April 1, 2026 Forum

Jo

Thank you, Jack. It speaks to my public health heart, certainly, and background. Our LA General Hospital, our county hospital. My public health project actually was looking at behavioral health integration into the medical work we do and working with an interdisciplinary team to try to address these hotspotters, in fact. And like you say, I think it’s the bottom line,. In my opinion, its easier to address the problems from an individualist perspective. It’s easy to identify individual people who have problems and address their individual problems, and it reduces your bottom line. But to then say, well, gee, what happens is that so many things need to be addressed in the area, the cold spot, if you will. It’s much harder to get all the social support groups together, to get political groups aligned, to get everybody aligned to make decisions. And LA is a terrible place to try to get people aligned on anything, unfortunately.

In our area, everybody has so many divisions and divides. You can’t get all the groups together to make changes in a bigger community, or it’s very hard to address all of the social determinants of health that you talk about, that I think make people into hotspotters. Often, then it’s individual champions and leaders who are able to get those groups of people together. However, it’s not so easy to do that. And that’s where I see that the challenge. The issues posed by the individual hotspotters are easier to solve than issues related to the cold spots. Bigger solution are needed. It is a major challenge to bring people together, in alignment, to construct these communities of solution and problem sheds that you talk about. And I don’t know that there’s an easy answer to that, and each individual community probably has its own resources to do that, and align people around it.

And I’m thinking of creative solutions. What is just one creative thing we’ve tried to do in our communities. What are things that I can change? There are a lot of things I can’t change, but there are things I can change. So, we’ve tried to use students. Nowadays, they’ve got to do projects. They have to do research..If you will, they are a free workforce composed of young people who are very smart and very motivated with lots of energy. And so, I’ve tried to align them around issues in our community to make change that way, whether it be climate change, or identifying resources for food, and clothing. So they go out and physically do things without needing much money. We have our students do research on a specific issue, it so that we can bring attention to it. I have found that a little small solution can make a little bit of a ripple. Then if you can publicize it, the issue and small solution gets out into a larger community. Members of this community say: “Well, look what’s happening here, maybe we can put some dollars toward it. “ And then more people get interested in this issue. So, sometimes that’s a little bit of a ripple that gets things going. However, it’s hard to align communities for bigger system change. Because, what you’re talking about is bigger system change, whereas work with hot spotters requires focused individual change.