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Video and transcript: President Cauce’s speech on population health

The health of an individual or a community involves more than just the absence of disease. Issues from poverty and equity, to health care access, to climate change and governance all combine to affect the health and well-being of populations around the world. The University of Washington and our partners in the Puget Sound region have a remarkable opportunity to develop solutions for these and other challenges.

On May 3, President Ana Mari Cauce invited the University community and our partners to join in the development of a 25-year vision to advance the health and well-being of people around the world by leveraging capabilities and opportunities at the UW and in our region.

Transcript: A shared vision for improving health and well-being around the world

Speaker: President Ana Mari Cauce
Location: Orin Smith Auditorium, UW Medicine South Lake Union Campus
Date: May 3, 2016

Remarks as prepared for delivery

Good afternoon, I’m so pleased to see all of you on this beautiful day. You work hard to make this world a better place – I’m grateful for what you do and for your being here today.

I want to start by thanking our deans and UW leadership, our government officials, and our global health partners. We all have busy lives, and this is an especially busy time, so I really appreciate your being here, because this is really about our community.

Today, I want to ask you to look ahead – to the future.

Thanks to your work, and that of those who came before you and will come after, we have an unprecedented opportunity to help people live longer, healthier, more productive lives – here and around the world. I’d like you to join me today in imagining how the University of Washington, together with the incredible organizations and people in this region, can contribute in even greater ways to the health and well-being of our world. How we can take the next big step to improve people’s lives by deepening our commitment to what I will refer to here as population health.

But first, I want to tell you about a community.

It’s a community like many others, full of people with dreams for themselves and hopes for their children. People facing all the challenges of our interconnected world, but with few of the opportunities most of us in this room enjoy.

The people of this community go off to work each day – when they can find work – not always sure of how much they’ll earn, or whether they’ll earn enough to support their families. Many women go back to work just days after giving birth, even those who are raising children alone – having lost partners to violence or drugs, disease or incarceration – or perhaps because they fled violence from a war or a natural disasters impelled by climate change.

Many in this community face discrimination because of their race or ethnicity. It presents itself in big and small ways, from whether they can find a decent place to live, to whether the local security services stop and question them on the street.

Parents in this community send their children off to school each day, hoping more opportunities will be possible through education. But a quarter of them leave without having breakfast. And when they do have food, it’s often lacking in the nutrients needed to power their growing bodies and minds. In this community, good food is expensive and scarce.

These children go to underfunded, and in some cases, declining schools. Dedicated teachers do their best with what resources they have. They do everything they can, as do their colleagues who work in nearby clinics – working with those who come to them with conditions that were preventable, and diseases that were treatable – if they had been covered by insurance, or if the treatment were affordable, or if they were able to afford missing work to get care.

The daily trials of the people of this community are largely invisible to the world, except for those times when a correspondent parachutes in to report on a tragedy – a singular event deemed more newsworthy than the day-to-day struggles of an entire community.

Yet the people of this community live in, or on the outskirts of, one of the world’s great cities. A few miles away, gleaming skyscrapers multiply on the horizon. This city is a boom town, like others that had the good fortune to be located on an avenue of world trade, at the intersection of a new economy. In this city, it seems as if wealth and happiness are there for the taking. But for the residents of this community, that boom town may as well be a world away.

I could be describing any host of urban areas around the world, where only miles away from the glittering towers are people barely scraping by, out of public view.

But, this community is right here, in King County. Where a distance of a few miles can mean a difference in life expectancy of more than a decade. Where two-thirds of black and Latino students go to schools where a majority of the students are from low-income families.

Ours is a region of opportunity, yes. But that opportunity is too often determined not by how hard you work, but by the circumstances of your birth.

We talk a lot about disruption, but less about the disrupted.

That is why our calling as a University so important. Like so many Pacific Northwest organizations, we are products of this beautiful land of the Coast Salish peoples, of glaciers and volcanoes, rainforests with giant trees whose roots spread out for hundreds of feet. We too are firmly planted on this land, in this community, but our reach is global and our aspiration is nothing less than to change the world. We are citizens of our state and citizens of the world. We are a state university and a global university. And we have a duty to act on behalf of the local and global good, because they are intertwined and inseparable.

Humanity’s collective yearning for a better life – not just today, as we grapple with refugees seeking safety from war – but over the course of history, shows us that oceans can’t divide us and that walls offer no defense against diseases that travel the globe. We have the capacity, together, to contribute to a healthy and productive life for all of us. And whether studying or working in business or social work, international relations or medicine, our students have an opportunity to have a tremendous impact on the world, because this is the right time and because of our partnership with you, this is also the right place.
It’s important to begin with defining what we mean by health. Health is more than the absence of disease, though that’s important and our University plays a crucial role discovering new treatments and cures for a wide range of diseases and conditions, from emerging diseases like Zika to age-old maladies like heart disease and cancer. Couple that with our work and interventions in developing countries throughout the world, and the more than $275 million in charity care we provide here at home – and we have a clear role in helping people live longer, happier lives – no question.

Yet, there are many conditions intertwined with physical and mental health and well-being: from nutrition and education, to the quality of the air we breathe, to social and environmental equity. And, there are the many ways one can fall – or be pushed – into poverty.

There are also many ways we can help people out of it – from providing access to better education and economic opportunities, to building more effective societal infrastructures and governance. By identifying and addressing the causes and impacts of a broad swath of health indicators for populations of people – from neighborhoods to countries – we have an opportunity to truly impact health and well-being in profound ways, here and worldwide.

We have an opportunity to improve the population health of the world.

The great news is, the UW and many of you, our regional partners throughout the Puget Sound, have built the capacity and resources to truly utilize knowledge in ways more powerful than we could have ever imagined. What I am calling for today is not for us to build something new, from scratch, but rather a strengthening of our combined efforts – a commitment to create a shared vision, to be implemented in shared partnerships, over the next quarter century – in service to the people we serve locally and globally. This can and should be a defining priority for our University, the Puget Sound region, and our state.

I come to this after having spent the last year gaining a unique view of our University. Despite having been at the UW for 30 years, and thinking I knew every corner of this place, as president I now have an even broader view – one that is enabling me to see the many opportunities that exist to connect, to weave together, seemingly disparate fields of study and research.

Serving as president means you get invited to more places than you do as provost or as a member of the faculty. I’ve had the incredible opportunity to learn about the work of the Road Map Project in South King County, to meet with tribal leaders at Lummi Nation, and to see – or rather breathe – first-hand the effects of pollution in China. These experiences, and my conversations with many of you and many of our global neighbors, have given me a deeper understanding of the role the UW already plays – and the additional role it can play – in contributing to the health and well-being of our world.

We are the leading public university in the country for sponsored research. We have one of the largest, most comprehensive biomedical research programs in the world. Given our size and breadth – three campuses, over 50,000 students and 5,000 faculty – we have impact on a massive scale, and our impact is focused on the public good. Our commitment to innovation in every corner of the University means that we are not only willing, but eager, to pursue new lines of inquiry. We’re undaunted by the risk of failure, because that’s how we hone in on success, and we know the tremendous good we will do when we succeed.

Our location in the Puget Sound region amplifies our impact on population health. We link arms with more than 130 organizations working on population and global health. From the Gates Foundation and PATH and the Washington Global Health Alliance, to organizations focusing on individual nations or specific maladies, there are few places on Earth with more opportunities for collaboration and collective impact than right here. We will need their – your – guidance and commitment as we shape this vision.

What’s more, our region’s role as a global hub for computing and information technology – we really do own the cloud – means we have at our disposal more talent and computing power than has ever before been assembled. Through big data research, patterns that once would have been invisible can now be studied, enabling us to identify the root cause of problems and measure the success of health interventions and ultimately preventive measures. We have the ability to not only diagnose individuals, but entire cities and even nations through the application of the technology at our fingertips. We know what ails us, our communities and our planet – and we can put that into better practices to do something about it.

As a university, we have the ability and responsibility to contribute to the public discourse about the best ways to solve the health challenges of our time. As scholars we test hypotheses, we engage in deep and rigorous analysis. We follow the evidence wherever it leads, and oftentimes that is someplace unexpected – even controversial. At a time when policy debates too often seem fact-free, we present our work to policymakers and the public so they can make informed decisions. This role isn’t always easy – challenging conventional wisdom and entrenched interests rarely is – but it is vital if we are to create inclusive, democratic societies.

People throughout our community and our world see the benefits of our collaborative, interdisciplinary, data-driven approach. It is an approach that, from the start, has been in partnership with many of you.

I’d like to share just a few of many, many, many powerful examples:

The UW’s Institute for Health Metrics and Evaluation, launched nine years ago with support from the Bill and Melinda Gates Foundation, is presenting leaders and policymakers with what amounts to a diagnosis for their nations. And those leaders are responding enthusiastically. Data from IHME led the Ministry of Health in Rwanda to create a program to deliver modern, cleaner burning cook stoves to 1 million homes.

In the world’s most populous nations, including China and India, policymakers are now using UW data to guide their decisions related to reducing air pollution. Perhaps most significantly, the National Institutes of Health is now using IHME data as one of its criteria for deciding where to fund research – that’s $30 billion in annual research funding distributed to improve the health of the world, and their decision about where it goes is informed by UW data. How cool is that?

UW Medicine has 26,000 employees and 5,000 students and trainees here and throughout the world focused on a single mission – to improve the health of populations. In line with our public mission, this work is done in concert with local government; we run the county’s hospital, and are among the first to become an accountable care provider to a local company.

Together with faculty across the health sciences and our collaborators throughout the extended region, we’re creating the next generation of health professionals, treating thousands of patients, leading in social work and public health interventions. I’m particularly pleased with our expanding collaborations to accelerate the pace of curing and preventing cancer within the Seattle Cancer Care Alliance. As well as with our new partner in medical education, Gonzaga University in Spokane, as we focus on the needs of communities is Eastern Washington.

The Department of Global Health is a crucial collaborator and leader in this worldwide mission, with active projects in 138 countries. One of those projects uses modern technology – text messaging – to address an age-old concern of new and expectant mothers: how can I best care for my baby? Led by Dr. Jennifer Unger, also in OB-GYN, the project shows that giving new mothers in Kenya the ability to ask questions of health professionals through two-way text messaging decreases infant mortality. Texting saving lives – remarkable.

In another groundbreaking effort, researchers from the School of Public Health and the Fred Hutchinson Cancer Research Center led the largest study of its kind into disparities in breast cancer treatment and diagnosis. What they found confirms the shameful existence of inequality in detection and treatment, with women of color up to four times more likely to be diagnosed with cancer in its late stages, and at much higher risk of not receiving the recommended treatment.

Meanwhile, the UW Jackson School’s Center for Human Rights is drawing attention to the direct connections between the management of our natural resources and the welfare of communities who depend on those resources. The “resource curse” is a well-known phenomenon; because of the hunt for natural resources that drives our world economy, millions of people around the world are exploited and their health and well-being threatened. Their lands are deforested, or simply taken, their water polluted, their communities forever altered – at least until we can develop scalable, sustainable alternatives.

The Puget Sound Institute, part of UW Tacoma’s Center for Urban Waters, is developing indicators, to help us better understand the relationship between habitat restoration and well-being. And knowing that our urban centers are our greatest challenge and our greatest opportunity, Urban@UW brings together faculty from all three UW campuses to build inclusive innovation collaborations focused on improving health in urban areas around the globe.

Similarly, the West Coast Poverty Center is taking a cross-disciplinary approach, uniting anti-poverty research, practice and policy by forging connections between scholars, policymakers and practitioners. For example, Professor Vicky Lawson – director of the Honors Program and the Relational Poverty Network – and her students are studying poverty as produced and addressed by economic, political and cultural relationships between social groups. Many different factors beyond economics conspire to force families into poverty and to keep them there – from the health care system, to climate impacts, to the criminal justice system, to discrimination in housing. A holistic approach is not only beneficial, but vital, as we strive toward social justice.

Improving well-being also means ensuring our individual actions and those of our institutions continue to combat the effects of racism and inequity. Through the Race and Equity initiative, the UW is taking up this challenge, and I’m inspired by the work happening across our campuses, particularly among our students.

Speaking of our students, you might want to check out “Skies Over Seattle” – three student-generated performances that have evolved out of a year of collaboration and conversation with three U-District community groups. The arts and humanities have a way of breaking down barriers in ways that other interactions cannot. You can learn from our students’ experiences – and support them on stage – during the world premiere next month. Be there or be square.

Our students are the leaders, innovators, change-makers who will shape the health of the world. And they aren’t waiting until graduation to make a difference.

Dentistry students regularly serve patients in rural and underserved communities, our Global Medicines Program pharmacy students take part in medical brigades, and students in law and political science work on human rights and labor issues in Central and South America. We are number one, in the world, in Peace Corps volunteers! And the University of Puget Sound and our new partner, Gonzaga University, share the number one spot for small schools in producing volunteers. That tells you something about our region’s culture.

In every one of our schools and colleges, students are working alongside faculty, and advocates, and community leaders to improve health and well-being – always learning, sometimes teaching, and invariably inspiring us with their drive and their passion. Our work is better because of the questions they raise and the barriers they’ve inspired us to break, starting with the barriers between disciplines.

So many of our students, in ways big and small, are leaders. And as they’ve led, they’ve done so with conviction. Sometimes they raise their voices to be heard, and I applaud their courage. Other times, the change they make is quiet, behind the scenes, but every bit as meaningful. As we look to the future and develop a renewed vision for this work, the student experience will be at the center.

So where do we go from here? I’ve shared a few examples of our commitment and the progress we are making. Yet, the challenges we seek to address remain daunting. But no one university, educational or health care institution in the country, and no region in the world, is better poised to lead us toward solutions than the University of Washington, right here in the Puget Sound, in the state of Washington – in part, because of you.

It’s time to renew our vision, together. Over the next quarter century, we will expand our ability to turn health evidence – to use our ability to diagnose patients, populations and the planet – into actionable policies, reforms, interventions and innovations. We will enlist all UW campuses, colleges, schools and units – those that are already driven by a mandate to improve population health and those that can contribute in ways perhaps less obvious, but just as important – in this effort.

Here’s where we begin:

It starts with doubling down on our commitment to reducing health disparities here and around the globe. There is no reason your place of birth should determine the likely date of your death, or that your race or ethnicity should predestine you to greater suffering.

It continues with a determination to increase global security by tackling the challenges of environmental sustainability. It is too late to stave off some of the effects of climate change, so we must also study ways to improve resilience, especially in those communities most likely to be harmed.

Those impacted by climate change are many of the same communities stricken by poverty. Which is why we must also strive to address social, economic and environmental inequities that so often go hand in hand, around the world, and here at home.

Our students are our world’s future and we will seek to inspire the next generation of decision-makers, who will drive evidence-based health policy guided by the strong conviction that every life has equal worth.

We will create new paths and encourage more students to pursue careers where they will do work that positively impacts population health, building synergies within the wide range of disciplines that can contribute to the mission. And we of course want these students to learn from the world’s most outstanding faculty, so we will add to the global leaders who already call the UW home.

Together, they will team up with leaders and collaborators from the communities who have the most to gain from the democratization of health evidence, unlocking the power of data for the benefit of all. We have in our pockets more computing power than could ever before have been imagined – let’s encourage people to use it for something more than Snapchat or Tinder.

The UW has excellent, world class programs in every school and college, the Puget Sound region has some of the most innovative public and private organizations in the nation, as well as progressive local governments that are excellent partners – we have all the parts that are necessary to create the change we want to see in the world. The challenge is to make sure that the sum of the parts equal more than just the sum of the parts. This initiative is about making sure the whole is greater than the sum of those parts.

It’s about catalysis and fusion across the full continuum of innovation, and disciplines, from neighborhood to transnational programs, anthropology to aeronautics, devoting our best talents and sharpest minds to finding solutions to these challenges.

That’s no small mandate. There is much to be done, and money is finite – so we must work with individuals, communities, governments and philanthropists to determine the most cost-effective and productive uses of public health and social service resources. We will engage with them – with you – in both the formation of this vision and its implementation over many years. That’s the only way to have the greatest possible impact, save the most lives, and build better, smarter, safer communities.

We will begin by engaging the entire community in the development of this initiative. A team of leaders from across the University has been putting ideas together – but this must be a collaborative initiative and we will be bringing more voices to the table. Even as we look at the range of actions we could take, including the possibility of new degrees in population health and ways to encourage more students to investigate population health-related questions, we’ll need more guidance from a broader range of faculty and from our community and governmental partners.

Within the next few weeks, I will appoint a Population Health Leadership Council to begin this work, and develop a long-range, University-wide plan. The Council, which I will chair, will consist of deans in the health sciences and from engaged colleges and schools – such as Arts & Sciences, Environment, Engineering, Education, Public Policy and Governance, and Law, as well as faculty and staff representing important contributing programs and stakeholder units on all three campuses. It will begin by taking an inventory of existing programs, opportunities, and partnerships related to population health. I expect that after this talk I’ll get e-mails about the important initiatives and programs I failed to mention, and that’s a good thing.

That inventory will be followed by the launch of a University-wide visioning effort this fall. I will ask the Council to develop recommendations for phase one by January 2017, with a full 25-year vision and action plan to follow. An external advisory council, comprised of representatives from our regional and world partners will also be essential to ensure we leverage our collective efforts to the greatest possible good. And we will consult closely with faculty and student governance to evaluate our progress and priorities, and to ensure alignment with the imperatives of diversity, equity, and inclusivity.

The implementation plan that we develop, together, will be part of our strategic planning, ensuring that it will be a priority for resource allocation and program development. Additionally, securing the resources needed for this effort will be a priority for the campaign that we’ll launch this October, as well as a when we meet with policymakers in Olympia and Washington, DC. (And, for those of you that worry about this kind of thing – it won’t detract from what you’re doing – it will bring them together. We all have something to contribute.)

To get this right will require deep reflection and analysis, flexibility, openness to changing course when needed, a sense of urgency, and determination to succeed. Some resources are limited – but our spirit is boundless. And we have so many partners and potential partners around the Sound, and experts in allied fields – in everything from cancer research to data visualization, from transportation and logistics, to personalized customer experiences – all the fields that are vital to doing work globally on a personal scale. Just feel the unique potential that exists here, now – right in this room!

The University of Washington, the Puget Sound region and our state can lead the world in improving population health. It’s time to take that mantle – together.

I started my comments today talking about a community. I want to close by talking about a person.

She was born into a comfortable life, though that comfort was soon shattered by political upheaval. She and her family had to flee their country, and the comfort they’d experienced was lost in the moment they became refugees. Her highly educated parents worked in shoe factories to support the family. Though they had little money, what they did have was optimism and a belief that education was the key to a better life.

She and her family also had the good fortune to come to this country, in a time when the divide between rich and poor was narrowing, not widening, and when higher education was more attainable. She went to college with the help of scholarships, and there she found mentors – and a calling.

If you haven’t guessed, the girl who came to a new land was me. And, despite some considerable obstacles – I’ll never forget the sacrifices my parents made for me – I must also acknowledge my privilege, the opportunities I was given, and the good fortune I’ve had, which all far exceed the opportunities available today to billions of people around the world, and millions right here at home. Opportunities to live truly healthy lives, enabling them to reach their full potential and fully contribute to a society that needs all our talents to move forward.

That’s what drives me and our University. It’s what inspires us – faculty, staff, students, at the UW and our many partners.

It’s why I’m calling upon you to join me. It’s why I’m calling on all of us to use our collective talents to improve the health and well-being of people – some we’ll never meet, some we pass every day on the street, and some in our own families. Because I know if we come together, as scholars, as leaders, as innovators and as human beings, grateful for the chances we’ve been given, we can truly create a world of good.

Thank you and onward!