Numbers Don’t Lie: Harnessing Data to Improve Health Equity

Speaker 1: (00:09)
Hello everyone and welcome to a very special collaboration between matter and millennial beacon, uh, conversation on health equity with the Morehouse school of medicine's stature, health leadership Institute. Uh, my name's Steven Collins and I am the CEO of matter matter is a healthcare technology incubator in an innovation hub with a mission to accelerate the pace of change of healthcare. Last year, we launched a series on advancing health equity, uh, featuring a conversation with Chicago public health commissioner, Alison Awadi and Chicago community trust CEO, Helene Gayle today. Uh, I'm delighted to continue that conversation broadly, uh, and we've partnered with millennial beacon, uh, in order to do so. Uh, millennial beacon is a healthcare incubator based on the south side of Chicago, uh, focused on improving the factors that determine health and overlooked, uh, populations and the focus of today's conversation will be on measuring and quantifying health equity.

Speaker 1: (01:09)
As the COVID 19 pandemic began, uh, the Satre health leadership Institute began work building the health equity tracker, which is a data visualization tool that displays the scale of COVID 19 cases, deaths, hospitalizations across a number of dimensions, race, ethnicity, sex, and age from a, uh, macro country level view all the way down to the county level, um, with an overall goal of making the data accessible ingestible and beneficial to everyone. Um, the Institute was founded by former us surgeon, general David Satcher, and their mission is to create systemic change at the intersection of policy and equity by focusing on three areas, the political determinants of health, health system transformation, and mental and behavioral behavioral health, uh, Nelson Dunlap, the Institute's chief of staff. He spearheaded the health equity tracker, and he's here with us today to discuss its Genesis and its impact, uh, to discuss leveraging data and research, to advance innovation in healthcare.

Speaker 1: (02:18)
Uh, and talk about how to design technology, uh, to be inclusive. Uh, as chief of staff Nelson leads the government relations and health policy initiatives of the Institute, and works very closely with Dr. Satcher on the Institute's, uh, priorities. He also serves as the senior advisor for legislative affairs for the health equity leadership and exchange network, which is a national network designed to bolster leadership and the exchange of ideas and information among health equity champions. Uh, leading the conversation today with, uh, Nelson will be Dr. Vieta Johnson of millennial beacon. Uh, Dr. Johnson is an orthopedic surgery specialist with more than 30 years of experience. Uh, she is only the 10th black woman orthopedic surgeon in the United States. Uh, thank you, uh, Dr. Johnson for your partnership generally, and for leading today's, uh, conversation, uh, special thank you as well to, uh, Pandora and of Sirius XM for supporting, uh, this event. Uh, so Nelson's going to, uh, provide a short overview of the health equity, uh, tracker, and then Dr. Johnson will come on to, uh, facilitate the conversation, uh, Nelson, thank you so much for joining us. Uh, we are really looking forward to your, uh, presentation and the conversation, uh, that ensues.

Speaker 2: (03:40)
Thank you, Steven. That was, uh, a phenomenal introduction. You did not have to go that far in depth for me, but I do appreciate you giving, uh, Dr. Johnson, all the kudos that she deserves. Can you guys hear me loud and clear? Perfect. Um, so, you know, let's just jump into it, um, correct me if I'm wrong. Cause I know it's been, uh, you know, it's been a long time coming. It's been a while for us to get this up and running, but I believe matters. Vision mission tagline is, is something along the lines of focusing on mobilizing a community of healthcare innovators who aspire to heroic change. And I know that millennial beacons is all about, uh, building out a pipeline to innovation in healthcare. And so it feels good to, you know, to be among like-minded folks. You know, I earnestly believe that innovation and the fight for health equity are not mutually exclusive.

Speaker 2: (04:29)
And that has always been one of, kind of the, the foundational foundational principles, uh, undergirding our health equity tracker. Um, so I should be speaking to folks who get it, but even still, I, I know it's worthwhile to, to really walk through what this is all about. Uh, about a year ago, May, 2021, we launched our health equity tracker, which you guys can all visit and I would implore you to at health equity, tracker.org. Um, but as many of you know, in the, as many of you in the tech space would know the launch, uh, of this tracker of this website. The launch of anything always is preceded by months and months and sometimes years of planning and work. And we spent a lot of time thinking about the gaps in tracking health, equities across the country and what that would look like. And we landed on a strong need for a single scalable platform that brings in all of the complex and dynamic sources of data, uh, related to health equity in one place, kind of a one stop shop. And the overall mission has been and continues to be and will continue, uh, to be, to support data driven decision making at all levels, but especially for policy makers and policy influencers. Next slide please.

Speaker 2: (05:42)
So where do we begin? Obviously at the beginning of the pandemic, uh, you know, it's January, February, March, um, and COVID 19 hits. The media cycle is buzzing about the disproportionate and disparate impact, um, of COVID on communities of color. But no one is really saying why that is. You know, there's a lot of discussion about high numbers in specific communities, but there's not a lot of discussion about why that is. And those of us in the health equity space, we knew immediately why we still know why. And, and it's really, it comes down to those political and social determinants of health. It comes down to the health of, of our nation of our society. And COVID 19 was able to just run rampant based on the system that we're are already in place. Right. And the key to telling that story is having the data to do so.

Speaker 2: (06:35)
But you know, we know that it's hard to tell that story if you don't have the data to tell the story, right? So for far too long, it's been effectively, no data, no problem. If there is no data to highlight an issue, then there obviously is no problem. And so we, if sat health, leadership Institute and more household medicine sat down and said, okay, well, if we can, if we can get our hands on some data to present you with the data, then what comes next, right? For, you know, there, there are data gaps specifically lacking in the areas of race and ethnicity, socioeconomic status, disability status, chronic conditions, mental health, youth, and young adults. You name it any really any group there's most likely a data gap in, you know, representative of that group. And because we know that this invisibility and unavailability of health related data hinders our, our collective ability to address the needs of vulnerable populations, especially for populations with small populations and stigmatized groups, we wanted to do something about that.

Speaker 2: (07:32)
So we set out to identify size and scope, you know, and it became central to the development of concepts that, you know, call out disproportionate impact and data gaps that really hinder us from, from understanding and telling the full story. And so, as we were sitting there at the beginning of the pandemic, you know, we had more time on our hands, um, than previously we, and we just kinda sat it on the table and said, what can we do? We being more household medicine, we being in C health leadership Institute, we are trusted messengers. How can we, how can we use this moment to do something worthwhile? And so we were fortunate enough to partner with some, some very, uh, well known and very resourceful partners, such as google.org, which is, uh, the foundation side of Googled sciences, the CDC foundation, Annie E Casey foundation at a R P.

Speaker 2: (08:20)
And they said, whatever you guys think is best, we are here to help you out. And with google.org specifically, they not only provide us with funding, but they also provide us with that all important manpower. You know, the, the, the folks who could really hit the zeros in one to help us build out the health equity tracker. And so we worked with a team of about 15 to 20, um, engineers, data scientists, UX, engineers, UX designers, you name it to really build out this health equity tracker and try to do something, you know, to, to leave an impact and, and help the most vulnerable among us. Next slide please. So, as we said on this Jo out on this journey, we coalesced around really three central pillars that have become core features and central to our philosophy on the gaps that the health equity tracker should fill.

Speaker 2: (09:07)
First and foremost, there needs to be a clear path to driving policy that advances health equity, you know, this is a health equity tracker, and I could still remember a number of conversations we had over, you know, around the virtual table about what to call it. And we, we decided on the health equity tracker and not a COVID 19 tracker intentionally, you know, there were then, and there still are a number of trackers out there that look at COVID 19 specifically, and they do a very good job, uh, at that. But we wanted this to live beyond that, you know, it has to outlive, you know, the prayerfully receiving moment that we're currently in and really focus on helping equities and health equity and health disparities around the country. Second, rather than, you know, just add data gaps or unknown data as a footnote, we actually wanted to highlight these gaps and other data quality issues.

Speaker 2: (09:53)
So action can be taken, right? So that we can say, we don't have this data because it's not readily available. And that's a problem not to just kind of, again, go with the, the flow of no data, no problem, but to say no data that is in fact a problem. And finally, we need to be agile. We need to have a, an agile, lightweight platform that can adapt as we learn more in data shifts over time. Again, this is a health equity tracker. My plan is for, to, to outlive the moment and to continue to be able to provide, uh, to be a resource to those who need it. So it's gotta be, you know, malleable next slide please. So, as I mentioned, COVID 19 really was kind of the accelerator for the health equity tracker, but the overall vision is to go beyond COVID 19 and we've made great progress, adding additional data sets, you know, so far in our first year on the screen, you can see some of the topics that, uh, we cover today.

Speaker 2: (10:44)
And most importantly, we are engineered and designed to add more data sets over time using our existing visualization assets. Um, we have a very solid foundational platform and it has allowed us to build even more than what we launched with in may. So we've got COVID 19 vaccination data, asthma diabetes, C O P D. You know, those are those kind of, uh, comorbidities that were very closely linked with COVID 19 poverty insurance rates, those social determinants of health that can really highlight, you know, why certain communities where heart is hidden, are continuing to struggle with coming out of this pandemic and then even, you know, the behavioral health and chronic conditions and disease. And again, this is just the beginning, you know, we're going to continue to add more data sets as time comes goes along. Next slide please.

Speaker 2: (11:31)
So we launched in may of last year with five topics, COVID C O P D diabetes, poverty and insurance rate rates. But since then, we've added 14 more topics that you can see on the screen and much to, you know, I would say probably the sugarin of my technical team gonna keep adding more. Um, we recently added our behavioral health section. We'll be adding more, we're working on a groundbreaking study, looking at the economic burden of mental health inequities and, and the data coming out that will be added. And we're actually working on a legal epidemiology data set right now, which I'll talk about a little bit later. And, and this really is, you know, one of the powerful ways of health equity tracker, uh, can support change. You know, it's adding all of these interconnected and dynamic diseases, conditions, determinants, comorbidities of health, all of them onto a single platform, but always with a health equity first perspective.

Speaker 2: (12:20)
You know, you, you very frequently hear people, policy makers, politicians, advocates talk about health in all policies, right? The, the notion that you should always have a health lens to whatever policy you're advocating for implementing. And I would argue that there should be a health equity in all policy. And so that's the approach we take for our health equity track that everything you see will have that health equity lens. So you can understand what's happening in the communities around you communities in your loved ones and across the, across the country. Next slide, please. So to dive into two quick examples, um, of how the visualization on the health equity track really work, uh, and how you can first, you know, approach and, and draw out additional, uh, insights. I brought these up here. So on the left, you can see, uh, when expressed in terms of rates per a hundred thousand people, African Americans currently have the second highest rates of death through COVID, you know, with, and you can see that some of those highest rates, uh, of death are occurring in Arkansas, Illinois, Arizona, Florida, and Alabama.

Speaker 2: (13:20)
And these visualizations really emphasize health equity by normalizing cumulative numbers. And instead shifting the focus to demonstrate outside impact on the community level. I am not, uh, I'm not a numbers guy. I went to law school to avoid doing as much math as possible, but under digging out a way to really kind of dive into the numbers to understand what these large data sets can really say and highlight is important for advocating, um, for a more equitable adjust tomorrow. So not only do we get a, a feel for a comparative impact of the population, we can also identify locations. We can, you know, for several topics all the way down to the county level, which is what's really innovative and novel about our tracker. Um, and it's also very important to drive actionable recommendations. Uh, I see a couple, uh, messages in the chat. Again, if you go to the health equity tracker.org, all of this, isn't just a, you know, a static slide, you'll be able to play around with it and has all of our methodology, all of our sources, you can also kind hit us on the contacts tab and, and ask any questions you need to, and our team will get back to you, but on the right, you can see this has become, uh, one of our standup features early on when we chart the prevalence of COVID 19 cases with unknown race and ethnicity data, you know, and it's concerning today that, you know, 34.5% or so of COVID cases, nationally, don't report this important attribute.

Speaker 2: (14:32)
We need to know where, where it's unknown race and ethnicity, because that helps tell, you know, that's, those are gaps that helps us tell, understand where our, our loved ones are being lost. And we know gaps in data and unknown data as part of the health equity narrative, which is why we continue to highlight that. And we think that it's important to be able to tell those stories that aren't being told, but what's important is that meaningful action cannot be taken unless we know who is impacted and where, and that's really kind of the driving force behind everything that we're doing. Next slide, please. So shifting to how we're structured, uh, I'll quickly note that we do not, uh, collect any data ourselves. We source everything through publicly available APIs. Even the, the data sets that I mentioned that we're working on, those will be publicly available, and we're working with a number of partners on that.

Speaker 2: (15:18)
And once we find, you know, the best sources of data available, we apply our standardization process to it, which drives a visualization that you see scifi. And I'd also like to add kind of, you know, in the spirit of health equity, cuz as I said, it's, it's really kind of the layer on top of everything we do. We are open source. So we're on GitHub. That means anyone can access the platform where our technical team develops and maintains our code base to lead comments for make contributions. And we greatly appreciate that. You know, I work in H B C U we are historically, uh, systematically and systemically, uh, under resource. So we are a small but mighty team. And uh, my technical folks are always looking for more, uh, more eyes and more hands to kind of really play around with the data and make sure that we're doing this correctly.

Speaker 2: (16:01)
Next slide please. So in total, all of this adds up to 60 degree variables that are being tracked with more in development right now, you know, we've worked closely with our partners to continue to refine the strategy on the use of the health equity tracker to a wide ranging audience and, and to those with an interest or ability to influence policy for health equity. Cause again, we don't wanna just do something for the sake of doing it. We're not just trying to put something on the internet. We're not just trying to, you know, collate data. We're trying to make sure that we've created a resource that is beneficial for those who are in the business and the, the, that have the strength and the motivation and the urge to really see, uh, change across the country. We see many organizations ranging from the CDC to the white house, praising the tracker as an innovative tool for advancing health equity.

Speaker 2: (16:47)
And you know, in our first year, so far, we've had over six 65,000 visitors to the website, which is a, you know, it's a demonstration of the interest and a tool like this support of work being done all across the globe. You know, at the end of the day, um, what I continue to preach to the google.org fellows and my team about actually building the platform is that we have to, we had to, and we have to build something that's not only scalable. But's also easily usable to a wide range of users. Right. And I would always tell them, you know, I want my grandmother in rural Kentucky to be able to use this tracker just as easily, um, as the data scientist in the office next to right. I want anyone and everyone who has the urge and understands the importance of addressing health inequities to be able to get on here, find something that is beneficial to the story.

Speaker 2: (17:33)
They're trying to tell that, you know, highlights so that they didn't know, so they can continue to have that conversation. And I think, you know, the number of users that we've had thus far really indicates that we're trending in the right direction, but us having these kind of conversations and, and you folks around the virtual table being here only continues to elevate the, the topic further. Next slide, please. Nothing. I think we all know that nothing comes easy in 2022. So we we've experienced our fair share of challenges and we're going to continue, try and overcome that. Um, you know, to highlight a few, we've learned that we've learned thus far in our first year and we're taking steps to really try to mitigate through that data quality. You know, there is a, a wide range of inconsistency in terms of how data's collected, how individuals are categorized or otherwise identified, which really inhibits our ability to report accurately.

Speaker 2: (18:22)
And you know, again, that's not, so just a challenge for us to address. It's also a challenge that we need to highlight so that others who aren't so in this space and be aware of such, we could continue to kind of, you know, beat on that drum. Another challenge is standardization, you know, further, you know, within each data set, there's tremendous variation in what is included as far as fields collected, formatting differences, other differences that make, you know, a one-to-one comparison, difficult or impossible. And that's what a lot of our technical team, a lot of our data scientists spend the bulk of their time doing, just making sure the data that we're pulling in plays nicely with, with the other data so that we can really provide a, a usable visualization and then another, you know, ongoing challenge. It's just data scientist, data science, you know, we have a special responsibility to report all the topics accurately in a single platform.

Speaker 2: (19:09)
And when you're grouping several sources and working with these different, you know, that I've mentioned, it's important, we're driving and, and creating a fair representation for each community. So that's something that we take very seriously. There's a concept we've been very careful to manage the, you know, of, of effectively doing no harm, meaning we're, we're going to be very intentional about not misidentifying, not misrepresenting populations by proliferating bad data. And so these are kind of the challenges and these are the things that we're always cognizant of as we continue working this space. Next slide please. But that said, you know, we pull on a tremendous amount of expertise to guide our technical team and our tracker team. You know, um, as we set out to build a self equity tracker, we knew that there were going to be, you know, biases. They were going to be, you know, spots where we were just technically ignorant about whatever we were trying to represent.

Speaker 2: (19:59)
So we wanted to make sure that we pulled together a health equity task force of leaders, um, that were at the top of their respective fields and representative of groups. So that we could say, Hey, look, we're doing this. And this is not just about black and brown communities. This is about disability. This is about LGBTQ. This is about indigenous nations. You know, this is about everyone who is struggling and fighting to overcome health inequities and health disparities. So you representative of that group, tell us, what are we missing? You know, what, what have we not thought about? In addition, in addition to our organizational partners, we've had this health equity task force that really allowed us to make sure that we were thinking through all of the potential barriers in pitfalls. And they are a phenomenal group that helped us in and they continue to help us.

Speaker 2: (20:41)
And I still email them at three o'clock in the morning and say, Hey, look, we're thinking about unraveling this new, or, you know, reporting this new behavioral health, uh, comorbidity or behavioral health factor. Is there something I'm missing? Is there something that we're, we're not considering? And I think it's important to make sure that you have that diversity of thought that diversity of voice as you're building something out, next slide, please. So I'd like to end with where we're headed next, always kind of, you know, go with the carrot and the stick. And I like to focus in on the carrot. Um, millennial beacon and matter are both Chicago institutions, you know, and I I'm just a kid from Texas, but I, you know, like I said, I, I have my ties to the Wendy city and I went to law school in Chicago. I've got a student loan debt to prove it.

Speaker 2: (21:23)
I I'm full-fledged. And so anything and everything that I'm doing, I'm going to always apply a legal lens to it, to get the, the most outta the work we're doing specifically when we're talking about political determinants of health, because there's, there's one thing, it's one thing to really highlight an issue. It's another thing to say, here's how we can address that issue. So right now we're working on building out a legal epidemiology data set, and that's really just looking at the intersection between legal and policy decisions and the impact they have on health outcomes. We've been working with the team of legal experts, legal interns, to really kind of build out this data, set, to look at, you know, things like voter participation, percentage of women, legislators by state homelessness, residential segregation, you name it. And this will really allow us to add one more variable, one more kind of layer to the health equity tracker, where you can see I'm seeing, you know, upticks in this overlaid by this comorbidity.

Speaker 2: (22:16)
And you know, there's also a lack of X, Y, and Z there. So that'll be coming out very soon. Again, my technical team, I don't think they're on the call. They would be upset about me, continue to push them, but there's work to be done. So we're going to continue to do it next slide please. So I know the time is of the essence. Uh, I know that Dr. Johnson has questions that she wants to get into. Um, so I will end here and I'll thank you guys for your time. Um, and I, you know, if I see again, I see a bunch of, uh, questions and comments in the chat. Um, so I would start by saying, please get on our, on our website, help track.org, hit the contact, uh, contact us tab and let us know what you think, play around with it, try and break it.

Speaker 2: (22:58)
You know, if you succeed in breaking it, that's okay, we'll fix it, but really see how it benefits you and your community. And if there's something we're missing, let us know. We have a pretty long roadmap of data sets, um, and, and variables that we would like to target. You can only move so quickly. So we'll continue to work on this, but if there's something that we're missing, something that we haven't thought of, you know, we would love to hear from you. So I will end there and I will give the floor to Dr. Johnson who said this was gonna be just a very casual, uh, fireside chat. And she brought up flame. So hopefully this is in fact, a very casual fireside chat,

Speaker 3: (23:32)
Good afternoon. And Mr. Dunlap, what a tremendous, tremendous presentation. And I just want to remind people that you are the chief of staff at the Satre health leadership Institute, which is part of Morehouse school of medicine. And that the Morehouse school of medicine is superbly engineered and run by the leadership of Dr. Valerie Montgomery rice. And I would just like to thank you for your presentation. And I wanna say hello and good afternoon to everyone in zoom land. I guess that's what we call it. Now. TV land is old like I am. And, um, I am thrilled to be a part of this collaboration between matter and millennial beacon. This is matter's second event on advancing health equity, and it is millennial Beacon's first fireside chat. So thank you for being our inaugural speaker, Mr. Dunlap, and our series of events in the future will focus on health innovation leaders of which you are one.

Speaker 3: (24:34)
Now I'm very excited to lead this conversation and focus on this brilliant tool and game changer for healthcare. And to start, I wanna actually take a step back. And the step back is to the history of the Satre, um, health leadership Institute, because the, the, the past is what leads to the future, which is, which has led to your existence of this tracker. So, first I'm gonna mention the mission of the stature health leadership Institute, or one of the missions is to create systemic change at the intersection of equity and policy. And we hear so much about the social determinants of health, but not much about the political determinants of health. So if you could expound upon what political D determinants of health are and why they're so important.

Speaker 2: (25:23)
Yes. Thank you. So most people have heard about the social determinants of health. Those are the conditions in which people live, work, play, and pray, and the impact that they have on health outcomes. When we talk about the political determinants of health, we're moving slightly upstream and effectively, you know, it's a, it's a term for something most people intrinsically already know for every social determin of health, for every factor, for everything that you can consider that would have an impact on your health, on your life expectancy, on your life. There was some preceding political, legislative policy, regulatory decision that led to that. So if we're talking about access issues, we're talking about, you know, the, the length of time it takes for you to get from your house to your primary care. Someone on city council made a decision about city planet. If we're talking about socioeconomic status, we're talking about education, there was some school board that made some decision.

Speaker 2: (26:17)
And so when we, when we talk about these political determinants of health, it's, it's not just moving upstream. It's also moving from just naming the problem to providing an opportunity, uh, to actually address it, right? So it's not just highlighting. These communities are under resourced. These communities are struggling. It's saying if we can leverage these political determinants of health that have for far too long allowed, um, you know, communities to continue to struggle, then we have an opportunity to, to turn the tide, to turn the tables. It's most political terms of health. Again, the, the, the short and sweet is it's upstream. It's us figuring out where the levers of power are and using those, the benefit of everyone.

Speaker 3: (26:59)
Sorry about that. Thank you very much. And now we will, um, now be more politically astute as to the importance of the political determinants of health, which have led to us to where we are now. And you mentioned in your presentation that it took a number of entities coming together to help form this wonderful tool. Can you expound upon who was involved and how long it took to make this a reality?

Speaker 2: (27:27)
Yeah. Um, so the listed partners, Google Gilead sciences, and the EKC foundation, the CDC foundation, a a R P, but outside of that, it was, you know, like I said, we've got a health equity task force of 50 plus people, all of them, um, you know, representing groups and organizations from different places. And really this was a, a all hands on deck moment. We started to think about this really in advance of COVID, um, because this was us realizing something's coming down the pipeline. This is, we need to do something COVID hit. That was the accelerator. And we jumped into it. Um, and like I said, you know, the google.org folks that gave us funding, but it was really being able to work with the employees of Google, who took six months sabbaticals from the work they're doing over at, you know, Gmail and Google search to really come and work with us in more household medicine and build this out. And so the, the team over there, the team at Gilead science at CDC, N E Casey, a a R P name, they have been phenomenal. And because my boss would never let me get away with not saying they were always looking for more partners. So if anyone wants to help us, let us know, and, and we'll, we'll find a place for you to do some work.

Speaker 3: (28:35)
Wonderful. And I, and I know that Dr. Valerie Montgomery rice, we will be able to find room for each and everyone who wants to be a part of this. And now, can you give us an example of how the health equity tracker can be used to actually address health inequities?

Speaker 2: (28:52)
Yes. So, as Steven mentioned earlier, um, one of the two hats I wear more hospital medicine is government relations. And so when staffers, both Senate house are calling the school for any number of reason, I'm usually the one fielding those calls. And so we've had a number of, or, you know, conversations with the administration with staffers to say, have you looked at our tracker, have you looked and seen what the numbers are, what the data is down to the county level and you're given area. And when you're able to provide them with those visualizations in a very quick manner. Cause we all know that things on Capitol hill and, you know, even in Georgia at your state level move very quickly. So when you're able to show them a resource that provides them the information they they can need and they can utilize at their fingertips very quickly, things move a lot quicker.

Speaker 2: (29:37)
On top of that, we have a number of, um, fellowships, uh, local organizations that we work with. Take, for example, the AMA fellowship that we have at HL I, where we're working to train kind of the next generation of, of mid-career, uh, MD professionals to really understand what health equity looks like in their practice. Being able to, you know, train them on what the health equity tracker looks like. Being able to bring together the MDs and our software engineers and say, this is what health equity looks like when you bring those two together, it's really been able to open their eyes and help them to understand, okay, I can, it's bigger than just my practice. It's bigger than just the communities I aim to serve. This is all interconnected. It's all, there's a whole bunch of interplay. And if I can, you know, apply my pressure to this sphere of influence that I have, you can really see some, some positive change, uh, as we move forward,

Speaker 3: (30:22)
This is an impressive and powerful tool. And I can't wait to, it becomes more and more and bigger and bigger and greater and greater. And to know that you presented with us,  here first. That's the

Speaker 2: (30:35)
Plan.

Speaker 3: (30:35)
Now I know you mentioned that there are going to be other, um, other indicators that would be added now, have you thought about adding gun violence?

Speaker 2: (30:45)
Yeah, yeah, we have. And as you, you know, our Institute is named after Dr. Sater, um, former us surgeon general, uh, Dr. Satcher is still in the office. He's probably in the office right now and his, you know, among the, the lineage of things that he, he accomplished and he advocated for, um, gun violence as a health equity crisis, and concern is at the top of the list. And so, you know, we would be remiss if we didn't consider that it's a matter of finding a suitable quality data set that provides that information to, to where we can, you know, overlay that and apply that to the health equity tracker. But it is most certainly on the whiteboard, in my office of things to tackle very soon. But, you know, as I said before, we have the problem is we've got too much work. There is any number of health inequities disparities out there. There are any number of concerns for us to address. And it's a matter of figuring out what do we tackle first? How do we get it in there? And how do we continue to build momentum wise and have these kinds of, you know, valuable conversations with 200 plus folks around the, the virtual table who can say, I, I work in an organization, we have data we can help, or I've got some spare time. I can do some coding. So the more the merrier.

Speaker 3: (31:53)
Excellent. Now I want to shift gears a little bit, and there are a number of healthcare entrepreneurs who are participating in this event. And can you talk about the importance of leveraging data to ensure yeah. That solutions are not repeating the history of leaving behind groups who have been otherwise groups of people who have been otherwise marginalized or minimized.

Speaker 2: (32:19)
Yeah. That's, that is a phenomenal question. And I'm glad you asked it with this audience. I, I understand and appreciate the entrepreneurs in the room, you know, uh, I get it, no money, no mission. And so there's an opportunity to do something, but I think that it's, it's important to just, like you said, make sure we're not repeating history right now. We are in the midst of a moment we're, we're grappling with COVID 19, we're grappling with any number of other societal concerns and health equity. The phrase is on the rise when you just kinda do a Google search. But what I'm talking about is bigger than the moment I'm talking about the movement, right? I'm talking about the health equity movement and figuring out how we can leverage this moment to continue the momentum. So when you are an entrepreneur, when you're sitting here and you're thinking about what comes next, I think it's very important to not lose sight of what has already come, so that we don't repeat ourself, right on talking about communities that have struggled with disparities have struggled with systemic systematic harms for any numbers of years.

Speaker 2: (33:20)
So if you're gonna go into those communities and try to help them out, you can't go in there with, you know, effectively a savior complex. You have to say, I'm here to help you. I'm here to figure out how I can be of systems. And when you listen to the communities and hear from them firsthand, they will tell you we've tried X, Y, and Z. It didn't work. And you being, you know, the entrepreneur that you are, you can say, well, I've got an idea about a, B and C let's work together, but it's important to know that, you know, nothing's doing to the sun. So you have to come with fresh ideas and opportunity and a willingness to listen to those that are closest to the pain.

Speaker 3: (33:48)
You pretty much answered this, but I wanna push the envelope. Okay. And how can you envision even taking it a step further as to how we can bring together innovation and the technology that we need to help close the gap of health disparities. But in other words, technology that is actually designed to be inclusive because what we don't want is, and as we all have learned that a lot of artificial intelligence has bias. And so how are we actually going to physically do this? Be it, the entrepreneurs, be it, the people who code, et cetera, if you can expound upon that a little bit more.

Speaker 2: (34:28)
Yeah. And you know, it's, I, I spend enough time in academia that these kinds of questions come up and far too often, the answer is a lot simpler than we think. If you want to design technology, if you want to design anything and you want to be more inclusive, which we all should, then you have to be more inclusive from the beginning. It's diversifying that pipeline. And that's not just a, you know, a phrase, that's not something you slap on the back of a brochure. Uh, when you send your kids off to college, it's important for, from design to, you know, creation, to implementation, you have diverse thought, diverse, diverse voices, diversity all the way through, from start to finish, right? So when we talk about artificial intelligence machine learning, we talk about AI ML. Like you said, there are any number of examples out there where bias comes into play.

Speaker 2: (35:17)
And that's because these algorithms to use, you know, a, a common phrase are designed by people and people have their own biases. People have their blind spots, but if you have a group of folks who are diverse, you're far less likely to encounter and, and to ingratiate those same kind of biases moving forward or in bed, whether, because you'll have different folks saying, well, did you think about this? Did you consider that? And you can, you can just search at any moment in time. Right now, there are, you know, there are algorithms that look at clinical care, um, decisions, and they have biases built into them. But if we had more diverse researchers, we had more D diverse designers. We had more diversity and clinical research. We had more diversity and insert the blank. We would have more diversity in our outcomes. Very simple equation. Again, I don't do math. I avoid as much as possible, but it seems pretty simple to me.

Speaker 3: (36:07)
I really appreciate your answer to that because as the old adage says, garbage in is garbage out. And exactly, we make sure that diversity in leads to diversity out. So we'll start quoing that phrase too. And you got it. Here's your next question. This is actually the second to last question that I have, and then we'll go to some questions, hopefully from the chat. What chances, what changes actually in health and equity policy, do you actually see realistically that are coming up in the next 2, 5, 10, and will venture out to 20 years?

Speaker 2: (36:41)
Yeah, that's a great question. You know, and giving a efficient area, an optimist, rather like myself, that kind of question. We could spend way too much time. Um, I hope that in the coming years we will obsolete ourselves. Right? I enjoy having a job. Uh, I've got bills to pay, but if we can get to a point where the, the notion, the phrase of health equity is no longer necessary, where it's just built in to the everyday conversations to use, you know, an election cycle phrase, it's just becomes a table, a kitchen table issue. Then we will have made significant progress. If we're no longer talking, we're no longer fighting for equity. And instead we're just fighting for the same. We're fighting for equitable outcomes regardless of your community. Then we will made significant progress. Um, whether or not that happens the next two, five and 10 years, that's up to all of us, honestly.

Speaker 2: (37:28)
You know, you asked me that question and I think I would turn around and give it to the rest of everyone who's around the table. That's a call to action. Um, my hope, the changes that I see in the next 5, 10, 20 years are that we achieve a more equitable tomorrow. And that's only possible by having these kinds of conversations, having the tough conversations about what does the intersection between healthcare, health systems, academia, entrepreneurship technology. What does that meeting ground look like? And I, I truly believe that if we can all kind of coalesce around the same idea, we'll be able to achieve more equitable tomorrow. And I'll be out of a job to a certain extent.

Speaker 3: (38:02)
You will not be out of a job and neither will I, because someone will need to make sure that it keeps going  it

Speaker 2: (38:08)
Keeps going. Fair enough. Fair enough.

Speaker 3: (38:09)
No, we will still be employed. Yay.  and you have been so wonderfully gracious. So patient so informative and accommodating, and I just want personally thank you for all the time that you've spent thus far, because we're not quite finished. And I want to give you the opportunity in this last question. And this op is really an opportunity for you to enlist more support for the health equity tracker. And when I say that, I want to say that this is a movement. And like you said, for us to be, to have the diversity and not have to look at the inequity inequities, et cetera, it's going to take a lot of people. So this is your chance. And how can people get involved with the health? Yeah, you mentioned it briefly before, but how can they truly genuinely get involved and add data to the health equity tracker?

Speaker 2: (39:04)
That is a great question. I appreciate you tee it up. Um, two things come to mind first and foremost, get on the click. If you get to the contact us page, there's an opportunity for you to shoot us an email. Um, my software engineers are always looking for beta testers. We're always looking for folks who can bounce ideas off of much like our health equity task force. We wanted to make sure that anything that we work on next, like we're working on the sleep epidemiology data set. We wanna make sure that before we go live, we had an opportunity to have the right kinds of folks review it, make sure that we're not missing anything. There's no implicit or explicit bias everything's above board. And that's not only to make sure that, you know, we've doted our, you know, doted our eyes and crossed our Ts, but it's also make sure that we're doing this right.

Speaker 2: (39:45)
And if there's something for us to add, we can get in there. We need to knock it out. At first second, beyond that, get into the, to the GitHub. Again, this is open source. So for the technical folks, you can get on GitHub. You can see the work they're doing in real time. And they're always looking for folks who can help them do some more coding and, and really kind of contribute to their, beyond that. It's our health equity, leadership and exchange network. It's Helen. That's one of our grass tops efforts that we run through. S H I and Morehouse school medicine. Um, we use it as kind of a, a virtual meeting space. There's a, a 2,500 plus officials, academics policy leaders that are on there that get a weekly digest what's happening across the country with regard to health policy and education and things along those lines.

Speaker 2: (40:27)
But it's also an opportunity for us to magnify what's happening. So if there's big things coming down, pipe, there's a symposium. There's a conference. If there's a, you know, a big piece of legislation that we think that people should be aware of, we use that to really kind of get the word out. So if you wanna join Helen health equity, leadership exchange network, or if you wanna kind of reach out to us on the health equity tracker website, either way, they will both come to my inbox and I'll get you to where it needs to go. We would love to kinda partner with you and go for it. Because again, you know, we didn't build this tracker for it to be a more house school medicine thing. Didn't build it for it to be an S H I thing. I didn't even want my name on the back of it, but they said that we need to put some stuff on there so that we can get the SDL hits.

Speaker 2: (41:03)
We built it so that it is a resource for everyone, because at the end of the day, it's about making sure that whoever you are, wherever you are, you have the tool you need to advance health equity in your own community and your own sphere of influence. So that again, tomorrow looks better than it does today. So if you work with an organization, if you just think of an organization that we should probably link up with, please reach out to us, let us know. We are always willing to have virtual meetings, um, and connect with them and continue to do this work. Cause the longer the list exists stuff for us to do the longer, I still have a way to pay my bills.

Speaker 3: (41:38)
And like I said, we're gonna keep even afterwards, we're gonna still have, make sure that you can pay your bills at this time. I want to, again, thank you. And now, just to make sure we utilize you more, we're going to take some questions from the chat room and the first question that I'm going to pull, it says, how do you balance access to the data and data privacy regulations?

Speaker 2: (42:05)
Yeah, that's a great question. Um, and so that was one of the, one of the first things we really wrestled with when we had these conversations with the, the Google fellows. Cause they have far more experience in that than we do. And so that's why we decided to go with publicly available data so that anything you see on there, you can very easily go through it and find a source so that we are simply showing you and aggregating what already exists. But at the same time, we had to have conversations, tough conversations. I will point to, um, some of our indigenous nations and tribes and the conversations we had with them about data sovereignty. I would, I learned so much from them, things that I, would've never known about how their data should be handled and even how to, even if they do approve, you know, the displaying of it, how to make sure that it's not, you know, it's, it's, de-identified because there's smaller populations.

Speaker 2: (42:50)
We don't want that information coming forward. And so there's all these concerns that go into play about how do you handle the data again, the balance between that, and what I can say is the key is to making sure that you are going above and beyond to ensure whatever you do. Isn't running a foul of anyone's personal interest. We all have an interest in making sure that the data is publicly available, um, and easily usable. And that's kind of the story that we're UNG with LV equity tracker, right, is the fact that if we're having to go through all these, jump through all these hoops and go through all these hurdles to even make this information available, why is it, why, why is that so difficult? We're willing to do it. So why haven't it been done before? Right. And the fact that there has to be this balance between that the story end of itself. But until we get to a point where someone else is doing it, we will continue to do it. We will continue to have the conversations. We'll continue to make sure that we're held accountable. If we do run a file of anything. So as you're playing with it, if you think that we've done something wrong, let me know.

Speaker 3: (43:42)
Excellent, excellent. This is another question. And it says, is there any thought on including gender to these analysis, as we know, sex and gender are not the same thing and many in the L G T Q community are dissuaded from even answering demographic data when male and female are the only options

Speaker 2: (44:08)
There is, there is, we've had length of discussions about that. Um, I think that our hands to a certain extent right now, our hands are kind of tied with the data that is available, understanding that we don't collect the data. And so knowing that what we're building is a resource, and like I keep saying is an opportunity to highlight missteps, highlight data gaps. We also have a platform of writing out academic white papers and blog posts. And so the opportunity, what we're working on now is ways to frame that issue so that we can highlight it. So we can say, we would love to do exactly what you're talking about, but we can't because of this data restriction, we can't, because this data is not readily available. That sounds like, you know, the perfect, um, thesis for, you know, any kind of writing for any kind of audience.

Speaker 2: (44:52)
And so those are the kinds of things that we're considering where if, as we're dealing with the data, as we run into barriers, if we can't do it, statistically, if we can't deal with it mathematically, that's a data gap. That's a problem. That's a community that's not being serviced. That's a story that needs to be told. How do we use this platform to tell that story? So continue to ask those questions, because if I, if, if we don't have it on our to-do list, it's because we can't do it. And we wanna talk about why we can't until we can push the right people to allow us to do so.

Speaker 3: (45:20)
Great. Thank you for that. And another question, are there any data sets for ages less than 18 years old and the, the person states that I don't see where children and adolescents are included in the tracker for chronic disease, behavioral health,

Speaker 2: (45:38)
Yes.

Speaker 3: (45:38)
And or social determinants of health.

Speaker 2: (45:40)
Yeah. And that's, that's something that's near and dear to my heart. Um, I'm a millennial I have, I'm not too far removed from being a child myself. Um, and I think it's important to tell those stories, because even as we're starting to see now specifically in the COVID space, right? Like we, we went through a period where we were worried about making sure that, um, the, the most vulnerable, the elderly had vaccination, we, we focused on how that was affecting, you know, the entire population. And now we're a place where we're having this kind of aggregate conversation about making sure that our, our children are, are zero to five and five to 11 are vaccinated. And so those concerns, those considerations about how things impact the next generation are quite literally an existential threat. So that's on the top near the top of our listing of what comes next and figuring out, you know, effective ways to find data sets that have that so that we can highlight that.

Speaker 2: (46:24)
But just like the gender conversation, if our hands are tied, data's not available. Um, it's a story for us to tell. And, you know, I, at the end of the day, I've got data scientists on our team. We've got software engineers on our team and they do what they do best. What I do is talk and just keep talking, I speak goodly, however you wanna say it. And so I'm always willing to tell a story. And so when it comes to highlighting these, these, uh, data gaps for our adolescents and our, and our younger neighbors, it's a story to tell. We're willing to tell it.

Speaker 3: (46:54)
Excellent. Now we have a question that asks about something that might be a little bit, um, no, it's, it's definitely within your wheelhouse and something else to add to the things for you to think about how does the data reflect the inconsistency in provide a competence and bias that seems to have a great, a direct impact on issues beyond access, um, and the access, like quality of care, empathy, and provider, patient relationships, and the like, so this person wants to know how do, how do you, how are you gonna reflect in your data incompetence and, and whether or not that is because it can skew the data.

Speaker 2: (47:35)
Yeah. And that's, you know, that's a great question. And I feel like you wanted to say, this question might be controversial. It is not controversial and more household of medicine because we make sure that all of our providers, all of our med students, all of our MPH students, everyone who comes through the door, that's even a staff person, understands the need to be empathetic, understands cultural competency understands the role that all of that plays in health equity. What we had built as a health equity tracker, you know, whether or not I can statistically find data that would highlight that is a different story. But what, what I can say is anyone who comes to it will be trained in the art even subtly of health equity, and should drive towards better outcomes in that respect, in that space. So, you know, whether or not we can find something that I could put on a map and show, you know, the actual numerical, statistical impact of the lack of empathy and providers, that's a whole different story. But what I can say is that more house in medicine, we're gonna do our part to make sure that any and all providers that come through our doors won't play a role in that they won't be a statistic. They won't be a number they'll make sure that their patients, their providers, their communities hit the care that they need both within the four walls of their practice and even on the outside, um, in the community.

Speaker 3: (48:45)
Well, I might add, and I thank you for that, that the health equity tracker might be an on ramp to better and improve physician competence and understanding the differences between people and that they're not that we're more far more alike than we are different that we just need to appreciate and respect the differences that do exist. Okay. And there is a question that asks about innovation, getting to the underserved communities, I service a predominantly black community. And just, what are your ideas on, in innovation such as innovation that can be that that might be the result of the health equity tracker. How do, what do you, your thoughts of how that can actually come to the communities? It should be targeted for black brown, Latin X, indigenous.

Speaker 2: (49:40)
Yeah. I think the most effective response to that is it has to be community centered, right? When we talk about the communities that are closest to the pain, we have to go to the communities that are closest to the pain. And you have to hear from them first and foremost, you know, we had these conversations early on when we were talking abouting hesitancy, we were talking about trust and messengers. We were talking about all of these phrases and what those all really get down to are you need to hear from people directly what they're struggling with. So when we talk about innovation, it's like I said earlier, when we talk about innovation, part of that thought process, part of that design process, part of the actual innovation of it has to incorporate the communities you aim to serve. So you can't just, you know, we I'll say we, we can't sit in our ivory towers and come up with something and then just kind of give it to a community and say, Hey, I thought that this is something you guys might need that might work, but it's also very, you know, patronizing.

Speaker 2: (50:31)
You have to go to those communi person and say, I want to work with you guys to do something worthwhile. What have you already tried? What's working. How can, what am I missing? What don't I understand. And when you hear from people directly, you hear them say, I think we should try a, B and C, then that will help you create whatever you need to create that will benefit the community. So at its core, it can't be about providing people with something. It's gotta be about partnering with people to create a better, more equitable tomorrow.

Speaker 3: (50:56)
That is excellent. And that is one of the goals of millennial beacon, trying to ensure that innovation gets to the people that a lot of the innovations are they're based upon, but they don't get to the targeted to, to the targeted group. Well, I believe that the, since it is now 1254, and I believe that it is time to close out and respect everyone's time and afternoon, but I would like to thank each and every person who has joined this webinar, please join us in the mission in the missions. Please join us in the mantras. Please join us in making health more equitable for everyone. Thank you very much.

Speaker 1: (51:42)
Well, thank you so much, uh, Dr. Johnson for leading this conversation today for and for your ongoing, uh, partnership, um, Nelson, thank you so much. The work you're doing is just incredible, um, and really appreciate the way that you laid it out for us and all the insights you shared, uh, throughout the conversation. This is an area that matter is really committed to helping address. And we look forward to working with both of you to support, do whatever we can to support, uh, support your work. Um, and thanks everyone for joining us. We hope you enjoyed the conversation. Um, you can find all of matters public programs@matter.health, and hopefully we'll see you again soon at, uh, at one of those. Thank you so much, everyone.