Saum Sutaria, M.D.

Drug and substance abuse issues and just the flow of things like fentanyl and others that are creating a different generational impact of mortality is quite significant. Obviously, the penetration of things like HIV and AIDS, and even though that's become a chronic disease over the last 25 years, it's been a significant driver of mortality.

Drug and substance abuse issues and just the flow of things like fentanyl and others that are creating a different generational impact of mortality is quite significant. Obviously, the penetration of things like HIV and AIDS, and even though that's become a chronic disease over the last 25 years, it's been a significant driver of mortality.

So you have these features that create excess mortality in the US, especially under the age of 65. Now, when you combine that with the fact that our rates of obesity leading to things like diabetes and heart disease when you're older are higher than the rest of the developed world, you have these unique issues, plus you have a fundamental health status issue.

So you have these features that create excess mortality in the US, especially under the age of 65. Now, when you combine that with the fact that our rates of obesity leading to things like diabetes and heart disease when you're older are higher than the rest of the developed world, you have these unique issues, plus you have a fundamental health status issue.

that we're now recognizing costs the healthcare system money. Obesity and its consequences don't just emerge when you have out-of-control diabetes 15, 20 years later. The expenditures, the lost productivity in the workplace, all of those things happen earlier. So when you put those two together, you have a health status problem.

that we're now recognizing costs the healthcare system money. Obesity and its consequences don't just emerge when you have out-of-control diabetes 15, 20 years later. The expenditures, the lost productivity in the workplace, all of those things happen earlier. So when you put those two together, you have a health status problem.

And by the way, they overcome and overwhelm the things we're better at. I mean, oddly enough, we're better at getting our vaccinations. We're better at cancer screening. We're better at treating blood pressure and cholesterol in this country. Back to the pharmaceutical culture, we smoke less significantly. But guess what?

And by the way, they overcome and overwhelm the things we're better at. I mean, oddly enough, we're better at getting our vaccinations. We're better at cancer screening. We're better at treating blood pressure and cholesterol in this country. Back to the pharmaceutical culture, we smoke less significantly. But guess what?

That's being overwhelmed by these other factors, in particular under the age of 65 or 70, whatever that range may be. And if you look at those conditions, unlike how effective the public health model was in infectious disease, in reducing mortality over the last 100 years, it's kind of been ineffective.

That's being overwhelmed by these other factors, in particular under the age of 65 or 70, whatever that range may be. And if you look at those conditions, unlike how effective the public health model was in infectious disease, in reducing mortality over the last 100 years, it's kind of been ineffective.

I mean, the combination of public health and nutritional science together in the way that they've evolved in the last 25, 30 years have been ineffective in managing or dealing with these issues. Now, you can get into debates about were they adequately funded or not funded and the quality of the science and all that. But the fact is they haven't been that effective relative to other interventions.

I mean, the combination of public health and nutritional science together in the way that they've evolved in the last 25, 30 years have been ineffective in managing or dealing with these issues. Now, you can get into debates about were they adequately funded or not funded and the quality of the science and all that. But the fact is they haven't been that effective relative to other interventions.

And we've got to deal with that. This isn't an insurance coverage problem. I mean, we pretty much cover everybody other than undocumented today in the US or people that choose not to get covered because there are options now for everybody. And in some states, we're even covering undocumented. It's not a coverage problem. This isn't a system problem in many ways.

And we've got to deal with that. This isn't an insurance coverage problem. I mean, we pretty much cover everybody other than undocumented today in the US or people that choose not to get covered because there are options now for everybody. And in some states, we're even covering undocumented. It's not a coverage problem. This isn't a system problem in many ways.

The healthcare system can accommodate the illness. It's the question of what led up to the illness that we haven't really fully dealt with in the country. And there's two forms, again, societal issues, whether that be gun violence or poverty leading to bad access to prenatal care, injuries, et cetera, or the chronic diseases that seem to be more prevalent here.

The healthcare system can accommodate the illness. It's the question of what led up to the illness that we haven't really fully dealt with in the country. And there's two forms, again, societal issues, whether that be gun violence or poverty leading to bad access to prenatal care, injuries, et cetera, or the chronic diseases that seem to be more prevalent here.

How you fix that, you and I have talked about this for years. I mean, it's hard to change behavior. If you really want to change trajectory, you really want to improve health span, it's hard to change behavior. And the more of that that can get built into the background...

How you fix that, you and I have talked about this for years. I mean, it's hard to change behavior. If you really want to change trajectory, you really want to improve health span, it's hard to change behavior. And the more of that that can get built into the background...

that just changes the way people eat or changes the way people engage in physical activity, which could mean designing cities where you have to walk to work the vast majority of time rather than drive like many European nations have done. Those interventions themselves must have some benefit because you're seeing different outcomes between the countries and it overwhelms all these other factors.

that just changes the way people eat or changes the way people engage in physical activity, which could mean designing cities where you have to walk to work the vast majority of time rather than drive like many European nations have done. Those interventions themselves must have some benefit because you're seeing different outcomes between the countries and it overwhelms all these other factors.