I want to talk about something that affects all of us some of us might wake
affects all of us some of us might wake
affects all of us some of us might wake up in the morning and we have some pain
up in the morning and we have some pain
up in the morning and we have some pain maybe a pain in the knee or a back pain
maybe a pain in the knee or a back pain
maybe a pain in the knee or a back pain that just won’t go away
that just won’t go away
that just won’t go away some of us might suffer something far
some of us might suffer something far
some of us might suffer something far more serious like heart disease or
more serious like heart disease or
more serious like heart disease or cancer or have had a stroke or two and
cancer or have had a stroke or two and
cancer or have had a stroke or two and if you suffer them now then you know how
if you suffer them now then you know how
if you suffer them now then you know how important poor health can be for you and
important poor health can be for you and
important poor health can be for you and if you don’t remember that at some point
if you don’t remember that at some point
if you don’t remember that at some point you probably will I want to talk about
you probably will I want to talk about
you probably will I want to talk about the differential experience of health
the differential experience of health
the differential experience of health why is it that some people suffer and
why is it that some people suffer and
why is it that some people suffer and other people don’t and what is it that
other people don’t and what is it that
other people don’t and what is it that we can do about that
we can do about that
we can do about that after all 69% of us just this year said
after all 69% of us just this year said
after all 69% of us just this year said we want to be a little bit more healthy
we want to be a little bit more healthy
we want to be a little bit more healthy want to lose some weight help is
want to lose some weight help is
want to lose some weight help is something that’s on the tip of all of
something that’s on the tip of all of
something that’s on the tip of all of our tongues on the edge of all of our
our tongues on the edge of all of our
our tongues on the edge of all of our minds so we might have googled something
minds so we might have googled something
minds so we might have googled something and you see here healthy steps to to
and you see here healthy steps to to
and you see here healthy steps to to healthy living or eight ways that you
healthy living or eight ways that you
healthy living or eight ways that you can optimize your health or we might
can optimize your health or we might
can optimize your health or we might have gotten one of these a fitness
have gotten one of these a fitness
have gotten one of these a fitness tracker that I wear that helps us to
tracker that I wear that helps us to
tracker that I wear that helps us to keep track of how much physical activity
keep track of how much physical activity
keep track of how much physical activity we have we’ve done how much we walk or
we have we’ve done how much we walk or
we have we’ve done how much we walk or how much we run and that’s because we
how much we run and that’s because we
how much we run and that’s because we assume that health is about lifestyle
assume that health is about lifestyle
assume that health is about lifestyle that we have a choice about the kind of
that we have a choice about the kind of
that we have a choice about the kind of health that we might experience or
health that we might experience or
health that we might experience or perhaps somebody might have gotten you a
perhaps somebody might have gotten you a
perhaps somebody might have gotten you a gift that allows you to take a cheek
gift that allows you to take a cheek
gift that allows you to take a cheek swab and see what your genes tell you
swab and see what your genes tell you
swab and see what your genes tell you about your past and maybe your future
about your past and maybe your future
about your past and maybe your future after all there are tons of studies that
after all there are tons of studies that
after all there are tons of studies that have linked all kinds of genes to all
have linked all kinds of genes to all
have linked all kinds of genes to all kinds of outcomes here you see studies
kinds of outcomes here you see studies
kinds of outcomes here you see studies find more genetic links to obesity
find more genetic links to obesity
find more genetic links to obesity so we also assume that health is about
so we also assume that health is about
so we also assume that health is about our genes health is either about what we
our genes health is either about what we
our genes health is either about what we choose to do in our lifestyles or health
choose to do in our lifestyles or health
choose to do in our lifestyles or health is embedded way before we ever had any
is embedded way before we ever had any
is embedded way before we ever had any choice in the matter but I want us to
choice in the matter but I want us to
choice in the matter but I want us to look at the evidence what does the
look at the evidence what does the
look at the evidence what does the evidence actually tell us what does
evidence actually tell us what does
evidence actually tell us what does science tell us about the experience of
science tell us about the experience of
science tell us about the experience of good health what you see here is a map
good health what you see here is a map
good health what you see here is a map of premature death for a hundred
of premature death for a hundred
of premature death for a hundred thousand people all over the country in
thousand people all over the country in
thousand people all over the country in which you should see is that it’s not a
which you should see is that it’s not a
which you should see is that it’s not a ubiquitous experience there are certain
ubiquitous experience there are certain
ubiquitous experience there are certain places where health is worse than
places where health is worse than
places where health is worse than other places and that takes us to the
other places and that takes us to the
other places and that takes us to the first fact which is that place matters
first fact which is that place matters
first fact which is that place matters more than either lifestyle or genetics
more than either lifestyle or genetics
more than either lifestyle or genetics and we can dig deeper we can ask
and we can dig deeper we can ask
and we can dig deeper we can ask ourselves about the variation in the
ourselves about the variation in the
ourselves about the variation in the experience of health and wellness among
experience of health and wellness among
experience of health and wellness among those who are poor what I’m going to
those who are poor what I’m going to
those who are poor what I’m going to show you is data by Raj Chetty and
show you is data by Raj Chetty and
show you is data by Raj Chetty and colleagues and economists at Stanford
colleagues and economists at Stanford
colleagues and economists at Stanford who wanted to ask where is it that the
who wanted to ask where is it that the
who wanted to ask where is it that the poor live longer versus shorter lives
poor live longer versus shorter lives
poor live longer versus shorter lives what you see here is a map and you can
what you see here is a map and you can
what you see here is a map and you can immediately look at our corner of the
immediately look at our corner of the
immediately look at our corner of the world the edge of the thumb and you see
world the edge of the thumb and you see
world the edge of the thumb and you see that that’s red generally when you see
that that’s red generally when you see
that that’s red generally when you see red on a map bad thing
red on a map bad thing
red on a map bad thing what you’re seeing here is a graph of
what you’re seeing here is a graph of
what you’re seeing here is a graph of life expectancy by income percentile and
life expectancy by income percentile and
life expectancy by income percentile and you’ll note among both men and women
you’ll note among both men and women
you’ll note among both men and women that generally income is associated with
that generally income is associated with
that generally income is associated with better health but what you’re seeing
better health but what you’re seeing
better health but what you’re seeing here is a contrast between New York City
here is a contrast between New York City
here is a contrast between New York City and Detroit and you see that after the
and Detroit and you see that after the
and Detroit and you see that after the 50th percentile you have this unraveling
50th percentile you have this unraveling
50th percentile you have this unraveling of the two curves how do we explain that
of the two curves how do we explain that
of the two curves how do we explain that but first the second fact is that place
but first the second fact is that place
but first the second fact is that place matters even more for the poor I want to
matters even more for the poor I want to
matters even more for the poor I want to get a little bit personal because I
get a little bit personal because I
get a little bit personal because I lived in New York just two years ago and
lived in New York just two years ago and
lived in New York just two years ago and when I moved to to Detroit my life
when I moved to to Detroit my life
when I moved to to Detroit my life expectancy didn’t really go anywhere and
expectancy didn’t really go anywhere and
expectancy didn’t really go anywhere and that’s because I’m insulated by the fact
that’s because I’m insulated by the fact
that’s because I’m insulated by the fact that I have money and resources and
that I have money and resources and
that I have money and resources and education and human capital so if I
education and human capital so if I
education and human capital so if I choose not to eat well it’s not because
choose not to eat well it’s not because
choose not to eat well it’s not because I was a prisoner to my context it’s not
I was a prisoner to my context it’s not
I was a prisoner to my context it’s not because I didn’t have that on offer it’s
because I didn’t have that on offer it’s
because I didn’t have that on offer it’s because I didn’t leverage everything I
because I didn’t leverage everything I
because I didn’t leverage everything I had to go off to the grocery store and
had to go off to the grocery store and
had to go off to the grocery store and get a healthy meal or go out to the gym
get a healthy meal or go out to the gym
get a healthy meal or go out to the gym and exercise I want to contrast that
and exercise I want to contrast that
and exercise I want to contrast that with miss joy she’s a 66 year old woman
with miss joy she’s a 66 year old woman
with miss joy she’s a 66 year old woman who I take care of in in Detroit she’s
who I take care of in in Detroit she’s
who I take care of in in Detroit she’s somebody who is part of the 677 thousand
somebody who is part of the 677 thousand
somebody who is part of the 677 thousand people who I’m responsible for as the
people who I’m responsible for as the
people who I’m responsible for as the health director in the city and if I
health director in the city and if I
health director in the city and if I were to say Ms joy you know you really
were to say Ms joy you know you really
were to say Ms joy you know you really ought to eat better you know what you
ought to eat better you know what you
ought to eat better you know what you tell me that is lovely except for the
tell me that is lovely except for the
tell me that is lovely except for the nearest grocery stores about three miles
nearest grocery stores about three miles
nearest grocery stores about three miles away from my house and I don’t have a
away from my house and I don’t have a
away from my house and I don’t have a car so I can’t really get there and well
car so I can’t really get there and well
car so I can’t really get there and well if you want me to exercise that’s really
if you want me to exercise that’s really
if you want me to exercise that’s really great too except for you know what time
great too except for you know what time
great too except for you know what time the Sun Goes Down it’s about 6:00 I get
the Sun Goes Down it’s about 6:00 I get
the Sun Goes Down it’s about 6:00 I get home from my second job around 6:00 and
home from my second job around 6:00 and
home from my second job around 6:00 and I’d love to go outside and I’d love to
I’d love to go outside and I’d love to
I’d love to go outside and I’d love to take a walk but unfortunately my
take a walk but unfortunately my
take a walk but unfortunately my neighborhood it’s a little scary after
neighborhood it’s a little scary after
neighborhood it’s a little scary after dark so I hear you about healthy
dark so I hear you about healthy
dark so I hear you about healthy lifestyles like that’s just not going to
lifestyles like that’s just not going to
lifestyles like that’s just not going to work for me
kind of challenge is not uncommon in
kind of challenge is not uncommon in Detroit we know the Detroit’s are
Detroit we know the Detroit’s are
Detroit we know the Detroit’s are relatively poor city with a poverty rate
relatively poor city with a poverty rate
relatively poor city with a poverty rate around 40% but it’s not just about
around 40% but it’s not just about
around 40% but it’s not just about poverty it’s about the alchemy of
poverty it’s about the alchemy of
poverty it’s about the alchemy of poverty and racism over a very
poverty and racism over a very
poverty and racism over a very particular geography because remember
particular geography because remember
particular geography because remember place matters more it matters even more
place matters more it matters even more
place matters more it matters even more for the poor Detroit is a huge city you
for the poor Detroit is a huge city you
for the poor Detroit is a huge city you can fit all of Boston San Francisco and
can fit all of Boston San Francisco and
can fit all of Boston San Francisco and Manhattan on our city and still have
Manhattan on our city and still have
Manhattan on our city and still have room to spare so we have poor people in
room to spare so we have poor people in
room to spare so we have poor people in a big city that’s highly vacant what
a big city that’s highly vacant what
a big city that’s highly vacant what you’re seeing here is the e flux from
you’re seeing here is the e flux from
you’re seeing here is the e flux from Detroit not since 1967 when it started
Detroit not since 1967 when it started
Detroit not since 1967 when it started but in the last completed decade between
but in the last completed decade between
but in the last completed decade between 2000 and 2010 and it’s really hard to
2000 and 2010 and it’s really hard to
2000 and 2010 and it’s really hard to get around the tragic irony of the Motor
get around the tragic irony of the Motor
get around the tragic irony of the Motor City is that only about 40% of
City is that only about 40% of
City is that only about 40% of Detroiters have regular access to a car
Detroiters have regular access to a car
Detroiters have regular access to a car 20 percent have no car at all and 40
20 percent have no car at all and 40
20 percent have no car at all and 40 percent they might have a car but it’s
percent they might have a car but it’s
percent they might have a car but it’s shared with so many people or it’s so
shared with so many people or it’s so
shared with so many people or it’s so broken down that they can’t really rely
broken down that they can’t really rely
broken down that they can’t really rely on it and the way that you or I might be
on it and the way that you or I might be
on it and the way that you or I might be able to and lastly we cannot ignore the
able to and lastly we cannot ignore the
able to and lastly we cannot ignore the fact of race what you’re seeing here is
fact of race what you’re seeing here is
fact of race what you’re seeing here is a map of redlining this is a map from
a map of redlining this is a map from
a map of redlining this is a map from the late 1930s by a group called the
the late 1930s by a group called the
the late 1930s by a group called the Hearn brothers who were real estate
Hearn brothers who were real estate
Hearn brothers who were real estate moguls in Detroit and what it shows you
moguls in Detroit and what it shows you
moguls in Detroit and what it shows you is where people of particular races
is where people of particular races
is where people of particular races could live and not live and so what has
could live and not live and so what has
could live and not live and so what has happened over 60 years is we have
happened over 60 years is we have
happened over 60 years is we have concentrated poor the poor and
concentrated poor the poor and
concentrated poor the poor and minorities in particular parts of our
minorities in particular parts of our
minorities in particular parts of our city even as we built highways for
city even as we built highways for
city even as we built highways for certain people to be able to leave we
certain people to be able to leave we
certain people to be able to leave we did not build public transportation we
did not build public transportation we
did not build public transportation we built highways because who built Detroit
built highways because who built Detroit
built highways because who built Detroit the automotive industry which gives us
the automotive industry which gives us
the automotive industry which gives us through the third fact that health is
through the third fact that health is
through the third fact that health is about access right the reason place
about access right the reason place
about access right the reason place matters is because health is about
matters is because health is about
matters is because health is about access to food and exercise and
access to food and exercise and
access to food and exercise and education and health care and social
education and health care and social
education and health care and social support and about exposure to things
support and about exposure to things
support and about exposure to things like trauma and violence and racism but
like trauma and violence and racism but
like trauma and violence and racism but there are opportunities Public Health is
there are opportunities Public Health is
there are opportunities Public Health is what we as a society do collectively to
what we as a society do collectively to
what we as a society do collectively to assure the conditions within which
assure the conditions within which
assure the conditions within which people can be healthy to assure the
people can be healthy to assure the
people can be healthy to assure the conditions within which people can be
conditions within which people can be
conditions within which people can be healthy public health is about place and
healthy public health is about place and
healthy public health is about place and the first opportunity that we have is to
the first opportunity that we have is to
the first opportunity that we have is to be able to think about access to food
be able to think about access to food
be able to think about access to food and exercise and education and
and exercise and education and
and exercise and education and healthcare and social support and
healthcare and social support and
healthcare and social support and exposure to trauma and violence racism
exposure to trauma and violence racism
exposure to trauma and violence racism and invest in public health the second
and invest in public health the second
and invest in public health the second to think about what causes disease in
to think about what causes disease in
to think about what causes disease in the first place heart disease is the
the first place heart disease is the
the first place heart disease is the most common killer in American society
most common killer in American society
most common killer in American society in the global overall so I want us to
in the global overall so I want us to
in the global overall so I want us to think about what causes this gentleman’s
think about what causes this gentleman’s
think about what causes this gentleman’s heart attacks now I know this gentleman
heart attacks now I know this gentleman
heart attacks now I know this gentleman looks a lot like President Barack Obama
looks a lot like President Barack Obama
looks a lot like President Barack Obama I mean the former president no harm so
I mean the former president no harm so
I mean the former president no harm so uh so let’s ask about what causes heart
uh so let’s ask about what causes heart
uh so let’s ask about what causes heart attacks in President Barack Obama not to
attacks in President Barack Obama not to
attacks in President Barack Obama not to this
but let’s get down to it so what causes
but let’s get down to it so what causes heart attacks if this was a room full of
heart attacks if this was a room full of
heart attacks if this was a room full of medical students you guys would tell me
medical students you guys would tell me
medical students you guys would tell me something like this
something like this
something like this atherosclerosis right it’s one you have
atherosclerosis right it’s one you have
atherosclerosis right it’s one you have infestation of the intima by cholesterol
infestation of the intima by cholesterol
infestation of the intima by cholesterol over time that causes a blockage of a
over time that causes a blockage of a
over time that causes a blockage of a coronary artery which blocks downstream
coronary artery which blocks downstream
coronary artery which blocks downstream blood from parts of the heart which
blood from parts of the heart which
blood from parts of the heart which kills the heart which causes a heart
kills the heart which causes a heart
kills the heart which causes a heart attack that’s it’s a right answer but we
attack that’s it’s a right answer but we
attack that’s it’s a right answer but we have to think upstream what are the
have to think upstream what are the
have to think upstream what are the causes of the causes things like
causes of the causes things like
causes of the causes things like hypertension and high cholesterol and
hypertension and high cholesterol and
hypertension and high cholesterol and obesity but let’s keep asking what
obesity but let’s keep asking what
obesity but let’s keep asking what causes a heart attack things like
causes a heart attack things like
causes a heart attack things like smoking and poor diets and low physical
smoking and poor diets and low physical
smoking and poor diets and low physical activity and smog you guys know the
activity and smog you guys know the
activity and smog you guys know the drill already right what causes that
drill already right what causes that
drill already right what causes that social policy poverty and economics our
social policy poverty and economics our
social policy poverty and economics our second opportunities that we have to
second opportunities that we have to
second opportunities that we have to think upstream it’s not enough for us to
think upstream it’s not enough for us to
think upstream it’s not enough for us to be focused just on pathophysiology in
be focused just on pathophysiology in
be focused just on pathophysiology in the physical realm we have to be
the physical realm we have to be
the physical realm we have to be thinking about pathophysiology in the
thinking about pathophysiology in the
thinking about pathophysiology in the social realm and let’s think about the
social realm and let’s think about the
social realm and let’s think about the consequences of a heart attack his
consequences of a heart attack his
consequences of a heart attack his gentlemen here he has a heart attack our
gentlemen here he has a heart attack our
gentlemen here he has a heart attack our protagonist he he suffers from a heart
protagonist he he suffers from a heart
protagonist he he suffers from a heart attack and he just moved into a really
attack and he just moved into a really
attack and he just moved into a really nice home in a nice neighborhood what
nice home in a nice neighborhood what
nice home in a nice neighborhood what happens well unfortunately the average
happens well unfortunately the average
happens well unfortunately the average heart attack cost you about seven
heart attack cost you about seven
heart attack cost you about seven hundred sixty thousand dollars that’s
hundred sixty thousand dollars that’s
hundred sixty thousand dollars that’s with the ACA and so what happens he
with the ACA and so what happens he
with the ACA and so what happens he can’t actually pay right he had to make
can’t actually pay right he had to make
can’t actually pay right he had to make whatever it was payment that he that
whatever it was payment that he that
whatever it was payment that he that that missed what his insurance could
that missed what his insurance could
that missed what his insurance could have paid for him and this gentleman
have paid for him and this gentleman
have paid for him and this gentleman unfortunately loses his home so he’s
unfortunately loses his home so he’s
unfortunately loses his home so he’s forced to move somewhere else so we see
forced to move somewhere else so we see
forced to move somewhere else so we see how poor health shapes poverty and so we
how poor health shapes poverty and so we
how poor health shapes poverty and so we look in his new home and then we asked
look in his new home and then we asked
look in his new home and then we asked well what are the kinds of things that
well what are the kinds of things that
well what are the kinds of things that his child could be exposed to in a home
his child could be exposed to in a home
his child could be exposed to in a home like this dirty water paint chips which
like this dirty water paint chips which
like this dirty water paint chips which cause lead poisoning which then drives
cause lead poisoning which then drives
cause lead poisoning which then drives how poverty shapes poor health keep
how poverty shapes poor health keep
how poverty shapes poor health keep going that child who is exposed to the
going that child who is exposed to the
going that child who is exposed to the lead in the home and now suffers in
lead in the home and now suffers in
lead in the home and now suffers in school because that kid never had the
school because that kid never had the
school because that kid never had the shot that you or I might have had to get
shot that you or I might have had to get
shot that you or I might have had to get to school with a healthy mind it was
to school with a healthy mind it was
to school with a healthy mind it was poison before ever before he ever
poison before ever before he ever
poison before ever before he ever started we reify the relationship
started we reify the relationship
started we reify the relationship in poor health and poverty keep going
in poor health and poverty keep going
in poor health and poverty keep going that child now lives in the same
that child now lives in the same
that child now lives in the same neighborhood that’s going to expose his
neighborhood that’s going to expose his
neighborhood that’s going to expose his children to the same things and we reify
children to the same things and we reify
children to the same things and we reify the relationship between poverty and
the relationship between poverty and
the relationship between poverty and poor health public health is about
poor health public health is about
poor health public health is about addressing this challenge and that
addressing this challenge and that
addressing this challenge and that opportunity is to tackle feedback cycles
opportunity is to tackle feedback cycles
opportunity is to tackle feedback cycles to be asking ourselves where is it that
to be asking ourselves where is it that
to be asking ourselves where is it that we can intervene where we can address
we can intervene where we can address
we can intervene where we can address these vicious feedback loops that trap
these vicious feedback loops that trap
these vicious feedback loops that trap people in both poverty and poor health
people in both poverty and poor health
people in both poverty and poor health and that takes me to our work at the
and that takes me to our work at the
and that takes me to our work at the Detroit Health Department what we do is
Detroit Health Department what we do is
Detroit Health Department what we do is we leverage health to disrupt
we leverage health to disrupt
we leverage health to disrupt intergenerational poverty our goal is to
intergenerational poverty our goal is to
intergenerational poverty our goal is to be thinking about the barriers that
be thinking about the barriers that
be thinking about the barriers that children face to being able to learn and
children face to being able to learn and
children face to being able to learn and earn like any child anywhere in America
earn like any child anywhere in America
earn like any child anywhere in America and our job is to systematically
and our job is to systematically
and our job is to systematically dismantle them so that those kids have
dismantle them so that those kids have
dismantle them so that those kids have the same shot at the life trajectory we
the same shot at the life trajectory we
the same shot at the life trajectory we all want for our kids I want to talk
all want for our kids I want to talk
all want for our kids I want to talk about four outcomes that we’re talking
about four outcomes that we’re talking
about four outcomes that we’re talking about that we’re working very very
about that we’re working very very
about that we’re working very very heavily on share with you a couple of
heavily on share with you a couple of
heavily on share with you a couple of projects that we’re building poor infant
projects that we’re building poor infant
projects that we’re building poor infant health did you know that a baby whose
health did you know that a baby whose
health did you know that a baby whose preterm is likely to earn about $3,000
preterm is likely to earn about $3,000
preterm is likely to earn about $3,000 less at 30 than the child who wasn’t
less at 30 than the child who wasn’t
less at 30 than the child who wasn’t preterm unintended teen pregnancy a
preterm unintended teen pregnancy a
preterm unintended teen pregnancy a woman who chooses not to get pregnant
woman who chooses not to get pregnant
woman who chooses not to get pregnant but becomes pregnant anyway before she
but becomes pregnant anyway before she
but becomes pregnant anyway before she graduates high school her likelihood of
graduates high school her likelihood of
graduates high school her likelihood of dropping out of high school is 50% and
dropping out of high school is 50% and
dropping out of high school is 50% and the likelihood of her child being pre
the likelihood of her child being pre
the likelihood of her child being pre term goes up twice asthma it’s a single
term goes up twice asthma it’s a single
term goes up twice asthma it’s a single leading health cause of school days
leading health cause of school days
leading health cause of school days missed poor vision if you can’t see the
missed poor vision if you can’t see the
missed poor vision if you can’t see the board you can’t learn the board and so
board you can’t learn the board and so
board you can’t learn the board and so we’re tackling these problems because
we’re tackling these problems because
we’re tackling these problems because they are a core to that feedback loop
they are a core to that feedback loop
they are a core to that feedback loop between poverty and poor health let’s
between poverty and poor health let’s
between poverty and poor health let’s talk about poor infant health first
talk about poor infant health first
talk about poor infant health first we’re building a program where we are
we’re building a program where we are
we’re building a program where we are teaching women across our city to be
teaching women across our city to be
teaching women across our city to be able to mentor women throughout their
able to mentor women throughout their
able to mentor women throughout their pregnancy it’s called sister friends and
pregnancy it’s called sister friends and
pregnancy it’s called sister friends and the goal of this is both to provide a
the goal of this is both to provide a
the goal of this is both to provide a mentor for a woman who becomes pregnant
mentor for a woman who becomes pregnant
mentor for a woman who becomes pregnant walk her through negative nine months to
walk her through negative nine months to
walk her through negative nine months to one year at the same time be able to
one year at the same time be able to
one year at the same time be able to connect her to the number of resources
connect her to the number of resources
connect her to the number of resources that are there unfortunately infant
that are there unfortunately infant
that are there unfortunately infant mortality is far more common among the
mortality is far more common among the
mortality is far more common among the most vulnerable and so if we can’t reach
most vulnerable and so if we can’t reach
most vulnerable and so if we can’t reach out via the best resources that we have
out via the best resources that we have
out via the best resources that we have which are Detroiters then we can’t
which are Detroiters then we can’t
which are Detroiters then we can’t address the challenge unintended teen
address the challenge unintended teen
address the challenge unintended teen pregnancy we know that long-acting
pregnancy we know that long-acting
pregnancy we know that long-acting reversible contraceptives are the
reversible contraceptives are the
reversible contraceptives are the leading way to prevent unintended teen
leading way to prevent unintended teen
leading way to prevent unintended teen pregnancy these are modalities of
pregnancy these are modalities of
pregnancy these are modalities of contraception that don’t require
contraception that don’t require
contraception that don’t require point-of-use
point-of-use
point-of-use you don’t have to take a pill every
you don’t have to take a pill every
you don’t have to take a pill every night you don’t have to use a condom
night you don’t have to use a condom
night you don’t have to use a condom when you have sex but unfortunately on
when you have sex but unfortunately on
when you have sex but unfortunately on about 2.5 percent of young women in
about 2.5 percent of young women in
about 2.5 percent of young women in Detroit use these even though their
Detroit use these even though their
Detroit use these even though their first line so we’re trying to take a
first line so we’re trying to take a
first line so we’re trying to take a multi-modal approach to this first we
multi-modal approach to this first we
multi-modal approach to this first we want to make sure that doctors in
want to make sure that doctors in
want to make sure that doctors in Detroit know how to use long-acting
Detroit know how to use long-acting
Detroit know how to use long-acting reversible contraceptives second we want
reversible contraceptives second we want
reversible contraceptives second we want to make sure that people know about this
to make sure that people know about this
to make sure that people know about this oftentimes people don’t know that you
oftentimes people don’t know that you
oftentimes people don’t know that you can get an implant or an IUD and it’s
can get an implant or an IUD and it’s
can get an implant or an IUD and it’s good for three to five years and you
good for three to five years and you
good for three to five years and you don’t have to worry about getting
don’t have to worry about getting
don’t have to worry about getting pregnant thereafter and then we want to
pregnant thereafter and then we want to
pregnant thereafter and then we want to be able to provide access to these
be able to provide access to these
be able to provide access to these services and places that are discreet
services and places that are discreet
services and places that are discreet and not stigmatizing and so we’re
and not stigmatizing and so we’re
and not stigmatizing and so we’re thinking about being able to put these
thinking about being able to put these
thinking about being able to put these in places that you wouldn’t otherwise
in places that you wouldn’t otherwise
in places that you wouldn’t otherwise think about going to get preconception
think about going to get preconception
think about going to get preconception services like a rec center where you
services like a rec center where you
services like a rec center where you could be just as well going to play
could be just as well going to play
could be just as well going to play basketball asthma or asthma
basketball asthma or asthma
basketball asthma or asthma hospitalization rate is three times as
hospitalization rate is three times as
hospitalization rate is three times as high as the rest of the state of
high as the rest of the state of
high as the rest of the state of Michigan like I said that yields
Michigan like I said that yields
Michigan like I said that yields children not in school not learning and
children not in school not learning and
children not in school not learning and this is largely because of the number of
this is largely because of the number of
this is largely because of the number of high emitters across the city of Detroit
high emitters across the city of Detroit
high emitters across the city of Detroit we are a relatively industrial city and
we are a relatively industrial city and
we are a relatively industrial city and so there are a number of polluters who
so there are a number of polluters who
so there are a number of polluters who live in and around our city which
live in and around our city which
live in and around our city which creates the context for asthma and what
creates the context for asthma and what
creates the context for asthma and what we’re doing is we are equipping children
we’re doing is we are equipping children
we’re doing is we are equipping children with inhalers that are equipped with
with inhalers that are equipped with
with inhalers that are equipped with sensors and every time a child uses that
sensors and every time a child uses that
sensors and every time a child uses that inhaler it sends information out to a
inhaler it sends information out to a
inhaler it sends information out to a cloud and what that allows us to do is
cloud and what that allows us to do is
cloud and what that allows us to do is to generate an asthma heat map to be
to generate an asthma heat map to be
to generate an asthma heat map to be able to give families and doctors taking
able to give families and doctors taking
able to give families and doctors taking care of children with asthma real-time
care of children with asthma real-time
care of children with asthma real-time information about their risk of an
information about their risk of an
information about their risk of an exacerbation and then lastly poor vision
exacerbation and then lastly poor vision
exacerbation and then lastly poor vision I want to share with you a couple
I want to share with you a couple
I want to share with you a couple statistics 35,000 children in Detroit
statistics 35,000 children in Detroit
statistics 35,000 children in Detroit are going to test positive for a vision
are going to test positive for a vision
are going to test positive for a vision deficit 35,000 a year positive for a
deficit 35,000 a year positive for a
deficit 35,000 a year positive for a vision deficit in about 30% of them on
vision deficit in about 30% of them on
vision deficit in about 30% of them on average over the past several years
average over the past several years
average over the past several years would come back the next year screened
would come back the next year screened
would come back the next year screened again meaning that we weren’t able as a
again meaning that we weren’t able as a
again meaning that we weren’t able as a system to give them a pair of glasses so
system to give them a pair of glasses so
system to give them a pair of glasses so we’ve launched a program where we’re
we’ve launched a program where we’re
we’ve launched a program where we’re teaming up with a non-profit to be able
teaming up with a non-profit to be able
teaming up with a non-profit to be able to do a full optometric exam at school
to do a full optometric exam at school
to do a full optometric exam at school provide children a pair of glasses every
provide children a pair of glasses every
provide children a pair of glasses every kid in Detroit who needs a pair of
kid in Detroit who needs a pair of
kid in Detroit who needs a pair of glasses will get one two weeks
glasses will get one two weeks
glasses will get one two weeks delivered at school and what you’re
delivered at school and what you’re
delivered at school and what you’re seeing here is a picture from the launch
seeing here is a picture from the launch
seeing here is a picture from the launch after all 69% of us this year made a
after all 69% of us this year made a
after all 69% of us this year made a goal about our health we decided that we
goal about our health we decided that we
goal about our health we decided that we wanted to be a little bit healthier we
wanted to be a little bit healthier we
wanted to be a little bit healthier we wanted to lose weight stay fit and
wanted to lose weight stay fit and
wanted to lose weight stay fit and healthy but unfortunately not all of us
healthy but unfortunately not all of us
healthy but unfortunately not all of us have access to that when I drove here
have access to that when I drove here
have access to that when I drove here the 45 minutes that I drove here I drove
the 45 minutes that I drove here I drove
the 45 minutes that I drove here I drove nine years of life expectancy but when
nine years of life expectancy but when
nine years of life expectancy but when we asked ourselves how that can happen
we asked ourselves how that can happen
we asked ourselves how that can happen in the richest country in the world we
in the richest country in the world we
in the richest country in the world we have to be focusing on opportunities to
have to be focusing on opportunities to
have to be focusing on opportunities to invest in public health to tackle
invest in public health to tackle
invest in public health to tackle feedback cycles and to think upstream
feedback cycles and to think upstream
feedback cycles and to think upstream thank you
all right guys wait up wait up wait up
all right guys wait up wait up wait up so my mom’s never gonna believe this I
so my mom’s never gonna believe this I
so my mom’s never gonna believe this I got to get the selfie okay all right
got to get the selfie okay all right
got to get the selfie okay all right ain’t you all to put your arms up let’s
ain’t you all to put your arms up let’s
ain’t you all to put your arms up let’s go let’s do this
go let’s do this
go let’s do this all right ready one two
”
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