ORAL HEALTH BENEFITS of OIL PULLING | 2 Minutes to Better Health

hi in this video I want to talk to you about a 
tremendous health practice known as oil pulling   and it's better than teeth flossing in many many 
ways hi I'm Dr Joe with two minutes to better   health well this has been used for thousands 
of years in Ayurvedic medicine and now it's   used in our culture for those that know it and 
I believe that most people that do know it they   don't actually apply this but if they did it would 
have tremendous benefits to their oral hygiene as   well as other health benefits so let's find out 
a little bit more about this so what is it first   of all you have to understand that it's a simple 
process you put oil in your mouth you chew it you   slosh it around your mouth for minutes at a time 
and these are the benefits that will come from it   it's that simple kills harmful bacteria there's 
over 700 bacteria that can be found in the mouth   at any given period of time and upwards of 350 
to 400 of them can be easily handled by using   this simple process and I believe there's one type 
of oil which we'll talk about in a moment that is   by far the best to use for this procedure helps 
reduce bad breath well ultimately by controlling   the bacteria growth the bad stuff in your mouth 
bad breath will be helped tremendously by this   helps prevent cavities same thing bad bacteria 
in the mouth then ultimately you can help prevent   cavity growth healthier gums gingivitis same 
thing inflammation is controlled in many ways by   controlling the bad bacteria there's good bacteria 
in the mouth as well but by controlling that will   help to prevent gingivitis from spreading reduces 
inflammation not just in the mouth but in other   parts of the body because as you'll see in a 
moment it has detoxifying effects soothe a sore   throat so when you do this you're going to chew 
this and slosh around in your mouth but as you   gargle it it'll get into the back of the throat 
as well the benefits are far beyond the mouth   whitens teeth tremendous benefits with 
this especially with a specific type of   oil I believe coconut oil is by far the best 
cracked lips because it is going to get onto the   into the mouth and into the lips area and there's 
certain nutrients that are going to be helped to   be replenished by certain oils that have vitamins 
and minerals in them as well detoxification   so this is huge oral detoxification is a big 
thing a lot of the the stuff that we ingest into   our bodies goes directly into the mouth goes into 
the thyroid into the digestive tract but as you   clean up what's going on in the mouth in many ways 
you're going to detoxify the whole body especially   for people that have heavy metals in their mouth 
still and a lot of metals from other appliances   and stuff this is a huge practice because that 
stuff doesn't stay inert in your mouth it does get   into the tissues the more you can pull it out the 
healthier you will be and many many more things   that are you know supported by this there's been 
research that shows that it helps with things as   far as like heart disease and preventing cancer 
and all the different body systems supported   Ayurvedic medicine done a lot more research 
especially anecdotal evidence on this so   look it up yourself how to do it very simple one 
tablespoon oil coconut sesame olive put it in the   mouth coconut oil will be solid at first and chew 
it it's actually like a chewing process because   they do talk about just swishing it around but 
at first chew it and that's going to help release   enzymes from your mouth which helps to enhance the 
quality of this process and do it for upwards of   10 to 20 minutes you won't start there but if you 
can build up to that that would be a tremendous   health benefit from it spit it in the garbage when 
you're done not in the sink not in the toilet it   will clog things it's not good tons of bacteria 
in that as well you don't want that in there rinse   with water and preferably salt water afterwards 
to definitely clean all that out of your mouth   get all those toxins out and repeat three to 
five times per week okay it's tremendous health   practice or upwards of three times per day if 
needed if you have a lot of oral health issues so   definitely try to utilize this share with friends 
and other people that have never heard of it and   more importantly leave a note to remind yourself 
or leave the oil in your bathroom to start this   process even if you did it once in a while or for 
two to three minutes at a time tremendous health   benefits will come from it hope this is helpful 
look forward to seeing you in a future video

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[PART 2] MedCircle Doctors Tell All: Mental Health Stories

– I am always looking in
every patient interaction to see, how does this make sense? How does it make sense
that you're anxious? What was going on beforehand that would have potentially
brought up some feelings and had your anxiety spike? So that we could
de-stigmatize mental health and we could help people understand that they're not crazy, this stuff doesn't come out of the blue. Your diagnosis is that you're human, that we all go through this together and that we can learn together and we can learn to heal together. (chime) (calm music) – I think that it is
important to reframe thoughts, but at the same time,
acknowledge that sometimes thoughts are not easy to reframe. And I have a three-step process
for working with thoughts. The first thing is to
challenge their veracity, or the truth of them. Just 'cause you have
a thought doesn't mean that it's more likely to
happen or that it will happen. So you need to really look at it and say, "Well, what's the evidence
for and against this thought?" And when we say evidence, it's
not another thought or belief it's actually something that's
observable by a third person.

A person that can say,
"This is what I observe to be true or untrue." And I think once you put
that through the litmus test, it's then important to try to reframe it in a way that can still feel
realistic to the individual and they can get on board with. So this is where purely
positive affirmations, especially super cheery
ones are not going to work because it doesn't feel
realistic to the person based on what's going on. And that's why I talk about this technique of yes, but, where you basically
construct your new thought using this structure. Yes, things have not been great lately, but I have practiced these tools and I believe they are
going to make a difference.

Right, so acknowledging
what's not going right, but then acknowledging something, particularly something that you
are working actively towards or something that honors
your process and commitment that gives you the other
side of the picture and really giving you a complete picture of what's going on, as opposed to just the one-sided picture. But sometimes your negative
thoughts are so strong and maybe there isn't a way
to reframe it in the moment because you're just so
stuck on that thought. Or maybe that thought
isn't even a thought trap. Maybe things are just
really bad right now. And that's when we use the
technique of de-emphasizing the impact your thoughts have on your behaviors and your emotions. And in order to do that, it's really about separating yourself and your identity from the
thoughts that you're having. And to do that, we really
essentially relabel the thoughts, and we label them differently
in that we label them as a mental event. So, if you have a thought that
nothing will ever get better, that sounds so final. That sounds like it's happening right now or it's going to happen, but if you could just add
the clause in front of it that says I'm having the thought that things are not going to get better.

It gives you the sense that the thought is just a mental event. It is a thought that you are having as a separate entity to the thought, and it gives you a sense that
perhaps there could be a way to resolve the situation, and that perhaps the situation you feared isn't even going to happen. (calm music) I can't be any different that I am right here in this moment.

And if I can give myself
permission to be exactly me, having areas of expertise
in certain places and that there may be some questions that really throw me that
I don't know the answer to, and that that in and of
itself could be okay, I could help regulate my anxiety. But absolutely, I still
get symptoms where, again, stomach upset, sweaty palms, heart racing, I can feel in complete self-attack mode. And the key for me is
being able to notice it, to regulate, to see what's going on and remind myself, often when I'm in this kind of self-attack, gosh, you can't be anywhere
other than where you are. What you have to offer is totally enough, and you couldn't offer any
more than what you have right here in this moment. And for me, that's an important mantra to keep my self-attack
and my anxiety at bay. – In the realm of mental health, what would your ideal world look like? – Gosh, in the world of mental health, my ideal situation would
be complete normalization of symptomatology. So that we could
de-stigmatize mental health and we could help people understand that they're not crazy.

This stuff doesn't come out of the blue. That I am always looking, in
every patient interaction, to see how does this make sense? How does it make sense
that you're anxious? What was going on beforehand that would have potentially
brought up some feelings and had your anxiety spike? Why might you be depressed right now? What's going on in your life that brought up some feelings, had you get anxious and now you're kind of attacking yourself or
isolating or avoiding? How can we make sense of
this and see, you know, the catch phrase that I love is that your diagnosis is that you're human.

That we all go through this together and that we can learn together and we can learn to heal together. – So many people have imposter syndrome and not just in a professional stance. Parents feel that way. Siblings, friends, coworkers, I mean in any situation you can
have that imposter syndrome. For those of us experiencing that, what would be your one word of advice? – So, if we think about imposter syndrome, so many people experience this.

And if we get really clear
about what is imposter syndrome? Imposter syndrome is
a form of self-attack. It's a way that I attack myself and tell myself that I am not enough. That they way that I'm
operating as a parent, as a worker, as a friend, a
son or daughter isn't enough. And so, part of it often, in places where we actually have a lot of experience or doing a great job, can
be related to struggling to hold healthy pride, to feel good and confident
about what we know. And then the other part can
come when there are holes in our learning or in our capacity, and that there is no one
who is a perfect parent, a perfect teacher, a perfect doctor, and that when we have to
hold this juxtaposition of I know a lot, I have
healthy pride over that.

But there are things that I don't know, and I might feel some guilt around that or feel uncomfortable that
I have to say sometimes I don't know. Rather than holding
these mixed feelings of this is who I am, this
is what I have to offer that I am enough exactly as I am, we get anxious and then
we attack ourselves. We say, "Gosh, you know nothing. You shouldn't even call
yourself a doctor, Kristy." Those are things that
we can do to ourselves, but it's so important that we recognize that self-attack comes
in the face of anxiety over mixed feelings. I'm proud of what I know. I'm proud of the position
that I've taken on, and there are things that I don't know. And can I hold this kind
of really complex mix of being an expert and a learner? Knowing things and not knowing things.

Gosh, can that make us anxious. And rather than tolerate the
anxiety and feel these feelings we often dump into this self-attack and call ourselves an imposter. So, the more that we can own what we know, allow the space for what we don't know, and settle into the
anxiety that that provides and let that kind of complexity sit, our anxiety can come down and we can be enough exactly as we are. – What is the role of
hope in mental health? – So, you know, I would suggest that hope is actually one of the
cornerstone kind of ingredients in regard to mental health.

That when I have patients who come in and tell me they have no hope, we actually can't go any further, we have to start right there. Because if they have no hope, I can hold 110%, 150%, 200% of the hope, if they have no hope, we
can't really go anywhere. That it is when we start to create space that things could change.

That we could work together to make things different in your life. Then we've got room for
potential, for possibility, for change, and this is what hope is. In my experience, we
really can't go anywhere in mental health in regard
to finding symptom reduction, in regard to changing our lives, unless we start with hope. Even if it's just a little window. I always tell my patients I
can carry the bulk of this, but I can't carry all of it. We have to align that
there is at least some hope that we can start to tap into and expand for change to happen. (calm music) – When I had that thought that I'm failing my
son and I am a failure, I noticed it and I caught it. I had probably been feeling that way and thinking those things
for quite some time, but when I noticed that thought, because I was able to
really pay attention to it, I was able to question it. I was able to label it as a thought as opposed to as reality.

And I was so, so grateful
that's something that I already had the skills to
do due to my own therapy and my therapy training,
that I challenged it. I said, "No, this is not true. I'm not a failure and
I'm not failing my son. I feel like I am, but
I'm not because I'm here. I'm doing the best that I can, and everything else
will figure itself out." This obviously didn't
magically fix everything. I didn't start to feel better right away, but I know that had I
not caught that thought and had I not labeled
it as just a thought, I would have spiraled and it would have been
really, really hard for me to manage my emotions, to actually give myself the opportunity to connect with my son, and to connect with those around me so that I could feel a
little bit less isolated.

(calm music) – I heavily believe in what I consider, I call it the five Vs for thriving. And I know that they
work because I use them. The first one was to
validate how I was feeling. A lot of times, especially
in the medical field and then professional fields, you feel like you have to
really put others first, but it's really important to
validate how you are feeling. So I have to validate that. This was painful, emotionally difficult, and then I had to vent. And so, venting for me
was regularly meeting with my own therapists. I had to really take care of the vitals. I had to take care of my sleep patterns, my eating, making sure
that I was still exercising and keeping my body in that routine. And then focusing on the
values, the fourth V, which is like, what are my true values? My values at the time were my family, my friends and his legacy.

And then vision, keeping
things in mind for the future. So, myself and the rest of the community made sure that we were going
to memorialize him every year, get together every year. So, having something on the
calendar to look forward to to keep you moving forward. Those five Vs really helped
me to get through that. And I really see this theme
with my patients today, like people who can
pull on these strengths and these five Vs, really do well in the face of obstacles.

(calm music) – You know the funny thing is is that when you talk about the moment I felt I could get out. And you know I've said this
on other MedCircle videos, is the only way out is through, Robert Frost and all of that. But I have to say it was less about I knew I was going to get out than I can think of a different
way of thinking about this. Because, to me, so much of mental health is about acceptance. We can't rewrite our pasts. The things that have happened to us have happened to us, they have. Can't go back and have different parents, can't eliminate the traumas
that have happened to us, can't eliminate the
losses that have happened.

Our stories are our stories. And so the question the becomes, for me it was the coming out of it moment, was I gotta do something differently. And so it was more of a, in a way, going through a mental health crisis, once you can start getting
almost to the other side, if you will, getting closer, is you start giving
yourself permission to say are there other options? Are there other things I could do? Can I do differently, feel differently, act differently? And that's really where it turned for me. It's like, okay there's things I can do. Part of that actually culminated in me retiring from a long
standing academic job. Some of the traumatic
things I've alluded to impacted that job. And while it hit me financially,
as you could imagine, I thought this is, in the
grand scheme of things, and this is when it's hard, you're doing all this accounting.

The one thing is dollars and cents and the other is like,
what's the price of my soul? Haven't quite figured that out, but apparently it was about the equivalent of my academic salary. So, I was like, I gotta get out of this. And, like I said, there's gonna be financial costs and all of that for me, but had this mental health
crisis recently not happened and the cumulative crisis of
COVID, family health issue, all not happened, I
think I would have stayed in an inertia state. And instead, basically
it was like the universe or the world or my mental
health or something metaphysical slapped me across the face and said, "What are you gonna do about it?" And so it was a huge call for me.

And some people around me said, "Are you sure you know what you're doing?" I said, "No, but I got to do something." And I have to say it's relieved
some fears and tensions and other things that
were coming from that, so that's great, but there's still some other tweaks that need to happen. And the other way I knew I
was kind of coming out of it was I was getting a lot
better at paying attention to sort of how I feel and
really giving credence to that saying on this day I feel well, on this way I don't feel well.

Well, let's look at the
difference between those two days and figure out what
things are in by control between those two different kinds of days. Now obviously between you and me, Kyle, if somebody gave me enough money, I'd be like peace, I'm out. I'm just gonna go sit in
some sort of green place or snowy place or maybe
go back to New England or something like that and live quietly. I could not work for the rest of my life. I have to be honest with you. But that's not in the cards for me. So for me, it was really like how is this going to lead me to think and do differently? And the severity of what I've gone through in the last eight, nine months, it ended up being a call to arms. And it's a call to arms
that has changed my life with an intentionality and a power that I don't think I would have had unless all this terrible
stuff had happened to me. – When you are in that space of an emotional mental
health challenge, obstacle, perhaps suffering from trauma
or any number of things, and you haven't reached the point of I need to change something, you're still at the point of, oh my gosh, I just wanna sleep, what is your advice to
those people in that space? – Yeah, you know it's interesting, when I look at my own story and say why didn't you crawl
into bed and not get out? 'Cause let me tell you, for several months there,
that is all I wanted to do.

I have a child. Child needs breakfast. Bills need to get paid. I have staff that needs to get paid. I have a mother that
I need to check in on. In many ways the people around me, and I think this is a
very, in some ways I know it's many women who certainly
find themselves in this role of there's people I gotta take care of. And those people I have to take care of, it wasn't in my reality or my identity, however, I know there's people out there who very much identify
as incredible caregivers and they still find that
they can't get out of bed.

And I understand that as well. For me, it was about breaking my day into pieces that were manageable. I would sometimes look
at my calendar and say, in fact, I don't want to
tell you the obscenity that more mornings than not I start. Like, I basically I'm like, curse word me, I can't believe I have to do this again. That was literally, I'm like, wow, that's really what
you say every morning. When that alarm goes off, first thing that comes out of my mind. And my cat's next to me
every morning hearing this. So, it's sort of a really tragic tableau if you want to think about it. But what I did was, and I do, and I've said this before, is I've got three things that I do in the same order every morning. This is actually many
ways where I think my cat may have saved me. She had to get fed. And she had to, she had
a routine in the morning. She'd come, she'd lay next to me, but then I'd stir and she'd
wait until the sun kind of comes up just a tiny bit.

So, she'd never wake me up in the dark. And then I had to get
out of bed to feed her. And once I was standing, I'm like, okay, girl, you're standing. And then I would use the
bathroom and brush my teeth, go downstairs, make my tea and now the day had started. One, two, three. Cat, basic ablutions, make the tea. And when that three-step
process had started, it was almost like imagining
a plane going up a runway. The day had kind of started, and then what I did try to do is I do try to follow routines. Like, then this is gonna
happen, this gonna happen, and I'd cut the day into pieces. When you're seeing clients,
that logically happens, it's an hour, it's an hour,
it's an hour, it's an hour.

And so that helped me. And on days that were more freeform, I'd cut the day up into chunks. Sometimes 15 minutes at a time because I couldn't imaging thinking about the 12 hours ahead of me. And I have to say sort of breaking it into these manageable chunks, before I knew it, I'd
lift my head and say, wow we got all the way to three o'clock. Or wow we got all the
way to seven o'clock.

And then I did other preventative things. A lot of the stuff that was coming at me that was harming me, was
coming by text messages and emails and that kind of thing, so my team, I have the
best team on the planet, they said, "We're managing these emails. And at the end of the day
we're sending you a summery, and you will handle the important stuff and we are going to protect
you from the rest of it." And that speaks to social support, Kyle. Because what I was surrounded by people who saw the cracks showing. They said, "We know what's causing this. It would cause it for us, but this isn't coming at
us, it's coming at you, so we're going to be
the front team on this." Just as I would do this for anyone else, they protected me from that and they helped me order my day too.

So that combination of social support, that cat that would get me out of bed, the three steps that I would do that the rest of the day would
kind of logically fall from, and deconstructing my day
into reasonable chunks, it was like cutting my food, you're not gonna stick a
whole pancake in your mouth, you're gonna cut it into pieces. It was the same thing. It made it digestible. And then, you know, some
days I have to admit, and it's still like this, Kyle, I feel like I'm just enduring the days. And then there's some days
where the joy cuts through.

And hopefully with time, more of the joy-filled days will be there than just the days where
I feel like I'm enduring and just pushing through. – Thanks for watching. Check out the links below
for more information on how to access this full series. And subscribe to our YouTube channel to watch new mental
health videos every week. Did you like what you heard in this video? If you want to ask a MedCircle
doctor a question directly, you can. Learn how by visiting the links in the description below.

(chime).

As found on YouTube

Essentia Health-Spooner Clinic

SPEAKER: Welcome to the
Essentia Health Spooner Clinic, providing primary
care, as well as a full array of
specialty services to residents of Spooner,
Wisconsin and the surrounding area. The clinic was opened in 2016,
and is conveniently attached to Spooner Health Hospital. Free parking is available to
all patients and guests, located right outside the main
entrance to the clinic. Once you arrive, our
staff will check you in at the registration area. Each patient is given this
yellow laminated sheet at registration,
which helps keep track of any needed tests or
treatments during your visit. After you've checked
in, you can have a seat in the clinic waiting area. During your
appointment, you will be seen by one of our
highly trained providers in a newly updated
treatment room.

Once your appointment
is finished, make your way to
the checkout counter to schedule any
future tests or exams. The clinic also
features an on-site lab for diagnostic
testing and radiology services for more advanced
comprehensive imaging. We look forward
to caring for you and your family at the
Essentia Health Spooner Clinic. [MUSIC PLAYING] .

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15 years Friend Europe Change in global Health Landscape

The difference between now and early 2000
when the Global Fund was designed is that at that time the World was rich Global North
and poor Global South, and the concept was of the solidarity between the rich and the
poor and a sort of vertical approach. Now the things have changed, the World is
no more North and South, it is global, everyone has been affected by Covid, and the World
geopolitically is multipolar. And what we have seen with Covid unfortunately
is that the system has kept being vertical and was not inclusive so that the people who
designed some of these mechanisms continue to think like we were in 2000 when we need
and I believe we can achieve, even with political tension and competition, for health that people
come and work together.

the Global Fund is well positioned to play
such an important role on one hand going on fighting the three diseases but also being
active in the prevention of pandemics but this future in the Global Health architecture
will need strong health fund and I think the Global Fund is well prepared to play this
role. A big challenge for the Global Fund now is
to find a way to both be able to meet the challenges of 3 years cycles without leaving
on the table also the actions for long-term impact , including giving more power to key
population..

As found on YouTube

1. Access to Maternal Health Care in Rural Communities: A Patient’s Personal Story

My name is Jenni Van Otterloo. I've been
married to my husband for about what will be four years this summer. We've lived
here in Sanborn, Iowa for the whole four years of our marriage. We have two kids.
We just had one about two and a half weeks ago. Being in Sanborn, Iowa there's
not a lot of close hospitals. The nearest hospital is in Sheldon Iowa which is 10
miles west of us, and they're pretty small. The only pregnancies they take in
Sheldon are what's considered a normal pregnancy. Before I got married, I found
out I had a pulmonary embolism; blood clots in my lungs that later on were
going to play a factor into pregnancies with being on blood thinners,
and things like that. I've been with McKay now for, oh
probably five, six years so she's been aware of my history for a while. My name is Kimberly McKay. I'm an obstetrician- gynecologist in Sioux Falls, South Dakota
and I am the Clinical Vice President of the ob/gyn service line for Avera
Health.

Avera Health is a health system that covers 72,000 square miles of South
Dakota, Minnesota, and Iowa, down into Nebraska
and we have about 16 facilities that deliver babies. We deliver 6,000 or so,
6,500 babies a year, so we know a lot about rural. We know a lot about what
goes on in rural medicine. 15% of our patients are American Indian, about 10%
are other nationalities. Half of our patients are covered by Medicaid,
either as a primary or secondary insurance.

And so, you know, large
geography, very diverse patient population. Care planning for rural
patients is difficult sometimes. Ideally they're low-risk, they have no
medical issues, they are normal weight, they have every resource available to
them, but as it turns out not very many pregnancies in the United States of
America are low-risk. So when I looked for different providers near me, both
places told me that with a condition like mine, with a blood disorder that I
have, they don't have the resources, like the blood bank on hand, at their
hospitals to handle anything that would happen, if something were to happen
during delivery or during pregnancy, so I was referred to Sioux Falls, therefore
back to Dr.

McKay in Sioux Falls at Avera. Prenatal care, in general, for a
low-risk pregnancy is 13 visits. 13 days out of that where you take time out of
work. 13 days where you need to travel for things like ultrasound and lab work.
Add 90 miles, a 90 mile drive, to that and it makes things extremely complicated.
geography doesn't pick and choose the low risk and high risk patients. The distance is huge. I have to travel an hour and a half to an hour and 40
minutes for every doctor appointment, and that's just one way, so I'm on the road
for over three hours for a 30-minute appointment every time that I need
go to a doctor's appointment.

We have Avera eCARE which is one of the largest
telemedicine networks in the United States. We're looking to add more
technology to figure out how to keep patients as close to home as possible
until they actually need to come into their maternity center to deliver. I had really good care. The only thing that Dr. McKay and I talked about, just
trying to cut back on some of the distance, and the traveling, and things
like that through video conference calls, or whatever, just to do some of those
would be really helpful. I think that would be something that would be great
to see happen in the future. And the other piece is that Family Practice
physicians, and nurse practitioners, and PAs are extremely important part
about how we provide care. They aren't always as comfortable with obstetrics
unless they, themselves, are personally providing that care in their community.

And so much of what we do, in particular through our eCARE services, is helped
them feel comfortable with what they're seeing. So when I went into labor with my
second child, I went to work that morning. I had contractions. They usually tell
you to go in when they're 5 to 7 minutes apart. They tell me to come in when
they're 10 to 12 minutes apart. So I actually went to work that morning
because they weren't that close yet, but by the time I made it to the hospital I
had my daughter within an hour of getting checked into the hospital, so it
was cutting it really close. I'm glad we made it, and everything worked out ok, but
yeah, there's just a lot of extra things that we have to plan with..

As found on YouTube

5 Phases of Marketing | Phase 1 – Lead Generation

Hey everyone Travis Robertson real
estate coach CEO and founder of Robertson coaching
international where we help agents just like you
create businesses that support their lives not run their lives. I'm really excited
to bring to you today the five different phases of marketing
and what we're gonna be doing is we're going to be looking at the five phases that every single person who comes in contact
with your business are gonna move through from the time
they become a lead to the time that they become a sale and give you the opportunity and the
understanding of how to capitalize on each of these five phases and drive
people through them to convert more clients, make more money
oftentimes off the lead you're already getting.

So
what's the first phase? the first phase is what we like to call
lead generation and every phase by the way has a
question; a question that you need to answer for your business or for your
marketing plan so what's the question here? the question
here is this: how will you generate new leads for your
business over let's say the next 12 months. now
most agents think well, I want to generate leads as many
ways as I possibly can the problem is this the more you try and
do the less effective you become.

Instead
what I want to do is this I want you to focus on one to three major lead generating activities
that you're going to employ in your business over the next 12 months.
become a master at them rather than trying to do them all
ineffectively so pick one to three different lead
sources now most people ask us okay but that's
great but what are the three that I should choose you know it's a great question. Some of
that's going to depend on your budget, the time that you have to invest
to the resources that you have available to you but beyond that what you want to do is
you wanna focus really on those things that are going to move you forward based
off of the goals that you set for your business but let me do this I wanna share with
you three of the lead generating tactics right now that are working very very well for our clients two of them
by the way are great at generating listing leads and if you're like most
agents pretty much everybody could use more
listing leads right so what are the three different tactics that are working
really well number one direct mail marketing.

I know it's old school people go oh
but direct mail marketing it's so 1995 but here's the thing: everybody's
been moving their business online right now all the marketing is in where? your inbox or on social media and
it doesn't mean I don't like marketing those areas but what I found is this our in
boxes or our mailboxes have become extremely quiet so this is
the thing is our mailboxes have become so quiet do what we want to do is you want to get
through that noise through that clutter what better way than to hit people in
their mailbox tactic number two Facebook leads Facebook advertising Facebook Ads have been generating hundreds and
hundreds of awesome listing leads for our clients if you're not doing facebook advertising
it's time to invest a little bit of money and a little bit of time and explode your
listing inventory and finally number three is strategic
calling…strategic calling, see what we found is that most agents that
come to work with us and that start working with our coaching
program have clients or leads or people that they haven't contacted in a while and so what we do is we have them make a
list about let's say the hot leads from the past six to 12 months that they were so close, right there of
either buying a home or listing their house and then what
happened? they never move forward.

So what we want you to do is we want you to
compile a list of all of those people but rather than just calling them and
saying "you know, hey, you still interested in selling your home or do you still want to buy a home?" what we
needed to do…the key is you must provide value. So how do we
do that? what we encourage you to do is call with
an item of value so maybe it's an updated CMA for an old listing lead or maybe you are working with a buyer and
that buyer had a certain type of home that they were looking for. It all comes down to providing value,
providing value, providing value.

So those three things right there can generate listing leads and buyer leads
very very quickly for your business. and they're working exceedingly well for
our clients but there are so many different ways so many different things that you can do
to generate leads the key is this fine just a few focus on one to three, cut all the crap and that simplicity is
gonna allow your business to explode.

As always, I'm Travis Robertson, it's been a pleasure to serve you. If you have any questions on this leave a
comment below like this video on youtube feel free to
visit us online at travisrobertson .com We'll answer any questions you have and if you
want to find out of coaching may be right for you we'd love to talk with you as well.

I look forward
to seeing you in the next video and serving you with more these. Take
care you guys..

As found on YouTube

Global Health Starter Kit: Module 2 Instructor Video

Hello and welcome to
module two, global goals, co-authored with John McDonough. Module two, global
goals, is designed to be presented in
approximately one hour and builds from module
one, though it can also be taught as a standalone module. The Module supplement form includes
four recommended pre-readings for students to complete
prior to the module session. The supplement also
includes recommended metrics for evaluating whether students
demonstrate the learning objectives or not
after your delivery of the module and three multiple
choice example assessment questions that correspond
to this module.

These assessment questions
can be administered at the end of the
module or, if you're teaching the entire series,
the assessment questions from each individual module can
be combined and administered as a single
assessment at the end. And you may, of course,
use the evaluation metrics as a guide to develop
your own assessment. To keep the session
engaging, this module contains thought
questions in the teaching notes to pose to your
students along the way as well as a warm up
activity and wrap up video. This learning
experience is meant to be an introduction only,
hence the name starter kit. And while there are numerous
resources and references available about
the topics covered, for the purpose
of this module, we have curated a small sample
of high quality resources to support the learning outcomes
with dental students in mind.

We encourage learners,
and you as educators, to explore the literature
further beyond what is contained in this module. To extend the
learning experience, optional in class
activities have been inserted along the way. These learning activities
allow for approximately one additional hour
of active learning during the module session. This module is related
to six competencies from the global oral
health competency matrix. While these competencies
cannot be met through a single teaching module, this module is
working toward competency based best practices in global
health for dental education. Topics covered in this module
include some selected events, highlights, and their outcomes
from the world development timeline, including how
these relate to oral health. We've also included four
measurable learning objectives written specifically
for this module. We've designed a
unique warm up activity to get your students'
thinking about their role within the health care system
in today's globalizing world. Here we introduce students
to a hypothetical dentist, Dr. Tooth. Dr. Tooth could be any one
of the students and anyone in the world, any gender, any
age, practicing in any country. To start, we suggest
asking the students a broad, open ended question
such as Dr.

Tooth is a dentist, what now? The students will begin to
give you a variety of answers and likely some will say that
Dr. Tooth should practice dentistry or treat patients. Use guiding questions
to eventually arrive with the students at the idea
that doctor tooth is a dentist within a health system. So I recommend for
this activity that you draw Dr. Tooth on the board
and have the students begin naming things that are
necessary for Dr.

Tooth to practice dentistry. These can happen in any order,
but create designated spaces on the board that
will be dedicated to each of the categories
within a health system, as I'm doing here in this photo
of my own in class warm up. Guide the students toward
filling in the board for each of the components. And this activity is not
meant to be exhaustive, but instead is meant only
as a warm up to get students thinking about the
complexities and multifaceted structure of the system within
which dentists deliver care.

For this module, we are
following the World Health Organization framework for a
well functioning health system and focusing on the six
major components, leadership and governance, health
information, health financing and payment, health care
workforce, supplies, equipment, and technology, and
service delivery. You can also have students
create their own health system maps in small groups as
we did in this example. Here is a close
up of the category leadership and governance,
which the students labeled as regulation. Additional photos from an in
class example of this approach are included with this module
under the Meet Dr. Tooth example. Overall, the details are not
the focus of this exercise. The point is to get the students
thinking about health systems and how the various components
impact their ability to provide care
to their patients. Following the warm
up, module 2 will review some major milestones in
global health and development and explore what they mean for
oral health and oral health care.

This will help us to
begin to understand what's in motion to assist
Dr. Tooth in providing affordable high quality care
to all patients who need it, particularly those who
can least afford it. These milestones include
the first global burden of disease study in 1990, the
1993 World Development Report, the United Nations
Millennium Summit and the resulting Millennium
Development Goals, the 2010 Global Disease Burden
Study, including the fact that dental
caries were found to be the most prevalent
disease in the world, the UN High Level Summit for
Non-communicable Diseases, and the UN Sustainable
Development Summit, including the 2030 Agenda for
Sustainable Development, and the Sustainable
Development Goals. This module then defines
universal health coverage and discusses why the progress
along the world development timeline has led us
to the recommendation for universal health
coverage worldwide. We also discuss what this means
for oral health specifically. We then introduce a
number of organizations and suborganizations
collaborating to ensure that oral
health is integrated into the global health
and development agenda. Collectively, these
and many other groups are focusing on access to
care, quality improvement, and controlling risk
factors for oral diseases through prevention
and health promotion.

I encourage your students to
further familiarize themselves with these entities
and explore how to get involved as both
students now and professionals in the future. I hope you enjoy
teaching module 2. And to continue your
teaching experience, please consider
our other modules. Thank you and happy teaching.

As found on YouTube

ALMONDS OATS SMOOTHIE/ Its Health Benefits/ @Apoorva Dietician

Hey people welcome back to my channel this is 
Apoorva i'm your dietician today you know what   i've come up with an interesting recipe that's 
almonds oat smoothie so why late let's get in   For this we require 1/4 cup of rolled oats soak it 
for at least 15 to 20 minutes take handful almonds   and soak it overnight and peel it. add the peeled 
almonds to the jar and grind it to a smooth paste   now strain the soaked oats and add it to the jar 
take ripe banana cut it and add it to the jar   and also along with it add some honey and cinnamon 
powder now grind it into a smooth paste again   pour it into a glass and garnish it with chopped 
almonds here's yummy almond oats smoothie ready   now shall we look into the benefits of 
this recipe Why Late let's get in.

Firstly   let's discuss about almonds almonds are high 
in proteins fiber and healthy fat which aids   the weight loss antioxidants in almonds protects 
the in against infection. It controls blood sugar   blood pressure lowers cholesterol it reduces 
hunger all things considered almonds are as   close to perfect whereas oats they are gluten free 
lowers cholesterol promotes weight loss as it's   high in fiber promotes healthy bacteria for your 
gut eases constipation whereas banana it supports   digestive health good for heart health and full 
of antioxidants which is good for immunity on   the whole this recipe is rich in protein fiber 
vitamins and minerals this boosts the immunity   aids weight loss good for people with diabetes 
and hypertension promotes better gut health and   is good for heart too isn't it interesting so 
many benefits in one single glass of smoothie   have it for your breakfast drink it and enjoy it 
leave your experience in the comment section below   do like share and subscribe Apoorva Dietician 
channel in YouTube bye bye stay healthy stay fit.

As found on YouTube

Dr. LaWanda Jim’s Indian Health Service Story | I Am IHS , Ep. 2

I found my vocation in one of the most amazing
places in the world. But it almost didn't happen that way. I'm LaWanda Jim, an Internal
Medicine physician and Chair of the Internal Medicine Department at Northern Navajo Medical
Center in Shiprock, New Mexico. I am originally from Blackrock-Bear Springs, Arizona, and
grew up in Shiprock. Dreaming of becoming a lawyer, I left the reservation behind I
thought for good. I went all the way to Dartmouth College, and after graduation I worked for
a while in Washington DC. When my mom got sick in the year 2000, I came back to Shiprock
to help her recover. I learned more about my rich heritage, met the Navajo man I would
marry, and decided to stay.

With the help of the Indian Health Service, I went to medical
school in New Mexico, and after finishing in 2012, came to practice at Shiprock. I love
working here. I enjoy using all of my medical skills, and getting to know our patients and
their families. I'm in a unique position, practicing Western medicine and revering the
old ways. There's so much to know and I am always learning. I live with my extended family
on a beautiful cattle farm that has been in my husband's family for generations. We all
love this land. My Dad used to say, "You need to know who you are and where you come from,
so you know where you are going." This is a fulfilling life, a life with meaning. I'm
LaWanda Jim, and I'm proud to be Navajo.

Naashgal dine' nishli, Bit'ahnii bashishchiin, T'aheedl
inii da shi chei, 'shiihi dashinal. I belong to the Mescalero Apache clan, am born for
the Leaf clan. My maternal grandfathers are Water Flows Together Clan and my paternal
grandfathers are Salt clan. I'm a doctor, and a healer, and I am I H S..

As found on YouTube

Public Health Ethics Forum 2020 Part 1

Craig Wilkins: Good afternoon, everyone. Craig Wilkins: And greetings from Atlanta, Georgia. Craig Wilkins: We want to welcome you to our 2020 public health ethics form ethical dilemmas and rural health Craig Wilkins: Co sponsored by the Office of Minority Health and Health Equity and the National Center for bio ethics and research and healthcare at Tuskegee University in Alabama. I'm Craig welcome senior advisor within the office and I'll be serving as your master ceremonies. Craig Wilkins: As distinct honor to welcome each of our special guests. Our speakers and each of you for joining us today via zoom Craig Wilkins: I had the pleasure of being part of a small Craig Wilkins: I had the pleasure of being part of a small planning committee that put this form together. My sincere appreciation and gratitude is extended Craig Wilkins: To them for all their heart efforts into planning of this year's event.

Craig Wilkins: Their names are noted here. As you see, I don't have time to mention everyone's name. But again, we wouldn't be here today without all of their planning for this year's form. So, again, on behalf of this committee and our office at Tuskegee University. We appreciate your attendance and participation. Craig Wilkins: Today form before today's forum and with a couple of housekeeping updates on we know today is a very special day. And we want to pay homage on this special day of 911 and we'd like to have a few seconds of silence.
11
00:02:03,560 –> 00:02:03,160
Craig Wilkins: Thank you.

Craig Wilkins: For those of you who want to send in questions for today's forum during the question and answer portions, please send those questions for our speakers via the zoom to amp a box. Craig Wilkins: If you're having any technical support related questions via the zoom via the zoom placing those also to the Q AMP a box or you can also email Kevin Owens, as noted at in 06 at cdc.gov Craig Wilkins: We also will have a form evaluation. Craig Wilkins: After the form the evaluation will be displayed when you exit the zoom webinar and I'll be half the planet committed. We really value your feedback. Craig Wilkins: To help us plan for future forums and your responses will be completely anonymous Craig Wilkins: We have a continuing education disclosure statement that I will not read, but we are asked Craig Wilkins: To share with you as part of architecture and education, our requirements. Craig Wilkins: You a note to receive continuing education. The instructions are will be available at this link.

As noted the activity code for those who wants this event live stream you a note also the access code. Craig Wilkins: Also the activity code for those who watch the archive event recording on no ethics code will be needed. Craig Wilkins: And there will be no fees for CDC continuing education activities. Craig Wilkins: Now, it gives me a great honor and privilege to introduce our opening for opening welcome and opening remarks.

Craig Wilkins: We first we have Dr. The antivirus live bird. Craig Wilkins: Talk a little bird currently serves as the associate director for minority health and health equity for CDC at SDR Craig Wilkins: In this capacity. She leaves and supports a wide range of critical function in the agencies work in minority health and health equity. Craig Wilkins: Women's Health and diversity and inclusion management. She also plays a critical leadership role in determining the agency's vision for health equity. Craig Wilkins: Ensuring a rigorous and evidence based approach to the practice of health equity and promoting it ethical practice of public health and vulnerable population. Craig Wilkins: Doing the Craig Wilkins: Pandemic and Casey's response. Dr. Live bird has been part of that response and serving as chief health equity officer. Craig Wilkins: Were in this role she has been working to advance health equity as a priority across the entire covert 19 response and lead a team responsible for developing a data driven strategy that will address all to persistence health disparities.

Craig Wilkins: Our second presenter for opening remarks will be Dr. And circuit Dr circuit currently serves as the principal deputy director of CDC. She has been citizens Principal Deputy Director since September 2015 Craig Wilkins: She served as acting CDC director from January through July 2017 in February, March 2018 Craig Wilkins: She also served as director of CDC National Center for immigration and respiratory diseases from 2006 and 2015 and chief of the respiratory disease branch from 1998 to 2005 she first came on board and CDC as a he is officer. Craig Wilkins: After completing 30 years of service at Craig Wilkins: Dr circuit retired from the Commission core of the United States Postal Service with the rank of her Admiral Craig Wilkins: And our third speaker this morning. I'm sorry, this afternoon to provide welcome and opening remarks is Dr.

Reuben morn Craig Wilkins: Dr. Reuben morn has a faculty appointment as a professor of by bioethics with joint appointments in The Graduate, public health program College of Veterinary Medicine. Craig Wilkins: And the vision of philosophic the College of Arts and Sciences at Tuskegee University. Craig Wilkins: He also currently serves as director of the NASA was center for our ethics and research and healthcare at the ski University. He also post adjunct Craig Wilkins: Academic appointments, including the following as a clinical professor within the Department of Community Health preventive medicine Morehouse School of Medicine. Craig Wilkins: And adjunct professor at the Department of dental public health School of Dentistry adjunct professor School graduate studies and research.

The Military Medical College in Nashville, Tennessee. Craig Wilkins: And Dr. Warren also served as our first Associate Director for minority health here at CDC so can be a great person to introduce Dr. Lambert Leandris Liburd: Thank you, Craig and good afternoon everyone. And I bring you greetings today from the emergency operation center. Leandris Liburd: Here at the Centers for Disease Control and Prevention in Atlanta, and I want to welcome you to our sixth annual public health ethics forum that we are pleased and honored to co host with Tuskegee University. Leandris Liburd: We are so excited about today's forum about our speakers and the participation of so many people from all across the country. Leandris Liburd: This year's forum would not be possible, as you've already heard without the leadership of our planning committee and if we weren't together in person.

Leandris Liburd: I would have every member of the planning committee stand and receive a big round of applause. You saw the names of the planning committee members but Leandris Liburd: I do want to acknowledge the dedication and the leadership of Craig Wilkens who I call Captain Wilkens Dr. David Hodge, and Dr. Reuben, Warren. Leandris Liburd: This year we turn our attention to rural health and how we can achieve an ethical practice of public health in rural communities across the country. Leandris Liburd: Rural communities can represent the best of our nation in the beauty of the landscape, the social connectedness that characterizes many of these communities.

Leandris Liburd: And the diversity of the people who live in rural and frontier areas from the standpoint of Health and Health Disparities in rural areas. Leandris Liburd: We are concerned about higher rates of mortality due to the leading causes of death lower insurance coverage rates higher poverty and increased age. Leandris Liburd: The worsening health providers shortages and the increased number of hospital closures in the era of covert 19 there is a dual disparity for people of color, living in rural and frontier areas. Leandris Liburd: As this audience as well knows, the population health impact of covert 19 has exposed in plain sight decades if not centuries of inequities.

Leandris Liburd: That have systematically undermined the physical, social material and emotional health of communities, particularly some racial and ethnic minority populations and other groups. Leandris Liburd: Persistent health disparities, combined with historic housing patterns work circumstances and other factors have put members of some racial and ethnic minority populations at higher risk for covert 19 infection for severe illness and even death. Leandris Liburd: The covert 19 pandemic has caused a national awakening to both the root causes of health disparities and the fundamental changes that are necessary to achieve health equity.

Leandris Liburd: While CDC and its sister federal agencies have long champion to efforts to advance health equity. There is a new focus on developing equitable recovery and resilience in communities across America. Leandris Liburd: Today I hope to gain new knowledge that we can use to inform the CDC covert 19 response and also specific strategies that can be deployed to improve health outcomes in rural in frontier areas. Leandris Liburd: So thank you again to our speakers to the planning committee and to all of our participants for your presence today and let's move forward with today's agenda. Leandris Liburd: Thank you. Anne Schuchat: Well, thank you, Leandra Thank you Dr. Liberty. This is Dr.

And shook it with us welcome from the CDC leadership team. I am so grateful to be part of today's Anne Schuchat: Session and I just want to emphasize how important a public health ethics forum is to our public health community and to us at CDC and how grateful we are for the partnership with Tuskegee University in hosting this annual Oram Anne Schuchat: public health ethics is always timely and perhaps never so much as today, while the entire world is facing the coven pandemic.

Anne Schuchat: And the western coast of the United States is facing unprecedented fire forest fires, leaving many rural populations. Anne Schuchat: You know, requiring evacuation in the middle of the night. I think we've never perhaps been in is fragile state as we are. And as Dr. Liberty just reviewed the stakes are so high right now in rural communities around the country. Anne Schuchat: Scarcity or disproportionate resources as a theme throughout ethics and the pandemic highlights Anne Schuchat: Whether it's the testing capacity, the contact tracing capacity, the healthcare resources needed for treating urgent and severe illnesses or the future vaccines that we hope will become available. Anne Schuchat: We know that they're vulnerable communities around the country and that was living in rural areas have particular challenges. Anne Schuchat: The Anne Schuchat: ability for us to be connecting today through this zoom platform is Anne Schuchat: Precious something we wouldn't have been able to do 10 or 20 years ago and something that we hope.

Anne Schuchat: Will be available to rural populations and caregivers throughout the nation, but it's not year, yet there. And I know that many of our speakers today. Anne Schuchat: Are working in communities that don't have the same kind of communication or technology access that people have in or urban or suburban Peri urban settings so I'm looking forward to today's Anne Schuchat: Discussions to learning and to being able to apply at the National, state, local, and community level the the way forward for these public health ethical dilemmas that are never really as real as they are today. Thank you. Rueben Warren: Good morning. Rueben Warren: I'm ruling one and I to want to do a couple of things. First, to pause about 911 Rueben Warren: And there's not remember but reflect and Rueben Warren: How to move forward collectively Rueben Warren: Secondly, I want to highlight these what they're calling unprecedented times I would suggest their unusual times, which is a more normal ethical frame on which to you where we are, where we've been and where we're going.

Rueben Warren: And Rueben Warren: The National Center for about ethics and research and health care at Tuskegee University joined in partnership Rueben Warren: With the Office of Minority Health and Health Disparities at CDC to really honor and recognize 100 year of the death of Rueben Warren: President Booker T. Washington, the first president of Tuskegee University. We did that to help the nation, understand that the whole issues around Minority Health install it in Rueben Warren: It started in Rueben Warren: 2020 note is started in 1915 with Booker T.

Washington founded Negro Health Week. He recognized disproportionate burden of health disparities with now impacting on African Americans in particular. Craig Wilkins: Oh, Craig Wilkins: Reuben one. Are you still there, sir. Okay. Craig Wilkins: I think we lost Craig Wilkins: I think we lost. Dr. Warren and we apologize about that and hopefully he he can get back on. Um, I will give it a just a second. And if he's not able to then we will continue on with the form Craig Wilkins: Okay, hopefully he'll be able to join us here in a few minutes. So I want to thank Dr. Byrd again and and Dr. Craig Wilkins: Dr circuit for their opening remarks, so like to introduce our first presenter for this year the form Craig Wilkins: Is Dr.

Alona condition daughter canoes and currently serves as a program area director and as the director of the walls Center for Rural Health analysis at North Craig Wilkins: Dakota condition has 20 years of experience leading health services and health policy research projects and implementing and evaluating the impact of public health programs. Craig Wilkins: She has conducted numerous health services and health policy studies and public health projects funded by the Agency for Healthcare Research and Quality, the CDC and the CDC and as soon as for Medicare and Medicaid Services. Craig Wilkins: Also includes the US A the US Agency for International Development and the Robert Wood Johnson Foundation her project findings have informed, state, tribal, and federal health policy.

Please join me in welcoming Dr Knutson Alana Knudson: Thank you so much. Alana Knudson: Thank you. I'm absolutely delighted to be with you today as a person who grew up in a frontier County. I grew up in a county that had three people per square mile Alana Knudson: So rural public health has been my passion from day one and I'm delighted to have this opportunity to share some insights with you and hopefully get some questions that can Alana Knudson: Be answered throughout my presentation at the end as well as later in the day to help advance your work in addressing rural health equity. Alana Knudson: I am the director of the wall Center for Rural Health analysis and we are soon to be celebrating our 25th anniversary Alana Knudson: On the wall center was brought to north in 2003 and by the way north is also a long history of Rural Health Research. Our first study was conducted 68 years ago so Rural Health has also been an important component of the work that we do.

Alana Knudson: In looking at how to advance health and wellbeing in rural America as mentioned, we do a number of projects for federal agencies and foundations, as well as serving as one of the seven Rural Health Research Centers. Alana Knudson: Funded by the Federal Office of real health policy our center is housed at Northwestern University of Chicago. And we're a nonprofit research organization and we conduct research and evaluation that serves the public interest and improves the opportunities to make informed decisions.

Alana Knudson: So with that, I just wanted to start with an overall discussion about what is we're all Alana Knudson: We're all means different things to different people. And I just want to remind you that every single day. You are touched by room America you eat food. Alana Knudson: You use energy you are in a building that often has some kind of materials that are Alana Knudson: Manufactured or produced in rural communities. And I think it's really important to think about rural as part of that interdependence that we have between rural and urban we have Alana Knudson: More success in our overall country when we have success in our rural communities.

And when we have success in our urban communities and that success starts with helping populations. Alana Knudson: To provide a little bit of background on rural. There are many definitions of rural. In fact, it's a federal government has over 70 definitions and the four definitions that I have included on this slide are the most common definitions that you see. Alana Knudson: That are provided by the US Census Bureau by the Office of Management Budget by CDC National Center for Health Statistics and by the United States Department of Agriculture's Economic Research Service. Alana Knudson: These definitions are built on different types of geographic units, which then comprise a different percentage of the population or categorize a different percent of the population as being world and the most comprehensive Alana Knudson: World Population is the definition that is used by the US Census Bureau and that captures almost one out of every five Americans almost 20% are categorized and rural living in rural communities.

Alana Knudson: The other populations that are included in world under OMB NCAA chess and USDA capture somewhere between 15 and 16% of the population. Alana Knudson: And these definitions are built on different types of geographic units. They can be zip codes. They can be counties and they can be census tracts. So when you're looking at one definition, you really need to know what underlies that Alana Knudson: Geographic unit to be able to make comparisons across time and across different populations. Alana Knudson: This particular slide shows OMB. And again, that is the definition that's most comprehensive and as you can see the orange. The orange darkens Alana Knudson: Counties represent natural and the gray represent non metro and for those of us that has spent our careers working in world.

Alana Knudson: We would much rather see natural versus rural then metro versus non natural Alana Knudson: But what this does depict is where we have concentrations of urban areas and as you can see the gray is most prominent in the Great Plains and in the West. However, there are still a number of rural areas that are interspersed in some of our most densely populated areas in the country. Alana Knudson: We also have differences with regard to the distribution of race and ethnicity in rural America. Alana Knudson: Race racial and ethnic minorities comprise about 22% of the rural population as compared to about 42% of the metro areas and the largest represented populations are lack in Hispanic Alana Knudson: There are also American Indian populations and Alaska Native as well as other population groups that represent a somewhat smaller demographic Alana Knudson: As was mentioned in the introduction to this forum.

Alana Knudson: World, America has some health disparities and we have been working on these however Alana Knudson: Rural Americans continue to be at greater risk of death for the five leading causes of death. Alana Knudson: So no matter what you look out with regard to rural health outcomes, particularly in mortality, you will see higher mortality rates for rural residents than you see for urban and there are a number of contributing factors. Alana Knudson: CDC produced this information to share that only one in four adults practice at least four of the five health related behaviors that we know Alana Knudson: Will improve health outcomes and smoking and tobacco use has been a long standing challenge in many of our rural communities.

Alana Knudson: Likewise, we have much higher BM eyes in our rural communities. And there are also some areas in rural America that have very high rates of binge drinking. In addition to not getting enough sleep. Alana Knudson: For a lot of rural communities. There's a lot of anxiety and a lot of challenge with regard to the economics that people are experiencing, particularly during these unusual times Alana Knudson: If we look at some of the underlying issues that contribute to those health disparities. Alana Knudson: On we always rely on our social determinants of health and this is particularly important when we look at our rural communities. Alana Knudson: By far economic stability is part and parcel to some of the health disparities that we see. And that also create barriers for us to be able to achieve health equity in rural communities. Alana Knudson: I'll share some additional information with regard to poverty, employment and unemployment in some subsequent slides. Alana Knudson: Row residence also do not achieve as high of educational attainment as their urban counterparts. And then this also contributes to long term earning capacity. Alana Knudson: Likewise, there is a difference in social and community contacts in terms of cohesion perceptions and discrimination and f we are Alana Knudson: Very important to consider when you're looking at working in rural communities.

Likewise, as was mentioned, there are some real challenges with regards to access to health and healthcare. Alana Knudson: Public health is not as prevalent in many of our rural communities and there is also less access to health care primary care and specialty care. Alana Knudson: There's also a number of areas that have no access to behavioral health and very limited access that best to oral health. So there are a number of challenges in accessing Alana Knudson: The health supports that also contribute to the overall health and well being. Lastly, there are some interesting challenges with regard to neighborhood and built environments. Alana Knudson: In including access to healthy foods. And in fact, as a person who grew up in a rural community. I had never been to a farmers market until I moved to a metropolitan area.

Alana Knudson: And so even the concept of farmers markets has not been as prevalent in rural communities as it has been in urban likewise, there's also a challenge in many rural communities of quality of housing and affordable housing, even including in some of our research affordable. Alana Knudson: Utilities that can also be cost prohibitive. There's also a number of environmental concerns and I have been to world communities. Alana Knudson: In particular, a tribal community in my past or there have been some challenges, even in getting drinking water. When you turn on the faucet.

The water is brown so we still have some way to go in even improving some of the drinking water that is available in our rural communities. Alana Knudson: But by far one of the most challenging issues that we've had in rural communities is access to employment and livable wages and as you can see from this particular slide. Alana Knudson: When we had that great recession from 2007 to 2009. This slide shows that we rural and urban we're pretty much on par with regard to where we were at the beginning of that time. Alana Knudson: If you look at where employment was on. As you can see over time. The Metropolitan or the urban areas have recovered from that time of the Great Recession but employment in our rural areas has never recovered. And in fact, Alana Knudson: We have continued to see that our rural areas have experienced higher unemployment rates than our urban areas consistently since 2007. The only difference was with Alana Knudson: This last coven 19 experience where we see our urban areas, having higher percentage of unemployment than our rural, but this is definitely an anomaly in the unemployment among rural and urban Alana Knudson: This also contributes to poverty and as you can see the blue represents rural and the yellow orange represents metropolitan or urban Alana Knudson: And there was a great disparity obviously in the late 50s between rural and urban but the challenges, even though we have seen improvements in decreases in the percent of people living in poverty.

Alana Knudson: Rural has never been able to achieve the lower rates of poverty that we see in urban areas. So again, we continue to see that there is long standing differences in poverty between rural and urban Alana Knudson: This issue of poverty is further exacerbated when we look at areas that have had persistent poverty and these are areas that have had poverty for over 40 years. And if you look at the darkest red Alana Knudson: Counties. Those represent rural and you can see across the country. We also have dual disparities, although we have Alana Knudson: Poverty in Appalachia. As you can see in central Appalachia. You can see that the poverty in our southern states. Alana Knudson: remains high and those are the counties that have the highest proportion of black residents living in rural in the rural South Alana Knudson: Likewise, if you look along the border in Texas and Arizona those counties also have the highest proportion of Hispanic residents living there.

Alana Knudson: Likewise, when you move to the West and the northern plains those areas that are dark is our where American Indian Reservations are located. Alana Knudson: Likewise in Alaska, where Alaskan Native slip. So there is a great dual disparity. When you look at to where people of color with and when you overlay it with those rural communities where they reside. Alana Knudson: So that brings us then to health equity. Why, what are we talking about when we're talking about health equity. Alana Knudson: And I draw from our colleagues at the Robert Wood Johnson Foundation in sharing this definition. Everyone has a fair and just opportunity to be as healthy as possible. Alana Knudson: And in order to do so, we need to remove economic and social obstacles to health, particularly poverty and discrimination. Alana Knudson: And when we talk about health equity. What we also talk about is reducing and eliminating health disparities and sometimes the to get intermix but really health disparities serve as the metric Alana Knudson: for assessing our progress toward health equity and as I shared in my previous slides.

You can see that we still have a long way to go to achieve health equity in our rural communities. Alana Knudson: I wanted to share with you some ethical considerations to achieving rural health equity that may be new to you and it may resonate with some of you who already practice in our rural communities. Alana Knudson: First of all, it's the value of place place is very important place to provide context of where you live, it is an issue of great pride for many Alana Knudson: Rural areas there are some very rich history and in some places.

There's some very painful history. In some areas, we have Alana Knudson: families that have lived there for generations, and in other places. We have people who are just now moving there because Kobe has opened up the opportunity to work remotely. Alana Knudson: And we are hearing more about rural communities welcoming people from urban areas who are looking for a different way of life during this coven and post hopefully post Kobe time Alana Knudson: We also have a value of community and community can mean so many different things on, you know, often we say you've been to one rural community. You have seen one rural community. Alana Knudson: And I think what's also important to understand is that there are networks within all communities. We have networks of churches. We have networks of senior citizens centers, for example. Alana Knudson: We have sport boosters in rural communities.

We have civic organizations. We have other community organizations that are connecting. So you have all of these different networks. Alana Knudson: That contribute to the vibrancy of our rural communities, but that also contributes to many dual relationships and Alana Knudson: In doing so, that means that for those of us who work in public health. There's often a lot of overlap between our personal and our professional connections and that can create some challenges. Alana Knudson: There, there can be some ethical issues arising because a relationship with a stranger is very different than a relationship with somebody that you see in your workplace as in public health. Alana Knudson: Versus that person that you may see in the grocery store that you may see at your children's sporting events and then you may go to church with on Sunday.

Alana Knudson: So there's a different sense of connectedness and sometimes it can be ethically challenging when you have information, particularly recognizing that stigma. Alana Knudson: Can still be a barrier to people getting the support that they need, in particular for substance use disorders as well as domestic violence. Alana Knudson: Those types of issues are sometimes very difficult to navigate in rural communities because there is the sense that people know your business. Alana Knudson: And when I used to work at the North Dakota, Department of Health. The number one question that was never answered in our Behavioral Risk Factor Surveillance System. Alana Knudson: Survey was a question on finances. So even that issue about finances can be seen as something very personal and it contributes to some of that. Alana Knudson: Autonomy that a lot of rural community members feel they feel very independent and they are very concerned about other people having more information about their family or perhaps having a different view of them because the community is small. Alana Knudson: It also affects organizational level decision making as well as state and national level decision making.

Alana Knudson: And one of the areas that I think that has been most challenging looking at rural public health. Alana Knudson: Is the allocation of resources. And this is something that we are always challenged with because oftentimes if we have a public health intervention, we want to reach as many people as possible. Alana Knudson: However, if we are really going to advance health equity we may need to reach to a smaller sub population that may have fewer people but have greater needs and sometimes it is difficult. Alana Knudson: To advocate for using those resources to reach smaller populations with policymakers or other decision makers, when the, the pressure or the accountability for that funding is to reach as many people as possible. So there's sometimes challenges in that arena as well. Alana Knudson: Um, and so when you're thinking about the ethics that really underlie what you're doing. I would really encourage you to think of a values approach because values are really central to what is framed as ethics. Alana Knudson: And really coming together and identifying what is the value of the community can also help provide some really important guiding principles.

Alana Knudson: And frankly, there aren't that many rural emphasis out there, particularly rural public health emphasis Alana Knudson: And so I think this is also an opportunity through this forum to bring together people who are interested in this area and perhaps create a network of public health colleagues who can come together and talk about these very unique and very important issues that really have Alana Knudson: Consequences for the health and well being of rural communities and ultimately the opportunity for us to achieve real rural health equity. Alana Knudson: And in doing so, it is also very important to think about that real context, because again, Alana Knudson: Plugging in playing rural and urban does not work. We have seen that in many, many examples in the past, trying to transplant, a program that will work well in a resource rich urban environment does not necessarily work well in in Alana Knudson: In a rural environment. So I'm going to share a visual that we developed as part of a Robert Wood Johnson Foundation project. Alana Knudson: In which we look at the strengths and assets of rural communities. And I think, again, that is another really important Alana Knudson: Perspective, when you're thinking about achieving health equity, look at the different types of strengths and assets that come together.

Alana Knudson: That create our world communities and our networks within rural communities because they're very important to the Alana Knudson: vitality of that community. And it also helps to bring people around a table to look at what is working well for any of you who have ever sat on the other side of the table and I have done that. Alana Knudson: It's really a challenge to have someone come and tell you all the things that are bad in your community.

Alana Knudson: But when you can come around the table and say, look at all the positive things that we have going for us. Alana Knudson: And look at where we want to get to, to be able to achieve even more for our community members, having a context and having a way to talk about strengths and assets is a value add that Alana Knudson: Not only can improve health, but it can improve the entire community in terms of looking at economic development in improving education, improving health and safety, all these different areas can greatly benefit from looking at strengths and assets.

Alana Knudson: One of the things that I think public health has a very unique and important role in doing and contributing to their real community is serving as a convener Alana Knudson: I cannot tell you how many times I have interviewed different types of successful networks Coalition's organizations that have said public health was really the catalyst that brought us all together. Alana Knudson: And if we are really going to be ethical in our work and advancing real health equity, we need to bring all stakeholders to the table. Alana Knudson: And that also include some of our communities that are marginalized and some residents that don't always have a voice and sometimes that means that we're going to have to nurture and grow and Alana Knudson: build trust relationships so that those community members can feel that they have a voice and that they are part of the decision making that goes into identifying Alana Knudson: How to address health disparities and how to look at improving on social determinants of health and ultimately how to achieve health access
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Alana Knudson: Health Equity Alana Knudson: And so whenever we talk in rural communities and I know the Surgeon General has had a Alana Knudson: Real focus on looking at how that link between health and wealth can improve health outcomes, not only at the individual and family level but at the community and at the state and national level.

Alana Knudson: It's in it's important and foundational to improve the economic well being of people to be able to improve their overall health and to achieve health equity. Alana Knudson: And so I want to make sure that you have some tools that you can draw upon, especially if you are new to working in rural communities or if you have some interest in starting to address some social determinants to address health disparities to further your achievement of health equity. Alana Knudson: In partnership with the Rural Health Information home which is funded by the Federal Office of Mental Health Policy. Alana Knudson: Our north wall center in partnership, also with the University of Minnesota is real Health Research Center have developed over two dozen toolkits Alana Knudson: That address different issues that affect the health and well being a rural communities and all of these toolkits are developed in a modular format so that no matter where you are.

Alana Knudson: Either at the very beginning and identifying an issue that you want to further pursue for addressing health and well being. Alana Knudson: Or if you are already in play and you want information on how you can evaluate a program that is part of your community. At this time there are different ways that you can just plug right into these toolkits to be able to get additional information. Alana Knudson: One of the things that we include in each of these toolkits our program models and these are models that have been tried, tested and successful Alana Knudson: In rural communities. And again, this is not about plugging in playing a role model. Alana Knudson: And trying to retrofit it into an urban area. It is really about looking at what is successful given rural contacts given girl resources.

Alana Knudson: And also given real values. And we also have a program clearing house that has specific programs. Alana Knudson: That are successful with not only the overview of those programs, but also a contact, because we know world. People like to talk to other real people. Alana Knudson: So provides an opportunity to talk directly to that program implemented as well as finding out information, information pertaining to implementation. Alana Knudson: Evaluation evaluations sustainability and how to share the great good work that you're doing. There are also some really important considerations. Alana Knudson: For example, on how to create networks and Coalition's and you know how to engage your rural community in the particular issue that you are trying to address. Alana Knudson: In addition to the social determinants of health toolkit. We have a number of other toolkits that may be particularly helpful in addressing social determinants of health. Alana Knudson: I have never been to a meeting in a rural community where transportation was an identified as either the first or second challenge.

Alana Knudson: That a real community has in being able to access health and other services and support health in wealthy, and again, all of these toolkits Alana Knudson: Are available on the Rural Health Information hub. The website is rural health info.org and this particular Hub has also access to information specialist Alana Knudson: Which you can contact by phone or by email, and usually within 24 hours, you will receive a response. So if you are interested in a specific topic. Alana Knudson: Or if you are interested in finding information about how to fund something or where there might be a program that you are interested in implementing and you can contact the Resource and Referral Center, and they will make that Alana Knudson: Provide that connection for you and please know all the services are free.

Again, it is sponsored by the federal office of rural health policy, which is located in the health services and resources administration and Alana Knudson: They also work very closely with Alana Knudson: All of your colleagues at CDC and if you have information that you would like to share. There's also a section to share successes. Alana Knudson: So we are always looking for ways to help disseminate the incredible work and innovation that is occurring in our rural communities. So with that, if you have any questions, I'd be happy to take them. Now, or if you think of them at a later time, please contact me. Craig Wilkins: Okay, thank you so much darker conditions for that very informative presentation.

We do have a time for just a few questions. Alana Knudson: One of the questions is what to COVID rates look like in rural communities and is the coded mortality rate higher in rural communities. Well unfortunately my home state of North Dakota has the highest Alana Knudson: Rate at this point. Alana Knudson: Some of our rural communities have had Alana Knudson: A coded Alana Knudson: rates that are high mortality is Alana Knudson: No, similar to across the country. It is Alana Knudson: It is some way Alana Knudson: Higher for those with multiple chronic conditions or in nursing homes. Alana Knudson: That are challenged with health issues, but we're always not immune to cold it and we have seen some Alana Knudson: Some high rates of Kobe in areas where there have been large like manufacturing or production plants like important work plants or other types of value add a good culture and so Alana Knudson: Kobe is something to something that needs to be continually monitored in rural.

I will say there are much fewer epidemiologists that are working in rural and oftentimes rural areas rely also on on the state and Alana Knudson: Having coverage for epidemiologists Alana Knudson: To help with the contact tracing and Alana Knudson: Follow up Alana Knudson: In those countries. Alana Knudson: There are a couple of questions. But are there any programs that are specifically addressing the persistent poverty in certain counties throughout the South Texas in the West. Alana Knudson: And as depicted in red and one of the slides and there are some programs that are targeted and if you recall in Appalachia. Alana Knudson: The Appalachian Regional Commission has had some success in reducing some of the persistent poverty counties, they have had funding to do so. Alana Knudson: The funding for example in the Delta region has not been robust. And so, there hasn't been quite as much investment in those counties. But clearly, there are a number of opportunities to make a difference. Okay. Craig Wilkins: Well, thank you again dr, dr conduction for all Craig Wilkins: Your participation in a form today and for your presentation.

Okay. Right, we're going to turn it out. Now I want to reintroduce. I'm Dr. Warren Craig Wilkins: Warren apologize early I'm having some technical difficulties and so on. If you want, you would like for you to take a few seconds to finish your remarks and then you could go right into our panel discussion for today's Craig Wilkins: Age form. Thank you. RuebenWarren: Thank you again and and that I'm back on and we have to deal with this as we did with other kinds of adjustments. RuebenWarren: I won't take any more of your time in my introductory remarks, except simply to as I reflected on Dr. Newton's comments certain things came to mind. And the most important from my context is the RuebenWarren: rural populations moving to urban areas and that that that adjustment. You mentioned people and places. And what we found is that people bring their culture to the new place.

And so in Chicago. RuebenWarren: In Washington, DC in Los Angeles, California. They are rural populations African Americans in particular that brought that culture right to the city. RuebenWarren: And we have to recognize that that people bring their culture to the new place. RuebenWarren: And I close it out with with my my reflections on the Great Migration 1920 to the 1950s when African Americans moved from the rural south into RuebenWarren: The North looking for new and and different opportunities to really respond to what we now recognize clearly institutional racism.

RuebenWarren: Let me close reminds them move on to what I think is a very exciting panel of speakers that want to talk about RuebenWarren: Rule health and the perspective on public of ethics and what I won't do is the labor, the time by introducing all of them have given you their backgrounds, they, they, you can read them. RuebenWarren: And what I want to do is follow the line as as they're listed and have them answer a couple of questions. RuebenWarren: And we want to at least leave some time for hopefully with some question and answers as we end this panel that we also say this panels over the years have had been exciting.

Our, our first one RuebenWarren: Dealt with a women's health and then we moved on to talk about RuebenWarren: The elderly and I last and most exciting for me was the one dealing with youth and so we're really having some exciting times. Talking about the opportunities from a four pound discussion.
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RuebenWarren: So I'll start with just a calling the names of our panelists and then we'll move on to the questions..

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