Host: Good morning everybody in Health Chatter Land. Welcome to Health Chatter and today's show is on addressing health in anxious times. And we decided that the Health Chatter crew decided that, all right, we're going to all chime in on this one. So, um, all of us have some ideas and um, things that we can maybe do as we proceed with all the changes that are going on in, um, in healthcare. So, stay tuned on that. We've got a great crew that I always introduce and I like to recognize Maddie Levine Wolf, Aaron Collins, Deandra Howard, Matthew Campbell and Sheridan Nygard are a crew second to none. I'd put them up against any podcast crew, uh, anywhere. Uh, you guys are are great. They provide great research for us, marketing, production, recording of shows, the whole nine yards. So thanks to all of you and they've been with us a long time. Um, so we must be doing something right because they still like us, right? So, all right, and also Clarence Jones is my uh co-host of the show. Clarence is great. We've been working together a long, long time. Clarence, it's a pleasure. Barry Baines, our medical advisor, he's on the show today. And thank you Barry for, for, for being with us. Human Partnership is our sponsor for all these shows. Uh, great community health organization. They're doing some really creative things and perhaps even more so and Clarence can probably touch on this, um, in these, um, anxious times. So stay tuned on that. You can check them out at humanpartnershipalliance.org. And you can check us out healthchatterpodcast.com for all the shows that that we've recorded. We have transcripts of shows, we've got the background research on there and often times we add to that research if more information becomes available. So, check us out, healthchatterpodcast.com. All right. I don't like to be anxious, but we are in anxious times and, um, and I guess, I guess what I'd really like to do is, um, is maybe go around the horn here a little bit and and ask all of us, um, you know, what's kind of affecting you the most. Um, and, and see if there's some commonality and then we can go from there. So, all right, so let's first start out with my, with, with Clarence. Go ahead.
Clarence: I think for me the, the biggest challenge for me right now is uncertainty. And what I mean by that is that I, in the work that I do, a lot of times, uh, the people that I'm working with are uncertain about what they should do. You know, they, you know, we're not, they're not sure certain about their funding, they're not certain about, you know, what's, what's acceptable. I mean, because it just seems like, uh, there are so many shifts and changes in, you know, what is appropriate now. And so I'm gonna leave it like that. I'm gonna be very, very at 10,000 feet and, uh, we can, we can talk a little bit about more about it later.
Host: Okay. All right. All right, Matthew, you're in the upper left hand corner of the screen here, so I'll start with you.
Matthew: Yeah, so I think it's helpful to kind of put in context of like where I came into public health at. You know, I started studying public health like maybe a year before COVID, then and we were immediately in the COVID era and that really brought an influx of like, you know, money and funds and then I went to grad school during public health. I mean, during COVID, so it was, you know, there's this huge emphasis on public health and like, well, we can have some debate about how COVID was managed. Largely, you know, we knew we had a lot to do. There were a lot of, um, excitement. Everyone was wanting to get into the field. How can we help? How can we, you know, that's when we get to see public health really shine in these times of like crisis if you will. And now we're on the other end of that. And so it's such a like a, it's, it's very interesting to see that other side and see kind of where we are now of, you know, how do we keep moving forward? And I don't know, like everything is, it's a tough time as a, you know, a newer grad and a newer, newer to the field, it it's definitely frightening to see. It's like, are nonprofits the place to work anymore? Do you have that job security? How, you know, how can we still do the good work with also maintaining, you know, a personal level of security as well. So it's, it's really balancing all of those things in these like difficult times.
Host: Yeah. I get it. It's like all of a sudden there was real excitement with regards to a public health issue crisis, namely, namely COVID and, and now it's just like, all right. And again, that was, you know, I mentioned this before, that was not self-inflicted, okay? That came to us, you know, this little COVID critter affected all of us. And, um, but yes, but yet it brought on public health response and at the same time, um, some real questions on, um, on public health going, going forward. All right, Barry. You're on.
Barry: Yeah, thanks. I I have uh a few, a few of the concerns and and actually they, uh, some of them, uh, really do hit at a, you know, more personal level and others are a little bit more, uh, I guess I'm going to join Clarence at the 10,000 foot level even though I'm afraid of heights. Um, but we'll, you know, we'll see where that goes. But I I think, uh, some of the things for me is the understanding that health in the United States, health in Minnesota is really global. It's not just local. Um, and so the things I worry about are like drug shortages as an example for, you know, there are a lot of drugs where there's a shortage. Not even thinking or worrying about the impact of tariffs and costs of drugs, which is another whole, you know, whole issue, you know, right now, but just an actual shortage of, of drugs. Um, at a more personal level, not surprisingly being a healthcare, uh, provider or former healthcare provider, um, in a direct way, a lot of my contacts are in the health field and the big anxiety for providers, uh, is not only the increased stress of burnout. I think Matthew, you know, highlighted like he he picked the perfect time to get to get into public health just before COVID, but this is just, you know, people have not in the healthcare field have not recovered yet from COVID. And this is like piling on. So I'm very worried about, um, increased, uh, burnout, uh, within, you know, among healthcare providers, doctors, nurses, nursing assistants, just, you know, from top, from top to bottom. And then the other thing is at at a a little bit higher level, there are so many people that are losing their jobs in these agencies, uh more in the public health sphere rather than direct care, um, that really drive the engines of innovation in our healthcare system. And so, you know, like one, one example that, you know, I chatted about before we went on air, um, is I have a relative who's receiving cancer treatment and what's going on now with a lot of the uh funding for universities where a lot of cancer research really takes place. Um, like I say, this relative is probably needing going to be needing to go into clinical trials and what's going on right now with the whole funding uh situation and uh sort of like targeting, um, seems to be anything to do with health. Um, she may not have options for clinical trials for, you know, for her cancer and that's going to directly impact not only for her in terms of uh, you know, prognosis, but for many people across the board in terms of mortality and morbidity. And I better stop there because because I can keep going on, but I'll be quiet now. Those are just a few.
Host: Yeah, and you know what? We all, you know, everything, you know, everything that's been said so far, we all own that. So all the all the things that that that Matthew's noted, Clarence noted, Barry's noted. All right, so now let let's let's keep going here. All right, so Sheridan, you're up.
Sheridan: Sure. I mean, I have a lot of big feelings if I'm being honest. Um, I'm graduating, uh, with my masters in the next three weeks here that I've been working on for a while. I lost my grandma during COVID. I was in grad school at that time as or that's what kind of inspired me to start grad school. So it's been four years part-time while I work full-time in research and I do health chatter, which I love doing all these activities so much. Um, but now I'm looking at a new stage in my life where I'm excited to start applying for jobs. There's no public health jobs out there right now. Um, it's a hiring freeze or hiring cool in most federal agencies, in a lot of research hospitals and a lot of research centers, in, um, a lot of nonprofits, uh, for profits. Everybody's struggling. Nobody knows what's going on. It's really that uncertainty that we talked about. And, um, I'm a really driven person. I'm really excited to take on more responsibility and take on a new title, but it just doesn't seem like it's going to happen for me in this climate. Which is obviously a personal concern. Um, on a broader scale, I worry about the disintegration of the systems that support health and community and the impacts on health that that will have. And certain communities are obviously feeling this more. I'm a really big, uh, social justice advocate and seeing human rights be violated. Not only do I worry for their health, it just really hurts my heart seeing human beings not be treated like human beings. And I think that can be true for a lot of things that we're seeing happen right now. Um, so overall, I'm, while I'm concerned about myself, my professional, my career, my professional life and my career, I think I feel more anxiety and uncertainty about our patients, our participants, and the people that we want to see healthier and happier.
Host: We can add all of that to the list. Um, All right. Deandra.
Deandra: Yeah, so I would say, um, just kind of jumping on to what Barry kind of said just because I work in research, um, clinical research at the U. So, you know, a lot of those, you know, government funded, um, studies, you know, have been affected and, you know, thankfully for my team, we do a lot of business and industry, but, um, it's just tough to see because a lot of those government funded studies, you know, are directly related to things that are really affecting public health and people today. Like a lot of cancer studies and just a lot of studies that need a lot of funding and, you know, so for me, it's just kind of tough to see that because it's, you know, for me, I'm in the a lot of business and industry studies, but I feel like we need that balance of, you know, business and industry is great. I think they do a lot of great studies. There's a lot of things that they've done to kind of further public health research, um, in a lot of different areas. Um, but a lot of this government funded research is really directly related to, you know, diseases and diagnosis that people are dealing with every single day. And that is like more directly related to the public population, where for me specifically, I'm only working in hematology. So this is a very, it's a rare disease group. It's a very like small niche group that may not affect as many people and not
Host: Oops, we lost Deandra.
Deandra: Oh, there you are. Sorry, I think it got muted somehow. What was the last thing that was said? Sorry.
Host: So, all right, so, you know, I realized that there's, there's personal aspects to what we're talking about here. There's, um, professional aspects, there's, um, community aspects, research aspects, etc. I want to hear from Aaron. So Aaron, what we're doing here is, um, we're going through and everybody's kind of listing out and they're for the show. Um, what's concerning you as it relates to health and what's going on in today's environment. Hey Aaron, there you go.
Aaron: Um, yes, I'm also trying to think how I want to consolidate my answer. Um, I think the first thing I think about is professional for me. Um, I worry about the people that we serve at our FQHC that without us, otherwise don't get the care or resources that they need. I think about people who sleep outside, um, who maybe are dependent on substances and will not have the resources they need to live a safe life without this FQHC. And I worry with some of the cuts that have happened and are continuing to happen and people are saying are going to happen, um, will take those resources away. Uh, I know my organization has already been affected by some of the grant cuts, one being the traditional health program. So a lot of the funding that funds the cultural things that we do at the clinic, um, are no longer. They lost a few positions in that department. And then the maternal and child health program is also no longer. So anybody who is employed under the maternal child health grants that were given to the state by the federal government and then the state obviously had to cease those programs. Um, we don't have a maternal child health program anymore. We don't have an OB case manager anymore. And so the 27 women that are pregnant at our clinic are going to see a disruption in their continuity of care and their care coordination and like the overall satisfaction of the care that they're getting because we don't have those positions anymore. And the money is just gone. It's not any notice, hey, your money's going to go away May 1st. No, it's gone effective today. There's nothing we can do about it. Um, and I think that's the jarring aspect of it is that it's gone now and you're not going to get it back and you have no way to prepare for tomorrow.
Host: All right. Um, let me add a couple things here. Um, what has struck me, um, over the last, you know, three months is, um, the immediacy and the processes that have gone on. And it it appears as though decisions are are literally based on, uh, saving a dollar here, saving a dollar there. Okay? Without realizing the the overall implications, um, for health. I've often said that, you know, if you don't have your health, we don't have anything. And, um, and and this is true for everybody. I don't care what whether you're Democrat, Republican, independent, doesn't matter. When you're sick or there's something that's going on in your community or there's an outbreak. It's like we depend on on certain things in order to assure our health. And that's being compromised. And it's one thing if it's compromised, it's another thing if we realize after the fact that, oh my God, what did we do? And it's not so easy to get these things back up and running again. So that's kind of a of of a major concern. Um, Stan, I want to say something real quick.
Host: Yeah, go ahead.
Clarence: Uh I know that you said that it's that uh it's around saving dollars. I I I think what I what I sense and this is from my own personal perspective. I think it's about what the people people like or dislike something. I mean it it's it's not it's not even about, you know, whether or not they've been the research that's been done about what the effectiveness of the project. It's like, I I just don't like this, so I'm just going, I'm in a place where I can just, I can dismantle it and I'm going to do that. And I I I and I think that that for me is is a more dangerous space for all of us is that, you know, it's now based on either you comply or you die. You know what I mean? So that that for me is, you know, like, you know, like I said and that might sounds kind of kind of harsh, but that's how I feel. Comply or die.
Host: Yep. And, um, here's the other thing and and maybe some some of you can chime in on this. Do you think the public cares? Really cares. In other words, oh, we're saving money by doing this. Great. Let's keep doing it. Okay? As opposed to truly understanding, um, what implications this has for our our health. So, I I just wonder whether there's, um, enough of a level of understanding that, um, drives people's concern that these things should be continued. Yeah, go ahead, Sheridan.
Sheridan: So I have a lot of folks on all sides of the aisle across all walks of life in my life. And I can say from what I've heard from people in my life and on social media, there is a certain percentage of people that do support these indiscriminate cuts, that do think that saving a few dollars here or there is worth it in the in the end. But I would say a majority of the folks that I talk to in both my professional life, my school life, my personal life, my family, and on social media, I would say a majority do care and do see the value in these services, especially when we're talking about stuff like cancer research, kids research, um, I mean there's there's a lot of people that especially if it personally affects them or if it's something that really tugs on the heart strings, I think we can get a lot, um, of attention in those areas. But I think the areas that are slipping under the rugs are like LGBTQ research and things like that that maybe not everybody agrees on or sees the value in. But when we're talking about losing kids cancer research, people are getting fired up for sure.
Host: Yeah, Barry.
Barry: Yeah, so I'm going to pile on a little bit with with Aaron, you know, here as well. Um, I think part of the problem is that at one level people don't know what they don't know. And the information they get is not very clear. And so it's very easy for that to get distorted and so people may go down a track of supporting something or at least tacitly supporting something that if they had all the information in a clear way, they probably wouldn't support it. That being said, um, I think what's going to wind up happening is that when people start to be impacted directly by these things, that's going to be the wake up call. And I'll I'll use Aaron's example of, you know, childhood cancer. When that hits, you know, in a community and they start to see that with their neighbors or their own family, it's like going to be, you know, I, oh, I what, you know, what the heck is going on is going on here. So I I think and that and this is going to take time clearly for it to play out. Um, the other thing is that rural America is in some ways going to be even more impacted by all these things that are going on and at least uh, you know, demographically that um, support for the current administration has been, you know, a lot more in in rural in rural areas. So when that comes home to roost, then maybe people will understand that. The other one last thing is that some of the public polling that I've seen has shown that there's been significant shifts again, building on what Aaron said that most, most people, you know, all now are seeing this are not supporting this. And that number continues to grow week to week and month to month. And so I, you know, I'll I'll te up because I know we're going to wind up going there during the show when we talk about what people can do, uh, because Stan as you said, you know, to just be sitting on your hands and doing nothing doesn't help our anxiety. Um but but I think the trends of what's happening is there there is an awakening that's happening in the population. And that awakening uh has to unfold and takes and takes time, but I think we're seeing the direction that it's going in.
Host: You know, one of the things that that that that's not just one, a lot of things that we're dealing with, but one for sure is the immediacy of the information that we get, um, either through the news or social media, um, and you get into this reactionary state, um, quickly. Um, what I'd like to do for our listening audience, our research crew, um, put together, you know, some of the things that have hit us so far. Um, and you know, it's kind of like we have to ask this question. All of us have to ask this question, what effect will this have? So, what effect will it have, uh, given the fact that we've withdrawn from the World Health Organization? What effect will it have by eliminating DEIA and for everybody that's diversity, equity, inclusion and accessibility programs and and policies? Um, what effect will it have, um, when we have to totally realign our US foreign aid? Um, what effect will it have when, um, our our government now through an an executive order, um, recognizes only two sexes, you know, male and female. Um, what effect will it have by removing those people from any care that they might receive through the existing, um, affordable care app? Um, Oh goodness. Um, funding, um, layoffs. What effect will that have in the immediacy of the situation and then when we get our wits be, you know, back to hire these people, these true professionals back. Are they willing to come back into the into the field? Um, university research is being compromised. Um, etc, etc. So these are there's probably more on this list. In today's paper, the Minneapolis Star Tribune, but it also hit the national scene as well. Um, that there is going to be a 40 billion dollar cut in health and human services. Now, this includes, um, a variety of different things, but one of the, one of the agencies that's really going to be hit is the, um, the centers for disease control where many, many programs are going to be cut drastically and, um, in many situations, um, eliminated. Um, and this by the way includes on both sides of the equation, infectious disease and also, um, chronic disease. So, um, here's a major concern that I have. Um, is our professional talent and our new and budding talent. Um, what, what's going to convince people to, uh, young talent to get involved in medicine? What's going to, um, get them involved in, um, in public health? What is it going to take to get them involved in community service? Um, and how is it that we can help? So one of the things that's that's that we're going to be doing here in the in the state of Minnesota, this might land up being done in other states as well, is that those that have been in the field, um, and who are very, very well connected, um, with with various people in the field will help mentor those people that were laid off and also new talent that are trying to land themselves into, um, into new positions in the health field. That's being coordinated here in the state of Minnesota by a former commissioner, Dr. Ed Ellinger. And that'll be happening within about the next two weeks. One thing that we're going to be doing, um, and again, this is kind of taking the hands out from underneath and and trying to do something. We're we're hopefully going to be doing a live show. Uh, health chatter show where we will be able to have audience participation and it's not the intent of the show will will not be to, you know, list out in many ways kind of like what we're doing here, um, the things that are troubling, but everybody will know what those things are and it's like, okay, let's put out some ideas and how it is that we can proceed in these, um, in these times to assure the uh the safety and and care of of people at the individual level and community level. Um, it will, we have gone through tough times, um, and we will we will we will get through this one way or the other. It's just I think what we're all anxious about is what will be on the other side. Clarence, thoughts.
Clarence: Yeah, you know, I I I think as you were talking, I think that for me, and I'm I'm coming from a community perspective, okay? Uh, not a clinician. Uh, for me, I am just trying to figure out what we can do. I'm trying to figure out based on on relationships, based on collaboration, uh, how do we move together? And I'm speaking from community perspective. How do we move together collectively to do what we can do? Because there's so much so much transition that's going on that, um, if we look at, you know, we look at everything, we can get kind of confused, but if we can talk about what do we specifically bring to the table, I think that that makes it a little bit easier for me to be able to to figure out, you know, what what we can possibly do with with whatever comes down the pipe. I don't know, you know, but but but the point is I'm not going to give up. I mean, you know, part of part of my work is that, you know, I am I'm truly committed to making my community healthier and so I I I'm gonna get in where I can fit in. And so, I I again, I'm taking that that that 10,000 foot level to say like there's some things that are totally out of my control, right? But there's some other things that I can do working with people like you, working with, uh, you know, like you said, with with Barry, with the with the with the other, uh, uh, our other colleagues. There are things that we can still do based on what what comes down. So, I'm gonna leave it like that.
Host: So Clarence, I have a question for you. All right, so you're, um, involved intimately with with, um, Human Partnership. And I'm sure, you know, as a community organization, you know, they're dealing with this. So how do you, how are they responding or how are people feeling, you know, based at at Human?
Clarence: I think, you know, saying I think we we are like the rest of the population. I mean, there there's struggles that we we've had some of our, some of our colleagues that that have been involved with the loss of funding and things like that. And we're just trying to figure out what we can do at this time. That sounds really, you know, like I said, that sounds like really pie in the sky kind of thing. But I I do think that, um, by finding out specifically what is available and being able to to uh, to work with that is how I feel like we have to move ahead. I can't do everything, you know what I'm saying? And and like I said, a lot of these decisions are totally out of my, out of my realm, beyond my pay grade, but I still have to figure out how do I creatively help my community to stay healthier.
Host: So, should let me just throw this out. So at CDC chronic disease programs are going to be cut a lot, okay? Um, and one that's near and dear to my to to me is in the area of of heart disease cardiac arenas. Um, heart and stroke. And, um, you know, just because we cut these programs doesn't mean that these that that people aren't going to suffer from heart diseases and and strokes. Um, so what do you think? I mean, okay, I I want to hear from the younger gang here. So what what do you think? I mean, it's just like, does this does this trouble you at all or we'll just have to wait and see or what what's your thought on that? I mean, that's just one arena. Any thoughts? Matthew, you got an idea?
Matthew: Yeah, I mean, I would just say it's deeply troubling. I mean, I, you know, when I think about our society as a whole, I have this like idealized view, I guess, of what we should invest in and I understand that everyone does. But I think that like health is at that core. And so the idea that like money is just being and not a small amount of money, right? Like this isn't like, oh, we're sunsetting a couple of programs that have not been effective. I mean, just completely yanking the rug out of so many programs and just completely upending the way public health and the way research is conducted is yeah, it's deeply troubling. And I don't even know, you know, similar to other people, it's like I don't even know what you do. Like I I don't think I I have no I'm at a loss of words of what to do. You know, it's just kind of like writing it out if you will.
Host: Aaron, what do you think?
Aaron: This darn mute button is going to be the bane of my existence today. Um, I think I have to echo Barry that uh the work we're doing is important, um, and at the end of the day like Sheridan said, we care immensely about the people that we're helping and we need to keep that in mind. I think the other side of the coin is that this is extremely upsetting for the arenas that we're sitting in and I am sending emails and making calls to our federal representatives weekly, giving them updates on what's happening in my environment. Um, senators and legislators, um, and I think that's important too. People, I think sometimes forget that those people are serving us, um, and and letting them know that the things that are happening right now are affecting their constituents is also really important. So if people are looking for tangible things to do, that is absolutely something that you can tangibly do to advocate for yourself and your community.
Host: Yep, yep, yep. Deandra.
Deandra: Um, yeah, I think it's, you know, for me I just want to, you know, kind of focus on, you know, doing my job and, you know, kind of taking care, kind of what Sheridan was saying about her mental health being affected, you know, we have to in these hard times like try and take care of ourselves and, you know, remember what we're doing is important and just, you know, maybe take a step back sometimes if we're just kind of struggling with everything that's going on. So I think that's kind of how I'm feeling right now about everything is, you know, wanting to continue to do my job, continue to help people, but also, you know, sometimes taking that step back and and making sure I'm okay.
Host: Yes. So, I've been sharing, you know, Barry's got the, you know, one word, you know, we we need to be resilient and and strong. Um, what I've been sharing and I want to share it with with our listening audience is this. Um, tend to your garden and don't compromise your values. Don't let in hard times, it's easy to get your values compromised, don't let that happen. I want to thank everybody for for their insights. I know this is not this is not an easy subject, but we're we're not in easy times right now. But, um, trying to stay positive is best we possibly can and if we need each other, all of it and it goes out to the listening audience, do something that's positive, even if it's even if it's walking your dog because they have an a unique perspective on putting things in perspective. So with that, thanks to everybody and everybody, keep health chatting away.
