Let's Talk Kids

How Parent’s Health Affects Children’s Health | Let’s Talk Kids

• Lets Talk Kids @ ACNJ • Season 1 • Episode 6

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0:00 | 1:12:40

Andrea Martinez-Mejia, Executive Director of the Greater Newark Healthcare Coalition, discusses the importance of many aspects of mental and physical well-being that are overlooked in New Jersey and the United States, as well as how Healthcare systems can be improved to better address these issues for families at risk.


Learn more about the Greater Newark Healthcare Coalition below!

https://greaternewarkhcc.org/ - Greater Newark Healthcare Coalition

https://www.newarkmom.org/ - Newark Mom


OUTLINE


00:00 - Intro

00:52 - What is the Greater Newark Healthcare Coalition?

05:48 - Andrea and GNHCC’s motivations & the Covid-19 Pandemic

08:00 - What other organizations work with GNHCC?

12:56 - How does GNHCC connect parents with resources?

21:41 - Lead Poisoning in New Jersey children

29:21 - Rise in Illness and Importance of Vaccinations

34:05 - Modern Mental Health of Teens and Parents

46:43 - Chronic Diseases in Children in the U.S.

51:49 - How to improve Healthcare systems in NJ

1:11:32 - Outro

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Thank you so much for watching. See below for more information on Let’s Talk Kids and ACNJ.

SOCIAL & WEB LINKS

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Advocates for Children of New Jersey (ACNJ) Official Website - acnj.org

PODCAST LINKS

CONTACTS

  • mcoogan@acnj.org - Mary Coogan - Host of Let’s Talk Kids | CEO of ACNJ
  • vjabon@acnj.org - Viggo Jabon - Editor of Let’s Talk Kids | Multimedia Specialist at ACNJ



SPEAKER_00

Welcome to Let's Talk Kids. I'm Mary Coogan, president and CEO of Advocates for Children of New Jersey and the host of Let's Talk Kids, a video podcast with community organizations, experts, and policymakers on issues impacting children and families. Today I'm joined by Andrea Martinez-Meja, who is the executive director of the Greater Newark Healthcare Coalition. Welcome.

SPEAKER_01

Thank you so much, Mary, for the invitation. It's really a pleasure for me to be here and talk to the community about the work that the Greater Newark Healthcare Coalition is doing trying to improve the health of our communities and in partnership with organizations like Advocates for Children from New Jersey.

SPEAKER_00

That's great. Thank you, Andrea. So why don't we start there? What is the Greater Newark Healthcare Coalition? What's its mission? What are the goals of the coalition?

SPEAKER_01

Yes, so we are a coalition that was that started in 2008 as a result of two hospitals in the city of Newark announcing their closure. And the idea was to ensure that the services, the healthcare needs of the communities were not impacted as a result of these hospitals closing its door their doors. So since then, the coalition has evolved and doing different things. Right now, we are a coalition that we have four main pillars of work. One of them is we, the number one is we're a neutral convener. We bring community members, we bring partners in the area. And when we say Greater Newark, we primarily focus on Newark, Estorange, and Irvington. And we do a lot of work too with our state partners. We have a designation as a regional health hub that was through legislation in 2020. Us the Trenton Health team in the City of Trenton, the Camden Coalition in Candem, and the Healthcare Coalition of Passe County are the four regional health hubs in New Jersey. So we do some work with them as well. So our work is elevated at the state level as well. So we convene partners, communities to find out what is happening on the health, what are the issues, what are the problems, and how can we address them, how can we tackle them. The other one is our data analytics component. We run and operate a health information exchange. So we get population health data. We also had some individual health data that we take a look and to identify trends, to identify what are the what is happening around our communities in terms of health, what is what is being reported to the exchange in terms of utilization of the hospitals, utilization of other services, Medicaid claims, et cetera. We utilize that. Our goal is to make that actionable data. So looking at the data and how can we address some of the needs that we're seeing that are, you know, uh that are racing to the top in terms of health. Um the third one is the development and the creation of innovative uh strategies around health and health intervention. So we do a lot of pilot programs testing different things on how we can better address the needs of the community through um through the work of the coalition. And then the last one is our policy and advocacy. So, as I mentioned, we we we partner with the other regional health hubs into looking at how we can improve the healthcare system in New Jersey. We work very closely with our Medicaid office at the state. So a lot of work is us talking to Medicaid beneficiaries on a you know day to day. What are how are they experiencing the Medicaid, you know, the services, the benefits that they provide, and what are the things that we can do better? Um, so all the work that we do focuses on those four pillars, and we're trying to bring them all together uh with a goal to improving the community, the health of the community that we serve. Those are some big goals.

SPEAKER_00

Indeed. So talk a little bit more about the data. So, where is your data coming from?

SPEAKER_01

So we have different um sources that feed our data. Um, one of them is through, as I mentioned, we have an agreement with Medicaid. Medicaid also funds um the work that we do. Um, and we get access to the Medicaid claim data. So that's one source. We also participate in the Health Information Network. So that is a um a network that uh collects health data at the state level, is run by the New Jersey Department of Health. So we also get that that information, that data that is feed to the network also comes to our exchange, and we're able to look at that. And some of the hospitals also feed that data into the exchange. So we got different sources that are fitting our health information exchange. We take a look at that. I said we can look at it at the individual level, we look at the population health level. Um, we primarily stay on the population health level. So uh we aggregate the data to find trends to identify what is, you know, what is really happening around uh specific issues in our community, and how can we identify either public health interventions, or how can that turn into a convening of partners or experts, or that turns into like a need for advocacy and policy changes?

SPEAKER_00

Okay. Well, that I mean it makes a lot of sense, right? Because you're looking, you identify some problem area, or you might identify something that's working well, and you might say we should do more of this, or if it's a problem area, this is something we need to address. So what drew you to the coalition in terms of deciding you wanted to work here or to the healthcare arena?

SPEAKER_01

Sure. I have spent um over 20 years working for the uh for the state, working for the state government. I I have done um, I have been in different positions in different departments in the governor's office. Um, but um I uh got my master's in product administration and concentration on healthcare policy and management. And yet that drew me to the New Jersey Department of Health, where I have spent the majority of my time um at the state level and also at the local, at the local level. I used to work at the Trenton Health Department, where I saw the impact of policy, the work that we do in government, um, how can it actually impact the community's day to day? A lot of the the work that we do in public health, we're able to see uh the results and um I think quicker than in other places. And then how we really can improve the lives of the community. One of the, to me, I think one of the um the most poignant experiences of that was the pandemic. And being at the Department of Health at that time, uh, we were, I was able to see how we were coming up with intervention decisions around public health. How we keep, at the end of the day, uh every day was how we're gonna keep people alive. And and just seeing that we were coming up with different things for something that was novel. We never we didn't see it, but we were tracking it. We were seeing how things were changing day to day. And and our efforts, our you know, the work that we were putting out there was really, you know, getting to the people right away. That has something, um and also health to me is if if we don't have healthy communities, we're not gonna have productive communities. If we don't have health, as I said, we don't have health, we don't have anything. So uh being able to contribute to keep communities healthy is really rewarding to me as a public servant.

SPEAKER_00

Well, that's wonderful. And uh it's good we have people like you who are willing to step up and try to take all this data and figure out how we can improve health outcomes for children as well as families. Right. So let's talk a little bit about health outcomes and health needs of children and what what are some of the things that the data might be showing you at the coalition and some of the work that you may be taking with other partners to try to improve health outcomes? So, as you said, if you don't have health, you don't have anything. So clearly you would agree that health impacts children, right? Yes. And they need to be healthy in order to learn in school and uh eventually lead productive lives, right? Correct. Yep. So who are the some of the other community organizations that partner with the coalition in terms of the work that you do when you're trying to make changes that might improve health outcomes for kids?

SPEAKER_01

As I mentioned, we you know, we are a multidisciplinary coalition. So uh around the table, we have uh the uh representatives from the local health department, we have representatives from the state, uh the the connection that we have with uh the state uh Office of Medicaid, um the New Jersey Department of Health, um, we have our hospitals at the you know around the table, and we have community, other community organizations like um the Advocates for Children for New Jersey, like Program for Parents here in Essex County, um, that help us build and help us uh address those needs, either by their sharing with us what's happening, but also as uh as a thought partners around what how can we bring some of this health information to the community? How can we ensure that, for example, we know pediatric asthma is a problem. We have looked at the data, we know that in Newark, you know, one in four children is diagnosed with asthma. And that is a big issue because that we we know if it's not treated, it's gonna affect their life. But also, um, we know as well, um, through our partners, through our, you know, our experts, that if managed correctly, kids can thrive with asthma, right? They can become productive adults and they can they can do a lot of things that we we think they can, right? We can say, oh, maybe they cannot participate in sports, maybe they cannot do this. But that's not true. If if well managed, treated properly, we know that they can live healthy, productive lives. And that's something that we have been working on. Um so when we identify issues like that, we we start thinking what can be our contribution to that? What can be our um uh innovation around that subject? So a lot of the stuff we encounter is communicating and educating the community. We know that we have access to different community groups. We know we have access, the community knows us because they have seen us in doing different projects out there. Um, and then we can bring that information in a way that is disseminated clearly, simply, where parents, caregivers can understand how can, you know, how we can be a good better advocate for the kids. Because when, you know, as parents, families, caregivers, we are the first um health advocates for our kids. So our goal is to empower our community, empower our um families, parents, and caregivers to really uh advocate for the treatment and the management of the conditions for children. Um in the case of asthma, I said we we run a couple of um community education sessions with the um Rothkirst School of Pharmacy. Um we have a steering committee that is uh is putting together an annual um asthma symposium that is gonna be run in uh at the end of May because May is asthma awareness month, and they're very committed to continue to bring real solutions to and the it continuous education of the parents and caregivers for asthma. So that's how we we collaborate. It depends on different issues, but we're always um connecting with um community organizations and looking at families as a whole. So we know the maternal health is another big issue around it. And you know, we had to have healthy moms, healthy babies, in order for them to be um productive, healthy adults. So um with um the support of grants, we have been able to run different programs. We have some experts around mental health. We were able to um launch a website that says NOAA mom, where you have resources that we put in information for our moms on how to access some of the maternal health benefits that have been expanded in New Jersey. We're very lucky to be in a state that has taken that very seriously and has been a leader in in terms of maternal health and improving the outcomes for uh for moms and babies. So um we want to make sure that a lot of also the other thing, a lot of stuff that's happening at the state level or resources that become available, we want to make sure the community knows it. And and through us, we see we can be a vehicle of bringing all those information, all those benefits, things that are happening new, make sure that our community knows and takes advantage of it.

SPEAKER_00

Okay, so can we go back to asthma just a little bit? So if let's say I have a child who has asthma, um what happens if my child probably needs an inhaler and I don't have the resources to get that inhaler? Is if I had insurance, it might be covered. Would the coalition help parents understand how they could enroll in New Jersey family care? Would they try to find them resources if the parent I mean, everybody kids qualify for insurance now in New Jersey because it covers all kids, but if they were hesitant maybe in trying to access New Jersey family care because it's a state system, are there resources out there through which I might be able to get an inhaler for my child?

SPEAKER_01

Yeah, so we are looking at um identifying some of those resources. Uh what we do, uh we don't provide direct care services. So that is um we link the individuals to organizations or providers or you know, um programs that provide the direct care. Uh, one of the things that we do through the education component is to uh ensure that folks know um what are some of the resources to better treat the asthma in the kid. Um, some of them is the what type of the type of inhaler, um, how we what is the right way of you utilizing it. And then at the system level, when we talk to paediatricians or when we're talking to providers, um some of them have shared their challenges around insurance and in and um so as with the ability and the connection that we have with the state and and the length that uh that the work that we do on Medicaid, sometimes we can also bring those up to them and say to the to the state or some of the managed care organizations that are running the state, um, the state program and saying, here are some some challenges, here's some things that you might want to consider to make it easier for the beneficiary to access those services. Um and as you mentioned, yes, we are very we played a big role in terms of uh make sure that we kids get enrolled in um cover all kits and then Medicaid in general. And that is one of those um aspects that we know it's important for the community. And one of the things that we're gonna be continuing to work because we know as Medicaid is changing, and this year is a big one because there's a lot of changes coming to Medicaid, we want to make sure that the community is informed and educated. So, um, and also identifying what other resources are there in terms of for those families who don't qualify for it. Unfortunately, you know, there are some, there's very the the the choices are becoming limited in terms of uh in um insurance for for folks that uh don't qualify for Medicaid or other programs, or like you indicated, they are fearful of accessing the programs because of um their status in this country. And I think that continues to be a pro a problem that um as partners have to continue to look at how can we ensure that um those families continue to get health. What we know is that preventive health is cheaper than you know, health at the bed at the hospitals are at the bedside. So um it's important that we continue to advocate for uh the access to care, uh, access to primary care. Um it again, foregoing health is is gonna be very costly in the end for some families, for some individuals. So um it makes sense that we continue to uh to look and find solutions on how we ensure that um individuals in New Jersey can access care that keeps them uh away from the hospital, which is more expensive. So even if you look at it in the economic side, is more uh is more expensive by us not taking care of uh of families and the prevention. Prevention is is always uh easier and cheaper and keeping people healthy.

SPEAKER_00

No, that's so true. So I know, and when you mentioned about the changes to Medicaid, I know some of the changes are gonna be with reference to eligibility, and with adults, they're gonna have to meet certain work requirements, right? And they're gonna have to document that they're either uh working, volunteering, or in some type of education program at least 80 hours a month. Correct. But it's my understanding that doesn't impact the children, right? And and New Jersey has a very expansive, I'm gonna say, program under New Jersey family care, up to 350% of federal poverty. So many low-income, middle income people who don't have health insurance through their employer, their children could still be covered by family care, right? Even if they are no longer qualified. And I guess to me, it's great that the coalition does that educational component to say to people you should still enroll your child and make sure you fulfill all the requirements to make sure the policy gets renewed, right? Which now that the pandemic is over, people have to be proactive in that regard. You mentioned something about the care management organization. So my understanding is if if my children are going to be in family care, it's sort of that's my network, right? My HMO. But those companies or those nonprofits, they also have people who are doing outreach, right? So they also could answer a parent's question about care and help find the provider, right? Yep.

unknown

Yep.

SPEAKER_00

So do you does the coalition work with some of those um care management organizations, or would they be at your event? Would somebody be at your event at the end of May talking about you mentioned like the proper use of the inhaler, but also answering questions about enrollment issues or yeah, no, we're we're utilizing all the events that we have to be an opportunity for different partners to come and bring their resources and the and and and answers to the to the people.

SPEAKER_01

So yes, our in I we invite them. Um we're gonna have opportunity for um folks to to be there to bring the resources and tabling. And when similar to what we did when you mentioned um, you know, the recertification, the redetermination that we call it after the pandemic ended, uh, is we partner with those. And then we had opportunities where we bring the education, but we also either link them to their how to connect them to get their application renewed, or there was an issue with their application, who to contact. We have those um contact information, those conduits to do that. And then when we were doing um re-enrollment events, that we we tried to bring all of them to the table. We're hoping to continue to do that once we have more information around the um the new changes that are coming. We still pending more information from the federal government. How is that all gonna be implemented and some regulations? But what is important to us is make sure that keep the majority of the folks that are qualified for Medicaid, even with the changes. And we know that some folks, unfortunately, are gonna be um not eligible anymore. But those that qualify, make sure that they understand their rights, make sure they understand what the criteria they have to fulfill, make sure that if they need uh um help with um that work requirements, volunteering, that is clear. Make sure for those folks who are exempt, because you mentioned it, that's correct. There's gonna be a percentage of the population, including children and some adults, that are gonna be exempt from those requirements. Make sure that they understand what those are and make sure that we keep them eligible for that as well. So it's gonna be uh a big undertaking that we're gonna be in partnership with the state and in partnership with the managed care organizations. We are gonna be working together. And I said we already working on other projects with them and they are very receptive and bringing the information to the to the people it's our main goal. So yes, we'll we'll we'll connect with them and uh as much as we can, you know, have make sure that uh we bring some of the majority of the resources into under one roof. So when people come to our events, our goal is to they can get as much information as possible. And then when there's opportunities for other organizations to be with us, we always open our doors for that as well.

SPEAKER_00

Okay. So before I forget, I'm thinking a lot of your events are listed on your website. How would somebody find your website?

SPEAKER_01

Yep. So our website is um www.greater, spell it out, greater norkhcc.org.

SPEAKER_00

All one word, lower cap. And if this event at the end of May, any other event you're having would all be on the website.

SPEAKER_01

Yes, we have the website, and we also you can find us on our social media platform as well. We are trying to keep that updated. Um, make sure that all the events are listed.

SPEAKER_00

Okay. So now I'm going to switch to a different health issue. So, what about childhood-led poisoning? Is that something that the coalition has been working in or trying to address? Because that, even though my sense is it's improved, there are still children who are negatively impacted by. lead.

SPEAKER_01

Lead, yes, continues to be an issue in New Jersey. And we're doing, you know, we're doing great in terms of changing some of the out outdated infrastructure that contributes to some lead. Like we talk about lead in the water. And I know Newark has done a big investment in replacing all the pipes so to bring that. But it's important that we as parents, especially, we understand what is lead and what are the resources available to them to ensure that the kids don't um you know they get tested, they get screened for lead. And if they have a high, you know, lead elevated levels in their system, that they get treated because they they are resources available and that can help, that can make a difference in in the uh in a child's life. So one of the things that we we know and there's a lot of also regulations around there. So one of them is um that kids have to be tested twice in their lifetime for lead. The first testing comes at 12 months old so at a year old when you go to the visit the doctor should be doing or you know there should be a prescription for like testing for for lead. And it's a blood test it's you know it's it's detected in the blood. And what we find in New Jersey is that parents and you know that we have a very high number of uh compliance with that with that role right we we have a good number of kids getting tested at that year old. But we see a drop is at the second year mark. So this should be as I mentioned they should be twice tested once at the one year old and the other one should be at two years old. And what we find is when we invest to the two year old, that's when we see a drop in testing. So as parents, let's just always remember remember that that we should be testing our children twice one when they're one year old and a second test when they're two years old. If the child comes back with an elevated blood level um the local health department gets involved and they will reach out to the family. The paediatrician connects that information has to go to the state as a state registry and then the local health department brings a team with them one uh to the house they want to identify the source of the lead. So they have some environmental health specialists that are you know with the city they work with them they come and test they they bring a little machine and and you know it's a UV machine and they they they're trying to identify the source of the of the lead in the house and also there comes a nurse a public health nurse is a case manager where she will ask questions about the the the family again the idea is to identify where the sources of lead is coming from but then also linking them to resources. What is the process, what they have to do and then how we can make sure that those um levels of lead in the blood for the child gets lowered. It's important that parents understand that it's important that their resources are available so that we are not afraid when people say oh your child has lead and you know I'm you know where is it now what I do and and it's it's very serious. We should not take that lightly right we know that the um unfortunately the lifelong effects of lead it's it's in the cognition of the children it's it's not good. So um understanding that we have the local health department involvement that coming to help to provide resources to help you identify where those sources are and the other one too is in education about what where the sources of lead. So because it was public and it's uh you know it had a lot of publicity water but we also know that it comes in paint and then a lot of that paint had now in New Jersey at least has been has been uh removed um but it's paint chip but it's also things that we're not thinking of um and especially if you you know you're immigrant family you're coming from other countries um products that are produced and manufactured outside the United States might not have the same um restrictions around lead as we have here in the United States. So it might be makeup it could be candies from other places right like I, you know, especially again as a as an immigrant as a coming from an immigrant family when we see that is connection to our roots. So you see in the store candy or some food that might be done from your country, you want to introduce that to your kids is it's a way for us to continue to keep our our um um our roots our cultural roots uh alive but they might have lead um toys the if you know again things that are manufactured outside the United States we have to be mindful um that they might have some higher levels of lead um even some things that we use at home like incense so um it's not only always like oh is the water is the paint is what we have known traditionally but there are other ways that um inadvertently we might be introducing lead into our children. So that's what it's so important to have the professionals come to your house, look at things, test a couple of things to identify the source of the lead so you can correct it.

SPEAKER_00

That's really I mean it is amazing when you think about traditionally people think old houses because of the paint and then water became an issue and I know sometimes they talk about there could be lead in the dirt right or in the soil. But when you start thinking about candy or you start thinking about other toys, right? So I guess it could possibly be in the paint or in the flavoring and people would have no knowledge of that, right? Yes. So for the people who are listening or watching today, what is the impact of lead on a child? And my understanding is the reason why we want kids test it when they're very young is because it could have a greater impact on very young children than on adults, right? Yes.

SPEAKER_01

So what are some of the impacts that lead could have you know so I should it does unfortunately affect uh you you know the brain you know the cognition of the child so you might experience some of those children might experience developmental delays uh in terms of um you know their their normal um development so they hence the importance and then some of those are irreversible so the earlier we can detect it make sure you know there's you know make sure that there's uh minimal exposure to lead uh it's gonna have a better outcomes uh into the to the child so that's what is the importance of uh prevention which is the testing and treatment you know like you know timely treatment because you can reverse that and then the child will be you know will will be able to to live a healthy life but if you forego that if you're not doing it the the consequences can be can be you know life like lifelong because it affects unfortunately um you know the brain some areas where like they you might experience some developmental delay okay it's harder to correct and my thinking is kids don't show a symptom correct right so that's why again that testing is so important.

SPEAKER_00

Exactly yeah there's not a and uh there's not a symptom exit oh yeah you definitely have been exposed to lead you have to you know you have to test the blood okay so I mean it's good to hear that at least the numbers are looking good in terms of many people are getting their child tested and then just the reminder like you said that that second test at at it is just as important. It's just as important. Correct. What is the data showing you with reference to people getting their children vaccinated? Is that something that because of all the the public discussions that we're we're finding people maybe are hesitant on certain vaccines or it's just dropping off?

SPEAKER_01

We haven't seen the latest numbers but we have heard um you know from professionals from a lot of uh healthcare providers that they have seen a decrease in vaccinations and immunizations of children and um we want to make sure that um we continue to educate the community around vaccinations. We know that they save lives we know that we have been able to eradicate some terrible diseases like polio as a result of vaccination and then unfortunately we are seeing some of those um diseases that have been eradicated decades ago they're coming back as a result of our, you know, we we're losing I mean during the pandemic we heard that immunity right the herd immunity we we're losing immunity so um we are seeing some of those coming back and and and we don't want that right it's like you know we don't want kids you know in in uh in this day in this day and age we're having developing polio when we actually have a very easy simple you know way to to prevent that from happening um so we continue to ask the parents and and and the community to educate themselves about the the the importance of the vaccines um if you have concerns uh you can talk to your healthcare professional certainly we encourage folks to make sure you you know you talk you bring your concerns to the health professional um but um you know we still it's important to vaccinate I said we have seen the results and in and again we don't want to see the uh again bring in some of those diseases that are you know again that they can be detrimental to the health of of a of a child um so we know there's a lot of information and misinformation unfortunately uh in uh going around these days but your paediatrician your healthcare professional you should trust them right you should find a provider that you find them that you're gonna have bring those questions and they're gonna have the best interests of your child of your family and uh an ask those questions to them to look for the experts look for the information that is being verified um and and you know really consider the in a lot of it's just just consider the impact the negative impacts that not having vaccination have not only to your child but also as a community um because um we see I mean we're seeing terrible outbreaks happening as a for the measles vaccine you know for the measles and uh let's just not make um let's not forget we just went through a pandemic a few you know a few years ago and how oh how terrible that was how many lives we lost and and you know when we know that we saw when we changed the curve was when we had a vaccine. So we have you know I think in our lifetime being able to see um what happens when we you know develop vaccines and and see the changes in diseases and the progression of our disease um and the protection that we can offer. So we want to continue to uh to do that. We want to give that opportunity to our future generations. And the other piece is too it's interesting because we have done such a good job and that's what usually happens with public health when they do a good job you don't see it. So for many years we didn't we didn't add polio missiles were something very like you hear from other, you feel like oh that happened at third world countries or that happens far away from our from our door um we also you forget that um might be a little bit harder to to be diagnosed these days because we haven't seen them in so many years. So doctors might take a little longer to identify what is you know what what what is that disease. So um we have to continue to uh educate our community we have to continue to ensure that immunizations um are still um and again is is is is a it's not expensive way to keep people healthy.

SPEAKER_00

Mm-hmm I it it appears from what you're saying it's the education part of it that we have to be really vigilant about. But also encourage parents who might have questions to ask those questions. Yeah right exactly and see what happens.

SPEAKER_01

And there are a lot of like trusted you know um professionals out there to who want to do that. And then again I said it's important to um make sure that you you have a trusting relationship with your provider will you they will you entrusting the health of your child or your family there should be somebody that you actually trust and feel comfortable asking those questions I have in the discussion.

SPEAKER_00

So kids a little bit older so you mentioned the pandemic and I do think there's been a general consensus in terms of well the people that I speak with um with the older kids that more young people adolescents had anxiety issues maybe were more hesitant going back to school and that's obviously going to impact their learning as well. So is that is the coalition or any of your partners working at all on addressing the anxiety or depression or are we looking at data in terms of the impact?

SPEAKER_01

Yeah we um we know that mental health is a is is a big issue a big health issue and one of the things that we also know is um that mental health and physical health they're together right then we can accept we can as separate our head from our body um and and and we here in New Jersey we we're seeing that there um we're moving towards um a holistic approach in terms of you know the behavioral health services and the physical health services they're provided in in the in the same area there they they're easier access to it because one of the things unfortunately we have seen uh is that for behavioral health services especially around kids is it's there's a need and there are gaps. We don't have you know there there are there's not enough uh in some some cases there are not there's not enough providers for behavioral health there's not enough in some of them um for those um patients especially pediatric patients that might need um hospitalization as a result of our behavioral um health uh condition uh they're not sometimes there are not enough pets in the state so um we know that it it's a growing problem unfortunately and I think uh we're still seeing studies of what is causing it we know the pandemic certainly had uh had an impact but also you know we're hearing a lot in terms of social media and you know and just the the environment that the the our kids are growing up these days. And we know that we have to do more to that offer. So it's actually very exciting to hear um that it's one of the priorities for the new administration Governor Cheryl has made uh youth mental health a one of her priorities and uh we welcome that um and we welcome participating in and contributing in any way we can um we did through our um um some grants that we receive and through some of the mentioning piloting programs that we have done, we did one around mental health um and it was uh around passive parenting so you know we know the effects of trauma and and we have you know that that is um uh everybody's faces trauma so you know I think all of us who went through the pandemic for example right we probably we we we we have experienced trauma um and um it affects folks differently and if you're you know you're exposed to trauma on a regular basis you know constantly that's gonna just you know it's gonna exacerbate be you know your mental health um you know we can pass it on sometimes to how we experience trauma and how we become parents so one of the the the the programs we had and it just finished was ensuring that um give your resources to parents how to what is positive parenting how we cannot bring our trauma to to our children by finding ways finding ways where we acknowledge our trauma as spaces where we know and we process some of that but also finding ways on how we can be um you know how can we parent properly to our kids right in in a positive way in a way that we we we empowering them empowering them um but it needs we know that it's a it's a big needs more needs to be done um and then yeah we you know that is the you know some of the advocacy and policy right we need to ensure that there's more resources and more conversations and then also we work together to uh continue to eliminate the stigma around mental health because we know that's still is is a stigma it's still behavioral health services mental health right uh we don't want to admit it because we feel that is some it's negative connotation around it but um we have to ensure that uh we you know we we treat it as a condition of us having diabetes or hypertension uh we are you know we we don't feel we don't feel shame to say oh I'm undiabetic right or I'm I'm hype you know I have high blood pressure but we're not gonna be saying I have mental health you know issues mental health problems um but we we we have to also work on the stigma and and in different ways and and you know in terms of of bringing that up so we're very excited to hear that um Governor Cheryl is going to make mental health and it's particularly young children um there's gonna make uh one of their priorities and you know we stand uh they're ready to to participate and and and collaborate in any way that we can so it's really interesting I I came up like listening to you I thought of like 15 more things I want to ask you or talk about.

SPEAKER_00

So going back to the the positive parenting to me it's implicit in there that just because you become a parent doesn't necessarily mean you know how to parent, right? And so that's a skill that people can work on or improve, right? And so that program, I guess when you say positive parenting teaching parents how to engage with their kids, right, in a better way. So I'm wondering with the the mental health issues um it's not to me it's not all about going to therapy either, right? So are there things that you're aware of that maybe students can be taught um to better self-regulate their emotions or is there some of things that we could be teaching kids as a prevention that they start to deal with their anxiety or maybe address the triggers that are causing the anxiety you know I just those things came to mind. I don't know if you have any thoughts on those things, but I started thinking, you know, are the social media right that maybe and I think part of what Governor Murphy tried to do is figure out ways to pull kids away from the social media because that's also causing a problem.

SPEAKER_01

Right. There is a lot I think and we're hearing um that the the in we hear the influence of uh social media uh in in especially in children and one of the things we we have to remember and I uh the work that I did at the local health department in Trenton with um tobacco use um we were um one of the policies we're trying to change was uh raise the age of tobacco sales to 21 instead of 18. And one of the things that was very it and very stayed with me was the fact that the brain is developing until age 25. So when we look at a child, you know, we also had to kind of continue to look that brain the little brain is growing and developing and it's not you're not fully developing your brain until you are 25. So anything that we expose to anything that we put into the child's brain to that is is shifting is is is making you know it's it's helping it's going to help them or influence them in certain way positive or negative um and and I think those things like social media and how to control and how to be exposed to it it's um shaping them negatively or possibly and I think for a lot of us parents where we have to be mindful is what are we exposing our children to, right? We don't want them to be smoking. So we we talk to them about the dangers of smoking and why you know we don't we have to do the same thing with social media and uh and it's hard you know to to police them but like we as parents we have a lot of because we are there with them you know how they access a phone I mean they don't want by themselves right they don't get the phone themselves so we we want to be as parents we want to educate ourselves what is the right way what is the right use of social media and how control that and then and add those those um those into the the teaching and the discipline that we put also into our kids right it's not we know that it's not right for the kids to be all night on the phone. We know that it affects them and we are we have we've even seen folks are saying uh even on an athlete like the use of the phone it's it's it it it makes you tired. So you might you might want to not expose them to if if you know you have an athlete and you go into a game you might not want to expose them the phone to like up to that point, right? You might want to give them a a a break or right. So there is the right use of it um of the of the the the social media parents being more aware of the negative impact of that uh staying on top of what's happening and and and you know part of the positive you know positive parenting is not um it's how you engage or how you have these conversations. It gets harder and harder as the kids are older and older um but we have to still be in in involved in that and and and and really identifying what is but also modeling behavior. If we are on the phone we can tell you know we can't we we and that has you know we told for everything is modeling behavior. So if I'm gonna tell my kid not to be on the phone, but I'm on the phone constantly then we're not modeling behavior. So the other things that we can do is how we model behavior. How do we uh for a lot of these things is Modeling what behavior can be for the children. I mean, it's hard. Um other things for um that I bring, you know, bringing some of those easy tips and terms so that we could do a thing more for children is bringing them the importance of um, I think some of it's like you know, even mindfulness, right? You said you just mentioned anxiety, some of those are like breathing exercises, for example. It's just very easy, very simple, that can help calm down your uh your nervous system and and then bring in some of some of those uh alternative practices to it, uh to give you know to give kids uh different tools. We have to um make sure that we give them different tools in their toolbox so they know how to handle it.

SPEAKER_00

No, that mindfulness, and I always forget that term. So thank you for reminding me. But I do think it's important because if you start to teach that what I was referring to as like self-regulation type behavior, then maybe kids won't get into fights with their classmates as often, right? Or they can start to adjust and it reduces things that typically would have been escalated, right? And then everybody's getting in trouble. So if parents want to know that or understand those things, um how do how do they find those things out? Are there community classes or um or is there work being done in the schools to teach students those types of mindfulness uh techniques?

SPEAKER_01

Yeah, no, it would be great to see a little more on things uh, you know, we have seen it as um as open or like being included in the curriculum as we want it to. Um, but it this is a good way in terms of like the internet, right? Or your library. I mean, there are books out there, they're they're tools, and this is a uh a way that you know the internet can help you to identify and what are some of the um mindfulness techniques that can be applied to the kids. I mean we want we want we hope that you know some of those will be being added more into the curriculum because they're important. Uh and you said some of them are like low-cost, uh, the self-regulation is very important as well. Um, we also know that because of the use of the phone, you know, our how we interact socially has changed. Because we are now, I think we're getting more used to interacting with the screen instead of like a face-to-face. So uh encourage that connection as well. Because um, and then utilizing cue, you know, taking cues from, you know, being across from the other person and saying, well, they're getting angry, maybe I need to, you know, like it we're losing that because we're just looking at a screen all day in many cases.

SPEAKER_00

So so the last topic is I'm thinking is diabetes. So there's been there is, or it appears that there's an increase in the number of children who are um pre-diabetic or diabetic. So, in terms of healthcare, my sense is some of that has to do with food as well, right? Is that something that the coalition has looked at, is looking at?

SPEAKER_01

Yeah, diabetes as a chronic disease in general has been um another topic that has been brought up by some of our partners that we need to look at. Currently, um we don't have a program specific for diabetes, yet we we have um ongoing and it's called a new work learning collaborative on chronic disease. So the goal of that is bringing different uh partners at the table who are either engaging, providing direct care services to the community, and uh we are learning from each other. What is working? How can we engage? Um, how what are the things that are making it difficult, the challenges to um talk to people or uh about chronic disease and management, right? Because folks know probably that you know um certain foods are not good and certain diets are not conducive to a healthy lifestyle. Um, but what are really the challenges uh for those individuals to others' families to really make a change and to really break from the pattern of chronic disease into a healthier one? So we're hoping that we through those learnings we can apply it to to other um to other diseases. And as I mentioned, for us, it is something that is in our in our uh radar that we would like to address, hopefully uh, you know, funding with non-profits, so we depend on funding. Um, but we also collecting, as I mentioned, lessons learned from chronic disease in general and how we address it. Now we know that unfortunately for a lot of our families, uh it's not like they don't know that they're not eating healthy. It's not like they don't know that, you know, there are better choices for their um for their diets or for the families, is access to it and the cost. So uh that is something that we, you know, food insecurity is it's a real problem. And it's a real problem in a lot of our neighborhoods in Norwegian and and the surrounding areas where there's not a lot of access or easy access to supermarkets, to fresh fruits and vegetables, but also is the cost. Right? It's it's um when you look at and when you go into the supermarket, you can see that you know, getting fresh fruits is more expensive than if you go and you get something else, uh, you know, those um high fructose, high sugary drinks, right? So a bag of oranges might be more expensive than Sunny Delight. And when we have families who are really um have tight budgets, um, the choices, you know, for them the choices are limiting. It's just either I give them something or nothing, right? So we have to continue to work on that. And how we uh address food insecurity and and and is not only and also it's not only bringing food to them in the supermarket, but it's the cost. Because you can have a supermarket, but if I have to pay five dollars for a bag of oranges and suddenly the light is 99 cents on sale, and I have to feed my family and I have to make all ends all meat, I think I'm gonna choose, right? And again, I think some of them is also we've gone back into modeling. Right? Our kids are gonna eat what we are gonna we engage with them and say, hey, let's go go to the park and play for an hour so they can do physical exercise. Um they're gonna do it. Um, but if you know it's it's it's a combination of uh the challenges we have, they're they're real in terms of food and security, transportation. But just we know New Jersey is an expensive state. We know that. We see it, you know, the prices of housing is it's increasing, uh, everything is costly. So we know families are struggling. Um, but also uh it's uh reminders of those modeling is just what we do, trying to how identify ways on how we can you know eat better if we do it, right? We can I tell my kids that well, you should eat an orange and I'm just have a big old glass of sunny the lie myself. Uh those, you know, it for a lot of these problems I find it is it's a combination of things. And you know, different partners at the table, uh, including the community, including the parents, uh the families, but also the other, you know, multiple partners that can help us address. It's not um help doesn't get addressed just by, you know, getting a doctor or giving having access to a provider or medication. It's it's it's uh it's a whole you have to look at us a holistic way and different partners at the table.

SPEAKER_00

That's so true. And I always think of myself, would I rather eat the orange or a bag of chips? Correct. So now just shift a little bit to the other one of your other pillars, which was the policy advocacy, right? Which you have been talking about, but I want to focus a little bit more. What in your experience, and this is going back from your work at the Department of Health to the current work with the coalition, what are some of the barriers that prevent either good preventive care, and you've alluded to some of them in terms of cost, that you would like to see and you think we can change in New Jersey? So cost you might not, but maybe some of the access issues, like what have you seen? And again, it's not just limited to your work with coalition, but going back to your work at state governments.

SPEAKER_01

Understanding care uh in a holistic way, I think is important. And and we have to do more of that. Understanding that really that prevention is cheaper than bed side care. Um, and what we have seen um, and it happens in a lot of things, uh unfortunately, in the way how we distribute funding, um, after a crisis, a lot of funding comes in. And we have seen it in our lifetime. So you know after 9-11, lots of funding for um, you know, counterterrorism and you know, improving our emergency preparedness services and make sure that we're like we have that remote network. And then as we go, uh as we drift away from that crisis, funding actually starts decreasing until the next crisis comes in. Um so you know, I think in my lifetime in starting my career, so it was 9-11, you know, it was 9-11, then Sunday hit in 2012. Yeah, and a lot of like emergency preparedness and how we prepare, how we make communism more resilient, funding's fall in. And, you know, then it starts winding down. And public health is is is uh I think is a prime example of it. When we, and we have see, we can look at the trends in terms of funding for public health. Uh, when there's not a crisis, it gets, it gets chipped away, chip away, chip away. So we're not investing into an infrastructure that it needs to be ready when a crisis comes in, but it requires it to continue to be funded. And I think that's one of the number one um uh issues that I would like to see is that we continue to fund um public health even in when there's not a crisis. That is the best way to really strengthen um, because a lot of them um, and some of our local health departments are also points of access to care. So folks who can, um, I will tell you, um, you know, for personal experience, when I, you know, um first came to this country, I had to get validated my vaccines and, you know, we had to get a checkup to go to school. I went to the local health department. I didn't know a clinic, a doctor, and you know, my family didn't know. So we went to the local health department. So for many families, your local health department might be the first contact, the first entry into the healthcare system here. Um, so we have to make sure that continues to be funded. Um, the other thing too, uh, I will say is continue to look and um identifying more options for folks to get care. Um, it is expensive, even with the marketplace. We have to continue to find ways that, and how can everyone in New Jersey, you know, can access some type of care, some type of preventive, ongoing care that is gonna keep them healthy. Um, and that continues to be uh a bar is like a barrier. Um, but I I hope that you know we we can actually um all come to together and and identify a real solution for that because I think we probably is gonna be more cost effective than what we have now, which is nothing, and really having a lot of families and and children foregoing health and then end up in the emergency room when the situation is more serious. And that's you know, that should not happen in a country that we spend significant amount of money on on healthcare. And um, there might be other better solutions. So I think that I would still, in terms of challenges, is identifying um what um true access to care for everybody looks like. Um and then the last one I will say is how we make it easier for folks to access care. You know, I know that we have it's the healthcare system is complicated. And uh like we and and there are some like so-hanging, you know, fruit uh solutions to it. Like we mentioned, like what require truly requires uh you know, prior authorization versus not requiring prior authorization for insurers. Um and then it's like that you can learn from listening from the community. I think we have to also listen more to what uh those who are experiencing healthcare every day and how we can make uh common sense solutions for their um for their problems. We and and this is I'll tell that this is the beauty of uh being on the the beauty of I had the opportunity to be on both sides, I'll say both sides of the street. Um I told constantly tell people that we, you know, when you're in Trenton, we don't sit there trying to how we might make people's lives more difficult or how we make them miserable. Um but when you spend a long time on that side of the street, um you don't know how, all good intentions, you don't know how that's gonna be implemented. And when you're I on the other side of the street and you get to see how some of these good policies that you think are good policies that were thought out because um you want to improve their lives, they're kind of hard to implement. Um, so that is the other component, I will say, is is really um making sure that we can't we we're constantly thinking um on how some of what is working well, like you said, and what is not, because we have a lot of rules and regulations, and that's when people talk about a lot of red tape. They're all some of the stuff created with good intentions, but implementation becomes harder. And a lot of it, uh, and also funding. It starts with funding because some of the stuff that has been put in laws, uh in, you know, I saw it saw firsthand in the department, there's a lot of things that people say like, well, there's legislation, you have to do this, you have to do that. And when you look at it, there's not a touch for funding. That makes it hard. And that's where the thing a lot of folks don't understand. It's like, why are you not doing that? Because there's the law says you have to do this, but it came with no funding. And uh so um it's it's the the um, I will say that is, you know, an exercise that we should do uh more, I think, at the state is uh assessing and evaluating more. What is working, what is really improving the health, and what is really improving the lives of the community, and what things are just, you know, good ideas in paper or you know, good thought, but implementation is hard and should be eliminated. Um make it easier. So those are, you know, like after 20-something years has been on both sides, I I I get to, you know, uh say that and say, you know, it really um you have to you have to be able to evaluate. Like, you know, we have to do all the time what is working well and continue and supported and properly funded, and what things are we're good ideas, maybe at some point, but now they, you know, times have changed and they need to be um replaced by other ideas that are more, you know, or less or less that's what they no, I totally agree with you.

SPEAKER_00

I'm thinking when you talk about the local health departments, so my sense is local health departments used to provide a lot more direct service. And so I guess that because of funding, they just do less and less, or is it because somebody else was deemed to be a better provider?

SPEAKER_01

Because both, I think. Yes, the local health departments have the ability for them to provide certain services has diminished. And it's also looking at what, you know, uh, I think it was starting to what is the um with the questions, what is the right way to go, what is the the right way to get it? Where will you get the best care that is easier for the for the individual? Um, and there are spaces for the local health department, and there's specific for a medical home, right, from for the clinics. Uh, but funding, I think, has has dictated a lot in terms of what can be offered. So, yes, back in the day, I think local health departments were able to do a lot more, a lot, even a lot more education. They have community, uh they had like um the community health uh educators really going and talking to people, educating them about the services. And now we're seeing that unfortunately it's been less and less because it's hard. It's you know, their budgets have been slashed. Um then um it goes into the question, is like what how we can make you know medical homes for individuals where they can get holistic care. Like we, you know, it's not only um it's not only your immunizations, it's not only your vaccines, it's not only, you know, um, but it's it's more is how we ensure that you know you are growing uh, you know, as you're supposed to be. Like who's doing your annual checkup? Um, who is doing your oral health? We haven't even you know touching oral health. Um is your mental health services as well, right? Like we talk about it's uh the body is all connected, and we somehow trying to separate in different things, right? We we we have funding for physical health, but you know, not so much for all health. Or, you know, we have funding for our health and physical health, but not so much for mental health. So the body is all one, and if and they all communicate, and if there's something that's working, it's gonna affect the rest of the body. It's finding out who who does it and said, you know, the the healthcare, you know, local health programs cannot do it all. Um, but certainly there's uh a big role they played, and in a lot of it is in the education, uh, in the access to, you know, some life-saving vaccines that some of them have done, and and uh is the investigation of bringing uh their environmental health specialists and the nurse together to identify layer. So there are spaces where they they can be very helpful. Um, and then you know, the others are with like maybe a medical doc, you know, a medical home, a medical doctor, primary care doctor provides more um continuous ongoing uh care.

SPEAKER_00

Has the coalition at all looked at um, or I don't know, what I'm I'm gonna call them local clinics? Like some of the a lot of communities have urgent cares now, or they have a walk-in. Is that my sense is that has relieved some of the emergency room care, right? That people so now go to these types of clinics. But is there a space for those clinics to maybe become more in line with what would be a medical home? Or and I don't know if you have any thoughts on that. Just from listening to you, I started thinking about those alternative care.

SPEAKER_01

Care, yeah. No, certainly, and that is a good question because we have seen uh an increase in our urgent cares uh across the state. Um, and then is how you engage them because they're like um, yeah, against some of the some of the system, they're private, they're kind of like private practices. So um, like for example, we don't, you know, um, it'd be great to connect some of the data, like to they participate in there on the health information exchange or the health information network, so we can see what who's going there and what is the data looks like. And again, uh as an individual, um, being able to um if I happen to be at an urgent care, because you know, I I spray my ankle, not necessarily have to go to the hospital, but I go, they take care of me, that that data follows me everywhere, right? Because then if I happen to be at university hospital and you open up my chart and then you see all the data, oh she was there, she was there, oh she's you know, she's hypertense, or she's diabetic. It's such it's it improves the care. Um, but so right now I um they are, you know, it's like private practices, so we don't have a lot of information yet on, you know, how is the utilization of there? Um, I mean, some of them you still have to pay. So I think goes into the question of who's going there and who's paying for it. Um, but that could be, yeah, as we're looking at how we expand, because that's the other thing we haven't touched in terms of this. Also, we have a workforce crisis. There's not, unfortunately, a lot of um family care physicians or primary care pediatricians. Those, believe it or not, family care physicians and pediatricians are like one of the lowest paid uh medical professions. So a lot of our uh, you know, a lot of our doctors, uh medical students are going for other, you know, more lucrative uh specialties because we know the cost of going to medical school is high. So uh we do have a crisis and they can be, you know, yes, when we're trying to expand the network of primary care, um, they can be ever they can be a good partner. But I think is the question uh I think we still have to learn more about them. And the question is who's utilizing it? How much is there opportunities to um identify ways of linking uh individuals who might be underinsured to a system that is um that the cost is affordable?

SPEAKER_00

You also mentioned something about prior authorizations. What is the requirement for a prior authorization?

SPEAKER_01

It depends and it's based on your insurance. So some insurers, um some procedures might require. So the doctor said, well, um let's pick maternal health. Uh you your doctor said, you know, um you have your pressure is high and you should be monitoring it, uh, because we know that, you know, hyperpression is a risk for a pregnancy, right? Uh so you should be monitor you should take your blood pressure every day. And some insurers, uh You cannot just go and pick up the blood pressure monitor from the pharmacy. The insurance company has to approve that. Even though your doctor said you need it, it's important for you to check it every day. But if you want to cover it by the insurance, they say, yes, we cover, but we have to approve it first. Adds delay, right? It just adds time by the time you get to the insurance approve and which one and where you get it. There might be days. So things like that, some procedures that probably you need prior authorization, but it's kind of looking what actually requires that kind of extra eyes in a way from the insurer to approve it, versus what are some things that should it just be, okay, if the doctor recommends it, it's important. And given in the condition or the history or the risk that the person can access it. Same thing for, you know, so it's medications, this treatment, as procedures, uh, that the insurance before the um the insurance actor is to pay for it, they have to review the case and they have to make that decision.

SPEAKER_00

Okay. And then you talked about oral health, which you're correct. We didn't really talk about oral health. Is our dentists just really separate from the rest of the medical community? Um, that or is it that we as a society just separate out oral health care and going to the dentist from all the other stuff we do in terms of health care? Because it does seem like it's very um separate.

SPEAKER_01

I think it's yeah, I think that that's that's the case. Um now we are seeing we and we hear more from oral health professionals in terms of um, you know, their importance for them to be included in the health because uh, as I mentioned, some it might be, you know, by just looking at your oil health, your mouth, there might be um some signs of other diseases. And then, like, for example, we know that for diabetic person, um, make sure that your health is, you know, is is um is well cared for, is gonna improve. It's gonna, you know, it's gonna, you're gonna have some uh uh interaction with your physical health, right? So um we are seeing more dentists, especially talking about how they should be included as part, and again, it's just we it's like the whole idea of the whole body, right? We cannot say part of our mouth. So um as part of uh preventing some, you know, some prevention medicine that can happen there, um, some recommendations. It just makes you health healthy, right? If something, you know, so for kids, if you if you have tooth decay, that's gonna um turn into a you know sort of a more expensive, you know, care of their teeth of their oil health later on, right? Um so the the importance that we also consider like same as we know that we have to work to a doctor for our I know checkup, then make sure that we also know that we have to go to our dentist every every six months and um you know, and and continue to have that prevention side. All that is just again, prevention in general is just cheaper than um you know the the having to treat something longer. And also we know, I mean, our oral health also is how people perceive themselves, right? Something is wrong with your mouth, I mean, how you your appearance, it's gonna it's gonna have uh an effect on your mental health as well. You're gonna be self-conscious.

SPEAKER_00

Or you might be in pain.

SPEAKER_01

Oh, you might be in pain. Yeah, yeah, yeah. Yeah, it is it it's yeah, it's it's fascinating to say, like, you know, we we when we have to look at uh at our health, we have to look at how the body functions. It's all connected. We can't separate it be great. Sometimes, right? It's like my toothpaste, I'm gonna separate that, but we can. We're all connected and and we should make sure that our how we're treating um the health is is connected.

SPEAKER_00

One last question. I do appreciate all this time. What do you want to see changed in the next 10 years?

SPEAKER_01

There's a lot of things. There's a lot of things, but I I think if we uh figured out a way to provide care, access to care, uh, in a way that is affordable and open to everybody, because you know, health is a human right. Um and I say at the beginning, you know, without health, you can't you know you can live a productive society. You know, without health we can't, you know, we don't we don't have anything. Um that would be a I think that would be a big achievement for us. If we can really find a way, uh we develop a system where we can um truly say that people can access care. Some you know, some type of care um will be I think we'll be happy. And I th I think it can be done. I think we also have to um be innovative in that. And I think we also have to look at, you know, if there are no other places that have done it, we don't always have to be the first ones. I don't think we have to reinvent the wheel. Um you know, I think we just have to have to really um be willing. And there's a lot of partners at the table, right? Because when we talk about why the cost of healthcare, so we start pointing at each other. We start saying, well, is the cost of medicine? Well, is the pharmaceuticals, well, is insurance? Well, I think we really have to find a way on how we can mold together and identify the way that we can provide access to care, um, which I said it's cheaper to prevent than treat um to everybody who needs to.

SPEAKER_00

Andrea, thank you so much. Any final thoughts, comments?

SPEAKER_01

Well, thank you so much, Mary, for today. It's been great for giving me the opportunity to talk about health, about the work that the Great Umwark Healthcare Coalition is doing. And and I hope that um some of these resonate with the families. I hope that uh what we talk about today uh really uh um, you know, inspire some of them to look into their health, to learn more, to educate themselves more about and really become the best health advocates for the children.

SPEAKER_00

Oh, that's wonderful. You've inspired me, and I hope we can can continue to collaborate, and we definitely should share more about all of your data and also the work you're doing and your community outreach work. Thank you so much. Thank you. Thank you so much for watching. Visit the description to find out more information about today's conversation. Be sure to leave a like, subscribe, and hit the bell if you enjoyed the video and want to be updated when our newest interviews are released.