I am the product of social mobility and financial progress these are pictures of
financial progress these are pictures of
financial progress these are pictures of my great-grandparents on the right hand
my great-grandparents on the right hand
my great-grandparents on the right hand side are pictures of my
side are pictures of my
side are pictures of my great-grandparents who came from the
great-grandparents who came from the
great-grandparents who came from the Netherlands to this country through
Netherlands to this country through
Netherlands to this country through Ellis Island looking for better
Ellis Island looking for better
Ellis Island looking for better opportunities they landed in the fields
opportunities they landed in the fields
opportunities they landed in the fields to provide better opportunities for
to provide better opportunities for
to provide better opportunities for their family and their children on the
their family and their children on the
their family and their children on the left-hand side or my great-grandparents
left-hand side or my great-grandparents
left-hand side or my great-grandparents on my father’s side who came through
on my father’s side who came through
on my father’s side who came through many many trials and tribulations who
many many trials and tribulations who
many many trials and tribulations who picked cotton for five cents a week and
picked cotton for five cents a week and
picked cotton for five cents a week and we’re just a step away from being
we’re just a step away from being
we’re just a step away from being sharecroppers living under Jim Crow laws
sharecroppers living under Jim Crow laws
sharecroppers living under Jim Crow laws and told their children go up north for
and told their children go up north for
and told their children go up north for better opportunities and better jobs
better opportunities and better jobs
better opportunities and better jobs things could have been different for me
things could have been different for me
things could have been different for me in my family I’m fortunate my parents
in my family I’m fortunate my parents
in my family I’m fortunate my parents were both first-generation college grads
were both first-generation college grads
were both first-generation college grads and made wonderful choices for me and my
and made wonderful choices for me and my
and made wonderful choices for me and my brother but easily along the way I could
brother but easily along the way I could
brother but easily along the way I could have made different choices and
have made different choices and
have made different choices and certainly things could have been
certainly things could have been
certainly things could have been different for me things could have been
different for me things could have been
different for me things could have been much more similar to they were for
much more similar to they were for
much more similar to they were for hundreds of patients that I’ve seen over
hundreds of patients that I’ve seen over
hundreds of patients that I’ve seen over the years you could be there now you
the years you could be there now you
the years you could be there now you could be there too sitting at the table
could be there too sitting at the table
could be there too sitting at the table with a stack of bills water electric
with a stack of bills water electric
with a stack of bills water electric trash service that credit card full of
trash service that credit card full of
trash service that credit card full of charges for the start of the school year
charges for the start of the school year
charges for the start of the school year you can’t send the kids to school naked
you can’t send the kids to school naked
you can’t send the kids to school naked right and there’s a cable and internet
right and there’s a cable and internet
right and there’s a cable and internet bill which maybe you could do without
bill which maybe you could do without
bill which maybe you could do without you don’t need your shows every night
you don’t need your shows every night
you don’t need your shows every night but you need that internet because what
but you need that internet because what
but you need that internet because what happens when the kids come home with
happens when the kids come home with
happens when the kids come home with questions that you don’t know the answer
questions that you don’t know the answer
questions that you don’t know the answer to I don’t know what number bonds are do
to I don’t know what number bonds are do
to I don’t know what number bonds are do you and then there’s that car payment
you and then there’s that car payment
you and then there’s that car payment which you need but realistically the car
which you need but realistically the car
which you need but realistically the car was on its last legs before I even
was on its last legs before I even
was on its last legs before I even bought the car and that’s just what’s on
bought the car and that’s just what’s on
bought the car and that’s just what’s on the table tonight
the table tonight
the table tonight you don’t know what else is going to
you don’t know what else is going to
you don’t know what else is going to come in and you know what else needs to
come in and you know what else needs to
come in and you know what else needs to happen everyone needs to be fed
happen everyone needs to be fed
happen everyone needs to be fed your kids are looking up at you those
your kids are looking up at you those
your kids are looking up at you those beautiful smiles you’re full of pride
beautiful smiles you’re full of pride
beautiful smiles you’re full of pride but your daughters looking up with that
but your daughters looking up with that
but your daughters looking up with that smile only a mother could love you know
smile only a mother could love you know
smile only a mother could love you know she needs a dentist and probably an
she needs a dentist and probably an
she needs a dentist and probably an orthodontist your son
orthodontist your son
orthodontist your son he definitely needs I glasses and you
he definitely needs I glasses and you
he definitely needs I glasses and you know just by the way he’s squinting when
know just by the way he’s squinting when
know just by the way he’s squinting when he’s looking at the television what is
he’s looking at the television what is
he’s looking at the television what is the cheapest meal for tonight and then
the cheapest meal for tonight and then
the cheapest meal for tonight and then again tomorrow it’s your list of worries
again tomorrow it’s your list of worries
again tomorrow it’s your list of worries a stack of bills a need for medical care
a stack of bills a need for medical care
a stack of bills a need for medical care don’t let anyone tell you your financial
don’t let anyone tell you your financial
don’t let anyone tell you your financial health doesn’t have anything to do with
health doesn’t have anything to do with
health doesn’t have anything to do with the health of your family it has
the health of your family it has
the health of your family it has everything to do with it a study by the
everything to do with it a study by the
everything to do with it a study by the Congressional Budget Office has shown us
Congressional Budget Office has shown us
Congressional Budget Office has shown us that income in America is becoming even
that income in America is becoming even
that income in America is becoming even more concentrated today the richest 10%
more concentrated today the richest 10%
more concentrated today the richest 10% are becoming even more rich and living
are becoming even more rich and living
are becoming even more rich and living longer and the median are growing more
longer and the median are growing more
longer and the median are growing more slowly and those who are born in poverty
slowly and those who are born in poverty
slowly and those who are born in poverty are having even more difficulty finding
are having even more difficulty finding
are having even more difficulty finding opportunities for jobs and education
opportunities for jobs and education
opportunities for jobs and education even more we know that people are
even more we know that people are
even more we know that people are becoming even more concentrated and
becoming even more concentrated and
becoming even more concentrated and where they live by race and income
where they live by race and income
where they live by race and income pockets of segregation are bringing all
pockets of segregation are bringing all
pockets of segregation are bringing all of us down we know that this means fewer
of us down we know that this means fewer
of us down we know that this means fewer opportunities for all of us to have
opportunities for all of us to have
opportunities for all of us to have better jobs and better education the
better jobs and better education the
better jobs and better education the Urban Institute has studied this and
Urban Institute has studied this and
Urban Institute has studied this and modeled it gregory axe has shown that if
modeled it gregory axe has shown that if
modeled it gregory axe has shown that if we could get to just average levels of
we could get to just average levels of
we could get to just average levels of segregation in cities like chicago this
segregation in cities like chicago this
segregation in cities like chicago this would provide better opportunities for
would provide better opportunities for
would provide better opportunities for everyone and for blacks it would mean
everyone and for blacks it would mean
everyone and for blacks it would mean that $2,400 more would be in people’s
that $2,400 more would be in people’s
that $2,400 more would be in people’s pocket every year it would mean that
pocket every year it would mean that
pocket every year it would mean that 80,000 more people would have college
80,000 more people would have college
80,000 more people would have college degrees and the homicide rate would be
degrees and the homicide rate would be
degrees and the homicide rate would be reduced by 30% this is a challenge
reduced by 30% this is a challenge
reduced by 30% this is a challenge and this is what we need to work on I’m
and this is what we need to work on I’m
and this is what we need to work on I’m a family physician by training so I
a family physician by training so I
a family physician by training so I often think about patients that I’ve met
often think about patients that I’ve met
often think about patients that I’ve met over the years and I’ll tell you this
over the years and I’ll tell you this
over the years and I’ll tell you this story we’ll call her mr. Rivera for
story we’ll call her mr. Rivera for
story we’ll call her mr. Rivera for today I met her in the clinic of San
today I met her in the clinic of San
today I met her in the clinic of San Francisco she came into this country
Francisco she came into this country
Francisco she came into this country looking for better opportunities
looking for better opportunities
looking for better opportunities escaping war and poverty
escaping war and poverty
escaping war and poverty she had a third-grade education had
she had a third-grade education had
she had a third-grade education had small kids and was very hopeful she also
small kids and was very hopeful she also
small kids and was very hopeful she also had diabetes and every visit we would
had diabetes and every visit we would
had diabetes and every visit we would try and try to get her diabetes a little
try and try to get her diabetes a little
try and try to get her diabetes a little bit better under control and every time
bit better under control and every time
bit better under control and every time she told me I’m doing so much better but
she told me I’m doing so much better but
she told me I’m doing so much better but the reality was it wasn’t budging
the reality was it wasn’t budging
the reality was it wasn’t budging I kept increasing her insulin up and up
I kept increasing her insulin up and up
I kept increasing her insulin up and up and up to the point that I really didn’t
and up to the point that I really didn’t
and up to the point that I really didn’t think this was working it wasn’t making
think this was working it wasn’t making
think this was working it wasn’t making sense anymore and it hit me over the
sense anymore and it hit me over the
sense anymore and it hit me over the head at that particular visit I asked
head at that particular visit I asked
head at that particular visit I asked her where are you keeping your insulin
her where are you keeping your insulin
her where are you keeping your insulin and she said it really depends on where
and she said it really depends on where
and she said it really depends on where I’m staying this week which friend’s
I’m staying this week which friend’s
I’m staying this week which friend’s house and when I’m at a shelter it’s not
house and when I’m at a shelter it’s not
house and when I’m at a shelter it’s not possible
possible
possible this is not uncommon it is the social
this is not uncommon it is the social
this is not uncommon it is the social determinants of health that matter most
determinants of health that matter most
determinants of health that matter most more than anything I learned in medical
more than anything I learned in medical
more than anything I learned in medical school the World Health Organization
school the World Health Organization
school the World Health Organization that’s estimated only 10% of what I do
that’s estimated only 10% of what I do
that’s estimated only 10% of what I do as a doctor actually matters it’s
as a doctor actually matters it’s
as a doctor actually matters it’s everything else that makes a bigger
everything else that makes a bigger
everything else that makes a bigger difference jobs income transportation
difference jobs income transportation
difference jobs income transportation housing neighborhoods
housing neighborhoods
housing neighborhoods it is these issues that impact health to
it is these issues that impact health to
it is these issues that impact health to a greater extent and for the family that
a greater extent and for the family that
a greater extent and for the family that shares medicines because well the
shares medicines because well the
shares medicines because well the symptoms are similar to the person who
symptoms are similar to the person who
symptoms are similar to the person who does grins and bears it and hopes the
does grins and bears it and hopes the
does grins and bears it and hopes the problem will go away these are the
problem will go away these are the
problem will go away these are the issues that impact our health and the
issues that impact our health and the
issues that impact our health and the health of families more than anything
health of families more than anything
health of families more than anything else even more we’re trying to figure
else even more we’re trying to figure
else even more we’re trying to figure out how to
out how to
out how to address the chronic stress that death
address the chronic stress that death
address the chronic stress that death can create this chronic stress creates a
can create this chronic stress creates a
can create this chronic stress creates a toxic reaction in our bodies that can be
toxic reaction in our bodies that can be
toxic reaction in our bodies that can be measured by small molecules called
measured by small molecules called
measured by small molecules called biomarkers it actually changes how our
biomarkers it actually changes how our
biomarkers it actually changes how our hormones work and creates the chance for
hormones work and creates the chance for
hormones work and creates the chance for stress to actually reduce the length of
stress to actually reduce the length of
stress to actually reduce the length of our lives on top of that it creates
our lives on top of that it creates
our lives on top of that it creates difficulty coping people tend to do
difficulty coping people tend to do
difficulty coping people tend to do things differently over eat exercise
things differently over eat exercise
things differently over eat exercise less maybe sleep less on top of that
less maybe sleep less on top of that
less maybe sleep less on top of that they may be depressed and coping by
they may be depressed and coping by
they may be depressed and coping by drinking alcohol or maybe even using
drinking alcohol or maybe even using
drinking alcohol or maybe even using substances or gambling we can work on
substances or gambling we can work on
substances or gambling we can work on this together even more we know that no
this together even more we know that no
this together even more we know that no matter what else we do more than
matter what else we do more than
matter what else we do more than anything incomes matters more than other
anything incomes matters more than other
anything incomes matters more than other factors like age and race if you are
factors like age and race if you are
factors like age and race if you are wealthier you live longer on top of this
wealthier you live longer on top of this
wealthier you live longer on top of this study by the Robert Wood Johnson
study by the Robert Wood Johnson
study by the Robert Wood Johnson Foundation that showed that income
Foundation that showed that income
Foundation that showed that income matters we’ve also seen in the reports
matters we’ve also seen in the reports
matters we’ve also seen in the reports of what people say in our country the
of what people say in our country the
of what people say in our country the Gallup share card report 2014 financial
Gallup share card report 2014 financial
Gallup share card report 2014 financial rankings also showed that people who are
rankings also showed that people who are
rankings also showed that people who are struggling financially are more likely
struggling financially are more likely
struggling financially are more likely than those who are less financially
than those who are less financially
than those who are less financially secure and those who are thriving
secure and those who are thriving
secure and those who are thriving financially to report things like higher
financially to report things like higher
financially to report things like higher rates of obesity high blood pressure
rates of obesity high blood pressure
rates of obesity high blood pressure diabetes on top of that people who are
diabetes on top of that people who are
diabetes on top of that people who are thriving financially are more likely to
thriving financially are more likely to
thriving financially are more likely to report other positive behaviors like
report other positive behaviors like
report other positive behaviors like eating healthy produce exercising and
eating healthy produce exercising and
eating healthy produce exercising and maybe even sleeping better people who
maybe even sleeping better people who
maybe even sleeping better people who are struggling report just those things
are struggling report just those things
are struggling report just those things that we talked about earlier if you’re
that we talked about earlier if you’re
that we talked about earlier if you’re struggling you’re more likely to report
struggling you’re more likely to report
struggling you’re more likely to report sleeping less being depressed anxious
sleeping less being depressed anxious
sleeping less being depressed anxious and maybe having more difficulty
and maybe having more difficulty
and maybe having more difficulty managing your health
managing your health
managing your health all of that puts you at greater risk for
all of that puts you at greater risk for
all of that puts you at greater risk for things like heart disease cancer
things like heart disease cancer
things like heart disease cancer and other problems that’s shorten your
and other problems that’s shorten your
and other problems that’s shorten your life on top of that this Gallup share
life on top of that this Gallup share
life on top of that this Gallup share card report showed that many people who
card report showed that many people who
card report showed that many people who are struggling financially do just what
are struggling financially do just what
are struggling financially do just what we talked about earlier they’re more
we talked about earlier they’re more
we talked about earlier they’re more likely to delay needed medical care as
likely to delay needed medical care as
likely to delay needed medical care as 30% of people in America have reported
30% of people in America have reported
30% of people in America have reported this is our opportunity to make a
this is our opportunity to make a
this is our opportunity to make a difference and help people where they’re
difference and help people where they’re
difference and help people where they’re at and address the other factors that do
at and address the other factors that do
at and address the other factors that do certainly make an impact we know that
certainly make an impact we know that
certainly make an impact we know that more than anything else from studies
more than anything else from studies
more than anything else from studies about what type of job you have or where
about what type of job you have or where
about what type of job you have or where you live income matters we can do
you live income matters we can do
you live income matters we can do something about this we can make a
something about this we can make a
something about this we can make a difference we can coach people we can
difference we can coach people we can
difference we can coach people we can stand by them when they need it most
stand by them when they need it most
stand by them when they need it most in fact in Delaware this is just what
in fact in Delaware this is just what
in fact in Delaware this is just what we’re doing through the Stand By Me
we’re doing through the Stand By Me
we’re doing through the Stand By Me program since 2011 we’ve had a program
program since 2011 we’ve had a program
program since 2011 we’ve had a program called Stand By Me which focuses on
called Stand By Me which focuses on
called Stand By Me which focuses on financial empowerment it leverages the
financial empowerment it leverages the
financial empowerment it leverages the capacity of local and state agencies
capacity of local and state agencies
capacity of local and state agencies private businesses philanthropy
private businesses philanthropy
private businesses philanthropy nonprofits colleges and communities it
nonprofits colleges and communities it
nonprofits colleges and communities it brings services to people where they are
brings services to people where they are
brings services to people where they are and where they’re at and what they need
and where they’re at and what they need
and where they’re at and what they need most it goes beyond just the basics of
most it goes beyond just the basics of
most it goes beyond just the basics of budgeting and saving but it gives people
budgeting and saving but it gives people
budgeting and saving but it gives people the skills to maybe buy that first home
the skills to maybe buy that first home
the skills to maybe buy that first home or buy that first car and it tells
or buy that first car and it tells
or buy that first car and it tells people how to avoid the dangers of
people how to avoid the dangers of
people how to avoid the dangers of predatory loans get out of debt and
predatory loans get out of debt and
predatory loans get out of debt and focus on everyday budgeting sometimes
focus on everyday budgeting sometimes
focus on everyday budgeting sometimes you need to know a little bit beyond the
you need to know a little bit beyond the
you need to know a little bit beyond the basics just like all of us you have a
basics just like all of us you have a
basics just like all of us you have a car and you need to know sometimes
car and you need to know sometimes
car and you need to know sometimes whether you need a major overhaul from
whether you need a major overhaul from
whether you need a major overhaul from the mechanic or whether you just need to
the mechanic or whether you just need to
the mechanic or whether you just need to add a little oil or gas we teach the
add a little oil or gas we teach the
add a little oil or gas we teach the basic indicators of whether you’re on
basic indicators of whether you’re on
basic indicators of whether you’re on track and how you can thrive financially
track and how you can thrive financially
track and how you can thrive financially how we can reduce that toxic stress and
how we can reduce that toxic stress and
how we can reduce that toxic stress and how we can help people manage and also
how we can help people manage and also
how we can help people manage and also healthier in Delaware I serve as
healthier in Delaware I serve as
healthier in Delaware I serve as Secretary of Health and Social Services
Secretary of Health and Social Services
Secretary of Health and Social Services and I know we need to do more to go
and I know we need to do more to go
and I know we need to do more to go beyond the typical social programs I
beyond the typical social programs I
beyond the typical social programs I know with federal leadership one day we
know with federal leadership one day we
know with federal leadership one day we should be able to get to a place where
should be able to get to a place where
should be able to get to a place where we align our social programs where we
we align our social programs where we
we align our social programs where we align welfare and food stamps and
align welfare and food stamps and
align welfare and food stamps and housing programs and what we’re doing to
housing programs and what we’re doing to
housing programs and what we’re doing to provide people those supports when they
provide people those supports when they
provide people those supports when they need it most when sometimes people just
need it most when sometimes people just
need it most when sometimes people just need a basic minimum rainy day fund and
need a basic minimum rainy day fund and
need a basic minimum rainy day fund and we know the evidence is out there that
we know the evidence is out there that
we know the evidence is out there that people really just need cash and not
people really just need cash and not
people really just need cash and not governmental oversight but until we get
governmental oversight but until we get
governmental oversight but until we get there let’s coach people let’s empower
there let’s coach people let’s empower
there let’s coach people let’s empower people to go beyond just needing those
people to go beyond just needing those
people to go beyond just needing those supports in place we can do this we can
supports in place we can do this we can
supports in place we can do this we can do this together collectively and we are
do this together collectively and we are
do this together collectively and we are doing it in Delaware and it’s making a
doing it in Delaware and it’s making a
doing it in Delaware and it’s making a difference since 2011 over the past six
difference since 2011 over the past six
difference since 2011 over the past six years we’ve helped over 15,000 people
years we’ve helped over 15,000 people
years we’ve helped over 15,000 people collectively we’ve gotten people out of
collectively we’ve gotten people out of
collectively we’ve gotten people out of debt that’s totaled about seven million
debt that’s totaled about seven million
debt that’s totaled about seven million dollars people have saved a collective
dollars people have saved a collective
dollars people have saved a collective almost 1 million dollars and the average
almost 1 million dollars and the average
almost 1 million dollars and the average credit score has increased by 88 points
credit score has increased by 88 points
credit score has increased by 88 points if you’ve been there you know that’s
if you’ve been there you know that’s
if you’ve been there you know that’s tremendous and we can continue on this
tremendous and we can continue on this
tremendous and we can continue on this path by focusing on financial health
path by focusing on financial health
path by focusing on financial health we’re going to keep working on this
we’re going to keep working on this
we’re going to keep working on this together and we can do this we want a
together and we can do this we want a
together and we can do this we want a healthier community we want lower rates
healthier community we want lower rates
healthier community we want lower rates of diabetes we want fewer people with
of diabetes we want fewer people with
of diabetes we want fewer people with obesity and high blood pressure we want
obesity and high blood pressure we want
obesity and high blood pressure we want fewer sub though fewer people using
fewer sub though fewer people using
fewer sub though fewer people using substances and we want a healthier
substances and we want a healthier
substances and we want a healthier environment we can do this by focusing
environment we can do this by focusing
environment we can do this by focusing on financial health financial health is
on financial health financial health is
on financial health financial health is public health trust me I’m a doctor
public health trust me I’m a doctor
public health trust me I’m a doctor you
you
you [Applause]
”
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