From a Great Society to a Resilient Society: Episode 2 – Public Health

[0:00:00 Speaker 1] This’ll is policy on purpose. Ah, podcast produced by the LBJ School of Public Affairs at the University of Texas at Austin Way take you behind the scenes of policy with the people who helped shape it. For more, visit LBJ dot utexas dot e d u For [0:00:25 Speaker 0] the next installment of our podcast, we’re going to explore why improving public health is critical to building a more resilient future. I’m joined by my two terrific LBJ colleagues, Professor Sherry Greensburg and Dr Michael Whole Sherry and Michael. Thanks for joining us. [0:00:39 Speaker 1] My pleasure. [0:00:41 Speaker 0] Thanks so much for having us. So Michael, your a pediatrician for families without health insurance, those experiencing poverty and homelessness here in Central Texas and some of the folks that are really, frankly the hardest hit by the pandemics effects. What are you seeing on the ground? Well, start with the bad and move on to the good. The obvious is that these folks were already behind the eight ball and hurting, and the pandemic put a lot of those issues that they’re facing in the spotlight. Eso to give you some examples, a lot of the families I care for use public transportation to get around town, and then all of a sudden the pandemic hit and getting on a crowded bus or a crowded train means potentially putting your life at risk. Um, students. A lot of the Children, of course, are now at home trying to learn well, if you’re in a family that doesn’t have access to broadband, that’s an issue saying goes for food. Ah, lot of families I care for The Children are relying on school lunches, sometimes school, breakfast for nutrition and now all of a sudden, there at home without that access. So the signs of malnutrition are written all over the bodies of students that I care for that air now at home more than they used to be. A lot of parents are essential workers, so, as you can imagine, they’re keeping our economy is going. But putting their lives at risk as a result. And, of course, of the economic downturn has affected so many of, uh it’s especially hit the pocketbooks of these families hard on. That means that they might not be able to afford the prescriptions that I write well food or keep up with their electricity or rent bills. The good is that we’ve seen a boom in telehealth services. We had some restrictions on those services lightened amid the pandemic, and we’ve seen some positive things from that. Mobile services for health and social services have seen an increase in improvement in their processes, which was forced essentially because we had to go and find people where they meet and frequent and trust on. Then, of course, a lot of remote connection to social social services. So applications that used to be, you know, paper now being moved online so that families who do have access to the Internet can fill them out. So it’s a mixed bag, but I think the bottom line is spokes air hurting more than they used to be because the pandemic. So, Michael, do you see some of these technology and innovations that are happening in the way that we’re providing care to population sticking around after the pandemic? I hope so. I mean, at least the good ones. I think it’s forced us to learn quickly about one how very cross sector these problems have become. Um, it’s no secret that there’s a whole host of things beyond medicine than impact people’s health. And so in some ways, the pandemic has allowed us to work across disciplines with people from the food industry or from the housing industry. From what have you more closely with the medical system, I think that those kinds of benefits are going to stick around for a long time because people have been able to see, Oh, there’s a lot of power at the intersection of discipline that we should be tapping into that even more so than we’ve been doing in the past, Yeah, I mean, it’s interesting you mentioned that. I mean, much of my work is in urban development in city economic development, and, you know, as someone that has been in that space for a long time, we never really thought about the role of public health in our economic development, community development strategies. But many of us now are coming back to say, Well, how does public health tie back to our You know, the way we think about our built environment, the types of jobs we’re creating in such eso, I agree that’s one of those civic innovations. Hopefully, that will hopefully see stick around. Perhaps so Sherry, you’re the chair of central health. That’s our local health care district here in Austin. For those that are not familiar with that organization on Do you are really in the thick of policy discussions about the vaccine roll out here in central Texas from a community health and resiliency standpoint? What do you see? Or some of the largest challenge that we that we face in terms of the vaccine roll out [0:04:41 Speaker 1] in terms of the vaccine rollout? Certainly from a community health and resiliency standpoint, the biggest challenge is equity and disparities. At central health. We provide health care for those at M below 200% of the federal poverty level and without health insurance. And what we’ve seen with the vaccine rollout is, of course, a lack of supply, a lack of the logistics that are needed to really get those shots and arms. And from a community health and resiliency standpoint, we need those individuals who we know our biggest risk and risk is not just dictated by age. It could be by zip code because you are living in an area where we know there’s higher incidence of disease and of death. It could be as a result, as we were talking about of your living situation from a public health standpoint, multiple generations in crowded conditions and because of your occupation. If you’re not in a privileged situation where you’re working from home but are out working in the community, so from a covert vaccine roll out, we really need to be focusing on the health and safety of those people who are most at risk. And that’s a number of factors. Is I just enumerated, and those people who really must be out in our community to keep our economy going? [0:06:02 Speaker 0] Yeah, so one of the things I think that you’re highlighting here is really tying. Um, sort of our economic policies and particularly maybe some of our community, local community development policies with our public health policies is we’re thinking about the rollout of the vaccine. [0:06:16 Speaker 1] Absolutely. You cannot separate the two. They’re joined at the hip when we talk about our public health policies and our economy, if we want to get our economy fully functioning, then we have to solve the issues with the vaccine roll out. And that is all the way from the supply to the cold storage to the logistics to the focus on who is getting the vaccine and when. You know, we’re just not in a situation now where we have an abundant supply where we could have people, uh, literally driving through, sticking their arms out the window and getting everybody vaccinated to get our economy up and fully running. We also have to keep in mind that the very same individuals who may have difficulty getting vaccines because of where they live or lack of transportation, lack of technology are many of the same, uh, individuals who are suffering from the economy. They may be unemployed or underemployed. They may be in a situation where, if they do not see additional help, they could frankly be homeless because they could face eviction At some point. There have been moratoriums on rent and eviction, but those will go away and the the the rent will come. Dio [0:07:30 Speaker 0] Yeah, so, Michael, one of the things that I I find really inspirational about your work as your colleague is how you’re always marrying the public and the private and non profit sectors to kind of address health issues, particularly through the roll out of new ideas and civic innovations. [0:07:46 Speaker 1] Can you tell us a little [0:07:46 Speaker 0] bit about your work in that space and particularly how it’s relating Thio the pandemic right now? Sure, I’d be happy to. Well, as I mentioned, uh, these cross sector problems are going to need cross sector solutions, and the other reality of that work is that I’m a big believer in human centered design. And that’s to say that the people who understand the problems we’re trying to solve best are the people actually facing those problems. And so we’ve got to start to work alongside those individuals as we create solutions. One of my big jobs here at University of Texas at Austin is running what we call the impact factory, which is this engine for social innovation and entrepreneurship and service learning. What we try to do is to tap into business tools and human centered design rigorous evaluation to build up these new programs that are bringing cross sector partners together to create these new solutions that haven’t been tried before. So we’ve got a few examples of those that have been impacted by the pandemic, in particular in out there, tackling some of these big hairy social problems like poverty and hunger and homelessness that I think require us to look at them in a fresh new way. Yeah, I think one of your company’s is good Apple. Um, that’s a grocery service delivery that’s trying to deal with food insecurity. Tell us more about that. That’s a great example of one of my favorites. Oh, sure, thanks. Uh, well, good apples, Grocery delivery service on a mission to include insecurity. And it started out as one for one model. Essentially, you are Professor Greenberg or others were to buy a box of fresh fruits and vegetables. Then we use the profit margin from those proceeds to subsidize the delivery of a box of those same fruits and vegetables as well as other pantry staples to a family who has been identified as food insecure amid the pandemic. And this is one of the lessons that I think was imparted on our team. Certainly we were able to leverage that infrastructure to start to deliver toe other populations around the central Texas area who were in need. So now, because of what we call our stay home stay healthy initiative, we’ve been able to deliver about £800,000 of food to 26,000 older adults and people with weak immune systems on back to that cross sector thing that I keep mentioning. Over and again, we’ve got farm partners from whom we buy our produce. We’ve got food pantries and banks that we get some of our dairy and meat and other types of produce. We’ve got transportation, private sector partners that help us deliver these goods. We partner with the city of Government to help us orchestrate and identify populations. The greatest me, of course. We’ve got student entrepreneurs leading the charge and, ah, whole host of philanthropists from private sector industry as well as foundations in town. So there’s Ah lot of different stakeholders at the table all focused on this one issue, and I think that’s something that I hope we continue to carry forward. Post pandemic. So, Michael, what’s needed to scale these ideas? A lot of these ideas seem like they’re having impact locally, but if you’re looking to scale these on a larger front, maybe the other cities or throughout the throughout the country, what you need to make these have, ah, large, maybe a greater impact. It’s as we look towards a global U S market? Sure, sure. Well, I think one of them is We need to be able to one create revenue generating financially sustainable solutions. Um ah, lot of the philanthropy that we have seen Boom at the beginning of the pandemic has slowed a bit. And so we just know, like we always had that We can’t rely on that for some of these social impact solutions. The second is that we’ve gotta marry these ideas with rigorous evaluation. We need to know if we have the data to support that we’re having the impact we hope we are. When we have those data, we can take that to policymakers and others and positions of influence who can help to institute these programs at a larger scale. And then once they do that, there will be gaps inevitably, and then entrepreneurs and innovators like us. If the impact factory can step in, create new solutions, study them, get more data, go back to the policy makers and it’s a cycle of shorts. Yeah. So, Sherry, sort of in that same sort of line of questioning. How is central health working with the private sector? to advance your efforts. [0:11:50 Speaker 1] Well, Central health works with all sectors, and I completely agree with what my colleague Michael has just said that we need cross sector collaborations with academia with the private sector with the public. With the nonprofit, we have the Emergency Operations Center, which Austin Travis County Public Health, uh, initiated at the beginning of the pandemic. And we have central health involved with that. We have our private sector, uh, actors. We have our hospital systems, so this really takes the entire community pulling together. [0:12:27 Speaker 0] And if we’re gonna address, you know, the vaccine roll out as we think through the role of the private sector. You know, what role do you see in terms of the private sector helping toe achieve those goals? [0:12:39 Speaker 1] We certainly need the help of the private sector. We need the help of the private sector. From a technology standpoint. One of the things that we’ve seen with the vaccine rollout is legacy systems, right. The I T systems that the state has doesn’t work with the city with the county with central health, we have seen disparities as far as access to broadband, you know, in 1936 Congress passed the Rural Electrification Act. I think it’s time for universal broadband Broadband should be a utility just like electric and water and wastewater contract tracing, which we still need. And, of course, with the actual rollout of the vaccine, we have seen that we need our private sector partners and pharmacies, Whether it’s an [0:13:21 Speaker 0] HPV [0:13:22 Speaker 1] or Randall’s or Walmart. They all have a role as well as the private sector technology sector. [0:13:32 Speaker 0] Great. And maybe a final question for both of you. And maybe Michael will start with you. You know, how optimistic are you about the future and sort of being able to get this pandemic under control and then really planning for those in the future? Well, look, it’s no secret we face multiple crisis, right? We’ve got the worst pandemic in 100 years. Worst economic downturn, perhaps since the Great Depression. Most compelling call for racial justice since the 19 sixties raging opioid epidemic and Heartland, which took my cousin’s life Thanksgiving Day of this past year. Uh, folks, aer hurting, but it is my belief, and it’s a deep belief that for all of that hardship, there isn’t anything Americans can’t do if we accomplish it together? Um, we put a man on the moon. We’ve ended world wars before we’ve eradicated the disease before. And so these air just today’s challenges. And to borrow a phrase from our school’s namesake, when the Johnson we shall overcome these two. Andi, I think that’s for me, embedded in monetary deep privilege of having the chance to work with tomorrow’s leaders of students. And I have got a chance. I think, like you and Professor Greenberg have to see their passion and their talent and their creativity and their energy across campus. Uh, in their commitment, like all of us on this podcast, too, seeing a brighter tomorrow. So I’m optimistic. I hope everybody else’s too taken army for sure, sharing any thoughts on that question in terms of looking to the future. [0:15:02 Speaker 1] Certainly I think we learned from history, but we move forward. We’re not going back, and we do need to seize the moment. We have seen with the Koven 19 Pandemic that things that were long standing in our society health disparities, racial injustice, the need to focus on the social determines of health. These were always there. They have come to the forefront. But since they are at the forefront, that does give us a chance to learn from history to seize the moment, to work with our students and young people for a brighter tomorrow. And Thio further accelerate some of the aspects that we have seen that have been beneficial two people. So if we talk about, for instance, health tell the medicine has been of great benefit to many people who, either because they were in rural areas or they didn’t have transportation or they were homebound could not get the care that they needed. So it is time to forge ahead. [0:15:57 Speaker 0] Michael. Working folks learn more about your work. They could go to www dot the impact factory dot org’s and share. What about you? [0:16:05 Speaker 1] Certainly you could certainly go to the LBJ School of Public Affairs as well as good systems, which is one of the grand challenges of the University of Texas at Austin. Uh, the Public Interest Technology Day One challenge. I have a paper there and Austin Forum on technology and society. [0:16:22 Speaker 0] Terrific, Professor Greensburg. Doctor Whole. Thank you both for joining us for this conversation. Thank you both so much. [0:16:29 Speaker 1] Thank you. my pleasure. Thistles. Policy on Purpose, a podcast produced by the LBJ School of Public Affairs at the University of Texas at Austin Way take you behind the scenes of policy with the people who helped shape it. To learn more, visit LBJ dot utexas dot e d u and follow us on Twitter or Facebook at the LBJ School. Thank you for listening