April 1, 2026 Forum

Bill B

Jo, what you’re talking about is called service learning. I think one of the first service learning initiatives was engaged at USC in Los Angeles. So, what it means is that increasingly colleges and universities, at least until the Trump era, are devoting an increasingly large percentage of their total curriculum to what Jo’s talking about, which is students getting out in the community, engaging in projects. Until the Trump era, service learning projects became a major part of the student curriculum in many places. And there is also the related issue of the national service corps. And the broader issue of requiring our young people to participate for one or two years in a service corps?

One other thing. I’m 85 years old. This qualifies me as an elderly hot spotter.

So, consideration needs to be given to hot spotting in the elderly population And so, Jack, what you’re talking about is relevant to my own community here in Harpswell, Maine. We are the oldest community in America. And what we have are these extraordinary volunteer services. For instance, we have a group of retired men, who go out and repair homes at no expense to the elderly homeowner. One of our friends went out to work on the home of a woman who kept going back in the hospital every month because of respiratory issues. Our friend went into her home and found that there was a massive amount of mold underneath her home. So, the mold was getting into her lungs. So, our friend brought in his volunteer team to remove all of the mold while doing extensive repair on her home. This woman now is no longer going to the hospital every month. This example is closely related, Jack, to what you’re talking about. What are the kind of activities, even volunteer activities, that can turn a hot spot community like where I live to someplace that’s a little cooler?

Jeremy

I think that’s well put. You’ve got the cold spot communities that are struggling with lots of unhealthy contextual elements that are not being addressed. Like what you’re saying, Bill, the woman’s home was making her ill. It wasn’t actually her getting on more antifungal medication or more asthma medicine or whatever, which is what the healthcare system will do.

But then you move from that kind of cold spot community that’s very under-resourced, maybe blighted, whatever description, it might evolve for some reason. And then it’s no longer a blighted area. It’s now become a gentrified neighborhood with good health outcomes. And then on the far extreme are these blue zones. We have one of those in the United States, which is Loma Linda, where people live for a really long time and no one’s really sure why. There are areas in Japan, I think blue zones are also found in other regions. Island residents tend to have especially long longevity.

Not that longevity is the singular most important moniker of health, but that is an example of communities, like you’re saying, Bill B, where you are in Maine, where people are living longer. So something health-promoting is probably going right there. And we’re not studying these communities in that way. All the resources are being used to identify the really sick people. And then we spend a fortune on them. So, it’s just a matter of a different perspective. So how do you change that? That’s why we’re talking about these matters. We are trying to reframe the major healthcare challenges, saying, this is a systems issue.