20 Episode results for "Robert Wood Johnson Foundation"
Poll: Many Rural Americans Struggle With Financial Insecurity, Access To Health Care
"Support for this podcast and the following message come from the university of Maryland where the founders of Google Oculus and squarespace got their started. Find out how you MD can start up your next adventure at you and you MD dot com. That's why. Oh, you and you MD dot com. The economy may be strong but many Americans finances are not. That's especially true in many rural areas in Opole of role. Americans by NPR last fall. Fifty five percent of those surveyed said their local economy was only poor or fair. A follow up poll by NPR the Robert Wood Johnson foundation and the Harvard ta Chan school of public health digs deeper. It finds four out of ten rural Americans struggle with routine bills for housing food and medical care, half of rural Americans say they could not afford it. If they got hit with a surprise one thousand dollar expense. NPR's petty name, and has more. Our new poll was telephone survey of just over fourteen. Nine hundred adults living in rural areas across the country areas like Weitzberg nestled in the mountains of eastern, Kentucky coalfields seventy two year old lethal dollar hide a retired caregiver lives nearby go out of town like you're going toward hazard. And there's a turn off there on nine thirty one south. It's within about four miles of where I was born. So I asked dollar hide the question we asked in our poll, could you afford an unexpected thousand dollar Bill? No, no. There's no way not even a two hundred dollar extra Bill. What about savings, my savings account zero I don't even have a savings account dollar hide worked all her life. But the jobs just didn't pay enough for her to put anything aside. She raised for children today, her income social security and supplemental. Security income adds up to seven hundred ninety dollars a month with that income. You watch every penny even so dollar high. Just couldn't afford to make it on her own. She recently moved into a two bedroom trailer with her daughter, even with the extra money from her daughter. It's still hard. They have no car and the cost of electricity is barely affordable. It was three hundred sixty something and the two hundred dollars rent, there's nothing left. So no movies. No dinners out. The only luxury is cable TV, but dollar Hyde says, she's one of the lucky ones she has Medicare and estate health plan that covers her health costs. That's not the case for many of those in our poll, Harvard professor Robert plantain, one in four reported that they could not get healthcare recently when they needed it, and majority said, it's either, because they couldn't afford it or they had insurance that would not be taken by local health providers a serious. National concern says blend and even with major improvements and health insurance coverage over the last decade, these. Problems are more severe for African American communities and native Americans as well as Latinos, and the future of healthcare, and rural America looks even more grim says Brock sleigh back with the national rural Health Association, one hundred six rural hospitals have closed of the past decade, which he says, can make timely medical care nearly impossible, take the town of China PA in Nevada. It's how spittle closed a few years ago this left the service to deal with all kinds of medical problems that are not situated to do. And so when they get on the road to the next nearest hospital as a three hour trip, one way, the hospital is more than a hundred miles away. We know that distance can be a barrier to timely and appropriate access to services. And so in that context delayed care can often lead to tragic consequences, especially in rural areas where people may not have a car. And public transportation may be unreliable. Bottom line says, sleigh Bach wealth equals health report, and were sicker, d Davis is president of the center for rural strategies in Weitzberg people in this congressional district have the shortest lifespan in the United States. We also are the poorest, but one of our big findings was that rural Americans are also optimistic about their communities, d Davis, people may be living more of a hard scrabble existence than folks in the suburbs, or a lot of the folks in the cities. But then mean they're not leaving decent life. And most people are pretty happy with it. And they've got friends and neighbors that they rely on their where they wanna be community activists. Now field says of the past few weeks when her husband was hospitalized her neighbors were extrordinary my neighbors come in Mohmand grass. And neighbors come and feed our cattle and our neighbors gather the eggs and every day for the last few weeks and says, so much to me makes me feel the emotion now of what it feels like to have such more, wonderful support. And I know that, that's the blessing of living in rural America. And that's what our poll found ninety two percent of those surveyed said they had people nearby. They could rely on in times of need. Penny Neiman, NPR news.
Coronavirus underscores need for broadband access for all
"Your destination for gadgets ungeared. I'm Fred fishkill. A survey conducted for the Robert. Wood Johnson Foundation recently showed the impact of the coronavirus pandemic. I'm so many families with children. One of the issues is how many children's simply don't have the Internet access needed to attend classes remotely, and that is even if they are provided things like from books by their schools. Robert Wood Johnson Foundation executive VP Dr Jewelry, I think what we're seeing with Bantam in terms with WHO's next getting sick who's getting hospital dying disproportionately impacted. Household those communities that have historically struggled in past the people lower income communities. The color have really been hit hardest until from the Internet connection perspective experts groups that are being charged prompting calls, which we've heard before better broadband access all. You can find us at text nation DOT COM I'm Fred Friskin. Cooking with the power of the songs. Hi, I'm Fred Friskin. Tell you about the latest innovation from my friend, Patrick Sherwin and his great team at goes on stove. The goes on fusion has arrived using the companies tried and true reflectors and the solar vacuum tube could get cooking without a massive charcoal, heavy propane tanks or smoke. A really bright idea and with an optional solar panel and battery storage on the ability to plug in at home or on the road really can use the goes on fusion to cook anytime and anywhere day or night. Nor Shy. I love what Patrick and this team are doing, and so will you want to learn more head to go some dot co two check out all of the company's products, sent innovations and use the code textile. To save ten percent that's goes on DOT Co..
Sound and Health: Hospitals
"Thanks to the Robert Wood Johnson foundation for under writing this special, two part series about the power of sound to affect an influence our health and well-being. The Robert Wood Johnson foundation is working alongside others to build a culture of health for everyone in America. Learn more about them at our W J, F dot org. This is ninety nine percent invisible. I'm Roman Mars. Sound can have serious impacts on our health and wellbeing, and ever since people moved into cities. We have been exposed to an unhealthy amount of noise cars power lines and the constant ding of our devices, we live in a very noisy world. And most of the noises, we hear aren't designed to work together. This is the second part of our special series on sound and health supported by the Robert Wood Johnson foundation. We're taking a look at how a more intentional approach to sound can help us live better healthier lives. And there's no better place to think about health than hospitals. Joe Slesinger is an anesthesiologist adventure built medical center. He spends a lot of his time in the operating room. The operating room is an interesting space because we think of it, it's like my cockpit. If you will, and anesthesiology is related a lot to aviation. We our culture of safety. We have safety checklist. Just like pilots. Do we think of takeoff and landing just like putting a patient asleep and waking them up in fact when we wake someone up from anesthesia, we call it landing the plane landing. The plane takes focus, but Joe doesn't work in. Silence. It might come as a surprise. But in the OR, there's music playing all the time, there's great data that shows that music improve surgical officiency, which can translate to an economic benefit and music, subjectively makes us feel good. And if you're working long hours, doing difficult cases in the operating room. If you can improve mood, certainly there's benefit, but who chooses the music is usually the surgeon and. If the surgeons excited the surgeries over and the music for him gets cranked up. It's really hard for us to be delicate an intentional and artful. And elegant about anesthetic. Joe remembers one surgery were music was playing. And then all of a sudden, the patient's vital signs started crash. And so now my alarms are going off to music volume is high the surgeon and I are having to raise our voices in almost yell at each other to communicate not, because we're mad at each other, but just to understand each other. So Joan is researchers are trying to figure out how to get the benefits of music in the OR without the risk of hearing we built this city on rock and roll while someone is having a heart attack. I'm working with a another anesthesiologist on a device, which is called the canary box. The canary box has two levels of alarm a warning zone and a danger zone. When the alarm is in the warning zone. It adds the music. And when the alarm is in the danger zone. It turns the music off fixing hell sounds worked together in the operating room is a step in the right direction. But it's part of a bigger problem, doctors know more about the human body than ever and are better equipped to save your life. But still hospitals are horrible places to get better, that sound designer Joel beckerman. And he's right. Hospitals can be bad for your health because hospitals sound terrible. I think of when I walk into the narrow ICU, and I hear the automatic door, which opens and closes as people walk by it opens and closes without anyone going in or out, and as I walk in there's the hubbub of people talking, and it might be clinicians and might be patients families. I hear the rolling of the big metal card that houses all the meals for the patients and it's the wheels rolling on the. Hardwood floor you'll go send is an electronic musician, researching sound in hospitals. It's quiet it's about forty to fifty disobeys, but when it's pretty road it goes up too easily sixty seventy spur, sometimes it hit eighty to ninety. DV some perspective, sixty decibels is the volume of an average office seventy does the bulls is about as loud, as vacuum cleaner eighty decibels as loud as a garbage disposal and ninety decibels is as loud as a motorcycle passing bond all this in your so called healing environment. Hospitals can be really loud. But volume isn't the only problem I hear the l'armee coming from multiple patient rooms and I don't know what's wrong with the patients alarms are difficult to localize. So I'm not sure which rooms they're coming from. And even when he knows what he's listening for Joe has a hard time figuring out what devices making noise, it could be the IV infusion pump the federal pump. The entry aortic balloon pump, the dialysis machine the ventilator. Joel beckerman has experienced the same thing in hospitals. He's worked in there is a cart monitor that makes eighty six different alarms. There's no way that, that can be meaningful to anybody. The scary thing is most of these alarms are false alarms. It could be due to a loose connection or a temporary blip in the patient's vital signs. But most of these alarms, don't tell you anything useful. Still, they saturate the hospital. Sounds soundscape. I go home at night, and I still hear the beeping of alarms and the beep of pulse. Ox imagery in my head. Clinicians are annoyed by votes volumes, but they are number of physicians and nurses, that I loved those alarms, like I have my adrenalin up but I get excited. The high from alarms is not sustainable s actually pretty exhausting. The result is something called alarm fatigue. The problem with alarm fatigue is that din of sound which caregivers and learn to ignore means that they also ignore critical arms and patients die. This is very, very serious problem. That needs to be addressed when thinks allowed people complain that it's difficult to sleep that night. It disturbs this sleep this stuff. Stay rest noisy environment could cause more anxiety since a fear and stressful patients and visit us a swear. I often hear from those parents that. Win on school full their babies. The first thing that young parents would think Ono is my baby going today. It's a very scary to neuro-psychological side effects such as I see delirium. ICU delirium is, when patients get confused in paranoid because of the exhaustion of stain hospital. Sometimes this can lead to who's nations up to eighty percent of patients in an ICU thought to experience some form of delirium during their hospital. Stay. It's the sort of thing that can leave hospital patients with PTSD. I interviewed one person he had his daughter, you know, more than ten years ago in Nick, you, that's the in ICU intensive care for infants. And there was this particular alarm sound that kept going off. So even after ten years if he hears the sound that similar to the I am on television or other places. He still gets this sort of a traumatize reaction there long lasting effects on the body, as well as the mind noise leads to stress and stress hormones in the body stiffen or. Or blood vessels, which can increase the risk of heart attack. I often could this phrase from Florence Nightingale, who said, unnecessary noise is the cruelest of sense of care, and she wrote that more than hundred years ago, but I'm guessing hundred years ago, there was no alarm fatigue as I do most things in medicine progressed, in one hundred years, but I feel like when it comes through the Kuiti of a sound environment. It's like a side effect of a technological advancement. So I bet things got louder. Alarms softer. You can silence them, but the FDA maintained a database, which found that nearly six hundred patients had adverse outcomes, mostly death from alarm mismanagement. We'll talk about how we can make the sound design of hospital alarms sophisticated in precise as the medical devices that are blaring them out after this. Support for this special two part series. Exploring the power of sound to influence our health comes from the Robert Wood Johnson foundation, the Robert Wood Johnson foundation is working to build a culture of health that ensures everyone in America has a fair and just opportunity for health and wellbeing, which includes exploring, how our current or future environments will impact daily life. Learn more at or w WJ F dot org. When you think of the design of a patient, monitor or any device, you think of the visual complexity of the device, and the expense of the device, but why is the sound that's generated by this highly engineered visually attractive, expensive device? So poor and usually comes out of a very cheap speaker attached to the device. I love all the medical device are tones, TV at least not disowned at least in how many was each other in. That's not that difficult as a musician. It's like can I just tune them at least? But Yoko isn't the only one taking a musical approach to alarm fatigue, Joe, maybe an anesthesiologist, but he's also a professional jazz musician some fear eating isn't it? This is him playing the piano right now. Ed been playing the piano since I was five years old. So music and medicine was part of my life together. For a long time. Right now, Laura GMs are loud and annoying, but they don't have to be. They just have to be different from all the other sounds in the hospital. Imagine that somebody down the hall where to scream. And it's not loud, but you can perceive it. We have our attention diverted, not because of the volume but because of the acoustic features of the human scream. There's an acoustic feature called roughness, which has enhanced sensitivity in the middle. So we have this reflex response. This has a surprising implication for our alarm tones alarms. Ken be softer than background noise, and you can still perceive them. A lot of the alarms have what's called a flat amplitude envelope. And so few magin the emergency broadcast signal that you hear on TV. That's a flat amplitude on float. And that's an unnatural sound in our environment. The unnatural sound is effective at grabbing attention, but in a hospital, these unnatural sounds layer on top of each other creating a wall of sound that we tune out. They also create a stress response. That's harming our minds and bodies compare that with what's called a percussive amplitude on vote, which has an exponential decay. So think about if you're clinking wine glasses together. That's a sharp up stroke with an exponential decay. And that's a sad. We have in nature by changing the impetus, envelope to something more natural. You can go from this. To this. But even this sound doesn't tell you a lot, the alarms need to be more informative what we are particularly working on is, how to contain information and sound. And that is what we call auditory icons, for example, having a Lub dub heartbeat type of sound in an alarm that is indicative of cardiovascular problem. The result is something that can tell you exactly what's wrong before you enter the room and that's just the beginning. I don't wanna know just when something is bad. I wanna know when something is trending towards being bad. I want visual signals that are always in my receptive field versus a monitor that right now. I have to be staring at it. I want to tackle information that is whereab- and comfortable. And I wanted to provide signals that are not so strong that they get fatigue, or Bidu waited to it. And I want auditory information that is directed to me when I get auditory information, it's information that can mean something in that I need to act upon it, and we can use the hospital soundscape to do even more. Researchers are finding ways to give a voice to people who have lost. There's you think of a patient in the ICU when they're non-communicative or in long term acute care, those patients often, get neglected, but they have ways to communicate in a non traditional sense, for example through their autonomic nervous system. Patients who can't speak or communicate their feelings are still expressing themselves through their heart rate or their body temperature, so they're communicating but not in a traditional verbal sense. How can we take this physiologic signals turn them into sound in a way that we can start to ascertain what these patients with these people are saying the result, is something called bio music pioneered by a colleague of Joe's at McGill University in Montreal. Sensors on the patient's body, detect vital signs. And that makes the data into sound heart rate, controls the tempo temperature determines the notes and skin sweat drives, the melody, the result is actually kind of beautiful bio music is being looked at as a way for non. Verbal autistic children to express themselves. Here's a comb, state of mind. And here's anxious. You don't have to be a medical specialist to hear the difference. Our hope is that we can make it easy to implement throughout the world where you don't have to be at a high powered academic institution with fancy EEG equipment to make this a reality Joel beckerman believes are hospital sounds gapes can be improved from an unhealthy and dangerous cacophony to something more useful than healthy. Imagine you could walk into a room and be able to sift through enormous data sets by sound alone. We actually create an idealized soundscape for what Asana fixation of data idea might be in a hospital room of the future. Good shape. Maybe then a week we can look at the chart again and make sure sounds good. You don't need to be musician. You don't need to be really intensely trained for this. You can determine whether a pitch is higher than other lower than another. If they're pretty far apart. You can determine whether a sound is rising or a sound is falling in a very, very short period of time, we can help people understand those differences of all the different key health care, data points to understand what a patient needs, or whether that patient is okay. And they can turn their attention elsewhere. When I was in his escort my piano teacher. I'm told me the more you actively. Listen to jazz. And you practice your adding colors cheer palim, the more I studied, the more I practice the more I listen. I have more colors on my palette. I can create a beautiful painting. And so the reason why we need to do this, because this adds colors to our palate. And I think it's important from a patient care perspective that we make the most beautiful painting that we can create. This special episode ninety nine percent invisible was produced by Layla Madison, and Dallas Taylor with help from SAM's Napley edited by Chris Burundi, sound design, and mixed by Colin davonte music by Sean real. Thanks. Also, to our guests Yoko. San and Joe slush. Injure special thanks to the Robert Wood Johnson foundation and man made music, who contributed as producers, and providing the soundscape and the show, Joel Beckham and has written a book. It's called the sonic boom how sound transforms the way we think feel and by go check it out. You can learn more about these stories and other topics related to sonic humanism, and sounds effects on our health by visiting info dot sonic, humanism dot com. Thanks again to the Robert Wood Johnson foundation for their underwriting support of this special series. Learn more about their efforts to help create a culture of health at RWJF dot org.
Episode 178: Healthy Patients, Healthy Providers
"Building healthy and equitable communities across the country is a tough challenge. But it's fun that public policy is opposition to address in the second episode produced in collaboration with the health policy research scholars program funded by the Robert Wood Johnson foundation. We look at research that can point us in the right direction and help us tackle some of the biggest hurdles to health and wellbeing in the US. Hi, I'm Randy Colley, and this is the scholar strategy networks jargon each week, we discussed an American policy problem with some of the nation's top researchers without jargon for this week's episode. I spoke to, to PHD students, I, I spoke with Christopher stolen off. Sqi Christopher is a PHD candidate in health behavior and health education at the university of Michigan and a Robert Wood Johnson foundation health policy research scholar. Here's our conversation. Christopher thanks so much for speaking with me today. Thank you for having me. I'm really excited to speak with you. So in his state of the union speech, Donald Trump vowed to radically eight HIV by twenty thirty which is obviously a huge goal to make sense of the problem. Let's kind of get onto basics can you just tell me a little bit about what each v actually is in. Why weaning to a radical it? That's a great place to start in. So let's think about the timeline of HOV throw history. And so it is a virus. The kind of enters your body really readily replicates, which essentially suppresses your immune system, kind of tax your own immune system. It's on kinda regulated. If you don't get treatment for it, it then progresses to something called aids, which is acquired immunodeficiency syndrome, which is essentially fancy word for just all the other diseases that you can more become more susceptible. To because your immune system isn't functioning the way it should in it started to kind of come about in the nineteen eighties really early around, like nineteen eighty one is when we started to see the first cases of HIV United States, some today, how many people in America have itchy and who are these people have HIV? I appreciate that question. Because there's a lot of nuance behind that. And so, in the United States, there's one point one million people living with HIV, however, there's big disparities in who those people are. So as an example, we see that white individuals in the US have seen in eighteen percent decrease in TV heterosexual individuals have seen a thirty six percent decrease. However, when we get into the elder BT population specifically gay bisexual men. We see that they had thirty five percent increase in then even more kind of wild on disconcerting is the fact that. There was an eighty seven percent increase among thirteen to twenty four year old gay in black men. So you see that there's huge disparities in who's becoming infected so keeping that in mind advocating HIV is a pretty big goal. But in your research, you argue we already have the tools to make this happen. What kind of tools do you mean the treatments today are wildly different than, you know, when we first started off at the pedantic in the eighties when there was nothing. We didn't know anything so we now know we can get people tested for HIV of we can get those who are living with HIV on medicine to help them kind of control the disease. They sense become non infectious. So they can't spread the disease to others in this is what the literature showing us in research, on the other side, we have, you know, group of individuals who may be at higher risk of each IV, or might have a greater tans of being infected with HIV in, we have new. Called pre exposure prophylaxis, which essentially is a pill similar to electric at the birth control HIV in that you take this pill every day, and it's almost a hundred percent affective in preventing those who might be at higher risk from getting infected. What it does. Is it suppresses the viral load or the replication of the virus in their body to essentially become that when you go, get tested? They can't even detect whether the viruses in there. It's so low, that is almost like, not existent, into really allows you to live a long, healthy productive life on par with those who aren't living with HIV. And then kind of on the other side of that is also helps prevent HIV because if he receive your viral suppression, you actually don't transmit HIV to sexual partners you may have. So as everyone who should be getting HIV suppressing drugs, actually receiving that medical treatment, I wish that were the case of virtually we haven't gotten there yet, which is why I wanted to come on talk to. Well about this. So a mentioned before that there's one point one million people living with HIV, only sixty three percent of them have actually received care and only fifty one percent, have actually achieved viral suppression in the United States, indicating that there's a huge population that isn't really getting the care, they need not being able to live long, healthy productive lives with the use of medicine and you know, referencing back to those statistics. I know that it just before about who's becoming affected. We see that. It's African American populations Latinos. Gay bisexual men predominantly in so you see this intersection of kind of these different identities about who's ten of getting infected a lot of that's related to kind of the racialism in stigma that these populations experience. Can you tell me a little bit more about how and why these inequalities are happening or playing out in the real world for people with HIV that's a really great question? I there's a lot of data. Information. So in my work, what I try to do is understand through the review of the literature also doing some modeling which we won't get into because it's pretty in depth. But what I try to do is understand the complexities surrounding HIV in how all these things connect together to shape. One's HIV risk in just as an example of what that looks like is that we have the literature that I've uncovered in my work in that I'm using that shows that providers is an example, prejudge black patients as more likely to have sex without a condom as compared to whites you're talking about providers Bhai providers. You mean doctors nurse practitioners anyone who prescribes drugs? Those are the ones who can prescribe prevention in treatment regimens. So they're less likely to prescribe the kinds of drugs that treat HIV. Yeah, not just that, but also drugs, that would prevent HIV. So pre exposure prophylaxis doctors are withholding this from black pace. 'cause they're fearful that they'll decide to have more sex without a condom as compared to white individuals. So going back to the beginning of our conversation about Donald Trump's Embiid goal in a radical HIV by twenty thirty tell me more about what needs to happen to achieve ambitious goal like that, right. Yeah. That hits a big big challenge that we have to grapple with. So, you know, essentially is we've, you know, uncovered during this discussion we have the tools to reach that goal. So if we can get those living with HIV tested and on treatment, and suppress their viral load daily will live long healthy productive lives and also, not transmitted to others. If we can get individuals on pre exposure prophylaxis essentially their risk zero so using those two strategies, which are pretty novel. You know, forty eight only been around for forty years. We've made a lot of progression. So using those two strategies how do we? Understand Javi risk in a more holistic sense, you know, as a mentioned, doctors aren't providing prep to black individuals. So what does that racial bias bear? Where's it coming from? How do we address that? But we need to take a larger approach as well, because we're seeing that things like stigma leaving in states. So as an example, let's say you reliving in Massachusetts after the adoption of same gender marriage there, so, before the federal law takes place, what you see is that individuals living in those states that offer those protections had reduced mental health issues in. We've now seen that, like mental health is being linked to increase substance use increased decisions, not to use condoms increase number of sexual partners. So we see how policies can shape these downstream behaviors of individuals. So how do we incorporate that into our science into our policies is what I try to do? Christopher. I'm interested in what makes optimistic. Nick, like, obviously, we have all these incredible scientific advancements that are making a radical HIV a real possibility. But you've also shared with us. How deeply ingrained some of these stigmas bias, are that are preventing that ratification? So what is it? That makes optimistic about our ability to make progress the great question in a, you know, answer that in a couple ways. First of all, we're seeing reductions in HIV in the United States across the board. However, you know as mentioned, certain groups aren't receiving that benefit. So the question becomes, how can we work to reach those populations in a way, that's meaningful to them in one example, is of this is that the government of Canada, as example in their HIV prevention strategies considers poor mental health, a risk factor for HIV, and that they would prescribe prep to individuals suffering from depression anxiety, more. Than they would those who are not. So that is a tool in policy, kind of guidance and regulation that we could easily apply the United States. It would open up the number of individuals who we would prescribe prep for. And so that's why I'm a bit. IM Optimus -tic is that we're seeing really novels strategies in different places. But how can we apply them here the United States? And I really that's the only way that we're going to Chievo the goal set a Trump for twenty thirty. Christopher thanks so much for sharing your research with us today. Thank you for having me. I hope this, you know, help clarify some things for the listeners. Okay. So now that we've heard from Christopher, let's explore the other side of the equation, the health and will being of healthcare workers themselves for the second part of our show. I spoke with Yemen at Diaz Lynn heart. She is a PHD candidate in social policy and management at Brandeis university. And a Robert Wood Johnson foundation health policy research scholar. Here's our conversation. Yemen. Thanks so much for coming in today. Thanks for having me. So, typically, when we think about health, where usually thinking about the patients who walk into a doctor's office or hospital. But your research goes beyond that, and looks into the wellbeing of healthcare workers, and what it means for their patients. What could you started on this line of research? Yes. So I am a public health social worker by training, and as part of that work, I worked directly with families, and then through some of the research that I was involved with became a program director, which meant I was doing lot of employee management. And so I was a program director, I was a mid level manager in a pretty large healthcare system. And that meant I got to learn a lot about working with healthcare workers, especially workers who are really on the frontlines. And so I decided this was just really interesting to me, because I don't think healthcare organizations really know how to manage healthcare workers on the frontlines, especially workers that are doing work on social health related needs. So. So, again, not just medical care, like physicians also folks, like myself social workers, 'patient, navigators, community, health workers, what is their work like and how it we're gonna really able to meet the needs of those types of healthcare workers? So now that you've transitioned to studying this topic, tell me a little bit about your research and your findings this past year. I had the pleasure of having a small funded pilot study. It's a case study of a pretty large health system that has many different sites. And so the case study is looking at complex care management workers in this includes a community health worker, in nurse that are working together as a pair, and they're deployed to really try to manage the health of very complex patients in these patients, typically have some type of a chronic condition, like diabetes. That's not really well managed may also have some type of social risk, so they could be home. Klis, or they, you know, have been maybe unemployed and are not really able to take care of themselves. So, yeah, Pete me a picture of what it's like to be one of these complex care workers. What sort of challenges are they facing on a day to day basis? What is their workday? Look like the work is really fascinating. They typically meet up at their kind of home based site, and, again, this is all over Massachusetts, and they planned together who they're going to be able to, to visit that day. And then they'll go from one kind of home, visit or site visit to another, so depending on where they are. They're in a, you know, a rural area Massachusetts. They're in their car lot traveling about thirty to forty five minutes each way, just trying to meet patients where they might be. So they're really kind of tracking patients in real time. And they have a an assessment that they do they kind of figure out what the patient what's going on. And what would you like to work on what are your goals, so based on that? That initial visit. They will then you know, it's very patient lead, which I think is really fabulous. They will work directly with the patient to figure out what are the most pressing needs, and that could be a social need that could be housing. For example, this patient is homeless. It could also be hey, my medications are a little bit out of whack and I can't really get to my primary care physicians office. Can you help me? So it really depends. It's very differentiated for each particular patient. So they're traveling a lot. There's lots of variability there could be anything from lots of traffic to we showed up at this patient's home, and they're not there in. Could they be in their phones now disconnected so they can't reach them? So it really depends in some of the, the workers have about four to five patients that they might see in particular day in addition to that they're doing data entry their looping back and coordinating with other providers to keep them in the loop around with. Going on. So what if you found about the well-being of these workers in these really complex and variable environments? So we have we've done focus groups, qualitative interviews, and we still have an online survey that still wrapping up, what we're finding is that the nature of the work because it's so complex it ends up being a pretty high stress job. And this is, I think very typical what you might expect when you're working with complex patients, especially because not a lot of these things, the healthcare workers can control. So, for example, housing crisis has come up again, and again, again as one of these really difficult parts of their job. When you have homeless patients or patients were facing Vic vision or housing insecure. It's not really easy for the actual healthcare workers to get them house. They can do the best it can. So when you have all this, you know, this combination of different things than the work itself, does become very stressful. I think. I think one surprising element though, is that many of the healthcare workers, I interviewed really actually feel very satisfied with the work, despite the high levels of stress. They're experiencing. And so this is something that we want to understand a little bit better. Yeah. Looking at these high levels of stress. Have you found a relationship between the wellbeing of these healthcare workers, and their patients health comes? So that's definitely something that I hope to continue to explore down the line. But what we what we are really kind of trying to understand in link with this particular case study is that there's a something called the value profit chain, which is a theory, you know, I'm in a PHD, I have to think about a lot of, but the value profit chain is using in the service industries created by Heskitt, and it says that if you leverage if you treat your employees customers, it actually will create even more. More loyalty on the customer side. And so what I'm doing is I'm using this model to adapted to health. Go to say, hey of we treat our employees like patients, we think about their wellbeing in their health outcomes. How is that also going to add value to the patients? And so I think this aspect of focusing so much on costs. It's very important. And this is why I'm in the field but it's also missing this really core aspect of the dynamics between the frontline workers in the patients in. So how do you leverage that to really understand? How does that relationship eventually or somehow really improve health outcomes has been other research in, in different types of healthcare, workers, about the impacts of conditions on the job and individual health outcomes? Yes. So there are a couple of really interesting sets of studies that have been done. The nursing field does have quite a bit in. There's also quite a bit on on things like physician. Burn out and trying to understand how things like burnout turnover in jobs actually impact patient outcomes. But one thing that I am I've been really drawn to this concept of human sustainability, and it's a work by, by gopher Encino that talks about particular actual workplace, stressors that impact worker health outcomes. These are things like jobs that have really high demands or jobs were there low control. They were able to associate these kind of markers with poor health outcomes in the workers across different industries. So not just specific tells gear but what's interesting about that it does kind of help us think about what might be some interventions that or what might be some things that we're gonna zanies can do to be able to change trajectory for employees. Yeah. Kind of going off that point. What can or should be done to better support healthcare workers were experiencing these high stress markers. So I think they're. Are two particular things that stand out at this point. One is to be able to create a culture of well-being within the organization, so that increasing things like social support or building helping workers build resiliency through supervision, or reflective kind of group work on those things a buffer, the effects of stress that the workers feel in day-to-day basis. So sharing the kind of burden of what it's like to, to do the work and to take care of patients. Another thing is to, to think about how to shift away from just offering, you know, employee wellbeing things like for yoga class meditation. Those are really important in there actually really great. They do work, which also start thinking about shifting more toward understanding how the organization might actually propecia wait, these high levels of stress including how you might design the work differently so that the workers have a little bit more of. A buffer in day-to-day work practices so that they can actually do their work in a way that sustainable in healthy. Yeah. Let's talk a little bit of little bit more about that. What are some concrete changes concrete, like worker policy goals that were places can implement to really tackle this issue, one particular idea that comes to mind would be thinking about, for example, the amount of data that the workers have to actually input after each visit, and so right now, many of them are inputting data in about two to three different systems in part of that is because there's a medical kind of eletronic medical record than there's a state level record and all these things are really crucial for cost outcomes, and health outcomes, really understands show, the cost reduction in the health improvements impatience, but it, it is burdensome because there again, many of these workers are on the road all day. And then they're also expected to. Document everything that they're doing in two separate systems. So one thing would be to really think about integrating, the health system in a way that is capturing their work in a meaningful way. So they're not just duplicating a lot of the same data entry in two different systems that takes a lot of time and energy Yemen at thanks so much for coming in today, Inc. So much for having me. And thanks for listening for more about the Wood Johnson foundation and their health policy research scholars program. Check out our show notes at scholars dot org slash new jargon and tune in next week for conversation with Peter Miller on gerrymandering and the courts as always know jargon, is the podcast of the scholars strategy, network nationwide, association of over thirteen hundred. Researchers in forty seven states, the producer of our show is Dominic Dermot, and our sound engineer is J M bias, if you like the show. Please subscribe and rate us on apple podcast, wherever you get your ships. You can give us feedback on Twitter at no jargon podcast or Email address no jargon at scholars dot org.
Facebook launches voting information center
"Your destination for gadgets gear I'm Fred fishkill. With a new voting information center facebook says it's already assisted more than two million people to register to vote and the numbers are growing daily director of social impact. Product. Emily Dalton Smith says beyond registrations facebook is providing information on how to vote working with election officials and individual states, and he'd been incredible partners really challenging election season for everyone I think especially for a state partners but they've done an amazing job of sharing information about than you know with their tires. About how people can get out to vote and making sure that the information and the. Information Center is correct whether it pertains to in person or vote by mail beside for more is F. B. Dot. COM SLASH VOTING INFO center. You can find us at textile DOT COM. I'm Fred Fish. A survey conducted for the Robert Wood. Johnson, foundation recently showed the impact of the coronavirus pandemic on so many families with children. One of the issues is how many children simply don't have the Internet access needed to attend classes remotely, and that is even if they are provided things like chromebooks by their schools. Robert Wood Johnson Foundation executive VP Dr Jalili Rita I think what we're seeing with fantastic in terms of WHO's actually getting sick who's getting hospital dying disproportionately impacting those households those communities that have historically struggled in past the people lower income communities, comedic color to have really been hit hardest and so from a connection prospective listening groups that are being hit hard prompting calls, which we've heard before for better broadband access for all.
Lutron brings reliability to smart home gear
"Your destination for gadgets ungeared I'm Fred fishkill. The latest home automation year from Lutron is the most reliable I've used, and that makes all the difference in the world. It can be more than a little frustrating when connected light switches bulbs in the like were some of the time but not all of the time with Lutron Caserta. Line. That won't be an issue. We've combined Caserta Smart Lighting Kit replacing a traditional wall switch with the. Company's Serena smart would blinds which can be set to adjust automatically at the time of day and even change with the season results are convenience perhaps even energy savings and just overall coolness. Here's a dimmer and even a little remote. You can add an emotion detector for the lighting and when you're doing, you want to bring the technology to other rooms of the house find more at Caserta cease. Wireless Dot Com you can find us at text nation. Dot Com I'm Fred Friskin a survey conducted for the Robert Wood Johnson Foundation recently showed the impact of the coronavirus pandemic on so many families with children. One of the issues is how many children simply don't have the Internet access needed to attend classes remotely, and that is even if they are provided things like chromebooks by their schools. Robert. Wood Johnson Foundation executive VP, Dr Julia Rita I think what we're seeing with fantastic turned with WHO's actually getting sick who's getting hospital dying disproportionately impacting those households those communities that have historically struggled in past the people lower income communities, comedic color to have really been hit hardest and so from the Internet connection perspective, it's listening groups that are being hit hard prompting calls which we've heard before for better broadband access for all.
"Points this is. Npr a annual new year's eve celebration in new york city's times square will look a lot different this year amid the coronavirus pandemic npr's z. Long reports the area will be close to members of the public to prevent the spread of covid nineteen high tout one times square. The famous ball decked with crystal triangles is set to slide down a pole towards a light at twenty twenty one side but down below. There won't be the tens of thousands of spectators who usually gather in midtown manhattan. It's the first time times square will be close to the public on new year's eve since the first ball drop there in one thousand nine hundred seven socially distance revelers around the world can watch video stream online or on tv and musical performers are still set to help bring in two thousand twenty one from times. Square for the cameras organizers. Say tonight's festivities will honor first responders and essential workers and their families ozzy long. Npr news new york. The number of americans filing for unemployment benefits has dropped fourth his second straight week. The labor department says the number of claims fell by nineteen thousand but remains high as the job market suffers amid the coronavirus. Pandemic economists says he doesn't expect a full recovery until twenty twenty three. There are a lot of businesses that have closed permanently. There are a lot of industries that have undergone huge changes That means that they won't need as many people as they did. Previously an additional seven hundred eighty seven thousand americans filed first time claims for jobless benefits of week. I'm windsor johnston. Npr news in washington support for npr comes from npr stations. Other contributors include the robert wood johnson foundation supporting those working towards a day when no one has to choose between paying rents putting food on the table and protecting their health and the health of others are j. f. dot org. I'm craig cohen. The host of houston matters weekday mornings at nine. And i'm earning news host of town square weekdays at three as we begin a new year together. We'll bring you relevant and diverse conversations like the ongoing covid nineteen response and vaccines issues about racist.
Episode 177: Unintended Consequences
"The influences just about every part of our lives. And perhaps one of the most important is health and wellbeing. We all wanna live healthy happy lives. But getting there can be a challenge, and that's a specially true for communities who've been left behind for far too long. So what policies are needed to help build healthy and equitable communities across the US this week in next, you'll be hearing to produced in collaboration with the health policy research scholar program by the Robert Wood Johnson foundation that provide some of the answers. Hi, I'm Lizzie Getty Erlich. And this is the scholar strategy networks. No jargon each week. We discussed an American policy problem with one of the nation's top researchers without jargon for this week's episode spoke to, to PD students. I, I spoke with Tyler Jimenez. He's a PHD candidate in social and personality psychology at the university of Missouri. And Robert Wood Johnson foundation health policy research scholar. Here's our conversation. Tyler. Thanks for speaking with me today. I saw haven't so you study how people feel about various policies based on the perceived threats in their lives. How did you come to this line of study in the first place? So I've been interested in how people respond when they feel like aspects of their beliefs or identities are threat and a lot of psychological research shows that when people believe that their identities or beliefs are under threat. They often lash out or act negatively towards those that they perceive as different from them. So those that are in different social groups or categories from them. And the thinking is that would people act negatively towards others kind of reassures them of their own security, or safety, and so, a lot of research has shown that it will act more aggressively when they feel like they're threatened and things of that nature. But I was interested in seeing how this might affect how people think about various po-. Policies. So I'm really interested in racial health inequalities. Right. This is very big topic now, we're very aware that just based on racial groups, people have different health outcomes, and when we're trying to fix this and create a more equitable world. I think we really need to think, on the policy level because that's where real structural and institutional change can happen. So I wanted to, I guess connect these two interests and see whether wind people feel threatened or undermined, or insecure this might actually affect how they view policies, attempting to redress or fix racial health inequalities. And so let's talk about those existentialist threats. You've said that, it's, it's not the same as fearing that someone is going to stab me, it's a threat to my identity. What, what are those? What are those look like exactly? Yes. So I think there's a lot of different things I would classify as an existential threat. But all of them kind of deal with. People sense of meeting or purpose. So in this line of research, I think most popular or most studied ex-central threat, so to speak is the fear or acknowledgement of death or mortality. So this is kind of considered the ultimate, right? It's the end of life. It's the end of meeting in a sense. Right. And this can be very scary. But it also can arouse these and of existential concerns that make people want to do something with their lives or make a Mark or pre real connection with someone in order to leave a legacy that will not be snuffed out, so to speak by the evid death. But that's not to say that that's the only existential threat. There's other threats that people have studied looking at losses of freedom or atonomy, and how this might undermine people's sense of self worth remaining, and another one, which we've actually looked at more in this present circumstance is changes to. The social system. So people derive censo- meeting or purpose or here. It's from the way that society is set up. So with our institutions people are allowed to feel like people have it under control. Right. We know what we're doing. But when changes to the system are made people can often feel like this is a bad thing, or they feel like they don't know where they fit in with this new order, so win political changes happen. People can often feel existential threatened. And when we were looking at this in this context, we use some material was previously used by researchers who show that changing racial demographics in the United States, are actually very threatening to a lot of people. So we've heard a lot of statistics, census bureau data predicting that white people in the United States or becoming a racial minority group. I think it's expected by the year, twenty forty two or around that, that white people in the US will comprise less than half the population. And what these researchers along with myself have shown is that reminding people of these statistics. It's them to think that the social order is under threat, or undermined, and that has ramifications on their political attitudes and opinions. And so tell me a little bit more about your study than you set up multiple tests to see how threats might affect support for policies that would create more health equity. Did you test for one specific threat? You were looking at were there multiple ones were there multiple policies. How did you actually test for this relationship? So we did it in a few ways. So we used experimental methods by recruiting people to complete our study and randomly assigning them to one or two conditions. And this allows us some insight into a causal effect of this thread on an an outcome in this case attitudes towards all seas. And like you said, we, we use a couple different types of threat. So in the first study we ask. Half the participants to write about their own death and the other half of participants to write about control topic. Something very benign, boring, just like watching TV. And then after they did the short task we ask them to indicate how much they support a fictional policy attempting to eliminate health inequalities between white and black people. So this was just three questions kind of answered on one to seven scale, and they were just getting at how much do you think that the government should intervene on these health inequalities and implement policies aimed at addressing them and what we found was that wind. People were previously asked to think about their own death. They indicated lower support for these policies. Trying to create a more equitable world. Wow. That's really interesting. I mean, I was imagining an maybe then the further research that you'll talk about did this. I can see how if you primed someone to think about a threat to their identity from different racial group. And then you ask them, do you support this policy that benefits that racial group that I just tore, it was threatening your identity? I can imagine that people might rate that lower, but you're saying simply the peer existential dread of personal death, not connected to any particular outside actor decrease support across the board for equitable health policies. Yes. It's really interesting because right? Like you say on face. They're two completely unrelated things right, personal death, and how I feel about racial groups on the face of it. They don't have any connection. But the idea is that when people are feeling exa sensually threatened by this manipulation that we use. They just wanna lash out at those perceived as different from them. And that's I think where the connection comes into play the other study that I wanted to mention is used a different manipulation because like you said this is completely unrelated. We also use one bit more related to the topic at and so for this study we used very. Similar methodology. We recruited people to take our survey and randomly assign them to one of two groups, the first group read information about white people becoming a racial minority group. It reference sense, Spiro data and talked about how by the middle of the century white people will comprise less than half of the population in the US those in the other experimental group, just read about also census bureau data, but unrelated to race or release socio political change at all. So this was the control group and after that we asked them to indicate their support, for health policies, but in a little bit different way than we did in the first study, just to see if this is a an effect that goes beyond the methods that we use in the first study, so to do this. We had people do a task where we asked them to imagine that they were a person in the government who was tasked with distributing, a large, but unspecified amount of money between six pretty salient political or social issues and. One of these issues that we included was attempting to reduce or eliminate health inequalities, particularly between black and white people. So we thought based on the results of study one that those who were made to feel threatened or those that read about shifting racial demographics would be less likely to allocate resources towards eliminating racial, health inequalities, and that's exactly what we've found. So just in that condition. People were less likely to give money towards eliminating racial health inequalities than any other political issue. And we didn't see that trend in the control condition. What do you think is the implication of knowing that, there's this causal relationship for how legislators need to do their jobs? Well, I think there's a few implications. The first one this is based on the second study that I was talking about, is that as these racial demographics in the US continue to change its likely to impact people's political attitudes and how likely they are to support. Policies. So there's a great line of research, done by Jennifer Richardson and worrying crag, other social psychologists showing that these reminders of shifting racial, demographics impact a lot of people's political attitudes. And I think our studies show that this extends into the realm of health policy. So when I think we can expect to see in, in the coming decades as these demographics continue to shift is, is a react against health equity by the broader population. So if we're committed to really passing legislation aimed at improving health equity, I think we really need to be cognizant of these broader socio political processes, and how they might influence individuals people's support for policies. I think it also has a lot of implications for how this demographic shift is covered in the media. So we see a lot in mostly right way nedia, but also just a media more broadly talking about kind of this threat of white minority. Eighty and we see the media kind of stoking this anxiety about how we're living in a changing culture because we're not having the same racial demographics that we used to have. And I think that this can have profound implications in health policy. And so I think that the media should really do a better job or at least be more aware of how their coverage of this process is going to impact people's Alcee decisions, great will, this is a really eliminating, thank you so much Tyler, thanks so much Redmond. Okay. And now that we've heard from Tyler, let's explore issues of equity in health on college campuses for the second part of our show. I spoke with Amy Jones Amy's, a PD candidate in sociology at the university of Wisconsin Madison, and a Robert Wood Johnson foundation health policy research scholar. Here's our conversation. Thanks for talking to us today. Yeah. Thanks for having me. So you studied diversity and what it means for health outcomes, so to start out. Can you briefly explain why diversity has become this new? It word when it comes specifically to college admissions in the United States. Diversity is talked about almost as if it's American as apple pie. Right. Everyone says, I support diversity. Most everyone does most everyone knows most everyone should say, so if it became it word probably in the last twenty to twenty five years, and particularly in relation to the supreme court supreme court rulings that have come down about affirmative action in the early two thousands of the university of Michigan that said that we couldn't use we case, quotas anymore case quotas for for mission. But what we can do is say that diversity. Eighty this diversity thing that, that was sort of bubbling up in universities about what, what is, what is the way that we can, we can save affirmative action because it's it was seen affirmative action is seen as something that was going toward a something good, right? Having more people of color more women in universities. But happily do this in a way that get through the courts. So diversity this benefits of diversity narrative began all literature McCain up about that. And that, you know, there's harnessing the power diversity that we capitalize on the stories and experiences of diverse people, and that it's a compelling state interest. Right. And so you have all of this literature in all of these arguments say diversity is a good thing that benefits everyone. But I think that it's important to look at that narrative into complicate the story that it benefits everyone because there's another story that. That's being told by students who are doing this diversifying your complicating the view that diversity benefits, everyone and you alluded to the fact that there are some people who benefit from diversity in, there are other people who are expected to be the diversity, and you studied some of the effects of that process. Yes. Right. Yes. So I've studied a student group at the university of west rock is what I'm calling it, it's a large midwestern university about forty thousand students undergraduates and graduates. You are calling at that meeting is real university. But you are anonymous thing it, it's a real university, but this is a name for it. So as to keep the interesting Optimus, so it's a program diversity inclusion program that is for students who do hip hop, art. So I'm break dancing spoken word poetry, choreography, all sorts of things that are related to hip hop arts into these students come from places like New York, Chicago, AUSSIE Angela. Washington DC and because the art form was developed in urban spaces and New York and Los Angeles. It means that the students in this program are primarily students of color. So while it's not an affirmative action program in essence, does the same type of work. And so you looked at that admissions program in the effects that it had on the student body. Can you tell us you know what that program did and didn't do to address questions of race in admissions? Yes. So I think a good way to explain this is to give an example. So I did ethnic graphic observations and interviews, and this is a type of method that scholars have used. It's quite effective to get at the lived experience of a group of people. Right. So there's only so much that a survey can get at the intricacies of, of someone's daily life. But being there for hours and hours and passing them after the fact about what the. Experience was like, is a good way to get lived experience to understand more deeply concept that could see more extract. So, in example, came from a student's using African American student from Chicago, and she was talking about what it was like for her to perform for these all white majority white audiences. So this is what she said. She said I thought performing here at west rock was year. But then, you know, I got used to it the rector would tell us, oh, you're gonna go perform for some teachers in west rock, and apper formed, for teachers in Chicago, but those were different teachers, the white teachers come up to you and give you compliments that are different. Oh, I can't believe you went through that in that you told us all about it. It's weird. So for this student, you have to kind of look through what she saying to see to see what the actual experience was. You know, she she performed this, this poem for these, these teachers who were majority. See white in this white teachers come up to her afterwards is giving her what could be called a compliment, but she is seeing it as as expressing that the poetry that she's just performed was for them that it was for their benefit for their knowledge of what the African American experience, was like in urban America, right in the student is saying, no, it is not it's not for you. It's for me. I did this because I wanted to I've been in, in program because I, I wanna do my art and how support around that. So there's a tension. There's a tension there between what the student feels like. She's doing and what the audience member thinks she's doing. And in that tension is what on calling diversity work. It's the work that the students are doing of a benefiting other people, and then getting their feedback around that or being asked to perform literally, on stage or in classrooms, right? Performing performing their race in other words. And so that was that was a feeling that was our ticky related to you by multiple students that you were serving not just the swimming's that held true. It seemed for people undergoing the part of this program. Right. Right. And it's in subsequent work. I've done another ethnographic study for the dissertation with another student group in various similar things have come up in this other this other student group is not a, a performance or tested group. But the same stories are coming up about being asked to perform their race or to be in pamphlets or to answer questions about about their experience. So another example, from a classroom, classroom example. She spoke about a US history class in the topic of affirmative action came up in the classroom. And so she says she says this I remember for some reason we. On this question of -firmative action in relation to, like, admissions policies with school. So I did like a but clinch like every time weird awkward conversations about to start about race. I just like but clinch like, okay, this is gonna be real uncomfortable for whatever reason, you know, whatever the reason is that day. So I just patiently way through those conversations. And then when I finally can't take it anymore. I'll say what I have to say. And so, you know, again, there's this visceral, physical reaction that that happens to these questions. Coming up, right? She's the only student of color, the only African American student in this class. And there's an expectation that, you know, the, the eyes of the students have come to her to explain affirmative action, not just explain it from vaction, but explained her very presence that if the pergram that she is in is part of informative. Action narrative is seen as something that is supposed to bring more students of color to the campus that she needs to defend both her son for very presence and the presence of her colleagues who in not just her diversity program, but the other diversity programs on the campus. And how did they cope with this? What were some of the things that students did to either reject that type of diversity work if they could or were, there ways that they had to figure out how to, to stay in those programs in meet their own objectives while still performing it? What does that look like? So a lot of it has to do with the supports that they build up around them with their friends, and with, there are some amazing amazing administrators in the program, who also feel this tension about, you know, how much they want the students to go into these spaces that are, you know, they can see that there Jordi white there on the campus. And so they feel Titian administers. Feel the tension of wanting to promote the program, but also wanting to, to shield the students, and so the students will talk to them. They'll talk to administrators about this tension. They'll live together ams actor the first year they can live together off campus. They can sort of have support that way in informal spaces. There's also the cultural centers. So the end the black cultural center in the multicultural center that provides space, that's more or less void of, of this diversity work. There's not that pressure to perform one trace. And so, you know, you look at the impacts that this has on health, clearly, you know, the anecdotes that you've shown things that are affecting people. Tell me how this diversity work directly affects student health, right? So diversity work this, this constantly being on for the benefit of other people that any moment, someone could ask you to explain, you know, the, the lake? Artist news report about a black man being shot. It wears people down emotionally physically mentally in the students talk about their light that, that those dim as as their on campus. Right into its mentally taxing. It's taxing on them and the university actually did a study a survey, and that was about mental health of students in general on campus. All students in it found that African American students were more likely than any other razor this city to score positively for depression anxiety, and I'm not saying that the results of the mental health study. Amer all attributable to diversity work. There's all sorts of reasons why people have insight or depression, or mental health issues. But I am saying that if you look at the interview data in the end, the graphic observations those are in line with a mental health steady and that diversity work is part of the. Problem. And so how do we change it? How does this one anonymous university, but colleges and universities, generally improve the experiences of students of color once they've been admitted right? I think that's a great question in ultima is, is what I'm I'm hoping to do is to fix policies, not just university policies, but a health policies, and all sorts of things. So I think first off, before we think about any specific changes that we need to make at the university level. I think that this is research points to the need to have a conversation as a country. We address the issues of passed in prison racial discrimination in its impact on current rates, the college admissions in the experience of college going. I think I'm also a discussion that those in these historically underrepresented groups who are starting to come to college at greater levels that they don't they're exp. -perience or their stories to the organizations that they wanna be a part of right? It's a shift. It's a conversation that, that needs to happen. And I think that funding cultural centers like the black hole center that I mentioned that's really important. Because those are spaces on the campus. Students can go in get some solace. It's some it's rest from this doing this work. And Finally, I think in the classroom, which is where a lot of this talk of diversity is supposed to be at the effects of it or supposed to be happening. It's important that professors set norms at the beginning of the semester, that are focused on equity. Right. So that, that no one has to speak or be pushed to speak about particular issues based on particular identity for Vimpel race. Thank you so much for telling us all about your research. Today me. Yeah. Thank you so much rivalry. Thanks for listening, the Robert Wood Johnson foundation and their health policy research scholar program. Check out our show notes at scholars dot org slash jargon. New jargon is the podcast for the scholars strategy network, and nationwide association of over thirteen hundred. Researchers in forty seven states producer of our show is Dominic Dermot sound engineer, j m bias, if you liked the show, please spread and rate us on apple podcast or ever, you get your shows, you can give us feedback on Twitter at no charge and podcast word our Email address no jargon at scholars dot org.
Sound and Health: Cities
"Thanks to the Robert Wood Johnson foundation for underwriting, this special, two part series about the power of sound to affect an influence our health and well-being, the Robert Wood Johnson foundation is working alongside others to build a culture of health for everyone in America. Learn more about them at our W J, F dot org. This is ninety nine percent invisible. I'm Roman Mars. Nearly everywhere we go. We're bombarded with human-made sound, it's especially bad in cities, shitty is in the past think about where you'd have horses and buggies. You know, you hear clopping you'd hear banging of wood against stone. Very noisy experiences. That's Joel beckerman. He's a composer, and founder of a sonic, branding and design company called manmade music. Then cars came along and we're sharing the road with these horses. And so not only did you have the horses at one rate of speed. The cars at a different rate of speed. So lots of honking of the horns, it must've been a cacophonous mess. But things got even worse when cars came to dominate the roads, if you fast forward to really what the soundscape were, let's say in the fifties. So in the fifties, it was all about muscle cars. It was all about the loudest car. You could have Mustangs corvettes that were really, really loud. We might not have muscle cars anymore, but our cities are still noisy places. We're pretty good at tuning it out. But our sonic environments have serious impacts on our mental and physical health. So is the blaring modern soundscape slowly killing us. This is part one of a two part series all about how sound can be designed create more wellbeing, and reduce harm. We really respond to sound quicker than any other sense. It really becomes the arbiter of all our senses. But many of the sounds, we hear are created with very little thought for how they interact with each other. They could be a byproduct, like engine sounds of a computer or they could be made intentionally like alarms or a cellphone paint. Add to that. The sound of overhead planes, air conditioning, units, patios and stores pumping out music sirens, and people talking loudly to be heard over the rest of the noise have trucks buses other kinds of transit, and then mechanical things like construction. And of course, there are cores the sound of cars is kind of inescapable, which is depressing. If you think about it. That's Kate Wagner, you might know her from her fantastic blog McMahon mansion. Hell, she's an architecture and design critic, and she cares a lot about sound cars, tens of drown out, other things like birdsong human speech. The rustling of leaves conversation things that maybe are more personal or like that we hold in higher, like, aesthetic value. Joel beckerman says we need a new approach to sound one were, we decide what we hear in our everyday environment is really about how do we use music and sound to make people's lives richer, and simpler, Joel want sound to be something we're thinking about all the time. But while cities have more noise laws than ever over half of the world's population live in urban areas experiencing way too much noise. Sound is measured in decibels, the louder the sound the higher. The number a quiet library is around forty decibels car noise can be anywhere from, like sixty five to eighty to even ninety decibels if you're really close to the highway. The dust will scale isn't linear. That means eighty two symbols isn't twice as loud as forty. It's actually ten thousand times, louder if you've ever like had to pull over on the side of the highway because maybe you have a flat tire something, you get out of your car. The sheer noise that you hear is quite startling, just like the sheer mass of sound that is an eight lane highway. The average level of car noise in a busy city is about the same as having your TV on at top volume all the time. Of course some sitting whizzes, or designed to be loud. Please sirens and ambulance sirens are one hundred and twenty decibels. We might try to escape this by sticking in a pair of headphones and cranking up the volume. But depending on what you're listening to headphones, can be over ninety decibels prolonged exposure to anything over eighty decibels will lead to hearing loss. So before we go any further while we're talking about the idea of sound in health do yourself a favor get into a little bit quieter area and turn this episode down a couple of notches, your ears will. Thank you. When it comes to city sound volume is not the only thing hurting us. It's not just how loud the sound is. It's the character of the sound, it's whether or not you have control over the situation. That's Aerica Walker. She's a researcher at the Boston University school of public health and a Robert Wood Johnson foundation grantee for Erica. The impact of sound is all about context, I lived in an apartment building and above me, were these neighbors, and they had two small kids and the kids used to run across the floor twenty four hours a day. The sound wasn't more than fifty or sixty decibels that's the same volume as the background music and a coffee shop. But Erica could feel that sound every moment of every day, I think, for different people, it's different things, but for me it was the rumbling, it's that low frequencies found you can't hear it. But, you know it's there and you don't know where it's coming from. But you can feel it. Living so close together, we're going to make sounds that will cross over into other people's spaces, and that's not always bad. In fact, it's one of the reasons why I love living in Surrey, some communities say that they appreciate the sound levels like they like hearing their neighbors at the barbecue, because it makes it feel like a sense of community. So there is a positive aspect. But when we don't have control that's when health problems start. Matijas Basinger is a professor at the university of Pennsylvania. He studies. How noise affects our sleep so noises stress, especially if we have little or no control over it. And so the body will excrete stress hormones like adrenaline, cortisol that lead to changes the composition of our blood and of our blood vessels, which actually have been shown to be stiffer after a single a night of noise exposure, people who are irrelevantly exposed for prolonged period of time, have an increased risk for cardiovascular disease, including high blood pressure and myocardial infarction, but also in some studies higher risk of stroke, a myocardial infarction, by the way, is another term for a heart attack. Now, though, the risk increases are relatively mild, relative to other exposures, like smoking, for example, this still constitutes a major public health problem. Because so many people are exposed to these differ. Noise sources and the World Health Organization published a report on the burden of disease by environmental noise, and they basically showed that in the western European Member, States alone one point six million healthy life. Use a lost every year due to the exposure to environmental noise. There's a study from the university of Michigan that looked at the effect of lowering sound exposures by five decibels that could save three point nine billion dollars in healthcare costs, and it would also save lives. There are so many other ways that noisy environments are bad for you. Think about allowed restaurant, there's the sound of the open bar, thumping music, you're shouting, your friend, and everyone else is shouting at their friends to it's pretty stressful. And when we get stressed studies show, we which for comfort food and alcohol. Also hurts our academic performance. Screws up our mood hurts, our concentration basically, we are being killed by noise and some of us or being killed faster than others. More after this. Support for this special two part series. Exploring the power of sound to influence our health comes from the Robert Wood Johnson foundation. The rubber Wood Johnson foundation is working to build a culture of health that ensures everyone in America has a fair and just opportunity for health and wellbeing, which includes exploring, how our current or future environments will impact daily life. Learn more at or w j f dot org. We know noise causes health problems, but they can be especially pronounced if you live in a less affluent neighborhood, if we live in a place, for example, with lots of environmental noise, as do many people in American cities, especially people of color, and low income families. Then we have to deal with essentially, this mechanical sound that can shave off sort of the high frequencies, just through repeated relentlessness neighborhoods near factories, highways and flightpaths are the loudest. And usually they're at the least expensive places to live. This is a noise equity problem, we should have the choice of living in a space that is not doing damage to us without having to move. We should have the agency to good health. Good hearing health, and we should have agency over the things that could harm us, essentially. The most obvious solution is to make laws. Some cities carve out quiet hours. You can't run a noisy leaf blower or practice drumming in your garage at night, or else, you'll get fined, but there's a couple of problems with noise. Abatement loss for one thing, they're often used to target vulnerable people, noise-abatement lawsuit are always singled out, powerless people people whose livelihoods impeded the sort of middle class vision of a quiet or orderly or blossoming city, et cetera sort of like, what this sort of Boers, why of what the ideal soundscape would be for the city. The very first restrictions on city noise came in the early twentieth century in New York. A rich woman named Julia Barnett rice campaign to silence. The horns and whistles from tugboats in the nearby pours all these noises were bothering her and her riverside mansion. It's not hard to see the threat of connection from someone like Julia Burnett rise in someone like barbecue. Becky, the white woman who call the police on a. Black family having a barbecue last year. In Oakland was the beginning of what we call gentrification, which is pushing out those who rely on the city for work in order to satisfy these sort of a static tastes of the wealthier people whose opinions were more of a concern to those in power. This is very much both a literal, and a sonic displacement. The other problem with noise laws is that they aren't very effective. So the way we currently regulate in measure sound in our communities by using this decimal. That's Eric Walker remember the decibel measures how something is. But most sound meters only listened to a specific range of frequencies, the kind that we hear with our ears, that's called an a weighted system, this weighted system that's tells us that it's only the sounds that we processed to the Dettori system that are important. But there are some sounds we don't process with our ears. Once the pitch gets low enough we no longer hear it. But feel it instead it's completely vibrational. So it's just essentially that feeling. So when you're in a community that's an flight path. And you say it's sixty five a weighted decibels. You're subtracting out the components that come from the lower frequency sound, so you're leaving out a huge part of the story. Not only is. That a flawed metric they using this metric to determine who's eligible for soundproofing criteria. Erica is working on a project called the community noise lab. And she hopes that by taking a much wider range of frequencies into account, we can get a better, grasp of, how sounds are affecting our neighborhoods and our health. In the meantime, Kate Wagner, says that there are steps everyone can take to make things sound a little better. You can make a Chris exchanges to the spaces. You're in there are sort of architecture and design choices that we can make to make our spaces a little bit quieter. You can always choose to sort of beep up the installation or have a floating for any other sort of expensive solutions that are more structural to isolating noise. You could also hang thicker curtains, which is cool because velvet is in Vova curtains might be a solution to noise problems in our home. But addressing the noise from cars and industry requires a fundamental change to the way, we live, often, the things that are making the most noise, especially sort of industrial noise are the things that are, perhaps, not exactly the healthiest for the environment. For example, it takes a lot more noise to have a natural gas plant drill or do what have you for any kind of sort of extractive purposes, than it does to have a solar farm, which is. Almost entirely silent the quietest city I've ever been in. That was a major city was Helsinki in Finland. I was astonished because the metro or the subway trains and the buses and whatnot. They're silent the train stations are very quiet. Let's partly because the majority of their trains or electric, but it's also down to the design of their stations from a mixture of materials sound absorbing materials, and also psycho, acoustic tricks, like pumping in noise that has this weird reverse effective making things seem quieter, which is a technique used in offices as well. The fins are able to make spaces quieter in the idea that they should be quieter. Seems to be more popular there probes through quieter public spaces play a small part in making Finland reportedly the happiest country in the world. It's a country that has so taken into account, the public good from all. Aspects things like health care child care, social services, a robust welfare state, and things like their outlook on sustainability so cleaner. Quieter vehicles make you happier. And when things are less noisy. There's a great opportunity to create a richer, and more useful sonic landscape. Electric cars, don't naturally make a sound. So if you've ever had one creep up on you. It's a really really scary experience. Joel beckerman says this silence of electric cars can actually be a drawback total. Silence is not a good thing. In fact, Joel says that electric cars need to make noise or else, they won't be safe. It's not for the people in the cards for the pedestrians to know that the cars coming, but the opportunity is also to create a personality for the vehicle for the electric vehicles. He actually worked with Nissan to create an identity for their new electric car here. It is coming right at you. In this case, what we were looking to do was create a car that had a personality, which is really new association with clean energy. One of the things we knew is it's going to be friction Lewis. When you hear a car accelerate if it exceleron, it's very quickly. Let's say and there is a sense of really smoothness lack of friction there is a almost a natural ambiance to it. We actually used natural sounds. But it still sounds like a car, and it absolutely had to, because we don't want pedestrians to hear it and say, oh, what's that? And get hit by the car. Joe wants a future city dominated by natural sounds. But also sounds that we've consciously chosen some cities are already taking a more thoughtful approach in the Tokyo subway station each station has a little tune associated with it. And if you know anything about the Japanese subway system aid is packed. So if you're in the middle of a car, and you missing announcement because it's noisy year sunk, you're going to miss your stop the Tokyo trains have short jingle, unique to each and every station along the line like this one for Ikebukuro station on YoM Notat line. These little tunes that show up at each station helps you understand where you are. And also, there are pleasing, they're, they're not a screaming announcement. We could live in cities full of intentional. Sounds with soundscape s- that we've chosen you might find some of these new sounds really pleasant or really annoying. But the nice thing is you will get to decide that for yourself because you'll be able to hear them all. This special episode of ninety nine percent. Invisible was produced by Layla Battiston, and Dallas Taylor with help from Sam Snead. Edited by Chris Baru bay sound design and mixed by Colin davonte music by Sean, real special. Thanks to the Robert Wood Johnson foundation and man made music, who contributed as executive producers and providing the soundscape in the show. Joel Beckham in his new book. It's called the sonic boom how sound transforms the way we think feel and by go check it out. You can learn more about these stories and other topics related to sonic humanism, and sounds effects on our health by visiting info dot sonic, humanism dot com. Thanks to our guests Kate Wagner, Erica, Walker and Martinez bass ner. You can find out more about erica's community noise lab at community noise lab dot org. Thanks again to the Robert Wood Johnson foundation for their underwriting support of this special series. Learn more about their efforts to help create a culture of health at our W J, F dot org.
Telemedicine underscores need for broadband for all
"Your destination for gadgets ungeared I'm Fred fishkill. The coronavirus pandemic has driven tremendous growth in telemedicine, but that has underscored the need for more universal high speed Internet access. On a recent episode of the living longer better smarter bod cast which I co host with Mary Furlong Managing Director of the healthcare practice. At Ziglar, Grand Chamberlain told, US. Broadband has to become a fundamental right in this country and outdoor air the benefit of. Department of Education Department of Health same. We've got to figure out a way to ensure we don't have these gaps in in these bears so that we do have. The quality both into the most underserved practice because honestly there's much an issue on the south side Astra Kogyo. There is in Montana Chamberlain serves on the Board of the American Telemedicine Association, which is a good place to turn for more info. You can find us at text nation DOT, com I'm Fred Friskin a survey conducted for the Robert Wood Johnson Foundation recently showed the impact of the coronavirus pandemic on so many families with children. One of the issues is how many children simply don't have the Internet access needed to attend classes remotely, and that is even if they are provided things like chromebooks by their schools. Robert Wood Johnson Foundation executive. VP. Dr Jewelry Rita I think what we're seeing with fantastic intern who actually getting sick who's getting hospital dying disproportionately impacting those households those communities that have historically struggled in past the people lower income communities comedian color to have really been hit hardest and so from a connection perspective listening groups that are being hit hard prompting calls, which we've heard before were better broadband access for all.
"Workers from the census bureau are still knocking on doors of some households for a survey that will help determine the accuracy of this year's national headcount. Npr's hansie long reports if you get a knock at your door from census bureau employees. It's probably for the post enumeration survey. Each national headcount tends to overcome one while under counting black. People latinos is in americans pacific islanders and american indians and the bureau uses that survey to estimate how much certain racial or ethnic groups may have been miscounted as well as how many people may be missing from the numbers altogether. The bureau says covid nineteen has made it hard to hire and keep interviewers and to travel in some parts of the country and that could hurt the accuracy of this year's post enumeration survey results on long news new york european union ambassadors are meeting today to review. The trade deal reached with britain yesterday governing relations in the post brexit era. The agreement needs the approval of the european parliament. And the twenty-seven member states. The uk withdrew from the block at the beginning of the year but was operating under the former rules on trade travel and business that transition period ends this a choir performed at notre dame cathedral in paris tamar christmas eve for the first time since the landmark was nearly destroyed in a fire in april of two thousand nineteen. The gothic cathedrals being rebuilt. The concert was recorded earlier this month and broadcast just before midnight last night. The singers were hard. Hats and protective suits. There was no audience. I'm nora raum. Npr news support for npr comes from the alfred. P sloan foundation bridging science and the arts books such as lisa feldman barrett seven and a half lessons about the brain more. It's sloan dot org. And the robert wood johnson foundation at our w j f. dot org
"You're listening to. Npr live from news at eight seven in. Houston i'm lauder. Fort bend county's top officials says he's calling a meeting with election administrators about delays with tuesday's returns late into the evening. The fort bend website posted only rea. The results from early voting county judge. Kp george blaine the delays on a late surge of mail in ballots. A huge number of ballots by mail came in and so they are not somebody. Dan not allowed to often eat like i dunno on the election. They are something. They're not completes the company. That's what i've been told for. Bend election administrator. John oldham confirmed the start of the count was delayed because of the surge. He said there were also some poll workers who didn't correctly shut down the election equipment. Tuesday brought some election surprises in the houston area. Not only did democrats failed. Flip the texas house. But jen rise tells us. Both parties made unexpected gains democrats and republicans. Each flipped one of houston's competitive seats in the legislature incumbent. Representative sarah davis. A moderate republican lost her reelection bid to democratic challenger and johnson a teacher and former human trafficking prosecutor that district includes rice university and the texas medical center. Meanwhile katie freshman incumbent representative gina kalani. A democrat lawyer seat. Voters went back to mike. Scofield the republican who held the seat before her democrats needed to pick up nine seats to win the house instead from the unofficial count it looks like republicans will maintain a strong majority. I'm generous in. Houston and johnson will be a guest tomorrow. One houston matters and you can hear that at nine. Am here on news at eight seven and for the latest on the election. You can go to our website. That's houston public media dot org some clouds in the forecast. This evening's the alo- around sixty one degrees partly sunny tomorrow. High around seventy eight right now. Seventy two on the u h campus on gilded lauder news eight seven support for. Npr comes from npr stations. Other contributors include the robert wood johnson foundation.
For Many Navajos, Getting Hooked Up To The Power Grid Can Be Life-Changing
"Support for this podcast and the following message come from mayo clinic if you're looking for answers no one else has been able to find, you know, where to go mayoclinic. More at mayo clinic dot org slash answers in much of the United States. Thousands of native Americans are living without some basic necessities, like trinity a running water. A new poll shows more than a quarter of native Americans living in rural areas of Ed problems with basic infrastructure, including electrobi-, or water, or high speed internet, which is becoming quite basic, of course, on Navajo lands in the southwestern U S utility crews from around this country are now volunteering their time to install power. Laurel Morello's of member station. K J, Z Z reports need a Billy has been waiting to turn on lights in your home for fifteen years. We've been living off their nose per pain, lanterns, did you ever think this day would come? Not really now, we know have to have Fash lights everywhere, all the kids have Fash light. So when they get up in the middle night, late to use the restroom, they have a Fash light to go to. Yes. Billy her husband and their five kids live in a tiny one room on a traditional Navajo home. There three sheep graze on sagebrush the carpets the rolling hills of Dil Khan era Zona on the largest reservation in the country. We watched two men and a cherry picker hook up the last wire to their home. Billy says they've gone through too many generators to count why two boys. They have really bad allergies and they have asthma. So sometimes they beat the nebulizer. So usually go to my mom's house travel in the middle of the night over there back and forth. The Billy's are not alone about one in ten Navajos live without electricity. And as many as forty percent of the tribe has to haul their water and use outhouses Opole of rural Americans conducted by NPR the Robert Wood Johnson foundation and the Harvard, teach Chan school of public health found more than a quarter of native Americans have experienced problems with electric city water and the internet northern Arizona university professor Manley. Gay is Navajo. Says the numbers are probably even higher became says he recently saw something strange when he pulled into a hotel parking lot in window rock the capital of the Navajo nation. He noticed a bunch of teenage. Gers in their cars. You could tell that they were high school students in so doing their homework outside of this hotel parking lot, and they had to light on their cars and do their homework. And it became quite clear that they didn't have the internet outside the Billy's home the couple waits patiently for the crew to finish the job, Brian Cooper from pm electric has an update. That will energize your power. Can wait to see the real small here. See don't cover it up. I want to see it. That's what joy looks like traveled from New Mexico, along with several other crews from around the country, volunteering their time to connect people like the Belize to the power grid on the Navajo nation. The homes are so spread out. It costs on average forty thousand dollars to hook up one home to the grid and half the tribe is unemployed. So you can't raise rates to energize all those homes. The Navajo tribal utility authority in the nonprofit American public power association, have put a call out to you till ladies across the country to help our no idea that, you know, it was people still in twenty nineteen without power. Finally after waiting for so many years, the Billy's watched the foreman turn on the meter behind their house and snap. The cover shut Nita then runs inside flip the switch to find you have electrobi- here after so many years without it. My kids. Don't be so happy. Keep asking that. We they. We have like finally out white. Now, the family will wait and pray for running water and internet for NPR news. I'm lorrimore Ellis in flagstaff.
How I Made It: 'El Gato' Of The Harlem Globetrotters
"Support for this n._p._r. Podcast and the following message come from better help online counseling by licensed professional counselors specializing in issues including depression stress endings diety visit better help dot com slash latino to learn more and get ten percent off your first month <music> from n._p._r. Doodo media it's latino u._s._a. I'm marina for sale today. Orlando in gotta melendez a member of the harlem globetrotters trotters in this episode. We're going to bring you one of our. Oh how i made it segments. These are back stories about latinos in all sorts of walks of life orlando el gato million. This is the first and only puerto rican born player to be a member of the historic harlem globetrotters. The globetrotters are an exhibition and team that has been around since the nineteen twenties there accomplished athletes and they're known mostly for their theatrical and comedic routines on the court orlando got his nickname when he was still a teen in puerto rico when he used to run to the nearest courts to play pick up ball he said stray cats would follow him him as he ran and eventually the guys he played with started calling him. Ill got which is spanish for the cat. Uh got takes it from here down. I don't know but it sounds like the bone football. I love everybody uses orlando and i'm the first puerto rican benigni threes to be part of the great hall and globetrotters. They aren't gonna try to tell him no threat. There's the we are in basketball. Team started in nineteen eighteen twenty cents meet. The most comedy acting doesn't spoke harlem globetrotters idolized by twenty minute basketball fans in the u._s._a. They say they make a mockery of the game they come. They juggle a full house g._i. They've played seventy three games nine different countries last only one we were created by the white jewish man call eight savage and the reason why he decided to create a team is because he wanted to give african unamerican <hes> basketball players a chance to play for money because they're not allowed to play professional basketball in n._b._a. Back in nineteen twenties so he we went to a place called the savoy ballroom and chicago illinois and picked out the best african american basketball players can find. I i the name of the team with the the superbowl five but then he decided to change the name to harlem because something happened here in harlem new york called the harlem renaissance off so it was a lot of famous musicians famous artists coming out of harlem so he decided to change inch named joe harland's irony we think we've famous and then he put globetrotters on the jersey so everybody would think we were traveling around the world beginning basketball we played today is influenced a lot by the harlem globetrotters three point line. We've been alex for the the alleyoop done. Here's the the razzle dazzle driven that you guys love to see now switzer deepest doing since nineteen the first i am. I saw the harlem globetrotter super interesting because it was one of those regular days that i was ready to go home and get ready to go play basketball and i turned the t._v. On and saw the episode when harlem globetrotters met shaggy and scooby globetrotters legitimize with a basket boy scooby doo and shaggy could make food disappear wash delicious but i thought the harlem globetrotters or cartoons for longtime batman was a cartoon supervisor cartoon and the next time i saw them was once i became gloat job. I grew up in small town. Call one eighty s and south of the island of puerto rico the it was a heel you oversee the town and you can hear the bells <hes> catholic church on every hour as a beautiful beautiful place to grow and to have family and everybody's reporting everybody. Nobody baseball was part of a daily routine for us. You know people love baseball because we have so many superstars blame professional baseball in the major leagues for us us so they're always encouraged kids to play baseball but they know anything about basketball and that's the thing that i fell in love with every single day. I wake up. Sometimes i go to sleep which is like playing with the basketball and my bad looking up shooting my dad be like hey gotta go to bed and take the ball away from me. The next morning i wake up the balls right data game and it's just repeated that over and over and over the way i got into the globetrotters was being the right place right time so i'm finishing my contract as a competitive basketball player so the exact day i'm i'm calling my agent saying hey we gotta work on a new contract and new team and i'm coming out of my apartment and coach samoyed loyd than who happened to be a professional coach than i knew. Growing up in puerto rico was coming my way. We kind of bumped each other. We talk and find out he's he's working for the harlem globetrotters organization and he asked me do you wanna be globetrotter and i'm like yeah and like three days later i get the call oh and then i did a really really going to try out and here i am seven years later so now well so i'm a globetrotter now and i'm sending down the bank watching this guy's doing all this amazing tricks inches i kind of stepped back from having having the uniform on and feel like a little kid like this is amazing this amazing the things this guy can do and then you realize i can do thinks that all the things that happened in the world and we ask rotana's. We'd do something special. We do something positive life and we just create memory that people don't want to forget. That's why i love what i do. The orlando mendez continues to play and entertain with the harlem globetrotters. You can catch him on the court <music>. This episode was produced by sarah gibson and edited by soviet policy. Let the u._s._a. Team includes finan the marina back and say he'll maggie freely and genesee mocha with help this week from genie montalvo. Our engineers are stephania boat and julia caruso our production. Coaching manager is not only a few hoops are new york. Foundation ignite fellow is none not egas our theme music was composed by venos- if you like the music you heard on this episode so stop by latino u._s._a. Dot org and check out our weekly spotify playlist. I'm your host and executive producer. Migraine pulsa join us again next time and in the meantime i look for us of all of your social media a senate proxima joe latino u._s._a. Is made possible in part by the annie e. Casey foundation creates a brighter future for the nations children by strengthening families building greater economic opportunity and transforming communities and and the john d and catherine t. macarthur foundation funding for latino u._s._a. Is coverage of a culture of health is made possible in part by a grant from the robert wood johnson foundation and led the ball row over my arm behind my neck to the other arm again into my left hand right hope everybody's following. This get might be hard to pin down. What makes a friendship really work. We're like the michael. Jordan of friendships like you can't ask jordan again as jordan how he does what he does freak of nature but clearly some people people know how to do it. Checkout life kids new guide from n._p._r. On navigating the highs and lows of friendship or subscribe to life kit all guides for all of our episodes all one replace by marina hassan and next time you say we go to texas to meet larry those premier citizen journalist. She's known as gordillo guy. That's next time on let him u._s._a.
Bringing Together Young And Old To Ease The Isolation Of Rural Life
"This message comes from n._p._r. Sponsor xfinity some things are slow like a snail races. Other things are fast like xfinity x. by get get fast speeds even when everyone is online working to make wifi simple easy awesome more at xfinity dot com restrictions apply. There's a part of minnesota that has more trees and lakes than people it's beautiful but the people who live there say can also be lonely for me to go anywhere to anyone that i know personally personally. It'd be like thirty mile drive. That's on of your can't. She's one of an estimated fourteen million rural americans who have few people nearby to rely on. That's based on a recent recent pullback n._p._r. Looking at life in rural america as n._p._r.'s redo chatterjee reports group in his hometown trying to reconnect the community nia job. Would you have to go outside on of your can't lives on a small farm in a rural town call mcgregor. She's twenty years old married married and has two children. The moon you see the moon. She's trying to create the kind the family she didn't have growing up when she was a kid. She and her family rarely early saw their neighbors or friends and there was this incredible distance within the family. We just be there to eat or if we did talk or on the off chance there. It was a good table conversation. It would just be an all someone. Beginning ridiculed on us recently had a baby and these memories of childhood are weighing on her mind. She had three siblings and three half siblings and they were on their own a lot being the oldest sister. I was expected to just help. Take care of the kids. Oh my mom wouldn't go out and play with them or anything like that. Sometimes we just be inside playing an she'd be in her room <unk> sitting on her phone. Her father lived in another town and her stepfather worked long hours. Ana felt alone by the time she was about twelve. She was struggling with anxiety and depression studies showed that social isolation and loneliness put people at risk for range of physical and mental health problems uh-huh but one day when i was in seventh grade she finally found an escape from her loneliness. She saw flyers for an after school. Program called hold each to each that connected kids with older people in the community like barbara copeland guys she'll be old memories not so good but barb does house remember when they first met very bubbly happy girl but she would be stress and inward and i think she needed a little bit of encouragement you to be more outgoing and to be on on as a really cool version so bob got to work on a says that meet about the school cool and head out into the community. I would help with the community meals. We went to a soup kitchen. Wants concession stands at school like we did a bake sale. We did a flower sale like anything really that they needed help with. I was usually there because they didn't want to be at home. As on a got no bar better she started to open up talked about how isolated she and her family were and also how she was afraid to talk to people barb would say to her hair grape version and is jockey people and communicate them like you want. I mean you're you're loving you understandings and if they don't want to talk to you what's very worst happen. She get away from me. Okay bourbon honor worked together for about three or four years through this program. It's run by a local group called kids plus and it connects about one hundred seventy five children each year with about thirty seniors in the community cheryl meld runs the organization. I would like to see more connected community one that sustains those connections the poll whole by n._p._r. The robert wood johnson foundation and the harvard t chan school of public health finds that forty six percent of rural americans say they have few or no one nearby to rely on nearly one in five say the often or always feel isolated or lonely cheryl who grew up in the next over from mcgregor assess things weren't always we is like this. These were once trading connected communities. There were large family so there are a lot of people doing things together and a real sense of neighbors and neighborhoods vat started to change a couple of decades ago when the local economy began to decline stores like walmart and costco arrive pushing out at local businesses minnesota's timber industry a big source of employment began to struggle and family farms due to as they became less profitable and young people moved away looking looking for other careers so we lost that sense of generational businesses and generational families living here people. Don't just get together or drop by to visit. You don't see kids playing pickup games. You don't see them getting together just to play a game of softball. Cheryl's poverty and isolation are part hot of the reason for rising addiction rates here. We see people trying to find happiness in self-medication alcohol use or substance use news. She's been working for about a decade on this program to give the town a different view to one with a sense of connection for all the people who may not get to see their kids or grandkids for months at a time and for young people like on aveer kent that's exactly mike is on a recently stopped by the kids plus to see cheryl and her mentor barb who continues to look out for her and eugene because you need that to you know says barbas like her second can mother. She's the first person she texted with pictures. After her baby was born she says barb changed her life by giving her a sense of purpose and belonging longing there are programs like this one in seventeen other rural communities in northeastern minnesota. It's one of few places in the country. That's working to fight 'isolation on such a scale by connecting different generations. We through tragedy n._p._r. News.
"We are live from news. Eddie eight seven Houston I'm game with water Houston firefighters of now recovered the bodies of all three people killed when a building under construction partially collapsed in. West. Houston Monday assistant fire chief Michael Mirror says a funnel victim was removed from the debris earlier today. About Greece stories high. So we had to do a lot of breaching, breaking, cutting and moving a lot of material to gain access to the de. Caused a collapse is still under investigation Governor Greg. Abbott is allowing bars in Texas reopened up to fifty percent capacity starting October fourteenth they've been closed around the state because of the Corona Virus Pandemic Jim Purnell downtown bar not shuo he says bar staying open isn't just up to the owners and staff will be responsible. Be Responsible, and then it becomes on the customers and you know we're not a porch. The Governor says. County judges will have the final say on whether bars can reopen. Kids, in Texas are more likely to be obese on the National Average Health Reporters Sarah, Willard earns tells us a pandemic might make things worse as access to healthy foods becomes a challenge for many families more than seventy percent of children between the ages of ten and seventeen are considered obese in Texas according to a new report from the Robert Wood Johnson Foundation that's higher than the national average fifteen point five percent. The report found a link between health disparities and income kids from households that make below the federal poverty line are two and a half times more likely to be obese. The report recommends that federal lawmakers increase funding for food stamps during the economic downturn as well as continue support a free meal programs for. Students. Emerging Research also shows that obesity is one of the elevated risk factors for severe covid nineteen symptoms. I'm Sarah Will Ernst and Houston the Astros are playing the Oakland Athletics and Los Angeles in Game Three of their American League division series at the top of the seventh, the game is now tied at seven all. Mostly cloudy Skies Tonight Low near seventy one, eighty, nine degrees on the UH campus I'm guilty Lauder News Eddie eight seven. Support for NPR comes from NPR stations other contributors include the Walton Family Foundation.
When Insurance Won't Cover Drugs, Americans Make 'Tough Choices' About Their Health
"What happens when insurance companies deny coverage for medications? It doesn't just force people to pay for drugs themselves. A survey finds that for almost half of Americans went. When Insurance Denies Payment? They do not get the drugs at all. The poll comes from NPR. The Robert Wood Johnson Foundation and the Harvard T H Chan School of Public Public Health. NPR's Patty name reports Sahlin. REDUC- is seventy eight on a fixed income. She has severe acid reflux. I have to eat very small all meals and when I eat sometimes it feels like everything's stuck in my chest and I get really bad pain. And I have to throw up reduces retired on medicare she also pays for supplemental insurance policy to cover the cost of drugs but it will only pay for the generic version of her heartburn medication. Her her doctor prescribed the brand name. She says the generic version just doesn't work for her. No it's not as effective now. Definitely not she can't afford the brand name so now she has extremely painful episodes of acid reflux about three times a month. Our poll shows that like Ridolfi. The vast majority pretty of Americans have health insurance that includes prescription drug coverage but one in three say that in the past year insurance. Didn't cover the cost of medication and for themselves or their household members Robert Blend in with the Harvard Chan School directed our poll. So what you see is insurers are not paying for some drugs that physicians are recommending. The patients think they need when that happened. Most of the highest earners paid for the medication themselves but Glendon says is that was not the case for everyone else. A half of the people who are middle class or or moderate income are not getting him because they can't afford to go out and pay for it themselves batum line. He says it's just not fair. This idea that if we save money we all have to make tough choices together. The tough choices really don't affects the most wealthy people in the United States. They just affect people who are middle and lower income and this could leave lower and middle income individuals more vulnerable to disease and other health problems for Sally Rideau see one example is her EPI pen. She's allergic to bees and needs the EPI pen to inject life saving medication in case she gets stung and the last time I was stung. The doctor said each time you get stung can be very serious and it can result in death so he's always carry the EPI pen and in my case. I do a lot of gardening and I'm by myself so just felt safe to have my Epi pen with me just in case but this time when she went to the pharmacy to get the pen prescribed by her doctor she was told her insurance wouldn't cover the cost. It was close to six hundred dollars and I said well how about the generic could I get generic and she said well. That's three ninety eight and I said you're kidding. She said no I said okay then. Just forget it so today when we're dosing gardens. She wears as long sleeves and long pants to try to protect yourself against B.'s. The situation she says it's upsetting. I have three insurances. I'm always pay a lot of copays as I pay a lot for my drugs. It's very frustrating. I think when you have insurance I think you should be able to get the drug. You need one unexpected. Finding from our poll on income inequality is that even people who can afford to cover the cost of their medication. Sometimes don't this is one of the first polls to survey the top one percent percent people earning over five hundred thousand dollars a year and eighteen percent of them chose not to fill prescriptions. When insurance wouldn't cover it? Tina Smith is one of them. She runs a technology consulting firm in Minneapolis last year when her doctor prescribed a medication to treat the skin condition rose Patia. She got a shock. When I went to fill the prescription the cost for the prescription was over six hundred dollars? She says for the past seven years. The medication costs about twenty dollars. So this was a huge increase and Smith decided not to get it because I felt that it was fiscally irresponsible and I have no interest in funding big pharma anymore than I absolutely have to. I feel big farmers than rob in the American people for years and they continued to increase. The cost of prescriptions drug. Drug prices have been escalating. Actually four in a significant way at least the last couple decades Frederica saucy is director of the Consumer Advocacy Group families. USA But in the last five. Or six years it's really hit a crescendo. Not surprisingly the smallest increase were in generic drugs but the adjective small small. He says pretty much ends there. You know an average increase for drugs might be fifteen or sixteen percent annually which is much much faster than our paychecks or inflation inflation. But you could see a doubling or tripling of drug cost year every year depending on the ability of that drug company to have no competition he says healthcare caused swallowing up more and more families discretionary income not only in higher drug prices but also in higher deductibles co pays and cost sharing we. We spoke with representatives of both the pharmaceutical and health insurance industries and they point the finger at each other. Insurers say the financial squeeze Americans are are experiencing is because of high drug prices the drug makers say it's High Insurance and hospital costs whatever. The reason Harvard health economist and primary Care Physician Ben Summers says not getting needed. Medication is not good news. There's more and more evidence that having health insurance really does improve people's health and lives and and medications are one of the key parts of that because it is such a mainstay of how we manage a lot of chronic conditions now says not all medications are equal some of the medications occasions we prescribe are really kind of options to a patient. You say look. This medication may help you feel better while you have this infection or while you are having some heartburn but if view feel fine without it that's okay but how there's a critical cholesterol lowering statins for example or insulin to keep blood sugar under control and and sometimes people won't even notice they're not taking it not all these conditions have symptoms. You can be building up dangerous levels of high blood sugar or cholesterol without noticing. It until it's too late. Sadly summer says he's not surprised by the findings of our poll he says at least a quarter of his patients. Don't get new prescriptions filled. Because they say they just don't have the money. Patty named N._p._R. News.
Former CDC Head Pushes For Equity In Pandemic Policies
"Welcome to tiny spark cast of a nonprofit quarterly. We take a close look at nonprofits. International aid and Philanthropy. I'm Ab Costello by all accounts. Richard Besser is a highly accomplished man. He's a medical doctor who has held many prestigious titles including ABC News Chief Health and medical editor and acting head of the Centers for Disease Control and prevention or CDC during an earlier deadly pandemic but through all his career moves. Besser says there is one job. He's always had you know hard. I'm a general pediatrician. I've kept at that in all of my jobs. It keeps me grounded. It keeps me focused on porn. What's really important in people's lives specifically the lives of low income families which is the population. Doctor Beyer works with when he volunteers as a pediatrician. He's always done this work. While simultaneously holding down other demanding jobs ones in which he is often creating policies that are aimed at improving public health. But we're hearing a lot these days about how tricky public health recommendations can be in the covert era who can abide by them who cannot. This is the tricky intersection where Besser has dwelled for much of his career where data driven scientific public health guidelines collide with the messy reality and limitations of people's lives. Dr Besser has seen this tension during his stints. Working as a volunteer pediatrician at clinics in places like Atlanta Trenton. New Jersey and Harlem. That's Dr Best has heard time and time again. How even the most sensible best intentioned health guidelines cannot always be embraced by the very people. They're designed to help in New York. I remember seeing a two children. They were in foster care with their grandmother and I talked to them about the CDC guidelines around physical activity recommend an hour a day for young children of physical activity and talk to the grandmother. About what type of activities? That kids do after school. And she said well they come home. They do their homework. And then they watch television or they're on the computer and I went through the guidelines with her and she said I know the guidelines. But it's not safe to play in our neighborhood for Dr Besser. These encounters highlight the way this country's long history of racial segregation and structural. Racism have affected communities income education living conditions and subsequently their health and he sees the ways cove nineteen has brought these ugly truths into sharp relief. What it's showing. Is that in America today. Your ability to thrive during this pandemic is very much dependent on your income and the color of your skin. We have had decades and decades of policy failures. That have left millions of people in America in a position where they're forced to choose between going to work so they can put food on the table and pay the rent or staying at home physical distancing to help protect themselves their families and their communities. And that's not a choice that anyone should have to make but it's the reality for millions of people in this country. Those stark choices millions of people have to make every day. Dr Besser is aware of them now but a dozen years ago when he was leading the CDC Dr Besser acknowledges he was blind to the fact. That good health policy on paper doesn't translate well people's lives. It was two thousand nine. The first global flu pandemic in forty years is beginning to emerge in the US unlike today's Kovic virus which mainly kills the old with h n one or swine. Flu Eighty Percent Virus Related. Deaths were estimated to have occurred in people younger than sixty five years old decisions. Dr Besser was making heading up the CDC. At the time would inform the American public's response to a deadly pandemic are focused with so much on the science. What is the science say that people should do that will truly reduce the likelihood that they're going to get sick? What kind of actions can people take to ensure that their health is protected or if they get sick that their needs are met and we didn't spend nearly the kind of time I it's hard for me to remember the conversations focused on okay? What will it take to ensure that everyone in America can do these things that we're recommending so two thousand nine? We're dealing with the start of a influenza pandemic and with influenza it's known that children are very important part of disease transmission. They spread it easily amongst themselves and they bring it home and they spent it to elderly people who may be at higher risk and so school closure was something that we recommend it early on and we put forward guidance that said that with the first case of suspected swine flu or confirms the school. The school should close for two weeks and investigate allow whoever was sick to get over this so they wouldn't put other children at risk and we really didn't focus on was well. What happens when you close the school and I started to hear from heads of health departments around the country. And they said the recommendations aren't working. You know we put those Ford to increase. What's called social distancing but people needed to work and so instead of children being at home they were being dropped off at libraries and community centers at the mall and so kids were hanging out together and if we had spent more time thinking about it and asking and engaging with communities we would've said okay if we really want to put forward social this what are we going to do in terms of providing childcare. How are we going to think about that? What services do people need in order to do this successfully? And it's not because parents didn't want to do the right thing with so many people in America. Not Having sickly family leave. We have node national standards for that so many people being in jobs where they not eligible for unemployment. What we're forcing people to do was to decide. Okay do I leave my child at home alone or at home with an elderly person who may be at increased risk or do I put them in a community center? Place that's known to be safe. But doesn't increase the social distancing. So that's just one example of a public health recommendation. There's a good one right now. Really highlights the major inequity. We have when it comes to healthcare in America the CDC and state health departments recommend that. If you have a mild symptoms. Do you think you have coveted infection instead of going to the emergency room Where you may put healthcare workers at risk of exposure and other people risk of exposure and yourself at risk of exposure that you call your healthcare provider and they will help you determine whether you need treatment and they can tell you over the phone what to do well. Twenty eight million people in America don't have health insurance and that number is going to skyrocket given how many millions of people in America have health insurance that comes through their job so here we are telling people to do something that for tens of millions of people is absolutely impossible to do. That's not success. If we truly want to be successful in a response to this pandemic we have to make sure that everyone has what they need. In order to protect their health the health of their families and their communities enabling people to make healthy choices is what now drives Dr current work as president and CEO of the Robert Wood Johnson Foundation. The nation's largest philanthropy focused on health but in the four years at the helm of the foundation. He's come to realize the hundreds of millions of dollars to give away each year is actually just a drop in the bucket. The amount of money we have is very small up against the problems. We're trying to address. But there are things that philanthropy can do. That can really be very helpful when it comes to governments and what they need to do to support public health for instance. We can invest in ideas in research in projects that may not have the highest likelihood of success. We can stick with things for a longer period of time. We can invest to try and learn things that will inform policy going forward. We have the power of convening to bringing groups together so that states locals that have learned one approach to a problem can share with others. You one of the things that struck me. I'm I'm still very new plant but I've never been in any domain that has less formal accountability So we have a large amount of resources. And we have a board to which were accountable. But that's very different from being in government where each year we had to go to Congress and get our budget renewed and make a case for what we wanted to do very different from when I worked in academia and was applying for a grant and trying to get funding different than when I was in the news and we were looking at ratings and how many people watched our our shows here. It's incumbent upon us to get input from the communities in which we are hoping to affect change to support communities in addressing the problems that they see in the solutions that they see to those problems. It's a very different way of trying to address public health problems but it is one that I think can have great impact. We're seeing some of the issues that we care most deeply about getting some traction during this pandemic because it's absolutely impossible not to see the impact of societal inequities on people's lives when they are stressed in a situation like this. And now we're going to take a short break to hear a little bit more about the nonprofit quarterly if you enjoy listening to our podcast and are looking to gain more indepth knowledge about the operating environment of the nonprofit sector. You should read the nonprofit quarterly magazine N. P. Q. Magazine is a trusted voice. In the sector that provides research based articles and strategies to give you an advantage in navigating the nonprofit landscape. Save twenty percents off your subscription. Today when you use the code N P Q T S at nonprofit quarterly dot org forward slash subscribe. You know it's interesting. I hear you talk about the lack of accountability and philanthropy. Not to something that I've looked at from various lenses over the years. In your opinion what is the consequence of this lack of accountability in philanthropy? I think if a philanthropy is not intentional about it and doesn't place high value on engaging with communities if philanthropy doesn't look to build equity into its processes then you can be in a situation where the few and the wealthy are deciding on major directions of investment and societal change. There's been a lot of critiques about that. So it's I think he'd come in on us in philanthropy to ensure that we are working equitably as we try and do our work. Your Foundation recently announced that it was a boarding fifty million dollars to various national and new jersey-based organizations to help communities hardest hit during the pandemic but the fifty million dollars that your foundation gave out in some ways seems like he made an explicit decision to go beyond your current grantee base and give to other organizations and to be as responsive as possible. And get in these dollars out the door pretty quickly. Talk to me about that decision to at this moment in time to go beyond your current grantee base. Yeah this pandemic is unprecedented in my lifetime. It's unprecedented in the lifetime of our foundation and because of that we felt that in addition to our traditional approach of grant making which is longer term strategic focused on policy change and mindset shift that we had a responsibility to help provide some direct humanitarian support. That's not something we've ever done on a large scale. After a hurricane we might get a small amount of money immediately but most of our resources would be helping on rebuilding but here. We decided to do this for several reasons. One is that the needs are enormous and while fifty million dollars is a generous amount of funds. It's nothing against the problems that that people are facing and we could use it to call out and draw attention to some groups who are not being captured by some of the federal support. That's out there. So domestic workers are who are hit incredibly hard to include home health aides. Who were there providing services Many without being provided personal protective equipment being paid low wages and struggling to pay rent and put food on the table so we decided that our resources should go towards food toward housing Towards getting cash into the hands of those hardest hit and to use it to draw attention to issues of equity and inequity. The third thing we wanted to accomplish was to try and encourage other philanthropies to be generous at a time. Like this You were recently tapped by New Jersey Governor Phil Murphy to become part of a seven State Council and I understand at this council is going to gauge how to reopen the regional economy once the covet nineteen pandemic winds down. And I'm interested in knowing whether you see your role of air as a foundation leader and pursuing kind of public private partnerships with this multi State Association or. Are you coming there more from your? Cdc Public Health background and just looking for wise policies to figure out how where we go from here on reopening economies. There are a couple of things that I hope to bring to the conversation. And we're just getting started one is an infectious disease. Epidemiologist and Iran emergency preparedness and response for four years at CDC so just experience in terms of from a public health perspective. What things need to be kept in mind as the state's looked to get people back to work and getting people back to work is critically important. But it's important that it's done as safely as possible based on the best public health science which is a moving target. But I think most importantly I wanNA make sure that conversations around equity are central to what we're doing and as states looked to reopen the economy. They're thinking about okay. We're seeing data that black. Americans Latinos are dying at incredibly high rates from this pandemic twice the rate of representation within the population in many places in many places. We're not even seeing data. It's not being collected and I want to ensure that as state's open up there looking at what do the poorest residents of states need to be able to get back to work safely what kind of resources and supports are needed across the state to ensure that not just people who are working remotely and hunker down at home or or getting back to the office but that people who are working in jobs where they're likely to be exposed to many people have the protection they need that as we switch to strategies that focus on trying to identify cases early. Isolating THEM THAT. Everyone has that opportunity to do that right now. If you look at the guidance go home and isolate or go. Homing Self Quarantine. Well what if you live in a home? That's multigenerational where they're elderly members of the family. Who were in a high risk group going home to isolate means you're putting someone that increase risk. So we'll we provide as a society safe places for people to isolate so that everyone has the opportunity for health. Everyone has the opportunity to go back to work in a safe way that we're thinking about childcare needs of of all of the people in our states. There's a lot to consider from an equity perspective. And if you don't come at it with that Lens Some of the things that we recommend that people do will be as impossible to do as some of the things that I recommended years ago when I was at. Cdc I I just WanNa take a moment. I WanNa talk about you just a little bit and just when I was getting ready doing some research and looking at your time at ABC News. I read the announcement of your departure which was written by. Abc News President. James Goldstone and he wrote a memo to staff. And I like most people have read. Lots of those memos And I it struck me as different And I wanted to share with you. Something he wrote in that letter he said referring to you know. He said he has been there for everybody at this news. Division out our most vulnerable moments the painful and scary moments and out those moments when we needed a shoulder to cry on on a personal note. Rich has often helped me and my family as well and I and I know all of you will be forever grateful to him and Someone who also spent her career in in news. I I found this really I don't know unusual and frankly touching that You were kind of known as a friend of so many people in the newsroom. Talk to me about how you have found that balance and frankly that time in what seems like an busy and full career to make time fear colleagues and for your bosses and and how you fit that in an what's motivated you to do. That didn't think he'd go there. You know when I was recruited. Abc News I was recruited Following my time as the acting director at CDC. And when I came Dr Tim. Johnson was the chief medical editor correspondent. Abc and wonderful wonderful man. Incredibly generous and one of the things. He said he said rich. You know I don't know if you knew this but in addition to being the medical editor you're also. Abc News is doctor and said Oh tim. You're an internist that's different. I'm a pediatrician. So that's not going to happen. He just kind of smiled at me and said we have. We'll say and and he was he was right One of the parts of the job that was unofficial but that I really valued was being someone that staff could come and talk to when they had a medical issue in the healthcare system in America is just so incredibly hard to navigate. One of the things that I would help. People do is figure out who to go see when they had a medical problem how to navigate the system. How to get a referral? What kind of questions to ask in a large news division like ABC News? There's always somebody who's got a serious life threatening issue in their life and so I became the place that people would come in and and talk about that and I'm still getting calls from my former colleagues at. Abc News helping them navigate. The system philanthropy and public health can be so removed from lived experience. People coming in to talk. It helped give me a sense of what's important and there's that personal sense of satisfaction that you've helped somebody in their life. That is much more mediate. Much more at the level of heart. Then you know the policy work that we do at the foundation which can have so much more impact on a population level but is much more long-term and much more removed doctor. Is there anything else that you wanted to say that? You didn't get a chance to say the last thing I I would say. Is that if you look over? The course of history pandemics have led to major societal changes. And I think coming out of this. We're going to have the opportunity to decide what kind of America we want to see. What's important Do we truly believe that this should be a nation in which everyone has opportunity that there is such thing as an American dream that upward mobility as possible. That everyone's life matters if so we've got a lot of work to do and a lot of policy work to do a lot of work to do. In terms of finding common ground bridging the enormous divide we have in this nation so that we will be in better shape when the next pandemic comes because the next pandemic will come and what we look like at that. Point depends on what we do in the next few years. Yeah my colleagues as far as it N. P. Q. Is written recently about the idea of resiliency. Which kind of suggest a return back to where we were and it is a time. I think where people are really questioning. Do we want to return back to where we were? I don't think it's possible to return back to where we were aware. We are coming out of this. It's too soon to say but when you look at the number of people who will be without a job the number of people who will be without health insurance the number of people who may be homeless buffoon insecure. We won't be back to where we were and so thinking about. How do we want to go forward? Those are going to be really important questions to ask. And for us as a nation to decide Dr Richard Besser President and CEO of the Robert Wood Johnson Foundation and former acting director of the CDC. Thank you so much for your time today. Great Talking With You. Thanks for having me on. And that's tiny spark if you wanNA leave a comment about our podcast. Please over to tiny spark dot org or you can email us at podcast at N. P. Q. Mag Dot Org and subscribe to our podcast on any platform where you listen to podcasts. And if you like what you've heard today it'll be great if you could give us a rating to help more people find out about our work also like us on facebook and you can tweet me. I'm a tiny spark. Underscore Org Dr Richard. Besser self recorded from his home in Princeton New Jersey. Today's program was produced by Freddie Boswell. Tiny spark a podcast of the nonprofit quarterly. Thank you so much for listening. I'm Amy Costello. This program was produced by the nonprofit quarterly. Which is solely responsible for its content. This podcast is made possible by a grant from the William and Flora Hewlett Foundation.
Selenis Leyva, Success With A Purpose
"This message comes from n._p._r. Sponsor xfinity some things are slow like a snail races. Other things are fast like xfinity x. by get get fast speeds even when everyone is online working to make wifi simple easy awesome more at xfinity dot com restrictions apply from n._p._r. And footer media it's let u._s._a. Magana hosa today. We bring you you an episode from our fault. A conversation with actor cellini sleep in two thousand fifteen salinas join me in the latino u._s._a. Studios in harlem to talk about her success in the hit netflix series orange inch is the new black the show revolved around the lives inside a women's federal prison and immediately gained praise for humanizing people who are behind bars back then it had just premiered its third season. The trap trap told the cages cages do they knew and this past summer after seven seasons orange is the new black has come to an end then you doing okay. I know well. We made a deal and we're going to get through this. In the series. Celanese played the character gloria mendosa. She's a strong and complex latino women in prison. Gloria is also a mother outside of prison and a mother figure to some of the young latinas inside the prison so needless to say her character is a natural leader in real life. Selling these labor is just as passionate. She uses her success to speak up on the issue. She cares most about but first a small spoiler alert for any of you who have never seen the show because this interview aired in june of twenty fifteen. We talked vaguely about glorious story on seasons two in three nothing too specific but you're warned celanese. Labor is such a pleasure to have you in the studios right here in harlem latino u._s._a. Thank you so much for joining thank you for having me really is a wonderful celebration of alcohol doodads but you know the first question i was thinking i i was like okay. Well i have to of course you are an actress that has a breadth of work but when i think of you now oranges in you black your characters gloria mendosa who manages the kitchen now and i was like e._s. I gotta that phase that pursing pursing of the lips is so perfect thank you and it is a little bit a little bit of the angry latina right it is it is and this is a woman. That's been through a lot you know when we got to to see glorious backstory in season two and we saw the she's a survivor of domestic violence. This is a woman who is poor or who was struggling to maintain a family at the same time you know having this relationship that was completely out of hand <hes> she's angry as she's tired hired and she's locked up in prison but she is. She's the mother hand. She's lama matala chico's so there is a soft side of her and i'm so happy that we got to see more of that. But what about this notion of the angry let me now. Do you worry about that. You know it doesn't. I don't think that i'm worried that it's just that that because the show has so many layers jaji cohen she's on his brilliant. She has introduced us to all these women and men and then she goes this. Is them and you think that's that's all you're going to get and then. She started stripping away layer after layer after layer so there's beauty in it yes first season. I came off as a sassy latina all my one-liners. It was all about my sas haven lanka you speak spanish and the the the mustache looking over. You seem like girl speak spanish then second season. It was like she was angry. You know but third season you get to see see a softer side of her and latina's we're layered women in general were layered and we do have to work extra hard as a latina in hollywood hollywood. I know i have to work extra extra extra hard. I even on a hit show like oranges. A new black celanese leiva has to work really really hard to be relevant because the scripture not no one's knocking on my door going here throwing scripts at me yet you know i don't know if if we get that most latinos don't john and there is a certain anger sometimes that one tends to kind of feel you know and i have to be very careful with that not because this has been twenty years to be an overnight success and has been very frustrating and their moments where you i from for me. I fight to to make sure that i don't become bitter. I don't become angry. You said it's been twenty years to become an overnight success and i'm just thinking about those twenty years as a latina athena actor. What kept you you know what kept you going into to not say because i'm sure there were people in your your family and it's at that i was like cellini cellini bureau so just get a real job. Yeah let me tell you something three years ago before orange six months before for orange i had a moment and i i remember it was alone in my living room. I i started to cry through myself on the floor and i said i get it. I'm not supposed to be doing this and i said god i get it. I surrender. I'm going to start looking for jobs and listen if we in twenty years. I've been able to work as an actress but it was gigs. You know it was like you have a gig for a couple of weeks and then you have six months of no work you know you have a gig where you'd say to lines and then you're not really part of of the work of the success of a show. I found it not to be cute to be a struggling actor. When you're in adult it was just hard and have a daughter order and i was like i have to leave her. Something a leg is i have to leave her something. She can't look. I'm see me struggling all of my life so so i was ready to give it up and then i got orange and it was i think that for me the true true breakthrough is when you surrender. That's that's when things come your way they do so. I'm wondering if there's like when you're having that moment of light yes they were like you know emmy the and this is a little voice that says i only wish i could tell fulani to the tile or if he could see me now. Is there a moment when you think about something that you heard from one of your auditions your many auditions. They turned you. They said and i don't know what is the thing that someone said that is like your blood boil. There's so many shop more enough yeah i. I think that they could see it. They've seen it unless you've been living under a rock. You've seen you've seen what i've done. What i've been able to accomplish not only in twenty years but in the last three years on the show i had got a guidance counselor <hes> when when i was <hes> in junior high school in the bronx and i said i want to go to laguardia high school i wanna go to laguardia high school so badly. I want the application and he said i know you should go into a secretary program. Norman thomas is a great place. You can go to and he didn't give me the application. I had to go back and ask for it again and he threw it at me so if i see you know i think i don't know if he's around still but <hes> if he is or isn't i think that <hes> i'd liked to say you see. I knew what i was talking about. You see i am somebody you know so and i say this to my my daughter all all the time until the young latinos come up to me. They're like what you know. How did you do with us and honey. It's hard. It's really really difficult but make sure you're educated indicated. Make sure you're prepared because when the opportunity does present itself you better be prepared because we don't get too many chances. We don't get a second chance and so in your own family <hes> there were tough times. I'm thinking about <hes> what your mom and dad had to do. When you're brother got sick yes and just reading that might my heart. Your brother was three years old when he was three years old when he was diagnosed with non hodgkin's lymphoma and they told my parents <hes> you should probably prepare funeral services. My father did not work once. My brother got sick. He didn't leave his bedside. My father was in. I see you for three months holding onto my brother's hand it day in day out and we suffered as financially. We saw ourselves in a really bad place and <hes> he was in i._c._u. For three months in montafir <hes> medical center in the bronx and <hes> it was rough but he survived and then something beautiful happens that is also really spiritual. <hes> is your parents basically say to los santos the nod to whoever whoever they say you know if you cure our son we will open our doors yes and then your home became open to lots of lots of foster children children too. Was that was strange. That was very strange because you know we went from being three. You know my brothers and myself and my mother said no. You're an she said she became a foster. Mom and i was like what are you doing and she's like i joyce. I made a promise and she says and i have to honor it and for years <hes> foster kids came in and out of our home and it was very sad and he was because we it was almost like yay. We have a new baby brother. There're sister and then they would leave but from that event <hes> my parents adopted two children and one of the things that happened with one of your your brothers that was adopted and that makes this incredible full circle for you. <hes> working with laverne cox is at your brother transition to being a female. She's a transgender woman and <hes> we knew i mean i knew from the age of three years old. I knew that that <hes> that she moved different that there was something a heart essence was different and i would let when we were alone yeah. I would let her be her. I would let her do my hair. That's what she wanted to do. <hes> i would let her put on my shoes. You know and i would just because i knew i couldn't tell you what it was at the time but i knew that made her happy you know and at the age of sixteen she <hes> the time when he she came out and said i'm gay and i remember saying do you wanna be a woman and at the time said no no no. I'm i'm just gay and then slowly realized it herself that indeed she was a woman. Do you remember when you share that with laverne cox yeah well well. We had a good cry. Oh my god don't get emotional nelson and he's <hes> it was the first season and and i remember looking at her and saying <hes> you have a big responsibility and i said you know and i shared. I said you know my sister's transgender you. You've given her voice and she says she's always had a voice. I said no not not in this way. I i saw what my sister lived through an could only imagine that you know and i know from conversations with laverne the she's had the same type of experience the same in pain and now my goodness. You know we are here. We're on a show that is giving us a platform to to have these types of conversations to educate people to say i am silence. Levi play glory and does on our inches a new blog. My sister's transgender and i'm going to tell you her story. I think i have a responsibility to do that coming up on that u._s._a. My conversation with sudanese labor continues. I am an afro latina and the roles being offered to me. Were we're well. You could play them me. Stay with us not the right yes <music>. The yield curve has inverted in the past. This has been an indicator that a recession is on its way but will this time be different. Listen to the indicator planet money n._p._r.'s daily economics podcast to find out uh-huh nope. Hey we're back and when we left off. Celanese leiva told me about toiling as an actress for years before her big break a break that has helped to amplify her voice. We look back now at her years of struggling as an actress and as a woman women of color and how they inform her roles today in the beginning of your career as an actor. You spend a lot of time in the theater yes in new york. You worked at the puerto rican travelling theatre. You were part of other theater companies. Can you take us back and describe those years hours at a time when being a woman of color in a latina breaking into theater. What was that like. You know. I was lucky i think it was fortunate that the puerto rican travelling theatre opens doors for me and that was my first professional job that i got my equity card from them. I was proud of that. I was is proud that i was going to be working on a stage where my parents would come and see it and understand what i was saying because my parents speak spanish and for me the fact the my first professional job was at the pierre t will forever be amazing because the first time i went to see a play as a young lady was at the pierre t t i got onto the yellow school bus and with my brown paper bag lunch and we sat there in that audience and i remember looking at the young latina onstage stage and i was mesmerized by her mesmerized i was like doug needs to be me and then years later that was my first professional job and and then after that i worked at la mama i you know i worked at the new rican poets cafe with new year. We can rule the sketch comedy troupe <hes> that was an amazing time. I'm in my life. It got me really really ready for like you know to work on t._v. Because you have to be fast you have to be quick you have to you know you have to know your you know what you're doing to. I do <hes> comedy period but it was difficult. Of course you know <hes> even even in the latino theater world. I think that there were moments where i i felt frustrated. Because i am an afro latino and the roles being offered to me were well. You could play the made we have a wonderful part in you know the enlarged gas production and you're the made so i would have to do plays where i would sit off in the side way from my you know entrance friends as the luxury isla while other lighter skinned actresses shined and had their moments and even even even doing latino theater because you're afro there was like <hes> i was. I was other in our communities still i would. I would would not be given the opportunity and then slowly when i was given the opportunity. It was like well. We're gonna give you this. You're going to share the role. You know. We're going to give you this but <hes> you know no. It was always there was it was a but there was always you know yeah. It was frustrating. It was really frustrating at times not all the time. Was it like that but there for many many many occasions where i felt that i was not given an opportunity because i was not fair skinned and unfortunately so you know our people have an idea sometimes going i get to the end you had a win over a mile or like that's such a big thing where <hes> i was always like well. What about me. He has an actress. I could do the part right <hes> so that was that was an interesting time but i those same people now. I think <hes> would probably want me to go to the theater and not play the mate. I'm not sure that what does it feel like to go from being an actor who sometimes was dismissed who had to to fight to feel visible to now being an actor. That's on a hit show critically acclaim but that you actually have the power within the team to have those conversations conversations with gingy the creator or with the writers and for them to listen to you. You're shaking amazing. It's it's a relief because azeem. Then you do feel like you're part of the creative process you know for years i came and i was given a script and i was told this which encourages going to say and this is what your courage which is an aware and i remember times going. Why would she wear this. You know <hes> because i'm latina stories about you know. Why am i looking like a prostitute if <music>. I'm you know playing a lawyer because i'm latina you know so but in this show you get to to have conversations you have dialogue and say you know what i don't think that gloria glory would say that or that doesn't feel right and it is a real collaborative effort to build these characters and that's why i think the voices are so authentic right so even though you started in the first season with as you're saying basically these great sassy one liners owners now we see gloria as as a full character so what does that mean for you for me to be here season three and to really have been given a story with a real nice beautiful arc to me was like the icing on the cake is what i wanted from day one as an actor just to have have a beginning a middle and an end a story. That's being told a story that is relevant to story. That's going to have people talking and i'm representing the latino community city in this show on this show. I'm representing the latina yes. I am a prisoner but she's layered. She's a survivor. She's smart. She was running a business before she got locked up. She's a mother she. She believes in her religion. She's a son data. She takes care of her cheek prison. She's no nonsense and she is what i think of. When i think of a latina i think of a strong survivor and that's what gloria mendoza is. She made the mistake yes but she's a survivor. She's a strong strong woman. Do you feel that that is sort of and i know that we're going from very specific to now. Hyper hyper brought about latinos and our position in this country. Are you feeling anything like something is changing because as you know latina's eighteen as are the most powerful consumers we make decisions about what movies we're going to see and take our families were often again. We're still not leads and yet we're still lucia or direct directing or calling major shots. I think there's an imbalance you know as much as we were saying oh but we are looking at and then look at the numbers. Look look at all the progress. They're still an imbalance in how that's being distributed. There's still an imbalance in how is being put out there and for some reason and this has been always been my frustration in an even so more now where i go. Why are we saying anything. Why aren't we getting angry. Why aren't we doing anything. Why aren't we being vocal and you seem very very comfortable with making these statements about what needs to happen. Were you always that wages and now people want to hear me where before i'd be like begging them. I have something to say. I swear have an opinion and they would and now it's like yes. We want to hear what you have to say. And what what what do you think about that as you look at in just a what just happened over the past twenty and then just three years i i say well. You know what it's about all time. It's good not only am. I a working actress. I have that i have the respect i feel of the community at large when it comes to my craft that's wonderful the thing but now i have a responsibility to really speak out for those that don't have the platform and that's what i was going to ask you about. Finally in the case of orange is the new black you know the fact that it is on netflix you know one of the first series from net flicks which is a very different dynamic make <hes> that show and the actors and writers are having a major impact in national conversations. That's a big these form. It's big but it's so sweet. You know. I think back in symptoms that go who what did it take so long long you know why did it take me so long to get to this place of success right of acknowledgement of <hes> celebrity status. Yes and i think it's because i had to live a life. I had to really experienced things so that once i got to a place i that i am now. I could really talk about it from a real place. I think i know listen. I had many opportunities where i thought he was going to happen. It was like got twenty years old. I was like oh. I'm gonna be famous and it didn't happen or or things fizzled out but i didn't have much to say. It was all about me me me me. You know i think that with time with experience you realize the importance that the world really does not just revolve revolver on new that it's bigger than you. It's bigger than this acting moment that that there's so many things that you need to fix as a mother. I want a better world for my daughter you know and now i'm on this show that entertaining and educating because it's worldwide there have been cases where people have said the word transgender gender <hes> even like oh. There's so many different types of latina is they're really different. Types of latinos. People didn't know that there were different types of latinos does somewhere in the midwest you know or or wherever in the country that to me is like wow this show has really started a a revolution. You know we are educating. We're entertaining and we are making history and i'm a part of that celanese. He's thank you so much for spending some time with us. Say thank you for all of your word. Thank you very much is my pleasure to be here. I was actress. Miscellany labor who plays gloria mendosa on the hit netflix series orange is the new black the seventh and final season is available streaming on net flakes this this episode was produced by daisy rosario and camino vargas the letter u._s._a. Team includes financier camarena neil yes sophia felisa undoing his he'll megi freely and genesee mocha withheld this week from gene. Our engineers are stephanie the boat and julia crusoe our production manager is not the hawks are or new york. Women's foundation ignite fellow is phenomenal league our theme music was composed. Bison yet-to-be knows if you like the music you heard on this episode stop by latino the u._s._a. Dot o._r._g. And check out our weekly spotify playlist. I'm your host and executive producer might gain of course i join us again on our next episode and in the meantime look look for us on all of your social media as an approximate joe. Latino usa is made possible in part by california endowment building a strong state by improving the health of all californians funding for latino u._s._a. Is coverage of a culture of health is made possible in part by a grant from robert wood johnson foundation and the housing simon's foundation unlocking knowledge opportunity and possibilities more at h. s. foundation dot org vote for whoever you want but vote.
Economic Pain From Pandemic Is Much Worse Than Expected, NPR Poll Finds
"A new survey measures the financial pain as the pandemic goes on. Almost half of American households have suffered serious financial losses were told in a new poll, by NPR, the Robert Wood Johnson Foundation and Harvard t H. Chan School of Public Health in the country's four largest cities. The situation is even worse especially for Latinos and black-americans fifty to eighty percent of those. Households report serious financial problems. They can't pay their rent or their mortgage or their credit cards, and they've depleted what savings they have had. NPR's Yuki. Noguchi reports on the findings. The pandemic is creating serious financial problems, job loss depleted savings or possible eviction. That's despite hundreds of billions in government stimulus and other support. The survey shows economic stress running higher in the. country's four largest cities, New York, Los Angeles Chicago and Houston. Latino and black families were substantially more likely to face serious economic distress compared to white counterparts. Robert Blend in is a professor of health policy and political analysis at Harvard and Co author of the survey. He says the results show the personal financial challenges run deeper and broader than previously understood. I would've. Expected that all the aid that was coming from various sources would have narrowed not eliminated the differences by race ethnicity the survey conducted. This summer also found distress among households making less than a hundred thousand dollars a year. It's a just a lack of funds creating knock on effects trouble paying for food or medical care, which in turn lead to serious health consequences. The surveys implications could mean everything from a bigger drag on the economy to the nation's mental health outlook and blending says, the prognosis is grim at the time of the survey. The federal government was offering six hundred dollars a week in additional benefits for the unemployed. That was not renewed after July it's going to get worse because there is nothing for the people we serve eight who earn thousand. Dollars a year already communities are not working fulltime to fall back on Cynthia. macklin is sixty six and lives alone in downtown. CHICAGO. Her forty five year career in medical administration ended eight years ago when she got chronic lung disease, her disability led to major depression none of which have been treated during the pandemic I have not seen my pulmonary dot listened to my lungs to check my oxygen. Love. My Psychiatrist, I have the seen him out four months. My primary doctor I have seen her all these things have an impact. The diary recently died on macklin truck, which she relies on to get groceries and medicine the twelve hundred dollar federal stimulus checks she received help pay for it. She says, but that money is now long gone financial stressors. Made harder for her to breathe and manage her depression. Be The first month that I'm not gonna able to pay Rent I. Sent my landlord email yesterday asking him what could I do? macklin says she's lost eight friends and relatives to covid nineteen including her ex husband the father of her two daughters. The second week of March all the sudden got. So he passed away he didn't have a place to stay. I was lead stay here with me above all macklin says coping alone is lonely I trust so hot. Cry I just just speaking to us has things I've been ness laugh. Clinton. But I I so far. I have nine grandkids as they. Great. Great to hear that would love. Them but. In the NPR pool one in five people's had family members couldn't get care for serious medical conditions for those. In Houston, the survey found seventy five percent suffered negative health consequences. As a result there is in other words a magnifying effect Ronan Rafferty is managing attorney at the Legal Aid Foundation of Los Angeles which helps low income families on a range of issues from employment and housing to medical benefits. She says she seen A. Surge in calls. There is a minimum of at least three issues per phone call whether it is housing insecurity. So they're not able to pay their rent because of their loss of job or they're dealing with food and security it was leading to their anxiety or their high blood pressure. Romo says some landlords harassed their tenants trying to find ways around state and Federal Moratoria on addictions that's exacerbating what was already of big housing. Crisis in La Renter's pay more than fifty percent of what they make towards rent. So that doesn't leave much room for life of people and you know we've been almost now in six months of life people Gregory Cooper moved out of Houston after over a year without work, he spent thirty plus years in accounting and operations in the oil and gas industry. I mean, I have an MBA and I have two certifications but up. Struggling. Still Unemployment Force Cooper who is sixty to move in with his elderly mother in Alexandria Louisiana. He finally landed a government accounting job making about forty thousand dollars a year half. What he used to make he says it will be terrifying to be without a job. Will you be able to get a job because of the age would be able to get a job because it'd be in black? We're almost allows people to recover. Down in Florida to percents. He worries about intensifying unrest over the racial inequities in education and employment. But it also feels familiar. Now parents, do it show us how to make ends meet to actually keep your head up and get through the shovel sometimes is is good versus being born with a civil spoon, your mouth. But for Alvarado Castro financial hardship is a new experience. The father of two was born in Columbia and lives in a suburb of Miami he was making more than one. Hundred thousand dollars a year until he lost his television producer job last. September. He since found work making less as a contractor was behind it in my modest women's I wasn't my car's main focus was put through cars in storage to reduce the insurance payments older stuff that kind of things that we had to figure out how to reduce but there were some things they could not postpone. Cataract surgery in April amid remembered that she coming from the feet down on the clinic not Collins said I don't have enough to make the payment. They moved funds around to scrape together the two hundred fifty dollar co payment. The pandemic he says has given him different perspective Mommy Eastern on the most important factor in our. Maybe the most important factor northerly is the way that do live with others. The way that you chaired the time with your real ones or the way that you already Upper Siri holiday cleanup argue that he says is the only silver lining you can achieve NPR news.