Essential population health goals include
- protecting and promoting equity and health,
- transforming people and place,
- ensuring a healthy planet, and
- achieving health equity.
Naturally, I am often asked to give talks on health inequities (see Presentations). My general approach is to connect
- structural trauma (poverty, racism, discrimination) and toxic (traumatic) stress (adverse childhood experiences),
- inter-generational transmission of biological and social risk to offspring,
- life course neurocognitive development affecting a child’s brain, learning, behavior, and health for life, and
- industry exploitation of our neuro-vulnerabilities to design and market products for addiction and overconsumption (tobacco, alcohol, prescription opioids, processed foods, gambling, gaming, mobile phones, etc.). Lustig calls this the “hacking” of the American mind .
While the most vulnerable communities are the most impacted, the truth is that we are all susceptible, we are all targeted, and we are all effected. However, connecting the dots with a simple story of how this all works is not easy. After much reflection and giving several talks I have adapted a simple model which I am calling the Radical Health Development Model (Figure 1). Why “radical”? According to the Oxford Dictionary radical is an adjective meaning “relating to or affecting the fundamental [root] nature of something; far-reaching or thorough.”
This approach enables me to present and connect
- Neurocognitive development (see Harris )
- System 1 and System 2 (also see Kahneman )
- Executive function (see https://developingchild.harvard.edu/)
- Cognitive biases (also see Kahneman  and Thaler )
- Decision making (also see Spetzler )
- Epidemics of addiction (“hacking”) (also see Lustig )
- Trauma-informed systems and Trauma-sensitive schools
- Cultural humility (also see Tervalon and Murray-Garcia )
- Racism, especially implicit biases (see Banaji )
- Health inequities through life-course lens (see Braveman )
- Social determinants of health that protect children’s neurodevelopment
From my experience and scholarship I have come to believe that (a) promoting and embodying universal values (dignity, equity, compasssion, and humility) and (b) understanding and leveraging brain science is the key strategic lever to achieving our essential population health goals. After all, all policies and actions are the result of human decisions. Decisions are driven by culture, norms, values, intuition (System 1), implicit biases, and human drives, including survival.
All meaningful transformations start with self and the people we interact with (teams, family, organization, community). My personal purpose has become:
Striving to embody the universal values of dignity, equity, compassion, and humility, I work to convene, connect, and catalyze communities and institutions to transform narratives, policies, and systems towards a sustainable culture of equity, healing, and health for all people and our planet.
Consequently, I focus on transforming hearts and minds via
- intellectual and cultural humility,
- mindfulness and heartfulness,
- healing systems and communities, and
- life-course, inter-generational, and community lens.
1. Lustig R. The hacking of the american mind : The science behind the corporate takeover of our bodies and brains. New York, New York: Avery; 2017.
2. Harris N. The deepest well : Healing the long-term effects of childhood adversity. Boston: Houghton Mifflin Harcourt; 2018.
3. Kahneman D. Thinking, fast and slow. New York: Farrar, Straus; Giroux; 2011.
4. Thaler R. Misbehaving: The making of behavioral economics. New York: W.W. Norton & Company; 2015.
5. Spetzler C, Winter H, Meyer J. Decision quality: Value creation from better business decisions. 1st ed. Wiley; 2016.
6. Tervalon M, Murray-Garcia J. Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. J Health Care Poor Underserved. 1998 May;9(2):117–25.
7. Banaji M. Blindspot : Hidden biases of good people. New York: Delacorte Press; 2013.
8. Braveman P. What is health equity: And how does a life-course approach take us further toward it? Maternal and child health journal. 2014 Feb;18(2):366–72.