Civic Rx

It was also, in 2020, one of its worst hot spots. But the COVID-19 crisis, like so many others that have afflicted Indian Country, was decades in the making — borne of a long legacy of neglect and promises broken by the U.S. government.

Here to share the unique challenges his people have navigated, their successes, as well as their priorities with a more receptive US administration, is Jonathan Nez, the 9th President of the Navajo Nation, and the youngest in its history. I learned a lot from him and am excited for you to hear what he has to say.

To learn more about the Navajo Nation, check out:

- this brief retelling of their history

- the Navajo Department of Health's page on COVID-19

- President Nez's testimony to the U.S. House last July, about tribal needs amid the pandemic

- this CNN feature on their tremendously successful vaccination campaign

To listen to more Civic Rx, visit us at civic-rx.org.

It's an interesting conversation, and I hope you enjoy it.

To learn more about what's discussed:

• Read more about Bhutan at the World Bank and World Health Organization websites
• Follow Minister Wangmo on Twitter
• Check out this feature in The Atlantic about Bhutan's pandemic response

To learn more about Civic Rx, visit civic-rx.org.

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Quick dictionary:

ILI and ARI surveillance = influenza-like illness (ILI) and acute respiratory infection (ARI) surveillance, performed by many health facilities around the world to monitor virus activity and identify novel viruses, as part of the global influenza sentinel surveillance system

Abbot = in Buddhism, the administrator of a monastery or large Buddhist temple

One year ago this month, America lost its first life to the coronavirus. Since then, nearly 500,000 Americans have succumbed to the pandemic, and many more have lost their family, their classrooms, and their livelihoods.

No person has been more widely reviled for dooming our response than former President Donald Trump. But a new report published in the British medical journal The Lancet finds that as damaging as were Trump's actions and his antagonism toward science, they represented merely the extension of a long tradition of harmful policies stretching back decades, which collectively left the United States acutely vulnerable to the pandemic: and resulting in the deaths of 461,000 Americans, in 2018 alone.

This report, published by the Lancet Commission on Public Policy and Health in the Trump Era, offers an unsparing assessment of the many and overlapping failures of the US health care system, as well as of the social mores and policy choices that fueled and have perpetuated those failures over four decades.

Here to discuss their findings, and what they mean for a nation still struggling to move forward, is Dr. Steffie Woolhandler, co-chair of the Lancet Commission and distinguished professor in the CUNY School of Public Health at Hunter College. Dr. Woolhandler is a practicing primary care physician as well as a co-founder and board member of Physicians for a National Health Program, the only national physician organization dedicated to implementing a single-payer health program in the United States — now encompassing more than 20,000 members. She has authored over 150 journal articles, chapters, and books on health policy and continues to guide the national debate as a staunch champion of Medicare for All.

For more about the Lancet Commission, check out:

- its landing page, with links to the full text as well as graphics and associated editorials

- the report itself, at 49 pages an excellent weekend read

Follow Steffie on her Twitter page.

And learn more about Civic Rx at our website, civic-rx.org.

Yesterday, we inaugurated a new president and vice president, and with them, a government invested in science, grounded in evidence, and committed to transparent and compassionate leadership.

Today, they face a global pandemic that has devastated the American economy, stolen 400,000 lives, and disproportionately harmed the poor and people of color. They also inherit a country deeply divided, suspicious of truth, and more vulnerable to disinformation than perhaps at any other time in our history.

To achieve any real progress in beating back the pandemic, they -- with us all -- must commit intently to combatting disinformation and restoring trust in scientific expertise. Honest, transparent, straightforward science communication is key to this mission. The past 10 months have demonstrated that the success of even basic public health measures like mask-wearing and social-distancing hinges on how well they are communicated, and who does the messaging.

To begin to plumb the complexity of communicating effectively, during this public health crisis, I wanted to talk to my dear friend, frequent media commentator, and brilliant epidemiologist, Dr. Celine Gounder.

Dr. Gounder is an infectious disease doctor and clinical assistant professor at New York University, the Founder and CEO of nonprofit multimedia organization Just Human Productions and, until just yesterday, a member of the Biden-Harris Transition's COVID-19 Advisory Board.

She's the perfect person to help us understand why effective science communication is so critical to curbing this pandemic, and what has made it in turn so elusive. And I couldn't be more thrilled to welcome her to the show.

To learn more about Dr. Gounder, check out her website.

For more on Civic Rx, visit civic-rx.org.

Dr. LJ Punch (they/them/theirs) is a critical care surgeon, a former professor of trauma surgery at Washington University St. Louis, and a staunch advocate for gun violence prevention. For the past four years, they have been building the T, an anti-violence center in St Louis that supports the local community in recovering from trauma — be it from guns, opioid addiction, COVID-19, or homelessness. Most recently, they opened the Bullet Related Injury Clinic, or the BRIC, to provide both physical and mental health care to those whose lives have been upended by gun violence. Today, we talk to Dr. Punch about community, gun violence prevention, their journey to St. Louis, and the imperative of rebuilding trust. To learn about Dr. Punch's work and see how you can contribute, visit their websites for the T and the BRIC. To listen to more episodes, visit civic-rx.org.

Today I'm thrilled to welcome two friends and brilliant policy leaders, Dr. Ben Miller and Dr. Kavita Patel, to explore what policies the Biden-Harris administration might undertake to redress the country's rapidly worsening mental health and addiction crises.

America is on the brink of an unprecedented mental health pandemic. A full third of Americans have reported symptoms of clinical anxiety or depression — a 200% increase from pre-pandemic levels; rates of opioid-related deaths are increasing in more than 40 states; and mental health emergency department visits have surged, as more people struggle without the providers to support them.

In our last conversation, we learned about what it was like to treat the surge of mental health cases on the ground. Now, we discuss what an enlightened government might do to build a system capable of meeting soaring needs in the future. We consider what the administration's foremost priorities should be, and how the bitter partisanship on Capitol Hill might thwart or inform this agenda. And we review the policy levers that leaders at the local and state levels are already pulling to break through the noise.

Ben and Kavita are the perfect people to walk us through these questions. Ben is the Chief Strategy Officer of Well Being Trust, a national foundation committed to advancing the mental, social, and spiritual health of the country. And Kavita is a primary care doctor and Vice President of Payor and Provider Integration at Johns Hopkins Medicine, as well as the former director of the White House Office of Intergovernmental Affairs and Public Engagement, under President Obama.

For more on Ben and Kavita, check out their websites, as well as this Atlantic piece they penned in May foreshadowing the national mental health crisis.

And for more on Civic Rx, visit our website at civic-rx.org.

For 10 months, we have borne witness to the unsparing ravages of a pandemic that has plundered over 250,000 lives, millions of jobs, countless life milestones and, normalcy. Throughout it all, the overwhelming feeling has been that of being unmoored. Which is why, as we enter what appears a resurgent phase of the COVID-19 pandemic, there's another crisis on my mind: mental health.

Yes, we are also in the throes of a mental health pandemic. Orders of magnitude more people, in the United States and around the world, are suffering depression, anxiety, PTSD than this same time last year. And this is due both to the direct mental health consequences of COVID-19 — which has effectively perpetrated a mass trauma on our psyche — and to the indirect consequences, ranging from joblessness to racial disparities to political rancor.

As divided as this country may be over even the basic existence of COVID-19, what remains uncontested is that we're not doing enough to shore up one another's mental health.

Enter Dr. Jessi Gold, an Assistant Professor of Psychiatry and the Director of Wellness, Engagement, & Outreach at the Washington University, St. Louis School of Medicine. Dr. Gold is a practicing psychiatrist and a prolific writer and observer of mental health as depicted in the media and popular culture. For years, she has shared candidly of her own experiences while speaking vigilantly against disinformation online. Today, Dr. Gold and I talk about her experiences discovering and practicing psychiatry, pre- and post-pandemic. We explore what it means when so much of the country is suffering from pandemic-induced anxiety and depression. And we reflect on the particular trauma befalling health workers, and how only recently that stigma has begun to lift. I hope you enjoy our conversation.

For more on Dr. Gold, including links to her writing, check out her website.

For more on Civic Rx, visit civic-rx.org.

And as a reminder, if you or anyone you know is suffering, please don't wait to get help. Call the National Suicide Prevention Lifeline at 1-800-273-8255, or reach the Crisis Text Line by texting HOME to 741741. Stay safe.

Fortuitously, we have a model for what this might look like. And it comes in the form of Cityblock Health, a growing public health startup that integrates primary care, behavioral care, and social services to deliver high-quality care to low-income communities.When the pandemic struck, it became clear that the racial and economic disparities long festering in our country would be splayed viciously open, and Cityblock's patients would bear their disproportionate toll.

Today, we talk with Cityblock's cofounder and Chief Health Officer, Dr. Toyin Ajayi, about how the company mobilized to meet this need, and why this moment only magnifies the urgency and value of its model. Cityblock spun out from Alphabet's Sidewalk Labs in October 2017 with a mission to treat, at scale, the root causes of poor health in underserved urban populations. It has since expanded beyond New York to Connecticut, Massachusetts, North Carolina, and Washington, D.C.

For more information, check out:

• Cityblock's blog
• Toyin's TEDMED talk

And listen to more Civic Rx episodes at civic-rx.org.

We are at a time of unprecedented upheaval and none is more affected, around the world, than women and women of color.

On the 25th anniversary of the Beijing Platform of Action, in the very year that we were meant to honor and redouble our commitment to gender equity, even the limited gains of the last two decades hazard being swiftly and summarily rolled back.

Here to discuss why these inequalities are so critical to redress is (my and) a #shero of global proportions: the Honorable Julia Gillard, Australia's 27th Prime Minister and Leader of the Labor Party, from 2010 to 2013. To this day, Julia is the first and only woman to have served as Australia's Prime Minister. She is the Inaugural Chair of the Global Institute for Women's Leadership at King's College, London; Chair of Australia's leading mental health awareness organization, Beyond Blue; Chair of the Global Partnership for Education; Patron of Camfed, the Campaign for Female Education; and, just announced, Chair-elect of the Wellcome Trust. Most recently, Julia published her second book, Women and Leadership: Real Lives, Real Lessons, with former Nigerian Finance Minister Dr. Ngozi Okonjo-Iweala — sharing the experience and advice of some of our most extraordinary women leaders, in their own words.

I am so honored, and grateful, that Julia joined us, and so thrilled to be able to share our conversation with all of you.

For more about Julia, check out her website.

View her famed misogyny speech, which rocked the world for its "masterful, righteous take-down" of sexism.

Read "Essays on Equality," the Global Institute for Women's Leadership's report on the gendered impacts of COVID-19.

And learn more about and purchase Julia's new book, Women and Leadership.