Jan Malcolm

Wow. So many inspirations along the way. But, uh, you know, I, I go back to, I mean, many years ago, I was a much younger person, you know, somebody who really inspired me a lot was Dr. David Satcher, former surgeon general of the United States.

Wow. So many inspirations along the way. But, uh, you know, I, I go back to, I mean, many years ago, I was a much younger person, you know, somebody who really inspired me a lot was Dr. David Satcher, former surgeon general of the United States.

I mean, I can remember him, you know, talking about this, you know, kind of the social determinants of health before very many people were using that terminology. Um, You know, and he would talk about I can remember vividly a speech that he gave. He was talking about how this was in the in the 1990s, talking about how unacceptable infant and maternal mortality rates were back then.

I mean, I can remember him, you know, talking about this, you know, kind of the social determinants of health before very many people were using that terminology. Um, You know, and he would talk about I can remember vividly a speech that he gave. He was talking about how this was in the in the 1990s, talking about how unacceptable infant and maternal mortality rates were back then.

And he said, you know what the most important factor is for infant and maternal mortality? Maternal income security. I was like, whoa, you know, light bulb just kind of went off. It's not just prenatal care or not. It's that more fundamental, do people have what they need to be safe and healthy? And so he really was, he sort of put that spark in me, you know, early, early on.

And he said, you know what the most important factor is for infant and maternal mortality? Maternal income security. I was like, whoa, you know, light bulb just kind of went off. It's not just prenatal care or not. It's that more fundamental, do people have what they need to be safe and healthy? And so he really was, he sort of put that spark in me, you know, early, early on.

And since then, it's really been, you know, leaders in the community, many of whom were were rightly kind of critical of kind of what we were doing with the response. And this is a dilemma, I'll just call it right out, between focusing on the largest number of people versus focusing on the biggest degree of harm, if you will.

And since then, it's really been, you know, leaders in the community, many of whom were were rightly kind of critical of kind of what we were doing with the response. And this is a dilemma, I'll just call it right out, between focusing on the largest number of people versus focusing on the biggest degree of harm, if you will.

So the whole tension between how do you deploy the resources from an equity perspective

So the whole tension between how do you deploy the resources from an equity perspective

Um, you know, whether we're talking about testing or vaccination, you know, how do we, how do we prioritize the populations that, that are at the greatest risk while the, the other side of the coin is saying, but you got to get the countermeasures and, you know, as broadly spread as possible, as fast as possible. And that kind of makes you do these sort of more, more untargeted mass events.

Um, you know, whether we're talking about testing or vaccination, you know, how do we, how do we prioritize the populations that, that are at the greatest risk while the, the other side of the coin is saying, but you got to get the countermeasures and, you know, as broadly spread as possible, as fast as possible. And that kind of makes you do these sort of more, more untargeted mass events.

And, and so that, you know, I, and I, you know, I kept being challenged appropriately. So by leaders in the community saying, this isn't working, you need to do more to get the resources deeper into the community. You know, and, and I mean, the, the, the, I will just call out, you know, kind of the black religious leaders, you know, the, the, the, the churches, the pastors, the,

And, and so that, you know, I, and I, you know, I kept being challenged appropriately. So by leaders in the community saying, this isn't working, you need to do more to get the resources deeper into the community. You know, and, and I mean, the, the, the, I will just call out, you know, kind of the black religious leaders, you know, the, the, the, the churches, the pastors, the,

You know, and the folks in service organizations like yours, you know, working with communities to try to get communities access to the resources and to get the resources deeper into communities.

You know, and the folks in service organizations like yours, you know, working with communities to try to get communities access to the resources and to get the resources deeper into communities.

I think we got better as we went, but it was always a challenge to, you know, to get that balance between the big, you know, the big P population and the more targeted communities where the needs were particularly great.

I think we got better as we went, but it was always a challenge to, you know, to get that balance between the big, you know, the big P population and the more targeted communities where the needs were particularly great.

Well, I think that is, you know, that's a question, that too is a question that really needs a lot deeper discussion. I mean, we've, to your point, public health is hugely underfunded. No matter what part of the public health Absolutely. Infectious disease is underfunded. Emergency preparedness is underfunded. Chronic disease is certainly underfunded.

Well, I think that is, you know, that's a question, that too is a question that really needs a lot deeper discussion. I mean, we've, to your point, public health is hugely underfunded. No matter what part of the public health Absolutely. Infectious disease is underfunded. Emergency preparedness is underfunded. Chronic disease is certainly underfunded.