Indigenous Health

Hello everybody. Welcome to today's special show on American Indian, indigenous and overall Indian Health. We have two great, wonderful guests with us today. We'll get to them in just a moment. I want to thank our illustrious staff that helps make all these shows successful and interesting for you, the listening audience, Maddie Levine-Wolf, Erin Collins, Deondra Howard, Matthew Campbell, Sheridan Nygard, are second to none. They take care of all of our research, our recording, our production, because Clarence and I don't know how to do that, so it's really, it's really nice to have them. They're really, really great, great colleagues. Thank you to all of you. We also have Dr Barry Baines, who, unfortunately can't be on the show today. He's our medical advisor and sometimes gives us some medical twists on some of the subjects that that we're talking about. So thank you to Barry. We have human partnership is the sponsors for our show. It's a wonderful community health organization that does wonderful things out in the community for everyone, everyone and so thank you to human partnership. You can check them out at human partnership.org, you can check us out Health Chatter podcast at Health Chatter podcast.com, all shows will have our research attached to the shows on our website. And also that's an opportunity for you to provide some insight and even provide us with ideas for shows that you might want to hear in the future. So thanks to everyone. Today, we have two great guests with us, Chris Rhodes and Raven. Raven Gibbs, Chris, which just started recently at the at the Minnesota Department of Health. She's an Anishinabe and Bad River Fond du Lac reservations affiliations. Was hired at the at as a director of the Office of American Indian health in January, just this last January, she comes with much, much background in in this area, she's a trusted leader and partner on indigenous public health issues. She launched the Health Education Department at the Fonda Lake reservation, the American Indian community tobacco projects at the University of Minnesota School of Public Health. And it goes on and on, a great, great addition to our health department. So thank you, Chris for being with us today and give us some perspectives on this. Also, we have Raven Gibbs is an ashinabe as an enrolled member the of the boys 40 Band of Chippewa has family ties with the Red Lake Nation. She focuses a lot on federal policy. She's a public health social worker, and she's focused not only on native and and tribal issues, but also overall in in in public health, holds a Bachelor of Arts degree in criminology at the University of Minnesota School of Public Health. Hang on one second. Here you

you gotta love dogs, right? Everybody, they're they're healthy for all of us. So she got her Bachelor of Arts degree and also masters in social work. Is currently in the doctoral program at Johns Hopkins University, focusing on health policy, again, unique perspective on the subjects that we're going to be talking about today. So both of you. Thank you. Thank you so much for being on Health Chatter. Actually, this show Clarence has been kind of a long time coming and and the reason why is for all the different subjects that we've talked about in the in the health arena, and you can imagine them all, inevitably, we will say that these populations are at higher risk. And it just goes on and on and on. And, you know, in the back of my head, I keep asking the question, you know, what's going on here? To kick us off, and I want to be, I guess, politically correct, or just correct in general, it's like, what? What's the terminology? What's the appropriate terminology? That we should use, everyone, all of us should use and be aware of when we talk about these populations. Should we be talking about Native American Health? Indigenous Health, American Indian Health, American Alaskan, native what? How do we encapsulate the population that we're that we're dealing with here? Or do we have to keep them separate? So who can? Who can start us out here? Maybe Chris, you can start us out

Bucha. I mean, thanks for having us today. I just want to also just give Raven and I have been with MDH now for a little over six months, and we work hand in hand as the Director of the Office of American Indian Health, myself and Raven as MDH as tribal liaison. So good question. This comes up a lot, right? What is the terminology? And it really comes down to asking the person or the population that you're talking to about what they want to be called, right? And so in our introductions, you shared that we are Anishinabe and and then you listed our tribal affiliations. Those are how I how I would want to be referred to as Anishinaabe, as the tribal community where my people come from, Ojibwe, Chippewa, are other terms for that, and then within that, we have a number of different in fact, 574 different tribal groups in the United States, 11 in Minnesota. The term indigenous is definitely on one end of the continuum, and it refers to indigenous people of any land of across the globe, right? There's indigenous people in every country, and so that really is that widest umbrella term, and American Indian has a special meaning because of the policy implications that is that treaty and how the US government identifies us and how we're identified within systems. Therefore, we have the American office of American Indian Health. And then, of course, we have Native American. Some people prefer that term for a variety of reasons. And I think that's in summary, Raven, if you want to add anything more, otherwise, we can move on to the next

Raven. What do you think?

Yeah, absolutely. I think Chris really captured it. It's not an easy answer. It's not so black and white. There's not one term that is going to be the safe bet, right? I really think the safe bet is to ask,

okay, so All right, so then I'll ask if we're, if we were going to label this show, okay, you know, for the for for the public, what do you think would be the best thing that we should label the show? Good guess, Chris, go ahead,

I would say it is on American Indian Health.

Okay, got it all right, so be it. And then one other quick follow up, Clarence, when we, we deal with things epidemiologically, you know, from a data perspective, when we, when we try to get a handle on all the different issues that are affecting this population again, is it kind of all combined, or are there things that are separated out?

Any thoughts on that? Chris, you there?

I'm so sorry. I thought you had to ask Clarence

the question, Chris or Raven, either one, it's like epidemic. When you get data, how is it? How is it presented to you? Is it presented to you as Native American health issues. Yeah, I can what I can say there is a lot of times data is presented as black, white and other, and a lot of times our data isn't even included. And that is and. Issue all together. What it comes down to is how the demographics are asked within the surveys, and there isn't this complication. What you brought up in our very first conversation here is exactly what can be problematic across any survey is how the demographics are asked and how that data is reported. Yeah. Again, yeah.

All right, Clarence. Here we go. Here's Clarence at his best. Now, here we go out of my desk, but here, here, first of all, you know standing now is the fact that we have such different kinds of health disparities among different groups of people. How do you or would you explain to us this complicated history that the Native American community has had with the US government? Because I think that part of you know whether we talked about the data, we talked about the narratives, a lot of this stuff comes back to the relationship between the the groups and the US government. Could you just kind of give us a short history of what you what you would you just share with us this complicated history between your communities and the US government? I'm going to ask Raven to go, yes.

Thank you so much for the for the question, another, a question that is difficult to summarize and such a sharp paragraph, we know that, in essence, American Indian people had ceded territory and land in exchange for certain trust and treaty responsibilities that the federal government is responsible to uphold and maintain, One of those being health care. And when you talk about the very complicated history, it didn't just end and start with those treaty responsibilities. We know that there are certain policies and Supreme Court decisions that have impacted the jurisdiction of sovereign nations and their ability to take care of the health and well being of American Indian people. So what we know of today is that one when it comes to health care, one of the major funding government bodies that is there to promote the health and well being of American Indian people. Is an Indian health service out of the Department of Health and Human Services, and we know many of our colleagues across the nation and Indian country have given testimony on the Hill stating that there is chronic underfunding of the Indian Health Service, and that is truly where a lot of the health disparities that we see stem from. In addition to the complicated history when it comes to the health and well being of American Indian people, it's really important to consider the indigenous social determinants of health, the really unique determinants of health that only American Indians have experienced, and those are related to the institutional racism, related to the traumatic history of of not only tribal nations getting certain rights stripped from them, but in addition to forced removal of children, in addition to policies that removed American Indian people from their tribal lands into urban spaces where they then have a disconnection to culture. There's so many pieces that, in essence, really surround and impact the health and well being of American Indian people.

So how can we enter into this question? Then, I mean, the thing for me, I thank you for that. I think you know you mentioned the term sovereign, sovereign nation, those kinds of things. How do we those of us who care but don't know how to care, how do we enter to this conversation about about this, about this issue of Native American Health? I

I think, from a government perspective, for example, at Minnesota Department of Health, we it is our duty, and my duty as the tribal liaison to help the agency to implement Minnesota statute 1065, Right, and that is a piece of legislation that recognizes that legal relationship between governments and the 11 sovereign nations in Minnesota, and in essence, making sure that frequent and regular consultations happen and connection and collaboration to ensure that tribes have are part of the decision making process when it comes to issues that have tribal impact.

Let me follow up, and I'm a program that will before we start. I'm a prober, okay, you talked about there 11 sovereign nations in Minnesota, but 80 is it? More than 80% of the people Native American community that live outside of the reservation. Is that correct? How then do we address that, along with this whole issue around American Indian health? Because if they're not, they're not in the sovereign nation. They're here in the urban communities. How then can we work together to make to make something happen, to address those issues?

I think first there is an education piece. You're absolutely right. That's a large portion of American Indian people live in urban spaces. And Minneapolis and Saint Paul, the Twin Cities nationally, are part of one of the urban hubs that have a large, large population of urban American Indian people. Minneapolis, as we know, is home to the American Indian movements. And I mentioned earlier, you know, there's a federal body of Indian Health Service, and in the Twin Cities, we have a clinic called Indian Health Board, and that is part of that. It you system that is out of Indian Health Service. There's i for Indian Health Service, there's T for tribal and u for urban, and they're only a handful of urban clinics nationally, and Minneapolis is home to one of them. We also have the Native American community clinic and FQHC in Minneapolis. These two entities target American Indian populations to serve them, and they also have these really unique factors that incorporate cultural, cultural aspects into their services. But again, we know that these two clinics are chronically underfunded. They see a broad spectrum of of clients. So when it comes to the health of urban American Indian people, I think it's multifaceted too. Of some tribal nations have the resources and the ability to extend their services into some urban spaces through their urban offices. And largely, you know, in the Twin Cities we have, I don't, I can't recall the number. I believe it's 30 plus urban American Indian community serving organizations. So they really do work to fill in the gap in need that American Indian people need in the Twin Cities area. So there are these really strong structures, these sometimes viewed as these non traditional systems of power, right? And they just need to be brought into the conversation, into decision making, really considered when it comes to health equity, whether that be in program delivery, in partnership, in funding.

So you know, this is a, is a, a huge ongoing problem, you know, I said, you know, before the show started, when I, when I headed up the cardiovascular unit at the Department of Health, always, and for 18 years, always, it was, it was American Indian and African American who are at high ER or high risk. So what's causing first of all, what's causing it? Besides the fact that, you know, we have, you know, social determinants of health. We have health care discrimination, but this has been going on for a long time already. It's like, what? What is it that we really need to do in order to impact stroke rates to impact, um, heart attack rates to impact, high blood pressure to, you know, all these things that seem to be ongoing, and it's like we're we're almost like tearing out our hair trying to figure out what. Uh, to do. So you know, Chris, you're heading up with this program now and and in many ways, I'm going to say to you, I wish you the best of luck, because I think it's way over, way overdue. But vision wise, going forward, maybe in the short term, and then, and then in the long term, what is it? What is it that is really going to make a difference here? Hopefully, finally,

thank you for that question. And I think just really expounding on the information that Raven just shared, it really comes down to the historic losses experienced by American Indian people that isn't just from one period in history, going back to the Federal policies that have harmed native people that now result in what we see today as land acknowledgements, right, where people are acknowledging the fact that we are often on stolen land. This is an example of historical trauma, and it continues today with the systemic racism that we see in a variety of systems, and that native people experience every day in our daily lives, and that experience of trauma really is resulting in these issues, These health issues that you talked about. You know, studies have shown the anxiety and effective disorders and substance dependence are correlated with these historical losses, and that intergenerational trauma continues and can really just exasperate life events and depression, anxiety, economic inequality, racism, poverty and so many other factors. But I don't want to get lost in that, in that, because what we know is native people were the healthiest people on this planet, and I truly believe that we can be again. And what that's going to take is trusting our communities to know what's best for them. And so that's really the approach I'm taking. As the Director of the Office of American Indian Health at the Minnesota Department of Health is really trusting listening to tribal governments, tribal health leaders about what is needed and what will turn this around. And what we're hearing is really around addressing the indigenous determinants of health, the access to high quality education, economic opportunities, food security and really the reclamation of things like our traditional lands, our tribal languages, our cultural practices for Healing, access to our tribal foods and food systems. These are the this is public health. This is what we're talking about, and these are what our community needs when it comes to turning around these horrific disparities that are present in our state.

You know? Yeah, you know, I know this is a very difficult conversation, you know. And I thank you for both for entering into it. And I am community person, very interested in your community, as well as my community. It's been difficult having conversations and like what we're having right now. You know, people are, are somewhat hesitant about having, I mean, just out, I call it eyeball eyeball conversations, because there are people in our communities that really do care. But the question for us is, what are the low hanging fruits that we can do? I mean, to assist you in this work. I mean, that's really where we're coming from. And so help me to be able to to share with others what we can do, just like short term and the long term. What? What is it truly in the short term that we can do that hopefully will make a difference, and then, and then, some of the seeds for long term.

I think what you're doing by having this show as a topic on your podcast is absolutely important. American Indian people have been erased. From society in many ways, and so a lot of people aren't even aware that we exist. Again, those data reports come in where it's white, black and other so constantly lifting up and asking those questions about where are our American Indian people in these conversations, making sure that American Indian at the table of these difficult conversations, part of what is so exciting about what's happening right now in Minnesota with having an office of American Indian health for the first time, and being one of the leaders across the country for establishing such an office that really engages my charge, even as a state employee, is coming as an American Indian women, woman first, and knowing that connecting with the community is of utmost importance, and A lot of the work Raven and I do within MDH and across our partners, and I consider you all our partners, is really just having the conversations that that make our Community visible and make it real. A lot of times, we are romanticized in these pictures of what Native people should be or were in the movies, or something that isn't real. Or on the other end, we only see the disparities. And in fact, our communities are amazing and vibrant, and our languages, our food, our lands are just there's a lot of pride in our communities, and there's a lot of joy and and we've had to have a lot of resilience to get to that point. And so again, it's about being good partners and not continuing to erase us, to actually lifting it up, lifting our community up and making it visible. That's how we get to solutions. And you know,

I was thinking that it's one thing having conversations, because I said that that people don't even know what to converse about. Besides that we have, you know, some problems here, as opposed to, maybe the first thing is getting some information out about what's going on, then you can, you can circle back and and talk about these things. I want to relate a quick story when, when we were dealing with cardiovascular disease for the indigenous populations, we realized that they were at very, very high risk, and we wanted to teach how to take blood pressure. So we went into the communities, literally, you know, people from our department went into the communities and started, you know, trying to educate. And then we realized that they, they weren't tuned in, because we weren't considered a trusted person to provide that information, even though, you know, we have all these degrees and all this other kind of stuff didn't matter. And then we, then we engage some of the the leaders of your communities, you know, the chiefs, even, and we would train them, and then they would go out and provide information. And then, lo and behold, we saw more engagement in it. So the point I'm bringing up is the idea of we, all of us, have to be aware of the culture and what the culture values, how it is that they want to receive information, and we all like to receive information in in in different ways. And for me as a professional, back then, that was a lesson, even for me. And I think that lesson still goes forward. Clarence, yeah. So first of all, let me command the command MDH for the creation of the environment, but it what took them so long. Yeah, the contributions of the Native community has been phenomenal for a long time. And so anyway, it's 2024 Okay, so we're grateful for that. But Sam mentioned the fact about getting information out, but I would, I would like to have. Doable information, okay? Because so many times when we talk about different communities, we always talk about the, you know, how bad it is, right? What I would like to see for me as a as a community person, is, what is it that we can do to assist, to help, to make it better, you know, I mean, in a doable way, because we have so many members that are not clinicians, so many of our members are not doctors. I mean, so, you know, many times when we do this, this, this information out there, it's directed at that level, but there are a lot of people that are not at that level that would love to be, to be allies. So help us to learn how we could be allies as well. Give us something that that's doable for us, and I think that we can then begin to see some movement. So that's just my thoughts.

Clarence Jones:
The contribution of the Native community has been phenomenal for a long time. And so, anyway, it's 2024, you know. Okay, so we're grateful for that. But Sam mentioned the need for getting information out. However, I would like to have actionable, doable information. Too often, when we talk about different communities, we focus on the negative aspects, right?

What I would like to see, as a community person, is what we can actually do to assist and help make things better. We have so many members who are not clinicians. So many of our members are not doctors. When we put this information out there, it’s often directed at that professional level. But many people are not at that level and would love to be allies.

So, help us learn how we can be allies as well. Give us something that’s doable for us. If we can get that, we can begin to see some movement. Those are just my thoughts.

Ravyn Gibbs (she/her/kwe) (MDH):
Absolutely, thanks, Clarence. I just want to reiterate and expand on what Chris was saying about the visibility of American Indian people. It’s important for individuals to do their research. For example, here in Minnesota, we have 11 tribal nations: 7 Ojibwe and 4 Dakota. Learn their names, go to cultural events, and see their culture. Be part of the joy; it’s open to everyone. Understanding who your American Indian neighbors are in Minnesota and your professional spaces is essential.

I’m not a medical doctor; I’m in government. But if you’re in a government institution or a community-based organization, educate yourself on the programs and services you offer. How can you include American Indian voices in your work? Don’t make assumptions about what’s needed—be a good partner. Reach out to the urban American Indian organizations. There are 30-plus organizations in the metro area, many of them along the American Indian Corridor on Franklin in Minneapolis, and several in St. Paul. Build genuine relationships with them to determine how you can be supportive.

This also applies to those outside urban spaces—reach out and build genuine relationships with your tribal partners, understanding and respecting their status as sovereign nations. Engaging with them in a meaningful way is a short-term, immediate step that folks who listen to this podcast can take.

Stanton Shanedling:
What about training healthcare professionals?

For example, if someone from your population presents themselves in a clinic or hospital with what seems like an apparent heart attack, how should health providers be trained to effectively treat someone in that situation?

I think they need to be trained on differences in values, trust, and communication. Any thoughts on that?

Kris Rhodes (she/her):
There are programs across the United States in medical and nursing schools that focus on this. Here at the University of Minnesota, there’s a strong program through the Center for American Indian Minority Health, led by Dr. Mary Owen.

That’s a wonderful resource. But why is this education only provided when people reach medical school? This is something that should be addressed earlier, like in K-12 education. If we have this information earlier, we won’t have to spend so much time educating people right before they provide services.

Clarence Jones:
Last question. Can I ask a question? This is just me. I’m putting it out there.

I think the thing for me is that I’m not sure how to get invited to these places where I can learn more. How do I get invited?You know, I think that many times when I think about it—I'm very open, but I'm not sure where I can enter the space of people who want to do that. How can they do it? You might say, "Just go to the powwow," but that's a whole different kind of thing. Is there a way for us, as a community, to be more proactive in inviting people to learn more in a safe manner? That's my community comment. How do we do that?

Ravyn Gibbs (she/her/kwe, MDH):
Yeah, that's a great question. I think for the general community member, it starts with individual research. For example, here in Minneapolis, we have a Native-owned bookstore, which is a great place to pick up resources for reading and education. A simple Google search can also be helpful. We mentioned Dr. Mary Owen—she's given a lot of interviews and training that are accessible to the public. I think the journey starts with reading and individual research. You can also look into the tribes in your state, understand their history, and then continue from there.

From a government perspective, I’ll mention the tribal-state relations training, which is available and required for certain state agency staff. It’s a two-day intensive course that helps people understand the history of tribes and American Indian people in Minnesota—from contact to today. This training incorporates Minnesota statute 1065, which explains how state agencies need to maintain a government-to-government relationship with Native nations.

Stanton Shanedling:
I remember distinctly doing that training and even sending my staff to it. I was incredibly impressed. It was eye-opening, and I kept thinking, "I wish I had known this earlier in my career." But, better late than never, right? I really encourage people to take advantage of these opportunities. When you come across something that embraces these populations, take the time to attend. It's a real wake-up call, and in a good way.

Clarence Jones:
Sheridan, you had a point about prevention. We often bring that up in our programs—prevention, acute treatment, and disease management. Knowledge from a young age plays a huge role in prevention. But Sheridan, you had something to share?

Health Chatter:
Yeah, I just wanted to go back to the topic of early exposure to these issues. I was born and raised in Minnesota and went through the public school system here. My first introduction to Indigenous struggles and Indigenous people came in 6th grade in a Minnesota history class, but, sadly, it was very whitewashed—watered down compared to what I’ve since learned from the community.

I want to share a few things that helped me get more involved in the community, which might help others. Indigenous Peoples’ Day, coming up on October 14, 2024, is a great time to check in with the community, ask people what they know, and connect with resources. Last year, I found a fantastic reading list with 15 books, and I read 7 of them. Every single one was great. You’ll find lots of resources and discussions shared around that time—on social media, especially. Just dig into it, click, read, and engage with these resources, because it takes a lot of effort to create them.

Also, locally in Minneapolis, there’s a great restaurant called Awami, run by a talented sous chef. It’s really one of the best places I’ve eaten in Minnesota, and they have beautiful views of the Mississippi River. My vegan brother and fiancé also loved it. Another place to check out is the Indigenous Food Lab in Midtown Global Market. They have Indigenous cookbooks, food, and other goods directly from Indigenous communities. It’s a wonderful starting point. Don’t be afraid to try something new and make mistakes along the way. Just apologize if needed and keep learning!

Kris Rhodes (she/her):
I love that! Thank you for sharing.

Stanton Shanedling:
Clarence?

Clarence Jones:
Thanks, Sheridan. I’d love to know—are there any brochures or resources that list 10 tips for learning about Native American communities in Minnesota? Maybe 10 things we need to know or 10 places we need to go? Just a starting point, like what Shannon was talking about with those spaces—great restaurants and so on. I’m really interested in learning more, and I’m sure others are too. Is there a place we can go for a list of tips or places to start?

Stanton Shanedling:
We can definitely add that to our website! If you want to know more about these communities, we can provide resources for you.

Clarence Jones:
That’d be great!

Stanton Shanedling:
For example, I’ve been reading a lot of William Kent Kruger’s books. He’s a local author deeply connected with the American Indian community, and his books offer an interesting perspective on these populations, their thoughts, and how we should appreciate their way of thinking, which might be different from ours.

There are major issues affecting these populations: addiction, substance abuse, tobacco consumption, violence, COVID, access to care, and trust with care providers. Diabetes is also rampant, and we need to help this population get vaccinated. These are just a few of the challenges they face. 

Stanton Shanedling: Things, including most recently, we're seeing up. There are like 35, 36 cases of measles just in Minnesota alone, and that can affect all of us. So how can we all work together to really make a difference? It goes on and on with this population. Aaron, are you there?

Erin’s iPhone: I thought this was a timely point to jump in and mention that if anyone is interested in really digging into the data on the issues mentioned, on the HRSA website (hrsa.gov), you can go to the UDS (Uniform Data System). You can select Minnesota, and it will pull up all the FQHCs (Federally Qualified Health Centers) or community clinics in Minnesota, including Native American Community Clinics like ours. You can view data from our clinic and the issues affecting us specifically. This is a great resource for those interested in the serious barriers and social issues impacting our community.

For example, in 2019, we had a total of 4,474 patients at MAC, but by 2020, that dropped to 3,654—nearly 1,000 patients lost due to COVID. If you're a numbers person, this is a great way to look at the real data.

Ravyn Gibbs (MDH): Yes, and I'll just quickly add a couple of additional resources. The Minnesota Indian Affairs Council (MIAC) has a government website with an overview of the 11 tribes in Minnesota. Another great resource is understandnative.mn.org. This campaign started by the Shakopee Mdewakanton Sioux Community aims to shift the narrative of Native American people, particularly focusing on K-12 education in Minnesota. This led to a major investment from the University of Minnesota, offering free online Indigenous education courses to the public, which should be available by mid-2025.

Also, Chris shared a book titled Everything You Wanted to Know About Indians but Were Afraid to Ask by Dr. Anton Troyer, an Ojibwe author from Minnesota. This is a solid resource to kickstart research.

Stanton Shanedling: If I may use myself as an example—if you're wondering where to start, reading a book like that is a great first step.

Chris, I have a question for you. Minnesota's Department of Health, like many health departments, is deeply involved in creating strategic plans. We’ve referred to "Healthy People" before, which is released every 10 years at the national level. Are there any similar plans for Minnesota, or are we moving along step by step?

Kris Rhodes (MDH): Thanks for the question. The strategic plan is still in development. However, several data reports have been put together over the years, available on the MDH website under the Office of American Indian Health. With the creation of our new office, we have an opportunity to expand and really address these disparities more effectively. We’ve been running programs for decades, but we need to take a new approach, especially in areas like chronic disease, chemical health, behavioral health, and tobacco addiction.

For example, when we talk about tobacco, it has a very different meaning in our community. As an Anishinaabe woman, tobacco is central to my health. I don’t use it in the harmful ways like smoking cigarettes. Instead, I place tobacco outside as part of my spiritual health and daily prayer. Once we understand this cultural context, we can approach addiction to nicotine in a more informed way, and that’s when we’ll see improvements.

Kris Rhodes (MDH): I also want to point out some positives in our community. For instance, American Indian populations have the highest immunization rates compared to any other group. Additionally, contrary to stereotypes, Native Americans actually have some of the highest sobriety rates. Although there are still issues with alcohol misuse, this is a strength that our community brings to the table, and we need to learn from it as we face new challenges, like the opioid epidemic.

Stanton Shanedling: Well put. It's easy to focus on the problems, but there are definitely positives to highlight as well. I recommend, if health chatter can be useful for you, that the podcast format doesn't have to end with just this one show. Contact us, and we’ll help get your message out. We can set up a show anytime. For our listening audience, our next show is a special one: it’ll be our 100th episode, and we'll have the whole Health Chatter crew on board, reflecting on the shows we’ve done so far. Stay tuned for that! In the meantime, keep health chatting away.