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NIMHD DIRECTOR SEMINAR

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SERIES.

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THIS IS THE LAST OF THE YEAR

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ENDING UNEQUAL TREATMENT: 

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STRATEGIES TO ACHIEVE EQUITABLE

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HEALTHCARE AND OPTIMAL HEALTH

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FOR ALL, I AM NEISHA DINWIDDIE,

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WHAT YOU SEE ON THE KREEN IS AN

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E-MAIL ADDRESS WHERE YOU CAN

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SUBMIT QUESTIONS FOR THE PANEL.

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WE ARE GOING TO GO AHEAD AND GET

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STARTED SINCE WE WANT TO BE

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RESPECTFUL OF EVERYONE'S TIME

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AND NOW I WILL HAND IT OVER TO

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DR. ELISEO PEREZ-STABLE.

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>> THANK YOU SO MUCH
NEISHA, AND

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WELCOME ERCH TO THE SPECIAL

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DIRECTOR'S SEMINAR MUCH  --

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SEMINAR.

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WE WANT TO HIGHLIGHT A REPORT

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PUBLISHED EARLIER THIS YEAR,

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ENDING UNEQUAL TREATMENT, AND

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THE HISTORY OF THIS REPORT DATES

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BACK TO OVER 20 YEARS AGO WHEN

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THE FIRST REPORT CAME OUT.

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IT WAS REALLY A GAME CHANGER IN

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MANY WAYS FOR THE FIELD AND AS

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DIRECTOR OF THE NIMHD WE CAN SEE

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THE IDEA OF DOING A FOLLOW UP

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NOW, 3 YEARS AGO, IT WAS A WHILE

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BACK.

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I GATHERED THE INTEREST OF A

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NUMBER OF INSTITUTES AT NIH AS

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WELL AS THE AGENCY FOR

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HEALTHCARE RESEARCH AND QUALITY,

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3 OF MY COLLEAGUES WILL BE HERE

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REPRESENTING THEIR INSTITUTES, 2

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DIRECTORS, AND SO WE WILL HAVE A

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GOOD CONVERSATION AFTER THE

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PRESENTATION.

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BUT JUST PUT IT IN CONTEXT,

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DISPARITIES, AWARENESS AND

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ACKNOWLEDGMENT, THAT WAS PHASE

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1.

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WE REALLY ARE ALL URGENTLY

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WANTING INTERVENTIONS TO REDUCE

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DISPARITIES.

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THERE HAS BEEN PROGRESS IN MANY

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AREAS, BUT WE STILL FACE

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DAUNTING TASKS.

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WE SEE THE POPULATION HEALTH OF

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THE UNITED STATES WHERE IT SITS

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45th IN THE WORLD ON LIFE

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EXPECTANCY AND VERY RECENT

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ANALYSIS WE SEE THAT WITHIN THE

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POPULATION OF THE UNITED STATES,

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AFRICAN AMERICANS AND AMERICAN

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INDIANS, ALASKA NATIVES DO MUCH

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WORSE IN ALL MEASURES OF

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POPULATION HEALTH THAT WE HAVE

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LOOKED AT AND IT GOES FROM

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HEALTHCARE ON 1 HAND AND ACCESS

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TO CARE AND GETTING THE PROPER

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DIAGNOSTIC AND THERAPEUTIC

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INTERVEKSS FOR INDIVIDUALS WITH

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ACUTE AND CHRONIC CONDITIONS TO

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COMMUNITY HEALTH AND POPULATION

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HEALTH AND WE CAN'T DO IT ALL,

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ALL THE TIME BUT THESE THINGS

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ARE INTERRELATED AND I THINK

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IT'S REALLY RELEVANT THAT WE NOT

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SEPARATE THOSE 2 COMPLETELY

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ALTHOUGH IN THE REPORT, WE DO

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NEED TO FOCUS ON SOME PARTICULAR

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AREAS.

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AND FINALLY I WANT TO SAY THAT

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NIMHD IS LEADING NIH PROCESS OF

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DEVELOPMENT OF A NEXT 5 YEAR

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STRATEGIC PLAN FOR NIH-WIDE

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MINORITY HEALTH AND HEALTH

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DISPARITIES RESEARCH.

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WE HAD HAD ALREADY 2 SUCCESSFUL

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OPEN TOWN HALLS.

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SO DIRECTORS THAT ARE HERE AND

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SORT OF WHAT WE'RE DOING TODAY

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SUGGESTIONS AND QUESTIONS THAT

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MAY COME UP THAT MAY HELP US

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SHAPE THAT AS WE DEVELOP THAT IS

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FINALIZE THAT OVER THE NEXT

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HOPEFULLY 6 MONTHS OR SO.

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SO WITHOUT FURTHER ADO LET ME

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INTRODUCE BRIEFLY MY COLLEAGUES

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WHO WERE ON THE NASEM COMMITTEE.

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I WILL START WITH JUST CONSUELO

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WILKINS.

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CONSUELO IS SENIOR VICE

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PRESIDENT FOR EQUITY AND

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PROFESSOR OF MEDICINE AT VANTER

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BUILT MEDICAL CENTER.

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JEN DEVOE IS THE CO-CHAIR OF THE

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COMMITTEE, THANK YOU FOR DOING

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THAT JEN AND PROFESSOR AND CHAIR

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OF DEPARTMENT OF FAMILY MEDICINE

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AT OREGON HEALTH AND SCIENCE

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UNIVERSITY AND MARGARITA ALEGRII

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WHO IS WITH MASSACHUSETTS

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GENERAL HOSPITAL WHERE ALSO AND

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ALSO WHERE SHE HAD OTHER TITLES

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OF PROFESSOR THERE.

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DARREL GASKIN IS EXPECTED TO

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JOIN US, ALTHOUGH HE IS DELAYED

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AND DARREL IS A HEALTH ECONOMIST

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AND DIRECTOR OF THE HOPKINS

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CENTER FOR HEALTH DISPARITY

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SOLUTIONS AT JOHNS HOPKINS

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UNIVERSITY.

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SO JEN, THE FLOOR IS YOURS.

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>> THANKS, SO MUCH AND
HUGE

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THANKS TO OUR COMMITTEE AND THE

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STAFF AT THE NATIONAL ACADEMIES

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AND OF COURSE NIH FOR SPONSORING

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THIS REPORT.

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WE SPENT SEVERAL MONTHS,

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ACTUALLY BETTER PART OF A COUPLE

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OF YEARS REVIEWING THE EVIDENCE,

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UPDATING THE REPORT AND

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RESPONDING TO AN INCREDIBLY

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BROAD STATEMENT OF TASK WHICH

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SPECIFIES THAT THIS COMMITTEE

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WILL CONSIDER WAYS TO SCALE AND

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SPREAD EFFECTIVE INTERVENTIONS

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TO REDUCE RACIAL AND ETHNIC

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DISPARITIES IN HEALTHCARE AND

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MAKE RECOMMENDATIONS TO ADVANCE

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HEALTH EQUITY AND APPLY ITS

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EXPERT JUDGMENT IN ORDER TO

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DEVELOP RECOMMENDATIONS WITH THE

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FOCUS ON ADVANCING HEALTH

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EQUITY.

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THE REPORT IS NEARLY 400 PAGES

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LONG.

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I UNDERSTAND WE ONLY HAVE A FEW

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MINUTES TODAY, SO WE WERE GOING

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TO BE HIGHLIGHTING A FEW

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SECTIONS OF THE REPORT WHICH

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WILL BE PRESENTED IN SOME DETAIL

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BY A COUPLE OF COMMITTEE

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MEMBERS.

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ONE OF THE AREAS THAT WE WERE

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ASKED TO TOUCH UPON WAS INCLUDED

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IN AN INTER CHAPTER IN THE

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REPORT RELATED TO ACCOUNTABILITY

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WHICH IS 1 OF THE CRITICAL

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ASPECTS WITHIN THE CONCEPTUAL

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FRAMEWORK THAT OUR COMMITTEE PUT

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TOGETHER IN UNDERSTANDING THAT

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GREATER ACCOUNTABILITY IS

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NECESSARY TO INSURE THAT

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PROGRESS IS MADE IN ACHIEVING

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EQUITABLE OUTCOMES IN HELT CARE,

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TO IMPROVE ACCOUNTABILITY,

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PROCESSES, CLEAR GOALS AND

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OBJECTIVES NEED TO BE

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STANDARDIZED, METRICS

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STANDARDIZES TOWARD TRACKING

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PROGRESS TOWARD GOALS AND

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CONSEQUENCES IMPOSED FOR THOSE

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THAT WHO NOT ACHIEVE THESE GOALS

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AND OBJECTIVES.

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AND THE COMMITTEE WENT INTO SOME

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DEPTH IN OUR ENTIRE CHAPTER 8

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REALLY MAKING -- REVIEWING THE

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EVIDENCE FOR THE NEED FOR

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ACCOUNTABLE AND IDENTIFYING A

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NUMBER OF DIFFERENT GAPS WHERE

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RESEARCH IS NECESSARY AND THEN

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CERTAINLY POLICIES AND LAWS

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STRENGTHEN TO INSURE

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ACCOUNTABILITY.

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SO JUST WANTED TO TOUCH ON THAT

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BEFORE WE CIRCLE BACK TO SOME OF

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THE AREAS SPECIFIC TO THE

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HEALTHCARE SYSTEM AND TO

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RESEARCH.

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SO I WILL TURN IT OVER TO I

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BELIEVE DR. WILKINS WHO WILL

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SPEAK NEXT.

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>> YES, THANK YOU SO MUCH.

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IT'S MY PLEASURE TO TALK A

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LITTLE BIT MORE ABOUT WHAT THE

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COMMITTEE, THE WORK THE

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COMMITTEE DID AS IT RELATES TO

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DISCOVERY.

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AND SO WHAT I WILL TALK MOST

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ABOUT IS IN CHAPTER 7 OF THE

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REPORT.

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SINCE WE ONLY HAVE LIMITED TIME

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AND AS DR. DEVOE MENTIONED, IT'S

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QUITE A LOT -- IT'S QUITE A LONG

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READ HERE, I'M JUST REALLY

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FOCUSING ON THE CONCLUSIONS THAT

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OUR COMMITTEE CAME TO AND

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HOPEFULLY THAT WILL SPUR SOME

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ADDITIONAL CONVERSATION.

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YOU KNOW THE FIRST INCLUSION

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THAT WE CAME TO, SO WE SPENT

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QUITE A BIT OF TIME LOOKING AT

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THE NIH PORTFOLIO, WHAT RESEARCH

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HAS BEEN FUNDED  FUNDED IN THE F

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HEALTH DISPARITIES AND HEALTH

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INIQUITIES AND LOOKING AT THAT

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AT PRESENT TIME IN THE LAST

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COUPLE OF YEARS BUT ALSO LOOKING

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OVER THE COURSE OF THE LAST MORE

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THAN A DECADE.

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AND OF COURSE, AS WE STARTED TO

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DO THIS, THIS GETS INTO THE

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HISTORY OF NIMHD, AND THE CENTER

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THAT PROCEEDED IT AND REALLY

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REFLECTS A LOT OF PROGRESS SINCE

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THE INITIAL REPORT 2 DECADES

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AGO.

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BUT WHAT WE DID FIND IS THAT

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EVEN THOUGH THERE HAS BEEN SOME

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PROGRESS YOU CAN SEE HERE THE

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INCREASE IN FUNDING OVER YEARS,

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THE AMOUNT OF FUNDING THAT IS

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GOING FROM OUR NIH CENTERS AND

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INSTITUTES TOWARDS HEALTH EQUITY

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IS STILL RELATIVELY LOW.

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AND THIS TABLE IN PARTICULAR

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POINTS OUT THE PERCENTAGE OF THE

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FUNDING THAT'S FROM EACH OF

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THESE EN--STRATEGIESITUTES AND

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CENTERS THAT WE IDENTIFIED AS

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FOCUSED ON HEALTH EQUITY OR

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HEALTH DISPARITIES, I'M SURE

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DR. PEREZ-STABLE IS THINKING ALL

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OF HIS 100% SHOULD BE IN THAT

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COLUMN FOR NIMHD, BUT YOU CAN

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SEE HERE AGAIN THE WIDE RANGE OF

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PERCENTAGES FROM THE DIFFERENT

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CENTERS AND INSTITUTES AND SO,

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OBVIOUSLY, YOU CAN SEE THAT

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NIMHD HERE IS THE HIGHEST AT

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MORE THAN 70%, NCATS IS

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FOLLOWING THERE, AND WE HAVE

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WITH MORE THAN 10% NINR AS WELL

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AS NIEHS.

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SO 1 OF THE THINGS THAT THE

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COMMITTEE SPENT SOMETIME TALKING

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ABOUT THOUGH IS WHAT THIS LOOKS

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LIKE AND OBVIOUSLY THERE'S

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DIFFERENT FUNDING AMOUNTS FOR

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THESE INSTITUTES AND CENTERS BUT

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RECOGNIZING THERE'S SOME

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DISPARITIES WITHIN THOSE

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INSTITUTES THAT HAVE SMALLER

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BUDGETS ACTUALLY HAVING A HIGHER

260
00:10:06,054 --> 00:10:09,257
PERCENTAGE OF THEIR FUNDING GO

261
00:10:09,257 --> 00:10:12,827
TO HEALTH DISPARITIES AND HEALTH

262
00:10:12,827 --> 00:10:13,495
INIQUITIES.

263
00:10:13,495 --> 00:10:15,997
THE NEXT CONCLUSION THAT WE CAME

264
00:10:15,997 --> 00:10:19,534
TO IS YOU KNOW WE RECOGNIZE THAT

265
00:10:19,534 --> 00:10:20,902
COMMUNITY ENGAGED AND COMMUNITY

266
00:10:20,902 --> 00:10:23,271
DRIVEN RESEARCH IS REALLY

267
00:10:23,271 --> 00:10:25,573
CRITICAL TO ADDRESSING HEALTH

268
00:10:25,573 --> 00:10:26,975
DISPARITIES AND HEALTH

269
00:10:26,975 --> 00:10:29,677
INIQUITIES, YET IT REFLECTS A

270
00:10:29,677 --> 00:10:32,180
VERY SMALL PERCENTAGE OF NIH

271
00:10:32,180 --> 00:10:32,781
FUNDED RESEARCH.

272
00:10:32,781 --> 00:10:36,284
THERE ARE OF COURSE A NUMBER OF

273
00:10:36,284 --> 00:10:39,120
LONG STANDING PROGRAMS ACROSS

274
00:10:39,120 --> 00:10:42,390
NIH AND AS WELL AS SOME NEWER 1S

275
00:10:42,390 --> 00:10:45,860
THAT FOCUS EXPLICITLY ON

276
00:10:45,860 --> 00:10:47,929
COMMUNITY ENGAGEMENT AND

277
00:10:47,929 --> 00:10:50,832
COMMUNITY BASED PARTICIPATORY

278
00:10:50,832 --> 00:10:53,368
RESEARCH BUT THERE WAS AN

279
00:10:53,368 --> 00:10:59,007
OBVIOUS DIRTH OF THAT AND REALLY

280
00:10:59,007 --> 00:11:00,975
LOOKING TO SEE THAT EXPAND.

281
00:11:00,975 --> 00:11:02,143
THERE ARE OF COURSE NEWER

282
00:11:02,143 --> 00:11:05,280
EXAMPLES OF WORK IN THIS SPACE

283
00:11:05,280 --> 00:11:07,982
INCLUDING THE COMPASS INITIATIVE

284
00:11:07,982 --> 00:11:09,851
THAT RECENTLY LAWRCHED BY NIH

285
00:11:09,851 --> 00:11:12,687
AND IS FOCUSED ON COMMUNITY

286
00:11:12,687 --> 00:11:16,724
DRIVEN HEALTH, QUITY RESEARCH

287
00:11:16,724 --> 00:11:17,559
WHICH WE -- EQUITY RESEARCH

288
00:11:17,559 --> 00:11:19,160
WHICH WE BELIEVE IS AN IMPORTANT

289
00:11:19,160 --> 00:11:20,461
STEP IN THE RIGHT DIRECTION BUT

290
00:11:20,461 --> 00:11:23,331
HOW CAN WE EXPAND EFFORTS TO

291
00:11:23,331 --> 00:11:26,067
REALLY ENGAGE THOSE COMMUNITIES

292
00:11:26,067 --> 00:11:27,902
THAT HAVE BEEN MARGINALIZED AND

293
00:11:27,902 --> 00:11:29,604
MINORITIZED IN THE WORK SO THAT

294
00:11:29,604 --> 00:11:36,010
WE CAN IMET TO SOLUTIONS FASTER.

295
00:11:36,010 --> 00:11:39,047
WE HAD A LOT OF DISCUSSION ABOUT

296
00:11:39,047 --> 00:11:41,549
THE WORKFORCE, THE SCIENTIFIC

297
00:11:41,549 --> 00:11:42,383
WORKFORCE, AND THINKING ABOUT

298
00:11:42,383 --> 00:11:47,355
WHAT NEEDS TO BE DONE IN TERMS

299
00:11:47,355 --> 00:11:49,524
OF STRENGTHENING IN THAT TO DO

300
00:11:49,524 --> 00:11:53,661
HEALTH DISPARITIES AND HEALTH

301
00:11:53,661 --> 00:11:56,331
EQUITY RESEARCH, RECOGNIZING

302
00:11:56,331 --> 00:11:57,498
THAT INDIVIDUALS FROM

303
00:11:57,498 --> 00:11:59,334
MINORITIZED RACIAL AND ETHNIC

304
00:11:59,334 --> 00:12:01,436
GROUPS ARE BOTH SIGNIFICANTLY

305
00:12:01,436 --> 00:12:03,137
UNDERREPRESENTED IN THE

306
00:12:03,137 --> 00:12:05,740
SCIENTIFIC WORKFORCE BUT ALSO

307
00:12:05,740 --> 00:12:08,243
MORE LIKELY TO DO RESEARCH IN

308
00:12:08,243 --> 00:12:09,544
HEALTH DISPARITIES AND HEALTH

309
00:12:09,544 --> 00:12:10,812
INIQUITIES IS SOMETHING THAT WE

310
00:12:10,812 --> 00:12:12,247
SPENT QUITE A BIT OF TIME

311
00:12:12,247 --> 00:12:13,047
TALKING ABOUT.

312
00:12:13,047 --> 00:12:16,351
WE ALSO DISCUSSED SOME OF THE

313
00:12:16,351 --> 00:12:17,185
STRUCTURAL BARRIERS TO DOING

314
00:12:17,185 --> 00:12:20,021
HEALTH EQUITY AND HEALTHCARE

315
00:12:20,021 --> 00:12:22,757
EQUITY RESEARCH IN THESE

316
00:12:22,757 --> 00:12:23,925
SETTINGS ESPECIALLY IN ACADEMIC

317
00:12:23,925 --> 00:12:27,195
MEDICAL CENTERS THAT HAVE BEEN

318
00:12:27,195 --> 00:12:28,162
DOING BASIC SCIENCE, RESEARCH

319
00:12:28,162 --> 00:12:32,667
SOLELY AND NOT NECESSARILY SET

320
00:12:32,667 --> 00:12:35,970
UP OR INCENTIVIZED TO DO

321
00:12:35,970 --> 00:12:38,172
RESEARCH FOCUSED ON COMMUNITY

322
00:12:38,172 --> 00:12:39,307
ENGAGEMENT, COMMUNITY ENGAGED

323
00:12:39,307 --> 00:12:40,808
RESEARCH AS WELL AS

324
00:12:40,808 --> 00:12:42,977
IMPLEMENTATION SCIENCE AND SO,

325
00:12:42,977 --> 00:12:46,681
AGAIN, WE HAD A NUMBER OF

326
00:12:46,681 --> 00:12:52,020
DISCUSSIONS ABOUT THAT AND THE

327
00:12:52,020 --> 00:12:52,954
COMPLEX RELATIONSHIP WITH

328
00:12:52,954 --> 00:12:55,123
MINORITY SERVING INSTITUTIONS AS

329
00:12:55,123 --> 00:13:01,296
WELL AS HBCUs IN THIS SETTING.

330
00:13:01,296 --> 00:13:02,463
THE HISTORIC UNDERFUNDING OF

331
00:13:02,463 --> 00:13:05,433
THOSE INSTITUTIONS WHO IMEAN MAY

332
00:13:05,433 --> 00:13:15,977
BE MORE LIKELY TO SUPPORT AND BE

333
00:13:17,478 --> 00:13:19,380
DOING HELT DISPARITIES RESEARCH.

334
00:13:19,380 --> 00:13:23,551
IN THE FACE OF THIS INCREASED

335
00:13:23,551 --> 00:13:24,919
INTEREST OF HEALTH DISPARITIES

336
00:13:24,919 --> 00:13:26,654
RESEARCH, WHICH WE SAW QUITE A

337
00:13:26,654 --> 00:13:28,756
BIT OF IN THE LAST 5 YEARS SO

338
00:13:28,756 --> 00:13:31,826
FOLLOWING THE PANDEMIC AS WELL

339
00:13:31,826 --> 00:13:35,129
AS THE HEIGHTENED AWARENESS OF

340
00:13:35,129 --> 00:13:42,770
RACIAL INJUSTICES WE HAVE SEEN

341
00:13:42,770 --> 00:13:43,905
INFLUX OF RESEARCHERS INTO THE

342
00:13:43,905 --> 00:13:48,443
SPACE AS WELL AS AN INFLUX OF

343
00:13:48,443 --> 00:13:49,877
INVESTIGATORS IN THIS SPACE.

344
00:13:49,877 --> 00:13:52,113
WE HAD A NUMBER OF DISCUSSIONS

345
00:13:52,113 --> 00:13:53,548
AND DATA LOOKING AT THOSE

346
00:13:53,548 --> 00:13:55,183
FUNDING TRENDS AS WELL AS WHOSE

347
00:13:55,183 --> 00:13:56,985
GETTING FUNDED AND RECOGNIZING

348
00:13:56,985 --> 00:13:58,152
THAT THERE ARE MANY RESEARCHERS

349
00:13:58,152 --> 00:14:02,056
WHO HAVE BEEN DOING THIS WORK

350
00:14:02,056 --> 00:14:05,226
FOR DECADES IN SETTING OF VERY

351
00:14:05,226 --> 00:14:10,531
FEW OPPORTUNITIES TO DO -- TO

352
00:14:10,531 --> 00:14:14,602
GET FUNDED FOLLOWED BY THIS

353
00:14:14,602 --> 00:14:15,770
BURST OF -- BURST INTO THE FIELD

354
00:14:15,770 --> 00:14:23,711
OF INTEREST IN THE AREA AND MORE

355
00:14:23,711 --> 00:14:25,113
FUNDING INTO THE FIELD, NOT

356
00:14:25,113 --> 00:14:26,381
HAVING BEEN WELL TRAINED OR

357
00:14:26,381 --> 00:14:30,184
HAVING SPECIFIC KNOWLEDGE OR

358
00:14:30,184 --> 00:14:31,986
TRAINING IN HEALTH EQUITY

359
00:14:31,986 --> 00:14:34,489
RESEARCH OR EXPERIENCE WORKING

360
00:14:34,489 --> 00:14:35,556
WITH THESE COMMUNITIES, WE

361
00:14:35,556 --> 00:14:41,162
BELIEVE HIGHLIGHTED THE NEED FOR

362
00:14:41,162 --> 00:14:44,032
MORE TRAINING AS WELL AS PERHAPS

363
00:14:44,032 --> 00:14:46,434
SOME GUARD RAILS FOR THE KINDS

364
00:14:46,434 --> 00:14:50,638
OF EXPECTATIONS WE SET FOR

365
00:14:50,638 --> 00:14:51,406
INDIVIDUALS DOING THIS RESEARCH

366
00:14:51,406 --> 00:14:52,874
AND WE THINK THAT A REALLY

367
00:14:52,874 --> 00:14:55,843
IMPORTANT ASPECT OF THAT WAS

368
00:14:55,843 --> 00:14:57,678
ALSO ACKNOWLEDGING THE HISTORY

369
00:14:57,678 --> 00:15:01,082
OF PEOPLE DOING THE RESEARCH,

370
00:15:01,082 --> 00:15:02,884
BEING MARGINALIZED AND NOT

371
00:15:02,884 --> 00:15:05,119
HAVING THOSE OPPORTUNITIES AND

372
00:15:05,119 --> 00:15:06,354
WHAT IS THE IMPORTANT PERHAPS

373
00:15:06,354 --> 00:15:10,825
SCIENCE AND WORK THAT WE'RE

374
00:15:10,825 --> 00:15:11,325
LEAVING BEHIND.

375
00:15:11,325 --> 00:15:14,529
ALONG WITH THAT, WE NEED TO

376
00:15:14,529 --> 00:15:16,297
FOCUS ON CRITICALLY EVALUATING

377
00:15:16,297 --> 00:15:20,068
THE WORK, THESE INCONSISTENT

378
00:15:20,068 --> 00:15:22,036
PRACTICES, AROUND TOOLS, HOW THE

379
00:15:22,036 --> 00:15:25,773
DATA IS COLLECTED, WE KNOW THAT

380
00:15:25,773 --> 00:15:28,743
NIMHD HAS BEEN REALLY PUSHING

381
00:15:28,743 --> 00:15:30,578
FOR MORE COMMON DATA ELEMENTS TO

382
00:15:30,578 --> 00:15:34,282
BE COLLECTED ACROSS STUDIES AND

383
00:15:34,282 --> 00:15:37,118
MORE CONSIDERATION FOR AGAIN HOW

384
00:15:37,118 --> 00:15:40,621
CAN WE LEARN FROM THE BODY OF

385
00:15:40,621 --> 00:15:41,956
WORK AS A WHOLE AND WE THINK

386
00:15:41,956 --> 00:15:44,959
THERE'S MORE WORK TO BE DONE IN

387
00:15:44,959 --> 00:15:45,793
THIS SPACE.

388
00:15:45,793 --> 00:15:48,329
AND WE ALSO FOCUSED QUITE A BIT

389
00:15:48,329 --> 00:15:52,166
ON THE NEED TO REALLY UNDERSTAND

390
00:15:52,166 --> 00:15:56,237
SOCIAL DRIVERS OF HEALTH AS WELL

391
00:15:56,237 --> 00:15:57,405
AS UNDERSTANDING THE SOCIAL

392
00:15:57,405 --> 00:15:59,774
CONSTRUCTS OF RACE AND ETHNICITY

393
00:15:59,774 --> 00:16:01,642
IN THE SETTING OF BIOLOGICAL

394
00:16:01,642 --> 00:16:04,979
DATA AND USE OF GENETICS

395
00:16:04,979 --> 00:16:09,884
GENOMICS AND ANCESTRY DATA.

396
00:16:09,884 --> 00:16:12,620
PROBABLY GOES WITHOUT SAYING

397
00:16:12,620 --> 00:16:15,356
THERE -- THERE STILL IS A GREAT

398
00:16:15,356 --> 00:16:21,362
NEED FOR MORE INFRASTRUCTURE TO

399
00:16:21,362 --> 00:16:23,064
DO HEALTH EQUITY RESEARCH.

400
00:16:23,064 --> 00:16:24,832
IT HAS BEEN HISTORICALLY

401
00:16:24,832 --> 00:16:25,800
UNDERFUNDED AND WE THINK THAT

402
00:16:25,800 --> 00:16:27,235
THE KINDS OF RESOURCES THAT ARE

403
00:16:27,235 --> 00:16:30,404
NEEDED BOTH WITHIN INSTITUTIONS

404
00:16:30,404 --> 00:16:32,974
WHO DO RESEARCH BUT ALSO TO

405
00:16:32,974 --> 00:16:36,277
SUPPORT IT IN COMMUNITIES NEEDS

406
00:16:36,277 --> 00:16:38,312
TO BE SCALED UP IF WE'RE GOING

407
00:16:38,312 --> 00:16:41,149
TO HAVE TRUE IMPROVEMENT.

408
00:16:41,149 --> 00:16:43,451
AND THEN OUR FINAL CONCLUSION

409
00:16:43,451 --> 00:16:47,622
FROM THIS CHAPTER WAS AS WE

410
00:16:47,622 --> 00:16:52,627
THINK ABOUT WHAT KIND OF

411
00:16:52,627 --> 00:16:54,795
RESEARCH MIGHT TRULY CHANGE

412
00:16:54,795 --> 00:16:57,465
HEALTH OUTCOMES AND REDUCE AND

413
00:16:57,465 --> 00:16:58,199
ELIMINATE INIQUITIES AND

414
00:16:58,199 --> 00:17:00,034
DISPARITIES, WE THINK THAT WE

415
00:17:00,034 --> 00:17:03,638
NEED MORE INTERVENTIONAL

416
00:17:03,638 --> 00:17:04,705
STUDIES, MORE WORK ACTUALLY

417
00:17:04,705 --> 00:17:08,509
LOOKING AT WHAT WORKS AND WHAT

418
00:17:08,509 --> 00:17:12,680
DOESN'T WORK IN COMMUNITIES AND

419
00:17:12,680 --> 00:17:15,983
YOU KNOW THINKING THROUGH HOW WE

420
00:17:15,983 --> 00:17:16,684
CAN LEVERAGE IMPLEMENTATION

421
00:17:16,684 --> 00:17:20,321
SCIENCE AS WELL AS COMPARATIVE

422
00:17:20,321 --> 00:17:22,156
EFFECTIVENESS STUDIES IN

423
00:17:22,156 --> 00:17:24,792
DIFFERENT WAYS INCLUDING USING

424
00:17:24,792 --> 00:17:27,461
MULTILEVEL AND STRUCTURAL

425
00:17:27,461 --> 00:17:30,665
INTERVENTIONS SO VERY FEW

426
00:17:30,665 --> 00:17:34,602
STUDIES EXISTING USING THESE

427
00:17:34,602 --> 00:17:35,303
STRATEGIES AND REALLY NECESSARY

428
00:17:35,303 --> 00:17:39,073
IF WE'RE GOING TO MOVE AWAY FROM

429
00:17:39,073 --> 00:17:41,509
JUST THESE OBSERVATIONS OF

430
00:17:41,509 --> 00:17:42,343
ONGOING DISPARITIES AND

431
00:17:42,343 --> 00:17:46,447
INIQUITIES AND MOVING TOWARDS

432
00:17:46,447 --> 00:17:47,081
ACTUAL OUTCOMES.

433
00:17:47,081 --> 00:17:51,152
AND THEN I'LL JUST END WITH, YOU

434
00:17:51,152 --> 00:17:52,653
KNOW THE GOAL 3 THAT REFLECTS

435
00:17:52,653 --> 00:17:55,590
WHERE WE THINK THIS WORK NEEDS

436
00:17:55,590 --> 00:17:57,291
TO GO.

437
00:17:57,291 --> 00:18:01,529
WE REALLY AS A COMMITTEE WANTED

438
00:18:01,529 --> 00:18:04,298
TO PUSH FOR WHAT

439
00:18:04,298 --> 00:18:04,932
DR. PEREZ-STABLE JUST MENTIONED

440
00:18:04,932 --> 00:18:07,535
EARLIER THAT WE THINK THAT THERE

441
00:18:07,535 --> 00:18:12,006
NEEDS TO BE MORE COORDINATION

442
00:18:12,006 --> 00:18:14,675
AROUND A HEALTH EQUITY FUNDING,

443
00:18:14,675 --> 00:18:17,378
HEALTH EQUITY RESEARCH FUNDING

444
00:18:17,378 --> 00:18:19,480
WITHIN NIH AND THAT THERE SHOULD

445
00:18:19,480 --> 00:18:21,182
BE MORE DISCUSSIONS AND OF

446
00:18:21,182 --> 00:18:23,017
COURSE MORE FUNDING TO SUPPORT

447
00:18:23,017 --> 00:18:24,719
THE WORK AND THINKING THROUGH

448
00:18:24,719 --> 00:18:30,024
HOW WE CAN ACTUALLY LEVERAGE THE

449
00:18:30,024 --> 00:18:32,093
EXISTING STRUCTURES TO SUPPORT

450
00:18:32,093 --> 00:18:34,829
NOT JUST THE RESEARCH BUT THE

451
00:18:34,829 --> 00:18:36,130
TRAINING, THE WORKFORCE, SOME

452
00:18:36,130 --> 00:18:38,099
STANDARDS, AS WELL AS BUILDING

453
00:18:38,099 --> 00:18:41,168
IN NEW AND DIFFERENT WAYS TO

454
00:18:41,168 --> 00:18:44,305
ACTUALLY EVALUATE THAT WORK.

455
00:18:44,305 --> 00:18:46,707
AND I THINK I'M PROBABLY OUT OF

456
00:18:46,707 --> 00:18:50,044
TIME SO I WILL STOP HERE AND

457
00:18:50,044 --> 00:18:55,916
PASS THE BATON.

458
00:18:55,916 --> 00:18:56,617
THANK YOU.

459
00:18:56,617 --> 00:18:58,452
>> WELL, I THINK I'M NEXT
AND I

460
00:18:58,452 --> 00:19:00,054
WILL BE COVERING HEALTHCARE

461
00:19:00,054 --> 00:19:08,029
SERVICE DELIVERY SO LET ME SHARE

462
00:19:08,029 --> 00:19:18,339
JUST FOR A SECOND.

463
00:19:24,545 --> 00:19:25,413
LET ME MAKE SURE.

464
00:19:25,413 --> 00:19:33,621
LET ME GO HERE.

465
00:19:33,621 --> 00:19:36,590
OKAY, I THINK CONSUELO DID A

466
00:19:36,590 --> 00:19:37,892
GREAT PIECE ON WHAT I WILL BE

467
00:19:37,892 --> 00:19:39,060
TALKING ABOUT AND THIS CHAPTER

468
00:19:39,060 --> 00:19:40,828
IS A VERY LONG CHAPTER SO I WILL

469
00:19:40,828 --> 00:19:44,031
TRY TO JUST COVER A FEW NOTES

470
00:19:44,031 --> 00:19:45,966
ABOUT THE CHAPTER BUT IT'S A

471
00:19:45,966 --> 00:19:48,602
VERY IMPORTANT CHAPTER AND I

472
00:19:48,602 --> 00:19:49,670
WANTED TO ALSO EMPHASIZE MORE

473
00:19:49,670 --> 00:19:53,307
THE ISSUES OF WHAT WE FOUND ARE

474
00:19:53,307 --> 00:19:55,943
PROMISING WAYS OF MITIGATING

475
00:19:55,943 --> 00:19:57,144
HEALTH INEQUITIES AND HEALTH

476
00:19:57,144 --> 00:19:57,445
DISPARITIES.

477
00:19:57,445 --> 00:19:59,547
I WANT TO JUST START BY TALKING

478
00:19:59,547 --> 00:20:02,616
ABOUT LIKE WHAT WERE THE MAJOR

479
00:20:02,616 --> 00:20:04,852
ISSUES THAT WE FOUND, THE

480
00:20:04,852 --> 00:20:08,656
OBSTACLES IN PROGRESS AND AS YOU

481
00:20:08,656 --> 00:20:12,059
CAN SEE HERE POLICIES THAT FALL

482
00:20:12,059 --> 00:20:14,528
SHORT OVER EMPHASIZE ON

483
00:20:14,528 --> 00:20:16,731
TREATMENT SICKNESS AND

484
00:20:16,731 --> 00:20:17,865
FRAGMENTED HEALTHCARE SYSTEM,

485
00:20:17,865 --> 00:20:19,166
FAILURE TO PURSUE PROMISING

486
00:20:19,166 --> 00:20:20,701
AVENUES OF RESEARCH, FAILURE TO

487
00:20:20,701 --> 00:20:22,570
INVEST THIS PROMISING SOLUTIONS

488
00:20:22,570 --> 00:20:23,404
AND   PERVASIVE RACISM IN

489
00:20:23,404 --> 00:20:25,673
HEALTHCARE AND YOU CAN SEE HERE

490
00:20:25,673 --> 00:20:28,776
MANY OF THE THINGS WE FOUND ARE

491
00:20:28,776 --> 00:20:32,146
REALLY TARGETING THE HEALTHCARE

492
00:20:32,146 --> 00:20:35,616
SYSTEM AS BEING VERY CENTRAL IN

493
00:20:35,616 --> 00:20:36,484
CHANGING WHAT'S HAPPENING.

494
00:20:36,484 --> 00:20:39,453
I ALSO WANTED TO SHOW YOU HERE

495
00:20:39,453 --> 00:20:41,389
WHERE WE FOUND, YOU KNOW WE DID

496
00:20:41,389 --> 00:20:44,358
A LOT OF REVIEWS LIKE CONSWALE O

497
00:20:44,358 --> 00:20:45,993
WAS SAYING AND WE FOUND THAT

498
00:20:45,993 --> 00:20:49,330
ACTUALLY THERE IS A LOT OF

499
00:20:49,330 --> 00:20:51,399
DISPARITIES AND INIQUITIES THAT

500
00:20:51,399 --> 00:20:54,535
ARE COMING FROM SPECIALLY

501
00:20:54,535 --> 00:20:56,270
OUTPATIENT CARE AND INPATIENT

502
00:20:56,270 --> 00:20:56,470
CARE.

503
00:20:56,470 --> 00:20:59,006
I JUST WANT TO SHOW YOU VERY --

504
00:20:59,006 --> 00:21:00,408
3 EXAMPLES SO YOU SEE.

505
00:21:00,408 --> 00:21:04,111
THIS IS THE NUMBER OF BLACK

506
00:21:04,111 --> 00:21:08,382
VERSUS WHITE PATIENTS VISITS AND

507
00:21:08,382 --> 00:21:09,483
IN ALL THE PHYSICIAN SPECIALTIES

508
00:21:09,483 --> 00:21:13,621
AND YOU CAN SEE HERE THIS IS A

509
00:21:13,621 --> 00:21:15,990
REALLY GOOD EXAMPLE THAT FOR

510
00:21:15,990 --> 00:21:18,993
ALMOST ALL OF THEM THERE'S A

511
00:21:18,993 --> 00:21:20,728
HIGHER VISIT RATES FOR WHITE

512
00:21:20,728 --> 00:21:21,462
PATIENTS COMPARED TO BLACK

513
00:21:21,462 --> 00:21:27,968
PATIENTS AS YOU CAN SEE THERE

514
00:21:27,968 --> 00:21:30,004
FOR RADIOLOGY, PLASTIC SURGERY,

515
00:21:30,004 --> 00:21:32,206
BLACK PATIENTS ONLY HAD HIGHER

516
00:21:32,206 --> 00:21:33,607
VISITS FOR NEPHROLOGY IN TERMS

517
00:21:33,607 --> 00:21:37,344
OF DIAGNOSIS AND TREATMENT AND

518
00:21:37,344 --> 00:21:38,712
THAT'S BECAUSE THEY RECEIVED

519
00:21:38,712 --> 00:21:41,015
CARE MUCH LATER AND HEMEATOLOGY.

520
00:21:41,015 --> 00:21:43,350
IF YOU GO BACK TO HISPANIC

521
00:21:43,350 --> 00:21:45,820
LATINO WHITE PATIENTS COMPARED

522
00:21:45,820 --> 00:21:47,922
TO 1 PATIENTS, YOU SEE EXACTLY

523
00:21:47,922 --> 00:21:50,691
THE SAME PATTERN, MANY MORE

524
00:21:50,691 --> 00:21:52,426
HIGHER VISITS RATES FOR WHITE

525
00:21:52,426 --> 00:21:54,595
PATIENTS COMPARED TO HISPANIC

526
00:21:54,595 --> 00:21:57,665
PATIENTS IN ALL TYPES OF

527
00:21:57,665 --> 00:21:59,700
PHYSICIANS SPECIALTIES AND YOU

528
00:21:59,700 --> 00:22:02,203
SEE THE SAME PATTERN AGAIN FOR

529
00:22:02,203 --> 00:22:04,271
ASIAN AND PACIFIC ISLANDERS.

530
00:22:04,271 --> 00:22:07,441
SO AGAIN, THIS WAS VERY

531
00:22:07,441 --> 00:22:08,375
CONVINCING OF THE PROBLEMS THAT

532
00:22:08,375 --> 00:22:12,680
WE'RE HAVING IN TERMS OF MOST

533
00:22:12,680 --> 00:22:12,980
SPECIALTIES.

534
00:22:12,980 --> 00:22:15,015
WE HAVE STILL HIGHER VISIT RATES

535
00:22:15,015 --> 00:22:20,087
FOR WHITE PATIENTS COMPARED TO

536
00:22:20,087 --> 00:22:21,088
OTHER MINORITIZED PATIENTS.

537
00:22:21,088 --> 00:22:22,289
I THINK BASED ON THAT, THERE

538
00:22:22,289 --> 00:22:24,124
WERE SEVERAL THINGS THAT WE

539
00:22:24,124 --> 00:22:26,961
FOUND THAT REALLY COULD BE

540
00:22:26,961 --> 00:22:29,463
CENTRAL IN ENDING UNEQUAL

541
00:22:29,463 --> 00:22:29,897
TREATMENT.

542
00:22:29,897 --> 00:22:33,133
ONE THAT WAS DISCUSSED ENDLESSLY

543
00:22:33,133 --> 00:22:35,436
WAS REFORMING PUBLIC HEALTH AND

544
00:22:35,436 --> 00:22:38,572
PRIVATE INSURANCE TO MAKE SURE

545
00:22:38,572 --> 00:22:41,308
THAT WE HAVE EQUITABLE ACCESS

546
00:22:41,308 --> 00:22:42,910
AND QUALITY OF CARE AND SOME OF

547
00:22:42,910 --> 00:22:46,080
THE THINGS THAT WERE MENTIONED

548
00:22:46,080 --> 00:22:47,214
AS ALTERNATIVES TO REALLY

549
00:22:47,214 --> 00:22:50,417
IMPROVE THIS AREA ARE

550
00:22:50,417 --> 00:22:51,118
ACCOUNTABLE CARE ORGANIZATIONS,

551
00:22:51,118 --> 00:22:53,954
THIS IS A HEALTH MODEL THAT USES

552
00:22:53,954 --> 00:22:55,823
SHARE SAVINGS TO INCENTIVIZE

553
00:22:55,823 --> 00:22:57,958
ACCOUNTABILITY FOR QUALITY AND

554
00:22:57,958 --> 00:22:58,425
COST.

555
00:22:58,425 --> 00:22:59,927
WE ALSO TALKED ABOUT HEALTH

556
00:22:59,927 --> 00:23:02,796
HOMES WHICH IS A PRIMARY BASED

557
00:23:02,796 --> 00:23:04,865
MODEL FOCUSING ON WHOLISTIC

558
00:23:04,865 --> 00:23:07,034
APPROACH TO PATIENT HEALTH AND

559
00:23:07,034 --> 00:23:07,868
PUBLIC HEALTH AND PREVENTION

560
00:23:07,868 --> 00:23:12,740
FUND, 1 OF THE AREAS THAT WAS

561
00:23:12,740 --> 00:23:16,210
DISCUSSED, YOU KNOW AD NAUSEUM

562
00:23:16,210 --> 00:23:17,678
AND HOW LITTLE PREVENTION THAT

563
00:23:17,678 --> 00:23:18,913
IS HOW IT CREATES POPULATIONS

564
00:23:18,913 --> 00:23:20,648
THAT ARE NOT TREATED UNTIL THE

565
00:23:20,648 --> 00:23:21,415
VERY, VERY END.

566
00:23:21,415 --> 00:23:25,286
I WANT TO SHOW YOU AN EXAMPLE OF

567
00:23:25,286 --> 00:23:27,154
DATA ON MEDICAID ACCOUNTABLE

568
00:23:27,154 --> 00:23:29,223
CARE ORGANIZATIONS, WHICH WAS 1

569
00:23:29,223 --> 00:23:32,593
OF THE AREAS WE ARE DISCUSSING

570
00:23:32,593 --> 00:23:34,662
AS AN AREA TO END UNEQUAL

571
00:23:34,662 --> 00:23:42,102
TREATMENT AND THIS IS STUDIES

572
00:23:42,102 --> 00:23:45,439
THAT WERE DONE WITH THE EQUAL

573
00:23:45,439 --> 00:23:47,608
SURVEYS SHOWING THAT USING

574
00:23:47,608 --> 00:23:50,878
ACOs, IN 7 STUDIES QUALITY

575
00:23:50,878 --> 00:23:51,812
IMPROVED, PREVENTIBLE

576
00:23:51,812 --> 00:23:52,880
UTILIZATION DECREASED IN 10.

577
00:23:52,880 --> 00:23:54,982
SAVINGS WERE FOUND IN 6,

578
00:23:54,982 --> 00:23:56,684
DISPARITIES IMPROVE IN 3 OUT OF

579
00:23:56,684 --> 00:24:04,758
THE 4 STUDIES THAT WERE ACTUALLY

580
00:24:04,758 --> 00:24:05,492
MEASURING INIQUITIES AND THIS

581
00:24:05,492 --> 00:24:07,461
LEADS US TO WHAT THE 4 AREAS OF

582
00:24:07,461 --> 00:24:09,964
THE ACTUAL REPORT TALKS ABOUT.

583
00:24:09,964 --> 00:24:14,768
WE TALKED ABOUT THE IMPORTANCE

584
00:24:14,768 --> 00:24:17,304
AS WE TALK BEFORE OF REALLY

585
00:24:17,304 --> 00:24:19,039
IMPROVING AND ACTUALLY MAKING

586
00:24:19,039 --> 00:24:21,108
SURE THAT HEALTHCARE LOSS AND

587
00:24:21,108 --> 00:24:23,043
PAYMENT POLICIES ARE REALLY

588
00:24:23,043 --> 00:24:27,081
REVIEWED TO MAKE SURE THAT --

589
00:24:27,081 --> 00:24:30,618
MAKE SURE THAT THIS LOSS AND

590
00:24:30,618 --> 00:24:31,652
POLICIES MITIGATED THE

591
00:24:31,652 --> 00:24:34,054
DISPARITIES THAT WE ARE FINDING.

592
00:24:34,054 --> 00:24:39,026
THIS INCLUDES ALSO HEALTHCARE

593
00:24:39,026 --> 00:24:41,028
DELIVERY, REALLY -- REDESIGNING

594
00:24:41,028 --> 00:24:43,364
HELT CARE DELIVERY TO MAKE SURE

595
00:24:43,364 --> 00:24:47,534
THAT WE CAN PROVIDE CARE THAT

596
00:24:47,534 --> 00:24:54,108
HAS BOTH CULTURALLY LANGUAGE AND

597
00:24:54,108 --> 00:24:54,808
REPRESENTATION FROM THE

598
00:24:54,808 --> 00:24:57,244
COMMUNITY TO DO THE BRIDGING

599
00:24:57,244 --> 00:25:00,180
THAT'S SO MUCH NEEDED.

600
00:25:00,180 --> 00:25:03,817
COMMUNITY CENTEREDNESS IS AN

601
00:25:03,817 --> 00:25:06,553
ENGAGEMENT AS CONKUELO IS AN

602
00:25:06,553 --> 00:25:07,621
AREA OF ENGAGEMENT BECAUSE WE

603
00:25:07,621 --> 00:25:09,223
TALKED ABOUT IN THE REPORT ABOUT

604
00:25:09,223 --> 00:25:11,792
HOW WE NEED TO MOVE MANY OF THE

605
00:25:11,792 --> 00:25:13,293
ASPECTS OF PREVENTION TO

606
00:25:13,293 --> 00:25:14,895
COMMUNITY CENTEREDNESS AND

607
00:25:14,895 --> 00:25:17,965
ENGAGEMENT AND AS CONSUELO

608
00:25:17,965 --> 00:25:18,966
REPEATED RECENTLY, A LOT OF THE

609
00:25:18,966 --> 00:25:20,734
WORK IN TERMS OF IMPLEMENTING

610
00:25:20,734 --> 00:25:24,038
THIS NEW MODELS OF CARE,

611
00:25:24,038 --> 00:25:27,408
REQUIRES TO HAVE MORE

612
00:25:27,408 --> 00:25:28,342
INFRASTRUCTURE AT BOTH THE

613
00:25:28,342 --> 00:25:29,810
SYSTEMS LEVEL AND AT THE

614
00:25:29,810 --> 00:25:30,944
COMMUNITY LEVEL BUT ALSO

615
00:25:30,944 --> 00:25:33,380
RESEARCH TO SEE WHAT WORKS UNDER

616
00:25:33,380 --> 00:25:35,949
WHICH CONDITIONS AND FOR WHOM.

617
00:25:35,949 --> 00:25:37,618
I WANT TO SAY THAT 1 OF THE

618
00:25:37,618 --> 00:25:39,687
THINGS WE DISCUSS IN THE REPORT

619
00:25:39,687 --> 00:25:43,424
IS THAT A LOT OF THE TYPICAL

620
00:25:43,424 --> 00:25:47,061
MODEL OF CARE OF PROVIDERS BEING

621
00:25:47,061 --> 00:25:49,229
IN A HIERARCHICAL POSITION NEEDS

622
00:25:49,229 --> 00:25:51,598
TO CHANGE TO MORE PERSON

623
00:25:51,598 --> 00:25:53,901
CENTERED CARE WHERE WE

624
00:25:53,901 --> 00:25:57,171
PRIORITIZE BOTH PROVIDER AND

625
00:25:57,171 --> 00:25:58,005
PATIENT SHARED DECISION MAKING

626
00:25:58,005 --> 00:26:01,909
TO MAKE THEM A TEAM WITH THE

627
00:26:01,909 --> 00:26:03,877
PATIENT HAVING THE KNOWLEDGE AND

628
00:26:03,877 --> 00:26:05,379
EXPERTISE WITH THEIR LIVED

629
00:26:05,379 --> 00:26:06,380
EXPERIENCE ALSO BEING PART OF

630
00:26:06,380 --> 00:26:11,285
HOW WE PLAN THE CARE SO

631
00:26:11,285 --> 00:26:12,686
PERSON-CENTERED CARE WAS

632
00:26:12,686 --> 00:26:14,054
DISCUSSED MAKING SURE THAT THE

633
00:26:14,054 --> 00:26:19,460
NEW MODELS OF CARE PRIORITIZE

634
00:26:19,460 --> 00:26:20,861
PERSON THINKING ABOUT THEIR

635
00:26:20,861 --> 00:26:22,529
ASSETS AND ABILITIES, FAMILY

636
00:26:22,529 --> 00:26:23,897
HISTORY AND CONTEXT TO MAKE SURE

637
00:26:23,897 --> 00:26:27,668
WE ARE RESONATING WITH WHAT THEY

638
00:26:27,668 --> 00:26:28,001
NEED.

639
00:26:28,001 --> 00:26:29,536
THE OTHER AREA DISCUSSED WAS HOW

640
00:26:29,536 --> 00:26:32,906
WE SHOULD BE MOVING TO TEAM

641
00:26:32,906 --> 00:26:38,846
BASED CARE BECAUSE REALLY THE

642
00:26:38,846 --> 00:26:41,348
EVIDENCE SHOWS THAT BOTH

643
00:26:41,348 --> 00:26:43,383
INPATIENT AND OUTPATIENT

644
00:26:43,383 --> 00:26:45,652
SETTINGS, IT INCREASES PATIENT

645
00:26:45,652 --> 00:26:47,387
SATISFACTION, IT REDUCES

646
00:26:47,387 --> 00:26:48,522
HOSPITAL READMISSIONS, EMERGENCY

647
00:26:48,522 --> 00:26:49,256
DEPARTMENT USE, CARE

648
00:26:49,256 --> 00:26:54,394
COORDINATION SO THIS IS AN AREA

649
00:26:54,394 --> 00:26:57,397
OF INTEREST IN DOING MORE WORK

650
00:26:57,397 --> 00:26:59,700
AND SEEING WHETHER THESE MODELS

651
00:26:59,700 --> 00:27:02,069
REDUCE COST AND IMPROVE

652
00:27:02,069 --> 00:27:04,138
COORDINATED CARE AND REALLY OUR

653
00:27:04,138 --> 00:27:08,342
MORE IN-LINE WITH WHAT PEOPLE

654
00:27:08,342 --> 00:27:09,810
ARE LOOKING INCLUDING MAKING

655
00:27:09,810 --> 00:27:11,712
SURE WE REACH THE HARDLY REACHED

656
00:27:11,712 --> 00:27:17,117
POPULATIONS AND WHEN WE TALKED

657
00:27:17,117 --> 00:27:18,252
ABOUT THIS INTERPROFESSIONAL

658
00:27:18,252 --> 00:27:19,319
PRIMARY CARE TEAPS WE WERE

659
00:27:19,319 --> 00:27:20,854
TALKING THAT WE SHOULD REALLY BE

660
00:27:20,854 --> 00:27:23,123
WORKING ACROSS THE SYSTEMS TO

661
00:27:23,123 --> 00:27:25,692
PROVIDE SOCIAL SUPPORT SERVICE,

662
00:27:25,692 --> 00:27:26,827
DENTISTS, PHARMACISTS, NURSE,

663
00:27:26,827 --> 00:27:29,029
THE PATIENT AND FAMILIES SHOULD

664
00:27:29,029 --> 00:27:30,297
BE CENTRAL BUT THAT THERE ARE

665
00:27:30,297 --> 00:27:32,800
MANY MORE PEOPLE THAT SHOULD BE

666
00:27:32,800 --> 00:27:35,335
PART OF MITIGATING THE

667
00:27:35,335 --> 00:27:36,103
DISPARITIES.

668
00:27:36,103 --> 00:27:38,472
AND THIS IS OUR THINGS THAT ARE

669
00:27:38,472 --> 00:27:38,705
NEEDED.

670
00:27:38,705 --> 00:27:42,342
WE'RE REALLY GOING TO PROVIDE

671
00:27:42,342 --> 00:27:43,410
SOCIOLOGICAL CULTURALLY TAILORED

672
00:27:43,410 --> 00:27:43,777
INTERVENTIONS.

673
00:27:43,777 --> 00:27:45,913
IF WE'RE REALLY GOING TO BE ABLE

674
00:27:45,913 --> 00:27:50,284
TO GIVE LINGUISTIC APPROPRIATE

675
00:27:50,284 --> 00:27:52,786
CARE WHICH REQUIRES FOR HAVING

676
00:27:52,786 --> 00:27:54,321
BILING Y'ALL CLINICIANS OR

677
00:27:54,321 --> 00:27:55,022
INTERPRETERS OR ACTUALLY HAVING

678
00:27:55,022 --> 00:27:57,324
PEOPLE THAT CAN DO THE WORK IN

679
00:27:57,324 --> 00:27:58,759
THE LANGUAGE, IN THE PRIMARY

680
00:27:58,759 --> 00:28:02,529
LANGUAGE OF THE PATIENT.

681
00:28:02,529 --> 00:28:03,964
ASK WE KNOW FROM PRETTY MUCH THE

682
00:28:03,964 --> 00:28:06,700
DATA THAT WE HAVE AND PRESENTED

683
00:28:06,700 --> 00:28:07,868
IN THE REPORT THAT IN THE STUDY

684
00:28:07,868 --> 00:28:10,871
THAT WAS DONE IN 2010 ONLY 13%

685
00:28:10,871 --> 00:28:15,008
OF THE HOSPITALS THAT WERE

686
00:28:15,008 --> 00:28:15,943
SURVEYED HAD CLASS STANDARDS

687
00:28:15,943 --> 00:28:17,644
THAT THEY WERE USING.

688
00:28:17,644 --> 00:28:21,415
ALSO I WANT TO SHOW YOU THE

689
00:28:21,415 --> 00:28:21,915
IMPORTANCE OF LANGUAGE.

690
00:28:21,915 --> 00:28:25,485
AND YOU CAN SEE HERE THAT FOR

691
00:28:25,485 --> 00:28:28,689
HISPANIC AND ASIAN POPULATIONS,

692
00:28:28,689 --> 00:28:30,824
PARTICULARLY NOT HAVING -- WE

693
00:28:30,824 --> 00:28:33,060
HAVE A VERY BIG PERCENTAGE,

694
00:28:33,060 --> 00:28:36,129
ALMOST A THIRD OF THE PATIENT

695
00:28:36,129 --> 00:28:38,899
POPULATION THAT DO NOT SPEAK

696
00:28:38,899 --> 00:28:40,000
ENGLISH AS THEIR PRIMARY

697
00:28:40,000 --> 00:28:41,501
LANGUAGE OR WHO SPEAK ENGLISH

698
00:28:41,501 --> 00:28:43,570
LESS THAN VERY WELL AND THIS IS

699
00:28:43,570 --> 00:28:44,605
GOING TO AFFECT THE QUALITY OF

700
00:28:44,605 --> 00:28:47,140
THE CARE THAT THEY RECEIVE.

701
00:28:47,140 --> 00:28:50,777
WHEN YOU ACTUALLY ADD TO THIS,

702
00:28:50,777 --> 00:28:52,479
WHAT TYPE OF INSURANCE THEY

703
00:28:52,479 --> 00:28:57,084
HAVE, YOU CAN SEE HERE THAT

704
00:28:57,084 --> 00:29:00,554
PARTICULARLY IN MEDICAID AND

705
00:29:00,554 --> 00:29:03,757
EVEN IN THE UNINSPURRED, THEY'RE

706
00:29:03,757 --> 00:29:07,294
VERY HIGH RATES, 29% IS LIMITED

707
00:29:07,294 --> 00:29:10,230
ENGLISH PROFICIENCY IN UNINSURED

708
00:29:10,230 --> 00:29:13,200
AND 28% IS IN MEDICAID AND OTHER

709
00:29:13,200 --> 00:29:15,269
PUBLIC PROGRAMS AND AS YOU CAN

710
00:29:15,269 --> 00:29:18,338
SEE HERE, THIS REALLY SHOWS HOW

711
00:29:18,338 --> 00:29:21,508
WE WOULD BE GIVING LOW QUALITY

712
00:29:21,508 --> 00:29:23,010
CARE TO THIS POPULATION.

713
00:29:23,010 --> 00:29:29,683
ONE OTHER THING THAT WAS

714
00:29:29,683 --> 00:29:32,319
MENTIONED IN THE REPORT IS

715
00:29:32,319 --> 00:29:33,153
MOVING AWAY FROM THE INDIVIDUAL

716
00:29:33,153 --> 00:29:35,255
TO SEE IF WE COULD DO MORE

717
00:29:35,255 --> 00:29:36,757
FAMILY CENTERED CARE MODELS THAT

718
00:29:36,757 --> 00:29:40,027
REALLY THINK ABOUT THE FAMILY IN

719
00:29:40,027 --> 00:29:42,095
A HOLISTIC WAY TO TRY TO COVER

720
00:29:42,095 --> 00:29:43,597
NOT ONLY 1 PERSON IN THE FAMILY

721
00:29:43,597 --> 00:29:48,435
BUT THE WHOLE FAMILY AS SUCH.

722
00:29:48,435 --> 00:29:52,906
COMMUNITY-BASED CARE WAS ALSO AN

723
00:29:52,906 --> 00:29:54,408
AREA AGAIN FOR PREVENTION AND

724
00:29:54,408 --> 00:29:57,377
FOR MAKING SURE THAT WE REACH

725
00:29:57,377 --> 00:29:59,012
PEOPLE EARLIER IN TERMS OF

726
00:29:59,012 --> 00:30:01,448
ASSESSMENT AND IN TERMS OF

727
00:30:01,448 --> 00:30:04,117
COORDINATING PEOPLE COMING IN

728
00:30:04,117 --> 00:30:05,986
AND OUT OF HEALTH SERVICES

729
00:30:05,986 --> 00:30:06,253
DELIVERY.

730
00:30:06,253 --> 00:30:08,088
WE NEED TO HAVE MORE COMMUNITY

731
00:30:08,088 --> 00:30:11,692
BASED CARE THAT PROMOTES

732
00:30:11,692 --> 00:30:13,093
PREVENTION, BUT ALSO THAT IS

733
00:30:13,093 --> 00:30:14,928
DEDICATED TO MAKING SURE THAT WE

734
00:30:14,928 --> 00:30:19,232
RESPOND TO THE NEEDS OF THE

735
00:30:19,232 --> 00:30:19,666
COMMUNITY.

736
00:30:19,666 --> 00:30:22,169
SO HERE IS WHERE COMMUNITY

737
00:30:22,169 --> 00:30:24,538
PARTNERSHIPS ARE VITAL, LIKE

738
00:30:24,538 --> 00:30:26,606
CONSUELO WAS SAYING IN TERMS OF

739
00:30:26,606 --> 00:30:27,908
HAVING COMMUNITY ENGAGED MODELS

740
00:30:27,908 --> 00:30:30,944
OF CARE WHERE WE HAVE THE

741
00:30:30,944 --> 00:30:31,979
COMMUNITY AS PARTICIPATING NOT

742
00:30:31,979 --> 00:30:34,581
ONLY IN TERMS OF TELLING US WHAT

743
00:30:34,581 --> 00:30:38,085
THEY NEED BUT ALSO SO IMPORTANT

744
00:30:38,085 --> 00:30:40,120
IN MAKING SURE THEY HAVE A SAY

745
00:30:40,120 --> 00:30:42,356
IN OW WE DESIGN THIS PARTICULAR

746
00:30:42,356 --> 00:30:43,890
MODELS OF CARE.

747
00:30:43,890 --> 00:30:45,058
SO ADDRESSING SOCIAL

748
00:30:45,058 --> 00:30:46,426
DETERMINANTS FOR EXAMPLE IN HOW

749
00:30:46,426 --> 00:30:49,396
TO MAKE SURE THAT WE REACH THE

750
00:30:49,396 --> 00:30:53,333
POPULATIONS EARLY ON IN THE

751
00:30:53,333 --> 00:30:55,869
HARDSHIP AND STRUGGLES THEY

752
00:30:55,869 --> 00:30:56,837
MIGHT BE CONFRONTING.

753
00:30:56,837 --> 00:30:58,405
SEVERAL OF THE FIELD STRATEGIES

754
00:30:58,405 --> 00:31:00,440
THAT WERE MENTIONED IN THE

755
00:31:00,440 --> 00:31:03,543
REPORT HAVE TO DO WITH

756
00:31:03,543 --> 00:31:04,344
ADDRESSING STIGMA, YOU KNOW

757
00:31:04,344 --> 00:31:07,647
MAKING SURE THAT WE HAVE

758
00:31:07,647 --> 00:31:09,016
ANTISTIGMA MESSAGES TO MAKE SURE

759
00:31:09,016 --> 00:31:12,519
THAT WE ARE NOT HAVING A DEFICIT

760
00:31:12,519 --> 00:31:15,822
MODEL TO ADDRESS MINORITIZED

761
00:31:15,822 --> 00:31:18,125
POPULATIONS THAT WE HAVE

762
00:31:18,125 --> 00:31:19,493
PROVISION OF NONTRADITIONAL

763
00:31:19,493 --> 00:31:21,962
SERVICE LIKE HOME VISITS THAT

764
00:31:21,962 --> 00:31:24,398
ARE NOW BECOMING MORE PART OF

765
00:31:24,398 --> 00:31:27,601
HEALTHCARE THAT WE HAVE A BILING

766
00:31:27,601 --> 00:31:29,870
Y'ALL BI-CULTURAL STAFF THAT WE

767
00:31:29,870 --> 00:31:31,038
INCREASE DIVERSITY AMONG

768
00:31:31,038 --> 00:31:32,873
PROVIDERS TO MAKE SURE THAT WE

769
00:31:32,873 --> 00:31:35,909
HAVE THE TRUST AND CONFIDENCE OF

770
00:31:35,909 --> 00:31:38,111
PEOPLE FROM THE COMMUNITY, THE

771
00:31:38,111 --> 00:31:39,646
FAMILY INVOLVEMENT THAT I TALKED

772
00:31:39,646 --> 00:31:42,182
ABOUT, BUT ALSO INCORPORATION OF

773
00:31:42,182 --> 00:31:44,384
RELIGIOUS AND SPIRITUAL

774
00:31:44,384 --> 00:31:45,385
PRACTICES AND COMMUNITY NETWORKS

775
00:31:45,385 --> 00:31:47,788
TO MAKE SURE THAT WE REACH

776
00:31:47,788 --> 00:31:50,490
PEOPLE EARLIER AND THINKING OF

777
00:31:50,490 --> 00:31:55,529
CULTURE AND CONTEXT AS CENTRAL.

778
00:31:55,529 --> 00:31:57,831
I CANNOT EVEN EMPHASIZE SO MUCH

779
00:31:57,831 --> 00:31:59,232
OF THE DISCUSSION OF THE

780
00:31:59,232 --> 00:32:01,168
IMPORTANCE OF MAKING SURE THAT

781
00:32:01,168 --> 00:32:03,336
WE DIVERSIFY THE HEALTHCARE WORK

782
00:32:03,336 --> 00:32:06,339
FOR US AND HOW CAN WE REDUCE

783
00:32:06,339 --> 00:32:08,742
BIAS, AND THIS IS AN AREA THAT

784
00:32:08,742 --> 00:32:10,777
ACTUALLY WAS VERY IMPORTANT AND

785
00:32:10,777 --> 00:32:13,980
DEBATED BECAUSE MANY OF THE

786
00:32:13,980 --> 00:32:15,048
INTERVENTIONS OF REDUCING BIAS

787
00:32:15,048 --> 00:32:17,484
MIGHT NOT BE DOING THAT WORK SO

788
00:32:17,484 --> 00:32:21,755
WE NEED EVIDENT BASED

789
00:32:21,755 --> 00:32:23,457
INTERVENTIONS THAT ARE MORE THAN

790
00:32:23,457 --> 00:32:27,027
1 OR 2 HOURS OF ANTIBIAS BUT

791
00:32:27,027 --> 00:32:30,030
ACTUALLY LONG-TERM INTERVENTIONS

792
00:32:30,030 --> 00:32:31,098
THAT ARE MORE INCISIVE ABOUT

793
00:32:31,098 --> 00:32:32,666
WHAT PEOPLE ARE DOING AND HOW TO

794
00:32:32,666 --> 00:32:35,268
CHANGE WHAT THEY'RE DOING.

795
00:32:35,268 --> 00:32:36,002
REDUCING PRACTICE BARRIERS TO

796
00:32:36,002 --> 00:32:38,738
MAKE SURE PEOPLE COME IN.

797
00:32:38,738 --> 00:32:41,241
USING COMMUNITY HEALTH WORKERS

798
00:32:41,241 --> 00:32:44,411
AND PEERS, TO MAKE SURE THAT WE

799
00:32:44,411 --> 00:32:46,847
CONNECT EARLIER AND WITH AN

800
00:32:46,847 --> 00:32:48,815
EXPANDED WORKFORCE AND CLINICAL

801
00:32:48,815 --> 00:32:51,118
ALGORITHMS AND THEIR

802
00:32:51,118 --> 00:32:52,052
IMPLICATIONS FOR RACIAL

803
00:32:52,052 --> 00:32:52,352
INIQUITIES.

804
00:32:52,352 --> 00:32:55,455
THERE'S GOING TO BE A LOT OF --

805
00:32:55,455 --> 00:32:56,623
WITH AI CLINICAL ALGORITHMS AND

806
00:32:56,623 --> 00:32:59,059
THIS WAS AN AREA THAT WE

807
00:32:59,059 --> 00:32:59,893
DISCUSSED.

808
00:32:59,893 --> 00:33:01,928
I WANT TO EMPHASIZE 1 OF THE

809
00:33:01,928 --> 00:33:04,331
THINGS WE ALSO DISCUSSED IN THE

810
00:33:04,331 --> 00:33:09,069
REPORT AND THIS IS WHERE WE HAVE

811
00:33:09,069 --> 00:33:11,371
A PREDICTED SHORTAGE BETWEEN

812
00:33:11,371 --> 00:33:14,508
20,000 TO 40,000 PRIMARY CARE

813
00:33:14,508 --> 00:33:16,276
PHYSICIANS BY 2036 AND YOU CAN

814
00:33:16,276 --> 00:33:19,946
SEE HERE THAT THIS IS GOING TO

815
00:33:19,946 --> 00:33:21,314
BE PARTICULARLY, ALTHOUGH IT'S

816
00:33:21,314 --> 00:33:25,986
ACROSS THE BOARD FOR BLACK

817
00:33:25,986 --> 00:33:28,088
POPULATIONS BEING SERVED AND FOR

818
00:33:28,088 --> 00:33:28,889
HISPANIC POPULATIONS BEING

819
00:33:28,889 --> 00:33:32,192
SERVED BECAUSE WE HAVE VERY FEW

820
00:33:32,192 --> 00:33:33,126
FULL-TIME EQUIVALENT PHYSICIANS

821
00:33:33,126 --> 00:33:34,194
THAT ARE PRIMARY CARE PHYSICIANS

822
00:33:34,194 --> 00:33:39,599
AND THOSE ARE THE VERY DARK BLUE

823
00:33:39,599 --> 00:33:45,272
AND PRIMARY CARE.

824
00:33:45,272 --> 00:33:47,407
SIXTY-FIVE FOR EVERY -- FOR

825
00:33:47,407 --> 00:33:48,375
EVERY HUNDRED THOUSAND PEOPLE.

826
00:33:48,375 --> 00:33:51,678
SO YOU CAN SEE VERY, VERY HUGE

827
00:33:51,678 --> 00:33:53,947
AND DRAMATIC SHORTAGES OF

828
00:33:53,947 --> 00:33:58,652
PRIMARY CARE PHYSICIANS AND 61

829
00:33:58,652 --> 00:34:00,387
FOR EVERY HUNDRED THOUSAND

830
00:34:00,387 --> 00:34:05,292
PRIMARY CARE PHYSICIANS FOR THE

831
00:34:05,292 --> 00:34:05,625
POPULATION.

832
00:34:05,625 --> 00:34:07,460
I WANT TO ALSO SHOW YOU THAT

833
00:34:07,460 --> 00:34:08,528
EVEN THE WORKFORCE THAT'S COMING

834
00:34:08,528 --> 00:34:11,665
IN, ARE THIS IS THE CATEGORY 6

835
00:34:11,665 --> 00:34:12,499
OF THE TEMWORKFORCE AND YOU CAN

836
00:34:12,499 --> 00:34:16,169
SEE HERE THAT WE ARE NOT REALLY

837
00:34:16,169 --> 00:34:19,172
MAKING BIG IMPACTS IN TERMS OF

838
00:34:19,172 --> 00:34:22,976
EXPANDING THE DIVERSITY OF THE

839
00:34:22,976 --> 00:34:23,243
WORKFORCE.

840
00:34:23,243 --> 00:34:24,377
SO GOING BACK THIS AND SEEING

841
00:34:24,377 --> 00:34:27,247
HOW WE CAN DO MORE PATHWAY

842
00:34:27,247 --> 00:34:31,651
PROGRAMS, HOW WE CAN PARTNER

843
00:34:31,651 --> 00:34:34,521
WITH HISPANICS SERVING AND BLACK

844
00:34:34,521 --> 00:34:35,989
SERVING INSTITUTIONS TO MAKE

845
00:34:35,989 --> 00:34:39,960
SURE THAT WE PROVIDE MORE ENTRY

846
00:34:39,960 --> 00:34:43,964
TO THIS POPULATIONS IN THIS

847
00:34:43,964 --> 00:34:44,197
ROLE.

848
00:34:44,197 --> 00:34:46,733
SO AT THE END, I WANTED TO JUST

849
00:34:46,733 --> 00:34:50,403
SAY THAT WE HAVE TO IMPROVE THE

850
00:34:50,403 --> 00:34:51,271
RATE OF FACULTY DIVERSITY

851
00:34:51,271 --> 00:34:52,706
BECAUSE WE NEED ALSO TO MAKE

852
00:34:52,706 --> 00:34:55,475
SURE THAT WE HAVE ROLE MODELS,

853
00:34:55,475 --> 00:35:00,347
AND HAVE PEOPLE THAT ARE REALLY

854
00:35:00,347 --> 00:35:02,415
DEVOTED TO ACCESSING AND

855
00:35:02,415 --> 00:35:06,686
SPONSORSHIP AND MENTORING THIS

856
00:35:06,686 --> 00:35:08,488
POPULATION AND MAKING SURE THAT

857
00:35:08,488 --> 00:35:10,590
WE INCREASE THE DIVERSITY IN THE

858
00:35:10,590 --> 00:35:10,890
WORKFORCE.

859
00:35:10,890 --> 00:35:14,794
AS YOU CAN SEE HERE, HALF OF

860
00:35:14,794 --> 00:35:16,730
U.S. PHYSICIANS ARE 55 YEARS OR

861
00:35:16,730 --> 00:35:19,065
OLDER SO THIS IS GOING TO BE A

862
00:35:19,065 --> 00:35:22,235
PROBLEM IN THE VERY, VERY NEAR

863
00:35:22,235 --> 00:35:22,469
FUTURE.

864
00:35:22,469 --> 00:35:25,805
I'M GOING TO END BY SAYING THAT

865
00:35:25,805 --> 00:35:27,974
TO OVERCOME INIQUITIES AND END

866
00:35:27,974 --> 00:35:30,143
UNEQUAL TREATMENT WE ALSO HAVE

867
00:35:30,143 --> 00:35:31,211
TO IMPROVE PATIENT PROVIDER

868
00:35:31,211 --> 00:35:32,212
COMMUNICATION.

869
00:35:32,212 --> 00:35:35,949
THIS WAS AN AREA THAT IS

870
00:35:35,949 --> 00:35:39,419
DISCUSSED IN LOTS OF WAY AND

871
00:35:39,419 --> 00:35:41,288
THIS IS WHERE INTERVENTIONS THAT

872
00:35:41,288 --> 00:35:44,791
CAN IMPROVE PATIENT PROVIDER

873
00:35:44,791 --> 00:35:46,726
COMMUNICATION, TO PROMOTE A

874
00:35:46,726 --> 00:35:48,128
WORKFORCE THAT IS REPRESENTATIVE

875
00:35:48,128 --> 00:35:49,963
AND TO EXPAND THE WORKFORCE ARE

876
00:35:49,963 --> 00:35:51,564
ALL THINGS WE CAN DO.

877
00:35:51,564 --> 00:35:57,404
I WANT TO THANK NIMHD, AND NIH

878
00:35:57,404 --> 00:35:59,706
FOR DOING REALLY PROMOTING THAT

879
00:35:59,706 --> 00:36:00,940
WE DO THIS REPORT.

880
00:36:00,940 --> 00:36:03,209
IT'S GOING TO BE VERY, VERY

881
00:36:03,209 --> 00:36:04,944
IMPORTANT AS A ROADMAP OF WHAT

882
00:36:04,944 --> 00:36:07,447
CAN BE DONE IN THE NEXT 20 YEARS

883
00:36:07,447 --> 00:36:10,183
AND I ALSO THINK IT'S VERY

884
00:36:10,183 --> 00:36:11,251
IMPORTANT TO DISSEMINATE THIS

885
00:36:11,251 --> 00:36:21,795
REPORT SO I THANK YOU.

886
00:36:21,795 --> 00:36:22,162
>> THANKS.

887
00:36:22,162 --> 00:36:23,797
I THINK I AM UP NEXT AND I WILL

888
00:36:23,797 --> 00:36:34,207
PULL UP THE SLIDES HERE.

889
00:36:39,946 --> 00:36:41,081
OKAY, SO CIRCLING BACK AGAIN, I

890
00:36:41,081 --> 00:36:42,482
WANT TO EMPHASIZE THIS WAS A

891
00:36:42,482 --> 00:36:45,985
VERY BROAD STATEMENT OF TASK

892
00:36:45,985 --> 00:36:47,954
THAT WAS PUT BEFORE THE EXITEE

893
00:36:47,954 --> 00:36:50,857
WITH RESEARCH ABSOLUTELY

894
00:36:50,857 --> 00:36:53,860
FEATURED IN IT AS A CENTRAL

895
00:36:53,860 --> 00:36:54,961
COMPONENT AND THE HEALTHCARE

896
00:36:54,961 --> 00:36:56,796
SYSTEM AS A CENTRAL COMPONENT

897
00:36:56,796 --> 00:36:58,698
BUT ALSO RECOGNIZING AND THE

898
00:36:58,698 --> 00:37:01,835
COMMITTEE RECOGNIZED THAT THE

899
00:37:01,835 --> 00:37:02,602
HEALTHCARE SYSTEM EXITS WITHIN

900
00:37:02,602 --> 00:37:05,105
THE LARGER SOCIETY AND THAT

901
00:37:05,105 --> 00:37:07,640
RESEARCH IS EVERYWHERE IN ALL

902
00:37:07,640 --> 00:37:09,709
THAT WE DO BUT THAT RESEARCH

903
00:37:09,709 --> 00:37:11,211
ALONE OR THE HEALTHCARE SYSTEM

904
00:37:11,211 --> 00:37:13,179
ALONE ARE NOT GOING TO GET US TO

905
00:37:13,179 --> 00:37:16,883
HEALTH EQUITY AND SO WE REALLY

906
00:37:16,883 --> 00:37:19,552
DID GO VERY BROAD WITH OUR

907
00:37:19,552 --> 00:37:21,755
RECOMMENDATIONS AND

908
00:37:21,755 --> 00:37:22,422
IMPLEMENTATION ACTIONS.

909
00:37:22,422 --> 00:37:24,591
AGAIN, THERE'S MANY OF THEM SO

910
00:37:24,591 --> 00:37:26,226
WILL NOT PRESENT ALL OF THEM BUT

911
00:37:26,226 --> 00:37:28,962
ALSO WANTED TO NOTE THAT WE

912
00:37:28,962 --> 00:37:31,698
ORGANIZED THEM IN A LOGICAL

913
00:37:31,698 --> 00:37:32,832
SEQUENCE RECOGNIZING THAT

914
00:37:32,832 --> 00:37:34,467
TRANSFORMATIVE CHANGE IS NOT

915
00:37:34,467 --> 00:37:36,336
LINEAR BUT THAT WE WANTED TO

916
00:37:36,336 --> 00:37:38,405
PROVIDE A NARRATIVE ON HOW WE

917
00:37:38,405 --> 00:37:42,776
FELT LIKE THE GOALS COULD BE

918
00:37:42,776 --> 00:37:45,812
ACHIEVED TOGETHER AND AGAIN,

919
00:37:45,812 --> 00:37:47,647
RESEARCH FEATURING VERY

920
00:37:47,647 --> 00:37:48,148
PROMINENTLY HERE.

921
00:37:48,148 --> 00:37:49,749
SO FIRST AND CONTINUOUSLY

922
00:37:49,749 --> 00:37:51,785
ACCURATE AND TIMELY DATA ARE

923
00:37:51,785 --> 00:37:54,454
NEEDED TO DESCRIBE THE HEALTH

924
00:37:54,454 --> 00:37:55,955
AND HEALTHCARE INIQUITIES TO

925
00:37:55,955 --> 00:37:57,590
INFORM THE DEVELOPMENT AND

926
00:37:57,590 --> 00:38:00,160
IMPLEMENTATION OF EFFECTIVE AND

927
00:38:00,160 --> 00:38:01,127
SUSTAINABLE INTERVENTIONS.

928
00:38:01,127 --> 00:38:03,496
NEXT HEALTHCARE SYSTEMS NEED TO

929
00:38:03,496 --> 00:38:05,799
BE EQUIPPED WITH INFORMATION AND

930
00:38:05,799 --> 00:38:07,801
THE CAPABILITIES TO MAKE

931
00:38:07,801 --> 00:38:10,303
SUSTAINABLE CHANGE AND

932
00:38:10,303 --> 00:38:11,671
ITERATIVELY MEASURE PROGRESS IN

933
00:38:11,671 --> 00:38:13,807
PARTNERSHIP WITH THE RESEARCH

934
00:38:13,807 --> 00:38:15,875
ENTERPRISE THAT CONTINUES TO

935
00:38:15,875 --> 00:38:18,178
DISCOVER AND RIGOROUSLY EVALUATE

936
00:38:18,178 --> 00:38:19,446
PROMISING NEW INTERVENTIONS THAT

937
00:38:19,446 --> 00:38:22,248
CAN BE WIDELY IMPLEMENTED.

938
00:38:22,248 --> 00:38:23,450
THIS ONGOING PROGRESS NEEDS TO

939
00:38:23,450 --> 00:38:28,087
BE SUPPORTED BY SYSTEMS OF

940
00:38:28,087 --> 00:38:28,788
ACCOUNTABILITY, AND ENFORCEMENT,

941
00:38:28,788 --> 00:38:31,124
FINALLY DELIVERY AND FINANCING

942
00:38:31,124 --> 00:38:32,625
MECHANISMS NEED AS THEIR CENTRAL

943
00:38:32,625 --> 00:38:34,894
GOALS TO INSURE ACCESS TO

944
00:38:34,894 --> 00:38:36,729
EQUITABLE HEALTHCARE AND TO

945
00:38:36,729 --> 00:38:39,666
ACHIEVE OPTIMAL HEALTH FOR ALL.

946
00:38:39,666 --> 00:38:42,869
AND WANT TO AGAIN REMIND US OF

947
00:38:42,869 --> 00:38:46,406
THAT GOAL #3 THAT DR. WILKINs

948
00:38:46,406 --> 00:38:49,108
ALSO FOCUSED ON WHERE THE

949
00:38:49,108 --> 00:38:50,043
COMMITTEE IS RECOMMENDING

950
00:38:50,043 --> 00:38:50,977
INVESTMENT IN RESEARCH AND

951
00:38:50,977 --> 00:38:52,846
EVIDENT GENERATION TO BETTER

952
00:38:52,846 --> 00:38:55,348
IDENTIFY AND WIDELY IMPLEMENT

953
00:38:55,348 --> 00:38:56,916
INTERVENTIONS THAT ELIMINATE

954
00:38:56,916 --> 00:38:59,586
HEALTHCARE INIQUITIES AND AGAIN

955
00:38:59,586 --> 00:39:02,589
THE DETAILS OF OUR GOAL 3.1 AND

956
00:39:02,589 --> 00:39:04,023
3.2 HERE BUT ALSO RECOGNIZING

957
00:39:04,023 --> 00:39:06,726
THAT THIS AGAIN NEEDS TO BE DONE

958
00:39:06,726 --> 00:39:10,797
IN CONCERT WITH THE DATA AND THE

959
00:39:10,797 --> 00:39:12,332
HEALTHCARE SYSTEM AND CONTINUED

960
00:39:12,332 --> 00:39:14,400
FOCUS ON DIVERSIFYING THE

961
00:39:14,400 --> 00:39:16,569
WORKFORCE, BUILDING OUT THE

962
00:39:16,569 --> 00:39:17,303
INFRASTRUCTURE THAT'S NEEDED TO

963
00:39:17,303 --> 00:39:19,772
CONDITION THE RESEARCH AND ALSO

964
00:39:19,772 --> 00:39:20,773
RECOGNIZING THE INCREDIBLE

965
00:39:20,773 --> 00:39:23,076
IMPORTANCE OF RESEARCH WITH THE

966
00:39:23,076 --> 00:39:25,778
ACCOUNTABILITY FUNCTION AS WELL.

967
00:39:25,778 --> 00:39:27,213
SO RESEARCH GENERATING NEW

968
00:39:27,213 --> 00:39:28,815
KNOWLEDGE THAT ABSOLUTELY NEEDS

969
00:39:28,815 --> 00:39:29,983
TO BE WIDELY IMPLEMENTED BUT

970
00:39:29,983 --> 00:39:32,619
ALSO THEN CIRCLING BACK AROUND

971
00:39:32,619 --> 00:39:35,221
TO INSURING THAT WE ARE

972
00:39:35,221 --> 00:39:36,289
MEASURING WHAT IS HAPPENING AND

973
00:39:36,289 --> 00:39:41,127
THAT WE'RE HOLING SYSTEMS

974
00:39:41,127 --> 00:39:41,895
ACCOUNTABLE.

975
00:39:41,895 --> 00:39:42,595
THERE WERE SEVERAL PRIORITY

976
00:39:42,595 --> 00:39:44,030
AREAS FOR RESEARCH THAT I JUST

977
00:39:44,030 --> 00:39:46,432
ALSO WANTED TO HIGHLIGHT HERE

978
00:39:46,432 --> 00:39:48,034
THAT I BELIEVE MANY OF THESE

979
00:39:48,034 --> 00:39:51,237
COME OUT OF THE RESEARCH CHAPTER

980
00:39:51,237 --> 00:39:54,874
THAT DR. WILKINS AND OTHERS LED

981
00:39:54,874 --> 00:39:56,276
LINKING MACROLEVEL POLICIES WITH

982
00:39:56,276 --> 00:39:58,845
THE LIVED PRESENCES OF RACIALLY

983
00:39:58,845 --> 00:39:59,779
AND ETHNICALLY MINORITIZED

984
00:39:59,779 --> 00:40:01,047
POPULATIONS TO FULLY UNDERSTAND

985
00:40:01,047 --> 00:40:05,351
THE VARIOUS PATHWAYS THAT LEAD

986
00:40:05,351 --> 00:40:06,386
TO INEQUITABLE OUTCOMES,

987
00:40:06,386 --> 00:40:07,320
INTEGRATING AND SUSTAINING

988
00:40:07,320 --> 00:40:09,289
INTERVENTIONS TO ADDRESS HEALTH

989
00:40:09,289 --> 00:40:11,591
RELATED SOCIAL NEEDS INTO THE

990
00:40:11,591 --> 00:40:12,392
HEALTHCARE DELIVERY SYSTEM.

991
00:40:12,392 --> 00:40:14,060
DEVELOPING AND TESTING NEW CARE

992
00:40:14,060 --> 00:40:15,361
MODELS DESIGNED TO IMPROVE

993
00:40:15,361 --> 00:40:20,533
EQUITY AND HEALTHCARE ACCESS AND

994
00:40:20,533 --> 00:40:21,901
OUTCOMES.

995
00:40:21,901 --> 00:40:25,204
FURTHER AREAS CONDUCTING THE

996
00:40:25,204 --> 00:40:25,705
IMPLEMENTATION, RESEARCH

997
00:40:25,705 --> 00:40:26,839
INCLUDING HEALTH POLICY RESEARCH

998
00:40:26,839 --> 00:40:30,543
TO ADOPT AND SCALE UP EFFECTIVE

999
00:40:30,543 --> 00:40:31,544
NEW MODELS.

1000
00:40:31,544 --> 00:40:34,614
CONTINUING TO ADVANCE INDIGENOUS

1001
00:40:34,614 --> 00:40:36,316
GOVERNANCE AND

1002
00:40:36,316 --> 00:40:37,250
SELF-DETERMINATION USING

1003
00:40:37,250 --> 00:40:38,751
INDIGENOUS AND CLONEICAL

1004
00:40:38,751 --> 00:40:41,487
METHODOLOGIES AND INDIGENOUS

1005
00:40:41,487 --> 00:40:44,757
ETHICS AND TRANSITIONING FROM

1006
00:40:44,757 --> 00:40:45,725
INTERVENTIONS FROM CERTAINLY

1007
00:40:45,725 --> 00:40:48,294
OBSERVATIONAL STUDIES AS WELL AS

1008
00:40:48,294 --> 00:40:49,395
INTERVENTIONS TO CHANGE

1009
00:40:49,395 --> 00:40:51,631
BEHAVIORS TO EFFORTS TARGETING

1010
00:40:51,631 --> 00:40:54,867
OTHER LEVELS OF CHANGE INCLUDING

1011
00:40:54,867 --> 00:40:57,236
THE MULTILEVEL RESEARCH SUCH AS

1012
00:40:57,236 --> 00:40:58,404
INTERVENTIONS AT THE COMMUNITY

1013
00:40:58,404 --> 00:41:01,074
AND SOCIETAL LEVEL AS WELL AS AT

1014
00:41:01,074 --> 00:41:07,680
THE INDIVIDUAL OR HEALTHCARE

1015
00:41:07,680 --> 00:41:09,515
SYSTEM LEVEL.

1016
00:41:09,515 --> 00:41:10,683
IDENTIFYING AND DELINEATING BEST

1017
00:41:10,683 --> 00:41:12,986
PRACTICES FOR CROSS

1018
00:41:12,986 --> 00:41:13,820
ORGANIZATIONAL PARTNERSHIPS,

1019
00:41:13,820 --> 00:41:15,188
DEVELOPING SUSTAINABLE MODELS

1020
00:41:15,188 --> 00:41:16,723
AND APPROACHES THAT BUILD

1021
00:41:16,723 --> 00:41:18,992
COMMUNITY EMPOWERMENT AND

1022
00:41:18,992 --> 00:41:19,325
CAPACITY.

1023
00:41:19,325 --> 00:41:21,160
EXPANDING BASIC SOCIAL SCIENCE

1024
00:41:21,160 --> 00:41:22,462
RESEARCH WHICH FOCUSES ON

1025
00:41:22,462 --> 00:41:23,396
UNDERSTANDING HUMAN BEHAVIOR TO

1026
00:41:23,396 --> 00:41:25,832
SUPPORT THE DEVELOPMENT OF

1027
00:41:25,832 --> 00:41:26,733
EVIDENT BASED INTERVENTIONS.

1028
00:41:26,733 --> 00:41:28,101
AND 1 OTHER SLIDE HERE

1029
00:41:28,101 --> 00:41:31,537
HIGHLIGHTING A FEW OTHER AREAS,

1030
00:41:31,537 --> 00:41:35,642
1 IDENTIFYING APPROPRIATE

1031
00:41:35,642 --> 00:41:39,512
COMPARATORS AND STUDYING

1032
00:41:39,512 --> 00:41:42,548
RACIALLY AND ETHNIC MINORITY

1033
00:41:42,548 --> 00:41:45,385
GROUPS AND UNDERSTANDING VITALS

1034
00:41:45,385 --> 00:41:46,486
TO REDUCE INIQUITIES.

1035
00:41:46,486 --> 00:41:47,587
AND WE SPENT A LOT OF TIME

1036
00:41:47,587 --> 00:41:48,788
TALKING ABOUT THE FACT THAT

1037
00:41:48,788 --> 00:41:50,823
EFFORTS TO ACHIEVE OPTIMAL

1038
00:41:50,823 --> 00:41:52,358
HEALTHCARE FOR ALL AND

1039
00:41:52,358 --> 00:41:54,193
ELIMINATING RACIAL AND ETHNIC

1040
00:41:54,193 --> 00:41:56,129
INIQUITIES IN HEALTHCARE IS NOT

1041
00:41:56,129 --> 00:41:58,197
A ANSWER SUM GAME.

1042
00:41:58,197 --> 00:41:59,465
ADDRESSING THE FACTORS THAT

1043
00:41:59,465 --> 00:42:02,468
CONTRIBUTE TO HEALTH AND

1044
00:42:02,468 --> 00:42:05,171
HEALTHCARE INIQUITIES BENEFITS

1045
00:42:05,171 --> 00:42:05,438
EVERYONE.

1046
00:42:05,438 --> 00:42:07,373
WITH CONCERTED NATIONAL EFFORT

1047
00:42:07,373 --> 00:42:08,941
AND ADEQUATE RESOURCES, THE

1048
00:42:08,941 --> 00:42:10,777
HEALTHCARE SYSTEM CAN BE

1049
00:42:10,777 --> 00:42:12,178
TRANSFORMED TO DELIVER HIGH

1050
00:42:12,178 --> 00:42:13,880
QUALITY EQUITABLE CARE TO ALL.

1051
00:42:13,880 --> 00:42:15,848
AND MANY OF THE TOOLS NEEDED TO

1052
00:42:15,848 --> 00:42:17,483
REACH THESE GOALS ARE ALREADY

1053
00:42:17,483 --> 00:42:21,888
AVAILABLE AND NEED TO BE FULLY

1054
00:42:21,888 --> 00:42:22,755
USED.

1055
00:42:22,755 --> 00:42:25,158
AGAIN, HUGE THANKS TO THIS

1056
00:42:25,158 --> 00:42:26,359
WONDERFUL COMMITTEE WHO

1057
00:42:26,359 --> 00:42:27,827
VOLUNTEERED HUNDREDS OF IF NOT

1058
00:42:27,827 --> 00:42:31,564
THOUSANDS OF HOURS OF THEIR TIME

1059
00:42:31,564 --> 00:42:35,668
TO DO THE RESEARCH NEEDED AND

1060
00:42:35,668 --> 00:42:36,669
GENERATE THE FABULOUS REPORT

1061
00:42:36,669 --> 00:42:38,271
THAT AGAIN IS NEARLY 400 PAGES

1062
00:42:38,271 --> 00:42:41,641
AND WE HAD A PHENOMENAL STAFF AT

1063
00:42:41,641 --> 00:42:43,142
THE NATIONAL ACADEMIES LISTED

1064
00:42:43,142 --> 00:42:43,576
HERE AS WELL.

1065
00:42:43,576 --> 00:42:45,478
SO THANK YOU AND AGAIN AS A

1066
00:42:45,478 --> 00:42:46,879
REMINDER ALL OF THESE

1067
00:42:46,879 --> 00:42:49,115
INDIVIDUALS SERVED AS VOLUNTEERS

1068
00:42:49,115 --> 00:42:50,650
AMIDST THEIR INCREDIBLY BUSY

1069
00:42:50,650 --> 00:42:51,317
LIVE ANDS SCHEDULES.

1070
00:42:51,317 --> 00:42:56,055
SO THANK YOU AGAIN TO LEARN

1071
00:42:56,055 --> 00:42:57,323
MORE, THE COMMITTEE REPORT IS

1072
00:42:57,323 --> 00:42:59,992
ONLINE AND YOU CAN DOWNLOAD

1073
00:42:59,992 --> 00:43:01,461
INDIVIDUAL CHAPTERS OR THE

1074
00:43:01,461 --> 00:43:03,329
ENTIRE REPORT FOR FREE AT THE

1075
00:43:03,329 --> 00:43:04,330
NATIONAL ACADEMIES.

1076
00:43:04,330 --> 00:43:06,232
AND I SEE DR. PEREZ-STABLE IS

1077
00:43:06,232 --> 00:43:09,535
HERE AND I WILL TURN IT OVER TO

1078
00:43:09,535 --> 00:43:09,736
YOU.

1079
00:43:09,736 --> 00:43:13,740
>> ALL RIGHT, THANK YOU. 

1080
00:43:13,740 --> 00:43:15,475
THAT WAS FANTASTIC AND REALLY

1081
00:43:15,475 --> 00:43:16,476
APPRECIATE IT.

1082
00:43:16,476 --> 00:43:18,578
DID DARREL END UP JOINING US OR

1083
00:43:18,578 --> 00:43:20,913
NOT.

1084
00:43:20,913 --> 00:43:21,214
>> NO.

1085
00:43:21,214 --> 00:43:22,648
>> OKAY, WELL, WE WERE
GOING TO

1086
00:43:22,648 --> 00:43:24,183
ASK HIM TO PRESENT BUT I WANTED

1087
00:43:24,183 --> 00:43:25,718
TO SEE IF HE WANTED TO

1088
00:43:25,718 --> 00:43:26,986
PARTICIPATE IN THE CONVERSATION,

1089
00:43:26,986 --> 00:43:28,621
SO WE HAVE A FEW MINUTES BEFORE

1090
00:43:28,621 --> 00:43:32,825
WE HEAR FROM THE DIRECTORS FOR

1091
00:43:32,825 --> 00:43:35,328
QUESTIONS, FIRST ASKING MY

1092
00:43:35,328 --> 00:43:36,763
COLLEAGUES WHETHER THEY HAVE ANY

1093
00:43:36,763 --> 00:43:37,964
QUESTIONS OR WHETHER THERE WERE

1094
00:43:37,964 --> 00:43:43,536
ANY QUESTIONS COMING FROM THE

1095
00:43:43,536 --> 00:43:43,803
AUDIENCE.

1096
00:43:43,803 --> 00:43:45,204
I GUESS THERE MIGHT BE NO

1097
00:43:45,204 --> 00:43:45,471
QUESTIONS.

1098
00:43:45,471 --> 00:43:53,146
OKAY, SO I WAS ACTUALLY

1099
00:43:53,146 --> 00:43:54,013
IMPRESSED WITH THE CO INCIDENCE

1100
00:43:54,013 --> 00:43:57,049
OF SOME OF THE ISSUES THAT WE'VE

1101
00:43:57,049 --> 00:43:59,786
BEEN TALKING ABOUT AT LEAST AT

1102
00:43:59,786 --> 00:44:03,790
NIMHD AND ALSO BROADER AT NIH,

1103
00:44:03,790 --> 00:44:05,691
WHAT YOU PRESENTED MARGARITA,

1104
00:44:05,691 --> 00:44:08,661
PARTICULARLY AROUND THE ISSUE OF

1105
00:44:08,661 --> 00:44:09,962
PATIENT CENTERED CARE, TEEN

1106
00:44:09,962 --> 00:44:12,665
BASED CARE, THE EMPHASIS ON

1107
00:44:12,665 --> 00:44:15,768
PRIMARY CARE AND ALTHOUGH THE --

1108
00:44:15,768 --> 00:44:18,905
YOU EMPHASIZE THE VISITS THAT

1109
00:44:18,905 --> 00:44:19,939
WERE DISPROPORTIONATELY

1110
00:44:19,939 --> 00:44:21,140
DIFFERENT BY RACE AND/OR

1111
00:44:21,140 --> 00:44:22,809
ETHNICITY, THERE WAS IN FACT

1112
00:44:22,809 --> 00:44:25,244
SOME SPECIALTIES THAT WERE

1113
00:44:25,244 --> 00:44:27,280
ACTUALLY PRETTY BALANCED AND 1

1114
00:44:27,280 --> 00:44:29,682
OF THEM WAS GERIATRICS, INTERNAL

1115
00:44:29,682 --> 00:44:30,283
MEDICINE, FAMILY MEDICINE, SO

1116
00:44:30,283 --> 00:44:31,984
THERE ARE SOME AREAS WHERE I

1117
00:44:31,984 --> 00:44:35,955
THINK WE'RE DOING THE WORK BUT

1118
00:44:35,955 --> 00:44:38,357
THE LACK OF PRIMARY CARE

1119
00:44:38,357 --> 00:44:40,159
PHYSICIANS, I THINK -- OR THE

1120
00:44:40,159 --> 00:44:41,294
PROJECTED DEFICIT, I THINK IS

1121
00:44:41,294 --> 00:44:44,530
SOMETHING TO BE VERY CONCERNED

1122
00:44:44,530 --> 00:44:48,534
ABOUT IN THE FUTURE.

1123
00:44:48,534 --> 00:44:53,339
I ALSO, YOU KNOW EMPHASIS OF THE

1124
00:44:53,339 --> 00:44:55,374
IDEA OF ACCOUNTABILITY, THOUGH,

1125
00:44:55,374 --> 00:44:57,476
SO WHAT DID DECREASING

1126
00:44:57,476 --> 00:44:59,445
INIQUITIES OR DECREASING THE

1127
00:44:59,445 --> 00:45:04,016
DISPARITIES GOING TO DO FOR THE

1128
00:45:04,016 --> 00:45:06,219
SOCIETY AND WE DID A WORK WITH

1129
00:45:06,219 --> 00:45:08,321
ACTUALLY 2 OF THE MEMBERS OF THE

1130
00:45:08,321 --> 00:45:15,595
COMMITTEE, DARREL AND TOM, TOM

1131
00:45:15,595 --> 00:45:18,097
LAVITSA SHOWING THAT 450 BILLION

1132
00:45:18,097 --> 00:45:20,099
DOLLARS WERE DUE TO RACE AND

1133
00:45:20,099 --> 00:45:22,468
ETHNIC DISPARITIES AND IF YOU

1134
00:45:22,468 --> 00:45:26,138
LOOK AT EDUCATIONAL LEVEL

1135
00:45:26,138 --> 00:45:27,273
DISPARITIES INCLUDING THE ENTIRE

1136
00:45:27,273 --> 00:45:29,809
POPULATION, IT WAS ALMOST A

1137
00:45:29,809 --> 00:45:30,576
TRILLION DOLLARS.

1138
00:45:30,576 --> 00:45:33,312
SO IF WE THINK WE COULD MAYBE

1139
00:45:33,312 --> 00:45:36,215
SHAVE THAT BY 10%, NOT A VERY

1140
00:45:36,215 --> 00:45:39,685
AMBITIOUS GOAL, I THINK, 10%,

1141
00:45:39,685 --> 00:45:43,923
THAT WOULD BE THE NIH BUDGET

1142
00:45:43,923 --> 00:45:45,324
TIMES 1 OR 2 DEPENDING ON WHICH

1143
00:45:45,324 --> 00:45:49,395
WAY YOU ANGLE IT AND CLEARLY IT

1144
00:45:49,395 --> 00:45:52,465
IS IMPROVING THE HEALTH OF ALL.

1145
00:45:52,465 --> 00:45:57,970
THE OTHER THING ON THE DIVERSITY

1146
00:45:57,970 --> 00:46:00,373
OF THE WORKFORCE IS WE DIDN'T

1147
00:46:00,373 --> 00:46:01,841
ACKNOWLEDGE THERE ARE SOME LEGAL

1148
00:46:01,841 --> 00:46:03,342
BARRIERS THAT HAVE BEEN

1149
00:46:03,342 --> 00:46:11,617
SOPHISTICATED  -- SOLIDIFYS IN

1150
00:46:11,617 --> 00:46:14,086
THE LAST DECADE OR SO AND THE

1151
00:46:14,086 --> 00:46:16,188
STRATEGIES NEED TO BE MODIFIED

1152
00:46:16,188 --> 00:46:17,790
BURR OUR GOALS HAVE TO REMAIN

1153
00:46:17,790 --> 00:46:19,358
STRONG BECAUSE AS I WAS REMINDED

1154
00:46:19,358 --> 00:46:22,295
BY TALKING TO A COLLEAGUE A

1155
00:46:22,295 --> 00:46:24,697
COUPLE DAYS AGO, SOMETHING LIKE

1156
00:46:24,697 --> 00:46:28,701
OVER 50% OF CHILDREN IN THE U.S.

1157
00:46:28,701 --> 00:46:31,704
TODAY ARE FROM MINORITIZED

1158
00:46:31,704 --> 00:46:34,206
POPULATIONS AND THE

1159
00:46:34,206 --> 00:46:35,007
UNDERREPRESENTED POPULATIONS

1160
00:46:35,007 --> 00:46:36,642
ACCOUNT FOR A SIGNIFICANT AMOUNT

1161
00:46:36,642 --> 00:46:38,210
OF THAT.

1162
00:46:38,210 --> 00:46:40,613
SO IT'S ACTUALLY ABOUT NOT SO

1163
00:46:40,613 --> 00:46:42,315
MUCH ONLY ABOUT DIVERSITY, BUT

1164
00:46:42,315 --> 00:46:43,849
IT'S ABOUT DEVELOPMENT OF FUTURE

1165
00:46:43,849 --> 00:46:45,952
HUMAN CAPITAL FOR THE COUNTRY.

1166
00:46:45,952 --> 00:46:48,321
SO IT'S REALLY THAT THE

1167
00:46:48,321 --> 00:46:50,122
COUNTRY'S FUTURE THAT

1168
00:46:50,122 --> 00:46:52,758
TAKEN--THEY MAKES THIS A

1169
00:46:52,758 --> 00:46:55,561
STRATEGIC APPROACH, IN THIS

1170
00:46:55,561 --> 00:46:56,362
CONTEXT, BUT INDEPENDENT OF

1171
00:46:56,362 --> 00:47:00,433
EVERYTHING ELSE THAT WE CAN OR

1172
00:47:00,433 --> 00:47:00,800
CANNOT DO.

1173
00:47:00,800 --> 00:47:05,304
OKAY, SO, ANY COMMENTS OR

1174
00:47:05,304 --> 00:47:15,848
QUESTIONS FROM RICHARD OR JEANNE

1175
00:47:17,650 --> 00:47:19,251
OR RICHARD?

1176
00:47:19,251 --> 00:47:23,556
YOU GUYS CAN TURN YOUR CAMERAS

1177
00:47:23,556 --> 00:47:25,257
ON, JEANNE AND RICHARD AND THEN

1178
00:47:25,257 --> 00:47:27,493
YOU WILL JUMP ON INTO YOUR

1179
00:47:27,493 --> 00:47:28,127
CONVERSATIONS AND PRESENTATION.

1180
00:47:28,127 --> 00:47:29,495
>> I JUST WANT TO RESPOND

1181
00:47:29,495 --> 00:47:32,098
QUICKLY TO 1 OF THE POINTS YOU

1182
00:47:32,098 --> 00:47:38,571
MADE ABOUT THE WORKFORCE I DO

1183
00:47:38,571 --> 00:47:40,006
THINK IT'S WORTH HIGHLIGHTING

1184
00:47:40,006 --> 00:47:41,741
AND WE REVIEWED SOME OF THE DATA

1185
00:47:41,741 --> 00:47:42,908
AROUND THE KINDS OF RESEARCH

1186
00:47:42,908 --> 00:47:45,411
THAT GOT FUNDED AND I KNOW YOU

1187
00:47:45,411 --> 00:47:49,715
KNOW THIS, BUT YOU KNOW

1188
00:47:49,715 --> 00:47:51,250
SCIENTISTS WHO WERE PROPOSING TO

1189
00:47:51,250 --> 00:47:52,852
DO RESEARCH FOCUSED ON MINORITY

1190
00:47:52,852 --> 00:47:55,054
HEALTH AND/OR HEGHT DISPARITIES

1191
00:47:55,054 --> 00:48:00,026
AND HEALTH INEXPECTATIONS QUITY

1192
00:48:00,026 --> 00:48:01,994
-- INIQUITIES WERE LESS LIKELY

1193
00:48:01,994 --> 00:48:03,162
TO GET FUNDED OVER THE COURSE OF

1194
00:48:03,162 --> 00:48:04,897
THE TIME THAT WE LOOKED AT THE

1195
00:48:04,897 --> 00:48:08,300
DATA SO AS WE THINK ABOUT YOU

1196
00:48:08,300 --> 00:48:12,038
KNOW THE SCIENTIFIC WORKFORCE

1197
00:48:12,038 --> 00:48:14,340
AND THE SETTING OF RECENT SORT

1198
00:48:14,340 --> 00:48:17,443
OF RULINGS ABOUT HOW WE CAN LOOK

1199
00:48:17,443 --> 00:48:18,944
AT DEMOGRAPHICS, I DO THINK WE

1200
00:48:18,944 --> 00:48:21,247
HAVE TO FOCUS ON IT, AND THE

1201
00:48:21,247 --> 00:48:22,782
COMMITTEE TALKED ABOUT THIS AS

1202
00:48:22,782 --> 00:48:24,717
WELL, YOU KNOW WHAT ARE THE

1203
00:48:24,717 --> 00:48:27,787
ACTUAL MEASURES OR METRICS OF

1204
00:48:27,787 --> 00:48:34,360
EXCELLENCE THAT WE'RE PUTTING

1205
00:48:34,360 --> 00:48:36,429
FORWARD AS WE KNOW SOME SCIENCE

1206
00:48:36,429 --> 00:48:38,230
RELATED TO HEALTH DISPARITIES IS

1207
00:48:38,230 --> 00:48:40,232
LESS LIKELY TO BE PUBLISHED IN

1208
00:48:40,232 --> 00:48:41,300
THE HIGHER IMPACT JOURNALS AND

1209
00:48:41,300 --> 00:48:44,170
SO WE NEED NEW AND DIFFERENT

1210
00:48:44,170 --> 00:48:46,806
WAYS OF EVALUATING RESEARCH AND

1211
00:48:46,806 --> 00:48:48,074
RESEARCHERS THAT REALLY

1212
00:48:48,074 --> 00:48:50,142
ACKNOWLEDGE THE STRENGTHS THAT

1213
00:48:50,142 --> 00:48:53,813
PEOPLE ARE BRINGING TO THE TABLE

1214
00:48:53,813 --> 00:48:57,750
AND NOT JUST AGE INDICES.

1215
00:48:57,750 --> 00:49:01,320
>> I ALSO WANTED TO
COMMENT ELIS

1216
00:49:01,320 --> 00:49:02,955
EO ON I'M GLAD THAT SOME OF THE

1217
00:49:02,955 --> 00:49:04,824
THINGS WE FOUND IN THE REPORT

1218
00:49:04,824 --> 00:49:07,793
ARE THE 1S YOU'RE THINK BEING AT

1219
00:49:07,793 --> 00:49:11,363
NIMHD, BUT I WANT TO ECHICIZE

1220
00:49:11,363 --> 00:49:12,098
GOING TO CONSUELO'S POINT ABOUT

1221
00:49:12,098 --> 00:49:13,933
THE IMPORTANCE OF MAKING SURE

1222
00:49:13,933 --> 00:49:16,535
THAT WE BUILD FOR THE FUTURE,

1223
00:49:16,535 --> 00:49:24,443
THAT IT'S NOT ONLY A SHORT-TERM

1224
00:49:24,443 --> 00:49:25,845
YOU KNOW ROADMAP WE'RE TRYING TO

1225
00:49:25,845 --> 00:49:28,614
DO HERE BUT IT'S A LONG-TERM

1226
00:49:28,614 --> 00:49:30,883
ROADMAP PARTICULARLY BECAUSE THE

1227
00:49:30,883 --> 00:49:32,051
DEMOGRAPHICS OF OUR CHANGE.

1228
00:49:32,051 --> 00:49:33,886
WANTED OR NOT WANTED IT'S COMING

1229
00:49:33,886 --> 00:49:35,621
ASK SO WE NEED TO MAKE SURE WE

1230
00:49:35,621 --> 00:49:37,389
CAN SERVE THAT POPULATIONS AND I

1231
00:49:37,389 --> 00:49:40,326
WANTED TO MENTION THE COMMUNITY

1232
00:49:40,326 --> 00:49:45,898
ENGAGE AND COMMUNITY BASED

1233
00:49:45,898 --> 00:49:47,299
RESEARCH BECAUSE I THINK THE

1234
00:49:47,299 --> 00:49:48,667
OTHER ASPECT WE FOWBD THAT'S SO

1235
00:49:48,667 --> 00:49:50,002
IMPORTANT AND WE LOOK AT THE

1236
00:49:50,002 --> 00:49:51,871
REPORT BECAUSE OF THE TIME

1237
00:49:51,871 --> 00:49:55,207
DIMENSION WE COULDN'T EXPLAIN

1238
00:49:55,207 --> 00:49:57,076
ENOUGH BUT COMMUNITY IS CENTRAL

1239
00:49:57,076 --> 00:49:59,745
EVEN IN OUR MODEL, AND EVEN IN

1240
00:49:59,745 --> 00:50:01,847
HOW WE'RE THINKING PROSPECTIVELY

1241
00:50:01,847 --> 00:50:03,315
HOW TO BUILD NEW MODELS OF CARE

1242
00:50:03,315 --> 00:50:06,085
THAT MOVE OUT OF THE HEALTHCARE

1243
00:50:06,085 --> 00:50:09,188
SYSTEM AND MORE TO THE COMMUNITY

1244
00:50:09,188 --> 00:50:12,358
AND I THINK -- I THINK EVERYONE

1245
00:50:12,358 --> 00:50:13,626
WAS REALLY PASSIONATE ABOUT

1246
00:50:13,626 --> 00:50:15,561
MAKING SURE THAT WE MAKE THAT

1247
00:50:15,561 --> 00:50:19,064
RICH AND MAKE THAT BRIDGE EARLY

1248
00:50:19,064 --> 00:50:20,232
ON TO REALLY RESPOND TO THE

1249
00:50:20,232 --> 00:50:24,703
NEEDS OF THE POPULATION.

1250
00:50:24,703 --> 00:50:26,805
NTHANK YOU FOR BOTH OF THOSE

1251
00:50:26,805 --> 00:50:27,072
COMMENTS.

1252
00:50:27,072 --> 00:50:31,577
I THINK THEY'RE HIGHLY RELEVANT 

1253
00:50:31,577 --> 00:50:32,878
I WILL JUST EMPHASIZE THAT I

1254
00:50:32,878 --> 00:50:34,580
REALLY DON'T WANT US TO THINK OF

1255
00:50:34,580 --> 00:50:36,982
COMMUNITY HERE AND HEALTHCARE

1256
00:50:36,982 --> 00:50:38,784
OVER HERE AND THEN WITHIN

1257
00:50:38,784 --> 00:50:39,685
HEALTHCARE, THERE'S A

1258
00:50:39,685 --> 00:50:43,522
SPECIALIST, HOSPITAL, YOU KNOW

1259
00:50:43,522 --> 00:50:47,326
THE HIGH-TECH PROCEDURES BECAUSE

1260
00:50:47,326 --> 00:50:50,262
50% OF AMERICANS OVER 50, 55, 60

1261
00:50:50,262 --> 00:50:52,464
HAVE MORE THAN 1 CHRONIC DISEASE

1262
00:50:52,464 --> 00:50:55,301
AND WHEN YOU HAVE A CHRONIC

1263
00:50:55,301 --> 00:50:57,136
DISEASE YOU REALLY DEPEND ON THE

1264
00:50:57,136 --> 00:51:00,206
HEALTHCARE SYSTEM FOR SOMETHING

1265
00:51:00,206 --> 00:51:02,575
AT LEAST. 

1266
00:51:02,575 --> 00:51:04,543
YOU NEED MORE THAN THE

1267
00:51:04,543 --> 00:51:06,178
ACCESSIBLE COMMUNITY AND I THINK

1268
00:51:06,178 --> 00:51:06,779
THAT'S THE CHALLENGE.

1269
00:51:06,779 --> 00:51:08,147
WE'VE DONE SO MUCH OVER HERE IN

1270
00:51:08,147 --> 00:51:11,884
THE HELT CARE AND ESPECIALLY IN

1271
00:51:11,884 --> 00:51:15,888
THE HOSPITAL SIDE, AND THE

1272
00:51:15,888 --> 00:51:16,889
HIGH-TECH SIDE OF THE HOSPITAL

1273
00:51:16,889 --> 00:51:19,024
WHICH IS GREAT BUT WE'VE NOT

1274
00:51:19,024 --> 00:51:20,726
BUILT CONTINUED THE QUALITY ON

1275
00:51:20,726 --> 00:51:22,261
THE WHOLE SPECTRUM AND SO I

1276
00:51:22,261 --> 00:51:23,929
THINK THAT'S -- THOSE ARE THE

1277
00:51:23,929 --> 00:51:24,396
CHALLENGES.

1278
00:51:24,396 --> 00:51:26,198
I WOULD SAY THAT OVERTHE COURSE

1279
00:51:26,198 --> 00:51:29,235
OF THE LAST DECADE WHILE I'VE

1280
00:51:29,235 --> 00:51:31,770
BEEN HERE, THE COMMITMENT TO

1281
00:51:31,770 --> 00:51:35,507
COMMUNITY ENGAGEMENT HAS REALLY

1282
00:51:35,507 --> 00:51:40,646
BLOSSOMED AT NIH WELL BEYOND THE

1283
00:51:40,646 --> 00:51:44,383
BOUNDARIES OF NI MHD, WE ALSO

1284
00:51:44,383 --> 00:51:46,819
HAVE COMPASS, SEAL, BOTH NINDS

1285
00:51:46,819 --> 00:51:48,687
AND NIA HAVE A PROGRAMS THAT

1286
00:51:48,687 --> 00:51:49,788
HAVE LAUNCHED THAT HAVE FOCUSED

1287
00:51:49,788 --> 00:51:52,524
ON THIS AND I THINK NIAID HAS A

1288
00:51:52,524 --> 00:51:55,394
HISTORY OF THIS WITH HIV, AND

1289
00:51:55,394 --> 00:51:59,898
SO, I DO THINK THAT THINGS ARE

1290
00:51:59,898 --> 00:52:00,232
MOVING.

1291
00:52:00,232 --> 00:52:02,434
THEY KIND OF MOVE SLOWLY

1292
00:52:02,434 --> 00:52:04,703
SOMETIMES BUT THEY'RE MOVING AND

1293
00:52:04,703 --> 00:52:07,006
WE ARE, I THINK IN A PHASE WHERE

1294
00:52:07,006 --> 00:52:08,574
WE CAN EMPHASIZE THAT.

1295
00:52:08,574 --> 00:52:11,210
I WAS ALSO CURIOUS ABOUT YOUR

1296
00:52:11,210 --> 00:52:14,313
TABLE OF MONEY THAT WAS ALL

1297
00:52:14,313 --> 00:52:19,251
DERIVED FROM THE RCDC PUBLIC

1298
00:52:19,251 --> 00:52:20,986
FACING INFORMATION?

1299
00:52:20,986 --> 00:52:21,587
>> YES.

1300
00:52:21,587 --> 00:52:22,588
>> YEAH, OKAY.

1301
00:52:22,588 --> 00:52:23,722
>> ALL PUBLIC FACING.

1302
00:52:23,722 --> 00:52:26,592
>> YOU KNOW WE MODIFIED
THE

1303
00:52:26,592 --> 00:52:29,028
ALGORITHM, IT USED TO BE ALL

1304
00:52:29,028 --> 00:52:31,230
MANUELLY CODED AND NOW WE HAVE

1305
00:52:31,230 --> 00:52:35,334
AN AUTOMATED WAY OF DOING THIS.

1306
00:52:35,334 --> 00:52:36,535
I BELIEVE THE LAST YEAR OF DATA

1307
00:52:36,535 --> 00:52:37,803
THAT ARE GOING TO BE ON THERE

1308
00:52:37,803 --> 00:52:39,872
THAT ARE NOT INCLUDED IN THE

1309
00:52:39,872 --> 00:52:41,807
REPORT ARE FROM THAT.

1310
00:52:41,807 --> 00:52:44,443
THEY WERE SIMILAR IN TERMS OF

1311
00:52:44,443 --> 00:52:45,277
TOTAL DOLLARS.

1312
00:52:45,277 --> 00:52:47,546
THERE ARE DIFFERENCES IN THE

1313
00:52:47,546 --> 00:52:49,515
CATEGORIES, SO WE CAPTURED MORE

1314
00:52:49,515 --> 00:52:53,352
AND DROPPED OUT THINGS THAT WERE

1315
00:52:53,352 --> 00:52:55,754
NOT REALLY CONSIDERED RELEVANT

1316
00:52:55,754 --> 00:52:57,790
IN HELT DISPARITIES AND IT'S IN

1317
00:52:57,790 --> 00:52:59,491
THAT 5 BILLION DOLLARS RANGE

1318
00:52:59,491 --> 00:53:03,395
GIVE OR TAKE A COUPLE HUNDRED

1319
00:53:03,395 --> 00:53:04,163
MILLION, RIGHT?

1320
00:53:04,163 --> 00:53:05,898
SO YOU CALCULATE IT'S ABOUT 10%

1321
00:53:05,898 --> 00:53:09,735
OF THE NIH BUDGET RIGHT NOW.

1322
00:53:09,735 --> 00:53:12,304
SO IT ISN'T -- IT HASN'T -- I

1323
00:53:12,304 --> 00:53:13,839
DON'T KNOW IF IT'S HARD TO SAY

1324
00:53:13,839 --> 00:53:15,607
IF IT'S INCREASING OR DECREASING

1325
00:53:15,607 --> 00:53:17,209
BECAUSE THE METHODOLOGIES IS

1326
00:53:17,209 --> 00:53:19,278
MODIFIED BUT IT'S NOT

1327
00:53:19,278 --> 00:53:20,679
DRAMATICALLY CHANGED FROM WHAT

1328
00:53:20,679 --> 00:53:22,247
HAD BEEN MEASURED BEFORE.

1329
00:53:22,247 --> 00:53:30,255
SO LET ME THEN TURN TO THE PANEL

1330
00:53:30,255 --> 00:53:31,757
OF NIH LEADERS.

1331
00:53:31,757 --> 00:53:33,258
I DON'T KNOW IF YOU HAVE AN

1332
00:53:33,258 --> 00:53:38,163
ORDER I HAVE DR. RICHARD BENSON

1333
00:53:38,163 --> 00:53:39,932
FROM THE NATIONAL INSTITUTE OF

1334
00:53:39,932 --> 00:53:41,300
NEUROLOGICAL DISEASES AND

1335
00:53:41,300 --> 00:53:42,901
STROKE, DR. RICHARD HODES, WHO

1336
00:53:42,901 --> 00:53:44,203
WILL PRESENT FROM THE NATIONAL

1337
00:53:44,203 --> 00:53:51,143
INSTITUTE ON AGING AND

1338
00:53:51,143 --> 00:53:57,716
DR. JEANNE MARRASWR, ZO WITH

1339
00:53:57,716 --> 00:54:04,289
NIAID. 

1340
00:54:04,289 --> 00:54:05,557
SO, RICHARD?

1341
00:54:05,557 --> 00:54:06,091
>> OKAY, THANK YOU.

1342
00:54:06,091 --> 00:54:09,528
CAN YOU SEE MY SLIDES IN

1343
00:54:09,528 --> 00:54:13,632
PRESENTATION MOAT MODE. -- MODE.

1344
00:54:13,632 --> 00:54:16,535
>> IT IS NOT IN -- NOW IT
IS,

1345
00:54:16,535 --> 00:54:16,902
YES.

1346
00:54:16,902 --> 00:54:17,669
>> OKAY, THANK YOU.

1347
00:54:17,669 --> 00:54:18,137
THANK YOU.

1348
00:54:18,137 --> 00:54:20,939
I WOULD LIKE TO SAY THANK YOU

1349
00:54:20,939 --> 00:54:22,274
DR. PEREZ-STABLE FOR ORGANIZING

1350
00:54:22,274 --> 00:54:23,175
THIS DIRECTOR'S SEMINAR TODAY, I

1351
00:54:23,175 --> 00:54:25,844
THINK THIS IS VERY IMPORTANT

1352
00:54:25,844 --> 00:54:27,646
EMPLOY ALSO DR. DINWIDDIE FOR

1353
00:54:27,646 --> 00:54:28,247
ORGANIZING THE NIH GROUP THAT

1354
00:54:28,247 --> 00:54:32,785
SORT OF HELPED TO PULL TOGETHER

1355
00:54:32,785 --> 00:54:34,052
THIS NASEM COMMITTEE AND ALSO

1356
00:54:34,052 --> 00:54:35,654
THANK YOU ALL ON THE COMMITTEE

1357
00:54:35,654 --> 00:54:38,624
FOR ALL THE HARD WORK YOU PUT

1358
00:54:38,624 --> 00:54:39,658
INTO DEVELOPING THESE

1359
00:54:39,658 --> 00:54:40,159
RECOMMENDATIONS TODAY.

1360
00:54:40,159 --> 00:54:42,761
I THINK THIS IS EXCELLENT.

1361
00:54:42,761 --> 00:54:47,366
IT WAS MENTIONED EARLIER THE

1362
00:54:47,366 --> 00:54:49,501
FACT THAT PROGRESS WAS NOT

1363
00:54:49,501 --> 00:54:50,135
ALWAYS LINEAR.

1364
00:54:50,135 --> 00:54:51,236
WE FORGET THAT SOMETIMES.

1365
00:54:51,236 --> 00:54:52,905
WE LIKE FOR IT TO BE BUT IT'S

1366
00:54:52,905 --> 00:54:55,874
NOT AND SO THAT'S SOMETHING THAT

1367
00:54:55,874 --> 00:54:57,476
WE THINK ABOUT SO I'M REALLY

1368
00:54:57,476 --> 00:54:58,544
HAPPY TO SORT OF HIGHLIGHT SOME

1369
00:54:58,544 --> 00:55:01,880
OF THE WORK WE'RE DOING AT THE

1370
00:55:01,880 --> 00:55:05,284
NINDS, THE DIAGRAM THAT

1371
00:55:05,284 --> 00:55:08,420
DR. PEREZ-STABLE REFERENCED, I

1372
00:55:08,420 --> 00:55:09,822
WAS ALSO JARRED A LITTLE BIT

1373
00:55:09,822 --> 00:55:11,557
LOOKING AT THAT AND I CAN SAY

1374
00:55:11,557 --> 00:55:13,459
THAT OUR LEADER SHOULD UPON AT

1375
00:55:13,459 --> 00:55:16,195
THE NINDS, WE ARE INTERESTED IN

1376
00:55:16,195 --> 00:55:18,897
SORT OF MOVING FORWARD.

1377
00:55:18,897 --> 00:55:20,632
OUR NUMBERS WERE NOT THE BEST AT

1378
00:55:20,632 --> 00:55:21,867
THAT TIME BUT HOPEFULLY THROUGH

1379
00:55:21,867 --> 00:55:23,001
SOME OF THE WORK WE'RE DOING

1380
00:55:23,001 --> 00:55:26,271
RIGHT NOW, WE CAN INCREASE SOME

1381
00:55:26,271 --> 00:55:27,339
OF THE ACTIVITIES THAT WE'RE

1382
00:55:27,339 --> 00:55:29,541
DOING IN THE HEALTH EQUITY

1383
00:55:29,541 --> 00:55:29,875
SPACE.

1384
00:55:29,875 --> 00:55:33,212
I WILL START BY MENTIONING THAT

1385
00:55:33,212 --> 00:55:35,247
THE NINDS, OR THE NATIONAL

1386
00:55:35,247 --> 00:55:36,482
INSTITUTE OF NEUROLOGICAL

1387
00:55:36,482 --> 00:55:37,583
DISORDERS AND STROKE, OUR

1388
00:55:37,583 --> 00:55:39,218
MISSION IS TO REDUCE THE BURDEN

1389
00:55:39,218 --> 00:55:40,619
OF NEUROLOGICAL DISEASE FOR ALL

1390
00:55:40,619 --> 00:55:44,823
AND THAT INCLUDES ALL GROUPS OF

1391
00:55:44,823 --> 00:55:46,091
SOCIETY DOMESTICALLY AND

1392
00:55:46,091 --> 00:55:46,358
GLOBALLY.

1393
00:55:46,358 --> 00:55:48,694
HOWEVER, DESPITE OUR MISSION FOR

1394
00:55:48,694 --> 00:55:49,761
THE LAST ALMOST 75 YEARS, WE

1395
00:55:49,761 --> 00:55:52,431
STILL KNOW THAT THERE'S A

1396
00:55:52,431 --> 00:55:54,600
DISPROPORTIONATE BURDEN OF

1397
00:55:54,600 --> 00:55:57,135
DISPARITIES AND INIQUITIES AND

1398
00:55:57,135 --> 00:55:58,737
NEUROLOGICAL DISORDERS AND CARE

1399
00:55:58,737 --> 00:56:00,772
BORN BY UNDERSERVED GROUPS OF

1400
00:56:00,772 --> 00:56:04,576
SOCIETY AND SO THE NIMHD HAS

1401
00:56:04,576 --> 00:56:05,878
DESIGNATED CERTAIN POPULATIONS

1402
00:56:05,878 --> 00:56:07,179
AS NIH POPULATIONS THAT

1403
00:56:07,179 --> 00:56:07,846
EXPERIENCE HEALTH DISPARITIES

1404
00:56:07,846 --> 00:56:09,915
AND WE HAVE THEM LISTED HERE ON

1405
00:56:09,915 --> 00:56:11,783
THIS SLIDE, AND IN ADDITION TO

1406
00:56:11,783 --> 00:56:15,988
THIS, WE KNOW THAT

1407
00:56:15,988 --> 00:56:16,788
INTERSECTIONALITY IS A MAJOR

1408
00:56:16,788 --> 00:56:20,325
PROBLEM AS WELL WHEN YOU START

1409
00:56:20,325 --> 00:56:22,528
TO THINK OF I GUESS THE

1410
00:56:22,528 --> 00:56:24,396
INCREASED BURDEN OF INIQUITIES

1411
00:56:24,396 --> 00:56:26,598
OR DISPARITIES AS WELL AS PEOPLE

1412
00:56:26,598 --> 00:56:28,100
WITH LIMITED ENGLISH

1413
00:56:28,100 --> 00:56:28,901
PROFICIENCY, SO, DESPITE OUR

1414
00:56:28,901 --> 00:56:31,670
MISSION AND ALL OF THE

1415
00:56:31,670 --> 00:56:32,504
WELL-INTENTIONS WE'VE HAD, WE

1416
00:56:32,504 --> 00:56:33,305
KNOW THESE NUMBERS ARE STILL

1417
00:56:33,305 --> 00:56:37,209
THERE AND THAT PEOPLE ARE STILL

1418
00:56:37,209 --> 00:56:39,278
DISPROPORTIONATELY AFFECTED.

1419
00:56:39,278 --> 00:56:41,146
SO, THE NINDS, RECENTLY

1420
00:56:41,146 --> 00:56:44,883
COMPLETED A STRATEGIC PLANNING

1421
00:56:44,883 --> 00:56:45,617
PROCESS FOR HEALTH EQUITY.

1422
00:56:45,617 --> 00:56:48,053
WE HAD A GROUP OF OVER 30 EX 

1423
00:56:48,053 --> 00:56:49,688
PERS FROM AROUND THE COUNTRY,

1424
00:56:49,688 --> 00:56:51,523
SIMILAR TO YOURSELF, SOME OF THE

1425
00:56:51,523 --> 00:56:55,827
PEOPLE ON THE COMMITTEE WHO MET

1426
00:56:55,827 --> 00:56:58,463
PAIN STAKINGLY TO DISCUSS THE

1427
00:56:58,463 --> 00:56:59,298
LITERATURE INPUT FROM THE

1428
00:56:59,298 --> 00:57:00,566
COMMUNITY AND TO COME UP WITH

1429
00:57:00,566 --> 00:57:02,568
THE SET OF RECOMMENDATIONS ON

1430
00:57:02,568 --> 00:57:05,704
WHAT THE NINDS COULD DO TO

1431
00:57:05,704 --> 00:57:07,873
ADDRESS HEALTH INIQUITIES.

1432
00:57:07,873 --> 00:57:10,175
THEY HAD A TOTAL OF 18 HIGH

1433
00:57:10,175 --> 00:57:13,145
LEVEL RECOMMENDATIONS EMPLOY ALL

1434
00:57:13,145 --> 00:57:14,212
OF THESE RECOMMENDATIONS WERE

1435
00:57:14,212 --> 00:57:15,480
PUBLISH INDEED A DEDICATED

1436
00:57:15,480 --> 00:57:16,515
SUPPLEMENT IN THE NEUROLOGY

1437
00:57:16,515 --> 00:57:18,183
JOURNAL AND I JUST MENTIONED

1438
00:57:18,183 --> 00:57:18,383
THAT.

1439
00:57:18,383 --> 00:57:20,052
I JUST SHOWED THAT PREVIOUSLY,

1440
00:57:20,052 --> 00:57:22,921
THE NEUROLOGY JOURNAL WHICH IS

1441
00:57:22,921 --> 00:57:25,857
THE LARGEST YOWRNAL FOR CLINICAL

1442
00:57:25,857 --> 00:57:28,327
NEUROLOGY IN THE WORLD.

1443
00:57:28,327 --> 00:57:30,395
WE TOOK THAT INFORMATION FROM

1444
00:57:30,395 --> 00:57:32,731
THAT -- OUR WORKING GROUP OF OUR

1445
00:57:32,731 --> 00:57:34,232
NATIONAL ADVISORY COUNCIL, THOSE

1446
00:57:34,232 --> 00:57:36,435
RECOMMENDATIONS AND WE PUT THEM

1447
00:57:36,435 --> 00:57:37,836
-- BUCKETED THEM INTO 4

1448
00:57:37,836 --> 00:57:40,672
CATEGORIES AS PART OF OUR

1449
00:57:40,672 --> 00:57:43,075
IMPLEMENTATION PLAN, AND THESE 4

1450
00:57:43,075 --> 00:57:43,909
CATEGORIES ACTUALLY ALIGN TO

1451
00:57:43,909 --> 00:57:45,777
SOME OF THE MAJOR CATEGORIES

1452
00:57:45,777 --> 00:57:48,747
THAT WERE OUTLINED IN YOUR NASEM

1453
00:57:48,747 --> 00:57:51,650
REPORT, THE 2 I GUESS, THE AREAS

1454
00:57:51,650 --> 00:57:54,086
OR LEVERS THAT WE HAVE HERE AT

1455
00:57:54,086 --> 00:57:56,388
THE NIH IS FOCUSED ON RESEARCH,

1456
00:57:56,388 --> 00:57:58,457
BUT THEY FALL INTO THE 2

1457
00:57:58,457 --> 00:57:59,925
CATEGORIES, 1 DEALS WITH THE

1458
00:57:59,925 --> 00:58:03,095
COMMUNITY AND THE OTHER RESEARCH

1459
00:58:03,095 --> 00:58:05,430
INFRASTRUCTURE AND SO OUR 4

1460
00:58:05,430 --> 00:58:06,598
CATEGORIES INCLUDE EXPANDING

1461
00:58:06,598 --> 00:58:08,100
RESEARCH FOR HEALTH EQUITY

1462
00:58:08,100 --> 00:58:10,068
RESEARCH, PROMOTING COMMUNITY

1463
00:58:10,068 --> 00:58:11,670
ENGAGEMENT WITH NIH DEFINED

1464
00:58:11,670 --> 00:58:13,839
POPULATIONS THAT EXPERIENCE

1465
00:58:13,839 --> 00:58:15,440
HEALTH DISPARITIES, ALSO

1466
00:58:15,440 --> 00:58:16,708
DEVELOPING THE HEALTH EQUITY

1467
00:58:16,708 --> 00:58:19,211
RESEARCH WORKFORCE WHICH WAS

1468
00:58:19,211 --> 00:58:21,847
DISCUSSED IN SLIDES FROM PANEL

1469
00:58:21,847 --> 00:58:24,149
MEMBERS, AS WELL AS EXPANDING

1470
00:58:24,149 --> 00:58:25,550
COMMUNICATION AND OUTREACH TO

1471
00:58:25,550 --> 00:58:27,819
THOSE POPULATIONS AFFECTED AS

1472
00:58:27,819 --> 00:58:28,053
WELL.

1473
00:58:28,053 --> 00:58:30,555
DURING OUR STRATEGIC PLANNING

1474
00:58:30,555 --> 00:58:33,792
PROCESS WE HAD AN NINDS SOCIAL

1475
00:58:33,792 --> 00:58:34,626
DETERMINANTS OF HEALTH

1476
00:58:34,626 --> 00:58:36,028
FRAMEWORK, THIS WAS DISCUSSED

1477
00:58:36,028 --> 00:58:39,331
EARLIER, THERE ARE OTHER FACTORS

1478
00:58:39,331 --> 00:58:40,699
UPSTREAM FROM THE INDIVIDUAL

1479
00:58:40,699 --> 00:58:42,567
THAT IMPACT PEOPLE AND A LOT OF

1480
00:58:42,567 --> 00:58:44,603
THESE INCLUDE STRUCTURAL

1481
00:58:44,603 --> 00:58:46,738
BARRIERS HERE, AND THIS NINDS

1482
00:58:46,738 --> 00:58:50,108
FRAMEWORK GOES ALONG WITH THE

1483
00:58:50,108 --> 00:58:51,843
EXPOETICSOME FRAMEWORK AND ALSO

1484
00:58:51,843 --> 00:58:54,546
CONSISTENT WITH THE NIMHD HEALTH

1485
00:58:54,546 --> 00:58:55,213
DISPARITIES FRAMEWORK, WE WANTED

1486
00:58:55,213 --> 00:58:57,349
ALL OF THESE TO BE CONSISTENT IN

1487
00:58:57,349 --> 00:58:58,417
TERMS OF WORKING TOGETHER WITH

1488
00:58:58,417 --> 00:58:59,351
THESE VARIOUS TBRAIM WORKS AND

1489
00:58:59,351 --> 00:59:00,819
SO WE HAD SEVERAL INITIATIVES

1490
00:59:00,819 --> 00:59:04,156
THAT WE CREATED SO FAR, WE HAD 1

1491
00:59:04,156 --> 00:59:05,524
CALLED THE COMMUNITY INGEAJED

1492
00:59:05,524 --> 00:59:07,693
HELT EQUITY RESEARCH AND

1493
00:59:07,693 --> 00:59:08,860
NEUROSCIENCE INITIATIVE.

1494
00:59:08,860 --> 00:59:10,962
THIS HAD 3 COMPONENTS, 1 WAS

1495
00:59:10,962 --> 00:59:12,931
THAT RESEARCHERS HAD TO BE

1496
00:59:12,931 --> 00:59:13,999
FOCUSED ON THE NEUROLOGICAL

1497
00:59:13,999 --> 00:59:15,600
DISEASE, THEY HAD TO HAVE SOME

1498
00:59:15,600 --> 00:59:16,902
FORM OF COMMUNITY ENGAGEMENT AND

1499
00:59:16,902 --> 00:59:20,105
SO WE LOOKED AT BEST PRACTICES

1500
00:59:20,105 --> 00:59:21,139
AND COMMUNITY ENGAGEMENT WHERE

1501
00:59:21,139 --> 00:59:23,308
THIS WAS A PARTNERSHIP BETWEEN

1502
00:59:23,308 --> 00:59:24,609
AN ACCESSING DEMIC INSTITUTION

1503
00:59:24,609 --> 00:59:26,344
AND A COMMUNITY ORGANIZATION,

1504
00:59:26,344 --> 00:59:29,581
COULD BE FEDERALLY QUALIFIED

1505
00:59:29,581 --> 00:59:30,315
HEALTH CENTER, FAITH-BASED

1506
00:59:30,315 --> 00:59:35,987
ORGANIZATION OR SOME TYPE OF

1507
00:59:35,987 --> 00:59:37,723
COMMUNITY ORGANIZATION THAT

1508
00:59:37,723 --> 00:59:38,590
REPRESENTED THE POPULATION THAT

1509
00:59:38,590 --> 00:59:41,259
THE INSTITUTION WAS STUDYING AS

1510
00:59:41,259 --> 00:59:43,261
WELL AS A HEALTH EQUITY AND

1511
00:59:43,261 --> 00:59:45,397
RESEARCH PROJECT INCLUDING

1512
00:59:45,397 --> 00:59:47,032
PEOPLE FROM THE REPRESENTATIVE

1513
00:59:47,032 --> 00:59:49,668
POPULATION THAT WAS BEING

1514
00:59:49,668 --> 00:59:50,969
STUDIED AND AN INTERDISCIPLINARY

1515
00:59:50,969 --> 00:59:54,139
TEAM THAT REFLECTED THE PEOPLE

1516
00:59:54,139 --> 00:59:54,706
BEING STUDIED.

1517
00:59:54,706 --> 00:59:58,910
SO WE HAD SEVERAL INITTIAIVE

1518
00:59:58,910 --> 00:59:59,678
ITS, RO-1 INITIATIVES, R34

1519
00:59:59,678 --> 01:00:02,781
INITIATIVES AND WE HAD ANOTHER

1520
01:00:02,781 --> 01:00:03,381
SIMILAR FUNDING ANNOUNCEMENT

1521
01:00:03,381 --> 01:00:06,451
THAT WAS PLACED, THAT WAS

1522
01:00:06,451 --> 01:00:09,688
ACTUALLY FOCUSED SPECIFICALLY ON

1523
01:00:09,688 --> 01:00:11,056
ALZHEIMER'S DISEASE RELATED

1524
01:00:11,056 --> 01:00:12,224
DEMENTIA WORK RESEARCH AND SO WE

1525
01:00:12,224 --> 01:00:13,759
CAN TALK ABOUT THAT IF PEOPLE

1526
01:00:13,759 --> 01:00:15,660
HAVE QUESTIONS LATER ON.

1527
01:00:15,660 --> 01:00:20,298
WE ALSO SUPPORT A DIVERSITY

1528
01:00:20,298 --> 01:00:21,600
SUPPLEMENT PROGRAM SPECIFICALLY

1529
01:00:21,600 --> 01:00:23,635
RELATED TO ADRD WORK AND SOME

1530
01:00:23,635 --> 01:00:24,870
OTHER INITIATIVES HERE.

1531
01:00:24,870 --> 01:00:27,405
I WILL HIGHLIGHT 1 OTHER -- 1 IS

1532
01:00:27,405 --> 01:00:29,274
SORT OF A NOVEL COMMUNITY

1533
01:00:29,274 --> 01:00:32,611
OUTREACH COMPAIN GEARED TOWARDS

1534
01:00:32,611 --> 01:00:34,646
AFRICAN-AMERICAN MEN.

1535
01:00:34,646 --> 01:00:35,480
WE KNOW THAT AFRICAN-AMERICAN

1536
01:00:35,480 --> 01:00:37,682
MEN HAVE THE HIGHEST RATE OF

1537
01:00:37,682 --> 01:00:38,683
UNCONTROLLED HIGH BLOOD PRESSURE

1538
01:00:38,683 --> 01:00:41,553
IN THIS COUNTRY AND UNCONTROLLED

1539
01:00:41,553 --> 01:00:43,522
HYPERTENSION IS ASSOCIATED WITH

1540
01:00:43,522 --> 01:00:45,557
MULTIPLE CO-MORBIDITIES AND

1541
01:00:45,557 --> 01:00:46,358
OUTCOMES LIKE CARDIOVASCULAR DEC

1542
01:00:46,358 --> 01:00:48,727
AND STROKE AND ALSO THERE'S A

1543
01:00:48,727 --> 01:00:51,363
CONNECTION WITH COGNITIVE

1544
01:00:51,363 --> 01:00:52,798
IMPAIRMENT AND DEMENTIA.

1545
01:00:52,798 --> 01:00:55,300
SO WE CREATED THIS COMMUNITY

1546
01:00:55,300 --> 01:00:57,002
OUTREACH RELATED PUBLIC HEALTH

1547
01:00:57,002 --> 01:00:59,304
CAMPAIGN AND WE PARTNERED WITH

1548
01:00:59,304 --> 01:01:01,006
MULTIPLE HEALTH ASSOCIATIONS AND

1549
01:01:01,006 --> 01:01:03,542
COMMUNITY ORGANIZATIONS LIKE THE

1550
01:01:03,542 --> 01:01:04,142
ALZHEIMER'S ASSOCIATION,

1551
01:01:04,142 --> 01:01:06,278
AMERICAN STROKE ASSOCIATION AND

1552
01:01:06,278 --> 01:01:06,511
OTHERS.

1553
01:01:06,511 --> 01:01:09,915
WE PARTNERED WITH OTHER HBCUs

1554
01:01:09,915 --> 01:01:12,651
AS WELL AS PULT PEL MEDIA

1555
01:01:12,651 --> 01:01:14,820
PLATFORMS LIKE THE NATIONAL

1556
01:01:14,820 --> 01:01:16,655
ASSOCIATION OF BLACK JOURNALISTS

1557
01:01:16,655 --> 01:01:21,560
AND OTHERS AS WELL JUST TO NAME

1558
01:01:21,560 --> 01:01:22,294
A FEW.

1559
01:01:22,294 --> 01:01:23,595
AND WE DID SEVERAL WEBINARS AS

1560
01:01:23,595 --> 01:01:26,097
WELL TO GET OUR MASSAGE OUT

1561
01:01:26,097 --> 01:01:28,600
THERE AND WE SAW THAT THIS

1562
01:01:28,600 --> 01:01:29,301
INFORMATION ACTUALLY DROVE MORE

1563
01:01:29,301 --> 01:01:31,670
PEOPLE TO OUR WEBSITE WHICH IS

1564
01:01:31,670 --> 01:01:35,774
SORT OF 1 OF THOSE INTERMEDIATE

1565
01:01:35,774 --> 01:01:38,543
MARKERS OF IMPACT WE LOOKED AT.

1566
01:01:38,543 --> 01:01:39,945
OBVIOUSLY WE CAN'T LOOK AT

1567
01:01:39,945 --> 01:01:41,713
OUTCOMES SUCH AS STROKE OR

1568
01:01:41,713 --> 01:01:43,448
DEMENTIA BUT WE LOOK AT

1569
01:01:43,448 --> 01:01:44,149
INTERMEDIATE IMPACTS OF PEOPLE

1570
01:01:44,149 --> 01:01:45,250
COMING TO THE WEBSITE.

1571
01:01:45,250 --> 01:01:46,852
I WILL TOP THERE, THIS WAS A

1572
01:01:46,852 --> 01:01:48,787
BRIEF OVERVIEW AND HOPEFULLY WE

1573
01:01:48,787 --> 01:01:50,121
WILL HAVE A NICE ROBUST

1574
01:01:50,121 --> 01:01:52,257
DISCUSSION AT THE END.

1575
01:01:52,257 --> 01:02:01,099
I WILL STOP SHARING THE SLIDES.

1576
01:02:01,099 --> 01:02:03,768
>> SO I HAVE RICHARD UP
NEXT,

1577
01:02:03,768 --> 01:02:14,179
NO, YES, RICHARD HODES. 

1578
01:02:15,947 --> 01:02:16,681
>> SHARING WORKING?

1579
01:02:16,681 --> 01:02:18,850
>> THERE YOU GO.

1580
01:02:18,850 --> 01:02:19,150
>> OKAY.

1581
01:02:19,150 --> 01:02:20,752
WELL, THANKS FOR THE CHANCE TO

1582
01:02:20,752 --> 01:02:21,786
PARTICIPATE IN THIS.

1583
01:02:21,786 --> 01:02:24,322
A LOST ACTIVITIES AS NOTED BY

1584
01:02:24,322 --> 01:02:25,390
RICHARD BENSON HAVE BEEN

1585
01:02:25,390 --> 01:02:27,259
COLLABORATIVE ACROSS THE

1586
01:02:27,259 --> 01:02:28,660
INSTITUTES AT NIH BUT 1 IN

1587
01:02:28,660 --> 01:02:30,462
PARTICULAR TO EMPHASIZE SOME OF

1588
01:02:30,462 --> 01:02:31,897
THE ASPECTS WHICH ARE SOMEWHAT

1589
01:02:31,897 --> 01:02:35,433
UNIQUE TO NIA AND ITS MISSION.

1590
01:02:35,433 --> 01:02:37,602
AS ILLUSTRATED HERE, THE CHARGED

1591
01:02:37,602 --> 01:02:39,337
CONGRESSIONAL MANDATE FOR NIH

1592
01:02:39,337 --> 01:02:42,374
FROM NIA AT THE TIME WAS

1593
01:02:42,374 --> 01:02:44,376
FOUNDATION HAS BEEN BROAD.

1594
01:02:44,376 --> 01:02:47,345
IT INVOLVES THE GENETIC CLINICAL

1595
01:02:47,345 --> 01:02:49,047
AND BEHAVIORIAL SOCIAL BUT ALSO

1596
01:02:49,047 --> 01:02:50,582
ECONOMIC AND VERY POLICY

1597
01:02:50,582 --> 01:02:53,018
RELEVANT ASPECTS OF AGING AND IN

1598
01:02:53,018 --> 01:02:54,986
THAT SENSE, PROVIDES A CRITICAL

1599
01:02:54,986 --> 01:02:57,355
PERSPECTIVE FOR THE RESEARCH

1600
01:02:57,355 --> 01:02:59,557
THAT WE SUPPORT AROUND THE

1601
01:02:59,557 --> 01:03:01,059
POPULATIONS OF OUR DISCUSSION

1602
01:03:01,059 --> 01:03:01,259
TODAY.

1603
01:03:01,259 --> 01:03:05,897
>> I WOULD LIKE JUST TO

1604
01:03:05,897 --> 01:03:08,400
EMPHASIZE THE PROGRAMS WHICH WE

1605
01:03:08,400 --> 01:03:09,367
PARTICIPATE IN AT NIEKSA.

1606
01:03:09,367 --> 01:03:10,969
WE HAVE THE GREAT OPPORTUNITY

1607
01:03:10,969 --> 01:03:13,872
AND PRIVILEGE IN PARTICIPATING

1608
01:03:13,872 --> 01:03:16,608
MANY NIH WIDE INITIATIVES BUT

1609
01:03:16,608 --> 01:03:18,109
SUPPORTED THIS ACTION 31A,

1610
01:03:18,109 --> 01:03:19,778
LOOKING TO INVEST IN DIVERSITY

1611
01:03:19,778 --> 01:03:20,879
OF RESEARCHERS, I WILL JUST

1612
01:03:20,879 --> 01:03:23,615
POINT TO A FEW RELATIVELY UNIQUE

1613
01:03:23,615 --> 01:03:26,885
1S AS PART OF NIA, 1 IS THE NIA

1614
01:03:26,885 --> 01:03:31,423
HEALTHY AGING START UP CHALLENGE

1615
01:03:31,423 --> 01:03:33,959
WHICH IS AN ENTREPRENEURIAL

1616
01:03:33,959 --> 01:03:36,261
EFFORT IN ADDITION TO OUR USUAL

1617
01:03:36,261 --> 01:03:38,096
GRANT MECHANISMS WE PROVIDE A

1618
01:03:38,096 --> 01:03:39,497
BOOT CAMP AND TRAINING

1619
01:03:39,497 --> 01:03:41,333
OPPORTUNITY FOR INDIVIDUALS FROM

1620
01:03:41,333 --> 01:03:43,635
DIVERSE BACKGROUNDS WHO MAKE

1621
01:03:43,635 --> 01:03:47,439
THEIR PROPOSAL IN DIVERSE

1622
01:03:47,439 --> 01:03:50,875
RESEARCH AREAS AS WELL, THEY GO

1623
01:03:50,875 --> 01:03:52,410
THROUGH CHALLENGES, PRIZES,

1624
01:03:52,410 --> 01:03:53,478
COMPETITIONS, AND THE PRIZE

1625
01:03:53,478 --> 01:03:55,313
WINNERS WHICH IS THE LARGEST

1626
01:03:55,313 --> 01:03:57,983
PRIZE AWARD AS WELL AS FUNDING

1627
01:03:57,983 --> 01:03:59,150
FOR THEIR SBIR INITIATIVE.

1628
01:03:59,150 --> 01:04:03,688
SO  IN ADDITION TO WANTING TO

1629
01:04:03,688 --> 01:04:05,857
PROVIDE THE NIH MAIN STREAM

1630
01:04:05,857 --> 01:04:07,592
SUPPORTED GRANT PROGRAM

1631
01:04:07,592 --> 01:04:08,193
REALIZING OPPORTUNITIES

1632
01:04:08,193 --> 01:04:10,095
ELSEWHERE, WE'VE HAD GREAT

1633
01:04:10,095 --> 01:04:11,396
SUCCESS IN FOSTERING A GREAT

1634
01:04:11,396 --> 01:04:12,430
DIVERSITY OF INDIVIDUAL WHO IS

1635
01:04:12,430 --> 01:04:14,299
MIGHT NOT HAVE BEEN A PART OF

1636
01:04:14,299 --> 01:04:20,338
THE USUAL GRANT APPLICATIONS TO

1637
01:04:20,338 --> 01:04:20,805
NIH.

1638
01:04:20,805 --> 01:04:21,506
>> THE BUTLER-WILLIAMS
SCHOLARS

1639
01:04:21,506 --> 01:04:23,241
PROGRAM IS A WEEK LONG PROGRAM

1640
01:04:23,241 --> 01:04:24,509
HERE AT NIH AND INVESTIGATOR

1641
01:04:24,509 --> 01:04:26,244
STAGE AND THOSE TO AGING

1642
01:04:26,244 --> 01:04:27,946
RESEARCH AND PROVIDES AN

1643
01:04:27,946 --> 01:04:30,348
OPPORTUNITY TO WORK WITH BOTH

1644
01:04:30,348 --> 01:04:31,950
NIH EXTRAMURAL STAFF AS WELL AS

1645
01:04:31,950 --> 01:04:35,854
LEADERS IN THE FIELD WHO WILL

1646
01:04:35,854 --> 01:04:36,855
CONVERGE FOR INTENSIVE

1647
01:04:36,855 --> 01:04:38,456
INTERDISCIPLINARY OPPORTUNITY

1648
01:04:38,456 --> 01:04:40,625
WITH EXERCISES SUCH AS GRANT

1649
01:04:40,625 --> 01:04:42,927
WRITING AND MOCK REVIEWS, BUT

1650
01:04:42,927 --> 01:04:45,430
VERY SUCCESSFUL OVER THESE YEARS

1651
01:04:45,430 --> 01:04:47,932
IN ESTABLISHING REAL COHORTS OF

1652
01:04:47,932 --> 01:04:48,967
INDIVIDUALS FROM COMPLEEM

1653
01:04:48,967 --> 01:04:50,402
DIVERSE COMPOSITION WHO

1654
01:04:50,402 --> 01:04:51,870
MAINTAINED THEIR CONTACTS WITH

1655
01:04:51,870 --> 01:04:53,805
THE INSTITUTE AND MANY OF WHOM

1656
01:04:53,805 --> 01:04:56,274
WHO HAVE GONE ON TO BE LEADERS

1657
01:04:56,274 --> 01:05:02,180
OF NIH NATIONALLY AND GLOBAL.

1658
01:05:02,180 --> 01:05:03,114
THE BEESON EMERGING LEADERS

1659
01:05:03,114 --> 01:05:05,417
AWARD IS 1 FOR EXPANDED

1660
01:05:05,417 --> 01:05:07,719
OPPORTUNITIES FOR FUNDING IN

1661
01:05:07,719 --> 01:05:08,553
RESEARCH SUPPORT.

1662
01:05:08,553 --> 01:05:10,755
GRANT FOR EARLY MEDICAL SURGICAL

1663
01:05:10,755 --> 01:05:12,357
SPECIALISTS IS 1 THAT COMBINES

1664
01:05:12,357 --> 01:05:13,525
SMALL GRANTS TOGETHER WITH

1665
01:05:13,525 --> 01:05:14,359
MENTORING PROGRAMS TO TAKE

1666
01:05:14,359 --> 01:05:17,529
PEOPLE AT EARLY STAGES OF

1667
01:05:17,529 --> 01:05:18,229
MEDICAL AND SURGICAL SPECIALTIES

1668
01:05:18,229 --> 01:05:21,099
AND BRING THEM INTO RESEARCH.

1669
01:05:21,099 --> 01:05:23,034
AND THERE TO WE'VE HAD GREAT

1670
01:05:23,034 --> 01:05:25,870
SUCCESS IN THE DIVERSITY OF

1671
01:05:25,870 --> 01:05:26,905
INDIVIDUALS RECRUITED.

1672
01:05:26,905 --> 01:05:29,340
WE HAVE DIVERSITY AND

1673
01:05:29,340 --> 01:05:31,609
TRANSLATION PROGRAMS, F31s AND

1674
01:05:31,609 --> 01:05:32,877
F32s, SMALL RESEARCH GRANTS

1675
01:05:32,877 --> 01:05:34,813
FOR NEXT AGAINERATION OF

1676
01:05:34,813 --> 01:05:36,548
CLINICAL RESEARCHERS AND THEN

1677
01:05:36,548 --> 01:05:38,716
MSTEM, AGING RESEARCH AGING

1678
01:05:38,716 --> 01:05:39,684
RESEARCH DISSERTATION AWARDS AS

1679
01:05:39,684 --> 01:05:39,884
WELL.

1680
01:05:39,884 --> 01:05:41,119
SO IN THESE SEVERAL AREAS

1681
01:05:41,119 --> 01:05:42,987
COUPLED WITH THE LARGE NUMBER OF

1682
01:05:42,987 --> 01:05:44,823
INITIATIVES THAT ARE AT NIH

1683
01:05:44,823 --> 01:05:49,627
WIDE, WE'RE COMMITTED TO DOING

1684
01:05:49,627 --> 01:05:52,797
WHAT WE CAN TO DIVERSIFY THE

1685
01:05:52,797 --> 01:05:54,065
RESEARCH FIELD.

1686
01:05:54,065 --> 01:05:56,067
LOOKING AT WAYS TO ENHANCE

1687
01:05:56,067 --> 01:05:58,169
INFRASTRUCTURE, JUST A NUMBER OF

1688
01:05:58,169 --> 01:06:02,240
PROGRAMS HERE, THE NIA FUNDED

1689
01:06:02,240 --> 01:06:03,541
RESOURCE CENTERS ARE RICK

1690
01:06:03,541 --> 01:06:05,810
NORRIS, A PROGRAM AIMED AT BOTH

1691
01:06:05,810 --> 01:06:08,246
FOSTERING RESEARCH WITH PILOT

1692
01:06:08,246 --> 01:06:09,781
GRANTS FOR RESEARCH AROUND AREAS

1693
01:06:09,781 --> 01:06:12,217
OF MINORITY HEALTH AND HEALTH

1694
01:06:12,217 --> 01:06:13,518
DISPARITIES BUT ALSO PROVIDING 1

1695
01:06:13,518 --> 01:06:14,953
OF THE GREAT OPPORTUNITIES FOR

1696
01:06:14,953 --> 01:06:16,488
TRAINING AND I THINK ONCE AGAIN

1697
01:06:16,488 --> 01:06:19,724
MANY OF THE LEADERS OF NIH, AND

1698
01:06:19,724 --> 01:06:20,525
NATIONALLY HISTORICALLY OVER THE

1699
01:06:20,525 --> 01:06:22,260
PAST YEAR ANDS NOW DECADE VS

1700
01:06:22,260 --> 01:06:24,662
COME THROUGH THIS PROGRAM.

1701
01:06:24,662 --> 01:06:29,501
THE LARGEST CENTERS PROGRAM AT N

1702
01:06:29,501 --> 01:06:31,936
IA EXCUSE ME IS THE ALZHEIMER'S

1703
01:06:31,936 --> 01:06:34,806
RESEARCH CENTERS AND THEY ALL

1704
01:06:34,806 --> 01:06:35,673
HAVE OUTREACH CORES.

1705
01:06:35,673 --> 01:06:37,775
THESE HAVE BEEN VERY MUCH DREKED

1706
01:06:37,775 --> 01:06:38,810
TOWARDS DIVERSITY IN THE

1707
01:06:38,810 --> 01:06:41,246
POPULATIONS THEY 7 AND HAVE

1708
01:06:41,246 --> 01:06:42,080
DIVERSIFIED BOTH BASIC RESEARCH

1709
01:06:42,080 --> 01:06:43,915
AS WELL AS THE TRANSLATIONAL

1710
01:06:43,915 --> 01:06:48,219
RESEARCH WHICH IS NO LONGER JUST

1711
01:06:48,219 --> 01:06:50,021
HYPOTHETICALLY BUT DEMON

1712
01:06:50,021 --> 01:06:51,990
STRAIBLLY ILTRAITIVE IN WHICH

1713
01:06:51,990 --> 01:06:53,091
THE WAY STUDYING DIVERSE

1714
01:06:53,091 --> 01:06:54,759
POPULATION SYSTEM IM  PERRATIVE

1715
01:06:54,759 --> 01:06:56,494
FOR SERVING THOSE DIVERSE

1716
01:06:56,494 --> 01:06:57,762
POPULATIONS BUT ALSO BEING

1717
01:06:57,762 --> 01:06:59,264
INFORMATIVE FOR THE RESEARCH

1718
01:06:59,264 --> 01:07:01,733
FINDING, BEING THEY GENETIC

1719
01:07:01,733 --> 01:07:03,101
MEDICAL, CLINICAL, SOCIAL,

1720
01:07:03,101 --> 01:07:11,042
BEHAVIORIAL ACROSS DIVERSE

1721
01:07:11,042 --> 01:07:11,342
POPULATIONS.

1722
01:07:11,342 --> 01:07:13,678
I WOULD LIKE TO TALK FURTHER

1723
01:07:13,678 --> 01:07:16,047
ABOUT THE CHALLENGES WE FACE IN

1724
01:07:16,047 --> 01:07:19,450
RECRUIT AM OVER THE TRIALS, SO

1725
01:07:19,450 --> 01:07:23,555
WE PUT TOGETHER A SERIES OF

1726
01:07:23,555 --> 01:07:25,323
WEB-BASED OUTREACH PROGRAMS,

1727
01:07:25,323 --> 01:07:26,824
THAT ARE AVAILABLE FOR

1728
01:07:26,824 --> 01:07:32,330
ADAPTATION AND USE

1729
01:07:32,330 --> 01:07:32,931
INVESTIGATORS, NATIONAL

1730
01:07:32,931 --> 01:07:34,499
STRATEGY, AND I'VE TURNED

1731
01:07:34,499 --> 01:07:38,670
FINALLY TO THE MOST RECENT

1732
01:07:38,670 --> 01:07:39,504
EDITION PROGRAM, ACCOUNTABILITY

1733
01:07:39,504 --> 01:07:41,873
WAS MENTIONED AND WE FOUND A

1734
01:07:41,873 --> 01:07:44,876
CHALLENGE IN THE WELL

1735
01:07:44,876 --> 01:07:48,246
INTENTIONED BUT SOMETIMES

1736
01:07:48,246 --> 01:07:50,248
INADEQUATELY DESIGNED AND

1737
01:07:50,248 --> 01:07:51,849
INADEQUATELY TRACKED EFFORTS TO

1738
01:07:51,849 --> 01:07:53,318
RECRUIT EFFORTS OF OUR

1739
01:07:53,318 --> 01:07:54,619
POPULATION SO WE IMPLEMENTED A

1740
01:07:54,619 --> 01:07:56,454
SERIES OF POLICIES WE'VE SEEN

1741
01:07:56,454 --> 01:07:59,090
ILLUSTRATED HERE BY A SERIES

1742
01:07:59,090 --> 01:08:00,358
EVEN BEFORE INVESTIGATORS HAVE  

1743
01:08:00,358 --> 01:08:01,559
PERMISSION TO SUBMIT THEIR

1744
01:08:01,559 --> 01:08:02,694
APPLICATIONS AND THAT AS YOU

1745
01:08:02,694 --> 01:08:05,863
KNOW IS NECESSARY FOR THE

1746
01:08:05,863 --> 01:08:06,731
APPLICATIONS OVER $500,000 THAT

1747
01:08:06,731 --> 01:08:09,601
ARE REQUIRED IN THEIR PROPOSAL

1748
01:08:09,601 --> 01:08:12,537
AS THE PREAPPLICATION TO HAVE A

1749
01:08:12,537 --> 01:08:14,072
PLAN FOR RECRUITMENT IN THE

1750
01:08:14,072 --> 01:08:15,807
DEMOGRAPHIC SO THAT RECRUITMENT

1751
01:08:15,807 --> 01:08:16,941
WITH A JUSTIFICATION THEREOF AND

1752
01:08:16,941 --> 01:08:18,676
IT WAS NOT ADEQUATE.

1753
01:08:18,676 --> 01:08:22,981
WE WON'T ACCEPT THEM FOR REVIEW.

1754
01:08:22,981 --> 01:08:24,515
ONCE THEY ARE ADEQUATE AND

1755
01:08:24,515 --> 01:08:25,917
ACCEPTED FOR REVIEW, WE TRACK

1756
01:08:25,917 --> 01:08:27,986
VERY CAREFULLY THROUGH THE

1757
01:08:27,986 --> 01:08:29,320
REVIEW PROCESS AND CONDITIONS

1758
01:08:29,320 --> 01:08:30,922
FOR AWARD BUT IN TERMS OF

1759
01:08:30,922 --> 01:08:31,990
ACCOUNTABILITY, CAN YOU SEE

1760
01:08:31,990 --> 01:08:33,858
ILLUSTRATED AT THE GRAPHS TO THE

1761
01:08:33,858 --> 01:08:35,126
RIGHT IS A NEWLY IMPLEMENTED

1762
01:08:35,126 --> 01:08:38,596
SYSTEM IN WHICH A NEAR REALTIME

1763
01:08:38,596 --> 01:08:40,465
AS INDIVIDUALS WERE RECRUITED IN

1764
01:08:40,465 --> 01:08:42,200
CLINICAL RESEARCH AND STUDIES,

1765
01:08:42,200 --> 01:08:43,835
BEGINNING FIRST WITH THE

1766
01:08:43,835 --> 01:08:45,136
ALZHEIMER'S STUDIES BUT MORE

1767
01:08:45,136 --> 01:08:48,473
GENERALIZED THEIR DATA ARE

1768
01:08:48,473 --> 01:08:50,575
ENTERED INTO A CENTRALIZED DOOTA

1769
01:08:50,575 --> 01:08:50,808
BASE.

1770
01:08:50,808 --> 01:08:53,444
SO NEAR A PERIOD OF TIME WE

1771
01:08:53,444 --> 01:08:55,780
SHOULD GET THE, CREWAL AND

1772
01:08:55,780 --> 01:08:56,848
SUBPOPULATIONS OF THOSE AND WE

1773
01:08:56,848 --> 01:08:58,082
HAVE EARLY WARNING AND SENSE

1774
01:08:58,082 --> 01:08:59,617
THERE OF HOW WELL THINGS ARE

1775
01:08:59,617 --> 01:09:01,185
GOING IN TERMS OF OVERALL

1776
01:09:01,185 --> 01:09:03,021
RECRUITMENT AND IN TERMS OF

1777
01:09:03,021 --> 01:09:04,889
RECRUITMENT MEETING THE TARGETED

1778
01:09:04,889 --> 01:09:06,424
GOALS OF DIVERSITY AND

1779
01:09:06,424 --> 01:09:06,724
POPULATIONS.

1780
01:09:06,724 --> 01:09:08,726
THIS MEANS THAT IN EARLY TIME WE

1781
01:09:08,726 --> 01:09:10,461
CAN DEVELOP AND HAVE A MECHANISM

1782
01:09:10,461 --> 01:09:11,663
FOR DOING SO, RECTIFIED

1783
01:09:11,663 --> 01:09:14,699
CORRECTIVE ACTION PLAN TO ASSIST

1784
01:09:14,699 --> 01:09:17,068
INVESTIGATORS IN MEETING THE

1785
01:09:17,068 --> 01:09:18,136
CRITERIA THAT THEY'VE INDICATED

1786
01:09:18,136 --> 01:09:19,170
AS THOSE OF SUCCESS.

1787
01:09:19,170 --> 01:09:20,938
IT'S EARLY IN THE PROGRAMS BUT

1788
01:09:20,938 --> 01:09:23,608
ALREADY WE'RE COMING ACROSS

1789
01:09:23,608 --> 01:09:25,476
SIGNS AND CRITERIA FOR THOSE

1790
01:09:25,476 --> 01:09:27,412
STUDIES WHICH WERE SHOWING

1791
01:09:27,412 --> 01:09:30,381
PROBLEM AT AN EARLY ENOUGH TAIJ

1792
01:09:30,381 --> 01:09:32,650
TO INTERVENE AND ASSIST, SO IT'S

1793
01:09:32,650 --> 01:09:34,385
NOT PUNITIVE OR RATHER

1794
01:09:34,385 --> 01:09:35,353
CORRECTIVE, AND THEN FINALLY

1795
01:09:35,353 --> 01:09:36,220
JUST ILLUSTRATE THE MULTIPLE

1796
01:09:36,220 --> 01:09:41,392
WAYS THAT ALL OF US AT NIH, BUT

1797
01:09:41,392 --> 01:09:43,528
NIA IN PARTICULAR HAVE TO STAY

1798
01:09:43,528 --> 01:09:47,699
INFORMED OF THE PROGRAMS

1799
01:09:47,699 --> 01:09:48,733
CARRYING IT OUT.

1800
01:09:48,733 --> 01:09:50,902
HERE'S 1 IN DIA OR HERE TOO THE

1801
01:09:50,902 --> 01:09:52,704
POINT OF WHICH WE'RE RECEIVING

1802
01:09:52,704 --> 01:09:53,771
RECOMMENDATIONS THAT WILL

1803
01:09:53,771 --> 01:09:54,706
ULTIMATELY DRIVE THE STRATEGIC

1804
01:09:54,706 --> 01:09:56,107
PLANS BY WHICH WE ACT.

1805
01:09:56,107 --> 01:09:58,776
SO THAT'S IT FOR THOSE

1806
01:09:58,776 --> 01:09:59,911
PRESENTATIONS FROM NIA.

1807
01:09:59,911 --> 01:10:07,018
AND THANKS FOR THE OPPORTUNITY

1808
01:10:07,018 --> 01:10:07,819
TO PARTICIPATE.

1809
01:10:07,819 --> 01:10:10,755
>> THANK YOU RICHARD AND
THEN

1810
01:10:10,755 --> 01:10:11,122
JEANNE.

1811
01:10:11,122 --> 01:10:13,191
NYEAH, HERE I AM HERE PULLING UP

1812
01:10:13,191 --> 01:10:15,560
THE END HERE, AM I THE LAST

1813
01:10:15,560 --> 01:10:16,260
PERSON.

1814
01:10:16,260 --> 01:10:18,229
YEAH, BECAUSE SHANNON'S NOT

1815
01:10:18,229 --> 01:10:18,563
HERE.

1816
01:10:18,563 --> 01:10:18,863
OKAY.

1817
01:10:18,863 --> 01:10:21,332
SO I'M GOING A BIT ROGUE IN A

1818
01:10:21,332 --> 01:10:22,734
COUPLE OF WAYS, 1 I HAVE NO

1819
01:10:22,734 --> 01:10:24,369
SLIDES AND THERE ARE 2 REALLY

1820
01:10:24,369 --> 01:10:27,071
BIG REASONS FOR THAT.

1821
01:10:27,071 --> 01:10:29,140
ONE IS THAT WHEN I THOUGHT ABOUT

1822
01:10:29,140 --> 01:10:30,641
THIS I QUICKLY GOT VERY

1823
01:10:30,641 --> 01:10:34,045
OVERWHELMED BECAUSE THERE IS SO

1824
01:10:34,045 --> 01:10:36,714
MUCH TO TALK ABOUT AND RELATING

1825
01:10:36,714 --> 01:10:38,583
IT DIRECTLY I THINK TO CARE AND

1826
01:10:38,583 --> 01:10:39,517
ADDRESSING UNEQUAL TREATMENT AND

1827
01:10:39,517 --> 01:10:40,551
REALLY HARD.

1828
01:10:40,551 --> 01:10:41,986
I MEAN LIKE AND I'LL COME BACK

1829
01:10:41,986 --> 01:10:46,023
TO MY THOUGHTS ABOUT THAT THE

1830
01:10:46,023 --> 01:10:47,959
OTHER REASONS IS I FIGURED YOU

1831
01:10:47,959 --> 01:10:50,261
WOULD BE TOTALLY POWER POINTED

1832
01:10:50,261 --> 01:10:52,363
OUT BY NOW AND NOT JUST MORE

1833
01:10:52,363 --> 01:10:54,031
POWER POINT EVEN THOUGH THE

1834
01:10:54,031 --> 01:10:55,533
SLIDES WERE EXCELLENT AND

1835
01:10:55,533 --> 01:10:57,368
PROBABLY HELP FOCUS PEOPLE AND I

1836
01:10:57,368 --> 01:10:58,669
WOULD RATHER HAVE MORE TIME FOR

1837
01:10:58,669 --> 01:11:02,874
DISCUSSION BUT LET ME TELL YOU A

1838
01:11:02,874 --> 01:11:03,241
FEW THOUGHTS.

1839
01:11:03,241 --> 01:11:05,209
SO FIRST OF ALL WHEN YOU LOOK AT

1840
01:11:05,209 --> 01:11:05,943
INFECTIOUS DISEASES AND LET ME

1841
01:11:05,943 --> 01:11:09,714
GIVE YOU A SENSE OF OUR MISSION,

1842
01:11:09,714 --> 01:11:11,516
WE SUPPORT AND CONDUCT

1843
01:11:11,516 --> 01:11:13,184
BIOMEDICAL RESEARCH TO BETTER

1844
01:11:13,184 --> 01:11:15,753
UNDERSTAND AND TREAT INFECTIOUS

1845
01:11:15,753 --> 01:11:17,622
IMMUNOLOGIC AND ALLERGIC DECS SO

1846
01:11:17,622 --> 01:11:19,824
TECHNICALLY A LOT OF PRIMARY

1847
01:11:19,824 --> 01:11:20,792
IMMUNOLOGIC RESEARCH IN OUR

1848
01:11:20,792 --> 01:11:23,628
INSTITUTE AS WELL AS ALLERGY AND

1849
01:11:23,628 --> 01:11:24,695
THAT'S HUGE FOR HEALTH EQUITY

1850
01:11:24,695 --> 01:11:29,133
AND I WILL COME BACK TO THAT.

1851
01:11:29,133 --> 01:11:30,668
BUT JUST SO YOU'RE AWARE OF THE

1852
01:11:30,668 --> 01:11:37,642
SPECTRUM OF WHAT WE DO.

1853
01:11:37,642 --> 01:11:39,710
SO THE -- WHEN YOU LOOK AT

1854
01:11:39,710 --> 01:11:41,446
INFECT YOURCANDIDATES DISEASES

1855
01:11:41,446 --> 01:11:43,147
IN HEALTH EQUITY IT IS NOT HARD

1856
01:11:43,147 --> 01:11:43,614
AT ALL.

1857
01:11:43,614 --> 01:11:45,249
THE REASON I GOT OVERWHELMED

1858
01:11:45,249 --> 01:11:48,653
THINKING ABOUT THIS IS JUST

1859
01:11:48,653 --> 01:11:49,720
UNBELIEVABLE EXAMPLES OF HOW

1860
01:11:49,720 --> 01:11:51,122
HEALTH EQUITY THROUGH CARE AND

1861
01:11:51,122 --> 01:11:51,923
THEREFOREY OF INFECT

1862
01:11:51,923 --> 01:11:53,558
YOURCANDIDATES DEC RELATED AND

1863
01:11:53,558 --> 01:11:56,427
INTERVENTIONS AND ALLERGY, TOO,

1864
01:11:56,427 --> 01:11:56,828
REALLY STAND OUT.

1865
01:11:56,828 --> 01:11:59,363
AND I JUFULT WANT  -- JUST WANT

1866
01:11:59,363 --> 01:12:00,698
TO GIVE YOU A COUPLE EXAMPLES

1867
01:12:00,698 --> 01:12:02,867
THAT I THINK WILL HELP SET AND

1868
01:12:02,867 --> 01:12:04,969
MAYBE IT WILL INFORM OUR

1869
01:12:04,969 --> 01:12:07,205
DISCUSSION IN PARTICULAR.

1870
01:12:07,205 --> 01:12:08,706
SO LET'S START BUT WITH 1 THAT

1871
01:12:08,706 --> 01:12:12,944
PEOPLE DON'T TALK ABOUT A LOT

1872
01:12:12,944 --> 01:12:21,953
AND THAT'S TUBERCULOSIS..

1873
01:12:21,953 --> 01:12:22,720
TUBERCULOSIS, SUPPRESSED KOSK 19

1874
01:12:22,720 --> 01:12:25,156
AS THE MOST INFECTIOUS DISEASE

1875
01:12:25,156 --> 01:12:30,261
IN 2022, WHICH IS THE YEAR

1876
01:12:30,261 --> 01:12:31,395
THEY'RE REPORTING ON.

1877
01:12:31,395 --> 01:12:32,363
AND PEOPLE OFTEN THINK THIS IS A

1878
01:12:32,363 --> 01:12:33,464
DISEASE THAT IS NOT A BIG DEAL

1879
01:12:33,464 --> 01:12:36,434
IN THE UNITED STATES BUT I WANT

1880
01:12:36,434 --> 01:12:38,836
TO POINT OUT A PAPER IN JARKS

1881
01:12:38,836 --> 01:12:40,304
AMA THAT CAME OUT JUST THIS PAST

1882
01:12:40,304 --> 01:12:43,007
SEPTEMBER AND IT WAS AN ANALYSIS

1883
01:12:43,007 --> 01:12:46,844
LOOKING AT CONTINUED RACIAL AND

1884
01:12:46,844 --> 01:12:49,347
ETHNIC DISPARITIES IN TB CASES

1885
01:12:49,347 --> 01:12:51,883
AND DEATHS AMONG U.S. PERSONS

1886
01:12:51,883 --> 01:12:52,950
BORN IN THE U.S.

1887
01:12:52,950 --> 01:12:54,886
AND BASICALLY THEY DID A -- TO

1888
01:12:54,886 --> 01:12:56,988
ME THIS IS TERRIFIC HEALTH

1889
01:12:56,988 --> 01:12:57,588
EQUITY RESEARCH.

1890
01:12:57,588 --> 01:12:59,624
IT'S NOT -- IT'S NOT AGAIN, I AM

1891
01:12:59,624 --> 01:13:01,692
NOT A HEALTH QUESHESITY

1892
01:13:01,692 --> 01:13:03,661
RESEARCHER PER SE, CERTIFIED BUT

1893
01:13:03,661 --> 01:13:06,097
TO ME, THIS IS GETTING AT SOME

1894
01:13:06,097 --> 01:13:08,232
OF THE ILLUMINATING SOME OF THE

1895
01:13:08,232 --> 01:13:11,869
DATA THAT WE NEED TO USE TO

1896
01:13:11,869 --> 01:13:12,803
DESIGN THE INTERVENTIONS TO

1897
01:13:12,803 --> 01:13:14,872
ADDRESS THIS, SO WHAT THEY

1898
01:13:14,872 --> 01:13:16,607
REPORTED WAS THAT UNDER THE

1899
01:13:16,607 --> 01:13:18,910
SCENARIO WHERE THE CURRENT

1900
01:13:18,910 --> 01:13:21,212
RACIAL AND ETHNIC INEXPECTATIONS

1901
01:13:21,212 --> 01:13:23,180
QUITYS IN TTB INCIDENTS AND

1902
01:13:23,180 --> 01:13:27,218
DEATH CONTINUE FROM 2023 TO 2035

1903
01:13:27,218 --> 01:13:29,887
AN ESTIMATED 45% OF ALL TB CASES

1904
01:13:29,887 --> 01:13:31,789
AND DEATHS IN THE UNITED STATES

1905
01:13:31,789 --> 01:13:33,524
AMONG U.S. BOARN PEOPLE THIS IS

1906
01:13:33,524 --> 01:13:35,259
NOT EACH THE PEOPLE WE OFTEN

1907
01:13:35,259 --> 01:13:37,128
THINK ABOUT AS QUOTE-UNQUOTE

1908
01:13:37,128 --> 01:13:38,729
BRINGING TB TO THE UNITED STATES

1909
01:13:38,729 --> 01:13:41,365
FROM OTHER COUNTRIES WHERE IT IS

1910
01:13:41,365 --> 01:13:44,235
PERCEIVED TO BE MORE COMMON.

1911
01:13:44,235 --> 01:13:46,070
SO AN ESTIMATED 45% OF ALL CASES

1912
01:13:46,070 --> 01:13:47,338
AND DEATHS WOULD BE ASSOCIATE

1913
01:13:47,338 --> 01:13:51,342
WIDE RACIAL AND ETHNIC

1914
01:13:51,342 --> 01:13:52,877
INEQUALITIES -- INIQUITIES AND A

1915
01:13:52,877 --> 01:13:57,315
GREATER PROPORTION OF CASES AND

1916
01:13:57,315 --> 01:13:59,617
DEATHS AMONG RACIAL POPULATIONS

1917
01:13:59,617 --> 01:14:01,485
AND IF YOU LOOK AT THE COST HERE

1918
01:14:01,485 --> 01:14:03,821
THAT COULD BE REMEDEIABLE IF YOU

1919
01:14:03,821 --> 01:14:05,890
ADDRESS THESE HEALTH EQUITY

1920
01:14:05,890 --> 01:14:06,924
DISPARITIES IT WOULD COST THE

1921
01:14:06,924 --> 01:14:08,559
U.S. ABOUT A BILLION DOLLARS.

1922
01:14:08,559 --> 01:14:12,997
SO TB IS A GREAT EXAMPLE OF HOW

1923
01:14:12,997 --> 01:14:15,232
INEXPECTATIONS QUITYS ACROSS THE

1924
01:14:15,232 --> 01:14:17,935
BOARD JUST CONTINUE TO CREATE

1925
01:14:17,935 --> 01:14:19,136
THIS VERY VULNERABLE POPULATION.

1926
01:14:19,136 --> 01:14:20,304
THE OTHER EXAMPLE THAT I WILL

1927
01:14:20,304 --> 01:14:23,374
JUST TALK ABOUT BRIEFLY IS HIV.

1928
01:14:23,374 --> 01:14:26,477
AND I THINK YOU ARE AWARE THAT

1929
01:14:26,477 --> 01:14:29,113
FOR EXAMPLE, IF YOU LOOK AT THE

1930
01:14:29,113 --> 01:14:30,581
MOST RECENT STATISTIC FOR HIV

1931
01:14:30,581 --> 01:14:34,085
INCIDENCE IN THE UNITED STATES,

1932
01:14:34,085 --> 01:14:37,221
AMONG WOMEN OVERALL IN 2022, 47%

1933
01:14:37,221 --> 01:14:38,456
WERE AMONG BLACK WOMEN.

1934
01:14:38,456 --> 01:14:40,992
FORTY-SEVEN% OF THE NEW HIV

1935
01:14:40,992 --> 01:14:42,026
INFECTIONS IN 2022 DESPITE THE

1936
01:14:42,026 --> 01:14:43,894
FACT THAT BLACK WOMEN ARE LESS

1937
01:14:43,894 --> 01:14:46,263
THAN 12% OF THE U.S. POPULATION.

1938
01:14:46,263 --> 01:14:49,834
SO I DON'T KNOW HOW YOU CAN GET

1939
01:14:49,834 --> 01:14:51,769
MUCH MORE STAGGERINGLY

1940
01:14:51,769 --> 01:14:52,069
IMPRESSED.

1941
01:14:52,069 --> 01:14:54,705
START TO LOOK AT THE NUMBERS,

1942
01:14:54,705 --> 01:14:55,840
PARTICULARLY LATINO HISPANIC MEN

1943
01:14:55,840 --> 01:14:58,776
WHO HAVE SEX WITH MEN AND THAT

1944
01:14:58,776 --> 01:15:00,845
IS REALLY STRIKING AS WELL, THEY

1945
01:15:00,845 --> 01:15:03,080
ACCOUNT FOR A LITTLE UNDER HALF

1946
01:15:03,080 --> 01:15:04,315
OF ALL INFECTIONS.

1947
01:15:04,315 --> 01:15:06,484
NEW HIV INFECTIONS AMONG GAY,

1948
01:15:06,484 --> 01:15:09,120
BISEXUAL AND OTHER MSM, SO I

1949
01:15:09,120 --> 01:15:10,988
JUST USE THOSE 2 INFECTION SORT

1950
01:15:10,988 --> 01:15:12,256
OF SCENARIOS TO FRAME THE

1951
01:15:12,256 --> 01:15:15,526
DISCUSSION OF HOW SEVERE THESE

1952
01:15:15,526 --> 01:15:16,460
HEALTH DISPARITIES ARE AND SO

1953
01:15:16,460 --> 01:15:19,497
MUCH OF IT IS RELATED TO HEALTH

1954
01:15:19,497 --> 01:15:19,730
EQUITY.

1955
01:15:19,730 --> 01:15:20,898
I COULD GIVE YOU MANY OTHER

1956
01:15:20,898 --> 01:15:24,935
EXAMPLES IF YOU LOOK AT RATES OF

1957
01:15:24,935 --> 01:15:28,239
CONGENITAL SYPHILIS, WE HAVE AN

1958
01:15:28,239 --> 01:15:29,674
EXPLOSION AS, LISEO AND I AND

1959
01:15:29,674 --> 01:15:30,808
OTHERS HAVE TALKED ABOUT IN

1960
01:15:30,808 --> 01:15:32,910
WOMEN WHO ARE IN TRIBAL

1961
01:15:32,910 --> 01:15:36,280
POPULATIONS, NATIVE AMERICAN

1962
01:15:36,280 --> 01:15:37,682
POPPULESS, JUST HUGE NUMBER OF

1963
01:15:37,682 --> 01:15:40,651
CASES OCCURRING IN THOSE AREAS,

1964
01:15:40,651 --> 01:15:42,620
TALK ABOUT HEALTH INEQUITY IN

1965
01:15:42,620 --> 01:15:46,557
TERMS OF ACCESS AND PROVISION OF

1966
01:15:46,557 --> 01:15:49,026
APPROPRIATE SCREENING AND CARE

1967
01:15:49,026 --> 01:15:51,462
FOR SYPHILIS IN PREGNANCY.

1968
01:15:51,462 --> 01:15:53,764
VIRAL HEPATITIS AND OF COURSE

1969
01:15:53,764 --> 01:15:54,265
SECTIONUALLY TRANSMITTED

1970
01:15:54,265 --> 01:15:55,232
INFECTIONS WHICH IS THE AREA I

1971
01:15:55,232 --> 01:15:55,866
KNOW BEST.

1972
01:15:55,866 --> 01:15:58,002
SO ALL THAT TO SAY IT'S A GREAT

1973
01:15:58,002 --> 01:15:59,837
LAB RAARE TOY FOR I THINK AND

1974
01:15:59,837 --> 01:16:01,205
IT'S WHAT BROUGHT MANY OF US

1975
01:16:01,205 --> 01:16:04,608
INTO THE FIELD, RIGHT WHO WERE

1976
01:16:04,608 --> 01:16:06,143
VERY INTERESTED IN SOCIAL

1977
01:16:06,143 --> 01:16:09,213
JUSTICE AND HEALTH EQUITY ISSUES

1978
01:16:09,213 --> 01:16:10,614
AROUND HIV CARE PROVISION.

1979
01:16:10,614 --> 01:16:15,853
WHEN THE DISEASE FIRST CAME OUT.

1980
01:16:15,853 --> 01:16:18,389
SO ELISEO MENTIONED HIV AND I

1981
01:16:18,389 --> 01:16:21,225
WANT TO TALK A LITTLE BIT ABOUT

1982
01:16:21,225 --> 01:16:23,194
HOW NIAID IN PARTICULAR OVER THE

1983
01:16:23,194 --> 01:16:25,029
LAST 3 DECADES HAS DRAMATICALLY

1984
01:16:25,029 --> 01:16:27,798
SHIFTED THE LEVEL OF THE CARE

1985
01:16:27,798 --> 01:16:30,167
AND DIALOGUE AROUND INVOLVING

1986
01:16:30,167 --> 01:16:31,335
COMMUNITIES AND ADDRESSING

1987
01:16:31,335 --> 01:16:32,603
HEALTH EQUITY IN RESEARCH

1988
01:16:32,603 --> 01:16:34,105
RELATED TO HIV CARE EMPLOY

1989
01:16:34,105 --> 01:16:37,708
BECAUSE I TIMES DON'T KNOW IF

1990
01:16:37,708 --> 01:16:39,610
PEOPLE REALIZE WHAT A GOLD

1991
01:16:39,610 --> 01:16:42,146
STANDARD, SOME OF THE HIV

1992
01:16:42,146 --> 01:16:45,649
RESEARCH NETWORKS HAVE SET, OR

1993
01:16:45,649 --> 01:16:47,818
ENGAGING COMMUNITY AND

1994
01:16:47,818 --> 01:16:49,019
ADDRESSING HEALTH DISPARITIES,

1995
01:16:49,019 --> 01:16:50,521
HEALTH INEQUITY WHEN WE THINK

1996
01:16:50,521 --> 01:16:52,323
ABOUT PARTICIPATION AND RESEARCH

1997
01:16:52,323 --> 01:16:53,491
AND ALSO IN IMPLEMENTATION

1998
01:16:53,491 --> 01:16:55,793
SCIENCE WHICH WE HAVE EMBRACED

1999
01:16:55,793 --> 01:16:58,462
QUITE A LOT MORE IN THE LAST

2000
01:16:58,462 --> 01:17:00,798
5-10 YEARS, 5 YEARS THAN WE EVER

2001
01:17:00,798 --> 01:17:02,633
HAVE BEFORE BECAUSE PEOPLE OFTEN

2002
01:17:02,633 --> 01:17:04,268
THINK OF NIAID AS DOING BASIC

2003
01:17:04,268 --> 01:17:07,638
SCIENCE ONLY AND THAT IS REALLY

2004
01:17:07,638 --> 01:17:09,907
NOT -- NOT EXCLUSIVELY TRUE AT

2005
01:17:09,907 --> 01:17:10,074
ALL.

2006
01:17:10,074 --> 01:17:14,779
SO I THINK I WOULD JUST POINT

2007
01:17:14,779 --> 01:17:16,647
OUT THAT THE HIV NETWORKS WHICH

2008
01:17:16,647 --> 01:17:19,416
INCLUDE THE HIV VACCINE TRIALS

2009
01:17:19,416 --> 01:17:21,452
NETWORK, HIV PREVENTION TRIALS

2010
01:17:21,452 --> 01:17:23,020
NETWORK, CLINICAL TRIALS GROUP

2011
01:17:23,020 --> 01:17:25,289
WHICH REALLY STUDIES TREATMENT

2012
01:17:25,289 --> 01:17:27,792
AND CO-MORBIDITIES IN HIV, VERY

2013
01:17:27,792 --> 01:17:30,728
IMPORTANT IN AGING AS RICHARD

2014
01:17:30,728 --> 01:17:33,197
HAS MENTIONED, THOSE GROUPS HAVE

2015
01:17:33,197 --> 01:17:35,399
PROBABLY SOME OF THE MOST ROBUST

2016
01:17:35,399 --> 01:17:38,569
COMMUNITY WORKING GROUPS I HAVE

2017
01:17:38,569 --> 01:17:41,105
EVER WORKED WITH AND THEY ARE

2018
01:17:41,105 --> 01:17:46,010
REALLY ENGAGED FROM THE CONCEPT

2019
01:17:46,010 --> 01:17:46,710
DEVELOPMENT OF AN INTERVENTION

2020
01:17:46,710 --> 01:17:48,712
ALL THE WAY THROUGH HOW YOU

2021
01:17:48,712 --> 01:17:49,480
DISSEMINATE THE FINDINGS TO THE

2022
01:17:49,480 --> 01:17:50,614
COMMUNITY AND WHAT THE IMPACT ON

2023
01:17:50,614 --> 01:17:52,650
THE COMMUNITY IS GOING TO BE AND

2024
01:17:52,650 --> 01:17:56,287
I THINK THAT THAT SORT OF

2025
01:17:56,287 --> 01:17:57,087
SPECTRUM OF INVOLVEMENT CAN

2026
01:17:57,087 --> 01:17:58,989
ADDRESS AT LEAST A LOT OF THE

2027
01:17:58,989 --> 01:18:00,491
ISSUES AROUND GETTING PEOPLE TO

2028
01:18:00,491 --> 01:18:01,826
UNDERSTAND WHAT PARTICIPATING IN

2029
01:18:01,826 --> 01:18:03,127
RESEARCH IS ABOUT AND MORE

2030
01:18:03,127 --> 01:18:04,295
IMPORTANTLY MAKING SURE THAT THE

2031
01:18:04,295 --> 01:18:06,831
RESEARCH SPEAKS TO THE NEEDS OF

2032
01:18:06,831 --> 01:18:08,465
COMMUNITIES ESPECIALLY THOSE WHO

2033
01:18:08,465 --> 01:18:09,567
HAVE SIGNIFICANT HEALTH

2034
01:18:09,567 --> 01:18:10,401
DISPARITIES, SO I'M REALLY PROUD

2035
01:18:10,401 --> 01:18:11,936
OF THAT, IT'S NOT PERFECT, I'M

2036
01:18:11,936 --> 01:18:14,004
NOT SAYING WE'RE THE ONLY PEOPLE

2037
01:18:14,004 --> 01:18:16,106
WHO DO IT, BUT HAVING GOTTEN

2038
01:18:16,106 --> 01:18:18,375
INVOLVED IN SOME OTHER NETWORKS

2039
01:18:18,375 --> 01:18:22,046
THAT STUDY INFECTIOUS DISEASES,

2040
01:18:22,046 --> 01:18:24,648
CAN SAY I THINK IT SETS A VERY,

2041
01:18:24,648 --> 01:18:25,115
VERY HIGH STANDARD.

2042
01:18:25,115 --> 01:18:26,283
THE OTHER THING THAT WAS

2043
01:18:26,283 --> 01:18:29,119
DISCUSSED A BUNCH OF TIMES

2044
01:18:29,119 --> 01:18:31,121
TODAY, AT LEAST FROM THE NINDS

2045
01:18:31,121 --> 01:18:33,324
TEAM AND ALSO FROM THE NIA TEAM

2046
01:18:33,324 --> 01:18:37,061
IS HOW YOU DEVELOP THE WORKFORCE

2047
01:18:37,061 --> 01:18:37,962
FOR SCIENTIFIC INVESTIGATION AND

2048
01:18:37,962 --> 01:18:39,263
OF COURSE WE DO ALL THE THINGS

2049
01:18:39,263 --> 01:18:41,765
THAT YOU ALWAYS MENTIONED IN

2050
01:18:41,765 --> 01:18:47,872
TERMS OF PRIMATES PORITIZING

2051
01:18:47,872 --> 01:18:49,373
RESEARCHER DIVERSITY, THE

2052
01:18:49,373 --> 01:18:52,243
NETWORKS HAVE FELLOWSHIP PILOT

2053
01:18:52,243 --> 01:18:53,777
AWARDS SO THAT THEY'RE WORKING

2054
01:18:53,777 --> 01:18:56,914
IN AREAS WHERE DISPARITIES ARE

2055
01:18:56,914 --> 01:18:57,381
REALLY INTENSE.

2056
01:18:57,381 --> 01:19:00,384
SO THEY DO A REALLY GOOD JOB,

2057
01:19:00,384 --> 01:19:02,386
BUT YOU KNOW I WANT TO MAKE THAT

2058
01:19:02,386 --> 01:19:06,490
LINK BETWEEN THE DIVERSITY OF

2059
01:19:06,490 --> 01:19:07,892
RESEARCH TEAMS INVESTIGATORS,

2060
01:19:07,892 --> 01:19:09,593
PROVIDERS AND QUALITY OF CARE TO

2061
01:19:09,593 --> 01:19:12,263
PEOPLE WHO ARE EXPERIENCING

2062
01:19:12,263 --> 01:19:14,298
HEALTH INIQUITIES, DOES IT

2063
01:19:14,298 --> 01:19:14,899
MATTER?

2064
01:19:14,899 --> 01:19:18,202
AND I KNOW VERY BRIEFLY 1 OF THE

2065
01:19:18,202 --> 01:19:19,370
INTRODUCTORY SPEAKERS INVOLVED

2066
01:19:19,370 --> 01:19:20,638
IN THIS EXCELLENT REPORT TALKED

2067
01:19:20,638 --> 01:19:25,109
ABOUT THE RESEARCH THAT LOOKS AT

2068
01:19:25,109 --> 01:19:27,144
CONCORDANCE OF PROVIDERS WITH

2069
01:19:27,144 --> 01:19:30,014
THEIR PATIENTS AND WHETHER THAT

2070
01:19:30,014 --> 01:19:40,491
RELATES TO OUTCOMES COMES OR

2071
01:19:40,724 --> 01:19:40,991
SATISFACTIONS.

2072
01:19:40,991 --> 01:19:42,826
AND THINK BEING THAT IN THE

2073
01:19:42,826 --> 01:19:44,962
SOUTH, CAN BE STIGMATIZED TO IT

2074
01:19:44,962 --> 01:19:46,463
CAN BE DIFFICULT TO TALK TO

2075
01:19:46,463 --> 01:19:48,265
PEOPLE WHO DON'T LOOK LIKE YOU,

2076
01:19:48,265 --> 01:19:49,266
DON'T UNDERSTAND WHERE YOU CAN

2077
01:19:49,266 --> 01:19:54,772
AM FROM, TALK LIKE YOU, AND I

2078
01:19:54,772 --> 01:19:56,273
HAVE ANECDOTAL DATA FOR THIS BUT

2079
01:19:56,273 --> 01:19:57,808
THERE'S A LOT OF DATA THAT LOOKS

2080
01:19:57,808 --> 01:19:58,842
AT THIS.

2081
01:19:58,842 --> 01:19:59,710
BUT I CAN'T EMPHASIZE ENOUGH

2082
01:19:59,710 --> 01:20:01,512
WHAT IS THE IMPORTANCE OF

2083
01:20:01,512 --> 01:20:03,147
CREATING A FORK FORCE WHETHER

2084
01:20:03,147 --> 01:20:09,486
YOU'RE TALKING -- WORKFORCE

2085
01:20:09,486 --> 01:20:11,689
WHETHER YOU'RE TALKING ABOUT

2086
01:20:11,689 --> 01:20:13,624
PATIENT CARE, I THINK THAT'S

2087
01:20:13,624 --> 01:20:14,692
SOMETHING WE HAVEN'T DONE A GOOD

2088
01:20:14,692 --> 01:20:17,962
JOB OF AND HAVE A REMAINING

2089
01:20:17,962 --> 01:20:18,329
CHALLENGE FOR.

2090
01:20:18,329 --> 01:20:19,330
THE LAST THING I WILL SAY IS

2091
01:20:19,330 --> 01:20:20,631
THAT THERE ARE A COUPLE OF

2092
01:20:20,631 --> 01:20:23,400
PROGRAMS AND AS PART OF THIS I

2093
01:20:23,400 --> 01:20:25,135
AM REALLY EMBARRASSED BY WHAT

2094
01:20:25,135 --> 01:20:27,705
COMES UP IF YOU DO A RESEARCH OF

2095
01:20:27,705 --> 01:20:28,605
NIAID AND HEALTH EQUITY BECAUSE

2096
01:20:28,605 --> 01:20:33,911
YOU GET A PAGE THAT I JUST TRIED

2097
01:20:33,911 --> 01:20:35,179
-- CONTACTED MY COMS PERSON

2098
01:20:35,179 --> 01:20:37,114
ABOUT BECAUSE IT IS REALLY LAME.

2099
01:20:37,114 --> 01:20:39,350
IT LISTS 2 PROGRAMS THAT ARE

2100
01:20:39,350 --> 01:20:39,650
EXCELLENT.

2101
01:20:39,650 --> 01:20:40,317
THE REPRIEVE PROGRAM WHICH YOU

2102
01:20:40,317 --> 01:20:43,520
MAY KNOW IS A STUDY WE DID WITH

2103
01:20:43,520 --> 01:20:45,723
NHLBI, TO LOOK AT EARLY STATIN

2104
01:20:45,723 --> 01:20:47,491
THERAPY IN PEOPLE LIVING WITH

2105
01:20:47,491 --> 01:20:49,193
HIV, REGARDLESS OF WHETHER THEY

2106
01:20:49,193 --> 01:20:53,364
HAD HIGH CHOLESTEROL AND IT

2107
01:20:53,364 --> 01:20:54,665
SHOWED BEAUTIFUL RESULT IN

2108
01:20:54,665 --> 01:20:55,733
ENHANCING OUTCOMES AND IT ALSO

2109
01:20:55,733 --> 01:20:57,968
TALKS ABOUT OUR ASTHMA WORK

2110
01:20:57,968 --> 01:21:00,738
WHICH GETTING BACK TO

2111
01:21:00,738 --> 01:21:01,171
INIQUITIES.

2112
01:21:01,171 --> 01:21:02,906
IF YOU LOOK AT RACIAL

2113
01:21:02,906 --> 01:21:05,509
DISPARITIES IN ASTHMA IN

2114
01:21:05,509 --> 01:21:07,478
CHILDHOOD, THAT IS REALLY WHAT

2115
01:21:07,478 --> 01:21:10,948
SORT OF GALVANIZED A LOT OF

2116
01:21:10,948 --> 01:21:13,650
PEOPLE TO STUDY THE PATTERNS OF

2117
01:21:13,650 --> 01:21:15,686
INNER CITY ORIGINALLY ASTHMA AND

2118
01:21:15,686 --> 01:21:18,155
REALLY DEFINE WHAD WAS MODIFYING

2119
01:21:18,155 --> 01:21:20,691
THE LIKELIHOOD OF REACTIVITY AND

2120
01:21:20,691 --> 01:21:22,993
INTERVENTIONS DESIGNED TO

2121
01:21:22,993 --> 01:21:24,228
ADDRESS THOSE THINGS.

2122
01:21:24,228 --> 01:21:25,462
WE HAVE DONE SO MUCH MORE AND 1

2123
01:21:25,462 --> 01:21:26,930
THING I WANT TO POINT OUT BAUDS

2124
01:21:26,930 --> 01:21:29,066
WE LOOK SO BAD ON THAT TABLE

2125
01:21:29,066 --> 01:21:30,734
THAT'S IN THE REPORT, I'M A

2126
01:21:30,734 --> 01:21:32,970
LITTLE DEFENSIVE ABOUT THAT

2127
01:21:32,970 --> 01:21:34,505
TABLE BECAUSE WHAT'S NOT

2128
01:21:34,505 --> 01:21:35,639
REPRESENTED IN THAT TABLE AND

2129
01:21:35,639 --> 01:21:37,274
ALSO IT'S A HUGE TIME SPAN, I

2130
01:21:37,274 --> 01:21:39,710
WILL TELL YOU THINGS ARE VERY

2131
01:21:39,710 --> 01:21:42,346
DIFFERENT THAN THEY WERE IN

2132
01:21:42,346 --> 01:21:42,679
2004.

2133
01:21:42,679 --> 01:21:44,348
WHAT IT DOESN'T TELL YOU IS THE

2134
01:21:44,348 --> 01:21:46,050
INVESTMENT WE PUT FOR EXAMPLE,

2135
01:21:46,050 --> 01:21:49,253
IN OUR HIV RELATED NETWORKS THAT

2136
01:21:49,253 --> 01:21:51,088
GOES TO THE COMMUNITY PIECES

2137
01:21:51,088 --> 01:21:53,457
THAT I THINK DIRECTLY ADDRESS

2138
01:21:53,457 --> 01:21:55,192
AND SUPPORT HEALTH EQUITY WORK

2139
01:21:55,192 --> 01:21:57,261
BUT IT'S HARD TO SORT OF DRIVE

2140
01:21:57,261 --> 01:21:58,996
THAT LINK OR SORT OF, YOU KNOW

2141
01:21:58,996 --> 01:22:02,099
SORT OF DEFINE THAT LINK

2142
01:22:02,099 --> 01:22:02,399
DIRECTLY.

2143
01:22:02,399 --> 01:22:03,934
COUPLE OF OTHER EXAMPLES THAT I

2144
01:22:03,934 --> 01:22:10,340
THINK SPEAK TO OUR POWER IN

2145
01:22:10,340 --> 01:22:11,975
ADDRESSING HEALTH EQUITY, WE

2146
01:22:11,975 --> 01:22:12,910
HAVE DONE AN INTRAMURAL PROGRAM

2147
01:22:12,910 --> 01:22:19,450
AND I SEE THIS WORK LARGELY LED

2148
01:22:19,450 --> 01:22:22,219
BY HENRY MASSUER, WORKING IN

2149
01:22:22,219 --> 01:22:23,821
INNER CITY BALTIMORE, INNER CITY

2150
01:22:23,821 --> 01:22:25,823
D. C. SPURRED BY FINDING IN

2151
01:22:25,823 --> 01:22:27,891
EARLY 2010s THAT THE HIV

2152
01:22:27,891 --> 01:22:30,727
INDENSE IN D. C. WAS HIGHER IN

2153
01:22:30,727 --> 01:22:34,698
SOME PLACES THAN IN SUB-SAHARAN

2154
01:22:34,698 --> 01:22:36,266
AFRICA, OVER 8% AND WE WORKED

2155
01:22:36,266 --> 01:22:38,102
REALLY HARD TO PARTNER WITH

2156
01:22:38,102 --> 01:22:39,269
COMMUNITY PARTNERS TO GET

2157
01:22:39,269 --> 01:22:41,004
INTERVENTIONS OUT THERE AND

2158
01:22:41,004 --> 01:22:42,573
AFFECT SOME OF THE CLIENTS THERE

2159
01:22:42,573 --> 01:22:43,907
AND HAD DONE THE SAME IN

2160
01:22:43,907 --> 01:22:44,174
BALTIMORE.

2161
01:22:44,174 --> 01:22:46,076
SO I WILL TOP THERE.

2162
01:22:46,076 --> 01:22:47,678
THERE'S JUST SO MUCH RICH

2163
01:22:47,678 --> 01:22:51,048
DISCUSSION TO BE HAD HERE.

2164
01:22:51,048 --> 01:22:52,983
AND I REALLY LOOK FORWARD TO

2165
01:22:52,983 --> 01:22:54,651
QUESTIONS AND PEOPLE CHALLENGING

2166
01:22:54,651 --> 01:22:55,452
ME.

2167
01:22:55,452 --> 01:22:55,686
THANKS.

2168
01:22:55,686 --> 01:22:59,022
>> WELL WE ONLY HAVE A FEW

2169
01:22:59,022 --> 01:23:02,693
MINUTES LEFT BUT THIS WAS REALLY

2170
01:23:02,693 --> 01:23:06,430
SPECTACULAR AND JEANNE, YOU'RE

2171
01:23:06,430 --> 01:23:06,864
RIGHT.

2172
01:23:06,864 --> 01:23:08,765
HIV IS A MAJOR MAJOR PART OF ALL

2173
01:23:08,765 --> 01:23:11,335
OF THIS AND IT'S A SUCCESS

2174
01:23:11,335 --> 01:23:13,270
STORY, THAT'S WHY WE WANT TO

2175
01:23:13,270 --> 01:23:14,872
KEEP PUSHING FOR ELEMINATION

2176
01:23:14,872 --> 01:23:16,740
WITH 70% OF BOTH PEOPLE LIVING

2177
01:23:16,740 --> 01:23:19,610
WITH HIV AND NEW INFECTIONS

2178
01:23:19,610 --> 01:23:20,911
COMING, AND MOSTLY WITH MEN OF

2179
01:23:20,911 --> 01:23:22,779
COLOR WHO HAVE SEX WITH MEN BUT

2180
01:23:22,779 --> 01:23:26,283
ALSO AS YOU POINTED OUT THE

2181
01:23:26,283 --> 01:23:30,787
WOMEN WHO HAVE INTIMACY WITH

2182
01:23:30,787 --> 01:23:32,956
THESE INDIVIDUALS I THINK IT'S A

2183
01:23:32,956 --> 01:23:34,358
MAJOR AREA OF EMPHASIS THAT WE

2184
01:23:34,358 --> 01:23:39,429
ALL HAVE TALKED ABOUT.

2185
01:23:39,429 --> 01:23:43,800
SO I ALSO WANT TO SEE IF

2186
01:23:43,800 --> 01:23:45,002
MARGARITA AND CONSUELO, AND

2187
01:23:45,002 --> 01:23:46,370
DARREL WHO JOINED US HAVE

2188
01:23:46,370 --> 01:23:48,138
QUESTIONS FOR YOU GUYS.

2189
01:23:48,138 --> 01:23:52,176
>> I JUST WANTED TO MAKE A

2190
01:23:52,176 --> 01:23:54,378
COMMENT TO DR. HODES, WE HAVE A

2191
01:23:54,378 --> 01:23:56,246
TRIAL THAT WE JUST FINISHED IN

2192
01:23:56,246 --> 01:24:00,918
YOU'RE INSTITUTE AND WE WERE

2193
01:24:00,918 --> 01:24:02,753
ABLE TO RECRUIT 427 MINORITIZED

2194
01:24:02,753 --> 01:24:04,621
INDIVIDUALS, SO IT'S DOABLE,

2195
01:24:04,621 --> 01:24:06,690
IT'S REALLY DOABLE, WHEN I HEAR

2196
01:24:06,690 --> 01:24:08,759
PEOPLE SAYING IT'S HARD TO

2197
01:24:08,759 --> 01:24:10,627
RECRUIT, I THINK IT DEPENDS THE

2198
01:24:10,627 --> 01:24:12,729
STRATEGIES THAT ARE DONE, WE ARE

2199
01:24:12,729 --> 01:24:14,831
DOING WAY BETTER IN TERMS OF

2200
01:24:14,831 --> 01:24:17,734
RECRUITMENT AND ALSO IN

2201
01:24:17,734 --> 01:24:19,036
REPRESENTING THE POPULATIONS.

2202
01:24:19,036 --> 01:24:21,438
I THINK THE BIGGEST ISSUE IS

2203
01:24:21,438 --> 01:24:22,372
HAVING TRUST, THE COMMUNITY

2204
01:24:22,372 --> 01:24:23,507
HAVING TRUST IN US.

2205
01:24:23,507 --> 01:24:26,410
AND I THINK THAT'S WHERE WE HAVE

2206
01:24:26,410 --> 01:24:28,145
FAILED AND I THINK WE NOW NEED

2207
01:24:28,145 --> 01:24:31,915
TO MAKE SURE THAT WE INVEST IN

2208
01:24:31,915 --> 01:24:33,617
THE NEXT YEARS TO DO THAT

2209
01:24:33,617 --> 01:24:35,219
BECAUSE IT'S VERY DOABLE AND

2210
01:24:35,219 --> 01:24:38,922
THEN DO DR. MARRAZZO, I'M SO

2211
01:24:38,922 --> 01:24:40,190
GRATEFUL FOR THE TB EXAMPLE

2212
01:24:40,190 --> 01:24:42,693
BECAUSE I THINK WE'RE MISSING

2213
01:24:42,693 --> 01:24:45,996
THE BOAT AND NOT SEEING THIS AS

2214
01:24:45,996 --> 01:24:49,066
-- ESPECIALLY HAVING RACIALLY

2215
01:24:49,066 --> 01:24:51,235
ETHNICALLY AND LANGUAGE

2216
01:24:51,235 --> 01:24:52,502
CONCORDANT PROVIDERS THAT CAN

2217
01:24:52,502 --> 01:24:54,338
REALLY LINK TO THE POPULATION.

2218
01:24:54,338 --> 01:24:58,175
SO THANKS FOR MAKING THOSE AND

2219
01:24:58,175 --> 01:25:00,911
DR. BENSON, I THINK IT'S

2220
01:25:00,911 --> 01:25:01,845
COMMENDABLE OF ALL OF YOU THAT

2221
01:25:01,845 --> 01:25:05,249
WE ALL HAVE THE SAME GOAL OF

2222
01:25:05,249 --> 01:25:06,650
MAKING SURE THAT THE NEXT 10

2223
01:25:06,650 --> 01:25:08,952
YEARS WE DON'T DO A REPORT THAT

2224
01:25:08,952 --> 01:25:15,058
HAS THE SAME RESULTS.

2225
01:25:15,058 --> 01:25:18,362
>> YEAH, I ALSO ECHO THE

2226
01:25:18,362 --> 01:25:18,895
COMMENDATIONS, EVERYONE'S

2227
01:25:18,895 --> 01:25:20,097
COMMITMENT TO THIS WORK, IT'S

2228
01:25:20,097 --> 01:25:22,499
REALLY GREAT TO SEE THIS

2229
01:25:22,499 --> 01:25:24,001
HAPPENING AT SO MANY INSTITUTES

2230
01:25:24,001 --> 01:25:30,741
AT THE N IH, I ALSO WOULD ECHO

2231
01:25:30,741 --> 01:25:32,576
MAGGIES COMMENTS ABOUT THE

2232
01:25:32,576 --> 01:25:36,546
RECRUITMENT, YOU KNOW WE SEE

2233
01:25:36,546 --> 01:25:37,614
RECRUITMENT INTO STUDIES AND

2234
01:25:37,614 --> 01:25:38,982
CLINICAL TRIALS BEING DONE VERY

2235
01:25:38,982 --> 01:25:42,119
WELL BY MANY PEOPLE AND THERE

2236
01:25:42,119 --> 01:25:43,954
ARE IMPORTANT LEARNINGS, I THINK

2237
01:25:43,954 --> 01:25:48,558
1 AREA THAT I WOULD PERSONALLY

2238
01:25:48,558 --> 01:25:50,627
CHALLENGE NIH IS AROUND

2239
01:25:50,627 --> 01:25:51,695
ACCOUNTABILITY THERE, YOU KNOW

2240
01:25:51,695 --> 01:25:55,766
WE HAVE STUDIES WHO SUBMIT THEIR

2241
01:25:55,766 --> 01:25:58,135
ENROLLMENT TABLES AND WHEN THEY

2242
01:25:58,135 --> 01:26:00,771
DON'T ACHIEVE THOSE GOALS AROUND

2243
01:26:00,771 --> 01:26:02,439
RACIAL AND ETHNIC DIVERSITY OR

2244
01:26:02,439 --> 01:26:04,508
GENDER DIVERSITY, YOU KNOW THE

2245
01:26:04,508 --> 01:26:06,076
FUNDING DOESN'T STOP, YOU KNOW

2246
01:26:06,076 --> 01:26:08,178
THERE'S NO 1 REALLY HOLDING THEM

2247
01:26:08,178 --> 01:26:10,147
ACCOUNTABLE, NOT THAT THAT

2248
01:26:10,147 --> 01:26:11,415
ACCOUNTABILITY IS TOTALLY PLACED

2249
01:26:11,415 --> 01:26:14,384
ON THE FUNDER, BUT I THINK

2250
01:26:14,384 --> 01:26:18,155
THAT'S AN IMPORTANT LEVER AND I

2251
01:26:18,155 --> 01:26:20,590
DO AGREE THAT THE TABLE WE

2252
01:26:20,590 --> 01:26:21,825
PRESENTED NEEDS CONTEXT AND

2253
01:26:21,825 --> 01:26:24,461
WOULD BE BETTER COMING FROM

2254
01:26:24,461 --> 01:26:26,096
THOSE OF YOU WITHIN THE

2255
01:26:26,096 --> 01:26:27,831
ORGANIZATION, WITHIN THE NIH WHO

2256
01:26:27,831 --> 01:26:33,704
COULD ACTUALLY TELL US WHAT

2257
01:26:33,704 --> 01:26:34,971
PERCENTAGES REALLY REFLECT

2258
01:26:34,971 --> 01:26:35,906
HEALTH EQUITY AND HEALTH

2259
01:26:35,906 --> 01:26:37,040
DISPARITIES RESEARCH BUT WHEN WE

2260
01:26:37,040 --> 01:26:38,475
ASK FOR THAT IT WASN'T AVAILABLE

2261
01:26:38,475 --> 01:26:41,445
SO WE DID OUR BEST WITH WHAT WAS

2262
01:26:41,445 --> 01:26:41,878
AVAILABLE.

2263
01:26:41,878 --> 01:26:43,880
>> I DID NOT MEAN TO BE
CRITICAL

2264
01:26:43,880 --> 01:26:46,183
OF YOU, OBVIOUSLY, IT'S JUST

2265
01:26:46,183 --> 01:26:47,317
THAT THOSE NUMBERS TINNING ME

2266
01:26:47,317 --> 01:26:48,618
PERSONALLY A LITTLE BIT SO THERE

2267
01:26:48,618 --> 01:26:50,320
YOU GO.

2268
01:26:50,320 --> 01:26:53,990
>> I THINK THE RANK ORDER
IS

2269
01:26:53,990 --> 01:26:54,958
CONSISTENT WITH THE ANALYSIS I

2270
01:26:54,958 --> 01:26:58,929
HAVE SEEN FOR THE MOST RECENT

2271
01:26:58,929 --> 01:26:59,363
YEAR.

2272
01:26:59,363 --> 01:27:01,498
IT'S IN THAT BALLPARK BUT THE

2273
01:27:01,498 --> 01:27:02,032
BUDGETS ARE DRAMATICALLY

2274
01:27:02,032 --> 01:27:03,834
DIFFERENT AND WE HAVE 2

2275
01:27:03,834 --> 01:27:06,236
INSTITUTES HERE WITH VERY LARGE

2276
01:27:06,236 --> 01:27:08,405
BUDGETS AND NINDS IS A HIGH,

2277
01:27:08,405 --> 01:27:13,243
VERY HIGH AS WELL IN THE MIDDLE

2278
01:27:13,243 --> 01:27:13,844
GROUP.

2279
01:27:13,844 --> 01:27:18,382
SO NURSING IS NIM HD ARE THE 2

2280
01:27:18,382 --> 01:27:20,150
HIGHEST AND I THINK NCATS BASED

2281
01:27:20,150 --> 01:27:24,121
ALSO ON HOW THEY DEVELOP THEIR

2282
01:27:24,121 --> 01:27:26,523
-- THEY'RE DIFFERENT RIGHT?

2283
01:27:26,523 --> 01:27:27,724
>> THE INFRASTRUCTURE IS

2284
01:27:27,724 --> 01:27:30,627
DEFINITE. 

2285
01:27:30,627 --> 01:27:33,230
>> YEAH, YEAH.

2286
01:27:33,230 --> 01:27:35,766
>> ALSO TO CONSUELO AND

2287
01:27:35,766 --> 01:27:37,300
MARGARITA SO IMPORTANT THAT WE

2288
01:27:37,300 --> 01:27:38,101
CAPTURE THE LESSONS YOU HAVE TO

2289
01:27:38,101 --> 01:27:39,636
TEACH US SO THAT OTHERS CAN

2290
01:27:39,636 --> 01:27:44,174
ACHIEVE AS WELL AS YOU AND WE'VE

2291
01:27:44,174 --> 01:27:45,509
HEARD SOME COMMUNITY INVOLVEMENT

2292
01:27:45,509 --> 01:27:47,077
BUT SOMEHOW THE WORD SAYS HAVE

2293
01:27:47,077 --> 01:27:48,478
BEEN EASIER THAN THEIR

2294
01:27:48,478 --> 01:27:49,179
CORPORATION INTO ACTION AND

2295
01:27:49,179 --> 01:27:52,149
PRINCIPLE AND HOW WE BUILD THOSE

2296
01:27:52,149 --> 01:27:53,884
INTO SOLICITATIONS AND

2297
01:27:53,884 --> 01:27:55,619
REQUIREMENTS FOR APPLICATIONS

2298
01:27:55,619 --> 01:27:56,987
FOR CLINICAL RESEARCH, WE HAVE A

2299
01:27:56,987 --> 01:27:59,222
LOT TO LEARN FROM THOSE SUCCESS

2300
01:27:59,222 --> 01:27:59,423
CASES.

2301
01:27:59,423 --> 01:28:02,058
>> WELL, I WILL SAY THIS
FOR

2302
01:28:02,058 --> 01:28:04,895
RICHARD AND CONSUELO, WHEN I WAS

2303
01:28:04,895 --> 01:28:08,865
ON RICHARD'S COUNSEL  MANY YEARS

2304
01:28:08,865 --> 01:28:12,235
AGO, I MENTIONED WHAT YOU SAID

2305
01:28:12,235 --> 01:28:13,737
CONSUELO, ABOUT ACCOUNTABILITY

2306
01:28:13,737 --> 01:28:15,305
AND RECRUITMENT, AND WE ALL SAID

2307
01:28:15,305 --> 01:28:16,206
YEAH, THAT'S GREAT.

2308
01:28:16,206 --> 01:28:18,608
BUT THERE'S NO LEVERAGE TO DO

2309
01:28:18,608 --> 01:28:20,610
THAT, THE NEW REVIEW CRITERIA

2310
01:28:20,610 --> 01:28:22,312
INCORPORATE THE HUMAN SUBJEKS

2311
01:28:22,312 --> 01:28:24,080
PART INTO A SCORING CATEGORY, SO

2312
01:28:24,080 --> 01:28:25,949
NOW IT'S NOT JUST A CHECK BOX OF

2313
01:28:25,949 --> 01:28:27,784
YEAH, THEY HAVE AN ADEQUATE

2314
01:28:27,784 --> 01:28:29,886
PLAN, BUT NOW IT'S SUPPOSED TO

2315
01:28:29,886 --> 01:28:31,755
BE CONSIDERED IN 1 OF THE

2316
01:28:31,755 --> 01:28:32,189
SCORING CATEGORIES.

2317
01:28:32,189 --> 01:28:36,092
SO WE'LL HAVE TO SEE HOW THAT

2318
01:28:36,092 --> 01:28:38,528
PLAYS OUT SO AND I THINK THAT

2319
01:28:38,528 --> 01:28:43,533
STARTS IN 25, RIGHT?

2320
01:28:43,533 --> 01:28:45,135
NEXT MONTH.

2321
01:28:45,135 --> 01:28:46,403
>> QUESTION FOR THE PANEL.

2322
01:28:46,403 --> 01:28:48,939
I THINK WHEN YOU THINK IN TERMS

2323
01:28:48,939 --> 01:28:49,973
OF ENDING UNEQUAL TREATMENT THAT

2324
01:28:49,973 --> 01:28:53,410
MAKES YOU SORT OF CONSIDER THE

2325
01:28:53,410 --> 01:28:54,911
HEALTHCARE SYSTEM AND THOSE

2326
01:28:54,911 --> 01:28:56,813
HEALTHCARE SYSTEM RELATED

2327
01:28:56,813 --> 01:28:58,448
FACTORS, JUST WANT TO KNOW FROM

2328
01:28:58,448 --> 01:29:02,252
YOU IN TERMS OF THE ACADEMIC,

2329
01:29:02,252 --> 01:29:02,953
EXTRAMURAL INVESTIGATORS WHAT

2330
01:29:02,953 --> 01:29:05,755
TERMINOLOGY ARE YOU USING NOW I

2331
01:29:05,755 --> 01:29:07,290
THINK IN THIS ENVIRONMENT IN

2332
01:29:07,290 --> 01:29:09,459
TERMS OF ADJUSTING THIS TYPE OF

2333
01:29:09,459 --> 01:29:10,060
RESEARCH?

2334
01:29:10,060 --> 01:29:12,028
ARE YOU CONSIDERING MOVINGA, WAY

2335
01:29:12,028 --> 01:29:15,065
FROM INDIVIDUAL LEVEL FACTORS?

2336
01:29:15,065 --> 01:29:17,167
AND MORE TOWARDS THOSE

2337
01:29:17,167 --> 01:29:22,539
STRUCTURAL BARRIERS THAT IMPACT

2338
01:29:22,539 --> 01:29:23,640
TREATMENT VERSUS FOCUSING ON

2339
01:29:23,640 --> 01:29:24,708
SPECIFIC GROUPS?

2340
01:29:24,708 --> 01:29:27,277
AND HOW THAT IMPACTS YOUR WORK

2341
01:29:27,277 --> 01:29:29,346
MOVING FORWARD BECAUSE I KNOW IT

2342
01:29:29,346 --> 01:29:31,882
MAY BE DIFFERENT BASED UPON YOUR

2343
01:29:31,882 --> 01:29:34,150
INSTITUTION, ANY THOUGHTS ON

2344
01:29:34,150 --> 01:29:34,351
THAT?

2345
01:29:34,351 --> 01:29:35,318
>> I'M GOING TO JUMP IN
BECAUSE

2346
01:29:35,318 --> 01:29:37,254
I HAVE TO LEAVE PRETTY SOON, BUT

2347
01:29:37,254 --> 01:29:41,858
1 OF THE THINGS I WOULD SAY IT

2348
01:29:41,858 --> 01:29:42,626
REALLY DEPENDS BECAUSE ALSO YOU

2349
01:29:42,626 --> 01:29:45,228
HAVE TO THINK ABOUT THE BUDGET

2350
01:29:45,228 --> 01:29:46,229
OF THE GRANT.

2351
01:29:46,229 --> 01:29:49,065
I MEAN THERE'S A LOT OF INTEREST

2352
01:29:49,065 --> 01:29:52,135
IN DOING POLICY AND DOING SOME

2353
01:29:52,135 --> 01:29:53,537
OF THE SYSTEM LEVEL, BUT THEN

2354
01:29:53,537 --> 01:29:55,405
WHEN YOU ARE THINKING ABOUT THE

2355
01:29:55,405 --> 01:30:00,310
SYSTEM LEVEL, LET'S SAY,

2356
01:30:00,310 --> 01:30:01,111
PRACTICES, HEALTHCARE PRACTICES

2357
01:30:01,111 --> 01:30:03,513
WHERE YOU'RE TALKING ABOUT

2358
01:30:03,513 --> 01:30:04,714
SCHOOLS, THEN THE UNIT OF

2359
01:30:04,714 --> 01:30:06,783
ANALYSIS IS THE SCHOOLS OR THE

2360
01:30:06,783 --> 01:30:10,086
PRACTICES AND YOU NEED VERY BIG

2361
01:30:10,086 --> 01:30:12,822
FUNDING MECHANISMS TO BE ABLE TO

2362
01:30:12,822 --> 01:30:13,290
DO THAT WORK.

2363
01:30:13,290 --> 01:30:14,691
SO I WOULD LOVE TO DO MORE

2364
01:30:14,691 --> 01:30:16,860
SYSTEM WORK OR I THINK MANY OF

2365
01:30:16,860 --> 01:30:18,595
US WOULD DO BUT I THINK WE NEED

2366
01:30:18,595 --> 01:30:22,599
TO SEE WHETHER IT'S FEASIBLE

2367
01:30:22,599 --> 01:30:23,400
GIVEN THE BUDGETS.

2368
01:30:23,400 --> 01:30:24,701
IME VERY GRATEFUL FOR THE

2369
01:30:24,701 --> 01:30:30,073
INVITATION, I HAVE TO JUMP OFF

2370
01:30:30,073 --> 01:30:30,874
, I

2371
01:30:30,874 --> 01:30:31,508
HAVE ANOTHER MEETING.

2372
01:30:31,508 --> 01:30:33,743
>> I WILL SAY BOTH AND AS
WELL

2373
01:30:33,743 --> 01:30:35,145
AND MULTILEVEL IS PROBABLY THE

2374
01:30:35,145 --> 01:30:36,513
BEST STRATEGY.

2375
01:30:36,513 --> 01:30:39,015
>> I THINK BOTH AND IS THE
RIGHT

2376
01:30:39,015 --> 01:30:41,651
ANSWER THERE RICHARD AND YOU IT

2377
01:30:41,651 --> 01:30:43,720
JUST DEPENDS.

2378
01:30:43,720 --> 01:30:45,221
SOMETIMES 1'S AMAZED AT

2379
01:30:45,221 --> 01:30:47,891
STRUCTURAL CHANGE AND IMPACTING

2380
01:30:47,891 --> 01:30:48,825
INDIVIDUAL BEHAVIOR, YEARS AGO,

2381
01:30:48,825 --> 01:30:50,660
I REMEMBERED THERE WAS A GREAT

2382
01:30:50,660 --> 01:30:52,662
GRANT THAT WE HAD FUNDED THERE

2383
01:30:52,662 --> 01:30:54,464
WAS AN INTERVENTION IN SCHOOLS

2384
01:30:54,464 --> 01:30:58,335
IN LA FOR DECREASING SWEETENED

2385
01:30:58,335 --> 01:31:00,770
BEVERAGE COMSUMPTION AMONG

2386
01:31:00,770 --> 01:31:02,572
ADOLESCENTS, YEAH, I THINK IT

2387
01:31:02,572 --> 01:31:03,773
WAS IN MIDDLE SCHOOL OR HIGH

2388
01:31:03,773 --> 01:31:09,179
COOL, IT MUST HAVE BEEN MIDDLE

2389
01:31:09,179 --> 01:31:09,412
SCHOOL.

2390
01:31:09,412 --> 01:31:10,080
THE EDUCATIONAL INTERVENTION

2391
01:31:10,080 --> 01:31:11,181
DOESN'T HAVE AN EFFECT BUT WHAT

2392
01:31:11,181 --> 01:31:12,349
THEY FOUND WAS THAT IN THE

2393
01:31:12,349 --> 01:31:14,851
SCHOOL WHERE THEY ACTUALLY GAVE

2394
01:31:14,851 --> 01:31:17,354
FREE COOL WATER, I GUESS LA, IT

2395
01:31:17,354 --> 01:31:19,422
WAS IN LA SO IT WAS ALWAYS WARM

2396
01:31:19,422 --> 01:31:20,724
THAT'S WHERE THEY SAW THE

2397
01:31:20,724 --> 01:31:22,792
BIGGEST IMPACT SO IN THE SCHOOLS

2398
01:31:22,792 --> 01:31:25,662
THAT HAD ACCESS TO CHILLED WATER

2399
01:31:25,662 --> 01:31:26,963
THEY ACTUALLY DID MAKE A CHANGE.

2400
01:31:26,963 --> 01:31:29,933
SO THAT'S A STRUCTURAL CHANGE AS

2401
01:31:29,933 --> 01:31:32,102
OPPOSE TO INDIVIDUAL EDUCATIONAL

2402
01:31:32,102 --> 01:31:34,237
THEY GET BEHAVIOR CHANGE THAT

2403
01:31:34,237 --> 01:31:34,471
WAY.

2404
01:31:34,471 --> 01:31:37,374
SO ON THAT POSITIVE NOTE, WE CAN

2405
01:31:37,374 --> 01:31:38,708
CLOSE THIS SESSION.

2406
01:31:38,708 --> 01:31:43,079
I WANT TO THANK FIRST OF ALL

2407
01:31:43,079 --> 01:31:44,280
NEISHA WHO TOOK THIS ON TO

2408
01:31:44,280 --> 01:31:45,715
ORGANIZE IT A COUPLE MONTHS AGO

2409
01:31:45,715 --> 01:31:47,450
WHEN I ASKED HER TO DO THIS,

2410
01:31:47,450 --> 01:31:49,419
DARREL FOR BEING OUR INITIAL

2411
01:31:49,419 --> 01:31:51,187
POINT OF CONTACT WITH THE

2412
01:31:51,187 --> 01:31:53,023
COMMITTEE, AND ALSO FOR THE

2413
01:31:53,023 --> 01:31:55,258
WHOLE COMMITTEE THAT DID THE

2414
01:31:55,258 --> 01:31:56,059
REPORT.

2415
01:31:56,059 --> 01:31:58,461
IT IS AN IMPORTANT WORK THAT WE

2416
01:31:58,461 --> 01:31:59,529
WILL BE PROUD OF FOR YEARS TO

2417
01:31:59,529 --> 01:32:02,766
COME AND FOR THE PANEL, THE 2

2418
01:32:02,766 --> 01:32:03,733
PANELS THAT PRESENTED, MY

2419
01:32:03,733 --> 01:32:06,136
COLLEAGUES HERE AT NIH AS WELL

2420
01:32:06,136 --> 01:32:10,874
AS THE 4 OF YOU WHO TOOK TIME TO

2421
01:32:10,874 --> 01:32:11,274
PRESENT.

2422
01:32:11,274 --> 01:32:12,909
I DON'T KNOW IF YOU WANT TO MAKE

2423
01:32:12,909 --> 01:32:15,412
YOUR SLIDES AVAILABLE OR NOT,

2424
01:32:15,412 --> 01:32:17,781
BUT WOULD BE HAPPY TO TAKE THEM

2425
01:32:17,781 --> 01:32:21,785
IF YOU MAKE THEM AVAILABLE.

2426
01:32:21,785 --> 01:32:23,019
SO ... THANK YOU.

2427
01:32:23,019 --> 01:32:23,486
>> THANK YOU.

2428
01:32:23,486 --> 01:32:24,654
>> GOOD NIGHT.

2429
01:32:24,654 --> 01:32:34,931
>> THANK YOU.