[Applause]
human connection requires trust
vulnerability and respect of others
human connection is the cornerstone of
health let me explain this is me in 1991
where were you maybe you are listening
to Nirvana’s smells like teen spirit
rescuing the princess in the Legend of
Zelda on your Super Nintendo or maybe
you are scared to death watching Jodie
Foster in Silence of the Lambs whether
or not you remember where you were
try to imagine with me a reality that
some people faced that year one that
makes Hannibal Lecter seem like a tame
nightmare in 1991 in the country of
Bhutan the government was carrying out
an ethnic cleansing on a minority people
Hannah Don Rai the smallest child in
this picture and her family were part of
that minority when she was just two
years old they were forced to flee to a
refugee camp in neighboring Nepal as if
that weren’t tragic enough her father
and brother died preventable deaths
within the next six months in the camps
there were no toilets or clean water
there were other conditions that
promoted disease and for the next 16
years Hannah and her family lived there
they received food supplements from the
UN twice a month her predominant memory
of childhood is feeling hungry there
like many of us Hannah found joy in the
midst of hardship she has fond memories
she had she remembers the taste of
cardamom and her chai as she as people
sat together drinking tea the clink of
marbles hitting each other as she played
with classmates after school or the
peals of laughter as she gathered with
friends on a holiday picnic like in this
picture that’s Hannah in the orange
scarf so Hannah connected not just with
her friends but also in service she
remembers helping her family with chores
around the house like laundry crushing
rocks with her mom in their manual labor
job even wanting to give rice to beggars
though her
family had no money of their own because
of these difficult circumstances
Hannah developed perseverance and a
strength of character and she carried
these with her even as she was resettled
to Nashville in 2008 here Hannah
rejoiced because she had plenty of food
she even ate eggs for a month straight
because they had been such a luxury in
the camp she remembers marveling at the
automated doors at Walmart but Hannah
was looking for something new without
remembering what she already had she had
left something behind the human
connection Hannah’s first two weeks in
Nashville she didn’t even open the doors
to her apartment because she didn’t see
people outside she heard the sound of a
television for the first time but not
the sound of real laughter Hannah was
incredibly lonely but her story
continues and her vulnerability became
the means through which she could serve
her own brokenness gave her insight into
another broken system would anyone argue
that our health care system is in
serious need of reform even health
itself needs redefining so often it’s
defined in terms of illness how are you
feeling today well I’ve got a headache
or my allergies are killing me
but if health isn’t just the absence of
illness then what is it usually we think
of health care the access to care our
quality of care but there are other
factors like our physical environment
our health behaviors and socio-economic
factors like housing and education these
are the social determinants of health
if these social determinants make up the
most of the factors that influence our
health where do we tend to invest
usually it’s in that 20% we get so
caught up and how best to implement
health care that we forget to invest in
opportunities that most impact our
health so let’s bypass today’s
gridlocked debate of health care reform
and look at these social determinants
what’s working in more resource limited
areas what can we learn from other
cultures about health and about
community especially as they come here
and become part of our own we’re not as
individualized as we like to think we
can’t be separated from our cultures or
our community
so why is our healthcare we know that
social isolation increases our risk of
illness and death and our medical system
tends to treat the individual without
the family or the community we’re
seeking innovation while forgetting
contextualization we’re looking for
something new without remembering what
we already have so let’s go back to
Hanna and follow her on a journey not
just around the world but from a belief
that resources are purely economic to
her realization that resources are
physical cultural social and spiritual
these resources these balanced
relationships with self and others in
the world around us or how we should
redefine health what if there is an
approach to health that really maximized
this human connectivity especially in
communities like refugees and immigrants
or rural communities that are already
relying on each other and depending on
each other for their daily interactions
when we look at this it’s called the
community health worker model a
community health worker is a frontline
public health worker who’s a trusted
member of the community that they serve
community health workers have this trust
that allows them to be a liaison a
connection between the health and social
service system in their own communities
they’re able to facilitate access and
increase the quality and cultural
competence of care and to teach
prevention and promotion and relevant
and engaging ways community health
workers aren’t necessarily highly
educated sometimes just middle or high
school level but they’ve been used in
global health for centuries with
incredible outcomes so if it is an
education that makes a successful
community health worker what is it it’s
their ability to listen to connect and
to empower it’s less the science of
health and more the art of it perhaps
you’ve heard of community health workers
this year’s million dollar TED Prize
went to Raj Punjabi and last mile health
in Liberia their community health
workers are extending primary health
services to over a million people in
rural populations throughout the country
panjabi says
our will to serve others can help us
transform our own communities and that
transformation is happening everywhere
around the world including here in
Nashville today Hannah is a community
health worker in our city she’s working
with refugees helping elders exercise
when they’ve never done so before she’s
helped lower a client’s hemoglobin a1c
from 10 to 8 in just three months but
more than that she’s building
relationships and practicing presence
listening when patients don’t feel hurt
or understood by their health care
providers or sometimes even their own
families the community health worker
model is one of capacity-building honing
skills restoring dignity and cultivating
whole person health in individuals and
in communities and it’s not just
communities for and outside the United
States there are over 48,000 community
health workers in our country for
comparison that’s about equal to the
number of professional photographers or
actors in our country so community
health workers like Hannah use their
unique backgrounds and their life
experiences to build trust within their
own communities there are rural women
working in maternal and child health in
Appalachia there are Native Americans
teaching diabetes management on
reservations african-american community
health workers advocating on behalf of
patients in hospitals and clinics in
states like Minnesota or North Carolina
and Hispanic from authorities teaching
in health departments in Texas in New
Mexico these community health workers
are being integrated into hospitals
clinics and community agencies around
the country and through these venues
they’re connecting with communities to
really transform health community health
workers are not just a cheap stopgap
they’re really building connection
studies show that community health
workers are reducing emergency
department visits and hospital
admissions related to diabetes with
savings of over $2,200 per patient per
year they’ve lowered asthma rates and
teens by 35% and did you know that one
in four American
is at risk of preventable disease just
because they don’t understand health
information even if they do speak
English community health workers can
help impact this health illiteracy
there’s a return on investment with this
model as well anywhere from a two to one
return to attend to one return and
Studies on diabetes hypertension asthma
and more these health Outsiders are
really transforming communities from
within they’re breaking down barriers
and capitalizing on cultural strengths
we see globally that they’re producing
generational effects as they multiply
the effects of and translate the
advances of medicine because they
understand the value of connection it’s
what makes a model that’s so seemingly
simple so very powerful so here we are
in Music City the health care capital of
America but it’s neither the music nor
the industry that we’re most famous for
or the most proud of its our southern
hospitality the human connection we’re
made for human connection whether we’re
young or old introverted or extroverted
we all desire to be loved and to connect
and it’s when we’re connected that we’re
most open to change so when we seek
change whether in our health care system
or our own behavior why are we looking
for something new without considering
what we already have this vision isn’t
something we have to create it’s already
here and all around the world community
health workers are part of the solution
we know that community health workers
are just one piece and that we can all
be a part human connectivity is greater
than any healthcare technology or
innovation that we can create because we
need the human connection for them to
work so let’s restore dignity in a
digital age and keep humanity at the
heart of health thank you
you
[Applause]
human connection requires trust
vulnerability and respect of others
human connection is the cornerstone of
health let me explain this is me in 1991
where were you maybe you are listening
to Nirvana’s smells like teen spirit
rescuing the princess in the Legend of
Zelda on your Super Nintendo or maybe
you are scared to death watching Jodie
Foster in Silence of the Lambs whether
or not you remember where you were
try to imagine with me a reality that
some people faced that year one that
makes Hannibal Lecter seem like a tame
nightmare in 1991 in the country of
Bhutan the government was carrying out
an ethnic cleansing on a minority people
Hannah Don Rai the smallest child in
this picture and her family were part of
that minority when she was just two
years old they were forced to flee to a
refugee camp in neighboring Nepal as if
that weren’t tragic enough her father
and brother died preventable deaths
within the next six months in the camps
there were no toilets or clean water
there were other conditions that
promoted disease and for the next 16
years Hannah and her family lived there
they received food supplements from the
UN twice a month her predominant memory
of childhood is feeling hungry there
like many of us Hannah found joy in the
midst of hardship she has fond memories
she had she remembers the taste of
cardamom and her chai as she as people
sat together drinking tea the clink of
marbles hitting each other as she played
with classmates after school or the
peals of laughter as she gathered with
friends on a holiday picnic like in this
picture that’s Hannah in the orange
scarf so Hannah connected not just with
her friends but also in service she
remembers helping her family with chores
around the house like laundry crushing
rocks with her mom in their manual labor
job even wanting to give rice to beggars
though her
family had no money of their own because
of these difficult circumstances
Hannah developed perseverance and a
strength of character and she carried
these with her even as she was resettled
to Nashville in 2008 here Hannah
rejoiced because she had plenty of food
she even ate eggs for a month straight
because they had been such a luxury in
the camp she remembers marveling at the
automated doors at Walmart but Hannah
was looking for something new without
remembering what she already had she had
left something behind the human
connection Hannah’s first two weeks in
Nashville she didn’t even open the doors
to her apartment because she didn’t see
people outside she heard the sound of a
television for the first time but not
the sound of real laughter Hannah was
incredibly lonely but her story
continues and her vulnerability became
the means through which she could serve
her own brokenness gave her insight into
another broken system would anyone argue
that our health care system is in
serious need of reform even health
itself needs redefining so often it’s
defined in terms of illness how are you
feeling today well I’ve got a headache
or my allergies are killing me
but if health isn’t just the absence of
illness then what is it usually we think
of health care the access to care our
quality of care but there are other
factors like our physical environment
our health behaviors and socio-economic
factors like housing and education these
are the social determinants of health
if these social determinants make up the
most of the factors that influence our
health where do we tend to invest
usually it’s in that 20% we get so
caught up and how best to implement
health care that we forget to invest in
opportunities that most impact our
health so let’s bypass today’s
gridlocked debate of health care reform
and look at these social determinants
what’s working in more resource limited
areas what can we learn from other
cultures about health and about
community especially as they come here
and become part of our own we’re not as
individualized as we like to think we
can’t be separated from our cultures or
our community
so why is our healthcare we know that
social isolation increases our risk of
illness and death and our medical system
tends to treat the individual without
the family or the community we’re
seeking innovation while forgetting
contextualization we’re looking for
something new without remembering what
we already have so let’s go back to
Hanna and follow her on a journey not
just around the world but from a belief
that resources are purely economic to
her realization that resources are
physical cultural social and spiritual
these resources these balanced
relationships with self and others in
the world around us or how we should
redefine health what if there is an
approach to health that really maximized
this human connectivity especially in
communities like refugees and immigrants
or rural communities that are already
relying on each other and depending on
each other for their daily interactions
when we look at this it’s called the
community health worker model a
community health worker is a frontline
public health worker who’s a trusted
member of the community that they serve
community health workers have this trust
that allows them to be a liaison a
connection between the health and social
service system in their own communities
they’re able to facilitate access and
increase the quality and cultural
competence of care and to teach
prevention and promotion and relevant
and engaging ways community health
workers aren’t necessarily highly
educated sometimes just middle or high
school level but they’ve been used in
global health for centuries with
incredible outcomes so if it is an
education that makes a successful
community health worker what is it it’s
their ability to listen to connect and
to empower it’s less the science of
health and more the art of it perhaps
you’ve heard of community health workers
this year’s million dollar TED Prize
went to Raj Punjabi and last mile health
in Liberia their community health
workers are extending primary health
services to over a million people in
rural populations throughout the country
panjabi says
our will to serve others can help us
transform our own communities and that
transformation is happening everywhere
around the world including here in
Nashville today Hannah is a community
health worker in our city she’s working
with refugees helping elders exercise
when they’ve never done so before she’s
helped lower a client’s hemoglobin a1c
from 10 to 8 in just three months but
more than that she’s building
relationships and practicing presence
listening when patients don’t feel hurt
or understood by their health care
providers or sometimes even their own
families the community health worker
model is one of capacity-building honing
skills restoring dignity and cultivating
whole person health in individuals and
in communities and it’s not just
communities for and outside the United
States there are over 48,000 community
health workers in our country for
comparison that’s about equal to the
number of professional photographers or
actors in our country so community
health workers like Hannah use their
unique backgrounds and their life
experiences to build trust within their
own communities there are rural women
working in maternal and child health in
Appalachia there are Native Americans
teaching diabetes management on
reservations african-american community
health workers advocating on behalf of
patients in hospitals and clinics in
states like Minnesota or North Carolina
and Hispanic from authorities teaching
in health departments in Texas in New
Mexico these community health workers
are being integrated into hospitals
clinics and community agencies around
the country and through these venues
they’re connecting with communities to
really transform health community health
workers are not just a cheap stopgap
they’re really building connection
studies show that community health
workers are reducing emergency
department visits and hospital
admissions related to diabetes with
savings of over $2,200 per patient per
year they’ve lowered asthma rates and
teens by 35% and did you know that one
in four American
is at risk of preventable disease just
because they don’t understand health
information even if they do speak
English community health workers can
help impact this health illiteracy
there’s a return on investment with this
model as well anywhere from a two to one
return to attend to one return and
Studies on diabetes hypertension asthma
and more these health Outsiders are
really transforming communities from
within they’re breaking down barriers
and capitalizing on cultural strengths
we see globally that they’re producing
generational effects as they multiply
the effects of and translate the
advances of medicine because they
understand the value of connection it’s
what makes a model that’s so seemingly
simple so very powerful so here we are
in Music City the health care capital of
America but it’s neither the music nor
the industry that we’re most famous for
or the most proud of its our southern
hospitality the human connection we’re
made for human connection whether we’re
young or old introverted or extroverted
we all desire to be loved and to connect
and it’s when we’re connected that we’re
most open to change so when we seek
change whether in our health care system
or our own behavior why are we looking
for something new without considering
what we already have this vision isn’t
something we have to create it’s already
here and all around the world community
health workers are part of the solution
we know that community health workers
are just one piece and that we can all
be a part human connectivity is greater
than any healthcare technology or
innovation that we can create because we
need the human connection for them to
work so let’s restore dignity in a
digital age and keep humanity at the
heart of health thank you
you
[Applause]
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