Jan Malcolm

You know, analysis and planning is certainly underfunded. So it's it's kind of I think where we in public health are kind of expected to do all of it. But but really without any appreciation of of. what it takes to do it, to do it robustly and well. I can remember you raised tobacco as a great kind of lesson, if you will, of how this works.

You know, analysis and planning is certainly underfunded. So it's it's kind of I think where we in public health are kind of expected to do all of it. But but really without any appreciation of of. what it takes to do it, to do it robustly and well. I can remember you raised tobacco as a great kind of lesson, if you will, of how this works.

I can remember in my first term at the health department with Governor Ventura, it was right after the tobacco settlement. And, you know, so we had this boatload of money coming from the tobacco settlement with kind of lots of differences of opinion about how that money should be spent. But very little support for spending it on prevention. Oh, let's spend it on cancer treatment.

I can remember in my first term at the health department with Governor Ventura, it was right after the tobacco settlement. And, you know, so we had this boatload of money coming from the tobacco settlement with kind of lots of differences of opinion about how that money should be spent. But very little support for spending it on prevention. Oh, let's spend it on cancer treatment.

Yeah. Let's, yes, exactly. Let's, you know, let's help people stop smoking. Well, yes, let's, but let's. try to work on the prevention side as well. And I think we had some real successes there because with that money and with, frankly, Governor Ventura's support, we were able to get more money put into the prevention side than we ever had before. We went from funding our

Yeah. Let's, yes, exactly. Let's, you know, let's help people stop smoking. Well, yes, let's, but let's. try to work on the prevention side as well. And I think we had some real successes there because with that money and with, frankly, Governor Ventura's support, we were able to get more money put into the prevention side than we ever had before. We went from funding our

our anti-tobacco efforts at a couple million dollars a year, which was like, if that's all you're going to spend, frankly, why don't you save it? Because it's not going to make a difference. It's not going to move the needle at all if you're battling against all these bigger forces that are much more

our anti-tobacco efforts at a couple million dollars a year, which was like, if that's all you're going to spend, frankly, why don't you save it? Because it's not going to make a difference. It's not going to move the needle at all if you're battling against all these bigger forces that are much more

successful in uh in getting people to smoke on the marketing side or use tobacco commercial tobacco but but when we could really appropriately resource it we actually produced some pretty good results it wasn't just the money but it was this multi-layered strategy of understanding oh you got to work at the individual level you got to work at the family the community the policy level

successful in uh in getting people to smoke on the marketing side or use tobacco commercial tobacco but but when we could really appropriately resource it we actually produced some pretty good results it wasn't just the money but it was this multi-layered strategy of understanding oh you got to work at the individual level you got to work at the family the community the policy level

And we had all these things kind of working in synergy. And we dropped youth smoking by 30 percent in about five years. It was like, wow. And it was a combination of lots of different strategies. So to me, that just sort of says we and I think we did it again in the pandemic with a lot of resources. We moved mountains in a hurry. We can do it.

And we had all these things kind of working in synergy. And we dropped youth smoking by 30 percent in about five years. It was like, wow. And it was a combination of lots of different strategies. So to me, that just sort of says we and I think we did it again in the pandemic with a lot of resources. We moved mountains in a hurry. We can do it.

But it takes it takes resources that we don't typically have in public health. So in chronic disease, I kind of went off a little bit there on a tangent, other than the point being our role is prevention of chronic disease.

But it takes it takes resources that we don't typically have in public health. So in chronic disease, I kind of went off a little bit there on a tangent, other than the point being our role is prevention of chronic disease.

And that's where, again, I think we need our healthcare colleagues to say, we have to be working at the population level to try to reduce these risk factors overall, because just trying to remediate or treat or cure at the other end is going to overwhelm us.

And that's where, again, I think we need our healthcare colleagues to say, we have to be working at the population level to try to reduce these risk factors overall, because just trying to remediate or treat or cure at the other end is going to overwhelm us.

And because, you know, people just like, well, you know, if I get diabetes, I'll take the drug, you know, or if I have a heart attack, the hospital will save me. You know, I mean, that's sort of how we think about, you know, kind of our individual perceptions of risk.

And because, you know, people just like, well, you know, if I get diabetes, I'll take the drug, you know, or if I have a heart attack, the hospital will save me. You know, I mean, that's sort of how we think about, you know, kind of our individual perceptions of risk.

And, you know, and I think a lot of folks in the legislature, for example, think, well, the chronic disease, you know, managing that, that's healthcare's job. We want you public health people to, you know, you do this emergency stuff because we just saw that we really need you to do that. You stop the outbreaks. And healthcare should deal with chronic disease.

And, you know, and I think a lot of folks in the legislature, for example, think, well, the chronic disease, you know, managing that, that's healthcare's job. We want you public health people to, you know, you do this emergency stuff because we just saw that we really need you to do that. You stop the outbreaks. And healthcare should deal with chronic disease.