Michael Bloomberg

Founder of Bloomberg LP, Bloomberg LP

2025 Bloomberg American Health Summit

🎥 Sep 30, 2025 📺 Bloomberg American Health Initiative ⏱ 285m

The Bloomberg American Health Initiative will bring together public health practitioners, policymakers, community organizations, ...

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About Michael Bloomberg

At the 25th anniversary of the Tribeca Festival, Michael Bloomberg reflected on the festival's role in revitalizing Lower Manhattan after the September 11 attacks. He stated that the "rebirth and revitalization of Lower Manhattan will be remembered as one of the greatest comeback stories in American history" and that "the arts can and must play a pivotal role in strengthening our city's spirit, our economy and our quality of life." At Bloomberg CityLab 2026 in Madrid, Bloomberg announced an additional $350 million commitment from Bloomberg Philanthropies to the Global Road Safety Initiative, with a goal of saving one million lives by 2030. He said that "the more national governments retreat from the world stage, the more important mayors become" and emphasized that "one city's success can spread to other cities and improve lives there, too." Bloomberg also discussed the launch of a Mayors AI Forum supported by the Bloomberg Center for Government Excellence at Johns Hopkins University and an expansion of global leadership programs in partnership with the London School of Economics and the Hertie School.

Source: AI-verified profile updated from Michael Bloomberg's recent appearances. Browse all interviews →

Transcript (360 segments)

✨ AI-enhanced transcript with speaker attribution

Angela2:17:30

Good morning. First, I want to thank you, Jay. Thank you so much for your leadership. It is such a pleasure to work with you, to see you as a leader in this important fight. It is such an honor to be here with you today, and today I want to talk about something that we all feel deep in our bones: the need to be safe. The need to dance at a concert, get our groceries, pray in your house of worship, and even be in your own home without the fear of being shot and killed. It seems like it shouldn't be that difficult. It's a basic right. But we don't have that kind of freedom here in America. Gun violence in all of its many ugly forms touches every single corner of this country every single day, and it leaves entire communities left to grapple with that trauma.

It's hard, y'all, to keep up with these headlines about gun violence and about all of the things happening in our world right now. Let's be honest, these are pretty tough times. People are feeling like they can't rely on the federal government to keep them safe. And it's easy to see what's happening in Washington and feel completely powerless. But the truth, which is sometimes difficult to believe, is that we are never powerless. While Congress and the White House attack our public safety, it is our communities that are stepping up.

So, what does that actually look like? I get this question all the time, and they say something like, "Angela, I want to do something about this crisis, but I don't know how. I'm overwhelmed. Where do I start?" Listen, I get it. I've organized my entire life, and it's hard to know where to begin. So, here are some truths that I've picked up along the way. The first is that building power starts where you are. There's no magic trick. Right where you are. Local action has never mattered more than it does right now. Y'all know that right here in Baltimore, we are seeing historic reductions in violent crime thanks to Mayor Scott's leadership.

And it doesn't stop there. We're seeing real progress happening in state houses and city councils and school boards across this country. This legislative session alone, Rhode Island passed a historic assault weapons ban, y'all. Historic. They were working on that for over a decade. And Texas passed $2 million in its budget for funding community violence intervention programs. So important. Colorado tightened access to the weapons of war used in our country's deadliest mass shootings. Our movement is demanding stronger laws like assault weapons bans, like secure storage requirements and protections for survivors of domestic violence. And when the gun lobby tries to pass bills that would make this crisis even deadlier, communities can rise up and defend that progress.

Every single phone call, every letter, every testimony matters because it tells lawmakers that we're paying attention and we won't back down. Are y'all going to back down? Every phone call, like I said, every letter, every testimony. The second, right now, we're embracing holistic solutions. I know how discouraging it can be when your politicians don't have much political will to make change. Your work still matters because showing up for safety of your loved ones will always matter. Even when your legislators won't listen, your community is listening. And you're planting the seeds of change. And there's so much work to be done beyond just passing laws. Handing out gun locks and secure storage literature can stop unintentional shootings. Partnering with local organizations that connect people to housing, to food, to health care — that's violence prevention, too. And normalizing conversations in your community about what safety really means — that's how culture shifts. These solutions might not make the headlines, but they make a difference, and that's what's important.

Third is we want to invest in your relationships. So much of safety is about connection. Talking about gun safety, talking about mental health, talking about domestic violence, all of that can be lifesaving. And it allows communities to build partnerships between local leaders, survivors, public health experts, faith leaders, law enforcement, veterans, doctors, students, and the list goes on. This ecosystem is the key to our success, and it's how Baltimore has become the safest it's been in 50 years, y'all. The safest it's been in 50 years. And it's how we all can find common ground in our movement because, like I said, we all share this need to be safe. None of us want our loved ones to be shot and killed. So let's start there. That's where our movement grows. More than that, investing in our relationships is what keeps us sustainable. This is a marathon. We must sustain. So we all have a role to play. But no one has to do everything. And I had to learn that the hard way. No one has to do everything. We have to be able to lean on each other. And that's how we create something big. Something strong enough to take on the gun lobby and protect that beautiful baby. Something strong enough to take on that gun lobby and a gun industry that profits off of our tragedies.

But I can say this every chance I get: gun violence is not inevitable. It is preventable. And our power to prevent it lies right here in this room, in our communities. And that's why you should never underestimate the ripple effect of just showing up. When you volunteer, when you speak out, when you support a neighbor through grief or you stand beside a student at a march, you're sending a signal that this fight is not someone else's responsibility. It belongs to each and every one of us. No single action will solve this crisis. But taken together, these actions build a movement, and that movement is how we win.

Every day I think about people I've met who have lost their children, their partner, their best friend. I think about the students, including my own girls, who practice active shooter drills when they should be practicing for spelling tests. I think about the survivors who never give up, and they get up every single morning and they choose to turn their pain into power. But then I think about rooms that I've been in like this one, full of people who refuse to accept that this is just the way it is. That's what gives me hope. That's exactly what gives me hope. And so whatever drives you to fight for safety, keep that close and keep going. That's how the magic happens, y'all. We need you more than ever right now. So thank you so much for showing up today. Thank you for everything you do. I really appreciate you. Thank you.

Please welcome Randall L. Woodman, mayor of the city of Birmingham; Brandon M. Scott, mayor of the city of Baltimore, in conversation with Jennifer Messia, senior news writer, The Trace.

Jennifer Messia2:26:14

Mayors, let's jump right in. The president has mentioned Baltimore as a city where he'd like to send troops for the purpose of fighting crime. But your city, Mayor Scott, is actually a success story. Five years ago, when you took office, there were 335 homicides. Last year there were 201. This past April, Baltimore set a record for fewest homicides in a single month. Now the city is on pace to record fewer than 140 homicides this year. That's less than half of what it usually is. It's usually about 300. But that didn't come easy. There isn't a one-and-done solution to reducing crime in Baltimore. Mayor Scott, you employ a public health approach to gun violence, which is a blend of planning, policing, data analysis, social outreach, and community violence intervention. It's a holistic, whole-of-government approach that's a much more nuanced solution than "send in the troops." And most importantly, you followed the data. And the data told you things you didn't realize, like that shooters and the victims were older than you originally thought, and it wasn't the drug trade but interpersonal conflict that's driving the violence. Tell us a little bit more about your signature policy, the Group Violence Reduction Strategy, and smart policing, and how data played a role in helping you land on these strategies.

Brandon M. Scott2:27:52

No, thank you, and thank you everyone for being here. I think first I have to just remind everyone that I grew up young, poor, and Black in Baltimore. And fortunately or unfortunately, depending on how you look at it, I grew up at the time of the height of the war on drugs, zero-tolerance policing. In Baltimore, in my neighborhood in Parks, we call it "breathing while Black" policing. Like if I walked outside, I could be set in handcuffs because they had determined that everybody that looked like me that was in this age range that lived in these places were the most likely to be the victim or perpetrator of violence. Well, look at those years. For example, in 2004, they arrested nearly 100,000 people in a city of 600,000, and we still had 270-something homicides. Last year in Baltimore, we had 201 homicides, and we had about 15,000 arrests. Significantly fewer homicides with significantly fewer arrests, because the reality is it's never been about how many arrests a police department makes. It's about who you arrest.

And when we're doing GVRS, it's really a focused deterrence model, but we're actually giving folks opportunity. We did the data. We actually had to delay the start of GVRS because when we looked at the data—folks were screaming and yelling at me, "It's going to be Black men between the ages of 18 and 25." Wrong. It was actually Black men around 30-plus, right? There were no organizations ready to work with that age of a population to help them if they wanted to change their life. So we had to stand that up. And when you're in GVRS, what we do is we actually give people a chance. They get a letter directly from me: "I know who you are. I know what you do. I want you to stay alive. The only way that you're going to do that is you got to stop what you're doing. We're going to give you every chance. If you need housing, we'll help. If you need education, we'll help. If you need to be relocated, we'll help. But if you don't, we're going to remove you with law enforcement." It's a partnership between my office, my police department that works under my command, the State's Attorney of Baltimore City, the Attorney General of Maryland, and most importantly, the community partners, because those individuals that we go to are brought in by trusted community moral voice partners that are able to bring them in to give them that hand up.

And this isn't the first time Baltimore has tried this strategy. This is actually the third time. But the previous two didn't have the most important ingredients: one, the political will to continue even though everyone thought this is the wrong way and they want you to go back to doing zero tolerance where it didn't work in the first place; and two, there weren't the resources on the community side. It has to be a both-hand approach. We have to understand that gun violence is the nation's longest-standing public health challenge, and police alone should never have been bearing the full burden of reducing it.

Jennifer Messia2:30:54

Right. Right.

What type of partnership would you like to have ideally with the federal government instead of the National Guard? Where would federal resources better be spent?

Brandon M. Scott2:31:15

Just one day I want to not talk about them. Not anytime soon. I think that we've laid it out—mayors have laid it out. If they truly wanted to help cities, one, they could restore all the grants to all the CVI and all the law enforcement and all the things that they cut. I want people to understand this: the largest defunding of policing and public safety, even from a law enforcement standpoint in this country, has happened under this current president. Right? So everything else you hear is hyperbole. But they could ban Glock switches. They could ban assault rifles. They could outright ban ghost guns. They could remove the Tiahrt Amendment that will allow my brother mayor and I to actually know where the guns come from. Right? Because it's illegal. Our police departments, they go out and recover all these guns. For me, 60% of them come from other states. And I'll just say those states don't vote the way Baltimore votes, right? But it's actually illegal for my police commissioner to tell me exactly where that gun comes from. They are protecting people who are trafficking weapons into cities. They are protecting gun stores like Hanover Armory that we in Baltimore sued and won the largest settlement ever with a gun store because they are purposely skirting the rules to put guns in the hands of people. That's how they could help us.

Jennifer Messia2:32:37

Yeah.

Brandon M. Scott2:32:39

Yep.

Jennifer Messia2:32:41

Mayor Woodfin, this is personal for you. You lost your older brother to gun violence in 2012. You lost your nephew—he was shot and killed in 2017. A few weeks later, you were elected mayor, and suddenly you're in a position to do something about gun violence. When you came into office, you inherited a city that had historically responded to violence by relying heavily on police. You decided instead to focus on the root causes of violence, like inequality and poverty reduction. You established the Mayor's Office of Peace and Policy to focus on prevention and reducing recidivism. In 2019, Birmingham was among the first cities in the US to declare gun violence a public health crisis. A strategy that, like Baltimore, encourages a holistic approach to tackling the issue. But results do take time. 2024 was a deadly year. But then something remarkable happened: homicides dropped 52% in the first half of this year. So tell us what's working, where are you seeing progress, what's moving the needle, and what are some outside-the-box strategies that you've employed in Birmingham, like concrete roadblocks, greening neighborhoods? Tell us more.

Randall L. Woodfin2:34:08

Well, good morning everybody. Let me first thank Bloomberg Philanthropies and Johns Hopkins. Also want to acknowledge your mayor, who is a national rock star. I got a chance to be on a panel with him last week, and the way he uplifts your community and your city is amazing. So, brother mayor, congrats on everything you're doing. Thank you, brother. I will say this to everybody in this room: in 2019, when we declared gun violence a public health crisis, it was for one reason—what the mayor said. You can't approach this only from a policing, zero-tolerance standpoint. For us, we look at it as a toolbox, if you would, and a minimum of three tools are in this toolbox: enforcement, prevention, and re-entry efforts. But this holistic approach from a public health crisis standpoint is quite simple: it is how do you engage poverty issues, unemployment, education, and a litany of things I don't even have time to name related to addressing this issue.

One of the most important partners for us was our actual Jefferson County Department of Health. You need your public health leader at the table when addressing gun violence, because you're going to get additional resources. One, they're going to give you a vantage point of how you should have tackled this. So this comprehensive approach has allowed us, five years later, to get to the point where we can say not just the first half, but now, ending three quarters of the year, we're at a 53% reduction in homicides. So it's holding. And it's not just policing. What we do as an example is not just play space. There's a neighborhood called East Lake. What we found in this neighborhood was that there was a significant amount of walk-ups, drive-by shootings. By the time the police got there, we couldn't identify who was doing all the shootings. But we also found this historic neighborhood had so many entry-exit points. So all we did was decrease the number of entry-exit points into the neighborhood. But we did that in partnership with the residents. We went door to door. We had town hall meetings, neighborhood meetings. We received information online—just a huge amount of feedback from the residents. This program has been in existence for over a year, and this neighborhood has had a 40% reduction in gun violence, in trafficking drugs, in shutting down the trap dope houses, as well as removing the blight—cutting the empty lots, going vertical with single-family homes on some of these empty lots, as well as other things we're doing to invest holistically in a neighborhood, not just decreasing crime, but seeding hope and opportunity as well.

Jennifer Messia2:37:06

Establishment Democrats, and this could be for either of you, seem to have a hard time owning the issue of public safety. What are you each doing in your leadership to counter this notion that Democrats cannot be effective at reducing crime?

Randall L. Woodfin2:37:22

Yeah. Well, one, you have to ignore the noise. A lot of people talking. I'm going to pass this question to my brother. My wife told me to choose peace today. She did. But the truth is, we're doing the work.

Brandon M. Scott2:37:48

That's right.

Randall L. Woodfin2:37:49

And we have real results.

Brandon M. Scott2:37:56

When you're at the local level as a mayor, you don't have time for performative politics. What we're doing is not political. We're actually governing. Governing means that you are solutions-based and you're focused on solving problems, protecting people. That means any and all types of solutions that actually work, we will try. What we know is that there are other people in other colors—and let's just say—it's performative politics, but we're focused on results. So, brother, close that for me strong, because I know...

Randall L. Woodfin2:38:36

Well, my wife didn't tell me to choose peace today. And even if she did, I pretty much never do on this topic. But I think that when it comes to us, if you ask me—and they know because I tell them this all the time—Democrats keep losing this issue because they are talking about it, and they have the wrong people talking. If they wanted to win on this issue, the folks that should be out in front to talk about this issue are us, the mayors. We're the ones that have to do the work. When someone gets shot, no one is calling their senator or congressman. And listen, everyone knows I love my congressman, right? But he—and here in Baltimore, we're blessed. They know that public safety strategy has to be led through the local government. But when you get on the high side of the Democratic party, they want to anoint people to talk about something that they have absolutely no clue of what they're talking about. You can't win.

If they want to win on this issue, they have to put the mayors in the forefront. And then also, you have to do what mayors have to do: we have to talk about this issue at the level of the people, not in hyperbole, not in academia, not in what actually is happening and what we're doing to resolve that. People want the information that way. If they want to continue to lose the effort, do what they have been doing. We're going to do what we have to do regardless, because we're the ones that have to make those phone calls when someone's son or daughter is now coming home. We're the ones that have to talk at those funerals. We're the ones that have to bury people that we know, right? We have to do that. We have to eulogize kids. We have to do that. And until you have lived that life, until you have had someone like I had a mother tell me that a young man that was killed outside my high school—that young man told her he was going to look for me before the game. He was looking for me. Then you have no earthly idea of what it means to actually work and try to solve this issue.

Jennifer Messia2:40:49

It says we're out of time. I would love to talk to you about this twice as long, but real quick, what is something you want people to know about crime in your city? Something you think is not getting out there?

Brandon M. Scott2:41:03

I guess I'll start that it's complicated, right? Even though we have now 101 homicides, that's 101 too many for me. But it's also the lowest amount of homicides we've had through the 30th of September ever on record, right? Like that's the reality. But we have a long way to go. And I think what I want to get out is that we've made significant progress, but we have to sustain it. And sustaining it means that we have to stay the course. We have to ignore the noise. As my fabulous brother mayor said, we have to continue to support the things that work. And for some folks, we have to understand that the success of what's happening in Baltimore is all of our success. And folks have to stop wanting to clamor and fight over it—it should be all about "me." This is the true definition of a "we" success, and we all should be happy in it.

Randall L. Woodfin2:42:08

Yeah. Very quickly, two things. 75% of homicides that occur in the city of Birmingham are interpersonal conflict. Within that number, 45% occur where police cannot be: inside a home, inside an apartment, or inside a vehicle. Within that information, the way we've been able to solve our homicides—we have an 82% clearance rate as of today. That's very high. Just some context: people, witnesses are coming forward, sharing information. We're getting beyond the "no snitching" culture.

Jennifer Messia2:42:44

Wow. And that's a very hard code to crack. So that's incredible progress. Mayor Woodfin, Mayor Scott, thank you so much for joining us tonight.

Moderator2:43:13

I started my career as a clinical psychologist working with individuals one-on-one. But when I became a suicide prevention trainer during my PhD, something shifted. I realized that if we want to save lives, we can't just respond after a crisis. We have to prevent it before it happens. That's when I pivoted to public health. Today, I am honored to co-lead the Commission on Suicide Prevention at Puerto Rico's Department of Health. Our wonderful team brings together experts in psychology, epidemiology, evaluation, and communications, all united around a single goal: to save lives. We train policymakers, empower community leaders, and ensure suicide data is accessible. At its heart, violence prevention is about equity, dignity, and the chance to live a full life. Every day, I see people from all walks of life working to transform pain into power, collectively building systems of hope. And now, a brief video highlighting a new strategy to prevent intimate partner violence in Baltimore. Take a look.

Narrator2:44:33

Well, House of Ruth Maryland got involved in intervention work really at the request of the survivors that we serve. One of the things we've been saying for years is that engaging with partners who are abusive is in and of itself a victim service. We have crisis lines for suicide prevention, general crisis, intimate partner violence victimization, of course, but we lack services to engage people who use abusive behavior. The Gateway to Change hotline is a 24-hour anonymous and confidential hotline that is dedicated to receiving calls from people at risk of causing harm to an intimate partner. We are fortunate to have received funding from the Bloomberg American Health Initiative to carry out this work. It's really an innovative approach because our primary approach to intimate partner violence prevention has been harm reduction for survivors, which is crucial. There's a need to engage some of the root causes of violence, which is the behaviors of abusive partners. Through the Gateway to Change hotline, they're able to have a more free-flowing conversation in a way that makes them feel heard, allows them to talk about other factors within their life that might be contributing to their use of violence.

We know that the legal system isn't seen as a resource for all of the families we serve, and we wanted to create a path for people to engage in our services that was low-barrier. And now this hotline is a way for people to reach out without engaging a police officer, maybe doing it within the privacy of their own home. When people access this new hotline, they're going to engage in services and get support for stressors in their lives like unemployment, mental health support, substance misuse. We talk about change looking like honesty and accountability and a willingness to work on themselves. I actually had a call from an individual recently who was calling the Gateway to Change hotline, and it was their first time actually ever talking about anything they had done to harm another person. They told me it made them feel safe to have this place where they could speak without being judged. We've been getting phone calls from all different types of people. We've had people who are seeking help because they are worried about the way they're treating their families. We've had survivors reach out to ask what change looks like and what services are available for their abusive partner. We've had community partners reaching out to figure out how they can make appropriate referrals for people because they care about somebody who's causing harm in their family.

We're hoping that community agencies implement the Gateway to Change hotline. We're learning that people want to voluntarily engage in supportive services to take necessary steps to change. I think this is really giving us the reach that we're looking for in the sense that we've always said everyone has a role to play in ending intimate partner violence.

Moderator2:47:37

Wow. Right. Here we are in 2025. It surprises so many people to know that intimate partner violence is still an issue today, affecting over one in three women, with health, economic, and housing impacts. We've learned since the Violence Against Women Act: we can't criminalize our way out of this. We really need the tools of public health. And it's incredible to see you really deliver this holy grail, which is creating an option for people that are at risk of perpetrating harm. And the video was amazing. I know it was so much harder than that. Tell us about some of the challenges in this work. Thank you so much, Michelle.

Michelle2:48:29

The hotline is one of several innovative approaches to addressing harm against women in intimate relationships that are taking place at House of Ruth Maryland. And in developing the Gateway to Change hotline, we conducted a formative evaluation which consisted of engaging a range of stakeholders through qualitative and quantitative research, developing a robust staff training protocol, and of course, making sure that we had evaluation and monitoring metrics in place. And we are thrilled since the implementation in April to have had a steady rate of calls. We received a call from a partner who had recently strangled their intimate partner, which in intimate partner violence research we know is an indicator of intimate partner homicide. This person found the hotline number through ChatGPT and reached out to the hotline at House of Ruth Maryland.

Some of our lessons learned in this work is that confidentiality begets trust. We had done our formative work, and we knew that the hotline was mostly welcomed by staff, by survivors, by potential callers. And we were also amazed at the level of candor that we have received among the callers. We also recognize that meeting people where they are, taking a stage-based approach to violence perpetration work, has been a missing aspect of our work in this space, and it has been beneficial in this regard. And also, as we know in any public health approach, proper infrastructure—so I mentioned the staff training, the protocol—all of these pieces, we want people to know that you can't, or you shouldn't, implement a hotline like this overnight. There are pieces that have to be in place. And so we developed a readiness protocol which is available on the website provided by the Bloomberg American Health Initiative. We invite folks to check that out.

And we look forward to scaling up this effort. So next steps include an outcomes evaluation, assessing or evaluating the impact of the hotline among callers. Also increasing visibility, our marketing strategies, engaging additional community partners. One of the strong points of this hotline is that there is a strong referral pipeline. When callers call in, they are referred out to supportive services that may help reduce their use of violence. And then technical assistance: we are available to organizations who might be interested in developing a hotline like this. So as we all know, engaging people at risk of causing harm to an intimate partner is really only one component—it's addressing the root of violence—and there is so much more work to be done to address violence against women, which is why I am deeply grateful for the work that you all do and are leading. Tiara, I know that you are doing amazing work in the sexual and reproductive health space regarding intimate partner violence. Do you mind sharing with us a little bit about your work?

Tiara2:51:30

Yeah, I'm happy to. I mean, we've seen a lot of promising results so far. We've been working with healthcare providers, clinical staff, even on the front line, in order to kind of respond to intimate partner violence among patients. We've seen those promising results that even though there was a little bit of a hesitation in the beginning from staff on how to actually implement these protocols, we've seen self-efficacy—their confidence to do these protocols—increase over time. We've seen a lot of trust be built between patients and providers as well, which we know is critical for disclosing and intervening on partner violence. And so we're really excited that that work has really been blossoming in Baltimore, and we're looking forward to seeing its impact just kind of grow, because we know that the healthcare sector can really be a solution for partner violence. And it's another reason why policy investment is really needed in order to kind of scale up this type of intervention. And I'll pass it to Michelle, who'll talk more about the policy landscape.

Michelle2:52:27

Oh, we are at such an important and exciting moment, I think, in this space, right? So, you know, building these threads, we know that there's no one single solution. We've got to layer in prevention. We've got to layer in access to support services through the health care sector and beyond. Scaling up our direct service providers and making sure that workforce is really ready and robust to handle the volume of all of this. And just in the past few years, the field has really coalesced around these multi-pronged priorities, generated that first national plan to strategize thoroughly across all of these aspects. And I think we're about to see just incredible movement from states and cities to really bring this into reality.

Tiara2:53:18

Super. I agree. Over to you.

Michelle2:53:25

So, watch this space. It is so incredible to see this solution lens and the incredible work that you've done. So, thank you.

Moderator2:53:35

All right.

Please enjoy a brief break. Refreshments and restrooms may be found in the lobby to your left. This will be a brief break. Thank you all very much.

Thank you.

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Welcome back to the Bloomberg American Health Summit. Please welcome Dr. Kadijah Ferryman, faculty at Johns Hopkins Berman Institute of Bioethics, an assistant professor in the Department of Health Policy and Management at Johns Hopkins Bloomberg School of Public Health; Dr. Irene Dankwa-Mullan, Chief Health Officer at Marty Health and board member of Heron AI; in conversation with Dr. Elizabeth Stewart, Bloomberg Professor of American Health, Department of Biostatistics at Johns Hopkins Bloomberg School of Public Health.

Elizabeth Stewart3:19:36

Welcome back. Thank you all for coming back from the break. Really happy to be here with you all. And I feel like it can't be a symposium like this without some discussion of AI right now. So we're happy to have our eight minutes on AI. You know, I think the thing I want to start with is we've already heard a bunch of themes today about data and evidence. And in some ways, AI isn't new to public health in that regard—the focus on data, computational tools. I think what's different is the scale and the potential scope. You know, when we think about AI, the two features that I might highlight right now: one is this ability of computers to do what we think of as human reasoning, we'll come back to that; and then also the fact that it learns from itself. And I think that is what makes it both powerful but also have some potential pitfalls. So that's what we're hoping to really dig into today.

But again, I want to stress that at the heart of AI is data, and I think we'll be hearing again about both the good and bad aspects of that. We're going to hear some examples from our two panelists about possible applications of AI in public health to give you some initial ideas. You know, within the School of Public Health at Hopkins, we have people working on TB screening in rural areas where AI is enabling mobile units to go and do screening and then provide point-of-care treatment for people who actually test positive, sort of in the field, much more automated than has been possible in the past. Another you might have heard at previous summits about work on suicide risk prediction models within the White Mountain Apache tribe, using that to identify people at risk and then intervene, leading to reductions in suicidal behavior in those communities. So there's a lot of promise, but we know that there are concerns about representativeness and this automated process and the black box nature. So we're going to have a little bit of time to talk briefly about some of these checks and balances and ways to think. So let me turn first to Dr. Ferryman. Can you tell us a little bit more about some of the data inputs used to build AI tools and the implications for their use in public health practice?

Kadijah Ferryman3:22:05

Yes, absolutely. So I'll give two examples. One example is the All of Us Research Program, which if you haven't heard of it, it's funded by the National Institutes of Health and it's on track to be the largest research study ever in history. The goal is to enroll 1 million people in the United States in the All of Us Research Program. At this point, 850,000 people have been enrolled. And although technically not a public health program, it is enrolling so many participants and there is so much data that we can learn a lot about population health and public health from the All of Us Research Program. So there have been really great examples of research using AI with the All of Us data. For example, researchers have used AI and machine learning to do things like predict weight gain, predict uncontrolled diabetes, predict glaucoma. And one thing I want to stress about the All of Us Research Program: not only is it a huge program with big data, from the very beginning it has been really intentional about enrolling a diverse set of participants. The goal has been to engage communities and populations who've been underrepresented in research in the past. So this makes it a really promising example of how AI can be used for population health when there is data representativeness and diversity of participants.

Now, let me just follow up with one quick example that shows the other side. So researchers, as Liz mentioned, have been using AI to do things like predict disease onset, epidemics, things like that. So there was a recent study using large language models—you might know those as the ChatGPT-type things. Using a large language model to analyze tweets from people in various countries to see if tweets could be used to predict an infectious disease epidemic. This large language model did really well at predicting when there would be outbreaks, except when they looked at tweets from the country of Haiti in the Caribbean. That is because Haitian Creole was not as well represented in the data that the large language model was analyzing. So that's an example where when you have unrepresentative data, it leads to bias and it leads to these AI tools not working as well for public health and for our public health goals.

Elizabeth Stewart3:24:49

Thanks. And I think a nice reminder that some of the evaluation tools that you all have been learning are still going to be incredibly important to help us study those sorts of issues and how they are or are not working. So Dr. Dankwa-Mullan, I know you work a lot with AI tools in practice. Can you give us a little bit of examples of successful implementation of AI in public health?

Irene Dankwa-Mullan3:25:11

Yeah, sure. Happy to. I would start by saying that successful implementation of AI in public health really requires a strong data governance. It requires a modernized infrastructure, a good, robust data architecture. It requires a trained workforce. It also requires strategic collaborations with not just physicians or health professionals but also with the community. And most importantly, it also requires an ethical framework to detect fairness and transparency. So what I'll say is that there are no really good, fully scalable, stable success stories remain rare, especially in public health. What we have actually are promising practices that are being implemented in collaboration with health departments, in academia, or public-private partnerships.

Some examples are disease surveillance that you mentioned, looking at outbreaks where they use social media, where you can also use environmental data. There's also predictive modeling where it's being used to detect, looking at emergency room visits or environmental data, to figure out where AI or an intervention could make an impact. A lot of these really rely on quality data, which is lacking, so there is some deficit there. There are also successful models in predicting asthma outbreaks using environmental data and geospatial modeling that's also going on. A fourth example I'll use is digital health communication. There's NLP being used in chatbots to communicate health messages. But some of those data also miss the local nuance or cultural values being put in the data. So there are some promising practices, but I think we're yet to get to a point where we would have successful AI implementation.

Elizabeth Stewart3:28:02

Great. Thank you. I think we're unfortunately already out of time. But we can clearly see lots that we can follow up on in future conversations and maybe even over lunch. So thank you so much for bringing your expertise to us today.

Irene Dankwa-Mullan3:28:15

Yeah, thank you.

Moderator3:28:21

Please welcome Dr. Arline T. Geronimus, professor of health behavior and health equity at University of Michigan and member of the National Academy of Medicine.

Arline T. Geronimus3:28:48

Good morning.

At age 50, Jason Hargrove was a proud and reliable Detroit bus driver and a married father of six. In early 2020, Mr. Hargrove's Facebook profile picture showed him on his bus wearing a face mask with the Detroit Public Transportation logo clearly visible on his hat. The hashtags that surrounded his photo read: "I cannot stay home. I'm on the road for you." Mr. Hargrove posted a video on March 21st, 2020, in which he stepped off his bus to record. Evidently in need of fresh air and cooling off—we see him wiping sweat from his brow on this Michigan winter's day—he shares his fear and righteous consternation at the fact that a passenger on his bus coughed repeatedly without covering her mouth. He makes an effort to prevent those watching from writing him off as an angry Black man by emphasizing his years of service and sacrifice. "There's folks dying of this," he says into the camera. "And I am trying to be the professional they want me to be." He assures his wife that when he comes home, he will take off his tainted uniform and put it in the wash, and himself in the shower, before uniting with his family.

Four days after making this video, Mr. Hargrove was diagnosed with COVID-19. Although he sought medical care, he was not admitted to the hospital. A week later, on April 1st, he died from complications of the disease. In March 2020, we were beginning to identify risk factors to inform triage as sick people overwhelmed hospital capacity. The clearest risk factor for death was being elderly. At 50, Mr. Hargrove didn't qualify. Indeed, on average, only three out of 100,000 50-year-old Americans diagnosed with COVID died of the infection. For Mr. Hargrove, as well as for many others in Black and other marginalized communities, his underlying cause of death dates back centuries, beginning long before COVID and echoing the tenacious civil rights activist Fannie Lou Hamer. Young through middle-aged adults of color speak of being sick and tired of being sick and tired. And they are right—physiologically as well as existentially.

The chronic activation of measurable physiological stress processes in their bodies over years and decades shortens their healthy life expectancy and hastens their death. I coined the term "weathering" to name the structurally rooted physiological process of accelerated wear and tear throughout the body. Weathering is a measurable biosocial process that leaves identifiable groups of Americans vulnerable to dying or suffering chronic disease and disability long before they are chronologically old. Through weathering, members of marginalized populations age prematurely, no matter how well they follow the social contract, the American creed, or the latest dispatches from the front lines of healthy behavior science. As human beings, the inner workings of our bodies are always active and adapting, physiologically responding to environmental stimuli to keep us safe—whether from a raging beast, an objective environmental challenge such as sub-zero temperatures, or a threat to our social identity safety such as a racist aggression. Our neuroendocrinological wiring is exquisitely attuned to being alert for such danger, both consciously and unconsciously.

Research in social psychology tells us that members of marginalized social identity groups enter new situations with uncertainty and become vigilant for cues indicating whether or not they belong, can trust others, may be in physical danger, can be authentic, or will be treated fairly. Such vigilance automatically activates the human physiological stress response, flooding our blood systems with stress hormones that mobilize sugars, fatty acids, and amino acids out of storage sites for energy and immune cells in anticipation of wounds. If we are able to evade the immediate danger or are reassured that it was a false alarm, the flood of stress hormones recedes and our body returns to baseline functioning in short order. This automatic process is protective when we are in an acute life-or-death situation and is also adaptive for other kinds of threats that are short-lived. However, our stress process stays activated when the stressors that trigger it appear repeatedly in our daily round, are prolonged, or remain unresolved.

Randomized controlled trials consistently find that these types of biosocial stressors can result in hours, even days, weeks, or months-long physiological arousal and reactivity, sustained even while you sleep. In this predicament over years and decades, any human being would experience cumulative stress-mediated wear and tear across their cardiovascular, metabolic, neuroendocrine, and immune systems. Those systems then become damaged, dysregulated, weakened, and eventually exhausted. Through this automatic and chronic process, populations subject to weathering pay a scientifically demonstrated health tax in the early onset of chronic disease, in unconscionably high rates of maternal and infant mortality, in depression and anxiety, in autoimmune diseases like lupus, in infectious disease, and in cancers. At the molecular level, cell aging, death, or senescence accelerates.

Based on his likelihood of being weathered, Jason Hargrove's biological age at 50 would look more like an affluent white American's biological age at 70. Indeed, in those early days of the pandemic, 50-year-old Black Americans died from COVID-19 at the same rate as 70-year-old white Americans. Now, of course, everyone experiences stress sometimes, and even stress and coping that is prolonged. But how likely or deeply you experience it, whether it gets into your body, depends on your social position and opportunities for recovery, including the balance of time spent in settings where you can relax and release instead of in places where you automatically remain vigilant and extend yourself beyond your physical or emotional limits to increase your chances of safety or success.

In the current historical moment, there are reasons to expect weathering to expand to new groups and intensify in historical targets. For many Americans, our everyday world is objectively becoming more uncertain and threatening. Protections are being diminished and opportunities for expressing ourselves freely are put on ice. From Latino immigrants to seasoned Black professionals to talk show hosts to school children, more and more of us need to keep our heads on a swivel to protect our lives and livelihoods, gain respect, or attempt to live unapologetically. As roving patrols of ICE agents now have license to show up unannounced and make arrests based on profiling, childhood vaccine mandates have been eviscerated, cancer and mRNA research defunded, jobs lost, housing unaffordable, and as climate change disasters loom, people's anxieties are multiple and sustained.

Weathering adds to and interacts with socioeconomic, environmental, and lifestyle determinants of health to exert its pressure on morbidity and mortality. Weathering most deeply afflicts responsible, tenacious, hopeful, and loving members of the working or middle class, like the late Jason Hargrove. Short of action, weathering will remain the destiny of the marginalized. But it doesn't have to. When confronted with such clear inequity, we have to see what we can do about it. In addition to the other levers being recommended today, approaches to advance health equity must also address weathering, or they will fall short of their goals. Thank you.

Narrator3:37:36

My work at the Sanitation Facilities Construction Program within the Indian Health Service is about increasing access to critical public health infrastructure that improves the health of American Indians and Alaskan Native tribes. This means coordinating with tribes and across federal agencies, nonprofits, academic institutions, and the Commissioned Corps of the United States Public Health Service to design and construct water, wastewater, and solid waste facilities. Thanks to the Infrastructure Investment and Jobs Act, we have an unprecedented opportunity: $3.5 billion dedicated to improving sanitation facilities in native communities. But money isn't the only resource needed to build infrastructure. We need partnerships, too. I've seen the power of collaboration firsthand. We formed the Navajo Water Access Coordination Group, a group of over 20 partners working side by side with the Navajo Nation to increase access to safe drinking water for an estimated 30,000 people. In doing so, we are closing gaps in service for thousands of households without piped water connections across the Navajo Nation. Projects like these should remind everyone that health is not just about access to clinical care, but is also about restoring dignity and well-being to communities that are often overlooked or undercounted.

It's now my pleasure to introduce Dr. Samuel S. Martin, the director of the Johns Hopkins Institute for Planetary Health.

Samuel S. Martin3:39:12

All right. Well, thank you, and what a huge honor it is to be with you today and part of this incredibly rich program. Over the course of about three weeks last year, the New York Times broke two stories. The first showed that declining bat populations in the US were associated with rising infant mortality rates. The second showed that deaths in the US from hurricanes over the past century had been dramatically underestimated. In the first study, a researcher showed that in counties where a fungal disease, white-nose disease, had wiped out bat populations, farmers responded by increasing pesticide use by 31%, presumably because the loss of bats had led to an increase in agricultural pests. He then noted that in those same counties, infant mortality rose by 8%, apparently because of the increased chemical exposures.

The second study, three weeks later, showed that mortality from hurricanes in the US was dramatically higher than anyone had anticipated. From 1930 to 2015, there were four to five million excess deaths resulting from hurricanes. This number represents about 3 to 5% of all mortality in the continental US over that time period. And the number has been accelerating since 2001, in line with the increasing frequency of hurricanes resulting from climate change. These stories are part of a bigger story: the story of planetary health. The field of planetary health has exploded over the last 10 years in recognition that the Earth crisis has become a global health and humanitarian crisis. Climate change, biodiversity loss, global pollution, and other environmental changes are degrading the foundational conditions for human health: the quality of air we breathe, the quality and quantity of food we can produce, our exposure to infectious diseases, our exposure to extreme weather events, and increasingly the habitability of many of the places we live.

As a result, we're seeing large burdens of disease across every dimension of health. In my own research, for example, I've found that rising concentrations of carbon dioxide in the atmosphere are making our food less nutritious and pushing hundreds of millions of people into the risks of nutritional insufficiency. We found that wild pollinator declines are causing about half a million deaths each year as a result of reduced production of the foods that protect us from heart disease, strokes, certain cancers, and diabetes. We found that changes in fisheries associated with ocean warming are putting nearly a billion people at risk for nutritional deficiencies, and that changes in land use in Indonesia are causing about 36,000 deaths every year from air pollution. These are just a few examples from my own research. But in an article we published this summer in the Lancet, we showed that changes in any of the planetary boundaries that we use to track the stability of the Earth system have health impacts across every dimension of human health.

So this is where we find ourselves. This is what Martin Luther King described as the fierce urgency of now. The way we have come to live is choking the life out of the planet. We as health practitioners are starting to sound the alarm that we can no longer effectively do our jobs. We can no longer safeguard human health into the future while the natural life support systems that we depend on are crumbling under the weight of our own collective ecological footprint. The good news is that there is a rich landscape of solutions to shift the way we live across food and energy systems, manufacturing and the built environment, to bring humanity back into balance with our life support systems. Universities can be critical catalysts of that transformational change through our work in research, education, policy, and practice. The role of the Johns Hopkins Institute for Planetary Health is to stimulate exactly that sort of transformational scholarship.

In the American context, communications is, I think, a critical component. At the Institute for Planetary Health, for example, we've been thinking about the opportunity to train some of our most trusted messengers—nurses, physicians, public health practitioners, first responders—to respond rapidly to climate change disasters, to help communicate to the public the connections between climate change and their health and prosperity. As we sleepwalk toward the edge of a cliff, it's our responsibility in the health sciences to sound the alarm and help humanity move onto a different trajectory, where we protect the natural life support systems that sustain us and the rest of life on Earth. Thank you.

Moderator3:45:45

Please welcome Dr. Barat J. Benut, director of the UCLA Heat Lab; Dr. Ben Zichek, Morton K. Blotstein Chair and professor at Johns Hopkins University Krieger School of Arts and Sciences; in conversation with Zara, climate reporter at Bloomberg Green.

Zara3:46:11

Well, thanks everyone for being here. We're going to continue the conversation on climate and health, and I'm really excited. We have two experts here, and we're going to really drill into two specific pieces. One of the interesting things about climate is that health is one of the ways climate can impact every single person in this room, but it doesn't impact people equally. So, Barat, you do a lot of work with extreme heat. Can you tell us a little bit about who are the most vulnerable groups your group is researching and why?

Barat J. Benut3:46:45

Yeah, that's a great question. You know, when we talk about extreme heat, the negative effects of extreme heat are incredibly unequally distributed. We often talk about being in the same boat with climate change, but that boat is very large but includes only some of us in particular ways. So what we do in my lab is try to understand what are the factors that contribute to making somebody vulnerable in particular ways, whether those be sociological, biological, the built environment, pharmaceutical even. For example, we know that a lot of commonly used pharmaceutical drugs, whether those be for heart disease or psychiatric conditions, actually impede our ability to stay cool, to thermoregulate. So for older populations that often take four, five, six drugs every single day, they can really feel these impacts strenuously. As you get older, it's also harder to thermoregulate even without these drugs. So for older folks, that means they're especially at risk of facing heat-related illness or even death.

You see this trend not only in older populations but also among the incarcerated. If you're in jail, you already don't control your thermal environment. You don't have access to air conditioning. You might not have access to ice, to regular water, to showers, and you're also probably heavily medicated. The American prison system is the largest purveyor of psychiatric drugs in the nation. Those drugs are going to heighten your vulnerability to extreme heat.

Zara3:48:10

So, what can be done to actually help protect those people, especially the incarcerated population?

Barat J. Benut3:48:18

This is a great question. I think it's really important that we understand that climate adaptation is also public health, and that can take forms that look really different than what we're accustomed to. Maybe that means fighting to have people be able to take different kinds of medications during heat waves, to modulate how much they're taking or what kinds of drugs they're taking. Maybe it means pushing further and saying, well, if prisons can't keep people safe, we might get rid of them. We might think about abolishing prisons, thinking about letting people free in order to protect their lives, and thinking about that as a climate adaptation policy and as a public health policy.

Zara3:48:56

Fascinating. I want to take a chance to bring Ben into the conversation. Separate from extreme heat, I know you've been looking at how climate can impact diseases, specifically dengue. Can you give us a little bit of an explainer on how this is impacting that and, again, who is most vulnerable?

Ben Zichek3:49:18

Yeah, thank you. I think the issue of vector-borne diseases like so many health issues reminds us that global change is a multi-scale and complex problem. As Barat indicated, there are a lot of very localized impacts that we see, but we also know that warming in the Arctic might be very relevant to South Florida or to Mauritius because of the way we're interconnected. When you talk about something like dengue or malaria, these kinds of diseases have heavily mediated processes where ecology comes into play and human systems come into play. You might see something like a gradual warming trend changing the range of Aedes aegypti, increasing the potential range of dengue. But you also see extreme events. For example, we look a lot at malaria in the Amazon. Fifteen years ago, we were talking about eradicating malaria from the western hemisphere, and now we're in control mode because we've had floods and droughts that have destabilized human systems and land use change. These are the kinds of impacts we're seeing, which point to the complexity of these systems and our need to take a holistic approach.

Zara3:50:23

So what can be done about it?

Ben Zichek3:50:29

Yeah, we just heard Sam Myers talking about planetary health, and that framing is vital. When we talk about vector-borne disease as an example, is it climate change? Yes. Is it many other systemic changes going on? Absolutely. When you talk about solutions, as we all said, we need to talk about the communication side of this, which includes very much a two-way, three-way, many-way communication because we're dealing with problems that involve multiple stakeholders and multiple objectives. What are you trying to accomplish with your solution? The only way to do that is through this kind of participatory wayfinding. I think something we've learned over the years in the climate realm and environmental health more broadly is that you can only get to solutions if you work in concert with communities, whether that means the affected community, people who are part of the solution, or people who are perhaps part of the challenge. We've had some luck on that right here in Baltimore through the Baltimore Social Environmental Collaborative, which I lead. We've worked effectively with our partners in city government, communities, and industry to define the problem, work together to see what pathways are available, realize we're wrong, argue—there have been more than one shouting match in these engagements—and then come around to a point where we say, "Okay, here is a messy but acceptable decision process that we can all engage in going forward." I think that's going to be true for many of the wicked problems we face under global change.

Zara3:52:03

Yeah. I'd be remiss if I didn't ask just very quickly: you're doing this work, the political environment has shifted. Have there been any examples where your work has been impacted, your ability to do this kind of research, because of a crackdown on grants or other things?

Barat J. Benut3:52:24

I can say briefly, I had a National Science Foundation grant suspended. Luckily it's back for now, but that impacts my ability to do this research. I think federally we're all watching the Endangered Species Act finding come under attack, which is the basis for regulating carbon emissions across the country. There's a lot to keep our eyes on.

Ben Zichek3:52:43

Yeah. We've had several projects defunded, which is a huge challenge. In some ways, it accelerates the timeline of translational research. We always said we were going to be able to make this self-sustaining, and now we have to do it faster. I have to say, going forward, I'm very concerned about protecting our translational research. I'm also becoming increasingly concerned about fundamental research. In some ways, making sure that our society values that fundamental discovery might be the bigger challenge as we also try to protect the translational work that people do value and will come around to support.

Zara3:53:14

Well, thank you so much. This has been a great discussion. Let's give a round of applause for Ben and Barat.

So, I'm really excited. We're going to have another session soon. But just to recap, one of the things that stuck with me was about how extreme heat can impact certain populations like the elderly, and learning about how medicine can have a similar effect. I want to welcome to the stage for our next conversation on urban sprawl an expert in the field, Dr. Shima Hamidi, an assistant professor and researcher at the Bloomberg School of Public Health at Johns Hopkins.

Hello.

Shima Hamidi3:54:29

Hello.

Zara3:54:31

All right. I think we should start with the basics. Do you think you could give us a definition of urban sprawl and maybe an example or two of a place that has a lot of sprawl versus a little sprawl?

Shima Hamidi3:54:43

Absolutely. Imagine you are living in the city of Boston, Manhattan, or San Francisco. You leave your house and you have dozens of destinations to go. You can walk everywhere. You can go to a restaurant, socialize with people, have an enjoyable nice walk or bike ride, go to a coffee shop. A 10 or 15 minute walk and you are in a train station and you can go to your job. You are well connected to everyone and everything, and that's what most developed countries are building—how they are building their cities and neighborhoods. On the other side of the spectrum, a suburban typical neighborhood in the US, which most of us have lived in and experienced, you are living in a place that has nothing but single-family detached homes, no other destinations, no other uses, all cul-de-sacs, no opportunities for walking and biking. You have no choice but to drive everywhere, drive long distances, drive frequently, and be in congestion all the time. That is the typical definition of sprawl, and that's what the US built environment and cities have been mostly dominated by. You see a huge difference in these two types of development and their health and quality of life outcomes.

Zara3:56:17

Yeah. So I wanted to ask about that. You mentioned the 10 to 15 minutes—I'm sure people have heard this buzz term "15-minute cities." It's part of the culture wars. When you're thinking about health outcomes on this spectrum of little sprawl to a lot of sprawl, is one considered healthier? What are the ways you're measuring and tracking that, and what could be done to address it?

Shima Hamidi3:56:43

Great question, Zara. In suburban areas, as I mentioned, you have to drive everywhere, and that means fewer opportunities for walking, biking, and physical activity, and a higher likelihood of obesity, which 43% of American adults are dealing with, and all the chronic diseases that come with that—high blood pressure, diabetes, cancer, heart disease, coronary heart disease. That's not because we don't want to be active; it's just we don't have neighborhoods that help us to be active. Long driving and frequent driving means more likelihood of crashes, and higher speed of driving means more likelihood of being in a severe and fatal crash. There is a 3.5 times higher likelihood of being in a fatal crash in sprawling areas. Crashes are a leading cause of death for people aged 15 to 65. There is less access to opportunities, healthy food, more likelihood of being located in a food desert. Also, mental health—more driving means more isolation. You are trapped in your neighborhood, not much opportunity for socializing, and more likelihood of depression. It's not only about our health but also our environment. More driving means higher rates of greenhouse gas emissions, hotter summers, and more frequent extreme weather events, all of which mean more heat-related health outcomes.

If you combine all of these, living in a more compact versus a more sprawling neighborhood means on average about three and a half years of difference in life expectancy. That is huge. According to the CDC, if there were a cure for cancer, the improvement in life expectancy would be about three years. We can do that through changing our neighborhoods and cities. Regarding how we can do it: through zoning reform. We should stop zoning and building exclusionary, only single-family detached homes. Our cities won't allow other types of development in neighborhoods, and that has been associated with "not in my backyard" causes. We have to change that. We have to go through zoning reforms and create neighborhoods that are inclusionary, that allow us to build everything connected, people next to each other, people next to destinations. We have good examples of that, like Minneapolis or Tacoma, Washington, where one of our fellows, Judy Austin, has been helping with zoning reform.

Zara3:59:55

I know that Judy and you were going to be available to talk about this stuff more. I really appreciate you taking the time. Thank you, everyone. You can find our experts out in the hall if you want to ask more questions. Thank you.

Narrator4:00:14

At Northern Nevada Public Health, we've reorganized around the Foundational Public Health Services model, creating a structure that can contract when resources are tight and expand when new opportunities arise. We're fostering a culture of resilience, adaptability, and innovation. In these uncertain times, information is the currency of the moment, something we must invest in. We have prioritized keeping our staff and community informed with accurate updates and leveraging the media to our benefit. This approach has helped us navigate the complexities of our current environment and maintain trust and confidence among our most important audiences. I am proud to share that even in the midst of uncertainty and local deficits, we secured an increase to our tax transfer this year, the only Nevada County Public Health District to do so. Why? Because we kept showing up, inviting everyone to the table, even those who didn't agree with us, and making the case that public health isn't optional. It's essential.

Public health has always been asked to do more with less and to do it quietly. But this moment is a chance to change that: to stand up, to advocate boldly, to correctly address state and local funding, and to tell our story in a way that resoundingly resonates with everyone. It is now my honor to introduce a staunch advocate for public health and the environment, who has made a career in making the most out of a little: Dr. Matthew Teala, Senior Vice President of Environmental Health at the Natural Resources Defense Council, in conversation with Joanne Kennan, journalist in residence at the Johns Hopkins Bloomberg School of Public Health and contributing writer at Politico Magazine.

Joanne Kennan4:02:04

We began the summit this morning hearing from Baltimore's new health commissioner, Dr. Taylor, and she talked about getting data in the hands of the community and the power that can have. What you've been doing with NRDC is helping communities gather and collect data and own it themselves. We don't have a lot of time. I want you to talk really briefly about what that means—data to the people—and then talk about two communities that are acting to make their communities more environmentally sound: one in progress and one a success story, because I think everybody here needs a success story.

Matthew Teala4:02:43

Yeah. so one of the things I first learned when I started doing this work in Houston—we're going to talk about Houston in a minute—is that there really isn't a whole lot of data about actual environmental conditions on the ground, especially in the communities that have the greatest environmental risks, the greatest pollution challenges, communities that have been most marginalized over time. We really don't understand what is happening in those communities. Luckily, with the increase in technology, the affordability of sensors, the reliability of the data that comes out of those sensors, we have a real opportunity—at a time when our democracy is being attacked on an hourly basis—to democratize environmental health protection by taking advantage of these low-cost sensors and the interest across the board from community advocates, public health researchers at academic institutions, and state and local governments to actually start putting those sorts of environmental monitors and sensors out on the ground across communities, and really from the ground up have communities generating the data, owning the data, and then using the data with their partners, with organizations like the Natural Resources Defense Council, to make informed decisions about the places with the greatest pollution risks and the interventions that are most effective at improving health conditions.

Joanne Kennan4:04:10

So, what's going on in Houston? A hugely polluted petrochemical hub.

Matthew Teala4:04:15

Right. You told me you were reading about Houston last night and you were a little scared. Going back to when I was first starting out as an environmental health and justice advocate there, I realized that we had huge pollution challenges all over the Houston region. Even though Houston would regularly tout itself as one of the most monitored parts of the United States, you really didn't know that much—especially in those communities that were right up against the refineries, the ports, metal shredders, or concrete crushers. You didn't know what the health impacts were in those communities. So we started using community monitoring decades ago in the Houston area—everything from getting a new ozone monitor put in a place that the model showed actually had some of the worst ozone in the entire region but didn't have an ozone monitor, forcing the state to work with the county to put an ozone monitor in there using our own low-cost sensors to prove the models were right, all the way up to using information we got about toxic chemicals around refineries when we would comment into federal rulemaking processes, down to what Air Alliance Houston, my former organization that's still down there kicking butt, is doing today: using those low-cost monitors and sensors to characterize the threats from things like a mobile batch concrete crushing facility that will go from community to community, to really get local city council members and mayors to understand, with their public health departments, just how big of a threat those small sources of pollution are for people that live right around them.

Joanne Kennan4:05:52

These tend to be mostly poor communities, communities of color, working-class communities, lower-income communities, communities that don't otherwise have a voice. And when they can show up at city hall or in a state capital or at the public health department and say, "No, no, no. My baby's sick. I feel horrible. I smell it all the time. I can see it when I wake up in the morning and I take the film off my car, and here's a report from a monitor that we put up," that can really be the straw that breaks the camel's back in terms of getting public health officials or elected officials to take them seriously, because now you have a piece of scientific data that the community trusts because they made it themselves, confronting experts who lack that data with information that fills in the picture for them.

Okay, we don't have a lot of time. Just three sentences on the big win in Buffalo.

Matthew Teala4:06:51

Sure. Another big win in my experience, when I was at EPA running the environmental justice program, was a really great environmental justice organization up in Western New York, PUSH Buffalo. They had many communities regularly impacted by really dirty, harmful pollution from a coking facility—one of the most dangerous forms of pollution out there. They started putting up their own monitors around this coking facility. After years of effort and years of fighting for it, they convinced both the State of New York and the Environmental Protection Agency to get that coking facility and its emissions in hand, leading to the closure of that facility that never should have been located in a place like the community of Tonawanda right outside Buffalo.

Joanne Kennan4:07:37

Unfortunately, that's all the time we have, but he's ending on a win.

Narrator4:08:04

When I tell people I work with data, they often imagine spreadsheets and charts. And yes, I spend a lot of time crunching numbers and running analyses. But here's the truth: data are stories. And it's my job to help communities in Michigan tell theirs. At the Michigan Fitness Foundation, I work with a team to evaluate two programs funded by the USDA: SNAP-Ed and the Gus Schumacher Nutrition Incentive Program. Together, these programs give families the tools they need to stretch their food dollars and access healthy food. One of my favorite examples of these programs in action is the Michigan Farm to Family CSA program. Families using SNAP benefits can purchase fresh, local produce boxes at a reduced cost. And we pair that with nutrition education so they know how to prepare and enjoy what's inside. In one of our focus groups, a participant told me that without this program, they simply couldn't afford vegetables for their family. That's the kind of data that really keeps me going.

Right now, public health is at a crossroads. Food and nutrition policies are shifting, resources are stretched, and communities are being asked to do more with less. At the Michigan Fitness Foundation, we're leaning in, helping local organizations build the capacity to lead, innovate, and create solutions that truly fit the needs of their communities. This is not business as usual, and that's exactly why we need to keep telling stories: to show that these programs really work, to secure continued investment, and to inspire tangible change for communities in need. I am now honored to introduce four people who certainly understand the importance of data: Crystal FitzSimons, president of the Food Research and Action Center; Dr. Erica Pan, director and state public health officer for the California Department of Public Health; Bloomberg Fellow Ally Wolgamoth; and Mattie Gelman, food reporter for the Baltimore Banner.

Mattie Gelman4:10:18

Hi. Okay. So, we know that healthy, accessible school lunches can be a lifeline for food-insecure, low-income families. And we also know from studies that it can improve childhood health outcomes, school attendance, and even test scores. So I would love to direct the first question to Crystal. Maybe you could talk a little bit about the exciting things that are happening with childhood nutrition to make sure that students are getting fed.

Crystal FitzSimons4:10:46

Absolutely. Well, I have to say one of the most exciting things happening in school meals right now is the movement around healthy school meals for all. It really is a win-win for schools, parents, and kids. Healthy school meals for all is when schools offer breakfast and lunch to all kids at no charge. It ensures that kids have the nutrition they need to focus, concentrate, and learn in school. It eases the household food budget for parents—they can count on school breakfast and lunch 180 days out of the year—and it helps them make ends meet. Schools can count on having students who are well-nourished and ready to learn, and it reduces administrative work for the schools. During the pandemic, we had a trial run of healthy school meals for all, and a lot of people decided they did not want to go back to the way the school nutrition programs operated before. So we actually now have nine states that have healthy school meals for all policies, 20 states that have legislation to try to move in that direction. And with the federal options and those state policies, we have 60% of schools offering free meals to all students. So I'm really proud that FRAC helps lead the National Healthy School Meals for All Coalition, working to make this a reality nationwide, and also working to protect the gains we've made so that the current administration and Congress don't roll that back.

I'm also really excited that we get to work with a lot of state campaigns leading these efforts. Breakfast is an amazing option as well, but participation lags behind lunch. We are focused on strategies to increase breakfast participation because the way most schools operate the school breakfast program, it's done before the kids are even at school. So breakfast after the bell, breakfast in the classroom, grab-and-go breakfast are all really important strategies that local communities can implement. So even at a point when there are a lot of negative things happening with federal nutrition programs, I am heartened by what's happening with school meals.

Mattie Gelman4:13:04

And Dr. Erica Pan, there's so much that California is doing, from trying to ban ultra-processed foods by 2035 to the universal school lunch program. Can you talk a little bit about what other innovative strategies the state is taking to feed students?

Erica Pan4:13:24

Sure. I'm happy to talk about one program we're really proud of called Farm to School. This has been championed by our first partner and working with our farms and our Department of Food and Agriculture. These are grant programs that connect local farmers with schools within a certain radius to provide fresh, farm-to-school lunches and also provide hands-on education in the classroom to learn about agriculture, food, and nutrition. This is now in half of the schools in California.

Mattie Gelman4:13:52

That's amazing. That's really exciting. And Ally, I know you've worked a lot in California in the Bay Area with schools and advocates, trying to educate people about policies they can take advantage of to make sure their students get fed. Can you talk a little bit about what you're seeing with schools and what policies they can take advantage of?

Ally Wolgamoth4:14:16

Absolutely. Fortunately out in California, we do have healthy school meals for all, but there are still places where schools can do a better job implementing these policies we have in place. One really cool policy that California has had passed for the last three years is that elementary schools can provide free breakfast to the siblings of low-income students. So two-, three-, four-year-old siblings can be getting breakfast at schools, but we haven't seen wide uptake of this particular policy. I think that's a huge way for schools right now, particularly with SNAP cuts, to support our low-income families.

Mattie Gelman4:14:53

That's really exciting. Are there certain areas where you're seeing a lack of education in schools over certain partnerships or things they can do to feed their students? I know you were talking about how a lot of your work is educating on what else they can do.

Ally Wolgamoth4:15:09

Yeah, absolutely. I think it's tricky, right? Policy changes all the time, and there's a real need for us as public health advocates to bridge the policy piece and what's going on on the ground so that schools can implement these policies better. When I was doing my research, I found that about 30 to 50% of after-school programs and school lunch programs are not allowing kids to leave the school lunchroom with non-perishable foods, despite the fact that this has been encouraged by the USDA since 2014. So I think there's a lot of work we can do on the ground to bolster food security for students and families.

Mattie Gelman4:15:43

And now, you mentioned SNAP cuts. It's being projected that over two million people could lose their SNAP benefits over the next decade. What can you tell people about the work being done on the ground? Is there a way for families, for schools, to sort of protect themselves from some of these consequences of federal spending cuts and SNAP cuts?

Ally Wolgamoth4:16:18

It's a great question. I don't know that I have the answer to that, but I think those solutions start locally. Listening to parents, listening to community members, being responsive to their needs, and then working out solutions that meet the local population's needs is a really critical strategy to employ.

Crystal FitzSimons4:16:35

I would love to jump in on the policy behind that. When we think about the changes that they've made to the SNAP program last summer, there is a cascading impact it would have on school meals because if kids lose SNAP—which some states might end up making because of the costs being shifted to states—they lose their direct connection to school meals, and that harms a lot of the work we're doing around healthy school meals for all. So we need to make sure that as states implement these new policies, they put state funding in to make sure the SNAP program can continue to operate, that they do their best to mitigate harm, and that they communicate clearly to families about the changes so no one is surprised by it. We have a lot of work over the next couple of years to make sure we mitigate the harm from these SNAP cuts and also advocate to try to reverse them. SNAP is our largest federal nutrition program; it combats hunger, improves nutrition, and lifts millions of people out of poverty. We need to be strengthening and expanding that program, not contracting it.

Erica Pan4:17:59

One more thought on this: thinking about all this dependency in general and strengthening our partnerships, looking to the healthcare delivery and healthcare insurance side for these upstream impacts like food. I know we'll have a later talk about food as medicine, but leveraging and thinking about other partnerships is another area we all need to work on.

Mattie Gelman4:18:18

In California, what is being done or what were you excited about seeing in school districts to mitigate the impacts of these SNAP cuts?

Erica Pan4:18:31

I think we're still struggling with that, to be really frank. And the other really hard part is that it's not just the direct nutrition; it's our nutrition education. On the public health side, basically 95% of our nutrition and physical activity branch was funded by SNAP-Ed, and now that has been completely decimated. So we're trying to work with other partners to figure out how to make up for these big gaps.

Mattie Gelman4:18:58

Contextualizing that—have you seen that level of cuts, that level of changes to something like school nutrition education programs prior to this administration?

Erica Pan4:19:15

I don't think I have. The level of cuts to many different programs has been unprecedented.

Crystal FitzSimons4:19:24

Yeah. I mean, they cut SNAP by about 20%, which is completely unprecedented. And the requirement for states to cover some of the benefits is a huge shift and incredibly problematic because there is significant variation among states in the resources they have to put into the SNAP program and the political will they have as well.

Mattie Gelman4:19:46

Is there anything that brings you hope? Conversations you're seeing with legislators or ways people are organizing on the ground after these cuts?

Ally Wolgamoth4:20:02

I could take that one first. One of the schools I've been working with is expanding their backpack program in advance of these SNAP cuts, knowing they're going to have a greater need for students to be able to take food home on the weekends. So they got ahead of this, working with teachers to identify additional students and working with the food pantry to make sure families are food secure.

Mattie Gelman4:20:23

That's great. That's a point of hope. It looks like we are out of time, but thank you so much.

Moderator4:20:43

Please welcome Dr. Tara Madri, assistant professor at University of Michigan, in conversation with Dr. Donald Warren, co-director of the Johns Hopkins Center for Indigenous Health.

Donald Warren4:21:13

Hello. Thank you to all my relatives here today. On behalf of the Center for Indigenous Health, we are so pleased to be at the table and part of these important discussions. We also appreciate the land acknowledgment at the start of this meeting. That was wonderful. I show this map to emphasize that colonization has had a huge impact on Indigenous peoples worldwide. Looking at the lower 48 states, keep in mind that with the loss of land and territory, it wasn't just sacred sites and locations; it was also food systems. Entire food systems were disrupted as a result of colonization. When we think about access to food since that time, we became dependent on federal government food programs, including rations and commodity food programs. Now a lot of people think of fry bread as a traditional food, but fry bread is not a traditional Indigenous food. It's people doing the best they can with federal commodity foods. We never fried dough; that is not a traditional Indigenous food.

Just very briefly, I'll show you a picture of some of the old commodity foods, things I even grew up with. I call your attention to the picture on the right: a large container of corn syrup. It says in very fine print, "Use in baby formula." This was part of our history in terms of the food we've had to endure. But we have good news as well; we have a lot of good programs. I'd love to hear from Dr. Mudrey.

Tara Madri4:22:40

Yeah, thank you so much, Don. I want to ground this in some examples from my own community. I come from a commercial fishing family and I'm a descendant of boarding school survivors. As a reminder, today is Orange Shirt Day, a day of remembrance for the many people that never came home from those boarding schools and the continued trauma our communities face. To talk a little bit about my community: I mentioned I come from a commercial fishing family, and over the last few years, we've had a lot of environmental injustices within our Great Lakes, causing continuing decline in our whitefish populations. But the Sault Tribe has done something innovative: they have the only inland walleye and whitefish ponds, and they're continuing to stock those waters with whitefish and walleye, trying to give back more than we're taking. That's a beautiful example of how we're trying to preserve our sovereignty and our way of life in the face of environmental injustices and the loss of knowledge from boarding schools.

If you're interested in learning more, this documentary that the Sault Tribe made is available on YouTube. Although Indigenous food systems are incredibly diverse, we do have shared commonalities. One is that we think of nutrition in a very expansive way. Compared to Western science, which defines nutrition in physical terms around nutrients, servings, and calories, our communities think about it as physical, spiritual, emotional, and relational. Those components of our food system cannot be separated from one another.

This Indigenous Nourishment Model I've used to develop strength-based Indigenous nutrition measures called the Indigenous Nourishment Scales. I'm currently working with the Fond du Lac Band of Ojibwe to develop a nutrition curriculum based on addressing food trauma, thinking through how we address it through physical, spiritual, emotional, and relational ways. It's been culturally adapted by people all over Indian country, and I'm truly honored by that. Speaking of cultural adaptation, I'd love to hear from Dr. Warren about how the culturally adapted Together Overcoming Diabetes intervention is going.

Donald Warren4:24:46

We have a wonderful program called Together Overcoming Diabetes that includes nutrition and recommendations for traditional foods, but in a much broader context. It's a holistic, intergenerational curriculum: an adult with type 2 diabetes and a youth family member. It focuses on diabetes management in the adult and prevention in the youth. We just finished Phase 1 in South Dakota. It was a shortened timeline with a relatively small number—just 40 dyads participated. Half got the intervention, half did not. But we already saw statistically significant reductions in depression, anxiety, and blood pressure, approaching significance for reductions in blood sugar. We're waiting for Phase 2, which depends on whether the government is still open tomorrow—happy new fiscal year's eve, everybody. We have a lot of examples in Indigenous populations that are very successful in improving outcomes and utilizing traditional culture as part of the intervention. The challenge from a policy perspective is how to scale that up. We need more resources and acknowledgement of these interventions as valid and useful. From a policy perspective, we need to see investment in traditional ways.

Tara Madri4:26:01

Thinking forward to what's possible and moving beyond this food trauma, there are a lot of exciting things going on in Indigenous communities, and an opportunity for everyone. Indigenous food system restoration work—there's a misconception that it's just about Indigenous peoples or just for us. But we all live here together on Indigenous lands. How do we live well here together, use these food systems together, and learn from one another? When we restore these relationships, it's not just about us or our communities; it's about climate-resilient ecosystems, neighbors helping one another, and thinking about how our foodways can be rooted more in reciprocity and responsibility to one another and the lands around us. As we think forward to the future, I hope we can continue to have hope as we work together, remembering that this work isn't just for us—it's for everyone. We invite you to be part of that work with us.

Donald Warren4:26:59

Pilo. Thank you all very much.

Narrator4:27:07

For over a decade, I worked in food service and farming, planting seeds, serving meals, and feeding people one plate at a time. But it wasn't until I joined Hunger Solutions New York that I truly experienced firsthand how accessible nutrition can transform communities. Our statewide organization focuses on federal nutrition programs, including summer meals, ensuring that kids have access to adequate nutrition in schools and out. This summer, I rode along with Saratoga Springs City School District's food truck and witnessed smiling kids run up, knowing lunch was waiting. At Pine Bush Central School District, I stood with food service staff supplying over 900 meals weekly to families. In rural areas, I supported libraries as they stepped in to offer grab-and-go meals for families. These institutions and the staff that support them are lifelines. But today, we're facing real challenges. SNAP cuts could mean that fewer families qualify for these food nutrition supports and fewer organizations are eligible to serve these meals. These policies have real consequences, and we're seeing them play out.

I believe in the power of federal nutrition programs to support and bolster our communities by providing stability, dignity, and connection. At Hunger Solutions New York, we're not just working to respond to hunger; we're working to restore hope. As so many in the food access and anti-hunger space have said before me, these programs are not a handout; they're a hand up. It is now my pleasure to introduce four individuals who know about the power of food firsthand: Dr. Steven Chin, Chief Medical Officer for Alameda County; Erica Hansen, Clinical Instructor at the Center for Health Law and Policy Innovation at Harvard Law School; Jordan Smith, my fellow Bloomberg fellow from the Hawaii Good Food Alliance; and our moderator, Dr. Eli Moy, Bloomberg Assistant Professor of American Health. Thank you.

Eli Moy4:29:11

Good afternoon, everyone. Thanks for sticking around. I know folks are hungry, but I promise you, you're in for a treat. I am so delighted to be sharing the stage with a fantastic panel to talk about food is medicine. Before we dive in, just to do a quick grounding, in case folks are not familiar, I wanted to ask Erica if you could kick us off and share how you define food as medicine.

Erica Hansen4:29:40

Sure. At its base, food as medicine is the provision of healthy foods for the purpose of prevention, treatment, or management of chronic conditions, with a nexus to the health care system. This could be a prescription, a referral, or even payment by healthcare.

Eli Moy4:30:04

Great. Thank you. That's really helpful context. Stephen, if you could share what this work looks like on the ground in your community.

Steven Chin4:30:16

Sure. I want to share that we're one of a handful of programs in the nation asking three critical questions: Where does food come from for these food as medicine programs? How is it grown? And who is growing it? We answered those questions in our program's design. Our program is called Recipe for Health in Alameda County. The first ingredient is our safety net health centers—18 clinics and clinicians prescribing food and health coaching to treat, prevent, and reverse chronic conditions and address food and nutrition insecurity. The second ingredient is food grown locally, organically, regeneratively, and by as many BIPOC farmers as possible. We put that together into a "food pharmacy" spelled F-A-R-M-A-C-Y because we're connecting food from 45 local farms to our clinics through a food hub that does doorstep delivery. Patients get discreet weekly deliveries of food boxes to their homes. The third ingredient is health coaching to amplify the effect of the food through movement, social connection, and talking about the food in the weekly box. The secret ingredient that puts it all together is our administrative and training team at the county. We train clinicians to use food as medicine in a 15-minute visit, train medical assistants to screen for food insecurity, make sure farmers and health coaches get paid, and connect the sourcing of food to food as medicine.

We create a health multiplier—not just human health, but economic health and ecological, soil, and climate health all at one time. That's how it looks on the ground in one program.

Eli Moy4:32:42

Thank you, Stephen. I really appreciate how you're using food as medicine not just to address food needs but as a leverage to spur broader food systems change. Jordan, I'd like to invite you to share what food as medicine programming looks like for you and your community.

Jordan Smith4:33:05

Definitely. Thank you. Building off Erica's definition, I think food as medicine is also this alignment and acknowledgement by federal and state governments that what Indigenous folks and communities have known for a long time: the connection between health, land, food, community is inextricable. When one of those is unhealthy, all are unhealthy. In Hawaii, that's the foundation of everything we do: ʻāina (land) accountability means "that which feeds." We're accountable to the people, the land, the sky. We're focused on prescribing ʻāina education—bringing folks to the farm, putting their hands in the dirt, seeing where that food comes from. We focus on 100% locally sourced, medically tailored meals, produce prescription boxes, and supporting farmers. We're also focused on reintegrating and reconnecting folks to their cultural foods.

Eli Moy4:34:12

Another great example of this holistic perspective and using food as medicine to support and celebrate cultural foods and Indigenous food traditions. Thank you. We all know these are incredibly uncertain times, especially for sustaining and scaling programs like food is medicine. I'm wondering if you could talk about some of the challenges and where you see opportunities to be innovative and creative when it comes to funding and supporting this kind of work. Stephen, I'll go back to you.

Steven Chin4:34:52

Sure. Funding is part of sustainability. I shared four ingredients; our fifth is braided funding. We fund this through Medicaid, but Medicaid is under attack. We use Medicaid dollars to pay for food, which is unheard of in our history of healthcare. But it can't just be Medicaid. The county has invested county dollars into our food as medicine program, and there's a role for philanthropy. One of my colleagues said, "Systems-level change needs systems-level funding." We need to get beyond pilot grants to system-level funding. Medicaid is one lever; we also pull down USDA funding. Given the federal landscape, it will be a braided approach.

Eli Moy4:35:43

Jordan, anything to add?

Jordan Smith4:35:46

Yes. Hawaii also has a Medicaid 1115 waiver similar to California. Hawaii was the first state in the nation to put in their application for nutrition supports that they would prioritize sourcing from local farmers, community-based organizations, and local growers over importing food—Hawaii imports more than 80% of its food supply. This is a miraculous policy opportunity but also a significant challenge. Healthcare is just getting its head in the game; Indigenous folks have been here for a long time. How do we bridge these two communities—healthcare and food—both of which have their struggles and have never formally connected in Hawaii? How do we do that while preserving the community aspect and not losing that each community is different and should drive solutions rather than top-down policy?

Eli Moy3:36:45

Yeah. I'd also invite you, Erica, from where you sit thinking about healthcare financing and policy—what challenges are you noticing, and where are there opportunities?

Erica Hansen3:36:58

Well, I would echo everything my colleagues said. They are the implementers on the ground where the rubber hits the road. From my perspective working with states and at the federal level, the programs they've implemented are replicable and adaptable to all states. We've seen successful programs in North Carolina and Massachusetts with rigorous, peer-reviewed evaluations showing statistically significant reductions in ER visits and hospitalizations and huge savings for Medicaid programs by investing in root causes. We've seen replications of what Jordan said in their 1115 demonstration. Legislation just passed in Oklahoma to fund these services in Medicaid with preferences for locally sourced food and community-based organizations. Legislation passed in Texas, Wisconsin, and Alaska last year. Even in challenging funding times, there is real momentum behind transforming our healthcare and food systems to have a more holistic approach.

The funding question is real. There are other sources of funding, like rural transformation funds. You have to find your champions, as Dr. Chen said. But the momentum is there. Listen to your communities—we've heard that time and again today.

Eli Moy3:39:00

Yeah. As we close, I wanted to open it up to the panel. If you could share a call to action or concrete ways that those of us here in the room can contribute and help move this work forward.

Steven Chin3:39:16

I'll jump in. For healthcare folks in the audience and my healthcare colleagues: ask the question, where does the food come from? Who's growing it? How is it grown? Get to know the food system. Let farmers know that healthcare is a possibility to help sustain a new way of farming for our health. At the end of this is the nexus of land and soil. Don't be siloed in healthcare or public health without thinking about the food and ag system.

Eli Moy3:39:50

Thank you. Thank you so much for sharing your insights. This is incredibly valuable. Appreciate it.

Moderator4:40:02

Please welcome back Dr. Joshua M. Sharoffstein and Michelle Spencer.

Michelle Spencer4:40:25

What a terrific morning. Would you agree? I was asked to sum it up, and I have like 20 different bullet points based on what everybody said, and Josh was like, "You can't do any of that." So I want to remind you all of what our dean said to us this morning about the power we have in ourselves, the collective power we have when we come together. When we think about how we do this work in community, in academia, with faculty, with clinical individuals, with folks in government, we do not do this work alone. We stand on the shoulders of each other, and we're here to support each other. It's the power that we have within ourselves and within each other. Also, I wanted to note the importance of advocacy. We can't do this work without individuals who are advocating for the work we're doing and for healthier, brighter communities. With that, thank you all again for the work you do and the power you hold within yourselves.

Joshua M. Sharoffstein4:41:29

Great.

A few acknowledgements. I want to thank all of the faculty at the school who participated and Dean Pollock Porter who has been here the whole morning. All the people who put this event together: Kelly Henning and her team from Bloomberg Philanthropies, Aoke Tate, our photographers Larry and Howard—we definitely have to thank them, willing to make a few little tweaks before the photos are finalized. And the initiative team at the Bloomberg American Health Initiative has an amazing team. We want to especially thank the producer of this event, Shannon Jones.

One of the things you should know: please check your apps. There are lots of skill sessions this afternoon, field trips, and a reception this evening at the Reginald F. Lewis Museum, a short walking distance away, but there will also be transportation. Please check your apps for updates.

Michelle Spencer4:42:40

Check your app updates. Now we have one more thing to do here. Occasionally, Michelle and I ask you all to help us express appreciation for someone. A couple years ago in Baltimore, we rose up and gave a standing ovation to the health commissioner of Baltimore after she led the city through the pandemic. We'd like today to do the same. This will be the last thing. Please stand up—come on up—for a special person to both Michelle and me: Jessica Leighton from Bloomberg Philanthropies. Jessica, come on up.

Jessica is one of the major reasons the Bloomberg American Health Initiative exists as it does. She was the head of environmental health in the New York City health department, worked at FDA, helped design the initiative, and literally every part of it bears her fingerprints. We give her little thanks every year, but this year we decided to do the big one. There is a something to give you, Jessica.

Joshua M. Sharoffstein4:44:06

It says: "To Jessica Leighton, PhD, MPH. Thank you for your commitment and unwavering support of the Bloomberg American Health Initiative and for not sending back any of the more than 100 monthly reports we have sent you since this initiative started. Your support has allowed our innovative approaches to advance public health research, practice, and education. We are forever grateful to you. September 30th, 2025."

Michelle Spencer4:44:36

Before you go, we want to do one selfie with you and the award. Everybody behind us, if you wouldn't mind, people can come on up if you're interested in being in the selfie. Jessica, we're going to look this way. Michelle, you're in the middle. Jessica, come on up. Turn around. Hold up your award. Okay. One, everyone's going to say, "Thank you, Jessica." One, two, three.

Okay. Excellent. Thank you, Jessica.

Thank you all for joining us. If you have signed up for a site visit, please proceed to the registration area for lunch. Again, if you have signed up for a site visit, please proceed to the registration area.