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Your Genetic Code or Zipcode? | Northeastern Professor Allison Bauer
23 Plays5 months ago
We're joined by Professor Allison Bauer of Northeastern's College of Health Sciences to explore how social determinants impact health delivery.
Professor Bauer shares her journey from law to healthcare policy and philanthropy, highlighting how community health centers are revolutionizing care through innovative, community-centered approaches that tackle food insecurity, housing instability, and healthcare access. Through her work at the Boston Foundation and the government, she demonstrates how addressing social determinants of health can transform healthcare outcomes. Learn how she's shaping the next generation of healthcare professionals while tackling pressing challenges in mental health, environmental health, and community care accessibility.
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Transcript
Podcast Introduction
00:00:00
Speaker
Welcome to the Healthcare Theory podcast. I'm your host, Nikhil Reddy, and every week we interview the entrepreneurs and thought leaders behind the future of healthcare care to see what's gone wrong with our system and how we can fix it. On today's episode, we're speaking with Professor Alison Bauer. She's an associate professor of public health at Northeastern University with research interests across health policy, the social determinants of health and healthcare care equity. Thank you so much for coming on today, Professor Bauer. It's great to have you.
00:00:29
Speaker
Hey, Nikhil, I'm really happy to be here.
Professor Bauer's Career Journey to Public Health
00:00:32
Speaker
Of course, and before we get into some of your work, can you quickly walk us through what's your background, what brought you to healthcare, care and what are you doing now? I'm happy to. It was a little bit of a of a winding journey. um i started When I graduated from college, I went straight to law school and um went from my law school in Philadelphia to Washington, D.C., started working as a lawyer, but I was always much more interested in policy and shifted into
00:01:02
Speaker
um lobbying and advocacy work. I did that over a period of time and eventually went back for a graduate degree. It intended to get an MPH and somehow wound up getting an MSW but focused in health and mental health policy while I was doing it and use that to transition into more advocacy work in the health space. I have a lot of expertise in the areas of HIV and AIDS, as well as mental health and addiction. um That transitioned when I left DC and came to Boston. I wound up putting it all together and working as the staff director and counsel for the Committee on um Mental Health and
00:01:47
Speaker
um addiction. It was actually called mental health and substance abuse at the time. um It's since been renamed actually to mental health substance use and recovery using sort of a less um stigmatizing name. But I worked on that committee for a number of years, staffing it, working on legislation, um left the state house to join, to do something completely different, joined the Boston Foundation and oversaw the health portfolio there.
00:02:17
Speaker
And then from there, I shifted to um back into government. And I oversaw the Bureau of Substance Addiction at the Massachusetts Department of Public Health and took all of that, all of those experiences and packaged them up in a nice bow. And now I teach at Northeastern. It's my sixth year. And I am really focused on taking those experiences and using them to help
00:02:48
Speaker
ah infuse experiential learning into my classes where I'm teaching about the American healthcare system and and health policy and community and public health in various classes.
Impact of Community Factors on Health Outcomes
00:02:59
Speaker
Yeah, of course. And I was actually one of Professor Bauer's students, so I can definitely testify to how experiential it is and how it can help. She always ties in her own experiences. I know one thing you always talked about was like, with mental health, it's like a very much, not just a healthcare system issue, but it's very ingrained into our community. Can you kind of speak on that aspect, just give the audience some brief background? Like, what does our community health actually mean? And how does that affect our healthcare system?
00:03:23
Speaker
Yeah, I think the best way to always to that we talk about that and and a phrase that no doubt you've heard is that what happens outside the clinic walls has a much greater impact on our out health outcomes than what happens inside the clinic walls.
00:03:40
Speaker
what we do in terms of the food that we eat, in terms of how we move our bodies, in terms of our level of education, the safety and quality of our housing, our ability to get to and from work, what kind of work we do, all of those things which obviously are grouped into a a term of art that we use called the social determinants of health, um literally have a deeper impact on our health outcomes than anything medical.
Social Determinants of Health in HIV/AIDS Policy
00:04:13
Speaker
And that's a big piece of what I focused on in terms of the work I was doing before I came.
00:04:21
Speaker
um to Northeastern and it's a big piece of what I infuse into my classes and all of everything I just said can be wrapped up really easily into sort of one expression, which is your zip code is a far greater determiner of your health than your genetic code. Yeah, which is definitely interesting. I assume it's like a very, it's a very hard problem to solve because we have so many different issues, but also people don't really recognize that fact or just don't understand it.
00:04:48
Speaker
um Through your experiences, like was there a time that, of course, at the Boston Health Foundation, even before that, like when did you try start to see this issue get brought up? Was that like very early on when you're getting your law degree, or was
Disparities in Food Access and Health Impact
00:04:58
Speaker
it more later as you were navigating your way throughout the system? I think it was probably staring me in the face when I was working on HIV AIDS policy back in DC, but I don't think I was as aware of it. I don't think that ah We were using the term as readily back in the 1990s as we were decades later. um But it was clear that if you looked at who was being affected by HIV and AIDS at greater numbers, at the time I was working in Washington, D.C., the epidemic had shifted slightly, obviously still affecting the gay male community, but it was affecting communities of color, particularly the Black community in D.C.,
00:05:42
Speaker
And what I didn't know at the time, I was really more in a frontline clinical space will and and also then advocating for a HIV AIDS vaccine. But what I didn't know at the time was how much the environment within which people were living was contributing to the spread of the illness. As I came up to Boston and particularly, I would say when I did a much deeper dive on this work at the Boston Foundation,
00:06:12
Speaker
That's where it became very, very evident to me that it's much harder to be able to advocate for people to eat a healthy diet so that it would be better for them for their health. And you're out there and you're working with communities and groups. And then, you know, the comment comes from someone you're working with in community that says, that's
Housing Stability and Children's Health Outcomes
00:06:36
Speaker
awesome. Where do I buy that food?
00:06:39
Speaker
because we take for granted that now I step outside my door, and and I always acknowledge this in my classrooms, the level of privilege that I know I have, that it's so easy for me to step outside my door and find healthy foods. And interestingly, I did't um i did a little TV event with, I think, Boston Neighborhood News or Boston Network News, so the local TV stations, and I appeared, or it might've been on, a another station but I appeared with Vivian Morris who was the founder of the Mattapan Food and Fitness Coalition. Vivian's a brilliant advocate in this space and she raised her family in Mattapan
00:07:23
Speaker
um Black woman raised her family there. She has ah degrees in nutrition and registered dietician, knows more about food than I do. But we always talked about the fact that the difference of we we grew up, you know, we raised our kids six miles away from each other. And the difference in food access in Newton versus the difference in food access in Mattapan meant that her kids started with a disadvantage notwithstanding all of her knowledge.
00:07:52
Speaker
And so that piece just became really clear to me when I was working in that space. And it became something that I, one, looked to Create shifts in with the investments when I was at the boston foundation And certainly something that I work very hard at imparting to my students um in classes Particularly those that are going into clinical fields because I always like to remind them. It doesn't matter how good a doctor you are if you're trying to address malnutrition and your patient doesn't have access to food
00:08:28
Speaker
What drug are you going to give them that's going to make them not malnourished? They need food as medicine. And food as medicine is even a concept that's come up. And that's just one example of where we see this play out.
00:08:42
Speaker
Yeah, definitely. I think so in my like social impact investing club that we run on campus at Northeastern, um one of the companies we had was Eat Well and their whole idea was like giving meal kits and they're billing healthcare insurance with the fact that, I mean, meal kits are the ones, like I mean, food is affecting community health. And it seems like a lot of people just don't really recognize that. But I mean, in your time in the Boston Health Foundation and your experiences so far like how are you helping advocate is it just more like talking to people sharing the issue or is it through your investments you're kind of developing and sharing the story yeah so so just to be clear the boston foundation is a community foundation um it's not specifically a health foundation though i would argue as a community foundation investing across different areas
00:09:25
Speaker
um We had, I think, the better opportunity to impact health outcomes than a dedicated health foundation because of everything I just said. If it was a dedicated health foundation, we'd be investing in health only, and those are important. But as a community foundation, my colleagues included ah program directors like myself who invested in education.
00:09:51
Speaker
or invested in workforce development or invested in housing. And in many of those cases, I would work collaboratively across lines with my colleagues. So for example, did a project at the foundation called Health Starts at Home.
00:10:09
Speaker
where I invested healthcare dollars along with my colleague who was investing in housing. And what we were trying to show was that if we could stabilize housing for families, so children's health outcomes would improve. Well, of course they will they're going to improve. And in fact, years after this project, we did ah um an initial year of bringing together these organizations and and there had to be at least one health and one housing organization together and After they got some planning time they implemented their their projects the projects were then evaluated and Not surprisingly our theory was right. Why does stable housing result in better health outcomes? Well with stable housing kids are sleeping with stable housing. They're going to the same school and
00:10:57
Speaker
With stable housing, they're more likely to go to their wellness visits, get their vaccinations. So all of the things that we know are going to make kids healthier happen when they have stable housing. And so I always felt like with the foundation, the way that we got to do this was we would in have organizations that came to us through open grant making requests. But sometimes for a project like Health Starts at Home, we would incentivize a model of people working together to test a theory, use those resources to do
Challenges in Healthcare Access and Insurance
00:11:29
Speaker
that. And in in this particular case, it proved to be a pretty successful.
00:11:33
Speaker
model that now these organizations hopefully continue to be working together. It's been a while since I've been there. I love ah left the foundation in 2016, so it's been a while, but um I know that a lot of these partnerships still persist to this day.
00:11:49
Speaker
Yeah, and I think, I mean, of course, like, yeah, housing's a big one. We kind of talked about food, employment, education. Like, yeah, if you're not you don't have employment, you obviously can't get access to healthcare. care There's so much too, and it's a very, like, multi-faceted issue, I'd say. But, I mean, out of curiosity, I know we've kind of talked about community health centers in class, and but can you kind of walk us, like, walk us through, like, what is a community health center and how have they evolved over time to hopefully, like, fit this need and, like, what what is going on with them today?
00:12:15
Speaker
Yeah, absolutely. I mean, community health centers are a backbone of providing health care and particularly providing it to um as ah an easier entry point in community and often communities that don't have a lot of access.
00:12:31
Speaker
um Believe it or not, the first community health centers were in two places, ah Massachusetts, as well as the Mississippi Delta, one of the founders, Delta. I don't know, I just sounded like a big New Yorker right there. um the Dr. Jack Geiger was one of the big um founders and proponents of community health centers, recognizing that you sometimes had to bring health to community if community wasn't in a place where they could get to healthcare.
00:12:57
Speaker
um And those models, um Massachusetts having, again, one of the oldest and first, um we also have a very extensive network of community health centers now.
00:13:08
Speaker
And they function like a, I'd say a mashup of a medical center, a community center, a clinic, ah ah just as a touch point, really lifting up the model of the patient centered medical home where they are responding to the health needs of the community, both clinically, but also non-clinically. So what do I mean by that?
00:13:37
Speaker
I've been really active in working with Bowdoin Street Health Center, which happens to be a community health center in Dorchester. They're affiliated with ah Beth Israel, um are Leahy now. And Bowdoin Street looks like a federally qualified health center, an FQHC, though they're not one because they're part of the Beth Israel system. So they're the community health department. There are lots of federally, FQHCs, federally qualified health centers in Boston,
00:14:06
Speaker
Dimic Community Health Center right by our campus at Northeastern Whittier Street, um multiple health centers. and But my knowledge around Bowdoin Street and working with the then long-time director, she used to say that she felt a responsibility to the community outside the walls as well as inside the walls. And so as a community health center, they had primary care, they had pediatric care, they provided the different care that um Individuals needed that was medical, but they were also aware of what the issues were in community. So whether it was HIV AIDS or gun violence or food insecurity, they would work to address those issues beyond their walls. Maybe it was by convening coalitions.
00:14:53
Speaker
I mean, the case of food insecurity, Bowdoin Street pops up a farmer's market in their parking lot. They bring a couple of vendors in, they have it right in their parking lot so that people in community who don't have easy access to transportation can walk right to the place that they're comfortable with. They make that food accessible by having the vendors that accept SNAP or EBT so that folks that have benefits can use them at the farmer's market. um That's the sort of community health center model.
00:15:22
Speaker
it's um literally um tied in to not just the care within the clinic, but outside the clinic. One of my classes, my policy class, I often have one of the medical directors there that I'm friendly with um come and speak, and she talks all about the environmental issues around the clinic.
00:15:46
Speaker
recognizing that sometimes the urban core doesn't have as much tree cover, which means that it's hotter, which means that that could exacerbate health issues. And so sometimes they'll advocate for just making the community look different, the physical structure of the community, because we know that that makes a difference. So that's what I love about community health centers is that it's so much bigger than just a doctor's office.
00:16:14
Speaker
Yeah, they're great because you have that. Of course, they started out as like a health in their name health center, but they've expanded off to do everything but health. So it's just it's kind of nice. They have like a full, like fully comprehensive system. But I mean, everything that is health. Right. Yeah, because they are how to. Yeah, exactly. Food showing and ah in the environment, everything like that is super important. But um I mean, the unfortunate thing is that in a lot of states and a lot of even areas of Massachusetts, I mean, community health centers aren't an option. And like, I think they're growing in popularity. But There is like 30 million people I think they serve right now and a lot of them are uninsured in the rural areas and there's far more people who might need them.
00:16:51
Speaker
What would be your going forward approach? I know, of course, it's not just one person to solve this problem, but how do you view this solution in the future? How can we help access? If this was an easy solution, it would have been fixed already. If I could come up with a way to fix it, I'd get a MacArthur Genius Award. I'm not sure either of those things are going to happen, are true or are going to happen.
Role of Technology and AI in Healthcare
00:17:18
Speaker
i would say that you know accessibility is always an issue and accessibility comes from both the insurance accessibility as well as having a place to use that insurance um obviously i think as a. The only.
00:17:35
Speaker
ah you know Nation within the OECD countries those economically advanced countries to not have universal health coverage is Obviously a problem. So that's just a hard stop right there. we've We've done some of that We've advanced it obviously with the ACA with Medicaid expansions, but we still have gaps so I think that's one coming up with some model to do a You know something that allows for universally people knowing they have health insurance is obviously a big piece How might that look? Um, I know I've I think i've you know, i've led a couple of our global programs to germany i'm pretty fond of the german model which has both a private insurance as well as a public model and between the two it's a it's a full safety net everybody gets coverage. Um, so I think that's one way of looking at it
00:18:30
Speaker
That's the the insurance piece. That doesn't speak to the other you know element that you raised up, which is sometimes there isn't access. There isn't access in in rural communities. There may not be access. um Some states versus others. Massachusetts has pretty broad access yeah because we're a smaller state with an extensive network of of health systems and in our state. But there are definitely places where that's harder. um you know I think we're finding and seeing lots of gap fillers. um I know you and I probably both got vaccines at pharmacies.
00:19:08
Speaker
You know, pharmacies have started to sort of fill the gap. We've seen urgent care centers grow amazingly ah across the United States, exponentially even. um Those are great too, but they're not a substitute because they're meant for urgent care. And what we really want is somebody directed into a medical home. You know, we want the continuity of care. um It's hard given our model to sustain healthcare care in smaller places where there are fewer people, perhaps utilizing Medicaid to provide
00:19:45
Speaker
um supports that get people to health care, not just the care, so transportation to facilities that might be farther away, having some of that pay for social determinant of health um Needs social supports. um I think if we could figure out a way to utilize You know care managers or patient care advocates um so that people had someone to call um Maybe this is a technology piece or at least a technology to connect to a human piece where individuals Know that there's an extensive system of care managers out there that they could
00:20:25
Speaker
link into to help them identify not only where the care is, but how they could get it covered, what the options were. i I think that historically because our system is only paid for direct clinical care and less paid for some of that wraparound services, right? for For the longest time, it was always a fee for a service and it wasn't a service if a care manager was trying to manage your care. That wasn't considered a medical service. So I think if we have different payment structures that pay for that kind of care management, maybe that could help fill the gap.
00:21:03
Speaker
Yeah, I think it'd be interesting. We actually had, I mean, just two weeks ago, we had a guest um Isaac held, so he kind of identified that dementia cares. And like there's a lot of lot gaps in Alzheimer's and dementia care. So you kind of create a whole fully vertical solution, the end-to-end solution. And ah along that way, these patients that are generally older might not have a huge support system with their family or community. um They have an advocate. And then also Stagely Health, um another company we spoke on that helps kind of pair people with like clinical trials and get them for cancer treatment. And they also have like a patient advocacy program. They run with Northeastern. so
00:21:39
Speaker
I think companies are starting to pick up on this, but it will be good to see, of course, like um from a policy perspective, insurer payer's perspective, that this gets brought into the healthcare system. And um that's come something I was curious about. I mean, we have all these different solutions like business, technology, policy. like Where do you kind of see what skill set do you think is kind of needed to like approach this kind of next wave of healthcare care innovation? you know it's It's interesting because we're still going to need the existing skill sets of the providers.
00:22:07
Speaker
yeah We're obviously going to need all of the providers. I think that in our American system, because we have so many fewer primary care providers than other developed nations, um filling the gap we often fill the gap with nurse practitioners and physician assistants. And I think we're going to see a rise in those um professions.
00:22:29
Speaker
um they you know they Obviously, it's a shorter period of training time. for the cost, you know what their reimbursement rates are, probably a little bit lower, but they can help fill that gap for primary care. So I think we might see some of that. I mean, we obviously do need all of the providers, but separate from the providers, I do think that, um I saw this in Germany, a little bit of the utilization of technology and AI to be a gap filler. When I was in Germany, we met with, um
00:23:03
Speaker
a number of innovators who were doing um technology and innovation. And one of the companies that we talked with or we got to hear from was something called Claire and Me. And it was sort of an AI mental health tool. And it was completely an AI tool. It was not a human on the other end. It wasn't you know a better help where you're calling in and you're getting a an actual human therapist who you are talking to, I think that's great too. I think the and the utilization of technology to connect with um clinicians because you're not near them is a great tool. But some of these tools are designed to almost be user-driven ways
00:23:50
Speaker
to manage some of your health issues. I think we'll probably see more of that in the behavioral health space than we will in physical health. Obviously, it's harder in a physical health space to do that. But to see some of the technology, again, we have in this moment in time, I think over the last few years, certainly before COVID, but with COVID and its aftermath, a real explosion of mental health issues, particularly in 18 to 25 year olds, maybe a little bit older, maybe a little bit younger. um And because that population can really utilize technology, I think we may see a little bit more growth in technology in that space as a way for individuals to have
00:24:37
Speaker
well-informed self-management tools that could be a bridge until they can actually see a human provider.
Teaching the Future of Healthcare
00:24:46
Speaker
I don't think it's a substitute, but it might be a tool that we can see to help bridge people. So that's one area that I would keep my eye on the ball on. Yeah, because kind of what we're seeing is that there's super long wait times to get a psychiatrist, especially if you're not well-insured and don't have the best insurance or insurance at all. um So when you have like these six months and someone finally gets the courage to go see a therapist,
00:25:07
Speaker
they're waiting for six months. I think that's just not the best idea. So I think having technology that can, yeah, fill that gap. It's like peer to peer support or something with AI. I think that's a great solution, but like in your classes, I know that you're kind of teaching a very holistic approach to solving these issues. You talk about technology, kind of talk about policy and everything else. Like what kind of, what is a really academia brought you in like your career and being able to like, kind of, as opposed to just like being directly on the ground and just, um,
00:25:34
Speaker
Like being the one time changing things and like from a more experiential perspective. So I love that question probably more than any question you've asked so far because I've been thinking about it a lot lately. um A lot of what's going on in the world politically is challenging for me right now. I'm seeing a lot of language and actions that look to undermine public health.
00:25:56
Speaker
And so what has academia brought me when I was out and doing my work elsewhere, whether it was you know me as an advocate in in health advocacy or whether I was running a bureau or doing that, um I felt you know good about what i was doing but often just exhausted because you know obviously i had a staff or i had people that i work with we had collaborations. But there's something there are a couple of different factors i love stepping in front of a classroom because every single person in that room,
00:26:31
Speaker
Provide the power of possibility they may be that person who invents the technology becomes the researcher that finds the new drug comes up with the great idea um that helps to change the health system.
00:26:47
Speaker
Or even just is that person who's providing health care in an underserved community. Whatever it is, I have such a wide you know array of students who have so many different interests and ideas and opportunities. And I'm there. I kind of feel like I'm the like kindling. And i I get
Student Concerns on Mental Health and Climate Change
00:27:10
Speaker
to stand in front. I get to share my knowledge. And hopefully,
00:27:14
Speaker
Create some spark that then takes they take and they're able to push it out right and so I feel like my effect can be amplified at much greater levels by being in my role as a professor, by trying to touch people, by trying to get, you know, the student who said she's on the swim team, she's going to physical therapy school, she takes my policy class, always a little bit grumpy when they have to take a policy class, a lot of the students, and like halfway through comes over to me after the end of one class and she's like, I didn't think I was gonna like policy, but this is kinda cool." And I said, you know what? That's great. So when you go out in your practice and you go be a physical therapist, remember, there's an American Physical Therapy Association. And when there are issues that come up that affect your patients outside the clinic, link into that association, tap into your policy background and make sure that while you're helping people in physical therapy in a clinic, love that,
00:28:17
Speaker
You're also thinking about the ways that you can ah Help them holistically outside the clinic if I do that and if every practitioner does that it's going to change the way we deliver medicine So I think for me that's really exciting that that's what I get to do. I love teaching um in many ways, I thought I was going to teach much earlier and I I may or may not have shared this in class, but I've taught at other universities only as a visiting professor or an adjunct, never never the full-time role that I've had at Northeastern. But it really suits me, and it does bring me unbelievable amounts of of joy, and I love connecting with the students. and i get When I get tired, um when I think back to God, how long have I been doing this? We haven't, we're we're back to, you know, rearguing the same issue. um I often get inspired by my students and that then keeps me going and and hopefully it's kind of mutually beneficial. Yeah, that's great. I mean, I started of this podcast to cover of like the future of healthcare.
00:29:23
Speaker
And one of those those areas or technology innovation is well identified but I mean really like the future of healthcare care is was like in that classroom. Like those are the people going to be out changing the system whether it's like policy or maybe technology like me hopefully or like some other lens just even helping people on a daily basis but I mean, we had our group projects in class and people really cared a lot about mental health, substance abuse, and what these students care about is going to be what eventually is going to change in the world, hopefully in the future. and What kind of issues do you think like these students really care about and what are you trying to see them talk about the most? Yeah, I think I've mentioned this in the in the past. You know, I talk about HIV AIDS and HIV AIDS a lot because of my generation. A lot of my peers who teach, that was the big issue when we were your age. When I was in my 20s, HIV AIDS, that was the thing. It was HIV AIDS, HIV AIDS. I think that for this generation, for people who, again, late teens into early, mid-20s, even late 20s right now, I think two issues are really popping. One is mental health, and the other is environmental health and climate change.
00:30:29
Speaker
Because I think that those are the two issues that mental health is a right now moment for students. um Again, pre-pandemic, it was certainly there, amplified by the pandemic, amplified by social media.
00:30:45
Speaker
um You know, I i remember I, you know, I talked to some of my friends were like, God, we're so happy we didn't have social media at the time, right? If we didn't get invited to something, we didn't know we didn't get invited to it. Now, I mean, I have 22 year old twins, I can watch as they've perseverated over things.
00:31:02
Speaker
Wait, how come I so-and-s so and so is having more fun, you know that and it and it really degrades I think your sense of self so I think mental health as a current real-time issue and I think environmental health and climate as the issue that you're all worried about because you know you want to have a planet at some point and is increasingly becoming obvious that something needs to change in order to preserve the planet. So those are the two issues I think are popping most with students right now.
Advice for Students in Healthcare
00:31:34
Speaker
Yeah, and that's really interesting. like i guess my I can definitely see mental health as something that we've touched on upon a lot, but then climate change is it's so pervasive and it definitely affects our healthcare system. So another thing these community health centers need to tackle, and kind of on unlike my last question that I was definitely really curious about to share with the audience is, I mean, all these are these some issues that we need to talk or tackle, but like what skillset and what kind of resources or advice do you have for students or entrepreneurs kind of looking to impact the space? What do you suggest to them when you kind of look backwards on your career?
00:32:04
Speaker
So I'm not sure that I have great advice for entrepreneurs because I don't know that that's my space, but they can um extrapolate from what I'm going to say and and see if it ah provides them any guidance. But I think for students, for me, the greatest advice is um be curious. Always try to learn about something you don't know.
00:32:27
Speaker
When I think about my my path and my career, I tell a really good story, right? These are the degrees I got, this is the work I did and I packaged all up and I teach at Northeastern. Well, that's a really good story that I can tell looking backwards now, making it seem like I had a great plan and tied it in a bow and it came out exactly the way I had planned. I had no idea.
00:32:52
Speaker
I just went from thing to thing. I was open to trying something I hadn't done before. I was a lawyer. I had never been a lobbyist. I became a lobbyist. I became a policy advocate. i when i When I joined the Boston Foundation, where I spent almost 10 years. I had left the state house. I was working as a lawyer, a legislative lawyer, that I knew. And somebody said, oh, you you know, think about this position. It came open. I didn't even know anything about philanthropy. I had never made a grant in my life. And then I spent 10 years becoming a leader in the in the country around health philanthropy. So I think for me, the advice is always be curious.
00:33:35
Speaker
Always try to learn something new, get out of your comfort zone. The way you're going to learn is by getting uncomfortable, being in an uncomfortable space. And I will, I would refer back to one of the innovators that I got to invest in um back in the time at the Boston foundation used to say the best job out there a decade from now hasn't been created yet. So always be thinking about what the new idea is, this is for your, I guess your innovators, here innovators yeah
00:34:12
Speaker
what's the unoccupied space that we haven't moved into to try to solve a problem? Because if we keep trying to solve problems doing the same thing over and over, we're going to get the same outcome. So what's unoccupied space that someone hasn't thought about yet?
00:34:29
Speaker
um And when I say I learned about the social determinants and really dug in on them at the at the foundation, it was this innovator, this particular innovator who came up with the idea that we really needed to take a look at doctor's visits and not just say, What's your height? What's your weight? What's your blood pressure? What's your pulse? But do you have food at home? Do you feel safe at home? Is your housing stable? Starting to make questions at the doctor's office be about those social determinants. She created a whole model and now it's so common you go to the doctor and what's one of the first things they do. They give you a form to fill out and they ask you when you're filling out your form,
00:35:14
Speaker
And often those are now on electric you know devices, right? They're on iPads or you know before you check in before you get there in the last Three months. Have you had any issues around food access in the last three months? Has your housing been unstable? They'll ask you that right off the bat because there's a recognition now in the health system That we need to look as I said inside and outside the walls to keep people healthy but that wasn't an idea before 30 years ago that this innovator came up with
00:35:51
Speaker
And now it's integrated in how we provide care really everywhere. So I think just always be curious. Always be thinking about where the unoccupied space is.
00:36:05
Speaker
put yourself in uncomfortable positions to grow and work collaboratively with people. Nobody's going to do anything by themselves, making sure that you're connecting. And if you have no idea what you want to do right now, that's perfect because it allows you to have something called the beginner's mind, which is every time you take on something new, you approach it with an open mind and you're going to be able to learn more, um, and learn from people.
Podcast Conclusion and Resources
00:36:32
Speaker
who've done pieces of the work and give you opportunities for growth. Definitely. Yeah, and that stuff, that's I think that's really good advice and definitely something people can take towards the rest of the world is like have their curiosity and be willing to fill those gaps. And just want to say thank you so much Professor Bauer for coming on today and really sharing your story, diving into what community health really means and just providing that background for us. It was a lot of fun. So thank you very much for having me.
00:36:58
Speaker
Thanks for listening to The Healthcare Theory. Every Tuesday, expect a new episode on the platform of your choice. You can find us on Spotify, Apple Music, YouTube, any streaming platform you can imagine. We'll also be posting more short-form educational content on Instagram and TikTok. And if you really want to learn more about what's gone wrong with healthcare care and how you can help, check out our blog at thehealthcaretheory.org. Repeat thehealthcaretheory.org. Again, I appreciate you tuning in and I hope to see you again soon.