April 1, 2026 Forum

Jack

I want to make sure that no one hears me saying individual efforts aren’t important. Individual patients, that’s what I see in my exam room every day. I don’t see groups of people in my exam room. I see individuals and individual care is essential. Helping people connect their individual passion with meaning is absolutely essential and so important for folks to be able to do. It’s that when we only do that, we miss an opportunity and there are places where they’ve taken advantage of those opportunities and there are places.

There are places where communities of solution have sprung up around the country and there’s a new international bit of work out of the University of Montreal that’s looking at communities of solution around the world. They are trying to develop examples of this for others that could be standardized and codified and (as gross as it sounds) monetize—because that’s where health care, at least in the United States, is right now. If you can’t make money on it, it ain’t going to happen.

Jeremy

Just to put a little bit of context from prior discussions that we’ve had that I think are interrelated with this is our discussions of allostatic load. As you guys remember, we really focused on the adverse childhood events. We’ve got a lot of data on what’s wrong within communities, and yet there are also, I think what we called in the book, community lifts. This is sort of a generic term that brings up the retirees who are building homes for people.

Jack, I think you called them the asset shed. Is that the term you use? It’s really kind of a strengths-based way of looking at communities, saying this community has resilience. It has some really great factors.

Focus on that and grow that, rather than humiliate and shame a community and then throw some vertical integration and some money at that community. Then leave three years later. Everybody goes, yeah, you didn’t really help us at all. That’s not dissimilar from what happens with a lot of global health efforts. The United States shows up with our jet planes and our helicopters and we hang out for a few years or months. And actually, when we leave, it’s not that much better off than it was when we got there. It just seems like we have not been looking at how to expand the assets within a community in a strengths-based perspective—a perspective that is inspiring for those communities.

Jo

I think some of the things that help that, Jeremy, are going into communities and learning with the spirit of “I’m going to learn from you” and “You’re going to learn from me.” An open spirit.

And I’ve seen lots of great things with the health promoters. Maybe you’ve seen of those we have in our own communities. Where we’ve gone into communities where sometimes they’re suspicious of people that are coming. We looked at the local leaders and the health leaders and a lot of our women who, particularly in our vulnerable Latino communities here in Los Angeles, found them, taught them things, and then they’re empowered and then they develop trust. We develop trust with them. They develop trust with us. Then they go into their own communities where they’re trusted.  And we’ve seen that in so many places. And then we work together with them. They help us identify assets.  I’m just thinking like the abuelas in our community that were knitting hats and booties and things for some of our L&D folks when they lost their babies.

And we try to set up opportunities to help support that community for fetal uterine demises. So many ways that this kind of stuff happens. And I think working within communities and identifying people really helps.