULTURE 4182 03:20:56,651 --> 03:20:57,985 SENSITIVITY, AND EFFECTIVE 4183 03:20:57,985 --> 03:21:00,121 HEALTH INTERVENTIONS. 4184 03:21:00,121 --> 03:21:02,056 AND TO EMPOWER COMMUNITIES TO 4185 03:21:02,056 --> 03:21:07,228 TAKE AN ACTIVE ROLE AND SHAPE 4186 03:21:07,228 --> 03:21:07,795 THEIR HEALTHCARE LANDSCAPE. 4187 03:21:07,795 --> 03:21:11,199 I'D LIKE TO ILLUSTRATE HOW A.I. 4188 03:21:11,199 --> 03:21:11,866 BIAS EXACERBATES HEALTH 4189 03:21:11,866 --> 03:21:12,300 DISPARITIES. 4190 03:21:12,300 --> 03:21:16,671 IF YOU TAKE A LOOK AT THE 4191 03:21:16,671 --> 03:21:18,740 ILLUSTRATION HERE, IT'S A CYCLE. 4192 03:21:18,740 --> 03:21:21,676 AND EVERYTHING STARTS WITH THE 4193 03:21:21,676 --> 03:21:23,211 DATA, WHICH MAY CONTAIN SAMPLING 4194 03:21:23,211 --> 03:21:27,482 BIAS OR MAY NOT BE 4195 03:21:27,482 --> 03:21:27,949 REPRESENTATIVE ENOUGH. 4196 03:21:27,949 --> 03:21:30,351 AND PATTERNS OF BIAS AND 4197 03:21:30,351 --> 03:21:32,420 DISCRIMINATION ARE OFTEN BAKED 4198 03:21:32,420 --> 03:21:33,454 INTO DATA DISTRIBUTIONS. 4199 03:21:33,454 --> 03:21:36,023 SO WHAT HAPPENS IN THE NEXT 4200 03:21:36,023 --> 03:21:40,628 PHASE WHICH IS THE DESIGN PHASE, 4201 03:21:40,628 --> 03:21:45,333 THERE COULD BE POWER IMBALANCES 4202 03:21:45,333 --> 03:21:47,301 IN SETTINGS, AND PROBLEM 4203 03:21:47,301 --> 03:21:49,504 FORMULATION, THE DESIGN OF THESE 4204 03:21:49,504 --> 03:21:52,106 ALGORITHMS CAN BE BIASED, OR THE 4205 03:21:52,106 --> 03:21:55,209 WAY THESE MODELS ARE BUILT OR 4206 03:21:55,209 --> 03:21:55,443 TESTED. 4207 03:21:55,443 --> 03:21:57,178 AND FINALLY, THERE COULD BE 4208 03:21:57,178 --> 03:21:58,713 BIASES IN THE DEPLOYMENT OF 4209 03:21:58,713 --> 03:22:02,417 THESE MODELS IN THE WAY THEY ARE 4210 03:22:02,417 --> 03:22:04,285 EXPLAINED, WHICH OFTEN LACKS 4211 03:22:04,285 --> 03:22:08,689 TRANSPARENCY, AND IN THE WAY 4212 03:22:08,689 --> 03:22:11,058 THEY ARE MONITORED. 4213 03:22:11,058 --> 03:22:15,997 SO, BIAS BY A.I. DESIGN AND 4214 03:22:15,997 --> 03:22:18,199 DEPLOYMENT TRANSLATES INTO 4215 03:22:18,199 --> 03:22:20,802 APPLICATION WHICH DEEPEN DIGITAL 4216 03:22:20,802 --> 03:22:23,104 DIVIDE, CAN EXACERBATE GLOBAL 4217 03:22:23,104 --> 03:22:25,206 HEALTH INEQUALITY AND TREATMENT 4218 03:22:25,206 --> 03:22:27,608 GAPS AND THEY COULD ALSO HAVE TO 4219 03:22:27,608 --> 03:22:33,314 DO WITH SCRIM DISCRIMINATORY PE 4220 03:22:33,314 --> 03:22:35,483 OF BIAS. 4221 03:22:35,483 --> 03:22:36,484 THESE INJUSTICES RESULT IN REAL 4222 03:22:36,484 --> 03:22:38,052 WORLD PATTERNS OF HEALTH 4223 03:22:38,052 --> 03:22:40,121 INEQUALITY AND DISCRIMINATION, 4224 03:22:40,121 --> 03:22:44,058 WHERE WE HAVE UNEQUAL ACCESS IN 4225 03:22:44,058 --> 03:22:45,693 LOCATION, DISCRIMINATORY 4226 03:22:45,693 --> 03:22:46,661 PROCESSES, OR BIASED CLINICAL 4227 03:22:46,661 --> 03:22:48,729 DECISION MAKING. 4228 03:22:48,729 --> 03:22:50,832 THE CYCLE CONTINUES BECAUSE 4229 03:22:50,832 --> 03:22:54,001 THESE PATTERNS OF HEALTH 4230 03:22:54,001 --> 03:22:54,902 INEQUALITY AND DISCRIMINATION 4231 03:22:54,902 --> 03:22:56,471 ARE IN DATA DISTRIBUTIONS. 4232 03:22:56,471 --> 03:22:59,607 SO, I'D LIKE TO GIVE AN EXAMPLE 4233 03:22:59,607 --> 03:23:06,280 TO MAKE THINGS MORE CONCRETE, 4234 03:23:06,280 --> 03:23:09,016 A.I.-DRIVEN DERMATOLOGY IS 4235 03:23:09,016 --> 03:23:11,686 LEAVING DARK SKINNED PATIENTS 4236 03:23:11,686 --> 03:23:14,188 BEHIND BECAUSE MACHINE LEARNING 4237 03:23:14,188 --> 03:23:17,692 TOOLS DISTINGUISH IMAGES OF 4238 03:23:17,692 --> 03:23:18,893 BENIGN AND MALIGNANT MOLES. 4239 03:23:18,893 --> 03:23:20,528 MODELS ARE TRAINED ON FAIR 4240 03:23:20,528 --> 03:23:23,164 SKINNED POPULATIONS MOSTLY SO 4241 03:23:23,164 --> 03:23:24,799 THEY MISDIAGNOSE LESIONS ON 4242 03:23:24,799 --> 03:23:28,302 PATIENTS OF COLOR. 4243 03:23:28,302 --> 03:23:31,405 BIAS HER FROM DATA REFLECTS 4244 03:23:31,405 --> 03:23:32,673 HISTORICAL INEQUALITIES. 4245 03:23:32,673 --> 03:23:35,643 THERE ARE MANY MORE EXAMPLES I 4246 03:23:35,643 --> 03:23:39,881 WOULD GIVE YOU. 4247 03:23:39,881 --> 03:23:40,948 SO, I CONDUCTED LITERATURE 4248 03:23:40,948 --> 03:23:43,050 REVIEW FROM WHICH IT WAS CLEAR 4249 03:23:43,050 --> 03:23:44,585 CURRENT MODELS FAIL TO REFLECT 4250 03:23:44,585 --> 03:23:46,320 THE DIVERSITY OF THE POPULATIONS 4251 03:23:46,320 --> 03:23:49,724 THEY SERVE, AND THIS LEADS TO 4252 03:23:49,724 --> 03:23:50,057 DISPARITIES. 4253 03:23:50,057 --> 03:23:52,460 AND THIS ISSUE IS COMPOUNDED BY 4254 03:23:52,460 --> 03:23:54,428 THE LACK OF STANDARD FRAMEWORKS 4255 03:23:54,428 --> 03:23:59,033 TO DETECT AND MITIGATE BIAS. 4256 03:23:59,033 --> 03:24:00,902 COMMUNITY ENGAGEMENT IS CRUCIAL 4257 03:24:00,902 --> 03:24:01,903 IN THESE TOPICS. 4258 03:24:01,903 --> 03:24:04,438 WE NEED TO BUILD CAPACITY WITHIN 4259 03:24:04,438 --> 03:24:06,173 COMMUNITIES, AND WE NEED TO 4260 03:24:06,173 --> 03:24:08,876 ESTABLISH BEST PRACTICES FOR 4261 03:24:08,876 --> 03:24:09,977 INTERPRETING DATA INPUTS. 4262 03:24:09,977 --> 03:24:12,613 ONLY THIS CAN LEAD TO MORE 4263 03:24:12,613 --> 03:24:16,117 EFFECTIVE A.I. SOLUTIONS. 4264 03:24:16,117 --> 03:24:19,754 BUT THIS REQUESTS CONCERTED 4265 03:24:19,754 --> 03:24:20,288 EFFORT TO FOSTER 4266 03:24:20,288 --> 03:24:21,188 INTERDISCIPLINARY COLLABORATION 4267 03:24:21,188 --> 03:24:24,125 WHICH IS LACKING RIGHT NOW. 4268 03:24:24,125 --> 03:24:28,296 SO TO BRIDGE THIS GAP TO DEVELOP 4269 03:24:28,296 --> 03:24:30,698 A.I. TOOLS THAT ARE INNOVATIVE 4270 03:24:30,698 --> 03:24:33,100 AND INCLUSIVE. 4271 03:24:33,100 --> 03:24:35,937 THESE TOOLS STRUGGLE TO 4272 03:24:35,937 --> 03:24:38,439 GENERALIZE ACROSS POPULATIONS. 4273 03:24:38,439 --> 03:24:40,207 SO, THIS REFLECTS THE NEED TO 4274 03:24:40,207 --> 03:24:43,911 BETTER CON CONTEXTUALIZE AND 4275 03:24:43,911 --> 03:24:46,247 VALIDATION OF THESE TOOLS. 4276 03:24:46,247 --> 03:24:49,317 IN TERMS OF NIH-FUNDED RESEARCH, 4277 03:24:49,317 --> 03:24:54,922 I RAN A SEARCH OF GRANTS FUNDED 4278 03:24:54,922 --> 03:24:56,123 2017 TO 2024, TWO SEPARATE 4279 03:24:56,123 --> 03:24:57,925 SEARCHES ACTUALLY. 4280 03:24:57,925 --> 03:25:01,028 I FOUND OUT LIMITED RESEARCH 4281 03:25:01,028 --> 03:25:02,863 EXISTS ON PROJECTS THAT 4282 03:25:02,863 --> 03:25:03,631 INTEGRATE COMMUNITY ENGAGED 4283 03:25:03,631 --> 03:25:04,632 RESEARCH WITH HEALTH DISPARITIES 4284 03:25:04,632 --> 03:25:06,701 RESEARCH AND A.I. 4285 03:25:06,701 --> 03:25:10,404 MOST PROJECTS FOCUS ON GENOMICS, 4286 03:25:10,404 --> 03:25:12,039 TRANSLATIONAL RESEARCH, MOBILE 4287 03:25:12,039 --> 03:25:14,809 HEALTH, AND CANCER. 4288 03:25:14,809 --> 03:25:17,578 AND ONLY SEVEN PROJECTS FOCUS ON 4289 03:25:17,578 --> 03:25:18,613 COMMUNITY ENGAGED RESEARCH, 4290 03:25:18,613 --> 03:25:21,816 HEALTH DISPARITIES, AND A.I. 4291 03:25:21,816 --> 03:25:22,483 BIAS. 4292 03:25:22,483 --> 03:25:25,853 AND TWO OF THEM IN PARTICULAR 4293 03:25:25,853 --> 03:25:28,055 ARE AN INITIATIVE ON DEVELOPING 4294 03:25:28,055 --> 03:25:29,590 AND EVALUATING COMMERCIALIZING 4295 03:25:29,590 --> 03:25:32,193 MONITORING TOOLS FOR PEOPLE WITH 4296 03:25:32,193 --> 03:25:34,061 ALZHEIMER'S DISEASE AND 4297 03:25:34,061 --> 03:25:35,496 DEMENTIA, AND SECOND PROJECT IS 4298 03:25:35,496 --> 03:25:37,031 A PROJECT FOCUSED ON BUILDING 4299 03:25:37,031 --> 03:25:42,403 MACHINE LEARNING MODELS OF 4300 03:25:42,403 --> 03:25:47,742 APPROPRIATE MEDICAL UTILIZATION 4301 03:25:47,742 --> 03:25:48,743 IN ALASKA. 4302 03:25:48,743 --> 03:25:52,680 SO, THERE ARE TWO CATEGORIES OF 4303 03:25:52,680 --> 03:25:54,348 INTERDISCIPLINARY PROJECTS THAT 4304 03:25:54,348 --> 03:25:55,983 THIS INITIATIVE COULD SUPPORT. 4305 03:25:55,983 --> 03:26:01,789 YOU COULD ACTUALLY -- I BROKE 4306 03:26:01,789 --> 03:26:03,424 DOWN, BUT YOU COULD READ THE 4307 03:26:03,424 --> 03:26:08,829 SLIDE LIKE THIS. 4308 03:26:08,829 --> 03:26:10,998 SO RESEARCH, RESEARCH 4309 03:26:10,998 --> 03:26:13,200 INITIATIVES, SO EPIDEMIOLOGICAL, 4310 03:26:13,200 --> 03:26:14,502 BEHAVIORAL, SOCIAL APPLIED AND 4311 03:26:14,502 --> 03:26:15,536 SURVEILLANCE RESEARCH TO 4312 03:26:15,536 --> 03:26:16,137 UNDERSTAND IMPACT OF SOCIAL 4313 03:26:16,137 --> 03:26:21,609 DETERMINANTS OF HEALTH ON HEALTH 4314 03:26:21,609 --> 03:26:22,076 DISPARITIES. 4315 03:26:22,076 --> 03:26:24,679 AND HEALTH INTERESTS, SO 4316 03:26:24,679 --> 03:26:26,213 PREVENTIVE SCREENING, DIAGNOSTIC 4317 03:26:26,213 --> 03:26:27,748 AND THERAPEUTIC BEHAVIORAL 4318 03:26:27,748 --> 03:26:29,483 HEALTH INTERVENTIONS AIMED AT 4319 03:26:29,483 --> 03:26:31,686 REDUCING THOSE HEALTH 4320 03:26:31,686 --> 03:26:33,120 DISPARITIES. 4321 03:26:33,120 --> 03:26:37,058 AND THE THIRD PART IS A.I. 4322 03:26:37,058 --> 03:26:38,259 TOOLS, SO VALIDATION ENHANCEMENT 4323 03:26:38,259 --> 03:26:43,864 OF EXISTING A.I. TOOLS AND 4324 03:26:43,864 --> 03:26:44,799 MODELS, CONTEXTUALIZATION AND 4325 03:26:44,799 --> 03:26:46,634 DEVELOPMENT OF NEW BIAS 4326 03:26:46,634 --> 03:26:47,935 DETECTION AND MITIGATION 4327 03:26:47,935 --> 03:26:49,804 STRATEGIES, BOTH IN DATA AND IN 4328 03:26:49,804 --> 03:26:50,137 MODELS. 4329 03:26:50,137 --> 03:26:51,672 AND I ADDED THIS PART BECAUSE 4330 03:26:51,672 --> 03:26:56,477 IT'S REALLY IMPORTANT THAT WE DO 4331 03:26:56,477 --> 03:26:59,346 NOT FORGET ABOUT BIAS. 4332 03:26:59,346 --> 03:27:01,849 SO, THERE ARE TWO IMPORTANT 4333 03:27:01,849 --> 03:27:03,384 COMPONENTS OF THIS INITIATIVE. 4334 03:27:03,384 --> 03:27:05,152 FIRST, THERE MUST BE COMMUNITY 4335 03:27:05,152 --> 03:27:08,422 ENGAGEMENT COMPONENT FROM DESIGN 4336 03:27:08,422 --> 03:27:11,292 TO IMPLEMENTATION. 4337 03:27:11,292 --> 03:27:12,393 SO RESEARCHERS CAN EXPLAIN BIAS 4338 03:27:12,393 --> 03:27:14,795 IN A.I. MODELS TO COMMUNITY 4339 03:27:14,795 --> 03:27:16,997 MEMBERS, AND COMMUNITY MEMBERS 4340 03:27:16,997 --> 03:27:20,201 CAN SHARE CONTENT AND INFORM THE 4341 03:27:20,201 --> 03:27:23,037 DEVELOPER OF THOSE TOOLS. 4342 03:27:23,037 --> 03:27:24,905 AND SECOND ESSENTIAL COMPONENT 4343 03:27:24,905 --> 03:27:26,674 IS DIVERSE RESEARCH SCHEMES. 4344 03:27:26,674 --> 03:27:29,610 DIVERSITY IN TERMS OF SCIENTIFIC 4345 03:27:29,610 --> 03:27:30,411 DISCIPLINE, SO BEHAVIORAL, 4346 03:27:30,411 --> 03:27:32,580 CLINICAL, PUBLIC HEALTH AND DATA 4347 03:27:32,580 --> 03:27:36,650 SCIENCE SHOULD COME TOGETHER AND 4348 03:27:36,650 --> 03:27:38,619 COLLABORATE ON PROJECTS. 4349 03:27:38,619 --> 03:27:41,122 DIVERSITY ALSO IN TERMS OF 4350 03:27:41,122 --> 03:27:42,923 COMMUNITY PARTNERS SHOULD BE 4351 03:27:42,923 --> 03:27:47,461 INVESTIGATORS AND DECISION 4352 03:27:47,461 --> 03:27:49,096 MAKERS IN THOSE TEAMS. 4353 03:27:49,096 --> 03:27:52,399 SO HERE ARE SOME AREAS OF 4354 03:27:52,399 --> 03:27:54,668 INTEREST THAT CAN INCLUDE BUT 4355 03:27:54,668 --> 03:27:56,871 ARE NOT LIMITED TO FIRST 4356 03:27:56,871 --> 03:27:59,406 CATEGORIES OF RESEARCH AND 4357 03:27:59,406 --> 03:28:00,708 HEALTH INTERVENTIONS WITH FOCUS 4358 03:28:00,708 --> 03:28:03,644 ON CHRONIC DISEASES SO FOR 4359 03:28:03,644 --> 03:28:05,513 EXAMPLE THEY COULD PREDICT 4360 03:28:05,513 --> 03:28:07,248 PROGRESS, IDENTIFY RISK FACTORS, 4361 03:28:07,248 --> 03:28:08,582 PERSONALIZED TREATMENT PLANS FOR 4362 03:28:08,582 --> 03:28:12,186 CONDITIONS LIKE DIABETES AND 4363 03:28:12,186 --> 03:28:12,853 HYPERTENSION, WHICH AFFECT 4364 03:28:12,853 --> 03:28:14,488 MARGINALIZED COMMUNITIES IN A 4365 03:28:14,488 --> 03:28:19,293 SPECIAL WAY, COULD FOCUS ON 4366 03:28:19,293 --> 03:28:21,495 MENTAL HEALTH, INCLUDING 4367 03:28:21,495 --> 03:28:26,967 DEPRESSION, ANXIETY, SUBSTANCE 4368 03:28:26,967 --> 03:28:28,202 ABUSE. 4369 03:28:28,202 --> 03:28:32,807 MATERNAL AND INFANT HEALTH, 4370 03:28:32,807 --> 03:28:35,042 MONITORING HIGH RISK PREGNANCY, 4371 03:28:35,042 --> 03:28:37,511 AND OUTCOMES. 4372 03:28:37,511 --> 03:28:39,580 INFECTIOUS DISEASES, TOOLS THAT 4373 03:28:39,580 --> 03:28:41,115 ENHANCE DISEASE SURVEILLANCE, 4374 03:28:41,115 --> 03:28:42,883 PREDICT OUTBREAKS, AND OPTIMIZE 4375 03:28:42,883 --> 03:28:43,417 RESOURCE ALLOCATION FOR 4376 03:28:43,417 --> 03:28:45,052 PREVENTION AND CONTROL OF 4377 03:28:45,052 --> 03:28:48,455 DISEASES LIKE COVID-19 AND HIV. 4378 03:28:48,455 --> 03:28:50,191 AND ENVIRONMENTAL HEALTH, SO 4379 03:28:50,191 --> 03:28:52,159 TOOLS THAT HELP ANALYZE 4380 03:28:52,159 --> 03:28:53,594 ENVIRONMENTAL DATA AND ASSESS 4381 03:28:53,594 --> 03:28:55,362 HEALTH RISKS IN MARGINALIZED 4382 03:28:55,362 --> 03:28:58,999 COMMUNITIES EXPOSED TO HAZARDS 4383 03:28:58,999 --> 03:28:59,733 LIKE POLLUTION. 4384 03:28:59,733 --> 03:29:01,735 FOR THE SECOND PART OF THE 4385 03:29:01,735 --> 03:29:03,470 PROJECTS, FOCUSED ON VALIDATING 4386 03:29:03,470 --> 03:29:05,773 AND ENHANCING EXISTING A.I. 4387 03:29:05,773 --> 03:29:10,811 TOOLS AND MACHINE LEARNING 4388 03:29:10,811 --> 03:29:13,247 MODELS FOCUS ON BIAS DETECTION 4389 03:29:13,247 --> 03:29:16,717 AND MITIGATION IN BOTH DATA AND 4390 03:29:16,717 --> 03:29:17,051 MODELS. 4391 03:29:17,051 --> 03:29:18,686 ON ENSURING COMMUNITY ACCESS TO 4392 03:29:18,686 --> 03:29:21,522 A.I. AND MACHINE LEARNING 4393 03:29:21,522 --> 03:29:23,624 TECHNOLOGY BY ADDRESSING COSTS, 4394 03:29:23,624 --> 03:29:26,594 INFRASTRUCTURE, AND EXPERTISE 4395 03:29:26,594 --> 03:29:26,861 BARRIERS. 4396 03:29:26,861 --> 03:29:28,729 AND PROMOTE RESPONSIBLE A.I. USE 4397 03:29:28,729 --> 03:29:31,398 AND TRUST IN A.I. 4398 03:29:31,398 --> 03:29:34,802 AND SECOND FOCUS HERE COULD BE 4399 03:29:34,802 --> 03:29:36,604 ON A.I. TOOLS CONTEXTUALIZATION 4400 03:29:36,604 --> 03:29:40,140 AND VALIDATION IN TERMS OF 4401 03:29:40,140 --> 03:29:40,908 VALIDATING A.I. TOOLS IN 4402 03:29:40,908 --> 03:29:42,076 CULTURAL SETTINGS. 4403 03:29:42,076 --> 03:29:43,210 THAT CONCLUDES MY PRESENTATION. 4404 03:29:43,210 --> 03:29:44,645 I THANK YOU FOR YOUR ATTENTION 4405 03:29:44,645 --> 03:29:46,447 AND LOOK FORWARD TO RECEIVING 4406 03:29:46,447 --> 03:29:47,748 YOUR FEEDBACK. 4407 03:29:47,748 --> 03:29:56,423 THANK YOU. 4408 03:29:56,423 --> 03:29:59,426 >> THANK YOU, DR. CALZONE. 4409 03:29:59,426 --> 03:30:02,496 IT'S A MUCH NEEDED STEP TO 4410 03:30:02,496 --> 03:30:03,998 DEVELOPING EQUITABLE HEALTHCARE 4411 03:30:03,998 --> 03:30:04,331 TECHNOLOGIES. 4412 03:30:04,331 --> 03:30:05,399 THE INTEGRATION OF COMMUNITY 4413 03:30:05,399 --> 03:30:07,101 BASED PERSPECTIVES INTO A.I. AND 4414 03:30:07,101 --> 03:30:09,169 MACHINE LEARNING MODELS AS 4415 03:30:09,169 --> 03:30:10,471 PRESENTED IN THIS CONCEPT WAS -- 4416 03:30:10,471 --> 03:30:14,208 I FOUND TO BE INNOVATIVE AND 4417 03:30:14,208 --> 03:30:16,710 TIMELY, HOLDING GREAT VALUE, 4418 03:30:16,710 --> 03:30:17,378 PARTICULARLY THINKING ABOUT 4419 03:30:17,378 --> 03:30:18,545 ADDRESSING HEALTH DISPARITIES 4420 03:30:18,545 --> 03:30:19,980 AND INEQUITIES. 4421 03:30:19,980 --> 03:30:21,448 I FOUND THE CONCEPT TO BE 4422 03:30:21,448 --> 03:30:22,950 RESPONSIVE TO PRESSING ISSUES AS 4423 03:30:22,950 --> 03:30:27,888 YOU NOTED HOW TO ADDRESS BIASES 4424 03:30:27,888 --> 03:30:29,757 IN TRADITIONAL A.I. AND MACHINE 4425 03:30:29,757 --> 03:30:31,058 LEARNING MODELS THROUGH 4426 03:30:31,058 --> 03:30:31,759 COMMUNITY ENGAGEMENT, SETTING 4427 03:30:31,759 --> 03:30:33,961 THE STAGE FOR PROGRESS IN HEALTH 4428 03:30:33,961 --> 03:30:37,231 CARE AND ARTIFICIAL INTELLIGENC. 4429 03:30:37,231 --> 03:30:38,966 BY ENSURING A.I. TOOLS ARE 4430 03:30:38,966 --> 03:30:41,168 VALIDATED AGAINST REAL WORLD 4431 03:30:41,168 --> 03:30:42,469 SCENARIOS PARTICULARLY IN 4432 03:30:42,469 --> 03:30:44,571 MULTICULTURAL AND UNDERSERVED 4433 03:30:44,571 --> 03:30:45,439 POPULATIONS THE CONCEPT 4434 03:30:45,439 --> 03:30:46,440 DEMONSTRATES FORWARD THINKING 4435 03:30:46,440 --> 03:30:48,275 APPROACH TO CREATING SYSTEMS IN 4436 03:30:48,275 --> 03:30:49,944 A.I. AND MACHINE LEARNING TOOLS 4437 03:30:49,944 --> 03:30:51,812 TO GENERALLY WORK FOR ALL OF US. 4438 03:30:51,812 --> 03:30:53,647 TO ACHIEVE THESE GOALS THE 4439 03:30:53,647 --> 03:30:55,082 CONCEPT HIGHLIGHTS POWER OF 4440 03:30:55,082 --> 03:30:56,283 COMMUNITY ENGAGED RESEARCH TO 4441 03:30:56,283 --> 03:31:00,020 COMBAT BIAS IN THESE MODELS, BY 4442 03:31:00,020 --> 03:31:00,888 INVOLVING COMMUNITIES FROM 4443 03:31:00,888 --> 03:31:02,423 INCEPTION AND REFINEMENT OF 4444 03:31:02,423 --> 03:31:05,292 THESE TOOLS THE CONCEPT ENSURES 4445 03:31:05,292 --> 03:31:07,594 CULTURALLY COMPETENT AND 4446 03:31:07,594 --> 03:31:08,262 CONTEXTUALLY RELEVANT MODELS 4447 03:31:08,262 --> 03:31:10,431 ACCURATELY REFLECT DIVERSITY OF 4448 03:31:10,431 --> 03:31:11,432 THE POPULATION SERVED. 4449 03:31:11,432 --> 03:31:13,167 TO THIS END EXPANDING THE 4450 03:31:13,167 --> 03:31:15,235 CONCEPT MAY BE WARRANTED IN TWO 4451 03:31:15,235 --> 03:31:16,203 AREAS. 4452 03:31:16,203 --> 03:31:20,274 THE FIRST IS TO ENSURE EMPHASIS 4453 03:31:20,274 --> 03:31:22,209 IN INTERSECTIONALITY AND 4454 03:31:22,209 --> 03:31:22,910 POSITIONALITY WHEN DEVELOPING 4455 03:31:22,910 --> 03:31:24,645 AND REFINING TOOLS. 4456 03:31:24,645 --> 03:31:26,647 SECOND, ADDRESSING BOTH PROVIDER 4457 03:31:26,647 --> 03:31:29,483 AND SYSTEM LEVEL PROCESSES THAT 4458 03:31:29,483 --> 03:31:32,553 MAY CONTRIBUTE TO BIAS, FOR 4459 03:31:32,553 --> 03:31:36,357 EXAMPLE OMITTED DATA IN EHR 4460 03:31:36,357 --> 03:31:39,560 SYSTEMS MAKING SURE WE'RE BEING 4461 03:31:39,560 --> 03:31:40,894 EXHAUSTIVE IN MODELS AND 4462 03:31:40,894 --> 03:31:41,428 INITIATIVES. 4463 03:31:41,428 --> 03:31:42,396 THE CONCEPT ENSURES THE 4464 03:31:42,396 --> 03:31:49,203 ADVANCEMENT OF SCIENCE IS NOT 4465 03:31:49,203 --> 03:31:51,372 ONLY TECHNICALLY PROFICIENT BUT 4466 03:31:51,372 --> 03:31:52,473 HIGHLIGHTS IMPORTANCE OF 4467 03:31:52,473 --> 03:31:56,010 GROUNDING THE WORK BY THOSE 4468 03:31:56,010 --> 03:31:57,978 IMPACTED, I THANK YOU AND YOUR 4469 03:31:57,978 --> 03:32:01,015 TEAM FOR THIS CONCEPT. 4470 03:32:01,015 --> 03:32:05,619 >> THANK YOU. 4471 03:32:05,619 --> 03:32:09,456 >> THANK YOU, DR. CALZONE, FOR 4472 03:32:09,456 --> 03:32:12,659 YOUR EXCELLENT PRESENTATION, AND 4473 03:32:12,659 --> 03:32:15,729 TO MY COLLEAGUE FOR THE COMMENTS 4474 03:32:15,729 --> 03:32:19,033 THAT HAVE BEEN SHARED SO FAR 4475 03:32:19,033 --> 03:32:20,034 REGARDING THIS MARVELOUS CONCEPT 4476 03:32:20,034 --> 03:32:22,436 THAT CONSIDERS ADVANCING DATA 4477 03:32:22,436 --> 03:32:23,971 SCIENCE APPROACHES TO ADDRESS 4478 03:32:23,971 --> 03:32:26,040 DISPARITIES THROUGH A.I. AND 4479 03:32:26,040 --> 03:32:27,775 MACHINE LEARNING. 4480 03:32:27,775 --> 03:32:30,978 AND COMMUNITY ENGAGED RESEARCH. 4481 03:32:30,978 --> 03:32:33,480 I BELIEVE THAT THIS CONCEPT AIMS 4482 03:32:33,480 --> 03:32:35,783 AT BRIDGING THE GAP BETWEEN DATA 4483 03:32:35,783 --> 03:32:40,254 SCIENCE AND COMMUNITY ENGAGEMENT 4484 03:32:40,254 --> 03:32:42,890 TO ADDRESS HEALTH DISPARITIES, 4485 03:32:42,890 --> 03:32:46,060 USING A.I. AND MACHINE LANGUAGE. 4486 03:32:46,060 --> 03:32:47,161 THE CONCEPT ENCOURAGES 4487 03:32:47,161 --> 03:32:49,296 DEVELOPMENT OF SELF-AGENCY AND 4488 03:32:49,296 --> 03:32:50,631 EMPOWERS COMMUNITIES 4489 03:32:50,631 --> 03:32:53,700 PARTICULARLY THOSE OF COLOR OR 4490 03:32:53,700 --> 03:32:54,601 UNDERREPRESENTED COMMUNITIES TO 4491 03:32:54,601 --> 03:32:55,569 ACTIVELY PARTICIPATE IN 4492 03:32:55,569 --> 03:33:02,476 DEVELOPING A RICH AND DIVERSE 4493 03:33:02,476 --> 03:33:03,911 HEALTHCARE LANDSCAPE THROUGH 4494 03:33:03,911 --> 03:33:05,112 INCLUSIVE AND CULTURALLY 4495 03:33:05,112 --> 03:33:07,181 SENSITIVE RESEARCH, THIS EFFORT 4496 03:33:07,181 --> 03:33:09,616 HOPES TO TRANSFORM RESEARCH 4497 03:33:09,616 --> 03:33:13,320 FINDINGS INTO MEANINGFUL AND 4498 03:33:13,320 --> 03:33:14,455 ACTIONABLE COMMUNITY-BASED 4499 03:33:14,455 --> 03:33:15,222 SOLUTIONS. 4500 03:33:15,222 --> 03:33:16,824 SCIENCE APPEARS TO BE BASED ON 4501 03:33:16,824 --> 03:33:18,692 SOUND METHODOLOGY AND IT 4502 03:33:18,692 --> 03:33:21,462 RECOGNIZES PROMISES OF DISEASE 4503 03:33:21,462 --> 03:33:23,430 PREDICTION, PERSONALIZED OR 4504 03:33:23,430 --> 03:33:24,164 INDIVIDUALIZED CARE, HEALTHCARE 4505 03:33:24,164 --> 03:33:27,935 DELIVERY, WHILE AT THE SAME TIME 4506 03:33:27,935 --> 03:33:31,438 ACKNOWLEDGING INHERENT BIASES 4507 03:33:31,438 --> 03:33:33,507 THAT COULD AGGRAVATE, WORSEN THE 4508 03:33:33,507 --> 03:33:36,143 CURRENT HEALTH DISPARITIES. 4509 03:33:36,143 --> 03:33:39,413 THE INHERENT BIASES STEM FROM A 4510 03:33:39,413 --> 03:33:41,715 VARIETY OF THINGS NOT TO MENTION 4511 03:33:41,715 --> 03:33:43,150 THE LACK OF DIVERSITY IN THE 4512 03:33:43,150 --> 03:33:47,287 DATA WHEN IT COMES TO 4513 03:33:47,287 --> 03:33:47,955 UNDERREPRESENTED COMMUNITIES, SO 4514 03:33:47,955 --> 03:33:49,590 RESEARCHERS PROPOSE TO OVERCOME 4515 03:33:49,590 --> 03:33:52,426 THIS CHALLENGE BY COLLABORATING 4516 03:33:52,426 --> 03:33:53,961 WITH THE COMMUNITY AND GROUPS 4517 03:33:53,961 --> 03:33:56,930 AND PERSONS SO THAT ADDRESSING 4518 03:33:56,930 --> 03:33:59,032 ISSUES LIKE DIGITAL DIVIDE, 4519 03:33:59,032 --> 03:34:00,200 TECHNOLOGY GAPS, AND PARTICULAR 4520 03:34:00,200 --> 03:34:04,271 DYNAMICS THAT OCCUR IN THE 4521 03:34:04,271 --> 03:34:06,039 CONTEXT OF UNDERREPRESENTED 4522 03:34:06,039 --> 03:34:07,875 COMMUNITIES BECOME PARAMOUNT FOR 4523 03:34:07,875 --> 03:34:08,342 DISCUSSION AND FURTHER 4524 03:34:08,342 --> 03:34:11,178 DEVELOPMENT OF A.I. AND MACHINE 4525 03:34:11,178 --> 03:34:11,478 LEARNING. 4526 03:34:11,478 --> 03:34:15,115 THE CONCEPT HELPS US IDENTIFY 4527 03:34:15,115 --> 03:34:16,083 THE KNOWLEDGE AND RESEARCH GAPS, 4528 03:34:16,083 --> 03:34:19,820 BIASES IN A.I., AND ML MODELING, 4529 03:34:19,820 --> 03:34:22,322 COMMUNITY INCLUSION IN ITS 4530 03:34:22,322 --> 03:34:22,923 DEVELOPMENT AND 4531 03:34:22,923 --> 03:34:23,924 INTERDISCIPLINARY COLLABORATION 4532 03:34:23,924 --> 03:34:27,394 AS WELL AS A.I. TOOLS WITH 4533 03:34:27,394 --> 03:34:30,664 REGARD TO CONTEXTUALIZATION AND 4534 03:34:30,664 --> 03:34:30,998 VALIDATION. 4535 03:34:30,998 --> 03:34:33,634 I USE THAT AS SORT OF A 4536 03:34:33,634 --> 03:34:35,068 FRAMEWORK OR LAUNCHING PAD TO 4537 03:34:35,068 --> 03:34:38,238 DISCUSS A COUPLE AREAS THAT I 4538 03:34:38,238 --> 03:34:40,107 BELIEVE ARE OF CRITICAL 4539 03:34:40,107 --> 03:34:40,407 IMPORTANCE. 4540 03:34:40,407 --> 03:34:45,679 NUMBER ONE IS THE SCIENCE OF 4541 03:34:45,679 --> 03:34:46,380 TRUST, BUILDING TRUSTWORTHINESS 4542 03:34:46,380 --> 03:34:48,215 AND TRUTH IS ALL IMPORTANT IN 4543 03:34:48,215 --> 03:34:49,650 TERMS OF COMMUNITY ENGAGEMENT. 4544 03:34:49,650 --> 03:34:52,152 I THINK THE PROJECT DOES WELL IN 4545 03:34:52,152 --> 03:34:57,057 TERMS OF IT'S TRYING TO 4546 03:34:57,057 --> 03:34:58,058 COMMUNICATE WITH COMMUNITY, 4547 03:34:58,058 --> 03:34:59,359 COLLABORATE WITH IT, WITH THE 4548 03:34:59,359 --> 03:35:02,763 COMMUNITY AS WELL AS WITH 4549 03:35:02,763 --> 03:35:03,664 RESEARCHERS, PROVIDE 4550 03:35:03,664 --> 03:35:05,299 INCLUSIVITY, BUT ONE OF THE 4551 03:35:05,299 --> 03:35:07,367 IMPORTANT THINGS IS ALSO 4552 03:35:07,367 --> 03:35:08,569 COMMUNITY EMPOWERMENT, BUILDING 4553 03:35:08,569 --> 03:35:11,838 A SENSE OF SELF-RESPECT, 4554 03:35:11,838 --> 03:35:13,607 SELF-AGENCY, AND BEING ABLE TO 4555 03:35:13,607 --> 03:35:16,577 SUPPORT THE COMMUNITY WHEN IT 4556 03:35:16,577 --> 03:35:20,047 NEEDS THE REQUISITE SUPPORT. 4557 03:35:20,047 --> 03:35:20,981 AND ALSO UNDERSTANDING WITH THE 4558 03:35:20,981 --> 03:35:22,449 COMMUNITY FROM WHEN A.I. IS 4559 03:35:22,449 --> 03:35:23,884 SUCCESSFUL AND WHEN IT'S NOT, 4560 03:35:23,884 --> 03:35:26,086 AND BEING ABLE TO CELEBRATE THE 4561 03:35:26,086 --> 03:35:26,286 WINS. 4562 03:35:26,286 --> 03:35:30,057 I THINK THIS BRINGS US TO A 4563 03:35:30,057 --> 03:35:33,860 POINT OF SENSE OF BELONGING AND 4564 03:35:33,860 --> 03:35:34,394 SELF-IDENTIFICATION. 4565 03:35:34,394 --> 03:35:38,365 WE ALSO WANT TO MAKE SURE THAT 4566 03:35:38,365 --> 03:35:41,101 IN BUILDING TRUST WE EMBRACE 4567 03:35:41,101 --> 03:35:42,869 TRUST IN CLINICAL DECISION 4568 03:35:42,869 --> 03:35:43,303 MAKING. 4569 03:35:43,303 --> 03:35:45,072 WHAT ARE THE CHALLENGES FOR GOOD 4570 03:35:45,072 --> 03:35:46,807 DATA COLLECTION? 4571 03:35:46,807 --> 03:35:51,845 HOW DO WE ENSURE THIS 4572 03:35:51,845 --> 03:35:53,513 INTERSECTIONALITY THAT MY 4573 03:35:53,513 --> 03:35:54,147 COLLEAGUE HAS DISCUSSED? 4574 03:35:54,147 --> 03:35:56,049 I THINK THESE ARE VERY IMPORTANT 4575 03:35:56,049 --> 03:35:59,286 THINGS THAT WE NEED TO ALSO 4576 03:35:59,286 --> 03:35:59,553 CONSIDER. 4577 03:35:59,553 --> 03:36:02,055 I WOULD ALSO RECOMMEND THAT WE 4578 03:36:02,055 --> 03:36:06,193 DO MORE ROUND AND MAKE SURE 4579 03:36:06,193 --> 03:36:07,094 WE'RE INTENTIONAL AROUND 4580 03:36:07,094 --> 03:36:08,295 BEHAVIORAL SORT OF MATTERS, 4581 03:36:08,295 --> 03:36:13,100 PARTICULARLY FOR ME AS I BELIEVE 4582 03:36:13,100 --> 03:36:14,568 IT'S INFORMED -- TRAUMA-INFORMED 4583 03:36:14,568 --> 03:36:16,603 STRATEGIES THAT GO ALONG WITH 4584 03:36:16,603 --> 03:36:18,472 THE MENTAL HEALTH AND RESEARCH 4585 03:36:18,472 --> 03:36:18,772 PRIORITIES. 4586 03:36:18,772 --> 03:36:21,408 YES, WE WANT TO TALK ABOUT 4587 03:36:21,408 --> 03:36:23,277 DEPRESSION AND ANXIETY AND 4588 03:36:23,277 --> 03:36:24,911 STRESS AND OTHER EFFECTS OF 4589 03:36:24,911 --> 03:36:29,483 OPPRESSION TO WHICH -- BUT WE 4590 03:36:29,483 --> 03:36:31,018 NEED TO GET UNDERNEATH AND SEE 4591 03:36:31,018 --> 03:36:33,654 WHAT IS THERE SO THAT GOES INTO 4592 03:36:33,654 --> 03:36:35,522 THE PROGRAMMING MODELS THAT ARE 4593 03:36:35,522 --> 03:36:37,591 ASSOCIATED WITH A.I. 4594 03:36:37,591 --> 03:36:39,426 THE OTHER PART THAT IS ESSENTIAL 4595 03:36:39,426 --> 03:36:44,498 IS TO MAKE SURE THAT WE HAVE 4596 03:36:44,498 --> 03:36:45,599 TECHNOLOGY THAT IS ACCESSIBLE, 4597 03:36:45,599 --> 03:36:48,101 TECHNOLOGY THAT WE HAVE GOOD 4598 03:36:48,101 --> 03:36:49,469 TECHNOLOGY TRANSFER, IN THE 4599 03:36:49,469 --> 03:36:52,072 CONTEXT OF COMMUNITY, SO THAT 4600 03:36:52,072 --> 03:36:53,373 THE COMMUNITY STAYS WELL 4601 03:36:53,373 --> 03:36:55,175 INFORMED AND ABREAST OF ALL OF 4602 03:36:55,175 --> 03:36:56,810 THE THINGS THAT IT IS 4603 03:36:56,810 --> 03:36:58,845 EXPERIENCING WITH REGARD TO THE 4604 03:36:58,845 --> 03:37:00,414 TECHNOLOGICAL SHIFT THAT 4605 03:37:00,414 --> 03:37:02,683 HAPPENED WITH REGARD TO A.I. 4606 03:37:02,683 --> 03:37:05,419 IN A NUTSHELL, WE WANT 4607 03:37:05,419 --> 03:37:07,521 TECHNOLOGY TO BE AN ABLE TOOL IN 4608 03:37:07,521 --> 03:37:10,791 THE CONTEXT OF COMMUNITY SO THAT 4609 03:37:10,791 --> 03:37:12,993 COMMUNITIES CAN HAVE BETTER 4610 03:37:12,993 --> 03:37:16,830 HEALTH OUTCOMES, AND WITNESS THE 4611 03:37:16,830 --> 03:37:20,100 UNDERSTANDING THAT DISPARITIES 4612 03:37:20,100 --> 03:37:20,500 DISPARITIES 4613 03:37:20,500 --> 03:37:23,470 CLOSE BY USE OF A.I. AND TOOLS. 4614 03:37:23,470 --> 03:37:28,308 I CONCUR WITH MY COLLEAGUE AND I 4615 03:37:28,308 --> 03:37:29,943 JUST HOPEFULLY AND WISHFULLY 4616 03:37:29,943 --> 03:37:32,679 UNDERSTAND THAT THIS CONCEPT IS 4617 03:37:32,679 --> 03:37:35,082 ONE THAT I WOULD LOOK FORWARD TO 4618 03:37:35,082 --> 03:37:37,484 GOING A VERY LONG WAY AND THANK 4619 03:37:37,484 --> 03:37:39,219 YOU FOR THE EXCELLENT 4620 03:37:39,219 --> 03:37:40,554 PRESENTATION, AND THE DETAILED 4621 03:37:40,554 --> 03:37:42,322 DATA THAT HAS GONE ALONG WITH 4622 03:37:42,322 --> 03:37:42,489 IT. 4623 03:37:42,489 --> 03:37:45,258 SO THANK YOU VERY MUCH, AND I 4624 03:37:45,258 --> 03:37:50,530 LOOK FORWARD TO SEEING MORE 4625 03:37:50,530 --> 03:37:51,431 REGARDING THIS PARTICULAR 4626 03:37:51,431 --> 03:37:51,965 CONCEPT. 4627 03:37:51,965 --> 03:37:52,966 >> ARE THERE ANY OTHER COUNCIL 4628 03:37:52,966 --> 03:37:58,739 MEMBERS THAT HAVE COMMENTS OR 4629 03:37:58,739 --> 03:37:59,306 QUESTIONS REGARDING THIS 4630 03:37:59,306 --> 03:37:59,940 CONCEPT? 4631 03:37:59,940 --> 03:38:01,742 >> GREAT, I LOVE IT, I SECOND 4632 03:38:01,742 --> 03:38:04,778 EVERYTHING THAT'S BEEN SAID. 4633 03:38:04,778 --> 03:38:10,350 CURIOUS HOW YOU'RE GOING TO GO 4634 03:38:10,350 --> 03:38:13,720 ABOUT INVOLVING -- SO 4635 03:38:13,720 --> 03:38:15,055 RESEARCHERS, COMMUNITY-BASED 4636 03:38:15,055 --> 03:38:17,557 GROUPS, OR COMMUNITIES, AND THE 4637 03:38:17,557 --> 03:38:19,192 A.I., THE TECHNOLOGY DEVELOPERS, 4638 03:38:19,192 --> 03:38:20,527 IT SEEMS LIKE THOSE WOULD BE 4639 03:38:20,527 --> 03:38:21,528 OVERLAPPING IN SOME WAY BUT 4640 03:38:21,528 --> 03:38:24,431 THAT'S GOING TO BE TRICKY, AND 4641 03:38:24,431 --> 03:38:25,565 I'M WONDERING, CURIOUS TO SEE 4642 03:38:25,565 --> 03:38:26,566 WHAT KIND OF MECHANISM YOU'RE 4643 03:38:26,566 --> 03:38:28,635 GOING TO SET UP TO DO THAT 4644 03:38:28,635 --> 03:38:30,470 BECAUSE COMMUNITY MEMBERS DON'T 4645 03:38:30,470 --> 03:38:31,905 GENERALLY WRITE THESE MODELS, 4646 03:38:31,905 --> 03:38:32,506 RIGHT? 4647 03:38:32,506 --> 03:38:41,948 HOW ARE YOU GOING TO DO THIS? 4648 03:38:41,948 --> 03:38:45,152 >> THROUGH CAPACITY BUILDING 4649 03:38:45,152 --> 03:38:45,452 INITIATIVE. 4650 03:38:45,452 --> 03:38:46,820 I'M SEEING CONSCIOUS EFFORTS 4651 03:38:46,820 --> 03:38:51,091 BECAUSE I'M DEVELOPING THIS WITH 4652 03:38:51,091 --> 03:38:55,662 OTHER COLLEAGUES AT NIMHD AND 4653 03:38:55,662 --> 03:38:56,296 RESEARCH COLLABORATION PLATFORM 4654 03:38:56,296 --> 03:38:59,933 FOCUSED ON A.I. BIAS MITIGATION 4655 03:38:59,933 --> 03:39:00,700 AND HEALTH DISPARITIES RESEARCH, 4656 03:39:00,700 --> 03:39:02,769 TRYING TO INVOLVE THOSE 4657 03:39:02,769 --> 03:39:03,904 COMMUNITIES, THOSE STAKEHOLDERS, 4658 03:39:03,904 --> 03:39:06,373 AND I SEE THE CHALLENGES BUT 4659 03:39:06,373 --> 03:39:08,041 WE'RE MAKING PROGRESS SO I'M 4660 03:39:08,041 --> 03:39:09,443 CONFIDENT THAT THERE ARE WAYS TO 4661 03:39:09,443 --> 03:39:10,343 DO THAT. 4662 03:39:10,343 --> 03:39:16,016 AND I LOOK FORWARD TO DISCUSSING 4663 03:39:16,016 --> 03:39:16,683 THE DETAILS. 4664 03:39:16,683 --> 03:39:17,651 >> THANK YOU. 4665 03:39:17,651 --> 03:39:21,922 >> OTHERWISE I GENERALLY LOVE 4666 03:39:21,922 --> 03:39:22,923 THE DIRECTION. 4667 03:39:22,923 --> 03:39:26,293 IS THIS A SBIR GRANT OR OUR 4668 03:39:26,293 --> 03:39:27,060 LEVEL GRANT, INTERESTING TO SEE 4669 03:39:27,060 --> 03:39:28,395 HOW YOU CAN DO THAT. 4670 03:39:28,395 --> 03:39:32,566 IT WON'T BE EASY. 4671 03:39:32,566 --> 03:39:34,067 THERE'S DIFFERENT GROUPS OF 4672 03:39:34,067 --> 03:39:35,836 PEOPLE THAT DON'T TRADITIONALLY 4673 03:39:35,836 --> 03:39:37,504 WORK TOGETHER ON NIH-FUNDED 4674 03:39:37,504 --> 03:39:42,209 RESEARCH THAT I KNOW OF. 4675 03:39:42,209 --> 03:39:45,145 >> OTHER COMMENTS FROM COUNCIL 4676 03:39:45,145 --> 03:39:50,183 MEMBERS? 4677 03:39:50,183 --> 03:39:50,350 YES? 4678 03:39:50,350 --> 03:39:52,352 >>> SO, IT OCCURRED TO ME, THIS 4679 03:39:52,352 --> 03:39:59,693 IS DIRECTED MORE AT JOSE AND 4680 03:39:59,693 --> 03:40:00,994 KENDRICK, YOU MENTIONED TRUST 4681 03:40:00,994 --> 03:40:02,762 AND CLINICAL DECISIONS SO I 4682 03:40:02,762 --> 03:40:03,730 GUESS YOU IMPLY THAT, YOU KNOW, 4683 03:40:03,730 --> 03:40:06,466 A.I. IS GOING TO MAKE CLINICAL 4684 03:40:06,466 --> 03:40:07,367 DECISIONS OR CREATE ALGORITHMS 4685 03:40:07,367 --> 03:40:10,403 THAT ARE GOING TO MAKE CLINICAL 4686 03:40:10,403 --> 03:40:11,705 DECISIONS WHICH I ASSUME SOME 4687 03:40:11,705 --> 03:40:18,812 PEOPLE THINK WE SHOULD GO THERE. 4688 03:40:18,812 --> 03:40:20,480 SO I DON'T THINK SO. 4689 03:40:20,480 --> 03:40:23,884 I DON'T KNOW WHAT CLINICAL AREA 4690 03:40:23,884 --> 03:40:25,719 A CLINICIAN MAKES A DECISION ON 4691 03:40:25,719 --> 03:40:28,121 THAT BASIS, YOU KNOW, SITTING 4692 03:40:28,121 --> 03:40:28,922 NEXT TO A PATIENT. 4693 03:40:28,922 --> 03:40:33,927 BUT, YOU KNOW, I CAN SEE THAT 4694 03:40:33,927 --> 03:40:35,262 HAPPENING POTENTIALLY SOMETIME 4695 03:40:35,262 --> 03:40:37,998 IN THE NOT TOO DISTANT FUTURE. 4696 03:40:37,998 --> 03:40:40,500 SHOULD RACE AND ETHNICITY BE 4697 03:40:40,500 --> 03:40:42,235 FACTORED INTO THOSE ALGORITHMS, 4698 03:40:42,235 --> 03:40:46,640 AND IF SO HOW? 4699 03:40:46,640 --> 03:40:48,842 OR SOCIOECONOMIC STATUS, SHOULD 4700 03:40:48,842 --> 03:40:51,711 IT BE FACTORED IN? 4701 03:40:51,711 --> 03:40:51,945 LUCA. 4702 03:40:51,945 --> 03:40:54,447 AND WE'LL HAVE OPPORTUNITY TO 4703 03:40:54,447 --> 03:40:57,284 DISCUSS THIS AND OPERATIONALIZE 4704 03:40:57,284 --> 03:40:58,919 FUNDING OPPORTUNITY BUT I'M 4705 03:40:58,919 --> 03:41:02,656 ASKING MY COLLEAGUES ON THE 4706 03:41:02,656 --> 03:41:03,790 COUNCIL. 4707 03:41:03,790 --> 03:41:05,959 >> MY TWO THOUGHTS ON THIS, 4708 03:41:05,959 --> 03:41:08,328 WOULD LOVE TO HEAR KENDRICK, A 4709 03:41:08,328 --> 03:41:10,764 LOT OF SOCIAL DETERMINANTS OF 4710 03:41:10,764 --> 03:41:12,332 HEALTH WHICH WE KNOW MATTER WHEN 4711 03:41:12,332 --> 03:41:15,702 WE THINK ABOUT INEQUITIES AND 4712 03:41:15,702 --> 03:41:16,937 DISPARITIES ARE OFTEN COLLECTED 4713 03:41:16,937 --> 03:41:19,105 OR SHOULD BE COLLECTED, THEY ARE 4714 03:41:19,105 --> 03:41:23,710 AVAILABLE IN MOST MAJOR EHR 4715 03:41:23,710 --> 03:41:25,011 PLATFORMS SO IT'S A 4716 03:41:25,011 --> 03:41:26,446 RECOMMENDATION TO NOT OMIT THAT 4717 03:41:26,446 --> 03:41:29,849 PART OF THE DATA STREAM, RIGHT? 4718 03:41:29,849 --> 03:41:31,451 AS PEOPLE ARE MODIFYING THEIR 4719 03:41:31,451 --> 03:41:33,753 TOOLS AND I THINK IN ITSELF THAT 4720 03:41:33,753 --> 03:41:35,622 MIGHT LEAD TO SOME POLICY CHANGE 4721 03:41:35,622 --> 03:41:36,923 BECAUSE IF FOLKS KNOW THIS DATA 4722 03:41:36,923 --> 03:41:39,693 IS GOING TO BE USED FOR 4723 03:41:39,693 --> 03:41:40,694 REFINEMENT OF ALGORITHMS, THEY 4724 03:41:40,694 --> 03:41:43,396 MAY BE MORE LIKELY TO ACTIVATE 4725 03:41:43,396 --> 03:41:52,706 IT IN PATIENT CHARTS. 4726 03:41:52,706 --> 03:41:57,777 >> I TOTALLY AGREE WITH WHAT DR. 4727 03:41:57,777 --> 03:41:59,379 BURMEISTER JUST SAID, IT BECOMES 4728 03:41:59,379 --> 03:42:02,349 FROM A COMMUNITY STANDPOINT 4729 03:42:02,349 --> 03:42:06,586 SOMETHING THAT IS NEEDED BECAUSE 4730 03:42:06,586 --> 03:42:07,387 WE HAVE -- HELLO? 4731 03:42:07,387 --> 03:42:07,587 OKAY. 4732 03:42:07,587 --> 03:42:10,023 WE HAVE TO BE ABLE TO LOOK AT 4733 03:42:10,023 --> 03:42:13,727 DATA ACCORDING TO RACE AND 4734 03:42:13,727 --> 03:42:17,130 ETHNICITY AS WELL AS 4735 03:42:17,130 --> 03:42:19,766 DISAGGREGATED DATA ACROSS 4736 03:42:19,766 --> 03:42:21,067 SOCIOECONOMIC FACTORS BECAUSE I 4737 03:42:21,067 --> 03:42:22,369 JUST BELIEVE AND I THINK THAT 4738 03:42:22,369 --> 03:42:24,571 WE'RE LOOKING AT SOMETHING THAT 4739 03:42:24,571 --> 03:42:27,173 IS SORT OF -- WILL BE CORRELATED 4740 03:42:27,173 --> 03:42:30,910 BUT WE HAVE TO ESTABLISH SOME 4741 03:42:30,910 --> 03:42:32,612 SENSE OF WHAT CAUSATION WOULD 4742 03:42:32,612 --> 03:42:36,182 GIVE, AND I THINK THAT AS WE 4743 03:42:36,182 --> 03:42:37,817 LOOK AT DISAGGREGATED DATA WE'LL 4744 03:42:37,817 --> 03:42:41,121 BE ABLE TO THINK THROUGH HOW WE 4745 03:42:41,121 --> 03:42:42,922 USE IT TO BETTER HELP IN 4746 03:42:42,922 --> 03:42:47,327 CLINICAL DECISIONS IN THE LONG 4747 03:42:47,327 --> 03:42:47,494 RUN. 4748 03:42:47,494 --> 03:42:53,166 I THINK THAT DOES INFLUENCE THE 4749 03:42:53,166 --> 03:42:53,767 PATIENT CHART, THAT DOES ALLOW 4750 03:42:53,767 --> 03:42:55,435 YOU TO SIT DOWN AND LOOK AT 4751 03:42:55,435 --> 03:42:57,937 THINGS THAT ARE IMPORTANT TO 4752 03:42:57,937 --> 03:42:58,605 COMMUNITY MEMBERS, PARTICULARLY 4753 03:42:58,605 --> 03:43:02,442 AS YOU START TO DRILL DOWN NOT 4754 03:43:02,442 --> 03:43:05,645 JUST LOOKING AT COMMUNITY AS A 4755 03:43:05,645 --> 03:43:09,149 BLOB BUT LOOKING IT AS SOMETHING 4756 03:43:09,149 --> 03:43:11,751 THAT BUILD BLOCKS, BLOCKS BUILD 4757 03:43:11,751 --> 03:43:12,318 NEIGHBORHOODS, NEIGHBORHOODS 4758 03:43:12,318 --> 03:43:13,086 BUILD COMMUNITIES. 4759 03:43:13,086 --> 03:43:16,189 BECAUSE I BELIEVE THAT 4760 03:43:16,189 --> 03:43:18,491 ULTIMATELY AT THE VARIOUS LEVELS 4761 03:43:18,491 --> 03:43:22,462 YOU'LL BEGIN TO START TO SEE HOW 4762 03:43:22,462 --> 03:43:25,031 THINGS ARE CHANGING IN THE 4763 03:43:25,031 --> 03:43:25,899 RESPECTIVE BLOCKS. 4764 03:43:25,899 --> 03:43:27,233 IF WE HAVE THE DATA AVAILABLE, 4765 03:43:27,233 --> 03:43:29,302 THE MORE WE CAN BEGIN TO LEARN. 4766 03:43:29,302 --> 03:43:32,572 AS WE BEGIN TO LEARN, THE MORE 4767 03:43:32,572 --> 03:43:36,943 WE CAN BEGIN TO HELP PROVIDE 4768 03:43:36,943 --> 03:43:37,844 DECISIONS AND MAYBE EVEN 4769 03:43:37,844 --> 03:43:39,279 TREATMENT FOR THOSE THAT ARE 4770 03:43:39,279 --> 03:43:41,481 FROM THE CONTEXT OF COMMUNITY. 4771 03:43:41,481 --> 03:43:43,316 I SAY THAT BECAUSE I'M HOPEFUL 4772 03:43:43,316 --> 03:43:48,421 THAT THIS SORT OF RESEARCH WILL 4773 03:43:48,421 --> 03:43:51,725 ONE DAY BE ABLE TO HELP, FOR 4774 03:43:51,725 --> 03:43:55,028 EXAMPLE, IN DISTRICT OF 4775 03:43:55,028 --> 03:43:56,029 COLUMBIA, THOSE RECOMMEND 4776 03:43:56,029 --> 03:43:57,931 TREATMENT SOLUTIONS FOR WHY AND 4777 03:43:57,931 --> 03:43:59,599 EXPLAIN WHY THOSE THAT ARE IN 4778 03:43:59,599 --> 03:44:02,669 CERTAIN PARTS OF THE CITY HAVE 4779 03:44:02,669 --> 03:44:03,770 HIGH INCIDENCE OF KIDNEY DISEASE 4780 03:44:03,770 --> 03:44:05,638 THAN THE OTHER. 4781 03:44:05,638 --> 03:44:07,507 AND GIVE THEM OPPORTUNITIES TO 4782 03:44:07,507 --> 03:44:09,709 HAVE BETTER UNDERSTANDING. 4783 03:44:09,709 --> 03:44:10,877 I'M ALSO HOPEFUL THAT AT THE END 4784 03:44:10,877 --> 03:44:15,148 OF THE DAY WE'LL BE ABLE TO 4785 03:44:15,148 --> 03:44:16,916 BEGIN TO LOOK AT WHY HIGH 4786 03:44:16,916 --> 03:44:20,253 MORTALITY RATES WITH REGARD TO 4787 03:44:20,253 --> 03:44:22,288 CANCERS ARE FOUND IN PARTICULAR 4788 03:44:22,288 --> 03:44:23,022 WARD 7. 4789 03:44:23,022 --> 03:44:25,892 IT'S THOSE SORTS OF THINGS THAT 4790 03:44:25,892 --> 03:44:29,262 I THINK A.I. STARTS TO HELP US 4791 03:44:29,262 --> 03:44:30,630 WITH, IF WE'RE STARTING TO 4792 03:44:30,630 --> 03:44:32,398 COLLECT ALL OF THE DATA BASED ON 4793 03:44:32,398 --> 03:44:34,367 RACE SO THAT WE CAN BEGIN TO 4794 03:44:34,367 --> 03:44:37,971 BREAK IT OUT AND DIS AGGREGATE 4795 03:44:37,971 --> 03:44:39,973 TO THE EXTENT WE CAN USE DATA TO 4796 03:44:39,973 --> 03:44:41,374 GUIDE OUR DECISION MAKING. 4797 03:44:41,374 --> 03:44:44,344 I ALSO THINK THAT WITH THE 4798 03:44:44,344 --> 03:44:47,514 NUMBER OF MEDICATIONS THAT SOME 4799 03:44:47,514 --> 03:44:50,116 IN THE COMMUNITY TAKE, I THINK 4800 03:44:50,116 --> 03:44:54,521 WE CAN REFINE EVEN THE ISSUES 4801 03:44:54,521 --> 03:44:55,588 WITH REGARD TO OVERMEDICATING, 4802 03:44:55,588 --> 03:44:56,055 GIVEN INDIVIDUALS. 4803 03:44:56,055 --> 03:44:58,892 SO I THINK THERE'S A LOT WE CAN 4804 03:44:58,892 --> 03:45:01,161 DO WHEN WE START DRILLING A 4805 03:45:01,161 --> 03:45:02,896 LITTLE DEEPER IN TERMS OF THE 4806 03:45:02,896 --> 03:45:04,330 CONTEXT OF COMMUNITY, IN TERMS 4807 03:45:04,330 --> 03:45:06,533 OF THE NATURE OF THE PERSON, SO 4808 03:45:06,533 --> 03:45:08,835 THAT WE CAN HAVE MORE 4809 03:45:08,835 --> 03:45:09,269 PERSONALIZED CARE. 4810 03:45:09,269 --> 03:45:13,106 AND I THINK THAT'S THE VALUE OF 4811 03:45:13,106 --> 03:45:17,243 JUST DISSING AGGREGATED DATA TT 4812 03:45:17,243 --> 03:45:22,415 DRILLS DOWN AS DEEP AS POSSIBLE. 4813 03:45:22,415 --> 03:45:24,684 >> THANK YOU. 4814 03:45:24,684 --> 03:45:26,920 >> THANK YOU, LUCA. 4815 03:45:26,920 --> 03:45:29,889 MAY I HAVE A MOTION TO MOVE THE 4816 03:45:29,889 --> 03:45:33,893 CONCEPT FORWARD FOR NOTICE OF 4817 03:45:33,893 --> 03:45:35,528 FUNDING OPPORTUNITY DEVELOPMENT? 4818 03:45:35,528 --> 03:45:37,130 >> I MOVE TO ADVANCE THE 4819 03:45:37,130 --> 03:45:37,363 CONCEPT. 4820 03:45:37,363 --> 03:45:39,933 >> MAY I HAVE A SECOND? 4821 03:45:39,933 --> 03:45:41,734 >> I SECOND. 4822 03:45:41,734 --> 03:45:42,869 >> ALL IN FAVOR? 4823 03:45:42,869 --> 03:45:45,505 VOTING MEMBERS, RAISE YOUR HAND. 4824 03:45:45,505 --> 03:45:55,849 ONLINE, LET'S SEE. 4825 03:46:00,486 --> 03:46:07,560 OKAY, THE MOTION CARRIES. 4826 03:46:07,560 --> 03:46:12,465 >> THANK YOU VERY MUCH. 4827 03:46:12,465 --> 03:46:15,902 >> WE'RE GOING TO MOVE INTO OUR 4828 03:46:15,902 --> 03:46:26,179 SECOND CONCEPT. 4829 03:47:06,586 --> 03:47:08,187 >> GOOD AFTERNOON. 4830 03:47:08,187 --> 03:47:15,695 MY NAME IS PRISCAH MU JURU, THAK 4831 03:47:15,695 --> 03:47:17,330 YOU FOR THE OPPORTUNITY TO 4832 03:47:17,330 --> 03:47:19,198 PRESENT THIS CONCEPT ADDRESSING 4833 03:47:19,198 --> 03:47:21,901 TOBACCO CESSATION ISSUES IN 4834 03:47:21,901 --> 03:47:22,702 POPULATIONS THAT EXPERIENCE 4835 03:47:22,702 --> 03:47:23,803 HEALTH DISPARITIES. 4836 03:47:23,803 --> 03:47:26,005 BEFORE I START, I WANT TO 4837 03:47:26,005 --> 03:47:30,476 ACKNOWLEDGE MY CO-AUTHORS WHO 4838 03:47:30,476 --> 03:47:37,250 ARE ALSO AT NIMHD, YEWANDE, 4839 03:47:37,250 --> 03:47:40,653 GABRIELLE, LIGIA, AND MONICA 4840 03:47:40,653 --> 03:47:42,722 WEBB HOOPER, FOR THEIR 4841 03:47:42,722 --> 03:47:49,195 PARTICIPATION ON THIS CONCEPT. 4842 03:47:49,195 --> 03:47:53,533 SO, THE OBJECTIVES OF THIS 4843 03:47:53,533 --> 03:47:56,169 CONCEPT IS TO SUPPORT INNOVATIVE 4844 03:47:56,169 --> 03:47:59,238 INTERVENTION RESEARCH TO ADDRESS 4845 03:47:59,238 --> 03:48:00,406 TOBACCO-RELATED CESSATION AMONG 4846 03:48:00,406 --> 03:48:02,208 POPULATIONS THAT EXPERIENCE 4847 03:48:02,208 --> 03:48:03,943 HEALTH DISPARITIES. 4848 03:48:03,943 --> 03:48:06,245 THE INITIATIVE SEEKS TO ADDRESS 4849 03:48:06,245 --> 03:48:08,748 GAPS IN SCIENTIFIC KNOWLEDGE AND 4850 03:48:08,748 --> 03:48:12,485 SUPPORT RESEARCH ON HEALTH 4851 03:48:12,485 --> 03:48:13,920 DISPARITIES FROM TOBACCO 4852 03:48:13,920 --> 03:48:16,089 EXPOSURE, USE, AND CESSATION 4853 03:48:16,089 --> 03:48:16,522 TREATMENT. 4854 03:48:16,522 --> 03:48:19,592 AND ALSO WANT TO ADDRESS 4855 03:48:19,592 --> 03:48:21,027 MULTI-LEVEL FACTORS AND 4856 03:48:21,027 --> 03:48:23,663 MECHANISMS THAT FACILITATE OR 4857 03:48:23,663 --> 03:48:25,832 CHALLENGE EFFECTIVE TOBACCO 4858 03:48:25,832 --> 03:48:27,700 CESSATION. 4859 03:48:27,700 --> 03:48:30,436 AND ALSO SUPPORT SUSTAINABLE 4860 03:48:30,436 --> 03:48:31,437 INNOVATIVE STRATEGIES TO IMPROVE 4861 03:48:31,437 --> 03:48:35,174 HEALTH AND HEALTH OUTCOMES FOR 4862 03:48:35,174 --> 03:48:36,576 POPULATIONS DISPROPORTIONATELY 4863 03:48:36,576 --> 03:48:44,417 IMPACTED BY TOBACCO USE AND 4864 03:48:44,417 --> 03:48:46,786 EXPOSURE. 4865 03:48:46,786 --> 03:48:50,056 SO BY WAY OF BACKGROUND, 4866 03:48:50,056 --> 03:48:52,158 CIGARETTE SMOKING REMAINS 4867 03:48:52,158 --> 03:48:54,227 LEADING CAUSE OF PREVENTIBLE 4868 03:48:54,227 --> 03:48:56,529 DISEASE DISABILITY AND DEATH IN 4869 03:48:56,529 --> 03:49:00,566 THE U.S. INCLUDING 25% OF ALL 4870 03:49:00,566 --> 03:49:02,101 CARDIOVASCULAR DISEASE DEATHS, 4871 03:49:02,101 --> 03:49:04,971 AND 30% OF ALL CANCER DEATHS. 4872 03:49:04,971 --> 03:49:08,775 PROGRESS HAS BEEN MADE OVER THE 4873 03:49:08,775 --> 03:49:10,510 LAST SIX YEARS IN DRIVING RATES 4874 03:49:10,510 --> 03:49:14,380 DOWN OF CIGARETTE SMOKING. 4875 03:49:14,380 --> 03:49:16,115 HOWEVER, THESE GAINS MADE OVER 4876 03:49:16,115 --> 03:49:17,650 THE PAST SEVERAL DECADES HAVE 4877 03:49:17,650 --> 03:49:19,719 NOT OCCURRED EQUALLY ACROSS ALL 4878 03:49:19,719 --> 03:49:23,289 POPULATIONS, AND HAVE LED TO 4879 03:49:23,289 --> 03:49:23,923 TOBACCO-RELATED HEALTH 4880 03:49:23,923 --> 03:49:26,325 DISPARITIES ACROSS THE LIFE 4881 03:49:26,325 --> 03:49:27,193 COURSE. 4882 03:49:27,193 --> 03:49:30,396 IN THE DATA OF 2021, FROM THE 4883 03:49:30,396 --> 03:49:32,365 NATIONAL HEALTH INTERVIEW SURVEY 4884 03:49:32,365 --> 03:49:41,974 IT SHOWED THE PREVALENCE OF 4885 03:49:41,974 --> 03:49:44,844 COMBUSTIBLE TOBACCO USE WAS 4886 03:49:44,844 --> 03:49:46,345 HIGHEST AMONG BLACK OR AFRICAN 4887 03:49:46,345 --> 03:49:46,746 AMERICANSS. 4888 03:49:46,746 --> 03:49:49,749 BECAUSE OF THE SMALL SAMPLE OF 4889 03:49:49,749 --> 03:49:51,284 SURVEY, OTHER RACIAL GROUPS ARE 4890 03:49:51,284 --> 03:49:54,887 NOT SHOWN IN THE SAME DATA OF 4891 03:49:54,887 --> 03:49:56,322 THE 2021, HOWEVER OTHER REPORTS 4892 03:49:56,322 --> 03:49:58,925 WE SCOURED OUT SHOW THAT THE 4893 03:49:58,925 --> 03:50:01,127 PREVALENCE AMONG AMERICAN 4894 03:50:01,127 --> 03:50:04,397 INDIANS AND ALASKA NATIVES IS 4895 03:50:04,397 --> 03:50:07,333 GREATER THAN 29%. 4896 03:50:07,333 --> 03:50:11,838 AND AMONG NATIVE HAWAIIANS AND 4897 03:50:11,838 --> 03:50:14,474 PACIFIC ISLANDERS, PREVALENCE IS 4898 03:50:14,474 --> 03:50:24,784 GREATER THAN 26%. 4899 03:50:26,018 --> 03:50:28,054 OVER 73% COMPARED TO OTHERS, 4900 03:50:28,054 --> 03:50:34,694 OTHERWISE, AND SO ON, WHO SHOW 4901 03:50:34,694 --> 03:50:41,868 19% IN ADULTS USE OF MENTHOLS. 4902 03:50:41,868 --> 03:50:45,671 RATES INCREASED OVER THE YEARS 4903 03:50:45,671 --> 03:50:47,306 IN NON-DAILY SMOKING PEOPLE. 4904 03:50:47,306 --> 03:50:51,377 DISPARITIES IN TERMS OF TOBACCO 4905 03:50:51,377 --> 03:50:55,214 USE AND QUITTING IN RURAL 4906 03:50:55,214 --> 03:50:56,716 POPULATIONS, SEXUAL GENDER 4907 03:50:56,716 --> 03:50:59,685 MINORITIES, AND THOSE WHO 4908 03:50:59,685 --> 03:51:03,856 EXPERIENCE SEVERE PSYCHOLOGICAL 4909 03:51:03,856 --> 03:51:07,126 OR MENTAL HEALTH ISSUES. 4910 03:51:07,126 --> 03:51:10,096 AND IN THIS GRAPH ON THE LEFT I 4911 03:51:10,096 --> 03:51:15,368 SHOW THAT THE PREVALENCE OF 4912 03:51:15,368 --> 03:51:18,938 COMBUSTIBLE USE OF TOBACCO BY 4913 03:51:18,938 --> 03:51:20,239 RACIAL GROUPS IS HIGHER IN THE 4914 03:51:20,239 --> 03:51:23,676 BLACKS BUT I WANT TO EMPHASIZE 4915 03:51:23,676 --> 03:51:26,279 ON THE RIGHT GRAPH THAT ABOUT 4916 03:51:26,279 --> 03:51:30,550 THE QUIT RATE THAT THE BLACKS 4917 03:51:30,550 --> 03:51:32,652 EXPERIENCE HIGHEST PREVALENCE OF 4918 03:51:32,652 --> 03:51:34,487 SMOKING, QUIT RATES ARE VERY 4919 03:51:34,487 --> 03:51:38,524 LOW, COMPARED TO OTHER RACIAL 4920 03:51:38,524 --> 03:51:38,858 GROUPS. 4921 03:51:38,858 --> 03:51:40,626 53%, COMPARED TO OTHER GROUPS 4922 03:51:40,626 --> 03:51:43,696 WITH QUIT RATES WHICH ARE HIGHER 4923 03:51:43,696 --> 03:51:45,431 LIKE THE ASIAN AMERICANS, 4924 03:51:45,431 --> 03:51:48,067 HISPANICS, AND THE WHITES. 4925 03:51:48,067 --> 03:51:50,236 AND AGAIN HERE THE AMERICAN 4926 03:51:50,236 --> 03:51:53,973 INDIAN AND ALASKA NATIVES 4927 03:51:53,973 --> 03:51:54,473 ESTIMATES STATISTICALLY 4928 03:51:54,473 --> 03:52:00,046 UNRELIABLE BECAUSE OF SMALL 4929 03:52:00,046 --> 03:52:00,279 SAMPLES. 4930 03:52:00,279 --> 03:52:02,348 QUIT RATIO, WE MEAN PERCENTAGE 4931 03:52:02,348 --> 03:52:03,749 OF PERSONS WHO EVER SMOKED 4932 03:52:03,749 --> 03:52:05,084 HUNDRED OR MORE CIGARETTES 4933 03:52:05,084 --> 03:52:07,486 DURING THEIR LIFETIME WHO HAVE 4934 03:52:07,486 --> 03:52:09,121 QUIT SMOKING. 4935 03:52:09,121 --> 03:52:10,990 AND ALSO SIMILARLY WE DO NOT 4936 03:52:10,990 --> 03:52:14,293 SHOW HERE IN THIS CHART THE 4937 03:52:14,293 --> 03:52:16,796 RURAL, THE SEXUAL GENDER 4938 03:52:16,796 --> 03:52:19,098 MINORITY POPULATIONS, THOSE WITH 4939 03:52:19,098 --> 03:52:21,767 DISABILITIES, INCLUDING THOSE 4940 03:52:21,767 --> 03:52:23,269 WITH PSYCHOLOGICAL ISSUES, IN 4941 03:52:23,269 --> 03:52:28,975 TERMS OF QUIT RATES, BUT 4942 03:52:28,975 --> 03:52:32,612 STATISTICS ARE QUITE DIRE. 4943 03:52:32,612 --> 03:52:34,680 SO, WE PERFORMED PORTFOLIO 4944 03:52:34,680 --> 03:52:37,416 ANALYSIS TO UNDERSTAND WHAT 4945 03:52:37,416 --> 03:52:39,051 NIMHD IS CURRENTLY FUNDING. 4946 03:52:39,051 --> 03:52:42,321 MOST OF THE AWARDS FOCUSED ON 4947 03:52:42,321 --> 03:52:44,290 STUDYING BIOLOGICAL BEHAVIORAL 4948 03:52:44,290 --> 03:52:45,825 AND SOCIAL FACTORS, INFLUENCING 4949 03:52:45,825 --> 03:52:48,995 THE ETIOLOGY OF TOBACCO USE OR 4950 03:52:48,995 --> 03:52:50,630 TOBACCO-RELATED OUTCOMES. 4951 03:52:50,630 --> 03:52:54,567 BUT VERY FEW FOCUS ON EVALUATION 4952 03:52:54,567 --> 03:52:56,569 OF SMOKING CESSATION 4953 03:52:56,569 --> 03:52:57,036 INTERVENTIONS. 4954 03:52:57,036 --> 03:52:59,739 AND NONE FOCUSED ON NON-DAILY 4955 03:52:59,739 --> 03:53:00,373 SMOKING PEOPLE. 4956 03:53:00,373 --> 03:53:06,979 I WANT TO MENTION HERE THAT 4957 03:53:06,979 --> 03:53:12,652 OTHER NIH I.C. FUNDED TOBACCO 4958 03:53:12,652 --> 03:53:16,555 RESEARCH, FEW HAVE FOCUSED ON 4959 03:53:16,555 --> 03:53:18,758 COMMUNITY ENGAGED APPROACHES OR 4960 03:53:18,758 --> 03:53:19,959 COOPERATED WHOLE PERSON 4961 03:53:19,959 --> 03:53:20,259 APPROACHES. 4962 03:53:20,259 --> 03:53:27,867 AND I WANT TO ACKNOWLEDGE THAT 4963 03:53:27,867 --> 03:53:30,136 THE NCI PROGRAM OFFICIALS AND AT 4964 03:53:30,136 --> 03:53:33,339 NIDA HAVE PARTICIPATED IN GIVING 4965 03:53:33,339 --> 03:53:38,144 US INFORMATION TO THESE 4966 03:53:38,144 --> 03:53:38,577 CONCEPTS. 4967 03:53:38,577 --> 03:53:41,881 SO, THEREFORE NEED FOR NOVEL 4968 03:53:41,881 --> 03:53:43,182 STRATEGIES TO ADDRESS HEALTH 4969 03:53:43,182 --> 03:53:44,917 DISPARITIES IN POPULATIONS 4970 03:53:44,917 --> 03:53:47,887 DISPROPORTIONATELY IMPACTED BY 4971 03:53:47,887 --> 03:53:50,089 CESSATION DISPARITIES, FOR 4972 03:53:50,089 --> 03:53:51,057 EXAMPLE AFRICAN AMERICANS, THOSE 4973 03:53:51,057 --> 03:53:54,894 WHO LIVE IN RURAL AREAS, SEXUAL 4974 03:53:54,894 --> 03:53:57,196 GENDER MINORITIES, AND THOSE WHO 4975 03:53:57,196 --> 03:54:01,233 EXPERIENCE PSYCHOLOGICAL -- 4976 03:54:01,233 --> 03:54:02,368 SEVERE PSYCHOLOGICAL EFFECTS OR 4977 03:54:02,368 --> 03:54:10,242 MENTAL HEALTH ISSUES AND THOSE 4978 03:54:10,242 --> 03:54:13,212 WHO HAVE DISABILITIES. 4979 03:54:13,212 --> 03:54:14,647 EVEN THOSE WHO SMOKE 4980 03:54:14,647 --> 03:54:20,453 INTERMITTENT AND AND USE TOBACCO 4981 03:54:20,453 --> 03:54:22,088 AND OTHER SUBSTANCES. 4982 03:54:22,088 --> 03:54:26,992 THIS INITIATIVE WILL SUPPORT 4983 03:54:26,992 --> 03:54:29,395 INTERVENTIONS THAT WILL DEVELOP, 4984 03:54:29,395 --> 03:54:30,463 IMPLEMENT, AND EVALUATE 4985 03:54:30,463 --> 03:54:32,698 INNOVATIVE INTERVENTIONS TO HELP 4986 03:54:32,698 --> 03:54:35,868 PEOPLE WHO SMOKE TOBACCO 4987 03:54:35,868 --> 03:54:37,069 PRODUCTS SUCCESSFULLY QUIT 4988 03:54:37,069 --> 03:54:38,404 INCLUDING NON-DAILY SMOKING. 4989 03:54:38,404 --> 03:54:48,047 THE INITIATIVE WILL SUPPORT 4990 03:54:48,047 --> 03:54:50,316 STUDIES INCLUDING ARTIFICIAL 4991 03:54:50,316 --> 03:54:52,284 INTELLIGENCE AND MACHINE 4992 03:54:52,284 --> 03:54:57,790 LEARNING TO CUSTOMIZE PLANS, 4993 03:54:57,790 --> 03:54:59,458 PREDICT RELAPSE RISKS AND 4994 03:54:59,458 --> 03:55:02,928 SUPPORT STUDIES THAT TEST 4995 03:55:02,928 --> 03:55:04,597 EVIDENCE-BASED LINKAGE MODELS OF 4996 03:55:04,597 --> 03:55:11,404 CARE DELIVERY VIA DIFFERENT 4997 03:55:11,404 --> 03:55:12,838 PLATFORMS TO FACILITATE 4998 03:55:12,838 --> 03:55:13,739 INTERVENTIONS INCLUDING 4999 03:55:13,739 --> 03:55:14,673 TELEMEDICINE, MOBILE UNITS, 5000 03:55:14,673 --> 03:55:15,674 COMMUNITY ORGANIZATIONS. 5001 03:55:15,674 --> 03:55:18,077 ALSO WANT TO SUPPORT STUDIES 5002 03:55:18,077 --> 03:55:20,045 THAT ADDRESS THE IMPACT OF 5003 03:55:20,045 --> 03:55:22,281 NATIONAL AND LOCAL POLICIES ON 5004 03:55:22,281 --> 03:55:27,253 POPULATIONS WHO EXPERIENCE THE 5005 03:55:27,253 --> 03:55:29,221 GREATEST IMPACT OF TOBACCO USE 5006 03:55:29,221 --> 03:55:32,958 AND BURDEN AND CESSATION 5007 03:55:32,958 --> 03:55:33,726 TREATMENT DISABILITIES. 5008 03:55:33,726 --> 03:55:35,261 AND THAT'S IT. 5009 03:55:35,261 --> 03:55:39,198 I'LL STOP HERE AND LOOK FORWARD 5010 03:55:39,198 --> 03:55:40,833 TO YOUR SUGGESTIONS AND 5011 03:55:40,833 --> 03:55:41,100 COMMENTS. 5012 03:55:41,100 --> 03:55:44,503 THANK YOU. 5013 03:55:44,503 --> 03:55:45,204 >> OKAY. 5014 03:55:45,204 --> 03:55:46,005 THANK YOU VERY MUCH. 5015 03:55:46,005 --> 03:55:47,973 FIRST FOR THE OPPORTUNITY TO 5016 03:55:47,973 --> 03:55:48,841 REVIEW THIS INITIATIVE. 5017 03:55:48,841 --> 03:55:51,710 I THINK IT'S AN IMPORTANT 5018 03:55:51,710 --> 03:55:59,919 INITIATIVE BECAUSE IT FOCUSES ON 5019 03:55:59,919 --> 03:56:00,920 HEALTH DISPARITIES. 5020 03:56:00,920 --> 03:56:03,522 THE OBJECTIVE IS TO SUPPORT 5021 03:56:03,522 --> 03:56:05,291 NOVEL AND INNOVATIVE 5022 03:56:05,291 --> 03:56:06,592 INTERVENTIONS TO REDUCE 5023 03:56:06,592 --> 03:56:12,064 TOBACCO-RELATED CESSATION AMONG 5024 03:56:12,064 --> 03:56:13,265 THESE POPULATIONS. 5025 03:56:13,265 --> 03:56:17,636 OVERALL, FEW AWARDS HAVE 5026 03:56:17,636 --> 03:56:20,506 OBVIOUSLY HAVE FOCUSED ON 5027 03:56:20,506 --> 03:56:22,341 EVALUATION OF SMOKES CESSATION 5028 03:56:22,341 --> 03:56:23,342 INTERVENTIONS, NONE ON NOVEL 5029 03:56:23,342 --> 03:56:25,077 STAGES, BUT TO ADDRESS HEALTH 5030 03:56:25,077 --> 03:56:28,380 DISPARITIES IN POPULATIONS 5031 03:56:28,380 --> 03:56:29,081 IMPACTED BY TOBACCO-RELATED 5032 03:56:29,081 --> 03:56:30,349 DISEASES, I BELIEVE THE 5033 03:56:30,349 --> 03:56:35,154 STRENGTHS ARE SEEN IN THE 5034 03:56:35,154 --> 03:56:37,156 RESEARCH PRIORITIES AS OUTLINED 5035 03:56:37,156 --> 03:56:38,390 IN THE INITIATIVE. 5036 03:56:38,390 --> 03:56:41,660 THERE'S A NEED TO CONSIDER 5037 03:56:41,660 --> 03:56:42,328 HOLISTIC CESSATION 5038 03:56:42,328 --> 03:56:42,661 INTERVENTIONS. 5039 03:56:42,661 --> 03:56:44,296 I THINK THIS COULD BE UNPACKED 5040 03:56:44,296 --> 03:56:47,666 MORE AT WHAT LEVEL ARE WE 5041 03:56:47,666 --> 03:56:51,070 TALKING ABOUT FROM A SYSTEMIC 5042 03:56:51,070 --> 03:56:52,171 CONTEXTUAL INDIVIDUAL LEVEL 5043 03:56:52,171 --> 03:56:52,605 BASIS. 5044 03:56:52,605 --> 03:56:57,309 BUT I DO LIKE INCLUSION OF 5045 03:56:57,309 --> 03:56:58,744 HOLISTIC FRAMEWORK. 5046 03:56:58,744 --> 03:57:00,613 ANOTHER STRENGTH MENTIONED THE 5047 03:57:00,613 --> 03:57:01,247 NEED TO CONSIDER SOCIAL 5048 03:57:01,247 --> 03:57:03,449 DETERMINANTS OF HEALTH IN 5049 03:57:03,449 --> 03:57:04,316 DESIGNING INTERVENTIONS. 5050 03:57:04,316 --> 03:57:06,852 THE NEED TO CONSIDER INNOVATIVE 5051 03:57:06,852 --> 03:57:09,955 METHODS STRATEGIES, DATA SCIENCE 5052 03:57:09,955 --> 03:57:11,590 APPROACHES, A.I., MACHINE 5053 03:57:11,590 --> 03:57:12,057 LEARNING. 5054 03:57:12,057 --> 03:57:13,225 THE CONSIDERATION OF ENGAGEMENT 5055 03:57:13,225 --> 03:57:16,729 OF COMMUNITY BASED CLINICS TO 5056 03:57:16,729 --> 03:57:19,465 TEST INTERVENTIONS IS VERY 5057 03:57:19,465 --> 03:57:21,667 IMPORTANT FROM ENGAGEMENT AND 5058 03:57:21,667 --> 03:57:22,434 EDUCATION AND IMPLEMENTATION 5059 03:57:22,434 --> 03:57:22,735 STANDPOINT. 5060 03:57:22,735 --> 03:57:24,737 I BELIEVE THAT'S VERY IMPORTANT. 5061 03:57:24,737 --> 03:57:28,707 I ALSO ALSO CONSIDERATION OF HOW 5062 03:57:28,707 --> 03:57:30,209 COMORBID PHYSICAL AND MENTAL 5063 03:57:30,209 --> 03:57:31,977 CONDITIONS MAY INTERSECT WITH 5064 03:57:31,977 --> 03:57:35,714 TOBACCO USE AND INTERVENE ON 5065 03:57:35,714 --> 03:57:38,450 THESE INTERSECTING AREAS TO 5066 03:57:38,450 --> 03:57:38,918 REDUCE TOBACCO-RELATED 5067 03:57:38,918 --> 03:57:39,218 DISPARITIES. 5068 03:57:39,218 --> 03:57:42,821 I THINK THERE'S AN OPPORTUNITY 5069 03:57:42,821 --> 03:57:43,689 HERE FOR AN INTERSECTIONALITY 5070 03:57:43,689 --> 03:57:47,092 APPROACH TO LOOK AT VARIOUS 5071 03:57:47,092 --> 03:57:48,727 IDENTITIES AND NARROW DOWN WHAT 5072 03:57:48,727 --> 03:57:50,930 APPROACHES ARE BEST TO ADDRESS 5073 03:57:50,930 --> 03:57:54,867 THESE DISPARITIES, GIVEN THESE 5074 03:57:54,867 --> 03:57:55,534 INTERSECTING IDENTITIES. 5075 03:57:55,534 --> 03:57:59,805 I ALSO APPRECIATE THE MENTION OF 5076 03:57:59,805 --> 03:58:02,641 DIGITAL MOBILE INTERVENTIONS, 5077 03:58:02,641 --> 03:58:05,077 APPS, TELEHEALTH, ET CETERA. 5078 03:58:05,077 --> 03:58:06,712 BUT I THINK A FEW THINGS TO 5079 03:58:06,712 --> 03:58:11,417 CONSIDER, I LIKE THE FACT THAT 5080 03:58:11,417 --> 03:58:14,687 YOU MENTIONED SOME INCLUSION OF 5081 03:58:14,687 --> 03:58:15,254 CONSIDERING DISCRIMINATION 5082 03:58:15,254 --> 03:58:16,655 INDUCED STRESS, I THINK THIS 5083 03:58:16,655 --> 03:58:19,291 NEEDS TO BE UNPACKED, WHAT IS 5084 03:58:19,291 --> 03:58:22,695 MEANT BY THIS, IS IT ATTRIBUTION 5085 03:58:22,695 --> 03:58:23,862 OF DISCRIMINATION TO RACE OR IT 5086 03:58:23,862 --> 03:58:31,103 COULD BE A NUMBER OF THINGS, 5087 03:58:31,103 --> 03:58:34,340 ETHNICITY, AS WELL AS AGE OR 5088 03:58:34,340 --> 03:58:40,312 SEX, SEXUAL GENDER STATUS, 5089 03:58:40,312 --> 03:58:42,181 GENERALIZED OR PERCEIVED RACIAL 5090 03:58:42,181 --> 03:58:43,282 DISCRIMINATION, EVERYDAY OR 5091 03:58:43,282 --> 03:58:44,249 LIFETIME BASIS? 5092 03:58:44,249 --> 03:58:48,187 RESEARCH WE'VE DONE SHOWS 5093 03:58:48,187 --> 03:58:48,754 EVERYDAY DISCRIMINATION, 5094 03:58:48,754 --> 03:58:49,555 INTERPERSONAL DISCRIMINATION 5095 03:58:49,555 --> 03:58:50,623 ASSOCIATED WITH TOBACCO USE 5096 03:58:50,623 --> 03:58:53,993 WHICH HAS BEEN RISK FACTOR FOR 5097 03:58:53,993 --> 03:58:55,894 HEART DISEASE SAND MANY OTHER 5098 03:58:55,894 --> 03:58:56,862 CHRONIC ILLNESSES, SO I THINK 5099 03:58:56,862 --> 03:59:01,233 OTHER FORMS OF DISCRIMINATION 5100 03:59:01,233 --> 03:59:03,302 ARE IMPORTANT TO MENTION, 5101 03:59:03,302 --> 03:59:08,407 PARTICULARLY STRUCTURAL 5102 03:59:08,407 --> 03:59:10,676 DISCRIMINATION DIRECTLY RELATEED 5103 03:59:10,676 --> 03:59:11,944 TO STRESS, OTHER FACTORS, OTHER 5104 03:59:11,944 --> 03:59:13,178 FORMS OF DISCRIMINATION IF YOU 5105 03:59:13,178 --> 03:59:19,852 WANT TO GET NOVEL LOOK AT 5106 03:59:19,852 --> 03:59:21,053 DIFFERENT DIMENSIONS OF 5107 03:59:21,053 --> 03:59:21,587 DISCRIMINATION, COLORISM, 5108 03:59:21,587 --> 03:59:23,589 INTERNALIZED RACISM AND THE 5109 03:59:23,589 --> 03:59:24,590 LIKE. 5110 03:59:24,590 --> 03:59:26,258 ANOTHER FACTOR AUTHORS MAY WANT 5111 03:59:26,258 --> 03:59:29,828 TO CONSIDER INTERSECTION OF 5112 03:59:29,828 --> 03:59:32,598 PSYCHOSOCIAL RISK FACTORS WHICH 5113 03:59:32,598 --> 03:59:33,565 ARE CONTRIBUTORS TOWARDS 5114 03:59:33,565 --> 03:59:35,534 PRACTICE OF TOBACCO USE AND 5115 03:59:35,534 --> 03:59:37,302 SUBSTANCE ABUSE AS WELL. 5116 03:59:37,302 --> 03:59:39,138 CHRONIC AND ACUTE STRESS, 5117 03:59:39,138 --> 03:59:40,539 DEPRESSION, HOSTILITY, AND HOW 5118 03:59:40,539 --> 03:59:42,641 THEY INTERSECT WITH TOBACCO USE 5119 03:59:42,641 --> 03:59:46,478 AND IMPACT TOBACCO USE 5120 03:59:46,478 --> 03:59:46,779 DISPARITIES. 5121 03:59:46,779 --> 03:59:49,515 ATTENTION TO THESE FACTORS COULD 5122 03:59:49,515 --> 03:59:50,416 DEVELOP MINDFULNESS BASED 5123 03:59:50,416 --> 03:59:52,418 INTERVENTIONS, FOR EXAMPLE 5124 03:59:52,418 --> 03:59:54,687 VARIOUS TRIALS HAVE BEEN USED TO 5125 03:59:54,687 --> 03:59:56,989 MITIGATE THE IMPACTS OF 5126 03:59:56,989 --> 04:00:02,594 BEHAVIORAL, SUCH AS YOGA TRIALS, 5127 04:00:02,594 --> 04:00:05,531 MEDITATION ON OPTIMISTIC 5128 04:00:05,531 --> 04:00:08,033 ORIENTATION, TO MITIGATE STRESS, 5129 04:00:08,033 --> 04:00:09,668 THAT MITIGATES NEGATIVE EFFECT 5130 04:00:09,668 --> 04:00:10,569 WHICH POTENTIALLY REDUCES 5131 04:00:10,569 --> 04:00:13,072 SMOKING, QUIT RATES, LOWER 5132 04:00:13,072 --> 04:00:16,341 PREVALENCE, RISK OF CHRONIC 5133 04:00:16,341 --> 04:00:16,909 DISEASES, DOWNSTREAM FACTORS 5134 04:00:16,909 --> 04:00:19,878 SUCH AS CARDIOVASCULAR DISEASE 5135 04:00:19,878 --> 04:00:21,947 OR CANCER, PARTICULARLY AMONG 5136 04:00:21,947 --> 04:00:23,148 HEALTH DISPARITY POPULATIONS. 5137 04:00:23,148 --> 04:00:26,151 MORE OF A FOCUS ON CESSATION 5138 04:00:26,151 --> 04:00:29,388 INTERVENTIONS AMONG SPECIFIC 5139 04:00:29,388 --> 04:00:31,590 HIGH RISK UNDERSTUDIED ETHNIC 5140 04:00:31,590 --> 04:00:33,225 POPULATIONS SUCH AS NATIVE 5141 04:00:33,225 --> 04:00:40,666 AMERICANS AND ALASKA NATIVES 5142 04:00:40,666 --> 04:00:42,201 GROUPS, NATIVE HAWAIIAN AND 5143 04:00:42,201 --> 04:00:44,069 PACIFIC ISLANDER, DO WE NEED TO 5144 04:00:44,069 --> 04:00:45,471 PARSE OUT INITIATIVES FOR EACH 5145 04:00:45,471 --> 04:00:48,407 GROUP OR UNPACK THEM WITH ONE 5146 04:00:48,407 --> 04:00:50,843 INITIATIVE SO MORE THOUGHT NEEDS 5147 04:00:50,843 --> 04:00:52,811 TO BE DEVELOPED IN THAT REGARD. 5148 04:00:52,811 --> 04:00:55,114 SO THAT WE CAN STRETCH OUT AND 5149 04:00:55,114 --> 04:00:58,817 HAVE MORE OF A CULTURALLY 5150 04:00:58,817 --> 04:01:06,158 TAILORED HOLISTIC INTERVENTION, 5151 04:01:06,158 --> 04:01:07,593 WHERE FACTORS ARE DRIVERS OF 5152 04:01:07,593 --> 04:01:09,995 TOBACCO USE DISPARITIES AND 5153 04:01:09,995 --> 04:01:11,096 STRUCTURAL AND POLICY 5154 04:01:11,096 --> 04:01:12,931 INTERVENTIONS MAY HELP REDUCE 5155 04:01:12,931 --> 04:01:16,668 TOBACCO USE DISPARITIES AMONG 5156 04:01:16,668 --> 04:01:17,202 HIGH BURDEN HISTORICALLY 5157 04:01:17,202 --> 04:01:19,104 UNDERSERVED RACIAL AND ETHNIC 5158 04:01:19,104 --> 04:01:19,404 GROUPS. 5159 04:01:19,404 --> 04:01:20,939 A FOURTH FACTOR THE 5160 04:01:20,939 --> 04:01:22,808 CONSIDERATION OF THE BUILT 5161 04:01:22,808 --> 04:01:24,109 ENVIRONMENT MAY PLAY AN 5162 04:01:24,109 --> 04:01:26,745 IMPORTANT ROLE IN IMPACTING 5163 04:01:26,745 --> 04:01:27,346 CESSATION INTERVENTIONS, WHAT 5164 04:01:27,346 --> 04:01:29,448 ARE SOME OF THE INTERVENTION 5165 04:01:29,448 --> 04:01:32,985 TARGETS IN THE BUILT 5166 04:01:32,985 --> 04:01:33,952 ENVIRONMENT? 5167 04:01:33,952 --> 04:01:34,520 POVERTY, SAFETY, CRIME, 5168 04:01:34,520 --> 04:01:36,722 ADVERTISING, ET CETERA, THAT CAN 5169 04:01:36,722 --> 04:01:40,292 BE FOCUSED TO REDUCE PREVALENCE, 5170 04:01:40,292 --> 04:01:42,161 INCREASE CESSATION EFFORTS, QUIT 5171 04:01:42,161 --> 04:01:46,565 RATES AMONG HIGH RISK DISPARITY 5172 04:01:46,565 --> 04:01:47,566 POPULATIONS. 5173 04:01:47,566 --> 04:01:49,301 ALSO CONSIDERATION TALKING ABOUT 5174 04:01:49,301 --> 04:01:52,137 NOVEL FACTORS TO SORT OF LOOK AT 5175 04:01:52,137 --> 04:01:55,874 THIS ISSUE, LOOK AT INTERVENING 5176 04:01:55,874 --> 04:01:58,510 ON SPECIFIC BIOLOGICAL FACTORS 5177 04:01:58,510 --> 04:02:00,779 ON THE PATHWAY BETWEEN 5178 04:02:00,779 --> 04:02:02,314 DETERMINANTS, BEHAVIORS, CHRONIC 5179 04:02:02,314 --> 04:02:03,182 DISEASES, A PRECISION MEDICINE 5180 04:02:03,182 --> 04:02:08,754 APPROACH WHERE YOU CAN INTERVENE 5181 04:02:08,754 --> 04:02:11,056 USING SPECIFIC THERAPEUTICS, 5182 04:02:11,056 --> 04:02:13,025 GENOMIC THERAPEUTICS, WHERE, FOR 5183 04:02:13,025 --> 04:02:14,793 EXAMPLE, DNA METHYLATION SHOWS 5184 04:02:14,793 --> 04:02:17,763 SPECIFIC GENES, ASSOCIATED WITH 5185 04:02:17,763 --> 04:02:19,064 CHRONIC DISEASES, ALTERED DUE TO 5186 04:02:19,064 --> 04:02:19,498 SMOKING. 5187 04:02:19,498 --> 04:02:21,466 AS WELL AS IN THAT REGARD 5188 04:02:21,466 --> 04:02:23,769 CHANGING OF BEHAVIORS, AS WELL 5189 04:02:23,769 --> 04:02:25,604 AS ENVIRONMENTAL CIRCUMSTANCES. 5190 04:02:25,604 --> 04:02:28,140 ALSO, I THINK THIS COULD BENEFIT 5191 04:02:28,140 --> 04:02:31,543 BY CONSIDERING IF NOT IN THIS 5192 04:02:31,543 --> 04:02:33,278 INITIATIVE DOWN THE ROAD OTHER 5193 04:02:33,278 --> 04:02:34,279 THAN PROJECTS RELATED, CONSIDER 5194 04:02:34,279 --> 04:02:37,015 TRAINING EFFORTS TO MENTOR AND 5195 04:02:37,015 --> 04:02:39,852 DEVELOP TOBACCO DISPARITIES AND 5196 04:02:39,852 --> 04:02:42,487 CESSATION RESEARCHERS, TO BUILD 5197 04:02:42,487 --> 04:02:43,589 CAPACITY, ETHNIC AND RACIAL 5198 04:02:43,589 --> 04:02:45,123 UNDERSERVED SCHOLARS IN THIS 5199 04:02:45,123 --> 04:02:46,992 AREA OF WORK. 5200 04:02:46,992 --> 04:02:48,527 ALSO, UNDERSTANDING CESSATION 5201 04:02:48,527 --> 04:02:50,929 EFFORTS AMONG THOSE WHO USE 5202 04:02:50,929 --> 04:02:51,463 VAPING PRODUCTS. 5203 04:02:51,463 --> 04:02:54,099 I UNDERSTAND THIS IS STILL A 5204 04:02:54,099 --> 04:02:55,400 NEWER AREA OF STUDY AND MUCH 5205 04:02:55,400 --> 04:02:58,770 DATA MAY NOT EXIST IN THIS AREA. 5206 04:02:58,770 --> 04:03:00,539 AND SO OVERALL I THINK IT'S A 5207 04:03:00,539 --> 04:03:01,406 VERY IMPORTANT INITIATIVE. 5208 04:03:01,406 --> 04:03:06,245 THE OFFICE DID A NICE JOB 5209 04:03:06,245 --> 04:03:06,979 UNDERLYING NEED FOR INNOVATIVE 5210 04:03:06,979 --> 04:03:08,080 RESEARCH STRATEGIES IN THIS 5211 04:03:08,080 --> 04:03:08,413 AREA. 5212 04:03:08,413 --> 04:03:13,585 THOSE ARE MY COMMENTS AND I 5213 04:03:13,585 --> 04:03:16,188 THANK YOU. 5214 04:03:16,188 --> 04:03:17,389 >> THANK YOU. 5215 04:03:17,389 --> 04:03:18,390 GREAT PRESENTATION. 5216 04:03:18,390 --> 04:03:22,661 AN IMPORTANT CONCEPT. 5217 04:03:22,661 --> 04:03:24,630 I WANT TO UNDERSCORE COMMENTS 5218 04:03:24,630 --> 04:03:26,832 REGARDING USE OF 5219 04:03:26,832 --> 04:03:27,432 INTERSECTIONALITY FRAMEWORK, 5220 04:03:27,432 --> 04:03:28,567 TOBACCO PREVENTION AND CONTROL 5221 04:03:28,567 --> 04:03:36,441 IS A GOOD EXAMPLE OF SUPPORTING 5222 04:03:36,441 --> 04:03:37,976 DIS AGGREGATED FRAMEWORK FOR 5223 04:03:37,976 --> 04:03:39,611 RACIAL MINORITIES AND IMMIGRANT 5224 04:03:39,611 --> 04:03:40,045 POPULATIONS. 5225 04:03:40,045 --> 04:03:42,581 FOR EXAMPLE, IN THE PRESENTATION 5226 04:03:42,581 --> 04:03:45,183 YOU NOTE THAT OVERALL PREVALENCE 5227 04:03:45,183 --> 04:03:46,852 FOR ASIAN AMERICANS IS 7% 5228 04:03:46,852 --> 04:03:48,387 NATIONALLY, SEVERAL STUDIES WITH 5229 04:03:48,387 --> 04:03:51,990 GOOD EVIDENCE HAVE SUGGESTED 5230 04:03:51,990 --> 04:03:55,193 THAT THERE'S SURVEY BIAS FOR 5231 04:03:55,193 --> 04:03:56,628 UNDERREPORTING SMOKING RATES, 5232 04:03:56,628 --> 04:04:00,666 MANY SURVEYS ARE CONDUCTED IN 5233 04:04:00,666 --> 04:04:03,402 ENGLISH, SOMETIMES IN SPANISH. 5234 04:04:03,402 --> 04:04:04,403 THERE'S CONSIDERABLE 5235 04:04:04,403 --> 04:04:05,704 HETEROGENEITY AND DIFFERENCES IN 5236 04:04:05,704 --> 04:04:08,006 THE PROPORTION WHO ARE FIRST 5237 04:04:08,006 --> 04:04:09,308 GENERATION IMMIGRANT FROM 5238 04:04:09,308 --> 04:04:11,710 COUNTRIES WITH HIGH TOBACCO 5239 04:04:11,710 --> 04:04:12,711 PREVALENCE RATES. 5240 04:04:12,711 --> 04:04:17,082 SO FOR EXAMPLE AMONG EAST ASIAN 5241 04:04:17,082 --> 04:04:17,983 AMERICAN SUBGROUPS, INDIVIDUALS 5242 04:04:17,983 --> 04:04:22,788 FROM CHINA AND KOREA MAY HAVE 5243 04:04:22,788 --> 04:04:25,290 RATES AS HIGH AS 20 TO 35%, MAY 5244 04:04:25,290 --> 04:04:35,834 NOT BE CAPTURED IN THE NATIONAL 5245 04:04:37,202 --> 04:04:40,305 POPULATION BASED SURVEYS. 5246 04:04:40,305 --> 04:04:41,640 NET PREVALENCE OF SMOKING, 5247 04:04:41,640 --> 04:04:42,708 THINKING THROUGH TOBACCO 5248 04:04:42,708 --> 04:04:44,109 CESSATION FOR FIRST GENERATION 5249 04:04:44,109 --> 04:04:45,243 IMMIGRANT OPPORTUNITIES, TO 5250 04:04:45,243 --> 04:04:47,846 ACCOUNT FOR DIFFERENCES BY 5251 04:04:47,846 --> 04:04:49,614 ACCULTURATION STATUS AND GENDER 5252 04:04:49,614 --> 04:04:54,653 WITH RESPECT TO BOTH PREVALENCE 5253 04:04:54,653 --> 04:04:56,288 AND INTERVENTION DEVELOPMENT. 5254 04:04:56,288 --> 04:04:56,922 IMPLICATIONS FOR MANY 5255 04:04:56,922 --> 04:04:58,256 COMMUNITIES THAT MIGHT 5256 04:04:58,256 --> 04:05:03,295 EXPERIENCE LANGUAGE ACCESS OR 5257 04:05:03,295 --> 04:05:04,396 LIMITED ENGLISH PROFICIENCY, 5258 04:05:04,396 --> 04:05:05,597 HIGH RATES. 5259 04:05:05,597 --> 04:05:07,199 TO ENCOURAGE APPLICATIONS TO 5260 04:05:07,199 --> 04:05:10,736 TAKE A LIFE COURSE AND 5261 04:05:10,736 --> 04:05:11,603 INTERGENERATIONAL APPROACH 5262 04:05:11,603 --> 04:05:13,372 REGARDING TOBACCO CONTROL, 5263 04:05:13,372 --> 04:05:16,108 MAJORITY OF ADULT SMOKERS BEGIN 5264 04:05:16,108 --> 04:05:17,509 YOUNG, ADOLESCENCE, AND THAT 5265 04:05:17,509 --> 04:05:21,446 IMPACTS ABILITY TO INTERVENE 5266 04:05:21,446 --> 04:05:21,780 EFFECTIVELY. 5267 04:05:21,780 --> 04:05:22,881 INTERVENTIONS THAT TARGET 5268 04:05:22,881 --> 04:05:24,616 ADOLESCENTS AND YOUNG ADULTS MAY 5269 04:05:24,616 --> 04:05:27,119 HAVE GREATEST PROMISE REDUCING 5270 04:05:27,119 --> 04:05:28,253 DISPARITIES IN TOBACCO 5271 04:05:28,253 --> 04:05:29,121 CESSATION. 5272 04:05:29,121 --> 04:05:31,289 I ALSO ENCOURAGE USE OF 5273 04:05:31,289 --> 04:05:32,290 IMPLEMENTATION SCIENCE FRAMEWORK 5274 04:05:32,290 --> 04:05:34,059 TO GUIDE EVALUATIONS OF WHAT 5275 04:05:34,059 --> 04:05:35,360 WORKS ACROSS POPULATIONS AND 5276 04:05:35,360 --> 04:05:37,562 DIFFERENT SETTINGS, AND WHETHER 5277 04:05:37,562 --> 04:05:40,399 PROMISING STRATEGIES CAN IMPROVE 5278 04:05:40,399 --> 04:05:41,700 THE REACH, ENGAGEMENT, 5279 04:05:41,700 --> 04:05:42,467 EFFECTIVENESS OF EVIDENCE-BASED 5280 04:05:42,467 --> 04:05:44,136 INTERVENTIONS FOR EXAMPLE USING 5281 04:05:44,136 --> 04:05:45,570 COMMUNITY HEALTH WORKER 5282 04:05:45,570 --> 04:05:48,073 APPROACHES FOR DIFFERENT RACIAL 5283 04:05:48,073 --> 04:05:48,840 AND IMMIGRANT POPULATIONS. 5284 04:05:48,840 --> 04:05:50,809 IN TERMS OF DATA SCIENCE 5285 04:05:50,809 --> 04:05:52,677 APPROACHES I THINK THAT'S AN 5286 04:05:52,677 --> 04:05:53,645 AREA OF INNOVATION. 5287 04:05:53,645 --> 04:05:55,714 MACHINE LEARNING COULD BE USEFUL 5288 04:05:55,714 --> 04:05:58,016 IN THE CONTEXT OF HEALTH CARE 5289 04:05:58,016 --> 04:05:59,551 FOR IDENTIFYING INDIVIDUALS WITH 5290 04:05:59,551 --> 04:06:02,821 COMORBIDITIES SUCH AS DIABETES, 5291 04:06:02,821 --> 04:06:04,489 HYPERTENSION, AND CANCER, AND 5292 04:06:04,489 --> 04:06:06,558 ALSO SUPPORTING MORE PRO-ACTIVE 5293 04:06:06,558 --> 04:06:08,093 OUTREACH TO ENGAGE INDIVIDUALS 5294 04:06:08,093 --> 04:06:11,296 EARLY ON, SO NOT ONLY SUPPORT 5295 04:06:11,296 --> 04:06:13,031 THEIR DISEASE MANAGEMENT AND 5296 04:06:13,031 --> 04:06:14,566 ALSO HELP SUPPORT TOBACCO 5297 04:06:14,566 --> 04:06:16,968 CESSATION IN ORDER TO IMPROVE 5298 04:06:16,968 --> 04:06:17,869 HEALTH AND SURVIVORSHIP 5299 04:06:17,869 --> 04:06:18,136 OUTCOMES. 5300 04:06:18,136 --> 04:06:20,405 I DO WANT TO NOTE THE CHALLENGE 5301 04:06:20,405 --> 04:06:21,840 OF MACHINE LEARNING IS THAT IT 5302 04:06:21,840 --> 04:06:24,543 IS GOOD -- AS GOOD AS DATA THAT 5303 04:06:24,543 --> 04:06:26,745 IS AVAILABLE. 5304 04:06:26,745 --> 04:06:29,614 SO THERE ARE INHERENT OR 5305 04:06:29,614 --> 04:06:32,317 SYSTEMIC BIASES OR OMISSIONS 5306 04:06:32,317 --> 04:06:33,452 THAT MIGHT PERPETUATE EXCLUSION 5307 04:06:33,452 --> 04:06:36,388 EVEN IN HEALTH CARE SETTINGS, SO 5308 04:06:36,388 --> 04:06:40,659 I THINK ONE PIECE ABOUT THE DATA 5309 04:06:40,659 --> 04:06:42,194 SCIENCE IS TO REINFORCE NEED TO 5310 04:06:42,194 --> 04:06:45,130 EMPLOY COMMUNITY AND PATIENT 5311 04:06:45,130 --> 04:06:45,997 ENGAGEMENT STRATEGIES REALLY 5312 04:06:45,997 --> 04:06:48,266 THINKING THROUGH HOW TO USE 5313 04:06:48,266 --> 04:06:50,402 MACHINE LEARNING AND ARTIFICIAL 5314 04:06:50,402 --> 04:06:51,970 INTELLIGENCE TO INTERVENE. 5315 04:06:51,970 --> 04:06:53,371 PARTICULARLY IN THIS AREA. 5316 04:06:53,371 --> 04:06:55,674 AND THEN FINALLY I WANT TO ECHO 5317 04:06:55,674 --> 04:06:56,441 DR. SIMS' OTHER POINT. 5318 04:06:56,441 --> 04:06:59,077 I THINK THIS IS AN AREA WHERE 5319 04:06:59,077 --> 04:07:01,012 NIMHD COULD ACTUALLY ADVANCE THE 5320 04:07:01,012 --> 04:07:02,447 SCIENCE TO SUPPORT RESEARCH TO 5321 04:07:02,447 --> 04:07:05,817 ACCOUNT FOR SOCIAL AND 5322 04:07:05,817 --> 04:07:06,718 STRUCTURAL FACTORS INCLUDING 5323 04:07:06,718 --> 04:07:08,420 BUILT NEIGHBORHOOD ENVIRONMENTS 5324 04:07:08,420 --> 04:07:10,655 THAT MAY ENCOURAGE OR FACILITATE 5325 04:07:10,655 --> 04:07:13,492 ACCESS TO TOBACCO PRODUCTS, 5326 04:07:13,492 --> 04:07:14,860 PARTICULARLY TARGETING CHILDREN, 5327 04:07:14,860 --> 04:07:16,595 ADOLESCENTS, YOUNG ADULTS IN LOW 5328 04:07:16,595 --> 04:07:17,362 INCOME NEIGHBORHOODS. 5329 04:07:17,362 --> 04:07:20,866 OFTEN NEIGHBORHOODS THAT ARE 5330 04:07:20,866 --> 04:07:23,168 ALREADY CHRONICALLY HISTORICALLY 5331 04:07:23,168 --> 04:07:25,704 DISINVESTED AND HEAVILY 5332 04:07:25,704 --> 04:07:27,005 DISPROPORTIONATELY COMPRISED OF 5333 04:07:27,005 --> 04:07:27,906 RACIAL AND ETHNIC MINORITY 5334 04:07:27,906 --> 04:07:28,206 POPULATIONS. 5335 04:07:28,206 --> 04:07:35,547 THANK YOU. 5336 04:07:35,547 --> 04:07:36,748 >> DO COUNCIL MEMBERS HAVE 5337 04:07:36,748 --> 04:07:37,682 COMMENTS, QUESTIONS? 5338 04:07:37,682 --> 04:07:38,950 GO AHEAD. 5339 04:07:38,950 --> 04:07:39,551 >> SO NEEDED. 5340 04:07:39,551 --> 04:07:42,587 I HOPE TO LOOK AT POLICY LEVEL 5341 04:07:42,587 --> 04:07:42,888 THINGS. 5342 04:07:42,888 --> 04:07:43,655 YOU DON'T NECESSARILY ADVOCATE 5343 04:07:43,655 --> 04:07:48,160 BUT WE CAN LOOK AT POLICY 5344 04:07:48,160 --> 04:07:49,794 IMPLICATIONS, AND LOOK AT 5345 04:07:49,794 --> 04:07:51,429 POLICY, I KNOW FINALLY WENT 5346 04:07:51,429 --> 04:07:54,065 THROUGH THE NEW LABELING THEY 5347 04:07:54,065 --> 04:07:56,234 CAN HAVE, SITES ARE SELLING 5348 04:07:56,234 --> 04:07:57,702 TOBACCO, I DON'T KNOW IT'S NEWS 5349 04:07:57,702 --> 04:07:59,137 TO ANYBODY THAT CIGARETTES 5350 04:07:59,137 --> 04:08:00,906 AREN'T HELPFUL BUT IT WOULD BE 5351 04:08:00,906 --> 04:08:02,007 SOMETHING TO INVESTIGATE. 5352 04:08:02,007 --> 04:08:03,308 THERE MIGHT BE ONGOING WORK IN 5353 04:08:03,308 --> 04:08:04,843 THAT AREA BUT SOMETHING TO LOOK 5354 04:08:04,843 --> 04:08:05,076 AT. 5355 04:08:05,076 --> 04:08:09,214 AND I HOPE THEY LOOK AT 5356 04:08:09,214 --> 04:08:09,881 COMMUNITY LEVEL FACTORS, TRUST, 5357 04:08:09,881 --> 04:08:11,249 SOURCES FOR THIS OPINION. 5358 04:08:11,249 --> 04:08:14,286 I KNOW THERE'S A LOT OF WORK ON 5359 04:08:14,286 --> 04:08:15,887 APPS, FOR A LOT OF PEOPLE THEY 5360 04:08:15,887 --> 04:08:16,988 DON'T WORK. 5361 04:08:16,988 --> 04:08:17,756 THERE'S REALLY LOW ENGAGEMENT 5362 04:08:17,756 --> 04:08:19,958 RATE IN THEM SO I HOPE THERE'S 5363 04:08:19,958 --> 04:08:21,693 SOME KIND OF CREATIVE WORK THAT 5364 04:08:21,693 --> 04:08:24,663 CAN BE DONE WITH COMMUNITIES OF 5365 04:08:24,663 --> 04:08:25,163 COLOR. 5366 04:08:25,163 --> 04:08:26,865 ESPECIALLY AROUND THE POLICY 5367 04:08:26,865 --> 04:08:28,266 LIKE WHAT REALLY HELPED IS 5368 04:08:28,266 --> 04:08:31,570 INCREASING TAX, THAT CUT THINGS 5369 04:08:31,570 --> 04:08:32,170 DOWN, NATURALLIVE COMMUNITY 5370 04:08:32,170 --> 04:08:33,338 THERE'S DIFFERENT RULES ABOUT 5371 04:08:33,338 --> 04:08:34,739 CHARGING SO MUCH TAX, A TERRIBLE 5372 04:08:34,739 --> 04:08:36,808 THING TO DO TO YOUR COMMUNITY TO 5373 04:08:36,808 --> 04:08:38,677 MAKE CIGARETTES CHEAP BUT I JUST 5374 04:08:38,677 --> 04:08:40,345 HOPE HIGHER LEVEL -- SOME THINGS 5375 04:08:40,345 --> 04:08:42,514 I TALKED ABOUT IN MY 5376 04:08:42,514 --> 04:08:43,181 PRESENTATION, HIGHER LEVEL 5377 04:08:43,181 --> 04:08:46,484 FACTORS CAN BE LOOKED AT, REALLY 5378 04:08:46,484 --> 04:08:49,955 THINK WHERE THE MONEY IS. 5379 04:08:49,955 --> 04:08:52,591 >> THANK YOU VERY MUCH. 5380 04:08:52,591 --> 04:09:00,165 ON THE POINT NUMBER 4, OBVIOUSLY 5381 04:09:00,165 --> 04:09:07,372 THIS CONCEPT WOULD ATTRACT TO 5382 04:09:07,372 --> 04:09:09,341 WORK WITH CENTERS, DEPARTMENTS, 5383 04:09:09,341 --> 04:09:09,608 POLICY. 5384 04:09:09,608 --> 04:09:12,944 FOR EXAMPLE IF YOU LOOK AT 5385 04:09:12,944 --> 04:09:19,184 CIGARETTE OR TOBACCO TAXATION, 5386 04:09:19,184 --> 04:09:19,384 RIGHT? 5387 04:09:19,384 --> 04:09:21,720 IF YOU LOOK AT TENNESSEE, 19% 5388 04:09:21,720 --> 04:09:25,090 COMPARED TO NATIONAL AVERAGE. 5389 04:09:25,090 --> 04:09:31,296 BUT TAXATION RATE IS 6 CENTS -S 5390 04:09:31,296 --> 04:09:35,533 PER PACK, CONNECTICUT IS $4. 5391 04:09:35,533 --> 04:09:38,169 YET TENNESSEE HAS HIGHER, SO 5392 04:09:38,169 --> 04:09:42,741 HOPING THAT THAT POINT NUMBER 4, 5393 04:09:42,741 --> 04:09:44,609 WORKING WITH THE DEPARTMENTS TO 5394 04:09:44,609 --> 04:09:46,478 POLISH UP POLICIES WHICH 5395 04:09:46,478 --> 04:09:52,917 EVENTUALLY WILL HELP TO REDUCE 5396 04:09:52,917 --> 04:09:54,986 THE TOBACCO CONSUMPTION. 5397 04:09:54,986 --> 04:09:55,120 5398 04:09:55,120 --> 04:10:04,729 >> LET ME CHECK ONLINE. 5399 04:10:04,729 --> 04:10:05,063 OKAY. 5400 04:10:05,063 --> 04:10:10,769 NOTHING IN THE CHAT BOX. 5401 04:10:10,769 --> 04:10:13,738 SO, THANK YOU, PRISCAH, FOR A 5402 04:10:13,738 --> 04:10:14,239 WONDERFUL PRESENTATION. 5403 04:10:14,239 --> 04:10:17,075 MAY I HAVE A MOTION TO MOVE THE 5404 04:10:17,075 --> 04:10:20,512 CONCEPT FORWARD FOR NOTICE OF 5405 04:10:20,512 --> 04:10:21,613 FUNDING OPPORTUNITY DEVELOPMENT? 5406 04:10:21,613 --> 04:10:22,781 >> MOVE FOR APPROVAL OF THE 5407 04:10:22,781 --> 04:10:23,048 CONCEPT. 5408 04:10:23,048 --> 04:10:25,583 >> MAY I HAVE A SECOND? 5409 04:10:25,583 --> 04:10:27,852 >> I SECOND. 5410 04:10:27,852 --> 04:10:28,186 >> OKAY. 5411 04:10:28,186 --> 04:10:31,122 ALL IN FAVOR SHOW OF HANDS, AYE, 5412 04:10:31,122 --> 04:10:33,358 IN THE ROOM. 5413 04:10:33,358 --> 04:10:43,501 ONLINE? 5414 04:10:46,438 --> 04:10:49,007 MOTION IS APPROVED. 5415 04:10:49,007 --> 04:10:49,974 THANK YOU. 5416 04:10:49,974 --> 04:10:51,943 AND WE HAVE COMPLETED OUR 5417 04:10:51,943 --> 04:10:54,346 CONCEPTS FOR TODAY. 5418 04:10:54,346 --> 04:11:01,353 I'M GOING TO TURN THE MEETING 5419 04:11:01,353 --> 04:11:03,355 OVER TO DR. PEREZ-STABLE. 5420 04:11:03,355 --> 04:11:07,592 >> WE HAVE NO PUBLIC COMMENT, 5421 04:11:07,592 --> 04:11:08,026 RIGHT? 5422 04:11:08,026 --> 04:11:08,593 OKAY. 5423 04:11:08,593 --> 04:11:09,561 ALL RIGHT. 5424 04:11:09,561 --> 04:11:11,763 SO THANK YOU, EVERYONE. 5425 04:11:11,763 --> 04:11:14,132 I THINK THIS CONCLUDES OUR WORK 5426 04:11:14,132 --> 04:11:16,134 FOR OUR SESSION, OPEN SESSION OF 5427 04:11:16,134 --> 04:11:16,368 COUNCIL. 5428 04:11:16,368 --> 04:11:19,170 I WANT TO AGAIN APPRECIATE 5429 04:11:19,170 --> 04:11:22,540 EVERYONE WHO ATTENDED. 5430 04:11:22,540 --> 04:11:26,878 AND COMMENTS THAT WERE MADE. 5431 04:11:26,878 --> 04:11:28,613 AND REMIND EVERYONE THAT AFTER 5432 04:11:28,613 --> 04:11:29,814 WE APPROVE A CONCEPT THAT'S WHEN 5433 04:11:29,814 --> 04:11:33,351 OUR WORK BEGINS IN TERMS OF 5434 04:11:33,351 --> 04:11:34,319 DEVELOPING FUNDING 5435 04:11:34,319 --> 04:11:35,053 OPPORTUNITIES. 5436 04:11:35,053 --> 04:11:37,922 BUT EVEN AS WE SPEAK, WE HAVE 5437 04:11:37,922 --> 04:11:38,923 ALREADY FUNDED APPLICATIONS IN 5438 04:11:38,923 --> 04:11:41,426 THESE AREAS, OR WILL BE FUNDING 5439 04:11:41,426 --> 04:11:43,828 APPLICATIONS IN THIS AREA, SO 5440 04:11:43,828 --> 04:11:46,131 KEEP GOOD IDEAS COMING. 5441 04:11:46,131 --> 04:11:50,935 I WANT TO THANK DR. COTTON AND 5442 04:11:50,935 --> 04:11:52,604 HIS TEAM FOR ORGANIZING US, AND 5443 04:11:52,604 --> 04:11:54,906 THOSE AT THE TABLE FROM NIMHD 5444 04:11:54,906 --> 04:11:58,610 AND ALL COUNCIL MEMBERS AND THE 5445 04:11:58,610 --> 04:12:02,013 TWO ONLINE. 5446 04:12:02,013 --> 04:12:05,950 IN FEBRUARY YOU'LL ALL BE ON THE 5447 04:12:05,950 --> 04:12:09,454 ZOOM MEETING, WE'LL DO IT 5448 04:12:09,454 --> 04:12:10,088 VIRTUALLY. 5449 04:12:10,088 --> 04:12:10,488 THANKS, EVERYONE. 5450 04:12:10,488 --> 04:12:12,957 HAVE A GOOD REST OF YOUR FRIDAY. 5451 04:12:12,957 --> 04:12:13,391 >> BYE, EVERYONE. 5452 04:12:13,391 --> 04:12:16,094 [END OF PROGRAM] 5453 04:12:16,094 --> 04:12:22,233 5454 04:12:22,233 --> 04:12:32,277