Stan and Clarence chat with Dr. Courtney Jordan Baechler and Dr. Jim Peacock about Minnesota's Cardiovascular and Diabetes 2035 State Plan.Dr. Baechler - board certified internist and cardiologist - currently serves as the Medical Director of Health Equity and Health Promotion at the Minneapolis Heart Institute Foundation and Health Promotion Specialist at Rosado Consulting. Dr. Baechler is especially interested in heart disease prevention and behavioral change to support overall wellbeing.Dr. Peacock serves as the Cardiovascular Health Unit Supervisor at the Minnesota Department of Health.Listen along as Stan, Clarence, Dr. Baechler, and Dr. Peacock dive into the 2035 State Plan.Join the conversation at healthchatterpodcast.comBrought to you in support of Hue-MAN, who is Creating Healthy Communities through Innovative Partnerships.More about their work can be found at http://huemanpartnership.org/
Hello, everybody. Welcome to Health Chatter. Today is, in my estimation, a special edition because we're going to be dealing with two subjects, namely cardiovascular health and diabetes as it relates to a new disease. brand new state plan that's being published or was published just a couple of days ago in the state of Minnesota. We have two great guests with us.
We'll get to those two great people in just a moment. In the meantime, as always, I like to recognize our illustrious staff that without them, Clarence and I would be lost altogether. We have great researchers that do background research and and give us some good talking points. That includes Maddie Levine-Wolfe, Aaron Collins, and Deandra Howard.
Matthew Campbell is our production guru without his logistics. All these shows would not get out to you, the listening audience. So thank you to Matthew. And then finally, Sheridan Nygaard helps us not only with research, but also marketing the show. So thank you to everybody. Then of course, there's my partner in crime in getting health chatter out for all of you. And that's Clarence Jones.
Clarence and I go back a long ways. He's a great community health organizer and professional. And I really appreciate his insights. I've learned a lot from him. Whoa, all these shows that we've done. So with that, let's get on to, oh, and by the way, we have a good partnership, right? With Human Partnership, who actually does some sponsoring of this show.
You can visit them at humanpartnership.com. Org. Yeah. I always get that wrong, don't I? Yeah. Dot org. Humanpartnership.org. Check them out. Great community organization. So with that, let's get into our great people that are with us today. And that includes two colleagues I've worked with for a long time. Dr. Courtney Jordan, bachelor who's got her MD, actually got all of her trainings.
at the University of Minnesota, her medical degree, her degree in public health and epidemiology and public policy. She's board certified internist, cardiologist, and is involved in a lot of different things way beyond, frankly, just the field of cardiology. Her insights and her passion to try to affect change to make us all healthy is really second to none.
You'll see her total bio on our website, so check it out. But just a dear, dear friend and colleague. So Courtney. Thank you for being with us. And then there's Jim Peacock. Jim and I have a great history. We worked together for many, many years at the health department in the cardiovascular unit. He started there back in 2007, wasn't it, Jim?
And to be honest with you, the listening audience is probably the best hire I ever did. He and I were like... linked at the hip. And it's just incredible interactions that we have had over the years and from different perspectives. But his training is a doctorate in epidemiology and his master's in public health. And I always have appreciated Jim's perspective as an epidemiologist.
And he recalls this as like, it's one thing to know the data and just to present that. But he always has always carried the torch of, so what? How is it that we can, based on the knowledge that we get from analyzing all this information, how is it that we can affect And he has really, really carried that torch professionally.
And I've greatly appreciated that perspective, not only working with you, but also the torch that you carry carrying on at the health department in the cardiovascular health unit. So thank you both for being with us today. All right, so let's get the ball rolling here. So, you know, I thought that, and actually both of you have been involved historically.
I thought maybe first to give the listening audience a perspective historically on we've had plans and what drove the creation of state plans. And mostly it was first, They were divided up, if I remember right. There was the cardiovascular health plans, and then there was a diabetes plan. But we'll get to the combination in a minute.
But what really drove the necessity historically of creating the plan? Any perspectives on that? Either one of you can just chime in.
I mean, I could jump in first, Dan, and thanks for that really warm introduction there. From a state health department perspective, when I came to MDH in 2007, we were in the middle of implementing a state plan. And I think that they largely were born, at least here in Minnesota, out of a necessity as a deliverable for the funding we receive from the Centers for Disease Control and Prevention.
CDC tends to fund programs in silos within a disease. So there's a CVH program, a diabetes program, cancer programs, and so on. And an important part of receiving that funding was to create a coordinated comprehensive plan for how you'll address those conditions in your state, bringing in community, clinical, public health support and information to design that.
CDC has moved away from that in recent years and requiring states to do that. But I think what was exciting here is that, you know, what is it, four years ago, pre-COVID, we asked that question of folks in cardiovascular health if they felt it was important.
And we heard a resounding yes, even though it's not required by the funder for MDH's work, that it was an important way to bring together many partners across Minnesota.
Yeah. So, Courtney. Yeah. You've been involved in the history, you know, from different angles, frankly. And I always appreciated your really good direct questions that really drove the development of plans. You oftentimes hit these questions, you know, they hit the nail on the head.
So as you reflect on the previous plans and then maybe morphing into the one that we're dealing with now, where's your head at? How do you think historically things have morphed or changed going forward?
Yeah. Yeah. Well, it's fun to hear, you know, just like Jim saying your intro into all of this, because I realized that Jim and I actually started at the same time in terms of my involvement with the Stroke and Prevention Committee was 2007. So I remember you getting introduced. It was either my first or second meeting and how excited I was that you were joining. Now, just to put this in context.
I was in the middle of my epidemiology and cardiology fellowship. So I think my mind had not been completely corrupted by medicine yet. So I did choose during my intern year to go get my public health training because I realized how broken I felt the system was.
But what I would say is at that time, I had just come back from Finland where I got to see the North Corelia Project and the way that they had, from a country level, improved cardiovascular disease mortality by 85% over 25 years. So I knew it was possible. And I am 100% being honest with you that the one thing that gave me the most excitement and optimism was
was the statewide committee where we came together around prevention of heart disease and stroke because as a clinician that rotated through five different of the leading hospitals in the Twin Cities, you realized how disjointed and fragmented it was for the human being, the community, everyone, and largely who we were and were not seeing and what stage we were and were not seeing them. So
I just think the infrastructure that the Department of Health and both you, Stan, and Clarence has been a part of all of this, and Jim leading now, that for me, it's been a really exciting to know that we've had this infrastructure in place, that despite funding changing, we still have continued it. And now I'm the most excited I've ever been with what the 2035 plan looks like, because it looks...
very different than the plans have looked in the past because of whose voices and thoughts have been involved, which was nobody's fault. But it's just exciting to see where we've evolved and the direction we're heading.
Yeah, Clarence. So both of you talked about joining the program in 2007. And now it's 2023. And we talked about the fact that there have been a lot of changes. I just want to know, walk me through, because I'm a community person, walk me through the changes that have occurred in terms of community engagement and community input as we've talked about these plans and
you know, where are we at today and how is the community going to be engaged in this? And we haven't gone very deeply into the plans yet, but I think from a community perspective, although this information is coming out, you know, where is that voice being heard or is it being heard?
Yeah, I can take an attempt at that answer first, Clarence. When Courtney and I joined back in 2007, and Courtney, I'd forgotten about that. So thank you for bringing that back to mind for me that we have a history going back 16 years.
The plan that was developed that was in place from 2010 through 2020 had a lot of engagement from many members of the professional clinical community, from academic settings, from public health, and not a lot of input from folks in the community that are working with populations that are experiencing disparities or populations that lack access to services.
And this change that we made with this new plan being developed as we centered the community voice in not only how we collected information, the people we brought together to discuss what was really going on, what do people need to be healthy in the community?
Many times people aren't thinking about, oh, I've got heart disease, but they're thinking about, oh, my blood pressure might be a little bit higher. I'm not able to eat the healthy foods or I don't have access to those. We wanted to bring those voices in to identify community based solutions to these problems that are happening way before someone would intersect with the health care system.
How can we help someone feel good and have access to those things to be healthy? So those voices were brought initially, and that's how we centered the plan outcomes, which there are 10 of them. I think we'll maybe talk a little bit about those later.
But they're really centered in a way that makes it so many different people could look at the plan and say, hey, there's something I can do in this space. I'm not a clinician.
I don't actually work in health, but I work in a small community and I can make things better for the people that live here by offering healthy fruits and vegetables in my store or by providing a place for people to be physically active and where they feel safe to do that and supported to do that. Those are just some small examples.
So one of the, one of the keys to, you know, certainly with anybody with some health education background will say that in order for, frankly, either an individual or in this sense, a community to be involved, it's one thing to show interest. It's another to show ownership and move with it. Okay. So my question is, you know, as I reviewed the plan There are great goals.
There are great strategies. As you developed them all and were engaged with community representatives, did you get a sense that they're going to run with it? They're really going to embrace it and run with it or not?
You know, what we all hope is that they aren't just phrases on a piece of paper, but they're really something that people and communities, organizations can really get engaged with and excited about. Did you get that sense?
I would say in the conversations that we've had so far, absolutely to the point that we have to cut people from talking about where they see potential partnerships or ways that they'd like to use this framework and these goals to implement change. So I think that there is a lot of enthusiasm of how we can do things differently.
And again, I think in part because of the, as I think we'll talk about, the goals and the outcomes are different. It doesn't mean that they won't Our goal, right, is that they lead to these other things that we've been measuring for a long time.
But rather than talking about an optimal vascular score to a community member, which isn't really right, how most people wake up and think, there's things about investing in partnerships with the community, you know, in community. improving and changing and diversifying who is a part of healthcare, making access easier.
I mean, all these things that people say, yeah, I waited an hour on a 15 minute lunch break yesterday to try to get into my primary care and ultimately just sat on hold the whole time, you know, well, there you go. Like that's not gonna, that's not gonna work. But when they hear things that resonate with them, there's interest.
Yeah. Yeah. So, all right. Um, you know, we're talking, you know, to our audience out here, we're talking with two epidemiologists here, you know, who have a strong, shall we say data, strong in inquisitive Sherlock Holmes types of minds. Okay. So I'll be honest with you that the situation in the state of Minnesota isn't great. You know, it was reported in the plan that
correct me if I'm wrong, that there were over 8,500 residents that died from cardiovascular disease, 2,400 around that that died from stroke, 1,500 died from complications of diabetes. So, you know, woe the years that certainly I was involved in the arena. The question that remains is, is from an epidemiological standpoint, are things getting better? Are things getting worse?
Are we at the same place? Or do we just assume that we're all going to die from something? And guess what? Those happen to be, you know, for human beings at this stage of the game, at least, cancer, number one in the state of Minnesota, then cardiovascular stroke, diabetes. Are we just going to deal with it like that going forward? And I'm talking from an epidemiological standpoint now.
So yes, Stan, it's an interesting trajectory for these conditions, sort of the deaths in Minnesota. For cardiovascular disease, especially, and for stroke to some degree, All across the country, we saw rapid declines, really big improvements for decades in the death rates due to these conditions.
And that's due to a number of things, reduction in the amount of people smoking, the introduction of new therapies like high blood pressure medications or statins as a way to manage and control the risk factors that lead to those conditions. But that has really flattened out since about 2010 in every state in the country.
Minnesota historically has had the lowest death rate in the country due to cardiovascular disease. I believe that's still the case. But the data that you quoted are from 2021. Although not released yet, provisional data from 2022 show a pretty large increase in heart disease deaths in Minnesota last year. Every state in the country has seen this happen in different ways and at different times.
I will say COVID has had a very large impact on chronic disease deaths and cardiovascular disease, diabetes, and stroke are part of that equation. Those have gone up fairly strongly in all parts of the country since 2020.
So it's really, it's not that we're at an inflection point, but we really are at a point where those trends that had existed for decades where we could sort of rely on improvements in health They just aren't happening anymore.
And COVID has, I think, laid bare not only it really is laid bare a chronic disease epidemic in the United States where many people have poor risk factor profiles, inability to access healthy foods or find a place to exercise. lack of awareness about whether or not they have high blood pressure and or not able to control that if they are on medication.
It's a larger problem in the United States than many other Western industrialized countries. And that's evidence in the fact that our death rate or our length of life has been slowing in this country compared to other places. We're falling behind a lot of other places with similar economies and similar levels of development.
Yeah, what do you think, Courtney?
Do you agree with all that? I do, but I don't, well, I don't want to miss Clarence's question. No, no, no, you go ahead. I can follow up. Okay. I just, I was, what I was going to say is, yes, Jim summarized the data perfectly.
And a couple of things that I would just add on to is number one, when we look at that data, the disparities within it of who's doing decent living with chronic disease and who's doing poorly and dying more prematurely definitely disproportionately impacts the black and brown people. Number one, that's a huge issue. It's particularly a really big issue in Minnesota.
We have some of the largest disparities based on our overall fairly great outcomes for white people. We do not see the same for our black and brown population. So that's a big issue. And then the other thing that I would just emphasize as somebody who is seeing people on the clinical side, People don't feel well.
So even though for a couple of decades, our life expectancy had been improving for folks with chronic disease, that we had been managing cardiovascular and diabetes better, people do not have a high quality of life with these coexisting diseases. And this is this, as you're talking about this inflection point of We're off the rails.
We have got to do more upstream primary and secondary prevention on. And that is what the community has been asking for loud and clear. Yes, no one wants to die from heart attack, stroke or diabetes complications. But in between, they don't want to feel like they're walking through, you know, a cloud their whole life because they're on drugs.
15 medications to manage this disease process, which is what it is for a lot of people who have these three conditions. So we have a lot of work to do to actually, again, respond to what people are asking for versus responding to the disease process. Those are two different things. And I think challenging as someone who was trained in a Western medicine.
That's not what we learned to do in medical school. So we got a lot of change that has to happen.
You know, what's linked to it, and Claire's I'll get to in a second, is just the idea of it's a balance in my mind between urgency, which we're seeing in a lot of situations, and motivations. Motivation is a key, not only from an individual standpoint, but also a community standpoint in order to engage in essence, in this case, around a plan. Clarence.
Yeah, I want to talk a little bit more about the community engagement aspect of it, because I think you made it very clear that we're growing and not in the right kind of way around these issues. And so in order for us to be able to address them, we're going to have to do something a little bit different. And I know that this plan...
But could you talk a little bit more specifically about the need for community engagement, but also a strategy for engaging people and making them feel like they're part of the solution and not just a problem?
Yeah, I can start on that, Clarence. So the point of this plan, and I think we list this how we describe it as a call to action. for communities and healthcare systems, community and organizational leaders, but we specifically put communities first in that list.
As Courtney just described, communities are much closer to understanding what's going right, but also what's not going right in their community. And we want to make sure that this plan is designed in such a way that it's not just the state health department, or it's this esteemed group of committee members that helped finalize this plan, making decisions.
It's creating the conditions for communities to come to us and say, we have a solution for this problem. We've identified a way to make our community members feel better, or we've identified a way to connect people with the right type of resource so that they're not experiencing 15 medications and living in this cloud as Courtney just described. So again,
The goal of this plan is really to grow and change over time, and it's an invitation for more community input. It's not just something we want to sit on a website and not be changed for the next 15 years or however many years until it's over.
But we want it to grow and change, and it's community input to tell us what's working and what's not working that is going to be so important for making this an impactful plan.
Not only improving outcomes for people, but in solidifying and increasing the types of partnerships that government, community organizations, healthcare systems, public health agencies can have with one another to affect positive change.
And if I can just say one more thing to that, Jim, and to answer your question, Clarence, one of my favorite systems that I have seen within the U.S. is in Alaska, NUCCA or the South Central Foundation, which is a federally qualified clinic for decades, or I should say federally qualified clinics.
received dollars from DC, you know, over to Alaska dictating how healthcare should be done there, as you would expect all the challenges that we face largely around cardiovascular disease. stroke and diabetes.
And a few decades ago, they decided to actually listen to what the community said, because while the healthcare system was saying, we need better diabetes control, we need better blood pressure control, we need all, you know, all these different metrics, the community said, what we want help with is domestic violence.
And you can, you know, keep saying all this, but this is actually the number one thing impacting us, And as soon as the health systems and, you know, largely collectively changed to listen and respond, then the community, there was different trust, there was different partnerships and relationships responded collectively to how best to they could engage around diabetes, heart disease, and stroke.
And now they have lower ER rates. They have better control of these diseases. They have all sorts of metrics that we consistently look at financially and otherwise of who's using what. But it was a different model. And took totally reversing how things were done, because I think on the clinical side, it was so hard for people to get to, well, is that our lane?
I mean, the number of times I hear that, is that our place to be in? You know, we're not going to fix homelessness, Courtney, you know, that's not, we treat cardiovascular disease, but it turns out, right, as everyone on this call knows, that
that to the individual experiencing this, that's what is, of course, most important to them, or whatever the case is, is that social need, and certainly as it relates to these healthy behaviors that we're talking about, all the time, you can't, right? We can't expect people to do any of this if these basic needs are not met. You're right.
You know, it's interesting. You know, it's a really good example of... People are really engaged with things that are really urgent in their mind. And if you show them first and foremost that, all right, let's tackle that. then they could be open to a true partnership in dealing with all the other stuff that we also have to address health-wise.
But I think urgency for a lot of people is right up there. You know, gun violence. If you don't solve that in our community, the heck with cardiovascular, the heck with diabetes. Let's deal with that first, and then we'll get to it. So it might be this kind of one at a time in order to help build trust. So...
You know, what's really cool to me is, you know, first of all, you have three major goals, but then you get into your outcomes and investing in partnerships, which I think we've alluded to a little bit here. It's like, you know, we've had in our show, Clarence and I, we talked about the issue of trust, right? And how it is that you build just a partnership with your primary care provider.
I mean, you could almost use that as an illustration and maybe bring it up a notch in a community. How is it that we can build trust with one another so that we can work together in order to do these things that are outlined in the plan? A perspective that I have, is this, that the previous plans kind of created a common denominator of things that we needed to address.
And now we're really coming up the funnel, so to speak, and really addressing and hopefully addressing the things that are we have to address, you know, disparities, social determinants of health, et cetera. Clarence?
Yeah, you know, I think one of the things that I like about this broader view of addressing these diseases is the fact that They're so interconnected with other things. You know, you talked about, Courtney, about the group in Alaska. You know, we talk about, you know, and talk about dementia in my group. OK, a lot. But but diabetes, type three diabetes is part of it. hearing is part of that.
I mean, you know, we're getting more out of those lanes and, you know, which I think lanes are important as well, but we're trying to get to the finish line. And I think it's only by running alongside of each other versus bumping into each other, I was going to be able to make that. And so, you know, I'm hoping that with this particular a plan.
We are talking more about the social determinants of health. We're talking about that broader perspective. And then we're really making people understand how important it is for us to work together versus trying to be, you know, this is just me and that's you and so like that. So I'm hoping that with this plan and looking forward to this plan, working with this plan to show
the importance of working together and then how we are, how we definitely are interrelated and these diseases impact one another. So that's just my quick community comment.
Yeah, Clarence, I want to react to that comment for a second and I want to verify this with Courtney, but Courtney, if I recall correctly, investing in partnerships, this very first outcome here in the plan, that's what our committee members were most excited about and felt intense passion for. around this is the place we need to start.
And it makes sense because as you've said, Clarence, we need to build trust and that trust is multiple directions. And there's a real opportunity and interest in doing that from all perspectives of the folks that contributed to putting this plan together. So we're excited about that. We feel like we're starting from a really good place where everyone has sort of a common understanding and interest.
So far, our listening audience, I'll tell you that there's, you know, there's 10 basic, what would you call it, outcomes that you're looking for here. We look at investing in partnerships. And I'll just kind of state what they are. And then you can kind of react to these kind of in the gestalt of it all. Working towards health equity, sharing power,
to affect change, creating systems that improve access to care, improve health data collection, which by the way, epidemiologists, I'm going to get back to you on that one in a second. Expand and diversify health care, expand health education, support the implementation of community-led programs.
Enhanced delivery of quality whole person care and ensure all people have access to the necessary resources. Okay, so Courtney and Jim, just respond overall to those outcomes that we're trying to do today.
I guess I would just say that it just makes me so excited because this is something that I can share with any audience, right? Sometimes I feel like when I bring things from the health side of things, the health system side of things, I have to justify or decode when I'm with
community facing and then vice versa if I come up with things on more with non-profits and different community facing folks I have to explain them to the clinical side so somebody who lives in both worlds I love that this is very unified and it's you know just to some of the other points that you brought up Clarence it's this could be any disease process yes we are talking about
cardiovascular stroke and diabetes, but we're talking about whole person. We are recognizing that people don't like having to see all these different specialists and kind of, well, how does that impact my mental health? How does that impact this? And so I just, I'm super proud of the work that we've done. I feel like it really is a great framework to move forward in
in getting to these outcomes and that I hope resonates with a lot of people. But like Jim said, we don't think we're perfect. And we are interested in wanting to adapt and change as people see fit if we miss the mark.
And people, because this is a podcast, you couldn't see me shaking my head vigorously during what Courtney just said there. Actually, we all are. Okay, there we go. So what I would add to it as well is these 10 outcomes, if you dive deeper into some strategies underneath them, there's so much overlap. And that was intentional.
We wanted people to be able to see work that maybe they found in one part of this plan intersecting with other parts. So it could open up the way that it could deepen the impact that their work could have. It could expand their ideas around how they can improve health and well-being in the community.
It can potentially unlock and open doors for new partnerships that can strengthen that impact that a community or health system or public health is having.
That's the question. Okay. All right, here we go. Here we go. I want to ask this question because it just popped up in my mind. How did cardiovascular health and diabetes join together to work on this plan? What was the impetus behind that?
I can jump in first, but I'd like Courtney to follow up on that is When people are talking about how they feel well or don't feel well, and they go to the doctor, they come in like, oh, my blood pressure is high. Oh, they said I might have something called prediabetes too. These conditions operate together. And many people who have cardiovascular disease also experience diabetes or prediabetes.
Folks that aren't able to manage their blood pressure often have another one of these. These conditions are so intersecting. We wanted to make sure that, you know, we were able to talk again about this whole person as much as we could with these conditions that are often happening, you know, at the same time in a person or in a family or in a community.
Courtney, how would you add on to that from a clinical perspective?
I would just emphasize that the number one thing people with diabetes die from or suffer with in between then is cardiovascular disease and stroke complications. It's so connected.
And in fact, from a research perspective right now, what we're seeing with all these new super expensive drugs that are coming out, these GLP-1 inhibitors that were initially created to manage diabetes, and we're talking about Ozempic semi-glutide will go be all those guys initially created to manage blood sugar. Turns out that they had weight loss implications.
And now, Oh, what did they just get an FDA approval for cardiac prevention? So it is so interconnected that basically all the trials that we do on the clinical side. Now we look at, the SLP ones that we use in heart failure have diabetes implications in terms of improving because it's just, it's such an interconnected process. And in fact, from an epi perspective, the next sort of biggest proposed
issue that we're going to have as a country is diabetes actually overtaking cardiovascular disease, which again, isn't surprising, like we just said, because in this case, it usually comes first, and then cardiovascular disease comes second with what we're dealing with now, with our culture of obesity and poor nutrition and poor exercise and poor sleep and high stress.
I am just, I'm glad to hear that. And I'm really hoping because, you know, when I think about community and, you know, I mean, this is important news for people to be talking about, you know, and I'm hoping that there is a plan to talk very clearly about the connection between the two because, you know, we think of them as two different things.
You know, it's interesting, historically, and Jim, you and I can reflect on this, good, bad, or indifferent, when you get funding mechanisms that require that you have state plans. Okay, so like from the Centers for Disease Control, they required that the state of Minnesota, in this case, actually every state in the country, have a state plan for cardiovascular and a state plan for diabetes. Okay.
Then when they loosened it up altogether and they say, well, we're not requiring that you have plans, then that kind of opened up the gates for like the state of Minnesota to say, hey, why don't we all talk together? OK, and put it all together in one.
And so, yeah, yeah, I agree with that completely, Stan. I mean, I think it allowed us a lot more freedom to be responsive to the community and flexibility instead of being responsive to the desires of the CDC who is funding things Cardiovascular disease funding is completely separate and distinct from their diabetes funding to support states and local governments.
If I have a chance, I just want to jump in something that Clarence mentioned a few minutes ago. You talked about a lot of conversations about dementia in the community. Something that we aren't talking about here, but it's is how what's good for your heart and what's good for your blood sugar is really good for your brain health as well.
And so communicating about how all of these conditions, high blood pressure, high blood sugar, high cholesterol, impact so many parts of our bodies and our ability to live well. There's great benefit to be talking about these as a group instead of individual distinct diseases. There's a lot of benefit in coming together. It's improving everyone's health.
And now I can't help, but yeah, I can't help, but just add one more thing for our, for your listeners too, is that the number one thing I hear from people when we want to start a statin drug, which, you know, is the number one drug that we prescribe in this country, not as cardiologists, but as anybody is, oh, I've heard that they cause diabetes, statin drugs in trials and
they showed people who are on statins got diabetes six months earlier. And for Gemini and anybody who's an epidemiologist, that is what we call true, true and unrelated because people are usually walking around with, diabetes for quite some time before we actually diagnose it.
And so it's totally not causally related to these drugs and speaks more to what we are saying in that these conditions, diabetes and cardiovascular disease for the individual that is living with them coincide often together. And so it really takes a more holistic look at how we prevent it, treat it effectively and prevent deaths.
You know, it's, I know, I was kind of chuckling, frankly, as I was reading this plan, because I know that epidemiologists will say, will ask this very question, how in the hell are we going to measure this? Okay. And
I kept thinking in the back of my head, and those of you who know, I've often signed off on emails with an infamous quote from Albert Einstein, who basically said, not everything that counts can be counted. And not everything that is counted counts. So when you really think about that, that really intersects beautifully with this plan. Epidemiologists will say, hey, you know what?
We'll still be able to report how many people died and how many people had heart attacks and how many people had strokes and et cetera, et cetera. We'll still be able to do that while hopefully the success of the plan will be inherently going forward with all these different objectives and strategies.
And then when we look at the data, we'll be able to say, geez, you know, something must be going on right here because we're seeing decreases in deaths, we're seeing decreases in strokes. So anyway, all right, so epidemiologists respond.
Well, Stan, you're right. We have a lot of data systems to sort of measure disease impact through things like number of deaths, number of hospitalizations, number of people that are meeting a vascular disease target for their blood pressure medication and their statin and so on. What we don't have a great time or great ability to measure is how people feel.
And that's another reason going up to community and having community really lead on this plan. And we don't want to be in a position as folks that have put this plan out of deciding how to measure some of these outcomes that you described a few minutes ago, we really want the community to help tell us what is the right way to measure this.
Community, tell us what is real impact for the populations that you work with or in the neighborhood where you operate. We believe this investing in partnerships outcome, which I mentioned a couple of minutes ago, is really key to developing that trust and communication so that we can together measure that impact. And the impact may just be who's engaged in the plan and what are they doing?
And we're working on those systems in order to put that together to communicate out the successes. Yeah, yeah. Courtney, what do you think?
Yeah. The only thing I would add to that is, can we, excuse me, be patient and wait? Because again, there are a lot of examples that have shown that if you respond to what community is actually asking for, we can get to this place. But so far, we've been impatient and wanting to our needs, our clinical needs met first and just met resistance.
So I think this is really, I think it's a critical piece that we give this time and are open to some of, quote, the softer metrics that might actually be more important than some of, quote, the hard metrics that we've done.
Yeah, yeah. So let me say this real quick because I know we're coming to the end of our program. This conversation did not emerge like I thought it was going to. It's very positive though. What I want to tell you is very positive because I think in what you have described has been the community engagement aspect, which I thought was so needed for the work that we're trying to do.
I mean, you have not talked so much about the clinical aspect of it as much as about the community engagement. And so I think I feel much more engaged myself with this plan because I see our voices in there. I see the fact that the way that the leadership talks about it, I feel very comfortable that we should be able to do more in terms of our community. So thank you very much from my perspective
of being open about community engagement, because I think it's so important, and for you hearing our voice.
Erin.
Absolutely.
I wanted to jump in and just kind of summarize what I've heard over the last 45-ish minutes. The conversation revolved prominently around an assumption that communities are eager to be engaged with this plan. And a thought that comes to mind is communities who are not eager to jump on with this plan or are reluctant to jump onto this plan.
And I just wonder if either of you had anything to say to our listeners in general about engaging in this plan or if you had any thoughts or ideas about how to get those reluctant communities engaged with this plan and on board with it.
I think your point is a good one, Erin. And we certainly did our very best in making this plan to be engaging with community. Obviously, the ones that we engage with were people who wanted to engage to what you're saying. But the Department of Health and the leadership team that helped create this had lots of
various connections that way that we tried to use as much as possible to engage with people and different sectors that historically have not been involved. And I think part of our thinking that way is that we sort of just continue to build that tree with broader roots as we change who is involved and look at different ways, easier ways for people to engage in terms of
how we access virtually in person, you know, all the different things that that's not how it's always been in the past. So I think like everything else, the proof will be in the pudding, right? And the final product in the sense of, I'm sure there are some people who are kind of cautiously watching from afar to see, well, let me see how that works with that group. And if that goes well, then
we would be willing to, et cetera. But open to people's feedback. And Jim, anything else that you would add there?
Yeah. One thing I would add to that, Courtney, I think spoken, that's exactly how I would answer that question. You said it more eloquently. What I would add is that embedded in these 10 outcomes, we also made an effort over the last 18 months to reach out to
diverse communities in multiple parts of Minnesota to show work that they were doing, demonstrate their successes that often were not funded by the health department. They may have not been funded by a health system, but they were community-driven initiatives that really speak to the spirit of this plan.
The idea there was to show Minnesotans, other organizations, folks from all across the country, the type of impact that a community-based initiative can have in improving the health and wellbeing of members of that community. So we're reviewing that as sort of, it's inspiration from many different types of players and organizations with whom we may have not worked directly in the past.
They may have not even been at the table with the development of the plan that we had in 2010 or the plan from 2000, but they were at the table this time and we're trying to elevate that voice.
You know, like I said, I read through this plan and in my mind, I kind of closed it and I sat back and I really felt good. And so I would encourage listeners, take 10 minutes and go through this plan because I guarantee you there will be something in this plan That will make you feel good that, yeah, this is a good direction to take. It's not as technically or medically oriented.
It's really getting down to us and what we really need to do to affect change and make us all feel healthy. So, you know, I encourage everybody, look at it. Pick something in there that's of interest to you and see how it is that you can link with another partner to affect change. I personally think this is a feel-good plan. There's stuff in it, frankly, for everyone. Clarence.
No, I was going to say, I think if you can give us information on how we could locate the state plan and talk about it, I think our listeners would love to do that.
Sure. The plan is available for anyone to view right now. I'll give you the website, but also give you a special trick as well. You can go to health.state.mn.us slash 2035plan. You can also just go to a Google browser and type in MN2035 plan. And I'm happy to say it's already the top link on that search history. Oh, good. Love it. Super. That's a way you can connect.
And as I mentioned, there's success stories. There's voices from community members, both Courtney and myself, talk a little bit in a short video about why this plan is needed in Minnesota at this time.
You know, and all this information will be available on the Health Chatter website.
website as well so all the all the background research and the the links to the full plan the pdf of it are also on our our website so again i i encourage you i i want to reserve and i say this actually to a lot of our guests but maybe in this case you know youtube for sure because going forward there's going to be a lot of action around this and i want to encourage you
feel free to use Health Chatter as another vehicle to communicate. And we'll continue to be your partner. There you go. You've got a partner, a number one partner from the plant in order to promote it and hopefully make it work. So thank you both very, very much. And thank you all to our listeners for listening in. And remember to keep health chatting away.
Hi, everyone. It's Matthew from Behind the Scenes. And I wanted to let everyone know that we have a new website up and running, HelpChatterPodcast.com. You can go on there. You can interact with us. You can communicate with us, send us a message. You can comment on each episode. You can rate us.
And it's just another way for everyone to communicate with Stan and Clarence and all of us at the Help Chatter team. So definitely check it out. Again, that's HelpChatterPodcast.com.