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Building A Culture Of Health – Aspen Ideas Health 2019

Our team attended the annual Aspen Ideas: Health conference, which brings together leaders in the healthcare space – from community-based organizations to large-scale research foundations – to discuss critical issues in national and global health. This year, a few of their program tracks we were most excited about included: Ethics, Value, and Health; Frontiers of Health and Medicine; Power to the Patient; From Lifespan to Healthspan; Health and Wealth; Inflamed!; Mental Health: Out of the Shadows; and Coming to Grips with Climate Change.

The festival officially opened Thursday, June 20 with memorable remarks from Dr. Dan Porterfield, the president of the Aspen Institute, who established that “a culture of health is a culture of freedom.” Ms. Peggy Clark, one of the program directors and Vice President of Policy Programs, powerfully delivered the vision of The Aspen Institute: to create a free, just, and equitable society.

On opening day, we listened to findings from the Wellcome Global Monitor Report, a global survey on what the world thinks and feels about science and health, from Imran Khan, Head of Public Engagement at the Wellcome Trust. Globally, only 18% of people surveyed (n=144,000) have a high level of trust in scientists, and that people from low-income countries are more likely to trust scientists and therapies like vaccines. These statistics reinforced that trust and transparency are integral to medicine and the progression of science – a theme we saw running throughout many sessions as the conference progressed.

The tremendous value of interconnectivity in technology was a major trend throughout different sessions. In a deep dive on artificial intelligence (AI) in health, we learned about the growing need for shared, large-scale datasets in order to accurately improve diagnostic AI from Padmanabhan Anandan, CEO of the Wadhwani Institute for Artificial Intelligence, and Lizzie Dorfman, Senior Technical Program Manager at Google AI – Catherine Mohr, Vice President of Strategy at Intuitive Surgical and President of the Intuitive Foundation, and Mike Nohaile, Senior Vice President of Strategy, Commercialization, and Innovation at Amgen, also participated in the panel. In particular, the panel emphasized the power of AI to highlight relevant information from these large data sets for doctors and scientists. As Nohaile explained, “one power of AI is in surfacing information because I want scientists to be analyzing data, not have to fiddle around to find it.” Similar ideas were mentioned in a session about big data’s potential to improve diagnostic tests when combined with AI.

As technology is rapidly evolving, so does the need for dynamic regulation standards and accessibility. The new age of interconnectivity can bring individuals a new world of ental health resources, gene therapy, and personalized care, and it is critical that accessibility remains center-stage. Inventors and allied health professionals should be held accountable to both practice ethically while also having a responsibility to increase access to these new-age technologies and innovations.

The importance of empowering patients was also of high priority. We heard about rebuilding the patient experience in terms of both prioritizing patient-centered care and encouraging physicians, allied health professionals, and institutions to rebuild patient trust. Ann Kim of IDEO emphasized transforming clinical settings to make patients feel more empowered, and Jennie Joseph of Commonsense Childbirth, Inc. discussed how patient-centered midwifery can eliminate racial/ethnic disparities in birth outcomes. Joseph showed striking data on how people of color experience more mistreatment in birth settings, ranging from 20-30% for black, Hispanic, and Indigenous women to a little over 10% for white women.

We were also inspired by the sentiments of multiple other speakers, including NYU Langone Medical Center’s Dr. Dave Choski, Penn’s Antonia Villarruel, and the American Board of Internal Medicine’s Dr. Richard Baron that highlighted the need for patient trust in healthcare; this, they explained, was absolutely essential to reach better outcomes for patients and allied health professionals. Learning more about clinical processes will only bring us closer to figuring out how to best support diabetes education and management.

We also saw an increasing focus on the power of social determinants on health - a topic so important to advancing the field of diabetes research and technology that we’ve heard raised many more times in 2019 starting with JP Morgan and continuing to ADA. Housing is one of the most impactful social determinants of health, and Dr. Richard Besser of The Robert Wood Johnson Foundation explained at some length that housing insecurity often co-occurs with food insecurity, toxic stress, and educational barriers to color health outcomes. The very inspiring former mayor of Atlanta, Shirley Franklin, emphasized the need for cooperation among multiple bodies in communities and local governance to create better housing conditions that lead to better health.

Access to healthy food is clearly essential to health and wellness and we heard several references to food as medicine. As Tufts University’s Dr. Dariush Mozaffarian stated, nutrition is the single modifiable factor that is the leading cause of poor health globally. Dr. Mozaffarian urged those in healthcare to mobilize, raise awareness, and make it easier for people to eat healthier. The US government spends about $160 billion a year on direct medical expenditures for type 2 diabetes alone (not even including indirect costs to work productivity, for example). The absence of food records in the EHR, lack of medical training in nutrition, and the lack of NIH funding for nutrition research will drive these costs to rise even further. Clearly, there needs to be more of a focus here – it was very inspiring to hear University of North Dakota School of Medicine’s Dr. Donald Warne discuss a South Dakota Native American reservation where soda machines have soda at $2 a can and water available at $0.25 – he said the demand for water had exploded with this change.

We were heartened to hear that the government can play a large role in promoting healthy diets. New policies, private sector innovations, and cultural change are needed to encourage healthy eating. The speakers provided several examples of potential government-led initiatives, including food in medicine working groups, fruit and vegetable prescriptions, nutrition science being taught in schools, an NIH institute of nutrition, medically-tailored meals, tax incentives, and subsidies on organic foods. The speakers agreed that nutrition science should shift from focusing on single nutrients to examining diets as a whole. Beans, nuts, seeds, fruits, whole grains, and vegetables are important to incorporate into diets, while refined starches/sugars and hyper-processed foods should be omitted.

Lastly, we saw continued discussion on the role of businesses in employee and even societal health. Friday’s session on the business case for health explored the relationship between financial and physical health and the call to leaders to align their business goals with community well-being. Donald Felix, head of Financial Health for Chase Consumer Banking, described financial health as the ability to “maintain day-to-day activities, withstand shocks to the system, and reach long-term financial goals.” He further characterized debt levels as the BMI of financial health. Leaders across the panel, including Prudential’s Jamie Kalamarides and HealthNow’s David Anderson, discussed the degree to which a meaningful level of security is essential to living a minimum full and balanced life that is necessary to feel happy and productive and healthy. In particular, Anderson highlighted HealthNow’s work in Buffalo, NY rebuilding the waterfront, investing in parks, building an ice rink, and creating primary care facilities in so-called “care deserts.”

Check out diaTribe's Twitter feed for a look at our live updates from Aspen Ideas Health.

By Ursula Biba, Emily Fitts, Divya Gopisetty, Sabrina Lin, Rhea Teng, and Kelly Close

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